Home Care Homes Complex care and the impact on the care home sector

Complex care and the impact on the care home sector

by Kirsty Kirsty

Kella Bowers, Partner, Forbes Solicitors

According to Care Home UK statistics from 2022, there are over 17,000 UK care homes, housing over 400,000 residents, with this population set to rise and particularly amongst those with complex and nursing needs.

Most care homes concentrate on residential care only, offering residents daily assistance with tasks such as washing, dressing, and eating. Medical and nursing care tends to be procured externally and provided by GPs and district nurses. Estimates suggest only 29% of all UK care homes are registered for the provision of nursing care, and with Alzheimer’s Society’s data showing around 70% of all care home residents are suffering with dementia or severe memory problems, it’s plain to see the bearing that complex health and social care needs are having on the sector.

Here, Kella Bowers from Forbes Solicitors, explores how this affects care home capacity, especially amidst the current staffing crisis.

Where does the issue stem from?

People are generally living longer, which is a positive. However, with a longer life comes age-related health issues, and modern familial structures often mean that being cared for at home is not a viable option.

When significant health problems require hospital admission and treatment, bed availability and occupancy issues within hospitals often see patients being discharged ever more swiftly. In many cases, the domiciliary and residential care sector is expected to take this strain.

Home care might be possible, but may not be feasible for those requiring 24-hour assistance. Situations commonly arise where funding is either unavailable or there is an argument about whether health or social care provision should provide financial support. This can leave people, who really should be funded for nursing care, receiving just welfare funding. The care home sector does its best to fill the gap.

As a result, an ever-growing number of people with complex care needs are now living in residential care homes and, understandably, staff find it challenging to fully manage their healthcare. Where the care home has no registered nursing presence, they are reliant on primary care providers for nursing support. District nurses provide most of this care for residents, but as an already stretched resource, caseloads are at breaking point.

What’s the impact of this capacity crisis?

A lack of training, understaffing and skills shortages can leave care homes at risk of claims for injury by both residents and staff. Inadequate resource may also lead to negligent acts or omissions; increased falls, bed sores, or the failure to recognise deteriorations in a timely fashion.

Such incidents seriously compromise the care residents receive and there might also be claims for breaches of a person’s human rights if deprivations of liberty are not properly managed and ‘least restrictive’ options trialled. Claims relating to these types of matters can heighten a care home’s risk profile, making insurance renewals potentially unaffordable. This can force homes out of the sector or leave them increasingly reluctant to take on residents with more complex care requirements.

What’s the solution? 

Care home innovation is essential, but there also needs to be government recognition and action on both a local and national scale. The British Geriatrics Society recommends that the NHS should work with care homes to fund and deliver programmes to enable the provision of enhanced healthcare services in all care homes. The Society suggests appropriate funding is ringfenced, where possible, for the training and development of care home staff, to ensure they have the required knowledge, skills, and competencies to support residents with complex needs.

Promisingly, in February 2023, the government confirmed it will make £15 million available over 2023 to 2024 to support international recruitment within the adult social care sector. Care workers have been added to the ‘shortage occupation list’ to support providers in addressing workforce pressures. This inclusion will enable the sector to employ staff from overseas. The funding is to be provided by way of partnerships which consist of a lead local authority, care alliances and other groupings of local providers. Care providers are therefore encouraged to contact their regional local authority to discuss how they intend to use this fund, and ensure they are part of the partnership to enable additional recruitment.

For more information about comprehensive legal expertise that helps care for your organisation, visit the Forbes Solicitors team at UK Care Week 2023. Stand G84, UK Care Week, 22nd – 23rd March 2023, NEC, Birmingham. Or email: care@forbessolicitors.co.uk

Image depicts Kella Bowers, Partner, Forbes Solicitors

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