Drastic action needed to stop more nursing home closures in Wales

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A social care boss has warned that 2018 will be a bleak one for nursing homes with more closures expected across North Wales at a time of increasing demand.

New figures from the Care and Social Services Inspectorate show there has been a loss of 423 places in Wales for people requiring 24-hour care in over the past three years.

But according to Care Forum Wales, which represents the independent social care sector, drastic action is needed to put things right and the official statistics may underestimate the true scale of the crisis.

Pictured is Mary Wimbury, Care Forum North Wales.

The sector required an urgent injection of money to make it viable, along with more partnership working with health boards.

Without a new approach Care Forum Wales chief executive Mary Wimbury warned the situation was going to get even worse because of the demographics of an ageing population with increasingly complex health needs.

The problems were being compounded because of the difficulties in recruiting and retaining nurses.

As a result, a number of nursing homes had been forced to close or de-register their nursing beds and only offer residential care.

The inevitable consequence was that more people would be stuck in hospital because there were no nursing beds available in the community.

Ms Wimbury said: “These new figures are incredibly worrying because we know that we’re only at the start of winter and we’re already seeing hospital beds filling up. “People need to be able to get out of those hospital beds to be cared for in their communities and for some people that’s going to mean in care home beds and specifically nursing home beds.

“We know there is a difficulty in recruiting and retaining enough nurses. Health boards across Wales are currently paying less than £1 an hour more for someone who needs nursing care compared to someone who needs residential care.

“What it means is that people who need that care aren’t going to be able to get it, and they’re going to be staying in hospital beds longer than they need to which is going to cause problems for them and for others who need those hospital beds as well.

“If you don’t need to be in hospital it’s probably the worst place for you.

“No one should be in hospital unless they absolutely need to be. the likelihood of a hospital acquired infection, and of reducing your mobility if you’re older is too high.

“It’s actually costing the NHS a lot of money to keep people there who don’t need to be there, and people who should be there can’t get in to hospital.

“In order to make the system work properly we’ve got to much better closer working relationship between health boards and care homes to ensure people get the care they need in the best possible place for them.

“”We also need investment in terms of money coming in to the care homes sector.

“The only places where we are seeing real increases in provision are the communities in wealthier parts of South East Wales where there is a significant self-funder market.

“As a result, the gap between the haves and the have nots here in Wales is becoming wider.

“We need to be able to recruit and retain staff and reward them appropriately for the valuable work that they do, and what we also need is more nurses coming through the system.

“A recent report by the Competition and Markets Authority said the current model of service provision cannot be sustained without additional public funding.

“It went on to say the parts of the industry that supply primarily local authority funded residents are unlikely to be sustainable at the current rates paid by them.

“Meanwhile, the interim findings of the Parliamentary review of the state of social care also pointed to an unsustainable sector, a situation not made any better by the unseemly three-year legal battle between local authorities and health boards.

“The nub of the case was who should pay a just over £20 a day fee for nursing care provided by care homes.

“In the event the Supreme Court ruled unanimously in favour of the local authorities and said that the health boards had misinterpreted the legal position.

“Even though the ruling was clear, care home owners have yet to see a penny of the money that is owed to them.

“Unless we see a serious injection of funding into the sector and unless we increase our ability to recruit nurses then it is going to continue, with things getting gradually worse and worse, and I can’t see that ending any time soon without some drastic action.”

It was a message echoed by Clive Nadin, the owner of the Abbey Dale House Care Home in Colwyn Bay, which provides residential and nursing beds

He said: “In the county of Conwy, we’re looking for 50-bedded homes every 18 months for the next 12 years, just to meet the projected demand from the figures from social services.

“That’s very worrying because with the level of fees at the moment there is just no incentive for people to build new homes and that’s what we need to meet the projected demand.

“The fees are just insufficient to warrant somebody building new homes.

It’s not going to happen.

“The people who need care are going to have to find provision elsewhere, maybe where there is more provision, which is predominantly self-funders and lot higher rates.

“A lot of people will not be in a position to self-fund but the local authorities will have a responsibility to pay for that care, and they will have to pay the rates at some stage so in the long run it could actually cost the local authorities more money by failing to invest now.”

The Care and Social Services Inspectorate Wales said: “There has been a significant rise in the acuity of people’s needs in recent years and this presents a challenge.

“It has resulted in vacancies in traditional residential care and higher demand for more complex care. We believe that new legislation provides a positive opportunity to improve the way care is commissioned and focus on achieving the best outcomes for people.”

A Welsh Government spokesperson said: “Whilst recruitment of registered nurses is a challenge across the UK, in Wales we continue to invest in the education and training of nurses across Wales, boosting nurse training places by 10% in 2018/19.”