An independent report into elderly care in England, commissioned by the UK Government and headed by Andrew Dilnot, has been released today.

The Dilnot report recommends that a person’s lifetime contribution towards his or her social care costs in England should be capped at £35,000.

The report also recommends that the means-tested threshold in England, above which people are liable for their full care costs, should be increased from £23,250 to £100,000.

The Dilnot report can be found here.

Two of Scotland’s leading economists warned that frontline services such as education and social care will lose out to Edinburgh’s troubled trams project as they raised serious doubts over every single aspect of the funding proposals.

Professor Arthur Midwinter of Edinburgh University Business School told The Herald the council’s plans to raise the extra £173 million needed are “full of questionable assumptions and there is risk in every element”.

In a scathing attack, Professor Arthur Midwinter of Edinburgh University Business School told The Herald the council’s plans to raise the extra £173 million needed are “full of questionable assumptions and there is risk in every element”.

The report from the Herald can be found here.

A former Glasgow city councillor has been banned from making solo visits to his elderly mother in a care home run by Southern Cross after complaining about her treatment.

The report from the Scotsman can be found here.

The chairman of BMA Scotland, Dr Brian Keighley, has questioned whether society can afford the cost of treatments designed to prolong the lives of terminally-ill patients for weeks or months, given the current pressure on health service budgets. Dr Keighley said in some cases tens of thousands of pounds were spent on drugs to extend cancer patients’ lives for relatively short periods He added that such treatments should be looked at ‘critically’ and that for life-prolonging treatments costing thousands of pounds, ‘useful’ longevity, should be the criterion for decision-making.

The article in the Scotland on Sunday can be found here.

A new report, Quest for Quality by the British Geriatrics Society (BGS), has highlighted the fact that up to 400,000 vulnerable older people resident in care homes are frequently denied access to routine NHS healthcare because they live in care homes. The inquiry found many often cannot get access to GPs, therapy services, out of hours services or specialist dementia services such as memory clinics.

The report can be found here.

The “Christie Commission” or to give it its Sunday name: “Report on the Future Delivery of Public Services by the Commission chaired by Dr Campbell Christie”, was published today.

One recommendation is that our health and care services are integrated.  I will write about this in more detail in my next article on Scotland’s care industry.

The report can be found here.

Is there a crisis in how we care for the elderly and other at risk groups in Scotland?  The recent media coverage suggests yes but I suspect even as I start a series of articles on this subject that any conclusions I draw will be more complicated than a simple yes or no.

I am in my mid forties.   My Mum is in her early seventies as are my wife’s parents.   How we care for our parents is an issue that my generation cannot ignore.   It is not just how we care for the elderly that is making news headlines.  The scenes shown in the recent Panorama programme on Winterbourne View care home were sickening.

Southern Cross

Southern Cross has rarely been out of the news recently.  Southern Cross, which operates across the UK, announced it is reducing its rent payments and cannot afford to meet its annual rental costs of £230million.  The background to this is the reorganisation of the business a few years before the current economic difficulties.  The recession has caused Southern Cross, and others, real problems.   I will look at this issue in more detail when I look at how we fund elderly care.  I will also look at the charge levied at Southern Cross that “they are just like the bankers”, i.e. they award massive bonuses when things are going well but, when things go wrong, demand public funding.

Winterbourne View care home, near Bristol

The Winterbourne View care home, near Bristol, was featured in a BBCPanorama programme.  The scenes shown in the programme caused revulsion and outrage.   Police in Bristol have arrested a number of people after the secret filming by Panorama found a pattern of serious abuse at this residential hospital.  Winterbourne View treated people with learning disabilities and autism. The hospital’s owners, Castlebeck, have apologised unreservedly and suspended 13 employees.   The hospital has now been closed.  Even though this is an English care home the issues raised cannot be ignored here in Scotland.  How robust is our own inspection process?  Do we listen to whistle blowers?  Does the buck truly stop somewhere?

Elsie Inglis care home, Edinburgh  

The Elsie Inglis private nursing home in Edinburgh has been forced to close down. The owners of the Elsie Inglis Nursing Home volunteered to de-register the business after it became clear they would not meet a deadline for improvements ordered by Social Care and Social Work Improvement Scotland. SCSWIS said it had: “very serious concerns about the quality of care” at the home.  There is also a police investigation into the death of two residents of the care home.

Ninewells Hospital, Dundee

Ninewells hospital, Dundee, was severely criticised in a report by the Mental Welfare Commission over the care of an 80-year-old woman with dementia. Before her death, the woman was given dozens of sedative doses over 16 days in ways the Mental Welfare Commission deemed distressing and unnecessary.  Ninewells Hospital was not named in the report and its identity only became public when the media and politicians started asking questions about the report.

Erskine care home, Edinburgh

Erskine’s Edinburgh care home received a critical report from SCSWIS. It was also reported that the Chief Executive Officer of Erskine, Major Jim Panton has resigned.  A spokesman for the care home said that the resignation was not connected to the critical report.   The inspection report found that prescription drugs had not been administered properly and that fluid and food intakes had not been recorded.

The last three matters may in fact point to the fact that our system of inspection is robust.  I will though look further at this issue in a later article.

Some facts and figures

There are over 900 care homes in Scotland.  Approximately 170 are owned by our 32 Councils, 240 by charities and just over 500 by private operators.

Southern Cross has 98 homes in Scotland, Four Seasons has 49 and BUPA 30.

Approximately half of Scottish homes are run by sole traders.

Some 39,150 people reside in Scottish care homes.

77% of care home residents pay for their care.

Scottish Councils pay £550 per week to private providers to look after old people with estates worth less than £22,000.

Councils spend approximately £800 per week per resident in their own homes.

Someone occupying a non-specialist hospital bed costs the Health Board approximately £1,500 a week.  An acute bed costs approximately £2,800 per week.

Future articles

Over the next few weeks I will look at a number of the issues mentioned above in greater detail.  This will include how we fund elderly care, the quality of care given, inspection and whistle blowing issues, the role to be played by the private, public and third sectors, the debate on merging our health and care sectors and the options for taking control of some or all of a person’s affairs.

If you have any questions on this issue or simply want to make a comment please either contact me or use the “comment” option below.

James Aitken

Legal Knowledge Scotland

Plans to use a £420,000 bequest to convert a substandard care home into a healthy living centre, complete with spa and gym, for pensioners in the Galashiels area have been ditched following a three-month public consultation.

The report from the Southern Reporter can be found here.

A residential hospital for vulnerable adults near Bristol where alleged abuse was secretly filmed by the BBC Panorama programme is to close on Friday.

Castlebeck, which runs Winterbourne View, said the hospital would close on 24 June when the last patients would be transferred to alternative services.

The BBC news report can be found here.

Police are trying to establish the circumstances surrounding the death of a Glasgow man whose mother took him to a Swiss clinic to die.

Helen Cowie told BBC Scotland’s Call Kaye show she helped her son Robert, 33, commit suicide after he was left paralysed from the neck down.

Mrs Cowie, of Cardonald, Glasgow, said her son went to Dignitas in October and “had a very peaceful ending”.

The report from BBC News can be found here.

Last December the Scottish Parliament rejected plans to give terminally ill people the right to choose when to die.  Independent MSP Margo MacDonald’s End of Life Assistance Bill aimed to make it legal for someone to seek help to end their life.  The Bill was defeated by 85 votes to 16 with two abstentions.