Bob Champion: The cost of care

Bob Champion explores the sensitive and thorny issue of social care and who should foot the bill

I recently saw a Twitter thread on the cost of care. This was not the usual thread started by a care professional but one beginning with a person’s experience in finding appropriate care for their parents and the cost of it.

The original tweet queried why it cost £1,000 a week for a care home. Comments on the thread moved between a multitude of issues ranging from how cheap £1,000 a week was to many explanations, some very wide of the mark, as to why care homes cost so much.

One response was from a person who worked in a care home accounts department. They commented on the disparity of fees between residents when they received the same level of accommodation of care. I wondered whether this was evidence of a cross-subsidy from privately-funded clients to local authority clients.

There were sad tales. One from a family who had raised £300,000 from the sale of a family home who had to move their parent to another home when that money ran out. Others being given limited time on death to clear possessions.

The thread did not touch upon receiving care at home. A close friend of mine, following the death of his father, had to arrange 24/7 live-in care for his mother. That cost far more than £1,000 a week and he and his family had to cover four hours respite care a day for the carer.

How much does the ordinary person understand about the state of adult care? I will go further and ask how many advisers understand care funding, who must pay what and when?

The problem with care is that we do not know who is receiving what. I remember, a few years ago, visiting an old soldier whose wife suffered from dementia. He was in his 90s and was abusive to anybody who tried to help with the care of his wife. If she was ill, he would phone for the doctor. Just because “she was forgetful” (it was far worse than that) she was not ill, and he did not need help looking after her.

It was obvious he needed help, but until an incident occurred, he was not going to request it. How many more unpaid carers are there not getting the help they should be getting?

In April I expressed surprise that my local authority had not taken advantage to raise council tax as permitted by the government to pay for social care. They cited impacts of Covid for their reasoning. I am now even more concerned when I read about care cost inflation, and the effects of the more severe incidences of ‘Long Covid’.

This all sums up the problems of adult social care reform. How many in the population, despite all the efforts of care professionals, are impacted by the challenges in obtaining and paying for the care of relatives? If you do not experience that, how do you know whether a government solution is a good or a bad one?

Are these subjects that prompt detailed conversations with work colleagues and friends? I suspect that it is kept within the family.

The problem the government faces is that to reform the system you have first to admit what is wrong with the current system. It is easy to say no one should have to sell the house to pay for their care. But how much should they pay? If someone pays less, somewhere else somewhere is paying more either directly or through taxation. This is amplified if the care professionals are correct and the industry is underfunded.

An £86,000 cap on care fees could be – for just about managing families – a substantial proportion of their wealth. Yet for a wealthy family it could be a small percentage of its value.

I look forward to understanding more about the government’s proposals, and hope they are debated widely. This should not be a party-political issue. It transcends generational fairness, wealth fairness and what society should provide for its lesser fortunate members.

This leads to a question for financial advisers. How many discuss the possibility of care and potential solutions with their clients as they age? It is estimated around a third of retirees will have to receive long-term care. This conversation should lead to having powers of attorney in place and all involved having a good understanding of the wishes of the client.

More importantly, when the government gets around to announcing and implementing the changes that will occur, how many advisers are planning to have a dialogue with their clients about how the changes could impact them?

Bob Champion is chairman of the Air Later Life Academy