Should we be surprised?
The Care Quality Commission finds that care homes serving more self-funders provide better quality of care than those used by more residents dependent upon local authority funding. Put another way, when you look at homes which are performing well they are looking after few people sponsored by local authorities Worst care homes more likely to have poorest residents, official data shows | Social care | The Guardian.
In homes rated inadequate 69% of residents were state funded, in homes rated adequate 53% were state funded.
The figures come from a reworking of CQC reports by ONS Care homes and estimating the self-funding population, England – Office for National Statistics (ons.gov.uk)
This gives a fascinating review of the characteristics of homes and their residents. There were 143,774 people living in care, a third being self-funders. Self-funders account for 45.4% of residents in the South East, 24.6% of those in the North East. Rural homes house more self-funders. Homes with fewer than 19 beds house only 15.1% self-funders. 75% of self-funders live in homes which cater for people with dementia, this is so for 70% of state-paid residents.
Payments for placements by local authorities averaged at £600 per week. Costs to self-funders were usually in excess of £1,000 per week.
Despite the details, the picture is blurred – It is understood that homes make ends meet by subsidising the care of state-funded residents from the higher payments from self-funders. This is clearly not reasonable. Some residents who were originally self-funders will have become dependent on state subsidies as their capital has been exhausted. Our discussions at Dementia Conversations have revealed that homes will barter with families about the scale of top-up payments rather to adhere to an advertised price and lose a resident. People are astonished and bewildered by such practices. There are heroic examples of homes which provide excellent care on a very tight budget, but overall the message is that you get what you pay for.
No surprise there