Social Care And NHS Services Are Struggling To Support The Elderly
The Law Of... knowing when to seek adviceA recent report published by The King's Fund and Nuffield Trust has found that social care services for elderly and vulnerable people in the UK are under intense pressure and are struggling to cope with demands.Zena Soormally
, a Court of Protection solicitor at Simpson Millar
, explores what the report's findings mean for the UK's aging population:"Many clients who instruct me (or who I am instructed on behalf of) are over the age of 70 and have complex diagnoses, both physical and mental. From these cases, I've found that social care and NHS systems in the UK are finding it really tough to manage the needs of the aging population – a point illustrated in the recent The King's Fund and Nuffield Trust report, Social care for older people – Home truths."
Cuts To Funding
From the perspective of local authorities and the NHS, the report focuses on the current situation regarding the funding of care for the elderly. Repeated references to cuts made to funding, overworked and stretched staff, and the shortages of appropriate provisions are accurate.
The report confirms that pressure on the NHS and local authorities is "undoubtedly driven by funding pressures on both services [social care and NHS] and exacerbated by workforce shortages in social care"
, but that the local authorities, NHS providers, and commissioners "must work more effectively together to address"
The cuts to funding are not only an issue for the NHS and social care – it also has an impact on the availability of free legal advice and disability benefits. Adding all of those issues together, it's no surprise that the system is under immense pressure – sadly, individuals who rely on this support are losing out.
Zena goes on to explain:"As a provider of legal services to vulnerable individuals, I recognise that the majority of those working in the NHS and in social care with those who are vulnerable try to do the very best that they can for them – even with the cuts to funding.""But, I act for and/or in relation to elderly clients who lack capacity – as well as young people and adults in general – and have seen how the issues facing the NHS and social care services are affecting them. As I currently work for those who lack capacity, it's difficult to judge whether the situation is currently the same for individuals who don't lack capacity, although from my past experience I have found that they face similar problems."
Acting In The Best Interests Of The Individual
Another concerning trend is that those caring for the vulnerable – whether it's social care or NHS staff – tend to avoid making decisions on options that are available to vulnerable individuals. This seems to be a result of them lacking an understanding of what the relevant local authority, NHS Trust, or CCG is required to do – or what they can do – for the vulnerable person.
When dealing with both Deprivation of Liberty and best interests cases in the Court of Protection, a review of the history of a client’s care (including looking at their medical and/or social care records) is completed in the first instance. This helps to form an idea of the client's past, such as what led to them being in the current situation, whether there are any patterns in relation to this, and what – if any – matters are outstanding or have been overlooked.
Usually, when the review has been undertaken and the client’s needs have been identified, fairly straightforward proposals can be made to try to get the client what they want/need, even if they've been told for months – or even years – that it wasn't possible.
Zena explains:"What I've most often found is that options available to clients weren't just rejected after being considered and/or because of a lack of funding – keeping in mind that most of my clients were able to support themselves financially. The biggest obstacle in those cases seems to have been social care and/or NHS professionals being confused or concerned about what decisions they were or weren't able to make for the individuals.""On top of this, the professionals were often under pressure to quickly find a solution that was 'good enough', but not necessarily the least restrictive option for that client."
Who's Responsible For Funding The Care?
In cases where family members have been actively helping with the care of a client – especially those who had been told time and time again that there was no way to get their loved one the change in care and/or accommodation that they wanted – it is often said that family members are responsible for the decisions, without all of the options being considered fully.
One of the ways in which the increasing pressure placed on social care for the elderly can be tackled, according to the King's Fund report, is that frameworks should clearly state that the primary responsibility for funding care should sit with an individual or their family – or both.
Talking of her own experience, Zena says:"I think this somewhat misses the point – where family members are involved in the cases I deal with, they know that they need to work with the authorities to find a solution for their loved one.""The issue is that they're not given the right support or information that will enable them to do this. Instead, they're told that they have to do everything – sometimes without any help being given to them – or they're kept out of the loop and aren’t given important information unless they spend their time chasing after the authorities."
Finding A Resolution
Zena concludes:"If I wasn't a lawyer – and didn't have any legal knowledge on the subject – and a social worker caring for my elderly or vulnerable relative said to me that "there are no options; your family member must stay where they are and/or keep getting the care they don’t like – even though they hate it, and fight against it, there is no other way to move forward", I would feel devastated and lost, and believe that I had no option but to agree.""Sometimes there isn't another option, but if you do find yourself in a similar situation – for example, your loved one has been told that they can't be helped and you know that they're unhappy or aren't comfortable with the decisions made – it's so important that you seek legal advice."
You might find that a review of your relative's records and some legal advice from an experienced solicitor could make the world of difference to the life of your loved one.
Our team has helped countless elderly clients obtain the care and support that they had been told they wouldn’t be able to have, whether it's:
- helping them return to their homes
- ensuring they're given less restrictive care regimes
- helping them move to a less institutionalised setting
- getting them access to more outdoor activities or
- enabling them to visit local shops or cafes
If you – or your loved one – need advice or legal help, our team will be happy to speak to you about how we can make sure you get the support and care that you're entitled to.