INVESTIGATION: Patients fit to leave hospital have been stranded at Mansfield’s main hospital for up to three months due to problems in social care, new figures show – and one person was even refused a place by 42 different homes.
So-called “bed-blocking” at the King’s Mill Hospital has been caused by a lack of available care home places, but also delays in securing patients’ funds and care assessments.
A Freedom of Information request sent to Sherwood Forest Hospitals Trust found almost a year of bed-days was lost as nine patients waited for more than a month each to be discharged from hospital due to a lack of available care, even though they were fit to leave.
The longest wait was for an elderly person, who was stranded in a King’s Mill bed for 93 days as two care assessment appointments had to be cancelled and rearranged, before two care homes declined to take them.
Paul McKay, service director at Nottinghamshire County Council, which has responsibility for adult social care in the county, said: “We are currently one of the best performing social care authorities in the country for hospital discharges.
“We will keep reviewing our resources and directing them accordingly to ensure people are able to discharge safely and quickly from hospital.”
The figures follow reports of a national “crisis” in the care industry, as 2,444 homes have closed across Britain since 2010, while a large number of privately-run homes have cancelled contract with the public sector, saying they cannot deliver services for the amount they were being paid.
In Nottinghamshire, 386 social care providers have deregistered with the Care Quality Commission since 2011 – including 48 in Mansfield and 16 in Ashfield – although some of these since re-registered under different names.
And research by Company watch shows one in four care homes in the UK is at risk of financial insolvency, with the majority of them “gearing” their finances by taking loans at an average of triple their actual assets.
Nick Hood, a risk analyst at the business advising firm, said: “A business model that dictates 75 per cent gearing, and delivers a profit margin of less than 1 per cent, is simply not sustainable.
“Along with wage rises, energy costs, and interests rates, this creates even more pressure on poorly performing homes.”
And the problem is set to get worse – the number of people in care in Nottinghamshire has risen from 4,668 to 7,770 in the past seven years.
The county council funds the care of 2,977 people and there are about 175 older people’s residential and nursing homes in the county, including five run by the authority itself.
David Pearson, council adult social care director, said: “We have dedicated about £15 million this year and next year – including £1.9m for older people’s care homes – to support local providers with this increased cost at a time of Government funding reductions and increased demands for social care. We are proposing to increase payments for all local care homes by 2.8 per cent for 2017/18.”
Phil Bolton, deputy chief nurse at Sherwood Forest Hospitals NHS Foundation Trust, which runs King’s Mill, as well as Mansfield Community Hospital, said: “We work extremely hard with all our partners to reduce delays, but changes in the population means a growing number of mainly older patients often have multiple, long-term conditions, which can add to the complexity of assessments and preparations for discharge from hospital.”
Mark Spencer, Conservative MP for Sherwood, said: “Obviously the Government recognises this is a problem, but throwing money at things is not an answer when the current system is unsustainable. What we need is to make sure that money is being used in the right way and that process is happening now with Sustainability & Transformation Plans for our health service looking at moving the money into social care and primary services to take the pressure off hospitals.”
What do you think?
Dominica Newton, aged 19, who works at Tesco, said: “We need more staff, more nurses and more doctors. I was apparently ‘bed-blocking’ when I had my daughter Sienna-Rose. I wanted to go home but they didn’t want to move me and other people were waiting for the bed.
Her mum, Anita Horsfield, 45, said: “The government doesn’t give enough. There are a lot of strikes and I understand why, because they’re under lot of pressure.”
Betty Dunkin, aged 75, from Mansfield Woodhouse, said: “When my friend went into care she was really lucky, but the under-financing is disgusting. They should be focusing less on the military and more on social care. These people worked all their lives, they should be regarding by being properly looked after.”
Jon Pertwee, aged 50, a shop owner who lives in Mansfield, said: “Bed-blocking is dreadful and something should be done about it. Our priorities are not always on the most important things.
George Cassettari, aged 68, from Sutton: “There’s all this efficiency and productivity talk about hospitals, but you’re playing with people’s lives. I think if the government could destroy the health service they would, they’re just doing it in a way that won’t effect a revolution.”
Liam Murphy, aged 24, a DJ from Sutton, said: “Bed-blocking is a new concept to me, and it’s something I can see happening without us being aware. The obvious solution is more beds, but what would that cost?”
Gillian Robertson, aged 72, a retired machinist from Huthwaite, said: “The government should be doing more but there’s not much money to go around. The NHS do a great job, so we should support them as much as we can.”
Labour MP Gloria De Piero, whose Ashfield constituency includes King’s Mill Hospital, said: “The crisis boils down to is drastic under-funding of social care by the Government.
“Councils have had to resort to putting up council tax in order to fund some of the care services needed, hitting residents’ pockets directly but by no means giving a sustainable solution.
“Our extremely busy hospitals are forced to care for these vulnerable elderly people while families and local authorities struggle to put appropriate care in place and that is having a knock-on effect on everyone who uses the NHS.
“Urgent action is needed.”
Patient turned down by 42 different homes
While some patients were stuck due delays in funding or assessments, others were accepted by homes, but the homes had no available capacity. One King’s Mill patient with learning disabilities waited for more than a month for a place after they were refused a place by 42 different care homes. The hospital was “chasing” homes for a week before a lengthy assessment process before eventually securing them a place. In other patients’ notes, they were described as being “not suitable for care homes”, and awaited care assessments, funding arrangements to get in place. One patient who was stuck in a bed for 85 days had a note on the file stating they “want to go home”, as they waited weeks for a mental health assessment.
CASE STUDY: Mum assisted into home by council scheme
Kiko Giles was just 15 and studying for his GCSEs when his mum suddenly fell ill and had to be rushed to hospital.
She ended up having a leg amputated which put an abrupt end to her job as a pub landlady, and also meant she and Kiko were suddenly homeless.
ASSIST, Mansfield District Council’s housing support service, stepped in to help Kiko and his mum.
They moved into one of its temporary homes, while a suitable property for a disabled person could be found for them.
Council officers ensured the family received the benefits to which they were entitled and also helped in other ways, such as clearing furniture the family owned out of their pub accommodation, and making sure a carpet was laid in their new accommodation.
Kiko said: “They played a fundamental role in giving my mum and myself the life we have now.
“The hard work and graft the council put in ensured that not only did we have a suitably adapted home, but they made sure it was in a suitable area, too. The understanding and compassion from everyone at the council made it happen.
“Everyone seemingly came together, just for me and my mum.”