Construction, funding and recruitment challenges in the next decade and beyond.
We recently carried out some research for the BBC on whether enough care homes are being built, looking into the current rate of construction and what may be required in order to meet the long-term care needs of our ageing population.
What we found was that, on average, around 7,000 new care home beds enter the market each year and that based on current planning applications this rate is expected to continue through 2017 and 2018. However, over the next ten years we predicted that an average of 14,000 beds would be needed to meet demand.
Furthermore, over three quarters of the 457,000 beds in the current market pre-date the former National Minimum Standards that were introduced in 2002, suggesting that a large proportion of care homes will likely need upgrading or replacing in the near future, only compounding this problem.
Regionally, the story is much the same but there are increasing concerns that necessary investment into new services in less affluent areas may be less forthcoming in the context of the ongoing funding challenges, as well as an increasingly problematic recruitment market.
It can be all too easy to complain that the government is not doing enough to support the care home sector, particularly when government policy has seemed to focus on greater provision of domiciliary care at the expense of care homes. With increasing likelihood of conditions such as dementia, strokes and depression in later life, it is hard to see how the support care homes provide can be wholly replaced. Perhaps it is time that these services are given greater recognition for the important role they play in our communities.
Our latest research into staffing suggests that putting these matters aside, an even greater challenge is facing the entire social care sector over the next 20 years.
No matter what policies adopted by government and what shape the market takes in the future, there is an inescapable need for staff and especially carers, whether in domiciliary care, community services or indeed in care homes. There are around 1.6 million people working in the social care sector, which we believe will need to increase by 1.2 million by 2036, during which time the working age population will only grow by 1.4 million. Even if domiciliary care were able to replace all new care homes, we would still predict a requirement for a million more staff.
Clearly, not all of the increase in the working age population will be available to work in the social care sector and so it raises serious questions about how care services will be able to recruit and retain sufficient staff to cope with the rising demand for long-term care for the elderly. Immigration is a difficult area politically, especially following the referendum on EU membership, but it will have to form part of an integrated response to the challenges ahead.
Our research suggests large regional disparities across the UK, with around 50% of the country facing falling working age populations (and therefore a falling labour pool) at the same time as increasing demand. Undoubtedly there will be winners and losers and the greatest concern has to be the entrenchment of a two-tier market in social care, with areas with affluent populations and availability of staff better able to maintain new, modern services, whilst less affluent areas with challenging employment markets facing serious barriers to much needed investment and reduced viability of care services.
This is a challenge we all face as a society and the regional disparities suggest that a national strategy for long-term care will be required to ensure that, whatever the shape of the sector in years to come, high quality care and support is available to everyone who needs it.