Social services leader says councils will not abandon private residents, but closures possible as landlords consider options
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Social services are poised to step in to protect the welfare of elderly people paying their own way in homes run by the embattled Southern Cross chain.
As central and local government moved to quell rising anxiety over the future of Southern Cross's 750 care homes, and the 31,000 people who live in them, a social services leader gave the first assurance that councils would go beyond their strict, statutory responsibility only to publicly-funded residents.
Sarah Pickup, the vice-president of the Association of Directors of Adult Social Services, said: "We are not in a situation where local authorities say 'You placed yourself [in the home], so you are on your own'. Absolutely not. Residents of the homes will continue to be cared for, regardless of how they came to be there."
The assurance came as Southern Cross, Britain's biggest care home operator, moved to offer shares in the company to the disgruntled landlords of its homes in a desperate rent-for-equity swap designed to save the stricken care group.
On Tuesday, the group unilaterally cut its rent payments by 30% for four months, in an effort to create a breathing space to restructure the business.
Southern Cross's chairman, Christopher Fisher, said: "The reality is that our problem is their [the landlords'] problem. Understandably, many landlords are cross and angry. There needs to be some give. Maybe that will be an equity proportion. It is very much in the melting pot."
The proportion of the company that might be handed over to landlords would depend on how many wanted other operators to run their care homes, he said.
Relatives of elderly people living in Southern Cross care homes expressed concern at the financial crisis. Michael Rouse, 54, from Penge, south-east London, who was visiting his father at the Tower Bridge care centre in Bermondsey, said he had not been told anything about the company's difficulties. "It's all pretty mum at the moment, the staff are all very quiet and not quite sure themselves what's going on. It's a big concern because there's a lot of Alzheimer's people here and with Alzheimer's you have to be comfortable with your surroundings. My father can be sometimes slightly up and down, whereas here he's very calm."
Stanley Tower, 74, from Rotherhithe, south London, visiting his sister Renee, 82, who has been in the home for nine years, said: "I'm worried about it. I can't look after her and she can't look after herself."
Social services directors say they have been in contact with Southern Cross and its landlords, and are confident there will be no abrupt home closures and no elderly people will be left without care.
Pickup said: "There may be some closures. It is a huge spectrum of homes and some will be more efficient and cost-effective than others. But we really don't expect it to be widescale at all."
Bondcare, which is one of Southern Cross's five largest landlords and a care home operator itself, has said it wants its properties back, and it is thought that Four Seasons, another landlord and care home operator that owns 45 Southern Cross homes, is considering a similar move.
A spokesman for Bondcare said: "If Southern Cross goes into administration, the care of these residents in our view would be jeopardised. Our suggested solution is to take back the operation of our homes and we have offered the same solution to other landlords to deal with this crisis. To date, we have not got past first base with Southern Cross in relation to this proposed solution, despite being in negotiations with them since December 2010. In our view, the rent reduction does not solve the underlying problem."
It is understood that Bondcare has polled other landlords who control about 200 properties in the Southern Cross portfolio and that these have also indicated they would like to opt out.
Southern Cross has been in trouble for several months and has breached key conditions imposed by its bankers. It has blamed public spending cuts for reducing its income from councils and the NHS, which fund more than seven in 10 of its residents. City analysts say the company is paying the price for poor decisions taken under private equity ownership – in particular, the selling off of the freeholds of most of its homes.
There is no contingency plan for the social care sector in the event of the collapse of a leading care home operator. Legislation is outdated, with council obligations set out in a 1948 act.
Private care home operators expect to continue to face a squeeze on the fees paid by councils and the NHS. An Audit Commission report published says 80% of authorities are looking to make savings on procurement of social care services.
The report, Improving Value for Money in Adult Social Care, shows that the median average cost of a place for an elderly person in a private care home is £455 a week, compared with £960 in one of the few remaining council homes.
Andy McKeon, the Audit Commission's managing director for health, said: "The pressures on councils are growing. They have many competing demands on their finances and, over time, more and more people will need their help."
Two trusts criticised
Two more NHS trusts have been criticised by the health service regulator in England for failing to ensure older patients have sufficient food and water.
Inspectors for the Care Quality Commission (CQC) raised "moderate concerns" over standards of nutrition and hydration at Barnsley hospital, South Yorkshire, and Whiston hospital, Prescot, on Merseyside.
Shortcomings included monitoring of food and drink and lack of alternatives when patients did not eat what was offered.
Two other hospitals – St George's in Tooting, London, and Newark hospital, Nottinghamshire – were told to improve standards, although they met the minimum legal dietary requirements.
Ten trusts got a clean bill of health in the latest reports on dignity and nutrition for older people. The first reports issued last week included those on three trusts where basic standards were not being met, prompting the health secretary, Andrew Lansley, to condemn "unacceptable" levels of care.
At Barnsley hospital, not all patients who needed help with feeding got it, said the CQC.
At meal times "none of the tables were cleaned before or after the meal and one patient had an empty urine bottle placed on their table alongside their meal during lunch".
Inspectors also said: "It was not clear which patients needed assistance with feeding and there was no visible bedside signage on some beds.
"The ancillary staff collected the trays at the end of meals and did not check how much food was left. No nursing staff were seen to check any trays either. We saw a good number of trays that had plates with a lot of food left on them."
At Whiston hospital, a meal was left on the table for more than half an hour before the patient was assisted to eat. Inspectors noted that on one ward "one person's meal was delivered and a member of staff promptly helped them to eat it. However, another person in the same bay had their meal delivered at the same time.
"The person did not have any assistance and the food was left on their table for over half an hour before they were assisted to eat.
"Some people struggled to remove the tops of pots such as trifle, yoghurts and staff did not attend to assist or remove the lids.
"We observed that although the mealtime was in place and staff members were needed to assist, several were occupied with assisting in doctors' rounds, giving out medicines and dealing with laundry returning."
On both wards observed by inspectors, all courses were served at once. "In general, people do not eat all their courses at once," inspectors noted. James Meikle