Coronavirus and Brexit blamed for soaring care home fee rises

The Scottish Government said care homes have received "significant" assistance with pandemic related costs, including emergency supplies of PPE and infection control support and said it would not expect residents to be facing "disproportionate" fee rises.

Henry Simmons, chief executive of Alzheimer Scotland, said it was “entirely wrong and wholly unfair” that care home residents were facing additional costs while Labour’s Monica Lennon said providers citing Covid-related reasons for rises could include homes, singled out for poor infection control by the Care Inspectorate over the course of the pandemic.

READ MORE: 'Shameful and negligent': Official report shows the care homes risking Covid infection spread 

Donald Macaskill, chief executive of Scottish Care, said the pandemic had placed huge financial pressure on providers because it had effectively turned care homes into “mini-hospitals” with PPE costs rising by as much as 1000%.

The daughter of one 86-year-old who has dementia and is in a home run by Brighterkind, which is part of the Four Seasons group, said her mother’s fees are being increased by £58.29 a week, the equivalent of £3030 a year. 

In a letter, seen by the Herald, the company writes that it has incurred “significant additional costs” for PPE, infection control enhancement and staffing and adds: “While we have received welcome support from the Government’s infection control funds, we continue to incur costs significantly in excess of what we would expect and we anticipate that this will continue for some time, certainly through to Easter and perhaps beyond that.”

The company also cites a rise in the National Minimum Wage and additional increases in other major costs, “in particular food due to the uncertainty surrounding Brexit.”

The Herald contacted around 12 private firms requesting information about fee rises and of those around half replied but few provided figures.

None of the relatives who contributed to this article were willing to be identified because they were afraid of any repercussions for elderly relatives if they criticised providers for fee rises.

The daughter of one elderly lady who is in a home in Renfrewshire run by Advinia, which has around 38 homes across the UK, said she will pay an extra £240 a month this year.

She said:  “The company say in the letter that they have received some support from the government and local authorities ”but this support has not been fully offset by the wide-range of increased costs.

“I wonder what they have been doing because there has been no activities for my mum.

"I’m stuck between a rock and a hard place and I can’t even think about moving my mum at the moment."

One woman said a letter informing her about an increase in her mother’s fees was the first time the family had been contacted by the care home provider since the start of the pandemic while another said: “Annual increases are part of the contract. Though with no access to podiatry, no GPs or external medical staff going in, no hairdressers, no trips out, deprived of any interaction with the outside world, you’d think there’d be savings to pass on.”

READ MORE: Scottish Government urged to end unfair 'dementia tax' on care home residents 

Another relative whose mother is in a home run by Brighterkind and has dementia said she will pay an extra £3030 this year.

She said: “In addition Four Seasons receive £261 per week personal care and nursing allowance paid direct from the Government.

“It’s not a cheap service to provide and the care at mums place is very good but it is a very harsh system. Her home and all her savings will be gone after a few years and then we will get Local Authority funding.” 

In response, the company said fees were reviewed by individual providers and rolled out at different times depending on geography so it was unable to confirm an across-the-board rise.

A spokeswoman added: “There are multiple factors that go into a fee increase for any particular resident. So it’s not possible for me to be able to say what portion of the fee you’re quoting is a general increase and what is particular to that resident’s care.”

The son of one man in residential care said he had been told by the same company that his father’s  costs will rise by 5%.

Barchester Healthcare, which runs around 20 homes in Scotland said it was unable to provide figures while Sanctuary Housing, which mainly provides care for local-authority funded residents said increases for private payers would be in line with previous rises and said there would be “no sudden and significant increase” due to the pandemic.

READ MORE: Covid service pressures blamed on 75% rise on women with dementia dying at home 

Donald Macaskill, chief executive of Scottish Care, said it was inevitable that care homes would seek to recover additional costs incurred by the pandemic.

He said: “For care homes which have few publicly funded residents or none, their whole source of income is through self-funded individuals.

“That brings into question a huge question about the level of funding and the adequacy and the extent to which, effectively, the state is countenancing self-funders subsidising the state.

“Our estimates before the pandemic was a typical cost of a week’s care allowing for a minimum level of return to a charity was about £1200 a week.

"Once you have the pandemic, there are huge increases around infection control because what the pandemic has done has turned care homes into mini-hospitals.

“To be fair the government has significantly addressed that for those who are providing publicly funded care home provision but that still leaves individuals who are paying for their own care to pay for it.

“Arguably that’s fair because why should the state pay for privately funded individuals."

Mr Macaskill said he hopes that an independent review of social care, commissioned by the government, which is due to publish its findings later this month, will address charging policy and in particular the costs faced by people with dementia.

He said: “The majority of people in care homes are living with dementia and The Herald’s been running for some time the ‘dementia tax’ issue.

"It’s iniquitous that if you are unfortunate enough to be diagnose with cancer, most of your care will be paid for by the state but if you have dementia you will probably have to sell your house to pay for care.

“And it also depends on where you happen to live because each local authority has a slightly different charging policy."

HC-One said the majority of its care home residents were local authority funded but said private fee payers would not have to foot the bill for additional costs incurred as result of the pandemic. The company said the 2021 increase of 5.5% matched the previous year.

A spokesman said: "“When reviewing our fees, our main consideration is that 80% of our costs go towards the salaries and pensions of our hard-working and compassionate front line carers.

"Last year’s 6.2% increase in the National Living Wage, and subsequent increases in other pay bands, coupled with increasing regulatory costs and inflationary pressures on food and utilities, all contributed to the 5.5% increase in running costs.

"Whilst the pandemic has also increased costs, these are not reflected in the private fee uplift as we are determined that the costs of responding to the pandemic are not met by our residents."

Henry Simmons, Alzheimer Scotland’s Chief Executive said there was “no justification” for elderly care home residents facing cost increases due to the pandemic.

He said: “In our view it is entirely wrong and wholly unfair for people living in Scotland’s care homes, and those with delegated decision-making power, to be met with any additional costs due to the pandemic.”

Fees for local authority run care homes are negotiated through the National Care Home Contract (NCHC).

READ MORE: Coronavirus: Cases surge by more than 2000 in 24 hours again 

A spokeswoman for Glasgow’s Health & Social Care Partnership said they were due to reviewed in March and added:  “Additional costs relating to Covid will not be a factor, as they are currently being paid by the Scottish Government.”

NHS Highland said fee rises will be aligned with the yet to be announced annual NCHC uplift which was 3.39% for 2020/21. 

Nick Kempe, who helped devise a national care costs calculator for the Scottish Government, dismissed suggestions by one provider that Brexit might have an impact on food costs.

He added “Some of these homes are charging £1000 a week. They could provide a good standard of care for around £800 and they not spending that additional money on staff.”

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A spokesman for the Scottish Government said: "The amount self-funders pay for their care home costs is a contractual matter between them and the care home provider. However, we continue to provide significant financial support for care homes for costs relating to the COVID-19 pandemic – including for additional PPE.

"Sustainability funding for care homes for the pandemic was recently extended until March 2021.

“Financial issues raised with us by Scottish Care and Coalition of Care and Support Providers in Scotland (CCPS) have been responded to.

"We would therefore not expect there to be a disproportionate fee increase in care homes this year, although care homes will be able to explain that with reference to their business model. "