Health and care services

Future trends in care

Young and old iStock_000017172581Medium Four major shifts that will influence how Northern Ireland cares for its older people over the next decade.

Fewer state-run homes

Much of the media commentary about Transforming Your Care has focused on the availability of residential care homes. The Health and Social Care Board wants to reduce the reliance on state-run care homes.

As of 30 June this year, Northern Ireland had 5,347 residential care places, of which 1,297 were in statutory residential homes, 3,102 in independent residential homes and 948 in nursing homes.

The board says that it is not possible to predict how many places will be available in 2020. This number will be influenced by how many private providers enter or leave the care home market and the impact of investment in services such as domiciliary care, telecare and reablement.

More care by home helps

The number of people receiving domiciliary care (from home helps) increased from 24,134 to 25,330 between 2012 and 2013: up by 5 per cent in one year alone. Demand for domiciliary care is expected to keep increasing and trusts have responsibility for commissioning the right number of care packages to meet that need.

A regional model is being drawn up by the Health and Social Care Board. When completed by next March, this will calculate the proportion of older people in the population and the number of older people moving from hospital-based care to care being provided at home. Reablement, telecare and the promotion of healthy living should, though, mean that not all older people will need the assistance of a home help.

More innovation

Reablement is a relatively new service whereby occupational therapists help older people to return to a healthy and active lifestyle after they receive treatment e.g. for a fall. As of July, this was available in all parts of the Belfast, Northern and South Eastern areas, 73 per cent of the Southern area, and 17 per cent of the Western area. Full coverage across Northern Ireland is expected by next April.

Back in 2011, the Transforming Your Care review group suggested financial bonds for new care home providers following the collapse of the Southern Cross Healthcare Group. This has not been implemented due to the difficulty of managing care home services. However, health and social care officials have been monitoring the market more closely and have updated their contingency plans.

Focus on carers

The Health and Social Care Board is reviewing the carers’ assessment tool so that their needs are recorded more accurately. This review will finish in September. However, the Executive has no plans to allow carers who claim the state pension to claim carer’s allowance as this would break parity with Great Britain. This currently stands at £61.35 per week and older carers claim that their exclusion means that their work is not being properly rewarded.

Full-time students are also excluded. Carer’s allowance is not affected by a person’s savings and supports people who provide 35 or more hours of care per week. A claimant must be earning less than £102 per week after tax and expenses.

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