CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK...
Transcript of CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK...
![Page 1: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/1.jpg)
CARE HOMES FOR OLDER PEOPLE
LaingBuisson#LBSocialCareSocial Care Conference
![Page 2: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/2.jpg)
LaingBuisson#LBSocialCareSocial Care Conference
Market size, care homes for older people and dementia, £ million UK 2019
![Page 3: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/3.jpg)
Age specific usage rates for care in residential settings, UK 2018
65-74 75-84 85+
% OF POPULATIONWHO LIVE INRESIDENTIAL SETTINGS 0.57% 3.6% 14.7%
THESE RATES HAVE BEEN DECLINING SINCE 1993 – WHY?
LaingBuisson#LBSocialCareSocial Care Conference
![Page 4: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/4.jpg)
0.90
1.10
1.30
1.50
1.70
1.90
2.10
2.30
2.50
2.70
2.90IN
DEX
1981
= 1
00
INDEX of population ageing* INDEX of occupied beds INDEX of deaths, persons aged 80+
Population at risk vs proximity to death as predictor of demand
BROOKINGS INSTITUTE HYPOTHESIS – DEMAND FOR CARE HOMES IS A FUNCTION OF THE NUMBER OF OLD PEOPLE AT THE END OF LIFE, NOT THE NUMBER OF OLD PEOPLE LIVING
*Expected number in care in year N divided by actual number in care in base year of 1981, where Expected number is the sum of % people in care in 1981 in each age group 65-74, 75-84 and 85+ times the population at those ages in year N
LaingBuisson#LBSocialCareSocial Care Conference
![Page 5: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/5.jpg)
Volume of demand for care in residential settings – actual and projected, UK 65+
0
100,000
200,000
300,000
400,000
500,000
600,000
Independent Sector actuals Public Sector actualsIndependent Sector projections Public Sector projections
Additional demand of 18,000 in 5 yearsand 66,000 in 10 years
LaingBuisson#LBSocialCareSocial Care Conference
![Page 6: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/6.jpg)
Capacity change from openings & closures, UK care homes 65+
LaingBuisson#LBSocialCareSocial Care Conference
-30,000
-10,000
10,000
30,000
50,000BE
DS
NEW REGISTRATIONS - Public Sector FROM 2000 OTHER NET CAPACITY CHANGE**NEW REGISTRATIONS - Independent Sector CLOSURES - Public Sector FROM 2000CLOSURES - Independent Sector TOTAL NET CAPACITY CHANGE
Capacity shakeout after Blair/Brown public Austerity ......................1993 Community Care Reforms expenditure boom
![Page 7: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/7.jpg)
Council paid fees for residential care of older people and people with dementia 65+, England £ per week
LaingBuisson#LBSocialCareSocial Care Conference
0
100
200
300
400
500
600
700
800
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
£ pe
r wee
k
Year ending March 31
Council paid fees (Fredom of Information requests) £pw Council paid fees (from NHS Digital Unit Costs, exc. SSMSS) £pw
'Care Cost Benchmark' CEILING* £pw 'Care Cost Benchmark' FLOOR* £pw
![Page 8: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/8.jpg)
Private pay premium43% higher than council pay (LaingBuisson research on behalf of the County Councils Network, 2015)
41% higher than council pay (Competition and Markets Authority, 2016 research)
Cross subsidisation is now so deeply embedded that it will be very difficult to turn back
LaingBuisson#LBSocialCareSocial Care Conference
![Page 9: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/9.jpg)
Profitability of old people’s care homes portfolios EBITDAR as % revenue
LaingBuisson#LBSocialCareSocial Care Conference
0%
5%
10%
15%
20%
25%
30%
35%
40%
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
EBIT
DAR
AS %
REV
ENU
E
Barchester (y/e Dec) Care UK (Residential Care Division) y/e SeptBupa (y/e Dec) Four Seasons Care Home Divisions (y/e Dec)HC-One (y/e Sept) Exc. HC-One Oval Caring Homes (y/e March)Avery Healthcare (y/e March)
![Page 10: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/10.jpg)
ADULT SPECIALIST CARE
LaingBuisson#LBSocialCareSocial Care Conference
![Page 11: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/11.jpg)
LaingBuisson#LBSocialCareSocial Care Conference
Market size, adult specialist care, £ million England 2018
![Page 12: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/12.jpg)
Demand for adult specialist residential and nursing care, UK occupied beds 1990-2018
LaingBuisson#LBSocialCareSocial Care Conference
0
20,000
40,000
60,000
80,000
100,000
120,000
Resid
ents
Adjustment for data discontinuity* NHS residential settings Local authority staffed homes
Independent residential Independent nursing Shared Lives
DATA DISCON
TINU
ITY
No trend data on supported living
![Page 13: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/13.jpg)
Occupancy rates (occupied divided by registered beds) UK younger adult specialist care homes
87% 85%
91% 91% 92% 90%94% 91% 91% 92% 91% 89% 89% 89% 87% 86% 88% 86% 86% 86% 85%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
CQC inspection reports LaingBuisson surveys, UK
LaingBuisson#LBSocialCareSocial Care Conference
![Page 14: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/14.jpg)
Council fees paid to independent sector homes for residential care of younger adults with learning disabilities, England
LaingBuisson#LBSocialCareSocial Care Conference
£0
£200
£400
£600
£800
£1,000
£1,200
£1,400
£ pe
r wee
k
Year ending March 31
Learning Disabilities Residential Mental Health Needs Residential Physical Disabilities Residential
High fee inflation in 2000s partly attributable to 'churn'
Future prospects for fees – no return to the high spending Blair / Brown era. Council paid fees will struggle to keep up with National Living Wage
Fees flatten with austerity from 2011/12
Learning Disabilities CAGR 2002/2011 7.7% pa
Learning Disabilities CAGR 2011/2015 1.7% pa
Learning Disabilities CAGR 2015/2018 3.5% pa
![Page 15: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/15.jpg)
Profitability of adult specialist care homes, EBITDAR as % revenue
LaingBuisson#LBSocialCareSocial Care Conference
0%
5%
10%
15%
20%
25%
30%
35%
40%
Priory Specialist Division (y/e Dec) Voyage (y/e March) CareTech (y/e Nov)
Care Management Group (y/e Feb) Prime Life (y/e March) Regard (y/e March)
AGGREGATE
![Page 16: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/16.jpg)
NHS FREE NURSING CARE
LaingBuisson#LBSocialCareSocial Care Conference
![Page 17: CARE HOMES FOR OLDER PEOPLE - LaingBuisson Events · Capacity change from openings & closures, UK care homes 65+ Social Care Conference #LBSocialCare. LaingBuisson-30,000-10,000.](https://reader033.fdocuments.in/reader033/viewer/2022060507/5f22175aa830505c2742a1ca/html5/thumbnails/17.jpg)
Revision of English NHS Free Nursing Care rate for 2019/20
LaingBuisson#LBSocialCareSocial Care Conference
£173.32
£165.56
£179.21
£3.91
£5.25
£1.40£7.76
£5.89
£155.00
£160.00
£165.00
£170.00
£175.00
£180.00
£185.00
LB calculation2018/19
DHSC agency cap DHSC 'efficiency'ask of 3.1%
DHSC inflationallowance of
0.85%
FNC for 2019/20 reverse DHSCadjustments
add 3.4% annualinflation
LB recalculation2019/20 with3.4% inflation