Abstract
The impact of the COVID-19 pandemic on the UK residential social care sector has been immense and tragic. Elderly, vulnerable and frail individuals living in residential care settings who should have been ‘shielded’ from the virus have died in disproportionate numbers. There are multiple and overlapping reasons for the very high rates of COVID-19 infection and death in residential adult social care settings. Some are immediate policy decisions relating to the management of the pandemic including to discharge older people from NHS hospitals into residential and nursing homes without a negative COVID-19 test result, and to prioritise the supply of (scarce) Personal Protective Equipment (PPE) to NHS providers. Others are endemic to the regulation of residential and nursing care, including the financial models that allow private equity firms to make significant profits while local authority funded placements pay at below cost, family members are required to pay care ‘top up’ fees, and self-funded residents are expected to cross subsidise those funded by the state. This chapter argues that a new model for adult social care, which focuses on fairness rather than profit is the only way to create a stable, safe and sustainable social care sector for the future.
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