Families urged to plan for later-life care before reaching adult social care crisis point
Families are being urged not to wait for long-promised social care reform before planning for later-life care, as fresh Government proposals restart the national debate over how support should be funded.
Neil Gandecha, manager at Foxholes Care Home, has warned that many families are still being left to make urgent, expensive and emotionally difficult decisions following a fall, hospital discharge or sudden decline in a loved one’s health.
The Government has announced renewed cross-party talks, an accelerated independent commission into adult social care and a wider national conversation about the future of care in England.
However, Neil says families making decisions now need clearer guidance around assessments, care costs, funding routes and the practical steps they can take before reaching crisis point.
The warning comes as pressure on adult social care continues to increase. The Care Quality Commission’s 2024/25 State of Care report said new requests for local authority-funded support increased by four per cent in 2023/24 compared with the previous year and were eight per cent higher than in 2019/20.
Skills for Care has also reported that more than half of unpaid carers were providing more hours of care than during the previous year.
Neil said: “Most families do not sit down and plan for care in calm conditions. They start thinking about it after something has happened, a fall, a hospital discharge, a phone call from a neighbour or a sudden change in someone’s health.
“By that point, they are usually worried, short on time and trying to understand a system they have never had reason to look at before. That is an incredibly difficult position for any family to be in.”
Recent research from Opera Beds highlights the scale of the issue, with its analysis of UK falls and accident data among people aged 65 and over revealing increasing pressure from emergency hospital admissions.
In England, local authorities carry out a needs assessment before deciding what support a person requires. This is followed by a financial assessment to establish whether the council will contribute towards the cost of care.
Families may also need to consider whether the person is eligible for NHS Continuing Healthcare or NHS-funded nursing care.
Neil continued: “The system is not designed to be easy to understand in a crisis, but that is exactly when most people are expected to understand it.
“Families may be trying to work out whether a parent qualifies for local authority support, whether health needs should be assessed by the NHS, what happens if there is a property involved, and how quickly a decision needs to be made.
“At the same time, they are dealing with guilt, worry and often disagreement within the family.
“One of the hardest things to explain is that moving into care is not a sign that a family has failed. In many cases, it is the point where a person needs more support than relatives can safely provide at home. Recognising that early can make the decision kinder, calmer and safer for everyone.”
Care homes are also facing growing financial pressures, with rising wages, recruitment costs, food bills, utilities and maintenance costs all contributing to the expense of delivering high-quality care.
Neil added: “Good care is not just about a safe room and enough people on shift. It is about continuity, routine, food, activities, relationships, dignity and the small details that make someone feel known.
“Families should feel able to ask homes what they are paying for, how staff are supported, what happens when a resident’s needs change and how quality is maintained behind the scenes.”
Neil is encouraging families to begin conversations about future care before they are forced into making a rushed decision.
He advises contacting the local council for a needs assessment as soon as a person’s care requirements begin to change, while arrangements such as Lasting Power of Attorney should also be considered early so that somebody trusted can help with financial or care-related decisions if the person later loses capacity.
Families can also prepare by gathering important financial information, including details of income, savings, property and existing care costs, before support is urgently required.
Neil says it is equally important to speak openly with the person who may need care about what matters most to them, including where they would feel safest, the routines they value and the type of support they would prefer.
Where residential care may become necessary, families are also encouraged to visit care homes before a move becomes urgent and ask questions about staffing, daily routines, mealtimes, activities and how the home supports residents if their needs increase.
Neil said: “The best protection families have is time. If you understand the questions before a crisis, you are in a much stronger position to make decisions calmly and confidently.
“Visit homes before you need one. Ask practical questions. Talk to your relative about what they would want. Look into the paperwork early. These conversations can feel uncomfortable, but they are far easier than trying to make every decision on the worst day of your year.
“Care reform is often discussed at a national level, but for families it comes down to something much more immediate: finding the right support, understanding the costs and knowing their loved one will be cared for properly.”
A report by Opera Beds revealed that 57 per cent of UK hospitals saw an increase in elderly falls last year.
