UK respite care provider closure signals a support system in crisis
For the past 60 years, the charity Revitalise has provided specialist respite holidays in the UK for people with severe disabilities to stay by themselves or with their families or carers. But the charity is closing these services, citing insurmountable financial challenges.
The charity’s two hotels, in Chigwell, Essex, and Southport, Merseyside, were unique as they were able to provide 24-hour care and support to guests during their stays. The testimony of people who had holidayed with Revitalise clearly shows how beneficial the service was.
Its closure means that no such support exists anymore in the UK. Its collapse has been seen by many within the social care sector as a bellwether for the precarious state of respite care in general.
What is respite?
Respite is the term used to describe services that enable carers to take a temporary break from their caring responsibilities, for anywhere from a few hours to a few weeks.
Although anything that gives a carer a break from their responsibilities could technically be considered a form of respite. The most common understanding of respite care in the UK involves cared-for people staying overnight in a residential facility.
Services that are explicitly badged as “respite” in the UK are provided by charities and local authority social care departments. However, local authorities will only pay for services for people that they have assessed as requiring respite care.
Respite is important because being a carer is really difficult. There is plenty of evidence to show that being a carer can take a toll on carers’ physical and mental health.
A recent review found that carers are less likely to smoke and drink alcohol, but are also less likely to do things that are good for their health, such as eating fruit and vegetables and exercising.
And caring responsibilities can affect the carer’s relationships, education, employment and finances. The situation is potentially worse for carers living in deprived areas.
Respite care is designed to alleviate the stress and burden of being a carer, and give them a much-needed break.
Although principally focused on carers’ needs, respite can also benefit the cared-for person. Revitalise, for example, offered their guests a programme of accessible day and evening activities, such as animal encounters, live entertainment and group excursions.
Strain on the system
Demand for respite services in England is increasing. This is due to a combination of our ageing population, cared-for people living longer at home or in the community, and austerity and the cost of living crisis increasing strain on carers. At the same time, local authorities and charity respite services are struggling with continuing and historic budget cuts, staffing issues and rising costs.
Respite care providers are either having to cut services or think of more creative – cheaper – approaches. This includes things like moving away from the traditional “overnight residential” model of respite to support being provided in people’s own homes, for shorter periods of time, using volunteers more, or during the day time.
The problem is that these new approaches may not be what carers want. My research with carers in Leeds showed that overnight stays in a residential setting were what most people think respite is and they did not want non-residential alternatives.
The cost of failure
Not providing enough respite care to meet demand has a human cost, and it probably doesn’t make economic sense either.
Respite care can appear expensive – estimates range from £700 per week to £1,500 per day, depending on the service. But the cost of not supporting carers is also huge. It includes their healthcare bill, lost productivity and the healthcare bill of the cared-for person.
Ultimately, if a carer is unable to continue in their caring role, the cared-for person may either move into a permanent residential placement or becomes a local authority’s responsibility. Either option costs more than respite would have. There is always the option of charging people who require care, but this creates inequalities between those who can and those who can’t afford to pay.
There is no simple solution. Respite services should be based on what carers and cared-for people want and need. If that is to include more flexible packages of support and not just overnight stays in residential facilities, then carers and cared-for people need to be able to make informed decisions about what to do.
The respite system needs enough resources – money and people – to keep it running. This finance needs to come from the government.
The recent budget included measures to (ever so slightly) ease the pressure on the social care system in general, but nothing specific for respite. Carers can now earn up to £196 per week, up from £151 per week and still claim carer’s allowance.
The chancellor also announced an additional £600 million fund for social care as part of a 3.2% increase in local authority budgets. However, this will have to be spread very thinly over adult and child social care. Charities and private businesses that provide social care services will face increasing cost pressure from a rising national minimum wage and higher national insurance employer contributions.
The government has promised a new ten-year plan for social care in the UK within the next 12 months. We will have to wait until then to see if anything more meaningful for respite is introduced. Läs mer…