Tendering, Brokerage and Competitive Caring

We recently told you about the launch by Rosa Monckton of the Campaign for Learning Disabled (CLD) with its petition on change.org calling for ‘the immediate halt of home closures for people with learning disabilities’. Hot on the heels of this comes an important feature article in Private Eye (Issue No 1380) entitled ‘Competitive Caring’. The article is still available (for free) on the Private Eye website, but it is so important and relevant (several Rescare members are being affected by the issues it raises), that we reproduce it in full here. Please read on…

Competitive caring

Disabled care, Issue 1380

WHAT a shameful state of affairs when some of society’s most vulnerable people are packaged up as a list of care needs and put out to tender. Welcome to the new world of market-driven social care.

Emma Knight was horrified to discover that her brother James (pictured together, below), who was brain-damaged at birth, had become the subject of an online bidding process run by Devon county council after charity Guinness Care and Support decided to close Bystock Court, the residential home in Exeter which has been his home for 28 years.

She was tipped off by a care home owner who identified James from the very personal details – including a full assessment of his mental and physical health, medication, care needs and behaviours – supposedly posted anonymously online under “Mr K, a 45-year-old white British man, with a learning disability”. His and the private details of other vulnerable adults are posted on a “brokerage” site, accessible to care providers, so that they can put in a competitive bid for people they might want for their homes or accommodation. Bidders are advised how much financial support might be expected from the local authority (in James’s case £500 a week) and given a deadline for tender.
Emma subsequently learnt that there was only one “bid” for James – who has a mental age of three and also has autism and epilepsy – and that was totally unsuitable.

A crude exercise to minimise costs

Alerted by the Eye, the Information Commissioner’s Office is now looking to see whether Devon council has breached James’s rights to privacy under the Data Protection Act. But his plight also raises other serious concerns – not least whether what looks like little more than a crude exercise to minimise costs by searching for the most “competitive” (ie cheapest) bids will compromise care and safety.

Nor is Devon the only cash-starved authority to decide to put an individual’s care needs out to tender. The Guardian reported in August that Birmingham and Southend councils were using a similar system. But James’s case also highlights the plight of many disabled people suddenly affected by a spreading rash of closures of charity-run residential homes and communities for the disabled – apparently in favour of “supported living” within the community. Guinness, Home Farm and Scope are among those who are closing around 30 generally highly rated residential homes or centres for those with disabilities.

Brenda Edwards, whose daughter Helen was left severely brain-damaged after being starved of oxygen during a botched operation when she was five, told the Eye: “Helen doesn’t just need support, she needs everything done for her. She may now be 33 but has the mental age of an eight-month-old. If you asked her about her wishes she would not answer you, and if you offered her the personal budget for her care, she would eat it. Without 24/7 care my daughter would stay where she was left, fill her nappy and eventually starve to death.”

Sudden loss of friends and regular carers

For people like Helen, Scope’s Drummonds Centre in Feering, Essex is ideal – except it’s earmarked for closure. Only six of Helen’s 40 fellow residents or their families have expressed a wish to move a small, supported house. For the others, closure is frightening. The sudden loss of friends and regular carers and the familiarity of “home” is compounded by the lack of alternative suitable accommodation available. Rosa Monckton, who runs Campaign for the Learning Disabled, has described the closures as “cruel and harmful”.
When Helen moved across county borders into Essex to live at Drummond, Suffolk county council (which funds her care) said she would remain on the “moving list” until suitable accommodation which could meet her needs could be found nearer home. That was in 2008. Now her parents are desperately back on the hunt, writing to the four nearest county authorities. So far they have been to look at only two potentially suitable places – the only available room in the first was not big enough to take Helen’s specialist supportive wheelchair, and the second has indicated it cannot deal with her profound disabilities.

Local authority-run homes and centres for adults with disabilities are largely things of the past. Now the charity sector is pulling out, that leaves the private sector to fill the care void. As Eye readers are well aware foreign private equity firms have been targeting UK real-estate rich health and social care homes for some time – and, as the collapse of the Southern Cross chain dramatically illustrate, private equity and social care can prove a toxic mix.