It has been predicted that by 2017 the number of elderly people in the UK needing care will “outstrip” family members in a position to provide it. Further to this an estimate in this recent report by the Institute of Public Policy Research (IPPR) suggests that by 2030 there will be more than two million people in the UK over the age of 65 who will have no family living nearby to support them if needed.

The report suggested a number of actions that need to be taken in the UK if this care gap is going to be filled.

• Widen the use of “neighbourhood networks”, highlighting those run in Leeds by older people and offering activities to reduce social isolation as well as providing care and support
• Invest in strengthening community groups in areas with the “weakest record for community-based care”
• Follow international examples, highlighting initiatives in Germany, Australia and Japan’s 10-year nationwide campaign “to train one million dementia supporters”
• House public services for different age groups, such as childcare and care for the elderly, together in the same buildings as is done in Germany
• Strengthen employment rights for carers

Clare McNeil, senior research fellow at the centre-left think tank, told the BBC: “There won’t be the family members needed to provide the types care that people see at the moment. That will mean there is more pressure on social services, and stretched services like the NHS.We need to have a fundamental rethink about the way that we look after each other later in life.” She said the government needed to invest in community networks and make it easier for people to combine care and work.

Also commenting on this report Helena Herklots, chief executive of Carers UK said “our families, society and economy need reliable, affordable, quality care and support services and solid support and rights for those caring to ensure such breakdowns are prevented”.

The Care Quality Commission’s (CQC) chief inspector of adult social care Andrea Sutcliffe has said that the inspectorate will discuss using mystery shoppers and hidden cameras to more effectively monitor social care services across the country. She added that there was a requirement to “consider the privacy and dignity of people receiving care” and that a decision to use such tactics would not be considered lightly.

Ms Sutcliffe who was appointed to the lead role within the CQC in July 2013 said that she had got the idea of hidden cameras particularly from the BBC Panorama expose on the Winterbourne View care home in Bristol in 2011.

Ms Sutcliffe has proposed a number of other changes to be considered in a CQC document ‘A Fresh Start for the Regulation and Inspection of Adult Social Care’ published in October.

Other plans for reform include changing the make-up of the inspection teams and recruiting a number of ‘experts by experience’ who will be users of care services, possibly family members. To date CQC have used general inspectors, but Ms Sutcliffe said that members of the public who have first-hand experience of the care sector will be able to offer a different and valuable dimension to the process of inspections. It has also been proposed that an ‘OFSTED’ style rating system be introduced where care services will be ranked as either outstanding, good, requires improvement or inadequate. Inspections will be based on five key requirements: assessing whether services are safe, caring, well-led and responsive to people’s needs. Ms Sutcliffe also said that services that had been rated as outstanding or good would be subjected to random inspections ahead of the time they might be expecting them to ensure standards remain high and to reduce the risk of complacency amongst staff.

Stricter monitoring of care providers is another feature of the report. From April 2015, and subject to relevant legislation, the CQC will monitor the financial records of 50 to 80 of the larger UK care providers to ensure that a situation similar to the bankruptcy of the Southern Cross Care Home Group does not reoccur.

More robust assessment of companies making an application to offer care services will also be undertaken to ensure that new providers of care services have the right values and motivations for providing care.

A full public consultation on the CQCs paper will be held in spring 2014.

A recent survey undertaken by the Royal College of Nursing (RCN) has found that nurses are enduring high levels of stress and ill health due to the ever increasing demands of their work load.  According to the  survey “unprecedented” levels of stress and ill health as a result of staff cuts and overwork were forcing some nurses to choose between their patients well being and their own.

The survey which looked at health, well being and stress amongst RCN members, canvassed the views of over two thousand nursing staff working both within the NHS and the private sector. It found that 82% of those consulted reported continuing to go to work whilst sick themselves as they were concerned about the risk of understaffing in their absence, fearing for their patients safety. Many respondents also felt that patient demands are increasing putting them at risk of verbal or physical violence, in addition they felt that bullying and harassment in the work place was becoming an increasing problem.

Half of those surveyed in the “Beyond Breaking  Point” survey  also said that their stress levels had increased significantly in the past twelve months citing staff shortages, long hours, fatigue from shift working as well as not managing to get the number of breaks or length of break they need all contributing to this. Nursing Staff mentioned that they face a wide range of issues that get in the way of being able to provide the high level of care that would like to. Further frustrations were also identified with the level of paperwork, the emphasis on targets and a general lack of equipment and resource in the work place, whilst feeling unsupported and detached from the changes being implemented around them. Dr Carter the RCNs chief executive said: “Individual nurses are clearly going the extra mile to make sure the job is done. However, the risk of burnout is very real, and very widespread,”

The RCN believe that the ever-increasing demands upon the health service’s resources, coupled with a slow down in funding and job cuts has put a serious strain on the nursing profession. As a result of the findings of the survey they have recommended that those involved in providing, regulating and commissioning services set clearly defined standards and adopt mandatory staffing levels and they have confirmed their commitment to making this happen.

A Department of Health spokesperson said: “Recent reports have shown clearly that we need safe numbers on wards and a supportive culture in the NHS. We have already introduced some major changes, such as a chief inspector [of hospitals] who will take action on staffing levels. We will announce more on our plans to guide staffing decisions in our full response to the Francis report later this year.”