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It is not clear how the lessons of Vista and Winterbourne Southern Cross will learn. The whole system is broken

The Care Quality Commission finally closed Winterbourne View, privately run home care in which patients with learning difficulties abused. Up a program Panorama revealed the abuse, the regulator was nowhere, admitting that "it does not first take effective action." This week, the Commission also recognized that only half of the 23 other houses Castlebeck acceptable standards. The recent collapse of another provider of home care, the Southern Cross, with 700 homes, will see its 31 000 inhabitants aged transfer to new landowners. Ministers described the process as "closing orderly. "

expansion of the UK sector of

home care is clearly in disarray. However, there is little evidence that the deep flaws in the policy, funding and design will be reformed. The controller is no more the fight against fires. Home care operators have learned from the banks that are "too big to fail" can mean "too weak to fail." They know the government is the operator of home care of last resort. The result, they have no incentive to improve performance. The Ministers discussed the insurance policies and performance obligations. It may be that the way to talk about the stable door and horse studs.

reform begins with the first identification of gaps in policy. Reflection on the care of seniors in the coalition is a disaster. Health, purchasing services from the private sector is supposed to be a bad thing, but in health care (in which health plays an important role), is promoted as a good thing. In fact, it is practically the only thing. Local authorities now have a decrease of only 10% of "market". While local councils and government are complicit in the private provision of a large public service of increasing importance. But companies such as Southern Cross and Castlebeck whole system collapses.

However, local authorities have reduced their monthly payments for residents of nursing homes. Sure, blame the government for the general strictures. However, squeezing the margins of care homes awaiting humanitarian standards must be maintained, is untenable. Poor training and low pay rates were factors in Winterbourne Vista. Therefore local authorities have to pay their fair share of actual costs of care. (Dilnot Commission's recommendations for funding will cost an extra £ 2 billion. Do not hold your breath.)

the complete dependence on the private sector affects the national infrastructure for nursing homes, too. In the absence of a single currency, the government is required to attract private capital in the sector. For that, investors need to make a profit, keeping operating costs at affordable levels. Recently, the Treasury offered a "buy now, pay later" deal with homebuilders. The lure is in the public domain. Why not spread sweetness of imagination to the attention of national operators who wish to promote innovation, the use of thousands of redundant assets NHS property

However, innovation is hard to find. A model of corporate governance introverted in which local authorities play an active role not dominate the area. The typical design model is "closed" instead of "open" (an approach that allows the disinfectant of light and fresh air in the management). Privacy and dignity - and the preferred class regulator "backup" - will be enhanced, not compromised by a commitment to good design

course, homes should be places of affirmation of life that ensures privacy and dignity. But who will insist on this point? Many new nursing homes today are warrens of corridors and rooms pokey. Yet to reach microscopic dimensions by the application of the Disability Discrimination Act fortuitous. Good architecture by registered architects (as opposed to local builders) is singularly absent. Local planning authorities covers only the appearance of buildings. His interest in parallel (as the body to pay for the care of residents) is totally disconnected. And planning of new government proposals announced this week, the boards will be deterred from offering an opinion on the design that is not to act as a brake on development.

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