By Caroline Ryan BBC News Online Health Staff in Harrogate

Nurses are concerned about home closures

The Royal College of Nursing's Annual Congress in Harrogate voted overwhelmingly for action after it heard thousands of beds had been lost in homes across the UK.

Nurses said it was the elderly residents and their families who were bearing the true cost of the closures.

They said elderly people had less choice about which home they moved into. And others had no option but to move from homes where they have lived for many years because they were closing.

Older people are being shunted from one care home to another, with no choice and little dignity Eirlys Warrington

The conference heard about Alice Knight, a 108-year-old, who starved herself to death when she heard her Norfolk care home was due to close.

Eirlys Warrington, of the RCN's Welsh Board said: "The closure of beds is just the headline. It's what's beneath those headlines that is the real tragedy.

"Older people, at the most vulnerable stage in their lives, being shunted from one care home to another, with no choice and little dignity."

Overwhelmed

She added: "Older people are being kept in a hospital bed for weeks on end because there's nowhere else for them to go.

"Older people are living miles from their own communities, their own families and their own friends.

"Older people in their 80s and 90s are being forced to pack suitcases and establish new routines, new habits and new friendships.

"This is tantamount to a policy of abuse of the elderly. We have a system where decisions are made for elderly people and not with them."

She told how one nurse, who had to oversee the closure of her care home, described it as the worst process she had ever had to go through in her career.

Ms Washington said: "She said 'I feel exhausted, I feel overwhelmed and I feel like I have let my older clients down so badly. How did we get to this state of affairs'."

Shortfall

There has been some increase in the amount paid to care homes by local authorities to fund the care of patients who do not have enough money to pay themselves.

But the RCN said the increase has not been enough to pay for the extra costs associated with the recruitment and retention of staff and of meeting new regulatory requirements.

It is estimated there is a shortfall of between �75 and �85 a week in the amount authorities pay to homes.

Government response

Department of Health spokesperson said: "We know that care home owners are concerned about fee levels and capacity. We provided an extra �300m to councils in 2001/2, which has been used to increase care home places and fees that they pay to owners.

"We also consulted care home owners, residents and relatives about the national minimum standards, many of which did not have to be met until 2007.

"We recognised that care home owners and residents were worried that homes would have to close if the costs could not be met. Many of these environmental standards have been relaxed.

"In July 2002, we announced that by 2006, an extra �1 billion a year will be spent on services for older people.

"Care homes may be a good option for some older people but not for all. Our objective is to broaden the spectrum of services available in order to widen choice and promote independence."