Agree with you Leon Smith that the system needs to be simplified and financing care must be fully transparent for the families. The sector does not need any more reactive policy based on misleading knee jerk to avoid bad press. Further, a total obsession with compliance and burocracy over quality care or new changes that people cannot keep up with. Many in the sector don’t understand the difference between Fundamental, Essential and National Minimum Standards – we need simplification of language and demands to be kept very simple so that people can get on with their jobs in a sector that is frequently unable to afford to have sufficiency of resources to deliver good care and work to unrealistic requirements within what is commissioned by the State.

Concern about impact of private pay sector could further destabilise - the sector needs to have massive investment as a legitimate part of the community care pathway if it is to be sustained – it is a national resource and older people should not themselves have to carry the burden for the quality improvement and educational focus that is needed to equip the staff with the necessary behaviours and practice to provide quality person centred outcomes for people with the most complex health needs in our health and care economy.