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Was anyone else as disappointed as me in the Which? report on care home standards?

Disappointed that, in two of the four residential homes surveyed, the food was unappetising and inadequate.

Disappointed that residents had to wait for up to 17 hours between meals.

Disappointed about the lack of activity in all of the homes.

Disappointed that a case of physical abuse in one of the homes was comparable to the treatment meted out in Guantanamo Bay, according to the National Pensioners Convention. 

But more than that, disappointed that Which? has chosen not to reveal the names of the offending establishments.

This is a curious decision because the Consumers' Association publication is more than willing to name names in its reviews of PCs, travel deals, insurance rates and so on - all sectors where questions of life or death are not so pressing an issue.

In its defence, Which? says it has passed on the names of the substandard homes to the Care Quality Commission. 

But with unannounced CQC inspections having been wound down so much they have virtually ended, one can only wonder when these care homes will get their comeuppance.

These are, after all, places where vulnerable people will spend the final years of their lives. Many of them will have relatives unaware of the shocking conditions and treatment. As a final insult, the same relatives may be paying for the "care".

To avoid further disappointment, it would be proper for Which? to unmask the offenders.

Or, if a sense of inhibition prevails, Community Care's adult care team is awaiting a call on 020 8652 4857. 

It was already known that chancellor George Osborne was minded to merge national insurance and income tax. Yesterday we found out that he meant it as he announced a consultation on the issue during his Budget statement. 

On the surface, a merger would sound common sense, if only for the sakes of simplicity and modernity. National insurance contributions were introduced in 1911, initially to provide pensions, but were the platform for the post-second world war welfare state.

Guaranteeing an income for people who became unemployed, the contributions also funded a universal health service free at the point of delivery. NI was even administered by its own body.

The Inland Revenue has since taken over collection and the contributions have become an extension of the tax-raising mechanism for governments that kid themselves they are freezing personal taxation.

So, a good idea from a chancellor intent on transparency?

Perhaps. It would be speculation to pre-judge the consultation but it is possible that older people's watchdogs may need to turn guard dogs.

Why? From 6 April pensioners will pay tax on income above £9,940. What they will not be paying - and never have - is national insurance. Merging income tax and national insurance would increase the tax take from older people, whose income in any case is stagnating or even falling.

It follows that those on incomes just above the threshold would be hit hardest from a merged tax system.

Unless, that is, the government introduces a pensioners' threshold, in itself a complication to what is intended to be a simplified system administered by an organisation renowned for its IT glitches. 

We also need to be told what will happen to employers' national insurance contributions. Will these be rolled into corporation tax? Unlikely, but, if they are, tax take will be dependent on the economy's performance as companies' profits wax and wane. On the other hand, employers' contributions may be abolished, handing the private sector another tax cut.

But someone will have to pay. You and me?

Not being one to kick a care home provider when it's down, I have been following closely the misfortunes of Southern Cross Healthcare.

I was intrigued, then, to read the comment of its spokesperson, Ben Brewerton, as he attempted to reassure the families of the provider's 31,000 residents that Southern Cross would not be going into administration.

The residents, he said, would "not see any changes in the way the care is delivered".

This is not necessarily good news. Sixteen of Southern Cross's establishments failed to achieve a single star when the Care Quality Commission's inspectors called in spring 2010 before the inspections were abolished.

As the nation ages, things seem only to get worse for our residential care home providers. We might (ahem) need them more than ever, but board members may be excused for reaching for the alarm pendants as they map out the next 12 months.

Southern Cross Healthcare is the latest provider to feel the chill, in its case a 65% fall in earnings and a 14% decline in admissions by local authorities in the final three months of 2010.

The UK's biggest owner of care homes blames local authority spending cuts, with only tacit censure of the government's austerity measures that have caused them.

Pointing to the fees feud with the boroughs, chief executive Jamie Buchan said in the Financial Times: "We are very concerned at what we see as local authorities ignoring the real cost of care." Perhaps he will elaborate when Care Quality Commission inspectors next slate one of Southern Cross's establishments.

Buchan went on to compare the provider's services to the ethos of the Big Society as NHS-referred admissions rose. A veiled appeal to the government, I wonder?

Certainly, it will be a challenging year ahead for everyone, including the courts. Providers are already threatening to take Wirral Council to court after the authority slashed care home fees by 9.5%.

And Pembrokeshire Council was ordered by a judge to raise its rates to providers at a cost of £1.5m after attempting to freeze fees for 2010-11 at 2009-10 levels.

Meanwhile, seven of County Durham's 12 local authority-run care homes are expected to shut, although the council says this is due to the rise in independent living. And North Yorkshire announced the closure of nine homes (see end of story in link).

The question remains: if the private sector can no longer expand provision and the public sector is forced to gradually withdraw, who will fill the space as the nation ages?

Any ideas? Let me know below.

Picture: Rex Features

Radio 4's Face the Facts investigated the exploitation of immigrant workers in care homes. The overriding conclusion was that an improvement in the employment regulation system was overdue.

The programme focused on two workers, one from the Philippines, the other from Romania. Their experiences shamed our system and attitudes towards foreign labour.

Justice must be seen to be done. It's a maxim that has never applied to the Court of Protection, which makes decisions on behalf of people whose mental capacity is impaired.

But a landmark ruling in the High Court, after a campaign led by The Independent newspaper, is bringing the Court of Protection out of the shadows and will allow hearings to be attended by the media, which can report on them.

Nineteen months ago one of the two chief architects of the National Dementia Strategy told an audience at Community Care Live of his optimism for the future care of people with the condition.

But a report on BBC News last weekend was surely the very antithesis of what Sube Bannerjee was expecting.

If it can be argued that the government's child benefit cap is targeted at better-off households, the same cannot be said of any cuts to the emergency fuel top-up payments made to pensioners and low-income families during cold snaps.

If you are older than 50 and can declare you are of sound mind, you are cordially invited to learn how to kill yourself.

Those are my words, but they might as well have come from Dr Philip Nitschke, whose suicide roadshow was touring the UK accompanied by Radio 4, which was given rare access to one of the Australian physician's workshops on ending it all.