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By Debbie le Quesne

Archive for August 2012

Are the bad headlines stopping informed choices?

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In an idle Google moment I was trawling the internet in an attempt to find some happier industry news. I failed.

Maybe it’s because I’m getting older that I crave a regular fix of good news, but my desires are seldom satisfied.

In a conversation with a seasoned journalist, he too confessed to being tired of reading miserable news, but added that we were a minority in our thinking and that bad news was the stuff that always grabbed the headlines.

I’m only too aware that we need a good digest of information so that we can be empowered to make proper choices. I need to know the bad . . . but also the good too.

I was recently made aware of an internet posting by Able Community Care Ltd, a company that offers live-in care services.

It said: Pick up and read your daily paper, listen to the radio, tune into the television news, read the internet headlines and what will you read or hear?

Headlines such as:

“£1bn ‘shortfall’ for care services”


“Osborne must raise taxes on ‘the rich’ to close social care gap”


“Councils facing ‘impending crisis’ in funding care”


“Home’s cash crisis”

These are the kind of headlines – and worse – that assault our senses every day.

In just moments we are told the care sector is failing, there’s never enough money, we can’t afford to provide good standards of care and, oh yes, residential care is generally terrible.

We know this is not true, but the daily onslaught of our embattled care sector must be having an effect on general public perceptions.

Able Community Care asked: “What is the point of publishing such articles and news? Unless you work in the care industry, few people are interested in the subject of care in anything but a perfunctory way until either they themselves or a loved one needs care.”

My answer: Because we all need to know. If the media were any other way, I’d be worried.

But it poses a big question. Does the plethora of bad news on care change our ability to make proper decisions at the time when the need for care knocks on the door of our homes?

It’s an issue I had not considered before, but one raised in the internet article.

The argument goes . . . “At that time, the fear of being told daily that the care sector is in crisis increases the risk of people making a wrong decision or getting into the mindset of being grateful for whatever care service or product is on offer.

“Whether it is a decision about home care or residential care, because the negative headlines have been absorbed on a regular basis the thought is present that it will be luck as to whether the care offered is compatible with their perceived need.”

I’m not sure if this could stand the scrutiny of academic study, but I do find myself sympathising with the viewpoint.

It also galvanises me to ensure any good news gets ‘out there’. That way those in need of care can begin to make informed choices. There are some excellent residential, nursing and learning disabled homes. And there’s plenty of good domiciliary businesses which offer credible, trustworthy service. We need to let the wider community know it!

Perhaps the time has come for us to look to a visionary leader who can take us out of the doldrums, or maybe we need business heavyweights who really can turn visions into reality? I don’t think so.

How much better it would be if the media gave out information that was directional and positive. That’s not going to happen.

The choice of care services is vast, flexible and increasingly innovative, but it’s down to us to tell the world and its wife how good we are.

We’re not perfect, but I believe we need to help enable people in making good decision about their futures.

West Midlands Care Association is slowly gathering status in social media. Recently, one of our members had a summer fair. There were a few pictures taken and the event was posted on our WMCA Facebook page.

Please do the same. It allows an audience we generally cannot reach know that happy and good things can happen within the care sector.  Sadly I’m convinced no-one else will champion our cause, so let’s do it ourselves and while attempting to bring some balance to the sector’s news, also provide a great public service in exposing the happier face of care.

Hey, our Facebook page is free publicity. Go use it.

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Written by debbielq

August 21, 2012 at 8:36 am

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More thoughts on the Winterbourne scandal

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Max Pemberton, celebrity doctor, journalist, author and thinker has now waded into the Winterbourne View debate, concluding that all of those with severe disabilities should be cared for within the NHS and not “dumped unceremoniously into the private sector.”

His observations, published in The Telegraph today, make interesting reading. Speaking of his personal experience of visiting care homes he says: “Some of the care homes I visited were exemplary: they had well-trained staff who were compassionate, interested in and engaged with the residents.

“But, sadly, they were in the minority. All too often there was disregard and apathy. I would describe it as “benign neglect” – that is, not demonstrably abusive but having an insidious, malignant malaise towards the welfare of residents, who were fed and watered but little else.”

The good doctor also notes that the victims at Winterbourne were “absolutely dependent on others to see to their needs and to stand up for them.”

I do not doubt for one moment his clinical understanding of such people is excellent, neither do I question his motives in joining in the debate which continues to make headlines, but I really wonder just how academic his analysis is on the state of care for the disabled in the private sector.

I am concerned that once again the unforgivable behavior of a few at Winterbourne becomes the ‘norm’ for all within the private sector. Nothing could be further from the truth.

Please don’t think my association would champion poor providers or not think of exposing their shortcomings, but I’m getting a little tired of the big stick bashing the good work of our members.

I agree with Dr Pemberton that “benign neglect” is an issue that needs addressing. We need more training and critically, more money to do it. Is there not a sound argument to bring extra funding into the private sector so that it can deliver better-informed care in these cases, rather than champion a cause to push the disables back into the NHS?

True, many people with difficult and complex needs are cared for by private sector careres who are not as qualified as some within the NHS. So let’s have some government investment to train them!

The NHS, for me, does not have a glittering track record at caring for the mentally ill, learning disabled, or physically disabled. It’s not that long ago there were large institutions and asylums which appall us as we reflect on their legacies.

This month’s Brunswick’s Healthcare Review also focuses on the Winterbourne scandal, printing South Gloucestershire Council’s independent Serious Case Review into the events at the hospital.

The review was commissioned by the Safeguarding Adults Board. The language is as you’d expect . . . “ serious and sustained failings in the management procedures of Castlebeck Limited.”

But the report highlights the need for outcome-based commissioning for hospitals detaining people with learning disabilities and autism and says that the use of ‘supine restraint’ – in which patients are laid on the ground with staff using their body weight to re- strain them – should be discontinued at such units.

The report also calls for notifications of concern, including safeguarding alerts, hospital admissions and police attendances, to be better co-ordinated and shared amongst safeguarding organisations to allow earlier identification of potential problems and earlier action to be taken.

In short, it’s thorough and predictable.

I would advise, however, that you take a look at the Brunswick’s Editor’s comments which can be found online.

The article comments all care providers to read the review in full – all 150 pages of it – to remind themselves of the utter wretchedness of the goings-on and to help serve as a guardian against such a repeat.

Written by debbielq

August 20, 2012 at 8:11 am

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Action on the White Paper proposals (we hope)

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Just when I thought the White Paper on care reforms had been put to sleep, I find that government ministers are set to include plans to limit how much people have to pay in its next next spending review.

Frankly, I’m surprised. But maybe this seemingly change of heart is something to do with the loud chorus of complaint from many and varied sources when no real action on the Dilnot reports was proposed.

The Beeb reported yesterday that a spokesman said the prime minister was serious about resolving the issue over capping social care costs.

Last year the economist Andrew Dilnot was commissioned to examine options for overhauling social care and a £35,000 cap – above which the government would meet the costs – was a key recommendation.

A growing consensus behind the move among political leaders agrees with the Dilnot outline. And now it seems Mr Cameron and Mr Clegg so too.

Last month Health Secretary Andrew Lansley said ministers supported the principle of a cap but there was no commitment to finding the money to pay for it.

The BBC added that the government is keen to scotch the impression that reform of social care in England is dead in the water and a Whitehall source said yesterday there is a will to include it in the next Comprehensive Spending Review, expected to begin next year.

This is great news, but the Dilnot package will cost the Treasury almost £2bn a year.

“A No 10 spokesman said the prime minister and the government were serious about resolving social care but stressed there was no final, signed-off plan ready to be announced,” the BBC reported.

In a statement, the Department of Health said it was continuing to “explore a range of options” for funding social care in the future.

Speaking on Radio 4’s World at One programme, Mr Dilnot told the BBC he was “delighted” that “significant steps” seemed to have been taken in recent days to agree the basis for a sustainable system for funding long-term care for the elderly.

 The issues remain, however, exactly what mechanisms will be brought to bear to raise the cash.

True, if the Dilnot proposals are adopted it would end the extortionate costs of care bills presented to families and it would probably save home legacies too.

In reality the latest news is not a huge step forward by the government, but undoubtedly an important one.

Enjoy the weekend, it’s almost here . . . thunder, rain, flooding. Grrreat!

Written by debbielq

August 17, 2012 at 7:02 am

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Investing in dom care ‘could keep 2.3m elderly out of hospital’

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Rarely do the issues of domiciliary care come on to the national radar but it appears that too many elderly are being admitted to hospital because their home packages are failing.

“The failure of GPs, community health services and social care services to work together means large numbers of over 65s are admitted to hospitals,” The Telegraph newspaper reported earlier this week.

The findings come from the King’s Fund think tank and are deeply worrying. Surely our West Midlands Care Association members with ‘dom care’ services are not all failing to deliver high standard caring.

Underlying this research which found that 2.3m overnight stays in hospital could be prevented if all areas of the country performed as well as the top 25 per cent, is an age-old problem – money, or more specifically, the lack of it.

The figures equated to 7,000 hospital beds being filled, or several medium sized hospitals full of elderly emergency cases every night of the year.

The Telegraph added that savings of £462m could be made which could be reinvested in community services to keep the elderly well at home.

For me, the cycle of reduced care budgets and their social consequences is clear to see.

Swinging cuts in local authority budgets are affect social care call times for the elderly and put further pressure on the NHS.

The King’s Fund found there was a fourfold variation in the use of emergency hospital beds between the best and worst performing primary care trust areas.

Where hospital services were well integrated with community services such as primary care nurses, GPs and social care, emergency bed use was low.

Rural primary care trusts and those with large elderly populations also had low emergency bed use, it was found.

Experts said – and this is wonderful news for ‘dom care’ – the findings were ‘important’ and proved that the NHS needed to move away from providing so much care in expensive hospitals and invest more in care closer to home (may I suggest in home).

The primary care trusts with the highest emergency bed use were: Trafford, Manchester, Hounslow, Wandsworth, Haringey Teaching, Waltham Forest, Lambeth, Hammersmith and Fulham, Bristol, and Ealing.

Those with the lowest were: Torbay, Herefordshire, Cornwall and the Isles of Scilly, Devon, North Staffordshire, Shropshire County, Great Yarmouth and Waveney, North East Essex, Norfolk, Redcar and Cleveland.

In conclusion, the report said: “Our analysis demonstrates a significant opportunity to reduce the overall rate of use of emergency hospital beds by people over 65 while at the same time not threatening and potentially improving the quality of patient care.”

 

Katherine Murphy, chief executive of the Patients Association, is reported as saying: “This is a really important report and its implications need to be recognised.

“However, even whilst the NHS is forced to adopt huge efficiency savings, the needs of patients must be put first. Where clinically viable, patients want to leave hospital as quickly as they can.

“But we don’t want to see a return to the days of targets that distort clinical outcomes.

“Patients should be treated for as long as needed, and clinicians should not be put under pressure to discharge patients before it is safe to do so.”

Critically, she adds: “Patients also need to be given the choice of where they want to be treated and many would opt for treatment in their own home or in the community but we must make sure the services are available to them in the community to allow this to happen.”

Written by debbielq

August 16, 2012 at 7:43 am

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The good, the bad and the ugly

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First the good news. Spirited residents of a care home proved that age is no barrier for catching the Olympic flame.

With their own opening ceremony, they then tried a variety of sporting activities including skittles, rookie golf, cricket and darts.

The ‘Games’ were organised by health trainers at North Tees and Hartlepool NHS Foundation Trust and proved popular with the residents of Parkside Court, in Thornaby, said the Northern Echo newspaper yesterday.

What a lovely idea. For those who are able exercise really is a golden opportunity (excuse the pun) to improve life quality.

Senior health trainer Elaine Russon was quoted: “Residents are really getting into the Olympic spirit. I regularly work with the residents on activities which not only keep them fit, help their co-ordination and memory, but keep their minds active too.

“No matter what age you are or how active you are – there is something out there to help everyone keep in shape and feel healthier.”

It leaves only one burning question: Who won gold? But we all know it really doesn’t matter because our elderly are all golden in their own way.

And now the bad news.

Health regulators, police, social services and the NHS have all been criticised for failing to spot the warning signs about the treatment of patients at the Winterbourne View care home.

I still cannot eradicate those terrible video images of ill treatment which flooded our TV screens. The secretly recorded footage was sickening.

Now a serious case review has been published just a day after the final member of staff accused of abusing patients at the home in Hambrook, South Gloucestershire, pleaded guilty.

A total of 11 former staff have admitted between them 38 charges of either neglect or ill treatment of people with severe learning difficulties.

The shocking catalogue of abuse at the hospital only came to light when whistleblower Terry Bryan, a senior nurse at the home, contacted BBC1’s Panorama.

A five-week undercover investigation followed and the programme was broadcast in June last year.

Secretly shot video showed frail and confused residents being forcibly pinned down, slapped, soaked in water, trapped under chairs, taunted and having their hair pulled and eyes poked.

I find it deeply worrying that Dr Margaret Flynn, who wrote the 150-page serious case review, is reported in The Guardian as saying said her findings could be the “tip of the iceberg” adding that care at Winterbourne View had become “institutional abuse”.

Her report detailed hundreds of incidents of restraint and dozens of assaults on patients and said that had it not been for Panorama the scandal may never have come to light.

It emerges that there were enough warning signs over the preceding three years for the authorities to have investigated further, but nothing happened.

And this next piece of information, for me, makes the whole nasty business worse. The 24-bed home was exclusively funded through contracts with local authorities and the NHS and charged on average £3,500 a week per patient, The Guardian says.

Exactly how this abuse continued so long without intervention is a mystery to me. How can people be so cruel? It concerns me too that this cruelty was “institutionalised abuse”. Did no-one think to shout ‘stop’?

I would like to think this is last of the whole ugly business, but it won’t be. The government is publishing its own review in the autumn.

Written by debbielq

August 15, 2012 at 8:38 am

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Robots: Is dehumanizing care really progress?

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There’s a thing called crowdworking – and it’s growing at a rate of 400 per cent a year with one company,

Sounds a bit like mass manipulation to me, but it isn’t.

 This ominous sounding technology beckons a new way of approaching huge, often dull, tasks.

“Where once a company would hire a bunch of temporary workers, or eager teens happy with minimum wage, it can now call on workers from all over the world to collaborate on huge tasks while simply sitting at their computer,” the Beeb business on line reports.

The article goes on to explain it’s a new way of outsourcing. And before we conjure up images of a low-paid army of workers shuffling onto almost impossibly long production lines in Asia, or the offshore call centre where English doesn’t appear to be a criteria in securing a help-line job, stop. We’re talking robots here – tele operation robots.

Willow Garage is a robotics company based in California. It pioneers the use of human-in-the-loop systems – that is, actions which robots can’t quite manage on their own, but with a simple piece of human intervention can finish the job, says the BBC.

But here’s the scary bit – the system is being tabled as another remote care tool.

Willow Garage’s Heaphy Project allowed remote users to control this robot and carry out tasks using just a web browser

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By using Mechanical Turk, Amazon’s crowdworking platform which allows workers all over the world to remotely carry out small tasks for small cash rewards, they have made the first steps in what they eventually believe could be a way to outsource even the most delicate of tasks, such as caring for the elderly.

Users, who watch what’s happening via a video feed, can move the robot around and control its arms to such a precise degree it can pick up objects.

Can you imagine a robot in the home that could be remotely controlled from a computer to pick of a dropped tablet or provide other care tasks?

Is this the ultimate development of remote caring?

The human/machine collaboration could open new boundaries in the care industry but it worries me.

Any good care delivery is built on relationship with those receiving it. I know there’s a generation of nerds who have enclosed world relationships with their computers, but I really can’t see my 92-year-old Auntie Lil getting a comforting hug from a robot.

Bob Bauer, Willow Garage’s director of commercialization, is reported as saying that as the demand for elderly care increases in years to come, such human-in-the-loop robotic care will become commonplace.

“We’re in conversation with everything from elderly care facilities to people who are doing security applications in order to understand what’s the right mix of being automated and human intelligence being brought to the problem,” he adds.

I am both fascinating and scared by this technology. An army of robots in homes doing menial tasks . . . perhaps yes; but I believe it could make a care a mechanised procedure and reduce the worth of those is should serve. And whatever happened to human interaction?

Is dehumanizing care really progress?

Written by debbielq

August 14, 2012 at 8:03 am

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Staffordshire’s Green Paper: We need to invest our thoughts

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“As a nation we love to talk, so perhaps it is not surprising that the quality of care services we provide has been the subject of much ongoing debate,” writes Matthew Ellis, the cabinet member for adults wellbeing at Staffordshire county council

Addressing the Green Paper his council has launched and the acute need for people to respond nationally, his words can be found in The Guardian on line.

And his well-crafted piece makes interesting reading. He observes the issues of care have made headline news, been raised in parliament and discussed by many informed audiences.

But adds: “More often than not, the interest and attention seems to wane before real progress is made.”

This is a real danger when the arguments on the future of care funding, policing, standards and delivery have been rehearsed so many times before.

Mr Ellis points out that pour country responds well to challenges –for example hosting the Olympics, and questions about whether we can do it; should we do it; can we afford it? – are met with a resounding “yes”.

And the Games have been the most successful ever. A record 65 medals, with 29 of them gold, were celebrated in the closing ceremony.

I agree with Mr Ellis when he says: “It’s a pity we can’t show the same passion and determination when it comes to addressing other challenges facing the country, not least the provision of excellent, quality care for the elderly and more vulnerable members of our communities.”

During the last two years Staffordshire have looked closely how care is provided now, against how they would like to see even better quality care provided in the future. The result is a radical proposal which I outlined in my blog the other day.

Staffordshire’s A Revolution in Care Quality green paper is the culmination of this research.

As a green paper, it is designed to promote debate.

Recommendations include adopting a zero-tolerance policy on poor quality, sharing more information with the wider community, for example by publishing details of complaints about providers, investing in more frontline monitoring and raising the status of the professional carer.

“Our green paper goes much further than dipping a toe in the water. It demonstrates a shift in approach to one which fundamentally measures the quality of services through people’s day-to-day experiences,” says Mr Ellis.

One of the issues under the proposals includes an innovative care match scheme which lets people choose their carers and vice versa.

“This covers not only their caring needs, but matches people with similar interests or maybe even just the same sense of humour. This more personalised approach doesn’t come with a huge price tag. It is simple, but brilliant at the same time,” adds Mr Ellis

Other matters in focus include making caring a real career option with better training, qualifications and better career progression, perhaps into areas such as nursing, rewarding good providers and penalizing those who deliver poor service.

The Games have undoubtedly given the nation a big confidence boost. I truly want the enthusiastic support found for our Olympians to be mirrored in our care sector.

As Mr Ellis concluded in his article: “At a time when performance counts and winning is everything, it is a reminder that when it comes to providing quality care to those who need it most, the time to raise our own game is long overdue.”

Let’s embrace the opportunity to contribute positively – it could be an investment into all our futures. Consultation on the green paper runs until 16 September

Written by debbielq

August 13, 2012 at 8:29 am

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