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By Debbie le Quesne

Archive for December 2012

All quiet, but Ms Rippon’s campaign is still in full flight

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Okay, we know the fat man with a red suit is getting his sleigh ready for the 25th, but why have the care sector movers and shakers all gone quiet?

I have scoured the heavyweights, red-tops and internet . . . and yes, you’re right, for the first time I’m struggling to blog about anything worthwhile.

So now it’s perhaps a good time to mention my admiration of Angela Rippon’s sterling work as an ambassador for the Alzheimer’s Society.

Somehow, this genius of PR, she steered an interview in a national newspaper about her remarkable and famous pins to promote the work of the society.

The Daily Express carried an article yesterday which trumpeted the need to geek your legs in good order. After Rippon’s famous leggy moment with Morecambe and Wise on their 1976 Christmas Show I can think of no-one better to lead the charge for keeping active longer.

But it’s the other stuff in the interview that grips my attention: The passion she possesses for people to understand the insidious symptoms of dementia.

She made public a long time ago her journey caring for her mother Edna, a challenging dementia sufferer.

In the latest interview, she recalled the capricious changes in moods and how aggressive behavior would be forgotten in a moment.

Rippon wants to spread understanding through the Dementia Friendly Communities Initiative – a champion group formed to establish what needs to be done to make our communities more dementia friendly.

Its work is stunning and worthy of a Google search.

In the Express interview it conclude with an alarming statistic. Studies show that dementia patients spend an average of 28 extra days in hospital because they are often misunderstood, unable to feed themselves, become dehydrated and are often agitated.

Ker-ching! Average cost of hospitalisation: £250 a day.

Keep up the good work Angela Rippon!

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Loneliness key to dementia onset

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Again we find the headlines dealing with the issue of dementia – with new research telling us that loneliness is key in the problem developing

It seems only a week or so ago I was blogging about  this subject which is now capturing a lot of media attention. And so it should, as one of the biggest ticking time bombs our nation will ever have to deal with, it threatens future care funding and not least poses a huge social test in how we should respond.

So I don’t really mind that I appear to have read before that an active social life is the key to warding off Alzheimer’s disease.

According to The Express – a great campaigner for dementia reform – people who are lonely are more at risk of developing the brain condition than those who have a fulfilling social life.

The new study finding come weeks after Health Secretary Jeremy Hunt announced new measures to tackle loneliness among the elderly.

“At least five million people are reckoned to see family and friends so infrequently that they have only a television for company,” The Express says.

The three-year study found that feeling lonely – rather than being or living alone – is linked to an increased risk of dementia.

Researchers studied more than 2,000 people with no signs of dementia who had been living independently.

At the start of monitoring, just under 20 per cent said they felt lonely. Around half were living alone and half were single or no longer married. Around three out of four said they had no social support.

Among those who lived alone, around one in 10 developed dementia after three years compared with one in 20 of those who lived with others.

The research is published in the Journal Of Neurology Neurosurgery and Psychiatry and revealed that of the people who said they felt lonely, more than twice as many developed dementia after three years compared with those who did not feel lonely (13.4 per cent compared with 5.7 per cent).

“Further analysis showed that those who lived alone or who were no longer married were between 70 per cent and 80 per cent more likely to develop dementia than those who lived with others or who were married,” the Express adds.

Meanwhile, I read that elderly people who are injured in falls are being checked for early signs of dementia.

Nearly half of all hip fractures in Britain happen to those with demenetia.

A team at Southampton General Hospital is separating patients over 70 who fracture bones in a fall from other patients in the emergency department. They are then seen by specialists to try to establish if dementia could be a problem. It’s a great initiative and hopefully will pave the way to effective treatments which will hold some of the symptoms at bay.

Hope springs from the Winterbourne affair

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Owners of private hospitals dealing with NHS-funded patients are to be subject to tests to check if they are “fit and proper” persons to be involved with healthcare.

As part of reforms the tests would aim to ensure there is no “repeat of the abuse uncovered” by the BBC last year at the Winterbourne View home owned by Geneva-based investors.

The reforms are designed to get hundreds of patients with learning disabilities and autism out of assessment and treatment units.

Reported in the Guardian we find that more than 1,200 patients were in such units when there only needed to be “300 to 400”, said Norman Lamb, the health minister.

Mr Lamb said they were meant to be short-stay places but many people with learning disabilities were in them for years and shouldn’t be.

As part of the new “culture”, Lamb said corporations and the City would need to act responsibly.

And here we have evidence of that.

Proposals should be put out by spring next year, and would include both “regulatory and criminal sanctions”.

Winterbourne View hospital near Bristol was closed last year after a BBC Panorama programme uncovered a regime of systematic ill-treatment of patients.

“People with learning disabilities were being pinned down, slapped, doused in cold water and repeatedly taunted and teased. Eleven former members of staff at the home, then owned by Castlebeck, admitted criminal offences of neglect or ill-treatment,” The Guardian said.

The NHS and local authorities paid Castlebeck an average of £3,500 a week to care for each patient.

Liz Kendall, the shadow care services minister, warned that “some parts of the country continue to use long-stay institutions because they haven’t developed alternative care in the community and at home”.

I can only hope that good will emerge from this terribly sorry affair. Perhaps too, this new initiative will provide the sufficient leverage to release much-needed funding into this critically needy field of care.

Unpopular Mr Osborne’s backlash

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George Osborne is not a popular man in the care industry and today the headlines keep coming, spelling out a chorus of warnings of what his budget cuts will mean to the most vulnerable of our society.

We know that social care in on the verge of collapse, but George Osborne failed to announce any new funding to help support older people, or those who have long-term conditions and need professional nursing intervention at home.

In a statement on their website, Age UK said: “While it’s reassuring that the National Health Service budget has been protected from the cuts falling on other areas of government spending, unless funding for social care is urgently addressed then the knock on costs to the NHS will continue to grow.

‘We already see hospitals under severe pressure because of a lack of community and social care services for older people who are left to struggle to cope without the vital support they need.

“’The Chancellor’s announcement that, in two years’ time, councils will have to cut another 2 per cent from their budgets is likely to lead to more cuts to frontline care and support services that are already in many cases stripped to the bone.

‘Allowing the social care system to limp along leaving too many older people isolated and afraid of what tomorrow might bring, is not only morally questionable but makes no financial sense.”

I think that just about sums up my sentiments.

Chief executive of the Alzheimer’s Society Jeremy Hughes said: “The decision to cut local authority funding by two per cent in 2015 will have a devastating impact on a social care system which is breaking at the seams and crying for investment and reform.

“Many people are already being forced to go without essential support and care they rely on to live well. We understand the need for austerity in combating the deficit, but with Britain’s ageing population, there will be over a million people with dementia by 2021. We can’t afford to continue to let down the most vulnerable in society.”

He too adds that the shortsighted nature of the cuts will load pressure on the NHS.

National Pensioners Convention general secretary Dot Gibson was even more scathing, saying: “George Osborne might gloat about how he intends to give older people a guaranteed 2.5 per cent increase in the state pension next April – but that guarantee was only put in place to avoid a repeat of the 75p debacle that happened 12 years ago. What he didn’t make clear was that this is just £2.70 a week extra and only £1.60 a week more for millions of older women who don’t get a full pension.

“Even with this increase, one in five older people continue to live in poverty, 3m pensioner households are in fuel poverty and millions more are struggling just to make ends meet.”

Ms Gibson continues: “His refusal to address these issues signals another twelve months of belt tightening amongst Britain’s pensioners – at a time when the super rich are still getting a 5 per cent reduction in their tax rate. It’s frankly immoral, but if he thinks we’ll go away by ignoring us, he’s got another thing coming.”

Well, that’s just the tip of the iceberg. What do we have to do to get this government to hear us? Clearly, they have no deep awareness of the suffering ‘out there’. I would remind the Chancellor of a Dalai Lama quote I learned at school: “ Love and compassion are necessities, not luxuries. Without them humanity cannot survive.” 

Pain for social care: Thank you Mr Osborne

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The season of goodwill is almost upon us, but it seems to have bypassed the care sector.

Social care is now facing deeper cuts after chancellor George Osborne announced he would slash an extra half a billion pounds from local authority budgets in 2014.

Oh yes . . . and the austerity measures will go on for an additional year until 2018.

Quite how the new cuts will drill down to care at the sharp end, I’m not sure, but suffice to say that the Local Government Association has already dubbed the move as “unsustainable”.

In his autumn statement, Mr Osborne said government funding for councils in 2014-15 would be reduced by a further two per cent than planned.

I want cheer, peace on Earth, festive favourites and life is La La Land, but what do I get? Gloom.

The new financial plans have prompted a warning from the Association of Directors of Adult Social Services president Sarah Pickup. She says in a Community Care Online article : “All does is make the problem worse. We need additional resources, for adult social care in particular.”

Additional resources. I’d say so! How does Mr Osborne think we can deliver more for not just less, but a pittance?

Ms Pickup said councils faced limited options in making further cuts to adult care. “Some councils are already in a place where they are doing things that they couldn’t keep doing, like holding down fees for providers. You can’t keeping doing that because the providers will not be able to deliver the care.”

True. So why can’t Mr Osborne relies that. Or perhaps, the government really doesn’t care a damn about those needing our services.

Critically, Ms said the reduction announced yesterday would also make it harder for councils to implement plans to transform social care. I fear all we’ll be doing now is responding to crisis rather than paving a new way forward. Do you remember Mr Dilnot . .  .?

Community care reports; “The 2010 spending review set out cuts to local authorities of 28 per cent in real terms from 2011-15, partially compensated by annual transfers of NHS funding – worth £648m in 2011-12 and £622m in 2012-13 – to fund adult social care. The 2 per cent cut to council budgets announced is in addition to this.

“And though the chancellor did not announce further cuts to council funding in 2013-14, the Local Government Association said measures previously announced had added a possible £1bn in cuts for next year to the 2010 spending review plans.”

Merrick Cockell, chair of the Local Government Association, was quoted as saying: “So far local authorities have largely restricted the impact of cuts to discretionary areas such as culture and environmental services, with councils working hard to protect spending on social care for children and the elderly. But even these areas are now facing reductions. That impact will only increase in line with any further cuts.”

I need a strong coffee . . .

Unnerving countdown to the autumn statement

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Like everyone who is a key player in the care sector, I’ve been on the edge of my seat all morning waiting for George Osborne’s autumn statement.

The Chancellor is set to start a new set of cuts at midday, but the big question remains: Where will this axe fall.

I have held off being speculative, but I need to vent my spleen and this blog is as good a way as any. He has already warned there are “no miracle cures.”

Mr Osborne will no doubt confirm in this bleak mini-budget that Whitehall departments are being ordered to find another £5bn in cuts to fund projects aimed at kick-starting the economy.

He is also widely expected to concede that sluggish growth means it will take longer to tackle the deficit and that his key target of having public sector debt falling by 2015-16 may be missed.

The Chancellor’s hands, I read, are largely tied because of weaker than expected economic growth and high borrowing, which have forced him to extend austerity well beyond 2015. Deep joy!

He has been battling to regain the upper hand since his Budget in March, which was heavily-criticised and led to a string of damaging U-turns over taxes on pasties, caravans and charitable donations.

I suppose it was at this point I lost all faith in a speedy economic revival. Pasties? What next?

I can only home that social care will be spared this afternoon.

I overheard a conversation in a store where two mature, but spritely ladies, were discussing care.

The one asked: What will become of us old people? The other replied with a question: And what will become of the young who need care?

Mr Osborne will confirm plans to use fresh cuts to fund capital projects in transport, schools, science and skills over the next two years.

They will include £1bn to build or expand up to 100 new academies and free schools over the next two years, with cash directed at areas experiencing a shortage in classroom places.

Pundits aplenty are speculating what will happen to social care. For sure, local authorities will have even less cash.

Here’s hoping we’ll still be able to deliver the care needed with the quality and compassion which marks us out as a civilised nation.

 

 

Last chance to get our voices heard

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Chief executive of the Care Quality Commission David Benham tells us in a national online newspaper that now is the time for everyone involved in social care and health to offer opinions on how his organisation should work.

In yesterday’s Guardian he encourages a robust response to the CQC consultation paper on the way forward. But I fear his attempts to drum up interest at the sharp end of care are a little late – the consultation closes on December 6.

Even so, it would be worth the time to add a comment or two as without them there is a danger that future plans will not be earthed in the reality of caring.

Mr Benham writes: “CQC has been subject to external scrutiny. It is important therefore to listen and respond to the comments made by the health select committee, the public accounts committee, the national audit office and the Department of Health’s performance and capability review.

“Our consultation document The next phase sets out what the public, partners and stakeholders can expect from CQC over the next three years. In developing our proposed purpose and direction, we listened to hundreds of people – our staff, stakeholders, professionals, providers, the public – who gave us their views.”

In a telling comment, he adds that there “are inevitably conflicting demands and pressures and, in some areas, we have made some hard choices about what we will do and where we will focus our efforts.”

He then appeals: “I would now like everyone involved in health and social care to engage with and give us their opinion on how we work and how we should work.”

The aims of the CQC during the next three years are laudable. They are to:

• Improve how we use information and develop a model of regulation based on what drives the greatest improvements in the quality of care

• Strengthen our work with strategic partners to achieve our common purpose of improving the quality of health and social care

• Continue to build better relationships with the public, making the most of the opportunity the healthwatch offers to ensure people’s voices are heard and using their views more systematically in our work

• Build further respect and credibility with providers and make sure we are good to do business with

• Make sure we are more fully equipped and able to deliver our unique legislative responsibilities in mental health and mental capacity

• Continue our drive to become a high-performing organisation

The problem as I see it is one of resources. Perhaps the government has a hidden plan to release new funds into the CQC purse. If not, I suspect, given its massively increased brief, it will suffer the same frustrations as the rest of the care sector at present where unrealistic cash shortages dictate an often-mediocre performance.

We’re all waiting  . . . and watching.