By Debbie le Quesne

Archive for February 2013

Care work ‘loophole’ simply does not exist

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I don’t normally read the Mirror, but I was pointed to a recent article over the disgraced carer who was struck off over the Stafford Hospital scandal and is still working with the elderly.

If true it’s both puzzling and worrying.

Bonka Kostova was found guilty of a string of charges including screaming at a 73-year-old dementia patient and dragging him out of a toilet with his pyjamas round his ankles.

The case emerged as part of the Stafford Hospital scandal and made headlines last month.

The midwife failed to turn up to a Nursing and Midwifery Council hearing, which banned her from ever working again in that role.

But, according to the Mirror “an alarming loophole in the system means she can still be a carer because healthcare assistants are not officially regulated.”

I see red. Yes, unless the law changed last night, carers are regulated and if there was any loophole at all in my opinion it’s because proper procedure has not been followed.

Clearly, this case should have involved the Safeguarding mechanics. Abuse and Safeguarding are synonymous – never the twain should part!

The case of Kostova should also have been referred to the International Safeguarding Authority (ISA) and it’s the employer’s responsibility to carry out that referral.

And what’s more, the new Disclosure and Barring service – the old CRB – will flag up any safeguarding issue.

The Mirror names the care home where Kostova is (or was) working, but I’m not that brave. A statement from the home said she had been suspended, pending an inquiry.

This woman trained as a midwife in Bulgaria and was working as a healthcare assistant at Stafford in 2010 while waiting for her authorisation to practice to arrive.

In July that year, the Mirror reports, she grabbed “Patient A”, shouting: “I hate you. You are no longer a human being but an animal.”

The NMC said at its hearing there was “no evidence” her failings would improve with more training and her misconduct was so serious she was struck off the nursing register.

Panel chair Timothy Cole said: “Ms Kostova had shown no remorse or offered any explanation for her actions.”

I’m not a health reporter, but the article, in my opinion is wholly misleading and serves to undermine the good work the vast majority of carers and nurses do. A little research into procedure may have enlightened the reader that such a glaring “loophole” really does not exist.

Written by debbielq

February 28, 2013 at 10:01 am

Deadline on report “unreasonable”

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Care home operators in Sheffield are considering legal action against the borough’s city council over a deadline for feedback on a funding report.

They believe the six-day deadline proposed by the authority for providers to offer comments on the Fees and Market Analysis: Care Homes 2013-14 report is unreasonable.

And it appears the Fairer Fee Forum (FFF) has also agreed that there is merit in pursuing the case.

According to Care Industry News, the online magazine, the forum proposes to correspond with the Council addressing this issue and requesting a more reasonable timescale for the consultation period.

The Council will be aware that the timing of the report falls close to the schools’ half-term holidays and many providers could be on a break and unable to respond in time.

Is this an oversight, or a devious bit of political timing? Either way, it’s good to gave bodies like the FFF, which continues to put pressure on the Council for a fair decision making process in setting care home fees, onside.

Aston Brooke solicitors, a firm which have successfully represented care providers in challenging fees set by Local Authorities, have been instructed by the Fairer Fee Forum to act on its behalf and already the deadline has been extended 14 days.

The FFF is also concerned that the Council has indicated a 1.86 per cent increase in fees paid to independent providers of residential and nursing care, which “indicates a possible failure to pay due attention to the cost of providing these services,” according to Care Industry News.

Predictably, the care providers are worried that the quality of care they are able to provided to their local authority clients is not sustainable unless fees become more realistic.

I’m sure many more stories like this will emerge over the next weeks as we begin the long, hard, slog to negotiate fees on behalf of our members. I can only hope that the officers with whom we deal, will be earthed in the realities of the cost of good care provision.

And finally, I’d love to see the contents of the  Fees and Market Analysis: Care Homes 2013-14. Interesting reading, no doubt! 

Written by debbielq

February 28, 2013 at 8:39 am

Sporting memories to help in battle against memory loss

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 Now there’s golf, the gym  – and other sport, most of which I really don’t understand.

But one sporty news item wee outside of my comfort zone has caught my attention – rugby.

And before you mention muscle-bound men of steel, a mid-life crisis or the need for someone to put the bin out, stop it now!

I’m interested only in the game and in particular one derby that will be played on March 3 between Huddesfield Giants and Bradford Bulls.

The clash in West Yorkshire’s  will help raise the awareness of the  and its worthy reminiscence therapy.


There is a growing platform of evidence that suggests that the opportunity to reminisce for those suffering with memory-loss conditions can drastically enhance their life quality.

The Mental Health In Later Life Inquiry in England found that “Participation in meaningful activity, staying active and having a sense of purpose are just as important for the mental health and well-being of older people as they are for younger people.”

The National Institute for Health and Clinical Excellence (NICE) issued specific guidance for Occupational Therapists working in residential care homes which reported that the provision of meaningful daily activities can restore and improve the health and mental wellbeing of residents.

And the National Mental Health Development Unit published a fact file on Wellbeing, identifying the factors most frequently mentioned by older people as important to their mental well-being include – social activities, social networks, keeping busy and ‘getting out and about’, good physical health and family contact.

As part of developing memory activity, the The Giants have asked supporters to submit their favourite Claret and Gold memories in the run-up to and on the day of the game.

The Giants will also use this fiercely contested home fixture to raise awareness of dementia, a condition that involves loss of memory, mood changes and problems with communication and reasoning.

The first man to submit his own rugby memory to the campaign is the perfect fit for this fixture having played for both the Huddersfield Giants and the Bradford Bulls – Giants’ Business Development Manager and rugby league legend Robbie Hunter-Paul.

My confession: I’ve never heard of him, but his name can be found dotted around the Google maze.

He is, I’m informed, a cult hero within the game and has had a prestigious rugby league career which involved leading the Giants to the Challenge Cup Final in 2006 against St Helens which he insists is his favourite rugby memory.

If you care to search on line you can find his memory account. “I just love reliving that feeling. It’s very, very humbling,” he comments.

As part of the game, the Giants are asking all fans to wear their favourite Giants shirt to the game from past years and there will be a  ‘Making Space Kirklees’ one-stop shop’ to find more about dementia.

After writing this blog, I’m left wandering whether there should be something similar staged in the golfing fraternity.

Images of women with hats, vintage golf breeches and hugely collectable vintage golf clubs . . . this could be an item on the next committee meeting agenda.



Written by debbielq

February 26, 2013 at 9:59 am

Growing old – the scary consequence of not heeding the alarms

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We’re living longer and costing the nation a king’s ransom – we all know it, but now the news is just about as official as it could be.

Details about the UK’s rapidly ageing population and the impact on social services’ resources have come in a Lords Committee investigation into the growth of the section of society above retirement age.

The findings are scary and have prompted calls for a proper plan to cope with the dramatic increase in those aged over 65.

Next month all will be revealed, but the committee chair, Lord Filkin, has already warned that social care, the NHS, public spending and the rest of society will inevitably face dramatic changes.

Reported in The Guardian online, the news so far from the investigation reveals:

• Half of those born after 2007 can expect to live to over 100.

• Between 2010 and 2030 the number of people aged over 65 will increase by 51 per cent.

• The number of people aged over 85 will double during the same period.

Lord Filkin, said the prospect of living longer was a “gift”, and added that studies suggest people’s happiness peaks after retirement.

“But six months of evidence gathering revealed the huge impact such changes would have on almost every aspect of public life,” the news item says.

The most dramatic warnings to the Lords committee, which focused on 2020-2030, were for the NHS.

Lord Filkin criticises health bosses for not making detailed forecasts, and evidence from experts showed the scale of the crisis facing hospitals, specialist services and care homes.

The Nuffield Trust predicted a 32 per cent increase in elderly people with moderate or severe disability, and a 32-50 per cent rise in over-65s with chronic diseases.

I have always said that life quality outweighs longevity, but if both length of years and fulfilled days can combine, great. But we all know that’s not always the case.

What concerns me most about these findings is that currently our care sector is in meltdown because funding is so restricted. Just how do we plan for a future crisis when the current issues cannot be resolved because, as I’ve heard as thousand times: ”We have no money.”

Professor Carol Jagger, of Newcastle University, forecast that unless treatment and cures were improved, the incidence of the five most common chronic conditions among the over-65s – arthritis, heart disease, stroke, diabetes and dementia – would increase by 25 per cent by 2020 and more than 50 per cent by 2030.

This fact alone is bleak.

“As a result of such stresses, the Nuffield Trust and the Institute for Fiscal Studies calculated that, even assuming “heroic” productivity improvements, the NHS would have a £28bn-£34bn shortfall – a significant proportion of its £110bn annual budget,” The Guardian says.


Sarah Harper, professor of gerontology at Oxford University, forecasts that about 8 million people in the UK who would be expected to live to at least 100, and some experts believe at least 50 per cent of children born since 2007 will live until 103.

The uncertainty of future, the fear of care failure, growing dementia numbers, failing fiscal policy and a Government without direction for the care sector, all amount to chaos on the horizon.

We know we need to save for our old age, but with most families stretched to their financial limits, how is that achieved?

Individuals can provide only part of a solution as I see it and I do happily stand with Lord Filkin, a Labour peer, when he says strategy along the lines of those developed for future defence needs, climate change and energy security are required.

“Today’s older people are in the vanguard of an extraordinary revolution in longevity that is radically changing the structure of our society,” Michelle Mitchell, director general of the charity Age UK, is quoted by the newspaper.

For many, however, they will be unwilling conscripts.

With the round of local authority care rate negotiations now taking place, the timing of this repot becomes politically interesting. Sadly, although its finding underpin our arguments for increased financial intervention from central government, I suspect it will be ‘just another academic exercise.’

Here’s to long life . . . and winning the Lottery!

Written by debbielq

February 25, 2013 at 10:30 am

CQC in new partnership to help elderly

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 The Care Quality Commission (CQC) and the Patients’ Association have joined forces in a move to speed up action on concerns over elderly care.

Information from members of the public about the care they receive is valuable intelligence to CQC, as it helps identify where standards of care may be falling below national standards of quality and safety.

People unhappy about their care can already contact the CQC directly, but the regulator wants to reach more people and gather more direct experiences about care received. 

 Under the joint project, the Patients Association will pass on to CQC any concerns from people who contact them so the regulator can take appropriate action.

The charity receives more than 8,000 calls to its Helpline every year and has a network of volunteer ambassadors who encourage people to share their experiences of care.

Published on the Care News Today website, David Behan, chief executive of the Care Quality Commission said: “We rely on information from the public to help us target our inspections.

“This important resource helps us to protect and promote the quality and safety of the care patients receive.

 “Our valuable partnership with the Patients Association will focus on gathering the experiences of elderly people and their families. As a number of recent reports, including our own State of Care report, have highlighted, there is a clear need to drive improvements to the care older people receive.”


As the head of an organisation which promotes excellence in care and tries to deliver the tools for providers to achieve it, I thoroughly endorse the new partnership. It is joined-up thinking in action and we need much more of it.

I am clearly aware the CQC is often seen as the demon in the cupboard, but we have to have an external system that can regulate our sector.

My only comment on this latest initiative is that it would be nice if some care excellence experiences could be fed back to the CQC officers.

Katherine Murphy, chief executive of The Patients’ Association, is reported as saying: “Health and care services must listen to the public when they complain about the quality of care they receive.

“Every day patients and relatives contact our Helpline to report poor care. Working with the CQC is important in driving improvements in the care experienced by patients, wherever it is identified.”

Have a good weekend . . . Did I hear on the weather forecast temperatures dipping to -2 degrees? Bring out the thermals again!

Written by debbielq

February 22, 2013 at 11:02 am

Shocking research over ‘cosh’ drugs prescriptions

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The health editor of The Guardian has published a worrying report, highlighting that prescriptions for drugs treating psychotic disorders soar among people admitted into residential care.

Only 1.1 per cent of elderly people still living at home take antipsychotic drugs, while the number tops 20.3 per cent for those in care homes, writes Sarah Boseley.

The so-called “chemical cosh” drug figures come from a study

in the Journal of the American Geriatrics Society, which looked at the prescribing of drugs to calm anxiety and sedate, as well as the antipsychotics which are supposed to be prescribed for severe mental health conditions such as schizophrenia and bipolar disorder and only for dementia as a last resort.

The Queens University, Belfast, researchers analysed information from the Northern Ireland prescribing database relating to over 250,000 people over the age of 65.

Yes, I know it’s a pattern that’s emerged in Ireland, but, the research says, the findings hold good for the whole of the UK.

Boseley writes: “They (researchers) discovered that only 1.1 per cent of elderly people living in the community in their own homes or with relatives were taking an antipsychotic – the so-called “chemical cosh” drugs, which the Medicines and Healthcare Products Regulatory Agency (MHRA) warns are not appropriate for most people with dementia.

“But in care homes, 20.3 per cent of residents were on them. They also looked at the dispensing records for those elderly people who made the move into care between January 2009 and January 2010 into care. Their medication shot up. In their own homes, 1.1 per cent were on antipsychotics, 7.3 per cent were on hypnotics – sedatives or mood stabilisers – and 3.6 per cent were on drugs for anxiety.”

The figures don’t get much better either. Once in a care home, 8.2 per cent were put on antipsychotics, 14.8 per cent were given hypnotics and 7.8 percent were prescribed anxiolytic. One year later, the amount of drugs they were on had jumped again and 18.6 per cent were on antipsychotics.

What is the link between the terrible hike in drug dispensing and residential care? Sadly the report does not draw conclusions. Clearly it cannot be explained by the continuation of drug use initiated in the community prior to entering care.

Lead researcher Aideen Maguire, who is based in the Centre of Excellence for Public Health Northern Ireland is reported in the article as saying: “With an ageing population globally it is important that we look at the reasons behind this type of increase following admission to care. Antipsychotic uptake in Northern Ireland is similar to that in the rest of the UK and Ireland, and this study highlights the need for routine medicines reviews especially during the transition into care.”

Do the figures reflect appropriate prescribing? We simply don’t know.

Are the homes to blame? No. Ultimately it’s doctors who prescribe, not carers.

It is time for the industry to press for fresh guidance on current drug review procedure with our GPs and NICE? I think so.

Written by debbielq

February 21, 2013 at 8:16 am

Mobility scooters for homes: What is the real price of independence?

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Mobility scooters give the elderly and disabled people independence, self-respect and dignity.

And now some care home owners are offering these machines for communal use by their residents. A great idea – perhaps.

But like all vehicles, they must be used responsibly in order to keep both the user and the public safe. The humble scooter may look innocuous enough as it makes its way along the busy high street, but there are some terrifying hidden dangers around for those who use these vehicles inappropriately.

The matter was raised by a man I know who picked up a speeding ticket and to keep points off his licence elected to attend a speed awareness course.

One of the issues raised at the TTC driver awareness group were the dangers posed by scooter users – and not the kind some of us can recall in the Quadrophenia movie.

My friend explained: “Put an orange flashing light on the back of a mobility scooter and they then become road legal.” Is this true? Well, yes.

Like all vehicles, scooters fall into a class; the ‘class 2′ category can be capable of travelling at speeds of up to 4 miles per hour, and it may only be driven on pavements or on road crossings. The ‘class 3’ go-faster type can reach a giddy 8mph and can be legally driven on the roads.

We all know our reaction slow as we get older, it’s not a criticism, it’s a fact of life. How many of us have been forced to doge the odd scooter driver and is there such a thing as scooter rage?

Perhaps it’s me, but the idea of care homes letting their residents use this kind of transport as a communal resource for outings seems a little scary, but doesn’t all independence come at a price?

I’m not advocating people going into care should lose all scooter transport privileges – in fact, I’m all for improving the mobility of residents in whatever form, but I can see possible perils ahead.

You don’t need a driving licence to a mobility scooter and far as I’m aware, there are no helpful courses available to give some crucial tips on, for instance, how to negotiate kerbs, traffic islands and bus lanes, crowded footpaths and travel in the dark. I’m certainly not suggesting a driving test, but being made aware of dangers would clearly be helpful.

Maybe, this is a new business proposition, because I can’t find anything like it on a Google search.

Mobility aids such as scooters give people the freedom to live their lives the way they want, but their use must be taken very seriously.

Written by debbielq

February 20, 2013 at 11:42 am