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By Debbie le Quesne

Archive for December 2013

Highs and lows of the passing year

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I have been thinking (dangerous I know) of what to blog on New Year’s Eve. There has been so much miserable news over the last 12 months that has both shaped and scarred the care industry.

But there have been some incredible triumphs and opportunities too where as an association we have been able to bring influence to the movers and shakers.

In recent months we have been able to respond to the Telegraph article on ‘the scandal of secret mark-ups’ and correct the over-generous figure of £486 a week quoted for the average care bed price paid by local authorities for a realistic £384.99. And we have argued also that self-funders are indeed to the difference between many home closure and survival in these difficult financial times.

Let’s take a look at the care sector highlights over the last year . . .

  • In January we had the so-called revelations on the Dilnot report where the long-awaited capping of care costs for individuals was set at a far higher £75,000 than the recommendation of £25,000 t0 £50,000. We were hoping for clarity and certainty and we got neither.
  • Domiciliary care agencies had been saying it for years, and in January the NHS Confederation adding to the chorus: GP and community services should receive a higher proportion of NHS spend to enable more care to be carried outside hospital, said the Confederation chief. Mike Farrar said in his New Year message that he would like to see ‘more investment in primary, community, mental health and social care services as a proportion of the total spend’. And wouldn’t we all?
  •  We also saw our MPs in confessional mode on dealing with mental illness – a brave and laudable move and one that could only help the funding issues around this care specialism.
  • In February the Lords Committee investigation into the growth of the section of society above retirement age tabled some scary facts, prompting calls for a proper plan to cope with the dramatic increase in those aged over 65.
  • The Care Quality Commission (CQC) and the Patients’ Association also joined forces in a move to speed up action on concerns over poor elderly care.
  • And there was a groundbreaking social media project, which aimed to trigger past memories in people with dementia, is to be piloted in Scotland. The Memory Box Network is a charity which aims to use online reminiscence therapy to increase the quality of life of those who live with dementia, which affects around 84,000 people in Scotland. The team developed a website where users can view and upload content to act as a talking point between the person with dementia their carers and loved ones.
  • In March the Joseph Rowntree Foundation encouraged care homes not fall victim of negative stereotypes. Critically, in conclusion, the report says: “With greater levels of staffing and investment, care homes will be better placed to understand and act upon the wishes and aspiration of older people.” So much of this report was based on the need for extra money and more staff and at the sharp end of care and still we need both like never before.
  • I loved the newsbreak on the care home where charity Magic Me was holding cocktail nights specifically aimed at bringing in new faces to residential care settings and establishing a larger friends network. Sadly, I never did receive my invitation.
  • The chancellor also announced that a modified version of proposals laid out in Dilnot report would be brought forward by a year to . . . wait for it, 2016.
  • April gave us Good Care Week Good Care Week, a national platform to be show off excellence in care and a fantastic initiative.
  • Also in April was the announcement that the Care Quality Commission (CQC) would be introducing bigger, more expert inspection teams to police the industry.
  • May’s centre stage event was work by pupils in Sandwell who created visuals to help understand dementia. It was a real privilege to be part of The Sandwell Dementia Friendly Event.
  • June came with a new buzzword – integration where NHS and social care funding pots combine. Hmm . . . My abiding concern in the ‘real world’ of caring is that there are huge divides still between social care and the NHS – not an easy fix; inadequate funding – CCGs are being asked to give two per cent of their budgeting to this cause and already cash is tight; there’s the political issue of who gets priority; and frankly, I don’t believe the initiative will fix the billions of pounds shortfall politicians are speaking of.
  • July – When you don’t know the way ahead, ask a care worker on the frontline. Well, at least that seemed exactly what the government was doing. Care minister Norman Lamb called for everyone in the care mix – service users, carers, managers and directors to submit ideas on how to make the home care system work.
  • August came with more agendas on the Care Bill, this time with a Prevention Matters initiative where investment into first-line social care was being sought as a way of saving NHS treatment costs.
  • Author Sir Terry Pratchet was in the news in September after going public with an update about his particular dementia condition and a memory lane street created at care home near Bristol. Great if you can afford this kind of therapy.
  • October saw headlines stating there was a RGN crisis in nursing homes. Burt there was joy for the National Care Homes Open Day with 2,500 care providers taking part.
  • Also in this month Health Secretary Jeremy Hunt found the solution to an ageing population and poor funding: Adopt the Asian culture in caring. The British way was deeply flawed, he maintained, so we must look overseas for sustainable answers. Hmmm . . . I’ve been privileged to travel a lot and what has struck me most in these cultures is the poverty, sickness, neglect and chronic conditions.
  • November saw The Work Foundation suggest that social care apprenticeships could “strengthen the pipeline for future talent.” The flouting of the minimum wage law was also highlighted this month with investigations by Her Majesty’s Revenue and Customs finding that of the completed 183 investigations, 48 per cent of employers had paid workers below the national minimum wage, set at £6.31 for adults. And so to December: It’s still Bah, humbug! Over funding from government but good will to the elderly from the young all over the country was in evidence. One very good piece of news in this month was Mr Cameron calling for an international summit to address the global problems of Alzheimer’s disease.

Care and support reforms: Help now online

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There are some things I don’t want to read because they’re often long, boring and complex. But, if I’m to carry out my job effectively, I have to grasp the nettle – over and over again, it seems – and catch up on the Government’s care and support reforms.

The Care Bill issues are both big and challenging, and the Local Government Association (LGA), Association of Directors of Adult Social Services (ADASS) and Department of Health (DH) are working in partnership to support local areas in implementation.

Like these useful bodies, the WMCA is also playing its part to roll out the reforms. I was thrilled to find extra help with this at a new monthly care bulletin – www.local.gov.uk/care-support-reform

Its aim is to provide leaders of local health and care systems and those delivering local health and care services with relevant and timely information about the process of implementing the care and support reforms, and the support, guidance and tools available.

It’s an invaluable time-saving service and I would strongly recommend using it to play ‘catch-up’. For me it saves hours of internet searches and of paperwork scavenging.

Policy delivery through people in the private care sector is hugely challenging at a time when there is little of no money to make it happen, so it will be interesting to see what support mechanics emerge in this service.

A joint Care and Support Reform Programme Board has been set up with representation from:

•ADASS

•Care Provider Alliance

•Care Quality Commission

•Homes and Communities Agency

•LGA

•National Skills Academy for Social Care

•National Institute for Clinical Excellence

•Skills for Care

•Social Care Institute for Excellence

•Local and central government.

Through the board, according to their media release, “the Care and Support Transformation Group and regional networks we will ensure co-production and engagement with all partners continues to happen at a national, regional and local level.”

The fine print of these aims is conjecture it seems but the targets are indeed laudable.

A National Care Association bulletin reports the group’s aims and I quote: ”The care and support reforms aim to improve the experience of people needing care and support. We are very aware that this programme joins an already challenging set of changes in health and are making great demands on health and wellbeing boards, local government and its partners.

“We intend to build on the work of local areas in transforming adult social care and integrating social care with health services. We will ensure the links between care and support reform and, for example, the Better Care Fund are clear and helpful.”

It goes on to commit to sharing tools of emerging practice, to offer support and urges people to subscribe to this bulletin by emailing carebillreform@local.gov.uk.

Good stuff indeed as we say goodbye to 2013. I can only hope this initiative has some good funding sources for 2014 as I’m sure they’ll need it.

Huge boost in numbers seeking residential care

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Christmas over and the reality of work dawns as we run into New Year . . . I always find this an odd time – sandwiched awkwardly between the celebrations of Christmas and New Year’s Eve, with so many people having to work but not yet recovered from their festive break, it’s a period that somehow has never really been defined.

Why is Christmas such hard work? And why do we need another holiday to recover from its madness?

Despite the seasonal hype, sadly there’s still plenty of gloom about if you wish to find it, but I’m all for a boost in spirits as the care sector embraces 1014. Goodness knows we need tonic.

The online newsletter put out by the National Care Association heralds January 1 with this heartening news: “Huge rise expected in the number of people looking for care homes after Christmas.”

Care home directory site carehome.co.uk, which helps people search for care homes in the UK, predicts nearly half a million extra people will visit its site in January looking for a care home. Wow – that’s an awful lot of potential new business and scarily, a huge amount of need.

I quote: ”Carehome.co.uk has seen a dramatic increase in traffic in January over the last three years, with an extra 395,868 visitors to the site in January 2013 and an extra 386,734 visitors in January 2012.

“It is often when families get together over the Christmas period that they realise their elderly relatives are no longer coping and need proper care – which could be one explanation for the spike in traffic to the site.”

Director of carehome.co.uk, Davina Ludlow, is reported saying: “Over recent years we have noticed a significant trend during January with a huge rise in the number of people searching for care homes after the Christmas period.

“We feel this increase is a reflection of how family members take positive steps in the New Year to assist their relatives.”

It’s clear that the spike in traffic demonstrates not only that older relatives are spending time with family during the festive period but also the increased need for residential care in the UK.

Being with elderly relatives at over a prolonged Christmastime provides a natural benchmark for measuring gains and losses and of course, the season becomes a time of reflection for those, as they say,  ‘of an age.’

Carehome.co.uk gets over 15m visitors to its site every year and is the leading online directory for care homes.

Elderly isolation: Meaning of Christmas needs to change

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Fact: A million older people live alone and some 500,000 spend Christmas Day alone.

It is a shameful indictment against society.

Fact: If we all did a little to change this we’d get a lot done.

But for many that would mean a change in their perception of what this festive season means

Fact: The Lennon-McCartney duo in their 1966 Eleanor Rigby begged a haunting question . . . All the lonely people, where do they all belong?

Some of us are still asking that question but I fear the numbers are getting smaller vas our family loves become more and more self-centred.

Fact: Investing into family at any time of the year is wholly good.

In a civilised society, however, I’m sure we’d all like to think that those who are left without family are embraced by a caring community.

Fact: In a survey by charity Friends of the Elderly, which asked about attitudes towards older people, found nearly one in four admitted they wouldn’t be including any elderly relatives, neighbours or community members in their seasonal celebrations and activities.  When asked what prevents them from visiting the elderly 44 per cent said that they don’t have enough time.

If we are to change what is around us, we too need to change and our vision become a little less introspective.

I applaud anyone who gives time to the elderly at Christmastime. Friends of the Elderly is not an in-your-face charity. My neighbours probably have never heard of them or their work.

Many older people will experience a cold Christmas this year; not only struggling to cope with escalating heating costs, fuel allowance but also by the absence of human company.

Friends of the Elderly aims to address the loneliness.

Volunteers will be phoning those spending Christmas alone, sending out cards and gifts and holding Christmas lunches and parties.

Our Supporting Friends service will be giving grants to community groups.

Everyone can make a difference. The meaning of Christmas for many of our elderly is very different to what it is to younger people today.

I’m not here to argue a theological point of the Christmas message – but part of its endearing spirit is “goodwill to all men,” a central pillar to the nativity narrative.

Perhaps we could raise our heads above the tinsel, feasting, presents and family commitments to focus on how we could possibly make Christmas brighter for the half million who will have only their own company on the 25th.

In the meantime, take a look at this video –  http://www.youtube.com/watch?v=6K4MPrp9FpI

Goodwill with young, but it’s ‘Bah, humbug!’ over funds

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A season of goodwill, Christmas still manages to bring out the very best in some people.

At a time when clearly funding for any kind of care for the elderly and marginalised is low priority, it’s heartening to see that all over the country young people are investing into the lives of those who are old.

The care industry is traditionally quiet on the policy front at Christmastime – that is unless there is something our coalition want to sneak through Parliament while we’re all busy networking good cheer.

I wanted to find something heartening to cheer the week so searching on Google I tapped in “elderly cheer.”

Bingo! Student gifts in Saltash, Cornwall, as part of a befriending service; Sixth formers carol singing at a residential home in Epsom; workers at a factory in Dundee handing our hampers at a retirement home, a school orchestra playing festive tunes and a sing-along in Portsmouth; Putney students on a Prince’s Trust Team Programme choosing to help the elderly for their community team challenge week; mince pie outings in Rippon and Thirsk; a works’ choir in fine voice for residents of an extra care scheme in Huntingdon; kids making 100 hampers to offer to Help the Aged in Kent; and the list goes on and on and on.

I am sure the same outpouring is found all over the country. Isn’t it such a shame that the same generosity of spirit cannot be found with those who hold the purse strings to caring at government level.

How silly of me: Of course it’s much more important to build HS2 at the cost of billions rather than invest into the biggest global issue of ageing we have ever seen.

I can only hope that some of these caring souls. who have given of their time and talents to bring some cheer to our elderly, will someday be the new movers and shakers in parliament. Perhaps they may remember their experiences this Christmas season and help redefine the priorities of funding need.

Less Bah Humbug! More goodwill, please.

CQC to target dementia care providers

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A ‘themed inspection’ of some 150 care homes and hospitals is to be carried out by the Care Quality Commission to see how people with dementia are cared for in England.

The idea is to find out what works well and what needs to improve on a national level.

The announcement came last week when Mr Cameron hosted a G8 summit in London on developing coordinated global action to prevent, delay and effectively treat the condition.

A staggering 670,000 people in England are estimated to have dementia and the number is expected to double over the next three decades.

David Behan, Chief Executive of the Care Quality Commission (CQC) said: “There is a real need to explore why people with dementia may not be receiving high quality care, as well as how the different services work together.

“This is the first time that CQC has undertaken a review, which specifically looks at the care service that people with dementia use and rely on.

“It will address the key issues that these people face, such as why admissions to hospital from care homes are higher for people who have dementia compared to those who do not have the condition.

“Our findings will draw conclusions on a national scale about what works well and where improvements are required.”

All of these inspections will be unannounced.

For every service inspected, CQC will publish a report detailing its judgments and any required improvements.

What I fond particularly encouraging about this initiative is they way CQC wants to hear from people with dementia, or the relatives and friends of those with the memory-loss condition. The access point can be found on CQC’s website or through Age UK, Dementia Action Alliance, Regional Voices, Dementia Advocacy Network and the Race Equality Foundation.

No doubt the bar will be set high and some of the finding damning. I can only hope that this inspection programme will be an added lever to get some proper government funding in place for both research and those who deliver the care at the sharp end.

Nearly half a million now missing out on state funding of care

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The term austerity has come to mean less care in a society that needs more than ever.

It’s a true but sad fact that almost half a million fewer old and disabled people are receiving care and support from the public purse than would have been the case before the financial rethink on priorities.

Doubtless the impending MPs’ vote on the care bill will make access to care even harder.

According to the Guardian: “Charities and care organisations are calling on ministers to address a ‘black hole’ in social care funding which they say has left the system short of £2.8bn a year that would be necessary to meet people’s needs assessed as ‘moderate’.”

The most recent damning figures on the analysis of the care sector come from the Personal Social Services Research Unit, based at the London School of Economics and the University of Kent, for the Care and Support Alliance, a coalition of 75 groups.

As they say in the Black Country, here’s the rub: The new study shows that since 2007-8 the number of older people and those with disabilities or mental health issues who receive state-funded care and support in England has slumped by 347,000 or more than a quarter.

“Adjusting the figures for population change over the period, the researchers calculate that this is equivalent to a drop of 483,000 on the number who would have received care services had five years of cuts not taken place,” the Guardian says.

And adjusted figures indicate that the number of mentally ill getting a service has fallen by almost half.

Just how long is it going to be before our politicians begin to address the fact that monies need to be redirected to more pressing issues?

We somehow always manage to find funds to get involved in nearly every global conflict, we’re happy to fund HS2 to the tune of billions and sometimes I feel we are the moral guardian of the world at whatever the cost.

In crippling financial times isn’t there a moral responsibility to care more for those whose needs are greatest?