By Debbie le Quesne

Archive for August 2014

NHS chief’s bombshell comment still causing care home waves

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 A number of weeks ago now, NHS chief executive Simon Stevens said he was looking forward to the demise of nursing homes,

The fallout from his “It would be a disappointment if in 30, 40, 50 years’ time, nursing homes still existed” is still ongoing.

I initially thought I would reserve judgment and his comment was so contemptuous it was not worth putting pen to paper so to speak.

Nursing homes, Mr Stevens? Really? So where do we put the chronically sick, elderly and frail? Who will care for them? The NHS? I think not.

There is a distinct difference between nursing and residential homes, though Mr Stevens was reported after he made the comment at an Age UK conference that had meant all care homes.

Like many, I’m left questioning that there perhaps is an agenda that has not yet been revealed. Whatever, Mr Stevens appears to possess knowledge the care industry is lacking.

It’s been noted in the media that he made the remark after a working trip to the US, where ‘nursing home’ is a generic term.

Maybe a slip of the tongue, but either way a disappointing one.

With the consultation period on the Care Act now complete, it will start taking effect from April. But there is still a chorus of concern that interpretation on some issues is unclear.

Mr Stevens’ comment – I suspect a deliberate bombshell – does nothing to – create the much-needed stable platform from which to launch such legislation.

Meanwhile, a joint submission by the Local Government Association and the Association of Directors of Adult Social Services is warning that the regulations, as they stand, appear to give local councils responsibility for accessing “medical services” when identifying people’s needs.

 Similarly, the associations point out, the regulations require councils to give people information and advice on available services including “effective treatment and support for health conditions”. As the submission states: “This suggests social care staff giving information and advice outside of their knowledge base.”

I can see the boundaries between social care and NHS becoming increasingly sticky ground. No doubt the legal arguments over wordings will emerge soon enough and with them a boatload of cash being sunk with the real winners being the lawyers.

Remembering the Fallen and honouring memories

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Some six million people from the UK took part and more than 700,000 of them died in the First World War.

On Monday night the lights across many of our cities went out to mark the moment when on August 4, 1914, Britain declared war on Germany.

Commemorations were led by the good and the great in churches and cathedrals, people turned lights out in their own homes and staged candlelit vigils, some posted their thoughts and prayers on social media, while others quietly reflected.

The Lights Out initiative was inspired by the words of wartime foreign secretary Sir Edward Grey. On the eve of war, he said: “The lamps are going out all over Europe; we shall not see them lit again in our life-time.”

There followed four years of conflict.

Care and nursing homes have also joined in marking this milestone in national history. For the elderly, perhaps more than most, recognising the sacrifices of not only the Great War, but other conflicts too, has a special significance. There is something hallowed in this kind of remembrance for our elderly.

The stories of outstanding bravery that have emerged on our TV screens have been touching with fiercely proud grandchildren telling of their grandfather’s exploits. And in our care homes too, the stories are still emerging and although poignant, many residents have thoroughly enjoyed the opportunity to discuss their thoughts and memories.

I am sure many of our care setting residents have stories to tell and homes throughout the country are staging many war-themed events.

Such events offer residents, their families and friends the chance to be part of this time of great importance and I’d love to know about them so we can post your thoughts and pictures on the WMCA blog and Facebook pages.

Please submit to Debbielequesne@gmail.com

CQC adviser with roots in the reality of care

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Beth Britton has had an unenviable journey to the very top of the caring business.

In just over a couple of years after writing her first blog on caring for her father who had vascular dementia, she’s now advising on the CQC special measures initiative for care homes.

I like this woman. She’s not an academic, was educated to GCSE level mostly at home because of bullying issues at school, and critically, has first hand -knowledge of care at the sharpest end of delivery.

You can find her talking about her father, who had vascular dementia for two years, on YouTube.

Now in demand as a writer, speaker and adviser, she was brought in by health secretary Jeremy Hunt to talk to the media about the Commission’s proposals for failing homes.

Her interview with the Guardian online is heartrending, as she describes her father Ray’s illness and what it meant to her.

After 10 years he suffered a major stroke, where in hospital, dementia was at last diagnosed and he went the first of three care homes. He spent spent most of the next eight years there, funded by the NHS.

She says that the first home delivered “good care, for what it was”, but it was unable to cope with her father’s behavior.

After a spell back in hospital, the second home “didn’t look much,” but staff were caring and competent.

Her interesting quote adds: “I always say to people: go with your gut instinct. Don’t go for something that looks like a hotel, or promises anything and everything. Go for something that feels right to you.” Good advice.

Sadly, that home went downhill with a succession of four owners. Ray ended up back in hospital after inhaling his own vomit.

Within three days, he was receiving what Beth says was “outstanding” palliative care in another home run by the Fremantle Trust, Ray died shortly after his 85th birthday,

It’s important to me that people like Beth should be the ones offering advice to the CQC. To use an expression ‘she’s got the T-shirt” for understanding care at its most critical points.

The mover and shakers need to be earthed in reality and I believe Beth and others like her have a lot to offer the industry. Let’s hope her voice is heard.

She is quick to acknowledge most of the care for her father was excellent, but clearly supports the idea of a special measures regime for struggling care providers.

She backs too, the idea for CCTV in residents’ rooms, but does not wish care homes to become “a police state’ environment.

Personally, I believe the use of cameras needs to be the very last step for monitoring quality and care delivery and should ideally be done on the guidance of police. Should anyone have any suspicions of poor care they should contact; managers, Local Authority Safeguarding, CQC or the Police immediately.