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By Debbie le Quesne

Archive for July 2016

Exceptional success at the double for care workers

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Brum care awards

Above: Nicholas Nolan and Cherry Harvey, centre, with ITV weather presenter Emma Jesson, left, and Jag Khatkar

 

Many of us in the care sector recently attended a glittering evening to celebrate the best of caring at the Edgbaston Cricket Ground. It was a great night that celebrated excellence in care and a night I was pleased for West Midlands Care Association to be part of.

Out of that event, one story has been prominent in my mind. Two newcomers to the care sector were honoured with an industry award for their outstanding commitment to the job after judges failed to decide on a clear winner.

The selection panel was so impressed with the nominations for support worker Cherry Harvey and community carer Nicolas Nolan it decided they both deserved the Exceptional Newcomer’s Award. The couple were shortlisted from hundreds of entrant across the city for the Birmingham Care Awards.

Support worker Cherry, who is part of the Precious Homes’ Kings Heath team in Birmingham, had no idea she had been nominated and was thrilled when her name was called out.

Judges commended Cherry’s dedication, commitment, compassion and loyalty, specifically in a first-time role within the care sector.

The awards ceremony was a joint venture between Birmingham City Council, West Midlands Care Association, Skills for Care and the Care Consortium. A regional event, its aim was to celebrate and reward excellence in social care.

Joint winner Nicolas, a community worker with Trident Reach The People’s Charity, caught the judges’ attention for his “rapid learning ability and willingness to better himself.”

With no previous domiciliary care experience, he joined Trident’s Birmingham Home Care team based on Hagley Road, Edgbaston, in January.

Already he handles a customer base of varying needs, working alongside people with learning disabilities, mental health issues and the physically disabled.

His award nomination said: “Nicholas’s understanding of all his customer needs and the nature of how domiciliary care services work is highly admirable, given he started with no care experience. He is a valuable member of the service who is always willing to help customers achieve, always puts customers first and applies a personalised approach to every customer he works with.”

This pair represent everything what good care is about and I thoroughly endorse the decision that both have been declared winners. Birmingham Care Awards is about celebrating care excellence.

They are the kind of role models the industry needs and proof that quality care is out there, valued and right on our doorstep.

 

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We need a break before we are broken: Message from carers to the Government

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Is it a sign of age that when one reads deeply touching accounts of caring, tears fall unbidden?

I’ve been catching up on last month’s Carers’ Week reading some accounts on the online version of The Guardian of how looking after a loved-one can be both hugely rewarding and devastating mentally and physically.

And then of course, there’s the financial challenge of it all.

And the economic difficulties look set to get worse, well at least if the forecast by the Carers’ UK study is correct. Changes in the benefits system will mean they face £1 billion of cuts over the next four years, according to the year-long investigation.

Those who care for someone for 35 hours or more each week are currently eligible to a weekly allowance of £62.10.

As part of Carers’ Week, The Guardian asked for people’s experiences, about the help available for those looking after a loved-one – and how the Government could do more.

 

Quote from Anonymous, aged 60, of London: “The monthly carers’ group meeting is good, but this is the only support available.”

Caring for someone with mental health problems is very stressful. I have a son with bipolar and autism, and husband with bipolar, she writes.

Any crisis at the weekend or on holiday inevitably means a trip to accident and emergency (A&E) “because the community service teams are not available.”

She adds that “getting home help is impossible as services are so overstretched.” and “the A&E duty psych team cannot prescribe drugs, so if strong sedatives are needed then hospital admittance is the only option.”

Patients and carers have to wait at A&E until a bed can be found:, she writes and “last year we waited there for 26 hours until a bed became available 60 miles away.”

“Providing the resources needed for home assessment and treatment would surely cost less than waiting for a crisis and hospitalisation, and I think maybe people get better faster at home,” she says.

Significantly it’s the care support group that wins praise. “The monthly carers’ group meeting is good, but this is the only support available in the evening; those of us trying to hold down jobs can’t access support resources offered during the day. Respite provision is non-existent.”

Anonymous, aged 47, north Somerset, writes:

Carers need a break before they become broken. Carers need support before they become ill themselves. Words and promises need to be translated into action and money.

Indeed they do.

Her plea seems nothing but reasonable: “I care for my three adult children, all on the autistic spectrum and with various mental health and learning disabilities. I have no support. My life would be made easier simply if I could have one day or night off a month, or if I didn’t have to shoulder all the responsibility and worry of applying for benefits.

“At the moment carers don’t have time for their own health.”

 

Jo Walton, aged 60, from Leeds, appears to have tremendous insight.

 

“I care for my daughter who is terminally ill with a neurological condition that has left her totally dependent,” she writes.

“She has been like this since 2004 and I first reduced my hours at work then took early retirement because it is impossible to carry on a responsible career when you do not know whether your carers will turn up for their shifts,” she adds.

His hopes for the future . . .”The issues for unpaid carers will not improve until we ensure that the status of paid carers is improved. They need to be properly paid, properly trained and given job security and progression – then maybe they will stay and the informal carers can get some of their lives back.”

I believe she is right.

David Blamires, aged 47, of North Yorkshire is “on duty 168 hours per week” and asks: “Take me off benefits and pay me minimum wage for the hours I work (approximately 130 per week). This would have three advantages – it would reduce the benefits bill, you could tax me, and it would improve people’s attitude towards carers. Currently we are perceived as scroungers.”

He continues: “I care for my autistic daughter and my disabled wife. What support do I get? I might get a grant of £250. There is no actual support available for me . . .

“Men under the age of 65 who are carers are in such a minority that they are ignored.”

Linda Curran, aged 64, of Essex, says the main challenge is stress.

This is her story: ”I am no longer a carer but I did care for my mum who has now sadly passed away. At the time I did not see myself as a carer and therefore did not seek help or support and I was also not made aware of any support being available.

“I coped because I felt I had no option other than to be nursing my mum with my brother as she went through the stages of breast cancer.

“Our lives and my mum’s quality of life could have been very different had we been informed or offered practical and financial support. The main challenge of being a carer is the stress experienced and the time spent looking after a loved one.

“This does not enable a carer to have a moment to even think of seeking help. There is also a guilt experienced if you’re not coping and considering asking for help outside of a family.

I am aware of several people currently caring for loved ones and none of them recognise themselves as carers. They simply see what they are doing as caring for their partner or family member.

“Health and social care services need to actively provide much more information to carers, especially those that seem to be managing OK. It should be assumed that they will require support advice and counselling at some point and this should be regularly offered and available. It may avoid burnout and stress-related health issues.”

Rob Gershon, aged 43, of Hampshire, believes that so many government policies make being a carer much harder.

He writes: “My message to government is please stop being so slapdash about which welfare reforms affect carers based on what you think you can get away with. It is disingenuous to suggest you support what we do, when so many of your policies make an already difficult job much harder. Cuts to local authority budgets, and welfare reforms, hurt those we care for, and us, too.

“Return the threshold for carer’s allowance back to the value of 16 hours of part-time work. The introduction of the national living wage has once again meant that carers who work 16 hours part-time to support their income, mental health and sense of self, are once more ineligible for carer’s allowance.

“Caring is often personified as being rewarding, but the long list of pressures it can bring (physical, psychological and emotional), can join forces in very destructive ways. Self-doubt, isolation, and the institutionalised devaluing of what we do through welfare cuts and being bracketed into ‘worklessness’ statistics all take their toll.”

Oh my life. Just writing this is crippling. I feel I should fix it . .I’ve worked in the care sector nearly all my life, know the right people and hopefully, with others, influence change for the better.

I suddenly feel overwhelmed.

Written by debbielq

July 4, 2016 at 12:18 pm

Posted in Carers' Week, Uncategorized

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Investment opportunity: Is this the ultimate care ‘spin’?

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In my job you get used to ‘spin’ . . . the way the truth is massaged to sound much more palatable than it really is.

But Jeremy Hunt’s comment on Britain’s care time bomb as ‘one of the biggest commercial opportunities’ for private firms, is frankly, priceless.

The Health Secretary made the eyebrow-raising remarks a few weeks ago as he was grilled by MPs on the influential Health Select Committee.

Let me quote the report that appeared in the Mirror online: “If there are people who are exiting the market because they don’t like the much greater scrutiny over standards of care, then that’s their choice – but I think it’s the right thing for us as a society.

“At the same time I would also say that in many parts of the world businesses, because many of these organisations are private businesses, are looking at the ageing population as one of the biggest commercial opportunities.

“Because this is an area that all of us are going to spend much more money on as time goes on, both for our own care and those of our loved ones.

“So it’s important not to take a short-sighted approach as to the opportunities in that market.

“This is a section of the economy going forward where were are going to be spending more and more money, both publicly and privately.”

Escalating costs, unresolved funding issues, care companies upping sticks, society’s most vulnerable at risk . . . and this is an “opportunity”?

Oh, and according to the Mirror, the Government had already taken the National Living Wage into account when doing its sums. My head’s spinning . . .

 

Now docs say bring forward the £700m Better Care Fund monies

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Fourteen doctors’ leaders have written to George Osborne asking for further funding for social care in next week’s Budget, the BBC has reported.

In a letter to the chancellor, they warn cuts in social care funding were putting real pressure on the NHS.

And they said investing in social care was “vital to the success of the NHS”. Err . . . yes.

The government response in the BBC report was that it was already giving local authorities access to up to £3.5bn of new funding for adult social care by 2019-20. By when? Far too late, I’m afraid.

The signatories to the letter are led by Clare Marx, president of the Royal College of Surgeons of England, and include the leaders of a number of royal medical colleges and societies.

In their letter to the Chancellor, they describe health and social care as “two sides of the same coin”.

It’s heartening that the letter describes the impact of an underfunded social care system on the NHS, saying patients fit to be discharged are unable to leave hospital because social support is unavailable at home. How long has the Association been saying this?

“This increases the likelihood of infections and falls,” the letter says.

The knock-on effect is that beds are blocked to new patients, they continue, “leading to cancelled appointments and operations”.

“This impacts on our ability to provide timely treatment and meet treatment targets, risking patient wellbeing, and is ultimately detrimental to the economy through delayed returns to work,” they wrote.

And here’s the bit I just love. In the letter, the doctors suggest bringing forward the extra £700m from the Better Care Fund to this year rather than waiting until 2017, when the money was due to be spread over three years.

NHS chief executive Simon Stevens has previously said that the success of the Five Year Forward View is dependent on adequate funding for social care.

 

The signatories to the letter are:

Miss Clare Marx, president of the Royal College of Surgeons of England

Prof Dame Sue Bailey, chairwoman of the Academy of Medical Royal Colleges

Prof John Ashton, president of the Faculty of Public Health

Dr Anna Batchelor, dean of the Faculty of Intensive Care Medicine

Dr Liam Brennan, president of the Royal College of Anaesthetists

Prof Jane Dacre, president of the Royal College of Physicians

Mr Michael Lavelle-Jones, president of the Royal College of Surgeons of Edinburgh

Dr Suzy Lishman, president of the Royal College of Pathologists

Prof Carrie MacEwen, president of the Royal College of Ophthalmologists

Dr Giles Maskell, president of the Royal College of Radiologists

Prof Neena Modi, president of the Royal College of Paediatrics and Child Health

Prof David Oliver, president of the British Geriatrics Society

Dr David Richmond, president of the Royal College of Obstetricians and Gynaecologists

Prof Sir Simon Wessely, president of the Royal College of Psychiatrists

Note: If this letter was on social media, I’d be adding my name to the list . . .

 

Still waiting for the Care Act to deliver

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I was reminded that it’s been more than a year since the Care Act was implemented. Last month saw the milestone pass by quietly . . . except for a report by industry big-player accountants KPMG, who offer advisory analytics to the care sector.

The paper, entitled “Reimagine Local Government – Time for the Care Act to Deliver, pulls no punches and is a timely wake-up call.

KPMG Director, Andrew Webster, outlined the promise of a better future in a Guardian article. He wrote: “It is now more than 12 months since the implementation of the Care Act, a legislative success many years in the making.

“The act spoke of fair and equal access to support services, vibrant and diverse care provider markets and of people having information about how and when to access services. It was to be a fundamental change in the foundations of social care.

In the run up to its implementation, local councils focused on what the act would mean for them. Directors and professional leaders sought to ensure their colleagues understood how services would need to change and momentum built behind the changes.”

But something seems to have gone wrong. In his words there is a “real risk this momentum has stalled.”

Significantly, he writes: “Instead of surveying a diverse care market, we read headlines about providers considering an exit from the sector.

“Council websites are filled with pages about getting recycling bins or parking permits, but little about how to have a grab rail installed so you can stay in your home safely. For now, the vision of the Care Act largely feels just that: a vision rather than a reality.”

He adds: ”The idea of councils as responsive organisations, guiding people to the best care, is the correct one. It is not only right for the wellbeing of our population, it is right in today’s financially constrained public sector.

“Fewer resources are forcing councils to consider making more radical changes to care, in the same way as they have already changed other services.”

He advises: “Councils should strike a new deal with local people, making it clear both sides have a responsibility to maintain independence and wellbeing. That means everyone acting quickly when long-term care starts to be needed. People have to raise the issue before reaching the point where they need care at home, and councils need to respond with accurate advice about local services.”

With a call that councils should raise their digital game to get simple, but still put comprehensive information ‘out there’ on social care, he acknowledges “all of this costs money.”

Added into his mix is a suggestion that all major local care providers should be brought together into one room; “not to drive prices even lower but to work out how to help providers thrive, support new services coming to market and create a digital platform offering access to these new services.”

These initiatives would then be supported by councils investing in training for specific staff groups, building investment in health technology into their economic growth plan, or working with schools to develop better ways to keep young people healthy.

The possible “foundation of the new era promised by the Care Act?”

Great ideas, but I suspect currently out of reach for too many people. One of the major problems we have as an Association is persuading people outside of our membership to talk to us and each other.

What a difference that would make. Not perfect, but a start . . .

Written by debbielq

July 4, 2016 at 11:54 am

Crumbs of comfort welcome, but the problem is still not fixed    

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I have concluded that a good barometer for the condition of the care sector can be the number of reports that land on my desk and the time I DON’T have to read newspapers.

Thank goodness for online material where I can catch up.

I picked up on piece by Paul Burstow in the Guardian where the former Minister of Sate for Care Services was reminding us what Jeremy Hunt, the Secretary of State for Health, told a local government audience.

It went along the lines that families should take more responsibility of caring for the loved-ones. Hunt then called for a national debate about caring for the elderly.

The comment at Local Government Association’s conference rattled more than a few boxes.

It’s easy to see why in the recent Carers UK State of Caring report which outlines the huge price that is paid, physically, psychologically and financially

What will happen to those without children? Ageing Without Children highlighted that as many as one in five over 50 have not had children.

Burstow, who I met in London at the Care Alliance meeting, poses the question: Will there be enough good quality care to support those without families in their old age? Will it meet their needs and lifestyles?

He goes on to write that there are fears that “a major provider the care home sector” will collapse, reasserting the gloom-laden forecast he made earlier in the year. Let’s not go there.

Certainly the news – especially for providers aligned to the West Midlands Care Association – has been bleak.

Perhaps one of the most telling bits of news was from Radio 4’s You and Yours programme where it was stated that around 5,600 care homes could go bust within three years. That’s one in four.

With other care providers, associations and representatives, we have lobbied the Department of Health about the continued squeeze on fees and delivered strong messages about the implications of the living wage.

In practical terms the only monies that have been generated are from the introduction of the adult social care precept, but in many areas it’s balancing the books for a previous year’s provision.

Let me quote Burstow’s piece, published at the end of May: “The trouble is that the precept yields its best returns in the areas where the care home market is more buoyant because of the higher rates of occupancy by self-funders. Those areas most dependent on the precept will raise the least and still be dependent on state funding.”

In fairness, Burstow does temper the misery with a heartening story about registered manager Blesson Thomas, who steered a care home to an outstanding CQC rating.

Key to the success was his approach to his staff, setting up career paths, and allowing them opportunity to showcase talents. As Burstow puts it, Thomas unleashed the potential in the care workforce.

We take comfort in every success story, but as Burstow rightly points out the Government still needs to find a plan that will work for the sector.

 

Written by debbielq

July 4, 2016 at 11:51 am

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Smart thinking, but ‘care bots’ can’t replace carers

Creating the ideal home is big business – in fact there’s a world stage out there for exhibitions that can both temp and puzzle. From the practical to the bizarre the evolution to help make us more efficient is rolling out rapidly.

In the home of tomorrow our front doors will be able to ‘talk’ to your smoke alarm, lights will flash when the fridge door is left open and, according to reports emerging from the Mobile World Congress in Barcelona, Teddy will put your child to bed.

Other features include at smart lock that unlocks the front door when the home owner is near, televisions that show notifications and can warn when a child is using the web when they should be asleep, and a system that lets you change all the clocks in your home at the touch of a button.

The vision of the future is restrained only by our imagination.

But this model, that’s also invading the care sector, is not without some serious pitfalls, as reported in the Telegraph online by Science Editor Sarah Knapton.

Last month’s article said these so-called ‘care-bots’ are “emotionally dangerous”. The warning comes from an artificial intelligence boffin Maggie Boden, professor of Cognitive Science at the University of Sussex.

She warned that machines would never be able to understand abstract ideas such as loyalty or hurt – essential in responding compassionately to those needing care.

“Computer companions worry me very much,” Prof Boden was reported as saying.

I understand her concerns, but one does not have to be a professor to comprehend that the elderly really do need real people to respond to their needs.

I read that last December the University of Singapore introduced “Nadine” the ‘care bot’, who, according to its manufacturers, will eventually provide childcare and offer friendship to lonely pensioners.

For those who know the care business well, loyalty from careers to their patients is something that is hugely appreciated by those receiving and those managing care. All excellent care on a personal level will have loyalty as a cornerstone.

I really don’t think ‘care bots’ can replicate that just yet, and even if they could, would I want to confide in a machine? Of course not.

Technology has its place and, fortunately I’m not one of those afraid of it. Telecare is a prime example where technology in the care sector can be helpful. It has been designed for people with social care needs and allows the remote monitoring of an individual’s condition or lifestyle. It aims to manage the risks of independent living and can include automatic movement sensors, falls sensors, and bed occupancy sensors.

But computer companions are very different. The simple act of sharing a cup of tea or listening to an elderly persons’s story can never be replicated by ‘bot’ science – well, at least not yet. Humans not only respond (we’re aware computers can do this too), but can respond in an appropriate emotional way (and it’s where, critically, the care-bots fail).

Smart technological thinking can help with being creative on stretched budgets, but even with all our faults, cannot replace that which makes us quintessentially human.

A robotic revolution to replace carers . . . Not on my watch.