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By Debbie le Quesne

Archive for January 2017

‘Jet-in’ carers fly from Benidorm to UK amid care chaos

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I could hardly believe my eyes as I read the in the Telegraph that builders, barmaids and bankrupt businessmen are  flying into Britain from Spanish holiday spots to earn lucrative sums as care workers for the elderly.

What is going on?

A Telegraph investigation tells us that “thousands of expats are funding lifestyles in the sun by jetting in for fortnightly placements to take sole charge of the vulnerable, with, in many cases, “just a few days’ training.”

According to the story, British agencies are trawling popular resorts such as Benidorm and Malaga to lure new recruits with the promise of good earnings, free accommodation and subsidised travel.

And these travel carers are then supposed to give the most intimate of care to our elderly – virtual strangers doing shifts alongside residents with whom they have no real connection.

Figures being banded about, suggest earnings can be up to almost £1,700 a fortnight, with an alleged admission that many of those on their books “did not want to look after the vulnerable, but were driven by the cash.”

Our social care system is breaking down – a shortage of Government investment that’s matched by a growing shortage of workers.

Is this the latest symptom of chaos? Indeed, I believe it is, along with the widespread care home and dom-care service closures and record levels of bed-blocking in hospitals for want of social care packages being in place.

Caroline Abrahams, charity director at Age UK, is reported as saying the revelations were “yet another symptom of a crisis in social care” and I agree.

The Telegraph investigation reveals that “former builders, barmaids and taxi drivers are among thousands of expats flying back to Britain each month to be responsible for elderly people, those with dementia and learning difficulties.”

I am assaulted by a multitude of emotions at this news . . . I’m angry, frustrated, overwhelmed, but mostly sad.

Clearly driven by the downturn in the Spanish economy, we now have the added danger of casual carers – not to be confused by the many other foreign care workers who have chosen to make a career in caring in the UK.

It will be interesting to see what the CQC has to say about this latest trend, which according to the Telegraph is dodging regulation because some of the workers are self-employed.

Dr Sarah Wollaston, chairman of the Commons health select committee rightly says we need to “completely rethink the way we care for the vulnerable; we should be growing our own workforce, not relying on short-term stints from people flying in from overseas.”

I understand only too well the need to improve the supply of care workers, but this development worries me.

By 2020, a shortfall of more than 200,000 care workers is forecast in the UK.

For some, that’s a business opportunity, but if this is the emerging model we must stay vigilant.

Such a system raises obvious questions about consistency, accountability and care inquiry follow-ups – the regular dialogue between carers about patient needs and changes in condition.

I need chocolate, another coffee and the heater on my feet . . . all bad signs, I’m afraid, as a reach for crumbs of comfort.

  • Have you heard? This winter, the gaps in Britain’s stretched social care services have seen some of the most extreme measures on record.
  • Every NHS hospital has been ordered to cease most planned operations for a month until mid-January, in a desperate attempt to empty hospital beds, many of which are filled with pensioners for want of care packages at home.

 

Call to faith groups to take up dementia inclusion challenge

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It’s pretty clear to me that those endeavouring to meet the challenges of dementia care in the New Year will need all the help they can muster.

The statistics on predicted diagnosis are scary and so is the Government inertia to fund adequately this needy specialised sector.

Currently there are 800,000 people living with dementia in the UK and by 2025 there will be over one million.

For those living with dementia and their carers, this memory-loss condition can be extremely demanding, physically, emotionally and spiritually – a real test of love and faith.

I was heartened to read over the festive break of a new initiative by Livability and the Alzheimer’s Society aimed at establishing dementia-friendly churches.

Building Dementia-Friendly Church is a new guidelines for faith communities.

Developing a Dementia-Friendly Church is a practical and much-needed guide and is suitable for faith groups across any denomination. It represents an ongoing commitment by both organisations to make our communities more inclusive to those living with this problem, their carers and families.

With understanding and knowledge, properly equipped churches and other faith communities can offer a welcoming, inclusive and safe place.

And safe places are an essential cornerstone of dementia caring.

The guide describes what dementia is, its impact and explores the ways in which churches can offer support. It is suitable not only for faith communities which are considering becoming dementia friendly, but for those gatherings, where, by default, they have people with dementia attending.

For those about to embarked upon this route of faith-at-work expression, it makes essential reading.

Published to coincide with Dementia Awareness Week (May 15 – May 21), this comprehensive resource has drawn from consultations with focus groups, church leaders and congregations.

Following the guidance helps offer a lifeline to those living with dementia and enabling them to stay connected to their spiritual and community life.

Interesting, isn’t it, that dementia is not a disease; rather a term given to a group of symptoms from certain diseases which affect the brain. Alzheimer’s, however, is the most common cause of dementia.

My own life journey has seen the devastation dementia can bring, having nursed both parents.

A diagnosis of dementia is often devastating to the person concerned. Some other serious diseases offer hope of treatment success, however small, The symptoms of dementia are progressive and on an unknown time scale – it could be months or many years before the symptoms become advanced. The patient/carer journey needs to be a positive one and I strongly believe faith communities have a role to play.

Living in the present, doing the fun things now, which were planned for later in life, is a strategy which helps some cope with this condition. What a great idea for churches to recognise in a practical way that dementia patients are more than the ‘disease’. Heartening stuff for the New Year!

  • Livability is a major provider of disability services, partnering with churches and other local agencies in the delivery of care throughout the UK. It delivers training on shaping Dementia Friendly churches. More recently, they have raised understanding for mental health issues within the church through their partnerships with Mind and Soul and Greenbelt – the national arts and faith festival.
  • The Alzheimer’s Society is the UK’s leading dementia support and research charity for anyone affected by any form of dementia in England, Wales and Northern Ireland. They provide information and practical and emotional support to help people live well with dementia, and invest in world-class research with the ultimate goal of defeating it. Alzheimer’s Society also campaigns to improve public understanding of dementia and the devastating impact it can have, and make sure it’s taken seriously and acted on by our governments.

 

 

Dementia clients – the business challenge

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Last week I was asked to write an article for a business publication. Here we go . . .

Dementia is now the leading cause of death England and Wales, and is thought to affect more than 850,000 people in the UK.

Caring for them is one of the biggest headaches facing the NHS and social care and the economies of the task are hugely complex, with Government austerity measures effectively strangling the private sector’s preferred responses.

It’s a fact of life that the majority of care homes and home care providers clients and residents will now have degrees of dementia. Integrity may cost a much-needed placement/client, but we must accept the limits of provision in place. Factoring in the necessary fee to be Commission-compliant with dementia takes carefully assessed scrutiny.

It is, therefore, paramount we get our business reaction right – embracing dementia clients can have profound ramifications on existing business models and understanding dementia is a steep learning curve

We need to be educators and ambassadors, be clear on the impact of the severity of dementia with which we’re dealing and the potential impact on our residential homes or domiciliary businesses. Also, families and Local Authority Brokerage have no idea why this specialised care so costly. Again, be clear and avoid the aggravation of unpaid invoices.

To run a successful business you need to consider, one or all of the following;

Possible collateral damage to the building:

Apart from the work needed to get the building dementia friendly, you will need to have a much more exhaustive maintenance plan to ensure standards are preserved and this element needs to be included in costs.

Additional staffing:

Staffing numbers need to reflect the extra support and extended hands-on care time required. There needs to be enough personnel to allow for breaks, as dementia care can be hugely stressful. Many individuals with the memory-loss condition have irregular sleep patterns and will require one-to-one companionship/conversation and feeding. Ensure that the maths stack up on staffing costs.

Secure buildings and safe gardens:

People with dementia need to be able to move round the building and grounds without constant supervision. To have sensory stimulants – things they can touch, feel and smell to help enrich their lives.

Additional staff training:

All staff, who work in the care Industry need and understanding of dementia, but senior staff and owners need a more in-depth knowledge so that they can competently tackle issues as they arise, be able to stand their ground with professionals and safeguarding, and engage innovative and very person-sensitive ideas. You will also need additional cleaning hours to keep the home/building up to standard.

Irregular dietary requirements:

Food needs to be provided when it’s required and in a format that people with dementia can access.

 Extended record keeping:

If you are trying different ways to support an individual, you will need to ensure that everything you try is recorded to show it is in their best interest. You should also try to engage family and friends and record their comments. An understanding of additional care support mechanisms, such as professional groups and representative bodies and dementia cafes are useful.

Hospital escorting policy:

You will need a clear escort policy budgeted carefully into the business plan. For instance, do you send a member of staff to all external appointments; emergency A&E visits; what’s the policy on appointments that require an extended stay beyond normal shift patterns; do you charge the family for one or all such accompanying trips as this is not included in the Local Authority fees; and do you have enough skilled staff to do this kind of care?

Tailored activities:

Traditional group activities are not ideal for many people with dementia, so you will need to have capacity for one-to-one initiatives and ensure all staff can engage with residents as they care for them. This is particularly vital in the stretched Home Care Market.

As care providers we need to clearly grasp the reality that symptoms of dementia are progressive and on an unknown time scale. Being fiscally cute and planning responsibly for such a capricious condition is immensely problematic, but it’s one that must be addressed. We need to ensure that there is a vibrant dementia market for the future and we can only do that if we are resolute in the knowledge of provision.

Visit carefitforvips.co.uk for help on person-centred dementia care, a site the Association recommends for its members.

 

As the Red Cross intervene with the NHS, what will it take force a social care lifeline?

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The other Saturday I watched the television news with a stunned sense of disbelief as the chief executive of the British Red Cross announced the NHS was in the middle of a “humanitarian crisis”.

I’d never thought of the Red Cross intervening in UK affairs in such a way – don’t the images of this worthy, brave orgaisation invade our news from far flung places where there’s famine and the ravages of conflict? Not any more it seems.

To hear its top man, Mike Adamson, explaining exactly what defines a humanitarian crisis and that it’s is now in England, stopped me in my tracks.

His definition was along the lines of . . .

“It affects many people over a prolonged period of time, something of threat to their health or wellbeing. Just think about the situation of someone, for example, waiting on a trolley in and A&E department for several hours, perhaps with no family around them after a fall, probably quite frightened. . . .”

The warning came as it emerged two patients died in the same A&E department within a week during “extremely busy” periods.

In December A&E department shut their doors 140 times and now cancer ops are being cancelled, I read in the newspapers.

Mr Adamson added extra cash was needed for health and social care to make the system sustainable.

What was that? Extra cash for social care. Indeed!

Sadly, at the root of the NHS crisis is a failing social care . . . and we have warned for years that it was terribly broken. They would not listen, and I’m not convinced they are listening now.

The official response from the NHS is predictable: What crisis? And this still remains the official line.

I find it odd that hospitals like Russells Hall, Dudley, is allegedly paying a company to try to help sort out their funding, either by pressurising care homes to drop their fees, or getting patients’ families to become fiscally involved. Surely this could never catch on after the government’s stalled attempt to get the public to invest in care insurance policies. The elephant in the room, of course, is a properly functioning social care system. Everyone knows it. The government, however, steadfastly refuses to acknowledge it.

Mr Adamson explained: “The British Red Cross is on the front line, responding to the humanitarian crisis in our hospital and ambulance services across the country.

“We have been called in to support the NHS and help get people home from hospital and free up much needed beds.” Called in by whom? I suspect the Department of Health.

Shadow health secretary Jonathan Ashworth said it was “staggering” that the Red Cross had been drafted in to help. I think so too, though I would add that his Government did precious little to grasp the nettle of social care during its term.

Of course, there’s much politicking to be had over this development in the care saga so we need to focus on facts.

Just about a year ago bed blocking was costing the NHS about £820 million per year.

Last summer the National Audit Office said delays in discharging patients from hospitals in England had risen by nearly a third over two years. Delayed transfers (bed blocking) have not improved and there’s a resigned approach that’s punching through that deeply disturbs me.

Across England, the audit office found that for every 100 beds, three days of use were taken by patients who no longer needed to be in hospital between March 2015 and February 2016.

Quite what 2017 analytics will deliver terrifies me, because it is in direct correlation to the ability of social care to unblock beds – something it can no longer do. And we all know the reasons why.

The question now is this: Exactly what will it take for the Government to intervene? Will it deliver the much-needed financial lifeline to social care, which could not only rescue struggling care providers, but also our hospitals and . . . dare I say, those people who need either one or both of those services,