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By Debbie le Quesne

Archive for the ‘Alzheimer’s’ Category

CQC: More companies are pulling out of contracts with councils

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Private sector care providers are ditching home care services, the Care Quality Commission (CQC) says.

And the regulator adds companies are pulling out of contracts with councils as they are no longer ‘profitable.’ A national trend, it’s now happening across the West Midlands, but the real crunch will come in April when we see the next increment in the National Living Wage.

According to the Commission the crisis in social care funding means authorities can only afford to pay firms very low rates.

How long has West Midlands Care Association been warning this will happen? Err, years.

David Behan, chief executive of the CQC, was reported in the media as saying several major companies, including Care UK, had pulled out of local home care contracts.

Giving evidence to MPs at the Health Select Committee, he said firms were unable to ‘deliver the quality of care and the volumes of care at the price being offered’.

Association of Directors of Adult Social Services figures show that 57 per cent of councils have reported home care businesses giving up their contracts in the past six months.

The research estimates that this had involved 10,800 elderly and vulnerable residents.

Some 400,000 people in the UK receive council-funded home care.

Quote: “Mr Behan told MPs that companies were ‘leaving the market’ and replacements were ‘not coming in.’ The vast majority of contracts handed back in our experience have been domiciliary care contracts where providers are saying:

‘We can’t deliver the quality of care and the volumes of care at the price being offered.’

The news has drawn comment from Caroline Abrahams, Charity Director at Age UK, who says ‘It’s worrying to hear that some care providers are giving up trying to make existing contracts work as their costs rise but funding fails to keep pace, and if these organisations are losing confidence in the sustainability of the care sector how on earth are older people and their families supposed to put their trust in it?’

Significantly she adds: ‘No care provider would ever walk away unless they felt they had no choice and the fact some are now doing so says a lot about the parlous state of the market at present.’

Very true. Austerity measures have had a catastrophic effect on care and ultimately the economies of council-funded packages don’t stack up with the inevitable failure to release bed-blocking at hospitals.

Estimates suggest that the number of those aged 85 and over will have almost doubled by 2030.

 

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Snapshot on social care: Could it get any worse?

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Following the collapse of Southern Cross in 2011, we all though it couldn’t get much worse. The then UK’s biggest care home operator was in utter shambles and the lives of residents in turmoil.

No other big players have folded to date, but smaller firms aplenty are failing across the country. And there’s evidence too of major players in the region feeling economically uncomfortable . . . Four Season have closed in Birmingham and HC one have sold many of their Midland Homes.

The Guardian revealed last year a staggering 380 care homes have been declared insolvent since 2010 (Insolvency Service figures).

The number of failures each year has risen sharply since 2010, when 32 businesses failed. In 2015, 74 were declared insolvent, while another 34 failed in the first six months of 2016.

Large companies are also hurting. Four Seasons, the biggest care home operator in the country with more than 400 properties, is the most at risk, recording a pre-tax loss of £28m in the three months to the end of September 2016, the Guardian announced.

Robbie Barr, the chairman of Four Seasons, warns the industry is “struggling at tipping point” with the company juggling its own challenges.

On the issue of increased council taxes, he says it’s essential that councils use the powers they have been given to raise the social care precept and pass it on to frontline elderly social care services to help offset the additional costs of the national living wage increase and avoid further pressures on a sector.

The national living wage is scheduled to rise by 4.2% in April to £7.50, which is larger than the proposed 3% increase in council tax.

The Local Government Association estimates there will be a £2.6bn funding gap in adult social care by 2020.

A study by the Health Foundation, the King’s Fund and Nuffield Trust estimate the gap would be £1.9bn this year.

The LGA, reported: “The care provider market cannot carry on as it is and there is a real danger of more widespread market failure.”

And CQC . . . the industry regulator warned that adult social care is “approaching a tipping point”.

 

Time for a holiday, or more chocolate biscuits, please. . .

Crisis care letter follow-up swamped by Trump headlines

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I see the Select Committee chairs have sent a frank letter to Theresa May urging action to tackle the social care crisis. Their biggest fear, it appears, is that the Brexit circus will crowd out ‘domestic policy.’

Not a chance, I say.

There’s only one headline maker out there at the moment and that’s the Prime Minister’s new American ‘friend’, Donald Trump.

I can recall my seniors shouting at the television, offering running commentary on everything from the news and football referee decisions to the latest saga with long-departed Ena Sharples of Coronation Street.

This weekend I was almost doing the same as Trump seemed to fill every waking hour of newsfeed time. Of course, I’m not decrying that his game-changer on the world stage is not newsworthy, but . . . on home soil the critical nature of the social/NHS care latest seems to have fallen below the radar.

Mrs May must still be under a deal of pressure over the correspondence from three of the most influential Commons select committees urging her to seek a rapid cross-party consensus on the “immense challenge” of paying for health and social care in the future.

But the media frenzy has now a new focus and she must be secretly breathing a sigh of relief – albeit for a just a little while.

The letter – sent jointly by the Conservative MP Sarah Wollaston, of the health committee, Labour MP Meg Hillier, of the public accounts committee and Clive Betts, also a Labour MP, of the communities and local government committee, highlights fears that pressing issues at home are being put on the back burner.

“We are calling for a new political consensus to take this forward,” the letter reads (Guardian). “This needs to be done swiftly so that agreement can be reflected in the next spending round.”

The MPs maintain that any review should target both the health and social care systems, warning that separation of the two is “creating difficulties for individuals and avoidable barriers and inefficiencies”.

Not surprisingly, Mrs May was accused of failing to grasp the scale of the challenge, after the chancellor Philip Hammond ignored the care sector in his autumn statement last November.

And then of course, we had the announcement from Downing Street that local authorities would be able to increase taxers to sort out short-term needs. Bit of a knee-jerk response to associations like mine, I suspect.

The political consensus appears to put the blame for everything at the Brexit door. As the Guardian reported: “The intellectual energy will go into Brexit, the most ambitious civil servants will want to be in the Brexit departments; it will just be the focus of everything.”

The letter concludes: “In short, the problem is widely recognised – we now need political agreement so that a solution for the long term can be found. For our part we shall do what we can to contribute to a consensus. We look forward to hearing from you.”

Backing for the letter has come from The King’s Fund and the Local Government Association.

Dementia clients – the business challenge

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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

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.

 

Written by debbielq

January 18, 2017 at 7:51 am

Angela Rippon gets CBE for services to dementia care

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Angela Rippon, who made national headlines last year by going public that she’d made provision in her will incase she fell victim to dementia, has been awarded the CBE for her work with the Alzheimer’s Society.

Angela was inspired to help the 850,000 people living with dementia in the UK by her own experiences caring for her mother Edna, who was diagnosed with dementia in 2004 and died in 2009.

The broadcaster, journalist and presenter is a dedicated supporter of Alzheimer’s Society and became an official Ambassador of the charity in 2009.

The former BBC newsreader co-chairs The Prime Minister’s Champion Group on Dementia Friendly Communities, alongside Alzheimer’s Society Chief Executive Jeremy Hughes.

I met Angela when she came to Wolverhampton to deliver a Dementia Friendly City talk. She has put her whole being into the dementia cause and passionately wants to help make life easier for those diagnosed.

The work of the Champion group has seen almost 220 Dementia Friendly communities established across the nation and Dudley has been in the vanguard of this great initiative.

The recent 2016 Dementia Friendly Awards, which Angela hosted, showcased the outstanding achievements of the work – ranging from the airport industry improving travel for people with dementia to Dementia Friendly football clubs helping football fans with dementia continue to enjoy their favourite past-time.

Angela has also backed Alzheimer’s Society’s Memory Walk campaign and supported the Counting the Cost project, which aimed to improve the quality of care for people with dementia on hospital wards.

There is nothing I can say about the great work she has already done that has not been said by others. But I would like to add my thanks and I do understand her motivation, having cared for both of my parents who suffered the memory-loss condition.

Undoubtedly she has made a difference. As the dementia issues escalate in society, I’m sure it won’t be that long before we all know someone who has been touched by this challenging condition. I’d like to think we can all do just a little to help this great work.

Volunteers, funding, acts of compassion and kindness . . . the creative expressions of caring are limited only by our own imaginations.

Also in the New Year honours was Care Quality Commission chief David Behan, who was awarded the CBE for his transforming work with the regulatory body.

 

 

 

Written by debbielq

January 17, 2017 at 9:15 am

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.