By Debbie le Quesne

Archive for the ‘Good Care Week’ Category

Join me in care pledge as the NHS welcomes us in

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Yesterday was NHS Change Day – a chance for health workers to make personal but public pledges to improve and inspire patient experiences.

Similar to our Dignity Action Day event it has grown for a single day into a whole month of activity and now those who work in social care are being invited to take part – a clear recognition by the NHS that we have a key role to play.

You have until the end of the month to make a pledge.

It’s all part of working together, integration, making a difference and ultimately crafting a better care service. You can make your pledge until 31 March.

Managers, consultants, carers, doctors . . . anyone in ‘the loop’ of care is welcome to “write on the wall” http://changeday.nhs.uk/wall or go to the Face Book page http://www.facebook.com/NHSChangeDay

In 2013, more than 189,000 people made their own personal pledge to do something different to improve care. Last week, the 2014 total was already 280,000.

Reported in The Guardian online, pledges so far include someone who has committed to learn more and educate more nurses to improve patient safety and outcomes; elsewhere, someone is pledging to tidy their desk more often; a mental health expert wants to be more punctual at meetings and clinics, and a care home manager in Devon has pledged to redouble efforts to prevent avoidable admissions to hospitals for frail, older people.

It’s a new push to embrace social care, something else to do, but the psychology of commitment in a public forum can only achieve good outcomes.

Social care is key to the mapping integration of care streams and obviously, looking at the number of people already pledging, it strikes a chord.

Patients and service users are also being encouraged to take part.

So what’s my pledge? To continue to equip and support the private sector care providers I represent at WMCA to deliver care excellence and to take every opportunity to influence a national upgrading of the worth of social care.

Dignity Action Day on the horizon

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We are fast pushing through January – scary isn’t it – with the national Dignity Action Day looming ever nearer.

West Midlands Care Association will be adding its significant contributions to the event (more on that as the countdown to February 1 gets closer) but I wanted to encourage you to get involved.

Our role in this initiative is primarily through training but I’ve been looking at how others who have become dignity champions have marked the event in recent years and what ‘s happening throughout the UK this year.

Hospitals, care and nursing homes, domiciliary services, community nurses, support networks and business for the disables and learning disabled and day centres have all taken part.

Teas, cakes, funny stories, memory jogging, lectures, forums, tombolas, care home open days, a transport theme day with everything from police vehicles to hoists and wheelchairs, a Fairy Godmother day, informal discussions with relatives and friends, coffee mornings, awareness events, around the world food fun, a daffodils day, a country and western themed event, tea dancing and drop-in sessions are all on the agenda for this year.

For many who have already signed up to this good practice framework the day’s activities have been extended through the week.

Before the Dignity in Care campaign was launched, numerous focus groups took place around he country to find out what Dignity in Care meant to people.

The issues raised at these events resulted in the development of the 10 Point Dignity Challenge. The challenge describes values and actions that high quality services that respect people’s dignity should:

  1.   Have a zero tolerance of all forms of abuse
  2.   Support people with the same respect you would want for yourself or a member of your family
  3.  Treat each person as an individual by offering a personalised service
  4.  Enable people to maintain the maximum possible level of independence, choice and control
  5.  Listen and support people to express their needs and wants
  6.  Respect people’s right to privacy
  7.  Ensure people feel able to complain without fear of retribution
  8.  Engage with family members and carers as care partners
  9.  Assist people to maintain confidence and positive self-esteem

10.   Act to alleviate people’s loneliness and isolation

So how can you help?

Dignity is a central pillar of all care and not only do we need care professionals to keep updated with training, we also need to tell the world – well, at least the local media – that honouring those for whom we care is the heartbeat of 99.9 per cent of those in care. Be creative, have fun and get the message out there . . . please.

Let me remind you of what happens when we lose sight of dignity.

Last week three care workers who abused elderly dementia sufferers at a nursing home were jailed and a fourth given a community sentence.

Residents at Hillcroft Nursing Home in Slyne-with-Hest, Lancaster, were mocked, bullied and tormented because they would have no memory of the abuse.

One man had his foot stamped on deliberately and another nearly tipped out of his wheelchair.

The vulnerable victims were also pelted with bean bags and balls at their heads “for entertainment”.

Carol Ann Moore, 54, Katie Cairns, 27, and Gemma Pearson, 28, were found guilty by a jury at Preston Crown Court of ill-treatment or neglect of a person who lacks capacity, under the Mental Capacity Act, after a four-week trial last November.

Darren Smith, 35, from Lancaster, who admitted ahead of the trial eight counts of ill-treatment in which he threw bean bags or ball at eight residents, has been jailed for eight months by Preston Crown Court.

Last week Cairns was sentenced to five months in prison, Moore was jailed for four months and Pearson was given a 12-month community order.

Sentencing, Judge Byrne was reported as saying: “Some of the offences were gratuitous sport at the expense of vulnerable victims. Each of these defendants broke the trust placed in them.”

Indeed they did. They also brought shame to our care sector which found headlines everywhere.

Let’s try to put some good headlines out.

More blogs on dignity coming soon,

New Year, new challenges, but please keep going

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I have been told that I ought to do a New Year message – a kind of general’s speech to rally the troops for the challenges ahead.

I recall having to read Shakespeare’s Henry V and the famous St Crispen’s Day Speech . . . the call to arms and war by King Henry against seemingly impossible odds. It didn’t seem to make much sense all those years ago, but now I find it incredibly fitting.

It was a king’s call to an embattled army, wearied with war and sickness and depleted in numbers. The French were “fresh” and eager to fight and the looming “fearsome” encounter (see

/www.youtube.com/watch?v=A-yZNMWFqvM )

Not one to over-dramatise, I do see similarities today between all care streams of our industry and whoever we deem the ‘enemy’ to be. For most of us it will be the austerity measures which have affected countless businesses as care fees paid by local authorities have lagged far behind spiralling costs,

It’s a sign of the times we are all in I’m sure when food banks and baby banks have sprung up seemingly everywhere. Doctors declared during last year that food poverty was a “public health emergency” . . . I find it all so peculiar, distant, and yet I know it’s true and daily impacts on the work I do.

The effects of the cuts for many of us have become sanitised but still remain unpalatable.

The industry faces many challenges and not least the Care Act revisions, cuts in public spending continue to bite and impact adversely across a range of council services, themselves victims of fiscal pruning.

I know businesses are suffering and for many they are in survival mode. I take heart that the need for them will not dissipate, but I worry that those who need them will be denied access.

Our government keeps insisting things are getting better and I really do hope that is true. Increased economic growth will help us continue to deliver the kind of care excellence we all wish to see,

My message for New Year is a simple one: Keep going . . . please, Our care providers and their staff do an invaluable job and the quality of their caring never ceases to amaze me, despite the unspeakable odds. You are amazing and I honour you for your unyielding professionalism.

As so many have reinvented themselves to help balance books, I believe we must do it over and over again but never lose the vision of why we do this work. Caring and the way we deliver it is indeed the barometer of any civilized society. I hope amidst the unpopular decisions of the future the reading on this hugely significant barometer will at least be ‘fair’.

May I wish all of my members and their care staff a very happy New Year.

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.

Fears over quality of training in Worcestershire as budgets shrink

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All credit to Worcestershire County council for providing a large programme of free training for the care sector. But like many other local authorities they have a massively reduced budget and training costs for independent sector providers is one of the areas under threat. I applaud the fact that they’re still offering a wide range of courses, but a course cancellation fee of £45 has been introduced. In a creative approach to cost cutting, the council is also running courses from premises owned by various care providers in order to avoid the hire fees at other venues. Some courses will in future be subsidised, rather than free and “train-the-trainer” sessions are likely to be introduced to allow providers to cascade certain training within their organisation.  Providers are also being encouraged to undertake e-learning in certain situations. Although these measures will hopefully eek out the council’s training budget, it remains to be seen whether the quality of the training can be maintained. The link between the quality of staff training and the standard of services delivered is well established. Sadly, reducing the training budget will almost inevitably erode the quality of training with the inevitable impact on front-line services. There’s an irony here: Those services are increasingly being monitored against ever-higher higher standards. By whom? You’ve guessed – the very same county council.

Dementia guide ‘first’ published

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A year ago an all-party parliamentary group commissioned to study the far-reaching issues of dementia published the Unlocking Diagnosis report.

A year on and as a direct result of its shocking findings, a new booklet to help guide people diagnosed with dementia and their carers was launched yesterday by Alzheimer’s Society.

The guide, a first of its kind, offers advice to help people come to terms with their diagnosis and plan ahead.

I was appalled to discover that the all-party report found that many people said ‘nothing’ happened after the initial diagnosis.

The guide will also offer GPs and psychiatrists the opportunity to provide people with dementia carers at the point of diagnosis.

How good is this!

Whilst diagnosis rates are increasing, some doctors still appear reluctant to diagnose the disease, Currently, more than 50 per cent (428,000) of people living with dementia still do not have a formal diagnosis.

The dementia guide, has been part-funded by the Department of Health.

It tackles the emotional impact of a diagnosis and drug regimes, ande; signposts services available.

The guide is available free of charge and to order visit alzheimers.org.uk/dementiaguide  or phone 0300 303 5933.

NHS professionals should order direct from NHS England’s Health and Social Care Publications Orderline (using product code 872).

A raft of advice on how to navigate the help systems is included, including financial support.

Diagnosis of dementia is truly daunting and the disease’s progression challenging. Please make use of this invaluable free tool.

Safeguarding: A need to open doors

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Action on Elder Abuse is campaigning for sweeping changes in the Care Bill – with safeguarding issues grabbing the headlines.

The pressure group is also defining a course of action rank and file care sector workers can take to help place existing infrastructure of adult protection onto a statutory basis.

In 2007, following publication of the Prevalence Study into the extent of elder abuse within the community, the Government committed to a refresh of the No Secrets guidance on safeguarding vulnerable adults, with particular reference to the legislation underpinning adult protection policy. This review was finally concluded in 2009. A large number of issues were identified by that review, the majority of which are not addressed by the current Care Bill.

Simply, AEA is saying the current clauses are not stiff enough to protect those who cannot protect themselves.

So what’s AEA looking to achieve?

Powers to stop abusers imprisoning victims in their own homes.

Some 40 per cent of referrals are regarding victims in their own homes. The law needs to allow, through a court process, entry into the homes of potential victims. All too often that access is dependent upon the co-operation of the abuser.

A duty on agencies to notify the Local Authority if they believe an adult may be at risk of abuse. There is a need to underline the responsibility of all agencies to report if they have reasonable belief that an adult is at risk.

Adequate Funding:

The greatest number of referrals to adult safeguarding is older people and, referrals are increasing year on year by at least 11 per cent. At the same time local authorities are making significant cuts in services, with a significant proportion affecting older people’s services. Funding limitations must not dictate whether an abused adult receives intervention.

There must be a minimum expectation of what we will collectively consider financially acceptable to invest in these activities, and this must be reflected in our financial priorities.

Clearly, given the gravitas of AEA and its robust response, something is wrong. Our most vulnerable it appears are still vulnerable.

What can you do?

  • Write to peers indicating your support for Baroness Greengross’ amendments. She is supporting the AEA proposed amendments.
  • Encourage others to get involved
  • If you work in this area, send examples to the AEA enquiries@elderabuse.org.uk of where a power of access would have been necessary

Already on deck pushing for powers of access are Mencap, the College of Social Work, the Equalities and Human Rights Commission and Age UK.