By Debbie le Quesne

Archive for the ‘reminiscence therapy’ Category

‘Billions’ needed to avoid social care meltdown

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Billions of pounds are needed to avoid the NHS and social care crisis – that’s the message which has been sent to Secretary of State for Health, Jeremy Hunt.

According to the Daily Mirror, leaders in the care sector have alerted Mr Hunt after three health areas revealed they face a combined shortfall of more than £2.4billion by the end of the decade

As we broke into November, the dire warning outlined that without extra money they will struggle to meet waiting time targets, provide enough hospital beds and basic levels of social care.

Sounds familiar, doesn’t it, and it’s right on our doorstep.

The Mirror reports: “The verdict is contained in the newly published Sustainability and Transformation Plans (STPs) for Birmingham and Solihull, North Central London and South West London.

Sustainability and Transformation Plans were ordered by NHS England boss Simon Stephens in December 2015 and charged 44 regions in England to come up with a five-year programme for providing health and social care in their areas.

I’m not a lover of red-top journalism, but this report is exactly what’s needed.

And it adds: “Of the three reports published so far Birmingham and Solihull warns it faces a £712million shortfall by 2020, South West London £828million and North Central London £876million.”

For the record, West Midlands Care Association is working very closely with Birmingham City Council and assessing the impact throughout the neighbouring Black Country region.

The shortfall will doubtless impact on areas already struggling like Sandwell, Walsall and Dudley.

Mark Rogers, the chief executive of Birmingham Council, says in the piece both health and social care face “huge challenges”. According to Mirror “this includes the need for at least 430 more hospital beds in the region.”

Personally, I’m struggling to find a creative way forward. All the cuts in social care have already been made and I fear the duty of care caveat is lost somewhere in the ether.

Budgets are not just shrinking, they are vanishing and the demand for care is astronomic.

Mr Hunt, I fear lives in a bubble as MP for South West Surrey, and as we all know the social care financial map is very different in his constituency.

There is a laudable push to get people out of hospital and back into their own homes with social care support. But it is catastrophically failing.

Let me quote the Mirror again: The North Central London STP says it is not “able to deliver universally for everyone to the standards we would like.

“Our analysis tells us that too many people stay longer in hospital than is medically necessary. There are challenges with meeting acute standards, as well as issues workforce sustainability.

“Some of our estates aren’t fit for purpose. Additionally, we face a financial challenge of £876million across health commissioners and providers by 20/21 if we do nothing,” the STP is reported as saying.

This could have been written of any number of LAs throughout the UK.

Chancellor Philip Hammond has a chance to help next week with his mini Budget on November 23.

In the light of bleak analysis, I truly hope he will understand his responsibilities towards care providers and those receiving care.

WE are working with Birmingham to look at the consequences for Domicilairy and Care Homes. The shortfall in Birmingham has impact on the Black Country with many people being placed in Sandwell Walsall and Dudley

The time to take part in funding consultation is NOW

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Unless a high-speed railway is about to be directed through your garden, why would a member of the public take the time to respond to a government consultation?

Take, for instance, the consultation from the Department of Health on the rules affecting who qualifies for care and support, which was published in June.

Much too long and boring?

Not so!

Independent Age points out that it’s one of the most important consultations for years but is concerned too little is being done to publicise it.

There is a real danger the only people who are responding will already be known to government. Local government will respond no doubt – and rightly so. And charities will be doing their best to present a powerful case for more funding so adults with significant care needs can receive state-funded care well into the future.

Which, according to Independent Age, begs a burning question” Whose consultation is this anyway?

Where are the voices of older and disabled people, those of care and nursing home owners and what more can we do to ensure people with care needs are directly influencing the consultation outcome?

In particular, the outcome will have a huge effect on the level of local authority bed payments being agreed in the future. Dare we miss having our say” No way.

The Care Act 2014 is an interesting piece of legislation which will change the dynamic of the care industry.

Its impact on the South of England where they rely heavily on the public to fund their own Care will be dramatic and will see the cost of care for the Local Authorities go up. There will be less impact here in the West Midlands, but it could mean that homes will need to introduce larger top-ups as localauthorities will cover less. There are other part of the legislation which will affect the industry, but truth be told, it’s what is being consulted on between now and mid-August that really matters, says Independent Age.

We all have an opportunity to a say about how generous the publicly-funded social care system will be and who it should support.


A good life with dementia: Keys for a brighter future

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Reports, reports and more reports . . . my desk is awash with them and my laptop groaning under the strain of Word documents.

It’s Friday and it should be happy because for many of the weekend’s almost here. But I’m feeling a little flat, bruised even, after the recent run of negative headlines in the Press.

Add to that my personal obligation to try to keep abreast of all the breaking news, latest industry gossip and legal updates, it doesn’t make the most palatable cocktail.

What I really wanted was a shot in the arm with inspiring, good news. Tempted by the title – A Good Life with Dementia – I set about reviewing the lasted piece of work commissioned by Red & Yellow Care. It outlines a six-part framework for enabling a ‘good life’ with dementia.

The publication of the report coincides with the launch of the new service, Red & Yellow Care, which uniquely offers specialist, dementia care tailored to the client. The report draws on the expertise and insights of those working in the field and six themes were identified.

Not surprisingly, the study showed that 43 per cent of people polled don’t think it’s possible to live a good life with dementia.

So let me tell you what the target areas of the report are . . .

  • How to better support people with dementia to maintain their sense of uniqueness and personal identity (Respecting identity: ‘It’s not one size fits all’)
  • Achieving the right balance between memory-based activities and enjoying the here and now (Embracing now: ‘It’s a moment-living life’)
  • Ensuring people with dementia are able to experience meaningful human connections (Sustaining relationships: ‘You don’t always need words’)
  • Ensuring people with dementia are able to experience a full range of emotions (Valuing contrast: ‘Good days and bad days’)
  • Taking risks – what are we protecting people with dementia from? (Supporting agency: ‘What’s there to worry about?’)
  • Promoting good overall health for those who are living with dementia including physical and emotional wellbeing (Maintaining health: ‘My priority in life’)


The report also examines the areas that people in the UK feel are important contributors to happiness such as independence (91%), freedom to take risks (65%), being supported and cared for (91%), living in the moment (94%) and not living in the past (72%).


The Good Life with Dementia report was funded by Red & Yellow Care and published in association with Alzheimer’s Society with a view of encouraging debate.

“What’s striking is that this new framework is actually just stating the obvious. It’s about the things we all take for granted, but which are eclipsed by the panic, fear and stigma that have come to surround dementia. We need to get back to core principles if we’re going to enable people with dementia to see past their fear, and make the most of what is potentially a long, rich and rewarding time of life,” said Dr Bahbak Miremadi, Founding Director of Red & Yellow Care.

I agree wholeheartedly.

The report also identifies three main barriers that exist to help people live well with dementia: diagnosis, public awareness and the need to improve care flexibility.

I seem to have read most of this before and it really does state the obvious. For people with the memory-loss condition and their families and carers, the report may offer pointers. Of course, the problem here is that there’s never going to be a neat model of achieving best outcomes as the disease is as individual as its victims’ response to therapies.

Good life with dementia – I really hope that we can achieve that and I applaud every last step taken to target this outcome. Sun’s out, forecast reasonable . . . have a great weekend.

The Good Life with Dementia report is available to download from www.redandyellowcare.com/goodlife.

ADASS – its goals to be ‘smart’ with money and my fears

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The Association of Directors of Adult Social Services is encouraging members to make `every pound stretch further.’

In a message today reported on the Care Industry News website, incoming president David Pearson says: “We have a responsibility to make the public purse go as far as it can.

“Our achievement
 2.68 billion while at the same time implementing personalisation, supporting carers, tendering or re-tendering services, joining up services with the NHS, providing better advice, reducing infrastructure costs and exploring ways of building community capacity has been absolutely extraordinary.”

Smart working, I think they call it – and there’s now plenty of it about.

Mr Pearson urges honesty with the public about the challenges social care faces, but to balance this with the abundance of examples of creativity, partnership and innovation from across the country.

He also notes that councils have `clear responsibility’ to ensure home care providers play fair with staff citing that it’s the providers’
responsibility to ensure that basics such as the terms and conditions of employment and paying for travel time and costs are honoured.

What’s encouraging here is that he says in an ADASS survey of social care procurement, it show there is an increasingly clear responsibility for councils to understand the actual costs of care and take this into account in setting prices.

Mr Pearson singles out sector-led improvement (SLI) as a growing success story for social care: 93 per cent of local authorities now publish local
accounts, and points out that the opportunities for mutual learning are enormous. There are, he acknowledges, remaining questions about the
universality of take-up; the extent of SLI’s impact, and the transparency of some councils’ performance.

“This coming year we need to continue with the SLI programme in each region, enhance our transparency and measure the impact,” he says.

In all, lots of things I’d expect Mr Pearson to say, but at the risk of being boring and repeating myself again, and again and again . . . if we’re looking to save £2.68 billion as the new target, which the quote suggests, we are all in La La Land if ADASS really believes the private sector can bear the brunt of such restraint. When will anyone believe the industry is at breaking point over funding?

Chance to have a say as Burstow heads new commission on care

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Informed choices need, by definition, good information – knowledge has the power to change our lives, increase the quality of human experience, create new environments and realise our dreams.

That same information can help us get beyond problems that challenge us – even in the embattled care sector.

In one of his more lucid moments, former USA president, Ronald Reagan, said “information is the oxygen of the modern age.”

Former health care minister, the Liberal Democrat MP Paul Burstow, is chairing a commission on the future of residential care for thinktank Demos. Over the course of a year, the commission will be developing a vision for the sector fit for the 21st century – a brave, but essential challenge.

And by locking into the Guardian newspaper’s Social Care Network, we get the chance as network members to quiz himon how to reform residential care.

In his latest health role, he is looking at how to we can bring social care into an environment where there is increased pressures and demands while public spending is falling.

The commission will take a look at how to learn from and share good practice in the sector. Oh to be a fly on the wall as this enterprise gets rolling!

The Guardian has announced: “Before the commission publishes its findings this summer, Mr Burstow has agreed to answer Social Care Network members’ questions on the future of the sector in a video interview later this month.”

My head is buzzing with so many questions, I really don’t know where to begin.

Questions can be tweeted – @GdnSocialCare – or emailed to socialcare@theguardian.com.

This is a golden opportunity to share your thoughts and fears and help shape share the commissioners’ recommendations.

Personally, I find the Guardian Social Care Network (Sign up for free here) a fantastic source of information. We have an opportunity to have our say – let’s do it . . . please!

Ageing Britain: Why getting oldere I not a picnic

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Elderly people gather in an idyllic woodland and settle down for a bite to eat, but the caption beneath this picture in The Guardian online tells us “Life is no picnic for many older people.”

And we are reminded too in an article outlining the fears of our ageing population that David Cameron once said: “We’re an old country – with our best years ahead of us.” Hmmm . . . well, that’s how he sees it.

Research, however, is not so optimistic with growing concern about pensions, rising costs, health and social care.

The survey for The Guardian shows that just 29 per cent felt the standard of living of older people in the UK was currently at a good level, compared with 46 per cent who disagreed.

The article adds: “And the long-term outlook is even gloomier: just over 11 per cent expect older people’s standard of living to improve over the next 20 years, against 79 per cent who disagree. Over 70 per cent do not believe older people’s overall quality of life will rise in the next two decades, compared with under 16 per cent who do.”

More than 1,600 took part in this study.

What emerged was a perception of a rich-poor divide – those who are financially secure as they retire and those who are struggling in their old age.

“One respondent is quoted: “Pensions are worth nothing, care is being cut back, people are living longer, jobs are going digital. All this, to me, adds up to a hideous time ahead, potentially, for older people.”

More than three-quarters (77 per cent) do not believe public services are working in a co-ordinated way to meet the challenges ahead.

Clearly, there are huge challenges ahead and the spin doctors’ work is not fining a resonance with the elderly. Good!

But what I find most sad is the fact that elderly people have a growing unease about their future.

In the report, Claire Turner, head of ageing society at the Joseph Rowntree Foundation, says: “There are some huge challenges ahead . . .”

Indeed there are and successive governments’ delay at not properly addressing the issues of an ageing Britain has not helped. As they say in the Black Country, the pigeons are now coming home to roost.

We need more joined-up thinking on the delivery of care, smart systems to make social care sustainable and most of all, some realistic funding.

The uncertainties of future as we desperately try to prepare for the unknown are not only found in those who will need care intervention, but those who delivery too.

I read that housing group Anchor has been spearheading a campaign called Grey Pride, calling on the government to appoint a dedicated minister for older people who could pull together policy on everything from pensions and social care to transport and discrimination.

In the survey nearly 60 per cent said that government should take the lead – something that in my opinion has been lacking and I don’t suppose this latest research will change a single jot.

On the subject of dementia . . .

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A Channel 5 News and YouGov poll has found that one in five of us fear developing dementia more than cancer.

Some two thirds of those polled also fear they may also be diagnosed with the memory-loss condition in the future.

In a statement the Alzheimer’s Society said: ‘With dementia treatments a generation behind those for cancer, it is not surprising that people are more fearful of dementia. With dementia now in the spotlight, we urgently need to turns words into action and see tangible improvements in the care and support provided to people with dementia and their carers.”

Some 800,000 people live with dementia in the UK.

And just to add to the urgency of finding a treatment or cure, I read that foods high in compounds called advanced glycation endproducts (AGEs) could contribute to the build up of beta-amyloid, a major hallmark of Alzheimer’s disease.

The findings are published in the Proceedings of the National Academy of Science journal.

AGEs are found in cooked foods and have previously been linked to health conditions including diabetes and dementia. I don’t understand any of the medical stuff here , but simply,  according to the authors, AGEs suppress SIRT1 – a protein in the body thought to protect against neurodegeneration.

AGEs are found in cooked food, particularly high fat proteins such as animal meat. Vegetarian recipes suddenly seem very exciting to me. . .

Launch of dementia app at theatre performance

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There’s no stopping technology and it can help enhance the caring an ever-ageing population needs, bring it on.

Dudley MBC undoubtedly has lit a beacon with its Dementia Gateway initiative and its success has received national acclaim.

The pathway ensures that formal diagnosis is made by a dementia specialist and a lifetime of care and support is offered by a dementia nurse or dementia advisor.

The outcome is that with the right treatment and support many people who have dementia are able to lead active and fulfilling lives.

In a new development, the authority is launching a dementia friendly community app at a special theatre performance about the life of someone living with memory loss.

The new app is designed to give everyone the knowledge and confidence to support someone with dementia. I love it, can’t wait to get and copy and do a review!

It had been produced by the Dudley Council’s dementia gateway service in partnership with community interest company, Equip 4 Change.  People will be able to download the app from the council’s website to their smart phone or other device.

The app will be launched during a special performance of Finding Joy, a funny and moving play performed by award winning mask and mime company, Vamos on Wednesday February 26 from 8pm at the Cornbow Hall in Halesowen.

The play tells the story of Joy and how she, her daughter and grandson are coping with her memory loss.  The performance is suitable for people aged 14 plus.

People with dementia and their families are invited to attend the free performance.  People can request tickets by calling 01384 818723 or by emailing carers.network@dudley.gov.uk

In a Press release, Councillor Dave Branwood, cabinet member for adult, community and housing services, says: “Supporting people with dementia and their families is a key priority for the council but we’re also keen to develop the wider communities’ understanding of the condition.

“As the number of people with dementia is predicted to rise in coming years, our new app can provide information about its effects and the support available locally.  I’m delighted we’re able to launch this app during the performance of Finding Joy and I hope people come along to enjoy it.”

The launch of the app and the Finding Joy performance is part of the council’s work to develop a Dementia Friendly Dudley.

The council, with the Alzheimer’s Society, Equip 4 Change and other key partners have been working with local people and organisations to establish Halesowen as the first dementia friendly town in the borough.

This success will be built upon and rolled out to other areas in the borough as part of Dudley’s commitment to the National Dementia Action Alliance.

To find out more about Vamos go to www.vamostheatre.co.uk

Do the Danes have the solution to cut care costs?

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I know very little about the care models of Denmark – but I do understand it has one of the most socially progressive cultures of the world and that alone should be reason enough to check out what they’re doing.

Browsing the news last week while on holiday, I found that the country is undergoing a care revolution in a true Tomorrow’s World kind of way.

We are aware of technology monitoring care, but the Danes seem to be taking things a step further.

Copenhagen is a lovely city and it’s clean and perhaps I now know why.

Making their presence felt in its residential care homes is an army of robots that take some of the jobs of cleaners and carers.

There’s a robot that does all the cleaning – well, most of it. Fewer cleaners means more personnel available for residents.

I quote a piece in The Guardian online: “Over the last six years Denmark has cut the amount it spends on care for each person over 65 by nearly a fifth, according to figures from Statistics Denmark – an average cut of 10,851 Danish kroner (£1,200) per elderly person every year.

“The robots are a key part of the ‘welfare modernisation strategy’, Denmark announced last September. The aim is to use technology to cut 12bn kroner (£1.3bn) from the government’s welfare budget by 2020.”

This, I hope, is a refreshing change from the UK approach of compromising frontline services. I read some 84 per cent of managers in care settings employ one of these cleaning robot.

And it doesn’t stop there. For those who are mobile, there are drink machines with special adaptations to help those with shaky hands. I can’t imagine how that must work . . .

Finally, there’s a general change in emphasis in the delivery of care: More able-bodied and alert residents are encouraged to help those less able. Everyday rehabilitation is training focused – most, with the elderly. It’s not so much about what they can’t, but what they can do.

According to Jens Hoejgaard at DaneAge, government spending on practical help for the aged at their homes has been cut by a third since 2008, while personal care has been cut by only 12 per cent.

The policy is not without its critics, with some arguing it is the beginning of the end for the Danish universal welfare state. Hey, this has a familiar ring, doesn’t it?

New chief is care pioneer, but beware the Red Indians

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Tony Hunter is the new chief executive at the Social Care Institute for Excellence and he’s written a heartening piece in the Guardian online.

Like other who wish to promote a more joined up approach to social care delivery, he’s a pioneer. But the problem with being a pioneer is that there’s always some eager Red Indian ready to take your scalp – or at least that was the way of TV Westerns when I was growing up.

In his article he recalls an incident when a colleague Last week, a colleague overheard a young woman’s remark on the 221 bus: “Yes; I’m working in the caring profession at the moment, but soon I’ll get a real job,” the traveller said.

Undeterred Hunter is “absolutely delighted to be re-joining the world of social care,” admitting that it’s “complex territory.”

The Social Care Institute for Excellence (Scie), is an organisation committed to improving social care experiences and outcomes. All good . . . and still not a Red Indian in sight

He writes with a knowing surety that: “We have to get our job right. All too often out there in the field, frontline staff doubt the real knowledge and credentials of those compiling advice and guidance; it can be seen to be raining down on them. We must find the best of what’s happening, what really works in practice, and tell people about it. It’s this foundation that gives us our strength, and gives authority to the good practice we embrace.”

Still no Red Indians. But keep an eye on that craggy outcrop in front of you . . .

Hunter observes that “it’s all too easy”  for people blame GPs, social care staff and other services in the community for care-related problems.

See I told you about the Redskins.

Hunter adds: “The need to integrate health and social care is a critical issue we all face in the caring professions . . .”

Frontline priorities are key for the work of Scie. “Our emphasis is not on generalisations but on the frontline priorities that really make a difference, for example when people leave hospital feeling anxious and sometimes isolated. They need to depend on the care and support of professionals operating in agencies focusing unambiguously, not on organisational boundaries and budgets, but on what needs to be done to promote their rehabilitation, confidence and quality of life.”

This oratory is a breath of fresh air, don’t you think? Maybe he’ll consider championing the care sector for us. Or perhaps Sir Digby could fit us in? For sure, the aspirations of Hunter tick all the boxes with me.

My big reservation (perhaps one for the Red Indians) is how he is going to find enough leverage to wrest from the Treasury the monies needed to make integration work. He is right that “real advances are being made by committed professionals,” but the cost of commitment is surely deserving of match-funding.