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By Debbie le Quesne

Archive for the ‘The Big Tea’ Category

King’s Fund warning on the rich-poor care divide

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George Osborne’s decision to sanction a two per cent rise in council tax to offset cuts to social care will lead to thousands more older people missing out on vital services, the Guardian newspaper has revealed.

For many the bible of social care, the newspaper said the chancellor’s spending review attempt to plug the hole in care funds, will only widen the gap in provision between richer and poorer areas and “raise at most only £800m a year – far less than the £2bn he predicted.”

The King’s Fund is a non-political body that harnesses the thinking of some of the finest minds in the UK. It needs to be heard.

In a detailed critique of the policy, the thinktank has found “that disadvantaged places in the north, Midlands and inner London with the greatest need for social care will lose out because they will be able to raise too little extra revenue from it to make any difference.” How true! We had said for years the Midlands has some of the most impoverished boroughs in the country and they are deserving of a ‘special case’ approach.

Quote from Richard Humphries, the King’s Fund’s assistant director of policy, who has undertaken the analysis: “Relying on councils to plug the gap in social care funding won’t be equitable or effective because of the inverse social care law that councils that have the greatest need for publicly funded social care are least able to meet it [because their council tax bases are so low]. George Osborne’s new policy is of very limited help for them,”

Do I hear an amen?

Humphries adds the precept is a “shortsighted” response to the growing crisis in social care,

And delivering more criticism, Humphries says the plan is ”very opaque, complicated and messy option, which, crucially, will not much help areas at greatest need. It’s a very high-risk strategy.”

Humphries then warns social care providers collapsing, more people going without the care they need or having to pay for it themselves, and even more pressure on families and the NHS to pick up the pieces when there’s a breakdown support.

Quote: “Older people will be more likely to end up in hospital.”

At the risk of overloading this blog, let me quote some more of the Guardian piece: “The thinktank believes that the 2% precept is based on ‘completely implausible assumptions made by the Treasury’. For example, the expected £2bn figure is based on all of England’s 152 councils levying it, but many councils are highly reluctant to raise council tax at all and quite a few were elected after specifically promising no rises. Only half of councils increased their rates this year.”

Humphries found that the two councils that would receive the least extra income from the levy would be Wandsworth, at £3.70-a-head, and Westminster at £4.90. But neither is typical because council tax rates in the two Conservative-run London boroughs are already so unusually low.

If you require more information look up the following link http://www.theguardian.com/society/2015/nov/20/osborne-plans-to-allow-2-council-tax-rises-to-plug-social-care-holes

It’s harrowing stuff, but we know that news, by its definition, is rarely good.

In a letter to the Guardian, the King’s Fund chief executive, Prof Chris Ham, and Nigel Edwards, his counterpart at the Nuffield Trust thinktank, say the spending review “represents another setback for people who need social care. [The] new powers to raise council tax will provide local authorities with some financial flexibility but … will disadvantage deprived areas with high needs for publicly funded care.”

Joining the chorus of criticism, along with our selves (WMCA) are charities such as Age UK and Alzheimer’s Society and bodies such as the Local Government Association and Care and Support Alliance.

It’s another example of central government dodging the bullet and putting the responsibility on already struggling local councils to raise more money for social care. Clearly, it should be the role of government to provide it to the growing number of people in need due to the UK’s ageing population.

I don’t doubt there are some politicians who do recognise the huge chorus of complaint, but additional money is still not with us.

The Better Care Fund won’t come into effect until 2017!

As the social care sector we still remain the Cinderella of caring with no frontloading of cash, unlike the NHS.

Okay . . . where’s cream cakes, biscuits? How I need something to ease the pain of reality! Returning to work after a break is that never easy.

 

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,

Social care – Japan’s way of meeting the bill

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Radical reforms in Japan may provide a model for surviving the political promises or more deep cuts to funding, according to a new Nuffield Trust report.

Attempting to deal with the world’s highest level of public debt and oldest population, the Japanese government introduced a system of long term care insurance in 2000.

It gives automatic access to social care to all those over the age of 65 on a need alone basis.

The system is partly funded by a national insurance fund that all over-40s pay into and partly out of general and local taxation.

It appears that the system has helped many vulnerable elderly who were not receiving care get the support they need.

Dementia care homes support independence and social interaction while ensuring safety and security, and a national campaign has focused on eliminating the stigma previously linked to the condition.

A campaign to train dementia supporters exceeded expectations, attracting 1.5 million people in just four years.

The UK’s Government’s planned reforms in England will allegedly see the cost that individuals have to pay for care in their life-time capped at £72,000 in 2015/16.

Nuffield says this policy will protect those incurring the highest costs (about one in eight of those who need care) but still leave many paying significant sums out-of–pocket.

In the meantime, for those who cannot afford to pay for their own care, cuts to local authority budgets have led to more areas giving help only to those who have the most complex needs.

It’s interesting to note that Japan’s care reform has risen beyond its budget, something I’ve been concerned with over the UK approach.

In Japan those whose social care is funded by the insurance scheme are required to pay 10 per cent of fees, and there is a debate over whether the wealthy should pay more than this in order to address rising costs.

Quite what the way forward is in duplicating such a model in the UK I haven’t a clue, but the system does appear to have met critical needs and standardised a national approach. I doubt if it’s perfect and the prospect of greater national insurance cost outgoings is never good. However, I‘m sure there are some lessons to be learned here.

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.

It’s time to Tweet and tell the world how good we are

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Moving ahead with technology in the care sector has never been easy. Computers still send shivers down the spines of some providers and I’m convinced there’s a brand of mobile phone that’s steam driven used by the industry’s diehards.

Joking apart, just getting people to use such free publicity ‘agents’ such as Facebook is a challenge.

But there’s a new initiative that’s worth braving the technology mountain for – #SocialCareHour launched last week on Twitter

The Twitter-based initiative has been set up as a news and networking platform to get people across social care talking openly and sharing positive experiences and ideas about how to develop the sector as a whole.

Social care providers, commissioners and customers are all encouraged to join the conversation, which will take place on Twitter every Wednesday evening between 8 – 9pm.

Anybody wanting to take part can do so by including #SocialCareHour in each tweet they post.

The new initiative is the brainchild of Midlands based creative company, GD PR & Media, which specialise in the Health & Social Care sector.

Reported in Care Industry News online, Company Director David Huckerby says: “Many social care providers, commissioners and customers we have met are frustrated by the increasingly negative image being painted of a committed, compassionate and ultimately vital sector.

“As such, we were keen to provide an effective platform for people to celebrate innovation, share best practice and explore collaboration opportunities for the benefit of social care as a whole. #SocialCareHour also provides a great opportunity for customers to share good experiences and suggest ideas to those commissioning and providing services.”

Let’s see if we can add to the followers’ list and indeed, help get the message out there that our care is good and our commitment to fight for better funding for all streams of service has not been diminished.

Spicing up care with the ultimate curry club

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Interim Assistant Director at Dudley MBC Matt Bowsher has written a piece for The Guardian’s Social Care Network which is guaranteed to spice up your day.

Along with George Julian, a freelance knowledge transfer consultant, he reveals the growing appetite for the ultra-informal Social Care Curry Club – formed after a chance exchange on Twitter.

As networking goes it’s unusual but truly believe its potential for good is probably much better than corridor meetings and snatched conversations at care conferences.

The basic premise is very simple. If you love curry and love social care, then you’re in, so says the online article.

There are no issues of ‘rank’ or status, it really doesn’t matter if you know plenty or little of social care and it really doesn’t matter what field of social care you are in.

The only rule: No selling.

According to the article: “People come as themselves, they are not representing their organisation, there are no pitches or presentations, no PowerPoints, prezzis or podcasts. This is quite simply curry and chat.”

The piece goes on the say that despite budget cuts and low morale, people are spending their own cash to attend these meetings.

There’s no clever answer to answer why these 12 ‘eat-ups’ across the country (and one in Canada) are so successful and why they have attracted the director general for social care, no less.

Access, as the article points out is easy and I would agree that a lack of structure could also be key.

So far, supported by a Twitter account, a blog and an Eventbrite page, a network of 700 people has been built.

I believe this is a remarkable organic response to a social care crisis primarily caused by the withdrawal of central government funding. It doesn’t matter what the politics are or who is to blame. What concerns these people, I’m sure, is how to continue to deliver credible care in the face of such austerity.

There is an odd comfort found in meeting likeminded professionals struggling with the same kind of business issues.

But social care is like no other business model with many providers doing what they do because simply, it’s their Raison D’etre. Yes, they want profit – all business does – but over and over again I hear they just want to be able to maintain excellence in caring.

There has been poor leadership from successive government on the issues of caring and funding. This current one is no different and I can’t decide whether they should be shamed or encouraged by the Social Care Curry Club gatherings.

Oddly, I’m reminded of an inscription on the Statue of Liberty, which reads:

Give me your tired, your poor, 
Your huddled masses, yearning to breath free . . .

Among the korma, masala, Rogan josh, the aloo gobi and byriani, are these the ‘tired’ and ‘huddles masses, yearning to breath free’?

Perhaps they are and just maybe, from this unusual groundswell, some common sense will decant to Parliament, to the financial movers and shakers who really do hold the keys to what history will write of this difficult social care period.

Cheer up the elderly and we’ll save a fortune: I don’t think so

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Cheer up elderly and ease pressure on NHS, so says the headline in the Telegraph online.

Inspired by Norman Lamb, the minister for care and support, it’s certainly an eye-catcher – well done that sub-editor.

The Lib Dem MP maintains that taking elderly neighbours to church or a football match will reduce pressure on the NHS by giving pensioners a “reason to live” and stopping their “dependency” on care services.

Is that right?

The article says that Mr Lamb wants people to offer their elderly neighbours “companionship” because those who are ageing are living “miserable lives”.

He adds, according to the Telegraph, that such action could be enough to stop them relying on professional carers.

Earlier this year I blogged a piece about Mr Lamb suggesting that Neighbourhood Watch groups could be responsible for providing care to pensioners. I was not impressed with his proposal then and neither am I heartened by his latest idea.

Where does he get the idea that the elderly, per se, are miserable and need reasons to live? This is hardly an evidenced-based generalism, Mr Lamb.

Yes, some are lonely, some are miserable – but so are a lot of young and middle-aged people.

Why do I find Mr Lamb’s comments so insulting? Am I now old?

According to the Telegraph he told a fringe meeting at the Lib Dem conference in Glasgow: “If you are on your own and you never see anyone from day to day and week to week other than a formal care worker perhaps only for a 15-minute visit in the morning and afternoon, your life is pretty miserable.

“If you start to get a visit from someone who says, ‘Let’s go out, let’s take you to church, let’s take you to [a football match]’ you give people their lives back. You give them a reason to live again.”

His comments are certainly partially true, I guess a little like politics. Did I read he’s a lawyer and wouldn’t his courtroom experience serve him well for the ‘whole truth’?

Ultimately the Telegraph article reveals the driving force behind Mr Lamb’s comments and I quote directly from the piece . . . “Mr Lamb said local authority finances are under huge pressure because of the growing elderly population. “As people get their lives back they are less dependent on statutory services to deliver support to them. And so the cost to the local authority starts to reduce.”

Is this the best he can offer in creative management of grossly inadequate social care budgets?

Come on, our elderly really deserve much better than this. Not least, they deserve properly funded care from paid professionals.