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By Debbie le Quesne

Archive for the ‘Uncategorized’ Category

Robots with a human touch . . . will it ever catch on?

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You know the care sector’s in trouble when the media is awash with robot stories.

Apparently they are part of the answer to the care crisis. I’m not convinced, given the time frame in which we need a resolve.

But they are being developed “with cultural awareness” and a good bedside manner, academics say.

An international team is working on a £2m project to develop robots to help look after older people in care homes or sheltered accommodation.

They will offer support with everyday tasks, like taking tablets, as well as offering companionship. I get that.

Researchers from Middlesex University and the University of Bedfordshire will assist in building personal social robots, known as Pepper Robots, which can be pre-programmed to suit the person they are helping.

These “culturally sensitive” robots will be developed within three years, I read.

Prof Irena Papadopoulos, expert in trans-cultural nursing, was reported as saying: “As people live longer, health systems are put under increasing pressure.

“In the UK alone, 15,000 people are over 100 years of age and this figure will only increase.

“Assistive, intelligent robots for older people could relieve pressures in hospitals and care homes as well as improving care delivery at home and promoting independent living for the elderly.

“It is not a question of replacing human support but enhancing and complementing existing care.”

Here’s the rub . . . not designed to replace human support.

I don’t doubt they could be of use, but no matter how well they are programmed to be culturally aware, they will never replace the bond that can exist between carers and those for whom they care.

Pepper Robots are already used in thousands of homes in Japan.

So here’s the future: The robots will communicate through speech and with gestures, be able to move independently and pick up signs the elderly person is unwell or in pain.

Can’t really see my old Aunt Hilda asking her robot for a not-too-milky tea, with the tiniest amount of sugar, served in her favourite porcelain tea cup, can you?

 

 

Higher local taxes not a proper answer

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While Surrey County Council leader David Hodge bleated an apology over his attempt at hiking up council tax bills by 15 per cent to cover spiralling social care costs, more than 90 per cent of councils in England told ITV News that being allowed to raise council tax has made little or no difference to their ability to provide social care.

In December the government announced it planned to increase the social care precept from two to three percent.

But with the crisis surrounding home care deepening, many councils told ITN its no more than a “sticking plaster”.

Interesting, isn’t it, that the Surrye ‘sticking plaster’ has just dropped off the ‘wound’ with the announcement earlier this month that the huge hike had been scrapped.

A survey by the Association of Directors of Adult Social Services (ADASS), commissioned by ITV News, contacted all 152 councils in England.

They were asked whether permission to increase council tax would make a positive impact on social care in their area. Just 112 responded.

Thirty said it would make no difference and 79 agreed it would make very little difference. Just three councils agreed the rise would make a substantial difference to their ability to look after residents needing extra help to cope.

Not a single local authority believed the tax initiative at a local level offered a complete solution.

Last year the Local Government Association claimed Treasury funding cuts of 40 per cent over the last five years have left councils facing a £5 billion funding gap on social care.

Mrs May, will you please listen to what is going on in our sector and help us?

Interestingly, I was in Surrey at an association members’ meeting when the 15 per cent shocker was announced and the care providers with me were as puzzled as everyone else by the move, given that the majority of their clients are self-funders.

 

 

 

Foreign aid – should charity begin at home?

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I’m not a great lover of the Daily Mail – but the newspaper did contact me the other day while gathering research on the state of the social care sector.

Perhaps I’ve made a new reporter friend, but time will tell. It’s a trust issue I have with the publication as so often the care sector has been pilloried by its editorial team.

There was, however, an interesting online report I read with the Daily Mail uncovering large-scale waste in the foreign aid budget.

Because of the Government’s pledge to spend 0.7 per cent of Britain’s income on aid, its overall budget is set to continue to rise inexorably.

The recent gloomy forecasts on care by the Institute for Public Policy Research in which a demand for a rethink on funding for care is central, has fostered calls for foreign aid to be curtailed and monies used to help tackle the care crisis at home.

Last year, then-chancellor George Osborne said the UK’s foreign aid budget would increase to £15.6billion by 2020. But the figure will rise significantly, hitting £19billion by 2030, if the economy continues to grow at the historic trend of 2 per cent a year, reports the Mail.

As you’d expect the call to divert some of the aid budget into social care has been backed by a number of MPs. So far, however, the Government says it keeping its 0.7 per cent manifesto pledge on foreign aid until at least 2020.

Interesting response, especially when the IPPR study predicts the ageing population will create a £9billion funding gap for the NHS – equal to about 5 per cent of its total forecast budget in 2030.

 

 

Written by debbielq

February 28, 2017 at 9:16 am

Shock report – ageing population will cripple care

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Looking after a rapidly ageing population will put Britain’s social care service into an unsustainable crisis by 2030.

That’s the cheery news from think tank, the Institute for Public Policy Research, which claims a £13billion shortfall on an estimated care budget of £21billion will emerge as the population of over-65s increases by almost a third – from 11.6million to 15.4million in 2030.

Over the same period, it has been estimated that Britain’s foreign aid budget will have risen from £12billion to an astonishing £19billion, sparking demands for ministers to divert payments to overseas governments into tackling the UK’s growing problems at home.

The IPPR report is a bleak read, with the consequences of such a massive shortfall in social care funding, creating huge pressure on the NHS.

I need cake and a chocolate biscuit and I’m not through with this piece just yet.

The report concludes: “On current trends, adult social care is unsustainable.”

It goes on to warn that the so-called ‘oldest old’ – those aged over 85 – will almost double by 2030.

Simultaneously, the number of people needing daily help to wash, feed or clothe themselves is also set to double to two million, while the number of over-65s with dementia will rise by 80 per cent.

I need more chocolate, coffee and comfort food. Now!

 

 

Written by debbielq

February 28, 2017 at 9:13 am

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.

 

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

LGA campaigning on our behalf

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At the end of last November the LGA ‘state of the nation’ report highlighted a £5.8bn funding gap in social care by 2019/20. Ouch!

This report from the Local Government Association (LGA) provides an overview of current issues for adult social care and it’s not light reading.

It says the core local government grant has been reduced by 40 per cent in real terms since 2010 and councils have been set a ‘flat cash’ settlement for the remaining years of the decade.

“This, the LGA explains, leaves councils exposed to the pressures from general inflation, increases in demand from population growth and increase in care costs, such as national insurance, the National Living Wage and pension contributions,” the report explains.

So we’re told the funding gap will be hitting £5.8 billion by 2020.

The Better Care Fund springs to mind . . . but has any local Authority seen any of this cash? Over the Christmas/New Year ‘hump’ there has been so much information arriving on my desk and I’m swamped in pile of data – only some which is relevant.

Ultimately, the industry needs hard cash, local authorities require the same and the only paymaster with that kind of financial clout is central Government.

I used to be struck that so many local authority offices in the West Midlands were bursting at the seams with busy, stressed employees. Not anymore – their work has been  outsourced and offices are empty. Whole departments gone and we’re well past the point of sensible economies here.

Politicians really must now decide if social care is a real priority that will cut through rhetoric, depleted LA resource  and deliver solutions.

The Guardian recently stated that adult social care accounts for around 35 per cent of total budget spending by local governments, so with such a high percentage of outgoing, it seems impossible for such a service to contribute significantly to savings.

Like never before the LGA is gaining traction with the media and the headlines being written can only help our case. I’ve seen so many figures that are beyond Monopoly money accounting it leaves me in a financial fog. Over the UK we’re looking at multi-billions of pounds of shortfall.

Ahead of the NHS, social care desperately needs attention as repairing it will have monumental benefits for our health service.

In a nutshell, the LGA report concludes unanimously that social care is chronically underfunded. Interestingly, it highlights that this vital service, that helps define our nation as civilised, does not seem a priority amongst the public. Is it because all parties have failed in the PR and the public really doesn’t understand the implications? Personally, I don’t think so. But I do believe the sheer scale of the problem has remained hidden by successive Government because of their refusal to respond realistically to the ‘help us’ calls of West Midlands Care Association and other similar representative bodies.

More and more I find myself juggling both national and local agendas that straggle both the NHS and social care. For me it appears perverse that over a decade the NHS quota has risen by about 25 per cent while social care has been flat-lined.

Quite what the financial rescue framework will become over the next months is a mystery, but I am certain history will write some pretty damning stuff if we don’t get it right very soon.

 

Written by debbielq

January 17, 2017 at 9:09 am