By Debbie le Quesne

Posts Tagged ‘care for the elderly

This is music to the ears

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Barbara Martin hasn’t played the piano for over 50 years.

Arthritis had crippled her fingers and tinkling the ivories seemed only a distant dream. That was until she received support from a student occupational therapist.

I caught this story in the trade press and it truly brightened my day.

A music lover from a young age, Connors House resident, Barbara, used to enjoy all things symphonic from playing the piano to singing in choirs.

With family life keeping her busy, she stopped playing years ago, and now, after two strokes and developing arthritis, she never thought she would play again.

Care Industry News, the online trade magazine, reports: “Barbara has recently been working with an occupational therapist student called Corin, who is on a placement from Canterbury Christ Church University. Together, the pair has been working on strengthening Barbara’s hands and fingers, through a range of activities and tools.

“Music is my passion,” Barbara says, “I can clearly remember singing around the piano as a family when I was younger, my children and grandchildren were all musical too. My first date with my husband, John, was to the BBC Proms! Corin and I got talking and I told him about my love for music and the piano.

“I honestly never even dreamt I would play the piano again. I always used to play Beethoven’s Für Elise and now I can’t believe I can play it again. Corin was so patient with me and has really helped my confidence grow, although I’m not ready to play for other people just yet. When I’m sitting in that big empty room and I can feel the sound coming from my fingers, it really is music to my ears. I can barely believe it is me playing it, it’s a real sense of achievement.”

How wonderful is this story! It’s a delightful antidote to so much gloom in the sector and again a great example of care excellence. Good care does exist. It tends to be only the media that fails to find it.


New PM downgrades care minister’s role

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Theresa May has an unenviable challenge. We have the Brexit issue, the unstable British economy, welfare issues, immigration problems . . . and social care all clamoring for her attention.

What’s going on, I ask. The minister of Care responsibilities have been downgraded and are now the remit of a parliamentary under-secretary. It’s the first time in eight years this has happened and I’m hugely disappointed.

The news appears to have caught the imagination of only a few journalists, but not surprisingly, the ones at the Guardian.

“This downgrade comes at a time when there is acceptance that social care is in crisis and there is unprecedented demand on care services,” I read in the paper’s online columns.

And the article points out the obvious. As we live longer and have more complex needs in later life, it is crucial that social care remains high on the political agenda.

The downgrading appears to suggest otherwise – this is now a post on the bottom rung of the ministerial ladder. I was hoping that things would be so much better with Mrs May.

According to the Association of Directors of Adult Social Services, to maintain care at the same level as last year would require more than an extra £1.1bn. But the National Audit Office, says the Guardian, has previously reported that councils increasingly pay less than the actual cost of the care provided.

Here we beat the same old drum: It is not a financially viable a situation.

Additional pressure on care provider budgets comes with the Living Wage and the fact that demand for care is only going to increase.

Jane Ashcroft is chief executive of Anchor, England’s largest not-for-profit provider of care and housing for older people, writes: “With a rising population and longer life expectancy, the number of people over 65 is set to rise by more than 40 per cent in the next 17 years.

“This will take the number of older people in the UK from 11.4 million to more than 16 million. This demographic change is welcome; it signals improving living conditions and advances in medicine. But if the funding of services is not updated for these new demands, we are undoubtedly heading towards an age of suffering and loneliness for older people.”

Rightly so she calls for a minister of state role – “someone with the power to make real change.”

I fully understand that good social care reduces the financial burden on NHS care. It cuts hospital admissions and heads off expensive health troubles with our vulnerable and elderly. Critically, it can also cut hospital bed blocking.

According to Ashcroft these combined woes cost the taxpayer £820m a year.

Can we have our minister back please. I think we need one, urgently. The downgrading of this portfolio is a huge step in the wrong direction.


The haves and have-nots: Bizarre economics of care

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The UK care home sector is losing managers and failing to replace them, that was what LaingBuisson was telling the media more than 12 months ago. And guess what, it’s not changed today.

The shrinking pool of talent for the top jobs with providers of elderly care is driving manager salaries to new heights.

In the latest data I have to hand it says new-build homes are offering in excess of £60,000 a year for managers.

That means with the additional costs of National Insurance employer contributions, pension payments and other sweeteners, the source cost for providers is rapidly approaching £100,000, and a bonus scheme can easily tip this even higher.

Of course, we wouldn’t expect to see these figures being paid amongst many of our members and it’s not because they are mean employers. It’s a simple case of economics: There’s just not enough money in the pot as the region is too poor.

It’s a fact that many of the lager corporates operate in much more affluent areas than the West Midlands and unlike many here, their main trench of income is from private payers. Most of my members survive on council-funded placements and it’s their primary source of income.

Austerity measures is seeing the industry becoming increasingly polarised – the haves and have-nots.

In May last year, according to LaingBuisson Recruitment co-founder James Rumfitt, the residential care sector as a whole was struggling to find managers of competence.

I am not surprised.

According to the healthcare consultant’s Care Home Pay Survey – second edition, the average care home manager salaries at the beginning of 2015 were up 4.2 per cent above the previous year.

This was incredible 49 per cent higher than salaries seen a decade ago. Compared to an increase of just 24 per cent in median full-time employee earnings in the UK economy as a whole, it’s an eye-watering hike.

Isn’t it odd, the general care market is in turmoil, yet the economic dynamics of a shortage of good managers, pushes up their salaries at the top end of care provision. Supply and demand are hard masters.

While there will always be those who can afford private care payments and thus fund very generous salaries for the elite operators, there will be many more people receiving care on local authority rates only. Their care providers, where pay rates remain anchored to the Living Wage, will not have the privilege of top-ups to fund such salary extravagance..

But I must say this: The care I have seen in some of our struggling homes has been exemplary. Plush surroundings, teas on the terrace, matching furnishings and expensive, oak flooring, does not necessarily equate to excellence in care.

What is it about never judging a book by its cover . . .


Now docs say bring forward the £700m Better Care Fund monies

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Fourteen doctors’ leaders have written to George Osborne asking for further funding for social care in next week’s Budget, the BBC has reported.

In a letter to the chancellor, they warn cuts in social care funding were putting real pressure on the NHS.

And they said investing in social care was “vital to the success of the NHS”. Err . . . yes.

The government response in the BBC report was that it was already giving local authorities access to up to £3.5bn of new funding for adult social care by 2019-20. By when? Far too late, I’m afraid.

The signatories to the letter are led by Clare Marx, president of the Royal College of Surgeons of England, and include the leaders of a number of royal medical colleges and societies.

In their letter to the Chancellor, they describe health and social care as “two sides of the same coin”.

It’s heartening that the letter describes the impact of an underfunded social care system on the NHS, saying patients fit to be discharged are unable to leave hospital because social support is unavailable at home. How long has the Association been saying this?

“This increases the likelihood of infections and falls,” the letter says.

The knock-on effect is that beds are blocked to new patients, they continue, “leading to cancelled appointments and operations”.

“This impacts on our ability to provide timely treatment and meet treatment targets, risking patient wellbeing, and is ultimately detrimental to the economy through delayed returns to work,” they wrote.

And here’s the bit I just love. In the letter, the doctors suggest bringing forward the extra £700m from the Better Care Fund to this year rather than waiting until 2017, when the money was due to be spread over three years.

NHS chief executive Simon Stevens has previously said that the success of the Five Year Forward View is dependent on adequate funding for social care.


The signatories to the letter are:

Miss Clare Marx, president of the Royal College of Surgeons of England

Prof Dame Sue Bailey, chairwoman of the Academy of Medical Royal Colleges

Prof John Ashton, president of the Faculty of Public Health

Dr Anna Batchelor, dean of the Faculty of Intensive Care Medicine

Dr Liam Brennan, president of the Royal College of Anaesthetists

Prof Jane Dacre, president of the Royal College of Physicians

Mr Michael Lavelle-Jones, president of the Royal College of Surgeons of Edinburgh

Dr Suzy Lishman, president of the Royal College of Pathologists

Prof Carrie MacEwen, president of the Royal College of Ophthalmologists

Dr Giles Maskell, president of the Royal College of Radiologists

Prof Neena Modi, president of the Royal College of Paediatrics and Child Health

Prof David Oliver, president of the British Geriatrics Society

Dr David Richmond, president of the Royal College of Obstetricians and Gynaecologists

Prof Sir Simon Wessely, president of the Royal College of Psychiatrists

Note: If this letter was on social media, I’d be adding my name to the list . . .


Beware the dodgy online home reviews

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TripAdvisor is an easy, accessible way of getting the lowdown on dining, cheap flights hotels and holiday destinations.

This layman’s approach to reviewing and sharing experiences has caught the imagination of the UK public and often is a first point of call to see how good – or bad – things can get.

But what about reviews for care homes? A report in the online magazine, care Industry News, informs us that after engaging constructively with the Competition and Markets Authority (CMA), websites including carehome.co.uk, Care Opinion and Most Recommended Care, have all agreed to tidy up their practices.

These improvements address concerns that were raised following a “call for information” by the CMA on online reviews and endorsements.

Let me quote the article: “A cross comparison with the Care Quality Commission suggests that ‘award’ winning care providers had in many cases received rather more negative inspection results. It makes absolute sesne that when people are searching for care; they are able to see transparent results just as they would if choosing a car.”

Oh dear . . .

Mark Sadler Founder of yourcarehome.co.uk and Hootvox.com advises readers to “look very carefully at how reviews are gathered and how stars and ratings are calculated, you cannot take anything on face value.”

Sad isn’t it?

The article can be found at : http://careindustrynews.co.uk/2016/02/care-home-reference-sites-agree-to-improve-transparency-for-those-looking-for-care/   Well worth a read.


For me, this whole business is frustrating. I spend most of my time passionately supporting the cause for good residential care and I like to think my comments are full of integrity.

Care home reviews are powerful marketing tools, an issue that the Government has addressed with www.nhs.uk/Service-Search/Care-home-with-nursing/Halesowen/Results/576/-2.051/52.45/1831/9261?distance=25

I don’t know what the traffic is on this site, but it desperately needs to be used more.

My advice: Always visit the home in the first instance – just drop in unannounced and note the response well. Then take a look at the reviews.

Some interesting comments come from Andrew Mabbutt, CEO of the feedback platform Feefo, Quote: “While improving practises is always a good step, unless reviews are collected by a trusted, independent third party, there is always the danger that they cannot be trusted.

Incidentally, Feefo provide a closed feedback system for both online and offline businesses. They invite only verified customers to leave their feedback, and ensure that they are unmoderated. This rules out any possibility of fakes, or sweeping negative reviews under the rug.”

Dear me! The care sector really isn’t very good at getting its own PR right.

The CMA’s call for information highlighted a number of general concerns about the review sector, including the potential for some review websites’ practices to prevent some genuine negative reviews from being published, some review websites not checking reviews sufficiently at all, and important information relating to poor CQC inspection results not being brought to the attention of the users of some websites.




Over the border in Shropshire – just as predicted

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It’s always good to keep eyes and ears open in the care sector and part of my remit tis to remain abreast of what’s happening to regions other than my own.

Recently, the Shropshire Star – sister paper of the Express & Star – announced that a social care overspend will soak up £8,5m of Shropshire Council’s extra funding.

Shropshire Council’s leader, Councillor Malcolm Pate was joined by the council’s chief executive Clive Wright on a visit to lobby Government at Westminster.

Their message to Marcus Jones MP, parliamentary undersecretary of state for local government: The council needs £20 million more a year to prevent deep cuts in services over the next three years.

It’s a familiar story across the regions north of the Home Counties.

But it appears, what’s reported as gentlemen’s agreement now exists and Shropshire is to get extra funding  – £8.5m – over two years.

Currently, said the newspaper report, “Shropshire Council’s growing elderly population means it faces a disproportionate bill to pay for adult social care. But Councillor Pate warned that despite the extra funding the council is effectively in the same position it was before the increase in its funding settlement was announced.”

The impact of the extra funding is being investigated by the authority’s officers, the report added.

My worry is that any extra funding that is squeezed from the purse of Government would be a drop in the ocean, but sadly our Cabinet currently holds all the cards.

Interestingly, Shropshire’s over-65-year-old population is growing at a faster rate than the national average. Shropshire can expect to see its population of over 65 year olds grow 14 per cent by 2020, this compares to 12 per cent nationally.

In a letter to Cabinet last December, local authority, NHS, provider and charity leaders, warned there was not enough cash in the system and called for urgent action.

In the letter to George Osborne, health secretary Jeremy Hunt and communities secretary Greg Clarke, the Association of Directors of Adult Social Services (Adass), NHS Confederation, Care and Support Alliance (CSA) and Care Providers Alliance (CPA) warned that the Better Care Fund initiative and the opportunity for LAs to up council taxes would not be enough to deal with current and future pressures.

The same drum was sounded by West Midland Care Association . . . and guess what? We were all spot on with predictions.

Inevitably we are going to see an acceleration of the failure of domiciliary, residential and nursing home providers; less support to needs the needs of the elderly within community and residential setting; and unbearable pressure on NHS beds.

No wonder in places like Wolverhampton the CCG is desperately trying to keep our elderly a whole lot healthier.

I’m a great believer in keeping things in context, so here’s a parting thought. I’m not diminishing Shropshire’s problem, but it’s nothing compared to those in Sandwell and Walsall where the older population is not only getting disproportionately bigger, but also much poorer than their Shropshire counterparts.



Cuts blamed on huge hike in deaths

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We said it may happen: Government cuts to social services could lead to more deaths. As they say, ‘it’s a given.’

Not surprisingly, the Telegraph has reported it could be the “largest factor” in the biggest annual rise in deaths in England and Wales for nearly half a century.

The data comes from the Office for National Statistics, which says that mortality rates last year rose by 5.4 per cent compared with 2014 – equivalent to almost 27,000 extra deaths.

This increase is the highest since 1968 and took the total number of deaths in 2015 to 528,340.

Interestingly, death rates in England and Wales have been steadily falling since the 1970s but the trend took a turnaround in 2011.

Advisers to Public Health England are calling for an investigation and add that the figures show the elderly, especially women, were now bearing the brunt of a growing crisis in the National Health Service and cuts to social care.

Quote – Professor Danny Dorling, from Oxford University and an adviser to Public Health England on older age life expectancy: “When we look at 2015, we are not just looking at one bad year. We have seen excessive mortality – especially among women – since 2012.”

He adds: “I suspect the largest factor here is cuts to social services – to meals on wheels, to visits to the elderly.”

Last year there was a £1.1bn cut in adult social care budgets.

We appear to have an ageing population that’s now more vulnerable to death and according to Age Concern: “These figures suggests something is going badly wrong.”

Predictably the DoH respond with a vague, meaningless reply, stating “excess winter deaths can be due to a number of causes and deaths can fluctuate from year to year.”

Oh yes. I hated physics at school, but I can remember this: Newton’s third law of motion says “for every action there is an equal and opposite reaction.”

I’m sure social care was never envisaged as being part of this equation by Isaac Newton, but I’m prepared to be a trailblazer here.



Written by debbielq

February 25, 2016 at 10:19 am