By Debbie le Quesne

Posts Tagged ‘old people’s homes

Record turnaround for fist WMCA DBS online

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It’s been a long time coming but it’s worth noting that the first electronic DBS check  completed by West Midlands Care Association was done so in record time.

Within just four hours the documentation was completed for Birmingham’s Albion Court which is part of Restful Care Homes.

The association won approval by the Home Office to deliver an online disclosure and barring service in November.

The move followed months of negotiating to secure a competitive deal with an accredited online operator. The contract finally went to uCheck.

A raft of security measures has been introduced at the WMCA headquarters to comply with HO regulations.

With strong support of its membership, WMCA has pushed hard to improve the current delays in processing disclosures.

This should now see the end to the horrendous delays we have experienced. One case took a staggering 141 days to process, with past averages working out at 33 days.

By committing to work alongside uCheck in this fast-track initiative we are underpinning our commitment to improve the DBS experience and we know it is something our members desperately need.

The new system helps eliminate common errors found in form filling exercises which often don’t come to light until the application is in the process system.

Care chief takes W. Mids care woes to London

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As the West Midlands Care Association Chief Executive I have a duty to take every opportunity to represent my members in places that can influence their care business.

Talks with the Department of Health over the financial restrictions that are currently strangling the industry proved no exception.

Representing both my members and those of the Care Alliance in which I holds a co-chair role with Erica Lockhart from Surrey Care Association, I spelt out how financial pegging threatened future provision in the private sector.

Meeting in Westminster with Paul Richardson, head of Quality and Safety, and Karen Dooley, Policy Lead for Adult and Social Care, under the Alliance banner I was keen to explain to the movers and shakers what is happening at grass-roots level across the country.

But I also took the opportunity to inform these senior staff what is happening in the West Midlands.

We spoke about the problems for our learning disability providers who have not had cost of living increases for over four years, despite huge rises in overheads.

The main outgoing for them is wages and the minimum wage has gone up at lease four times in as many years.

We also discussed the difficulties of running care businesses in areas where the local authorities don’t pay the full cost of care.

Also on the agenda were the implication of the new inspection regime and the number of failing homes and why they are in trouble.

I questioned whether the right areas of the care sector are being examined and sought policy pointers from government on how it thinks failing homes can recover.

Watch this space . . I’m sure more will follow.

‘Make or break’ time looms for social care

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Councils in England face a funding gap of £5.8 billion between March 2014 and the end of 2015/16, new Local Government Association analysis shows.

The figures are scary and according to Care Industry News, the online magazine, local authorities will need to make huge savings equivalent to 12.5 per cent on their total budgets before next April.

Successful integration of health and social care is vital, says the LGA to stop the care system from collapsing.

The £5.8 billion shortfall in council budgets will be caused by a combination of reduced government funding and rising demand on services – particularly from the elderly.

The funding gap in adult social care alone already amounts to £1.9 billion by 2015/16 – based on council adult social care budgets in 2013/14, says the Care Industry News report.

My abiding fear is where new saving will be made. Already we have heard pledges to protect spending on adult social care next year as much as possible, but I can’t help worrying worse is to come.

Next April, will mark a critical point for adult social care in England with the pooling of £5.4 billion from councils and the health service. The Better Care Fund will aim to improve care for older people and reduce financial pressure on councils and the health system through stopping lengthy waits for discharge from hospitals and avoiding unnecessary admissions to care homes.

Initiatives like the Vitality Partnership are already under way to make a difference in the community and funding for such work has been assigned for the year.

But the scale of savings which need to be found next year illustrate the urgent need for the Better Care Fund to “quickly succeed in radically improving the way public money is spent on looking after England’s elderly,” says Care Industry News.

Indeed, 2015 I believe will be make or break for social care and council leaders are saying the same.

Quoted din the online article, LGA Chairman Sir Merrick Cockell says: ”In recent years, local government has worked tirelessly to save billions while protecting services for those who need them most. But the scale of the challenge facing local authorities next year is stark. Council finances are on a knife-edge and the old way of doing things – including the way we care for our elderly population – just won’t work anymore.

“Next year will be a make or break moment for adult social care, for local services provided by councils and for the NHS.”

Central to the rescue mission is the introduction of the Better Care Fund (BCF).

“Neither councils, the NHS or England’s elderly can afford for this not to work,” he adds.

And I have just returned from a meeting about the Better Caring Fund. Interesting – it seems the Government is still “deciding and discussing,” while local authorities and CCG’s are now too far down the line to stop in what seems a perfectly reasonable use of money. Spend the money to help people stay healthy in their own homes or care homes and spend a whole load less on acute hospital admissions.

More cuts to an already financially struggling industry or cutting back on the BCF would be catastrophic.  The challenge ahead is enormous and I for one have everything crossed that all will be well.


Care reforms in danger of ‘screening out’ needs

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People living at home with dementia could be “screened out” of the care loop, Caroline Abrahams, director of charity Age UK, has warned.

She said that those with dementia and who needed daily help to live at home could become victims of the care reforms.

In particular, she was concerned that the criteria for accessing care was “far too restrictive.”

She added that those who struggled with day-today tasks such as dressing, washing, going to the toilet or preparing food were at risk and explained that “from now on the inability to do just one of those fundamental things will not be enough to qualify for support.”

Age UK is concerned that some older people’s needs will escalate and “undermine their ability to live at home.”

The report, to which I was referred, appeared in the Western Morning News, but has not seen this story anywhere else. I find it worrying that these kinds of alerts are not getting more exposure and the fact that the historically very measured Age UK appears to becoming more political also sets alarm bells ringing.

Home Group, one of the UK’s largest social care providers, has also called for an “urgent amendment” to the rules, so that those with moderate as well as substantial needs can access support packages.

Rachael Byrne, executive director of the operation, was reported as saying: “Many people who have relied on care from their local council will find themselves squeezed out.”

Mencap also gets a platform in the Morning News with charity chief executive Jan Tregelles saying the bar has been set too high and fears for the future wellbeing of those afflicted with mental illness.

I quote: “We know the huge difference support can make to people’s lives and how devastating the consequences when they don’t get it – needs can quickly escalate, pushing people and families to crisis point.”

I really do wonder for what this coalition government will be remembered most.

As the Care Bill progressively makes its presence felt, we wait with bated breath to see how it will standardise the criteria for care across the UK. Presently, we still have in place a postcode for care delivery.

Recently, our Worcester Care Association director Rakesh Kotecha  (left in the photo), gave a talk to a briefing at a Colliers International event in Birmingham for financial,  legal and care industry representatives.

We were all in awe of the task the Act is trying to cover. There are consultations aplenty as none of the parties really know how it can all work.

Part of the event was also an interesting presentation from Nicholas White of Colliers (right in the picture) on the key performance indicators financial institutions use to calculate what is happening in the industry – a real insight


Guilty until proved innocent – how the law works with residential care

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The care industry is getting very twitchy over the new raft of regulatory demands and possible inspection outcomes that can now be deemed criminal offences.

High levels of corporate accountability that could end in the courts have racked up insurance policy bills and according to Caring Times editor Geoff Hodgson’s blog insurers seem to “rank care homes with paragliding and rodeo work.”

At odds with all of the UK justice system, the biggest problem is that provider are assumed guilty until they can prove their innocence.

Geoff point out, quite rightly, that we rarely hear much of lack of accountability of the public agencies involved in the investigation of safeguarding incidents.

Let me quote this incident he highlights in his blog: “In a letter published in the June issue of Caring Times, Paul Simic of the Lancashire Care Association recounts the sorry saga of Palatine Lodge in Burnley where a patient died in early 2012.

“The home had been cleared of any fault by the Coroner, the police, CQC and the local authority, but as a consequence of the safeguarding investigation, all the residents were moved and the proprietor of the home, its reputation in tatters, was compelled to sell the business at a substantial loss.

“In his letter Mr Simic asks: ‘How can it be that all this time on – with what happened to the other residents, to the proprietor, to the manager, to the staff, to any family and friends of Mrs A who also may have had to travel this unhappy road to the Coroner’s verdict – that no fault is found in a provider with an established good name, those who made such consequential judgments en route are subject to no independent review or scrutiny or consequence?

‘Where is the justice or fairness in this instance? Without the right checks and balances in place, the SME provider sector is too easily a secondary level victim.’”

I know too of another case where a male career was accused anonymously of sexual assault with a client in a nursing home. A massive, often hostile, police inquiry followed. The carer was suspended for months, his domestic life fell apart, the home’s manager was devastated and the owners distraught. Outcome: No case to answer – the letter believed to be sent by a former disgruntled employee.

Issues of a legal nature in safeguarding sometimes have catastrophic consequences, which, as these cases show, are not always fair.

Geoff quotes 
“All are punished,” – the Duke in Romeo and Juliet after the lovers’ joint demise’ and notes well it’s not so in the safeguarding scenario. I have a quote to add here too: “The law is an ass” – Charles Dickens (Oliver Twist).

Unveiling the myths about care

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That great advocate for those pressing on in years, Age UK, has recently made headlines saying social care in this country is in crisis and is calling on the government to implement much-needed change.

But care is a mystery to many of us, the organisation says, and has examined five key areas that are commonly misunderstood to try and help explain the social care system better.

So here’s their piece and I would advocate all over-55s should be reading this.

1. The costs of care

The common misconception: It’s free isn’t it?

The truth: Care isn’t free and it’s easy to confuse healthcare services (which are free of charge) and social care services.

Social care is means-tested which means that, if you have income or wealth, you may be asked to contribute or pay in full for services.

Many people pay for care privately by directly arranging support with a provider organisation. People who receive support through a Local Authority may also be charged.

In England, if you are moving into a care home and have more than £23,250 in savings or assets (including your property, if no one else lives there), you will usually have to pay the full cost for the care home fees.

If you have less than £23,250, or your spouse or another dependent still lives in your home, you may qualify for council-funded care. The rules setting out how these payments work are set nationally by the Government.

You can also be charged for home care services, although the value of your house is not taken into account in this case. Local Authorities use national guidance for charging for home care services, but they are allowed to use their discretion and local charges and capital limits can vary.

2. Home help

The common misconception: Councils can provide home helps

The truth: Many councils now provide care only to people who have high levels of care needs. This is because in many areas demand for services outstrips the available funding, and so people with higher needs are the first priority.

People with lower needs can arrange to have help with domestic tasks such as washing and cleaning, but it’s likely these would have to be arranged privately rather than through a council.

3. Care workers’ skills

The common misconception: Care staff are unskilled

Caring is a skilled profession, although, unfortunately, many care workers receive low levels of pay. Providing care is a difficult job and the sector is full of excellent care workers, social workers, advice workers and care coordinators.

Social workers and care home managers are required to have specific qualifications before they are allowed to practise and many other workers need to have on-going training to develop their skills.

However, it’s not all about paper qualifications: the best care workers are those skilled in listening and engaging with older people so that they understand their needs better and can provide tailored support.

4. Paying for care

The common misconception: My home will be taken away from me if I need care

The truth: For some people the value of their house will be taken into account when charges are made for care services.

However, there are many people who will not be affected by these rules. For example, someone’s home is not taken into account in the means test for home care services.

Likewise, if there is a partner or dependent relative living in the property it remains outside of the residential care means test.

There are also other options available to people who do need to use the value of their property to pay for care fees.

Local Authorities are able to offer people a deferred payment, where the council agrees to provide funding as a loan, which is repaid when the property is sold at a later date. This helps residents who do not wish to sell their former home immediately.

Alternatively, some people choose to rent out an empty property, using the income to support with the care home fees.

5. Choice of care

The common misconception: There is no choice of services – you get what you’re given

The truth: Councils are increasingly designing services so that individuals are placed at the centre of the care arrangements, with full choice and control about what services and support they use to meet their assessed needs.

People who are eligible for support are allocated a ‘personal budget’ and can receive it as a cash payment, or ask the council to arrange the support that they want.

This is known as personalisation. It means that individuals work alongside the professionals to set up a care package that they are really happy with.

Experts show the way forward over wall of silence on references

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Left: Jenny Jones, barrister with Harrison Clark Rikerbys Solicitors, addresses the workshop

Right: CQC manager Jane Rumble explains what to expect with future inspections

West Midlands Care Association has hosted a successful workshop looking at the thorny issues of employment law and its interaction with CQC compliance demands.

Staged at the Portway Lifestyle Centre, Sandwell, employment law barrister Jenny Jones of Harrison Clark Rikerbys Solicitors shared the podium with Care Quality Commission manager Jane Rumble, who outlined clearly the emerging compliance issues.

In tackling the issue of care worker references which employers are often reticent to offer, both speakers agreed that new ideas needed to be developed so that those offering observations on workers did not feel legally compromised.

We had a very focused session and achieved a lot in a short time– that’s great news for the care sector!

The workshop has resulted in the Association now working with both parties to offer guidelines and support mechanisms to its members on what can be included in these essential references.

With help of both speakers four ways were agreed to tackle the problem:

  • Care providers should take all practical steps to get current references, including sending forms and follow-up phone calls. Each action should be and applicant requested to make a self-declaration. Once completed, providers can employ someone with other references and evidence.
  • The Association will work to get members to support fellow members in supplying necessary references.
  • The Association will work alongside Harrison Clark Rickerbys to create a reference form, which will give guidance about what care providers can safely say.
  • And together we’ll do our best to ensureg care providers understand that a ‘well led’ organisation would indeed give valuable information to fellow care providers to ensure good carers remain in the industry and bad one leave.

It was pointed out from the floor: “Everyone is scared to give references in case they get taken to tribunal and there are a huge number of requests in this industry.

“This means that people have to remain on the dole and providers have to manage with less staff by getting people to do more hours, or agency staff are used, who are very expensive and do not know the residents or clients.”

In a PowerPoint presentation, Jane gave a comprehensive overview of what care providers can expect from CQC over the next two years and how its strategy aims to rebuild public confidence in the sector.

I spend quite a lot of my time in conferences and workshops and this was simply one of the best meeting of minds I have seen for a while. I’m only sorry that some WMCA members were unable to attend – such was the demand.


Night hospital discharge system must change

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The practice of discharging thousands of NHS patients from hospitals in the middle of the night – despite bosses ordering a crackdown to stop it – made Sky News headlines.

In a special investigation the news team found the “number of patients leaving hospital in England between 11pm and 6am has actually risen in the last two years.”

Way back in April 2012, NHS called on hospitals to cut down on overnight discharges following a series of cases where vulnerable patients had been left to make their own way home.

Some of those vulnerable patients are elderly and in care. It’s a shameful state of affairs.

Clearly the NHS needs to free up beds – but like this? No way!

Figures obtained by Sky News following Freedom of Information (FOI) requests show that despite pleas for it to end, the practice is still widespread and in many cases rising.

Figures show more than 300,000 patients have been discharged late at night since 2012 – an average of around 400 a night. Tens of thousands of those patients were over 75.

A Sky online report claims that “experts say that patients often end up in care homes in the middle of the night.”

Let me quote some more – Nadra Ahmed, chair of the National Care Association, says: “They [the residents] are going back without any relevant information about how their care might have changed, what the diagnosis might have been, their paperwork is not following because people are off duty and often without the relevant medication they need for the following day or even through the night.”

Now the National Care Association is attempting to gather information on how many residential-setting residents this has affected within its membership. The data would be useful and I would encourage a good response . . . please!

But for me there’s a more important question to address: If these patients can be discharged, why no during the day? Many service users who have emergency admissions are left waiting with their carers for hours and delays sometime result in overnight stays. It’s the economies of madness.

Frankly it’s a shambles and here are the stark facts as reported. News asked 160 NHS trusts in England how many patients had been discharged between 11pm and 6am in the past three years.

“Of those, 72 trusts provided figures for all three years. In 41 cases, the number of patients discharged overnight increased.

“In 31 cases the proportion of patients discharged between 11pm and 6am increased. In three trusts it remained the same.

“Of the 72 trusts that replied, 152,472 patients were discharged between 11pm and 6am in 2011/12, rising to 152,479 in 2013/14.

“The figures also reveal that 20,152 were aged over 75 in 2011/12; 19,728 in 2012/13 and 18,548 in 2013/14.

“The proportion of patients discharged overnight remained the same at 2.41%.”

Ombudsman complaints soaring over social care

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Social care complaints to the ombudsman have rocketed in the last five years.

In fact, I read in the Guardian online that they have more than doubled.

In an interesting twist, East Sussex Council believes that rather than being evidence of a worsening service, it all to do with people being able to make their voices heard.

In a new ombudsman report the council is sited as the English authority that generated most social care complaints per head of population to the local government watchdog.

And according to East Sussex, the trend is because of “excellent signposting” for complaints. If this is not wholly true, this is very clever media spin. I do note, however, that the number of complaints upheld was below average.

Quoting the council, the local authority is reported as saying in the Guardian: “In East Sussex people’s right to go to the LGO is actively encouraged as a positive step if they are unhappy with our approach.”

The report goes on to say that others may take a different view of the figures, which “show a rise of 130% between 2009 and 2013 in all social care complaints received by the ombudsman.

“Almost 2,500 complaints and inquiries were dealt with last year. This has made social care the fastest growing area of the LGO’s work and also the area with the highest rate of complaints upheld (46%).”

It worries me that the Guardian report tells us that the majority of complaints concern assessment of need, care planning and funding or charges. However, it adds, complaints about residential care are rising fastest and last year accounted for more than twice the number of grievances about home care.

It’s the first time the LGO has named councils that attract most complaints. In the top five are Walsall, East Sussex, Redbridge in east London, Blackpool, and Bromley in south London.

It is true that like never before, people are aware of the complaints mechanism and I believe the majority of local authorities with which I deal have a robust information system in place to inform clients of their complaints mechanisms.

But I can’t help feeling disappointed, I know that East Sussex is a long drive from the Midlands where much of my work is done, but to me the geography is immaterial. Everyone needing this kind of care intervention should be happy with all aspects of its delivery, but we live in an imperfect world. That imperfection in social care is fuelled, I believe, not only by flaws in humanity, but by an on-going unwillingness to fund the industry properly.

With a General Election now on the horizon, let’s see what political pledges for change will be made.

As ever, the West Midlands Care Association will be happy to remind politicians of all persuasions just what they have committed themselves to.

Dementia, the news headlines and how we can we help?

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Dementia is big news at present – and I mean massive. Our TVs are full of programmes revealing the true extent of the problem and the varied attempts at solutions.

Last night was no different with the Tonight team from ITV broadcasting Living with Dementia,

By 2021 the number of people living with dementia will reach about a million, with one in three living today developing the memory-loss condition.

It’s also estimated that almost all families will be affected.

Rightly so, the Prime Minister has called it a “national crisis” and has promised to double the budget for research into the condition.

And I would join a growing lobby of people who would say to the PM that he needs to match his good intentions with hard cash and fund the resources needed to deal with the crisis.

Despite little funding coming on to the frontline of caring for dementia sufferers, the government says it is committed to tackling the problem and is increasing research funding to £66m next year.

And they speak of hopes of a cure by 2025.

Last night’s footage featured producer Becky Colls’ grandmother, who has had to move to sheltered accommodation because of her Alzheimer’s.

What surprised – indeed, shocked me – were the small numbers of specialist Admiral Nurses who care for dementia sufferer. Just 117 throughout the country and apparently they’re funded locally, because the government thinks it’s best the way as their numbers can be tailored to regional demand.

Well, let me say – it’s not working! Why? Because the local authorities have not got any budget to fund such appointments. And where does the budget come from? We all know!

The programme highlighted Playlist for Life, a new initiative aiming to stimulate memories through music therapy. It’s not a new concept, but the programme showed two families playing uniquely personal music to their loved ones to try improve communication with them. The results were wonderful.

Also in focus was a vitamin B trial that appeared to slow down memory loss in the early stages of dementia.

With Dementia Awareness Week is looming (May 18th to May 24th) it’s a good time to reflect on how we all can help.

We can’t replace professionals, but we can become a Dementia Friend. See http://www.dementiafriends.cog.uk

For info: Admiral Nursing DIRECT helpline – 0845 257 9406 or emaildirect@dementiauk.org