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Levels of Care Within West Sussex Revealed with an Interactive Tool

The differing levels of care in England have been revealed with the launch of a new interactive tool from Caring Homes, a UK care home provider. The tool uses data from over fifteen thousand checks, carried out by the CQC, to uncover the truth about standards of care in England.

CQC standards

The Care Quality Commission (CQC), a non-departmental government organisation, is responsible for regulating UK care in the following areas:

  • Care homes
  • Care given in your home
  • Dentists
  • Hospitals

The data used in the tool was sourced using these results via the Open Government Licence.

Key findings

Shropshire is crowned as the highest scoring county, with 94 per cent of its care homes passing CQC quality checks. On the other end of the scale, Nottinghamshire is exposed as the worst performing county, with 36 per cent of care homes failing inspections.

West Sussex

West Sussex was found have 288 care homes, which passed the CQC inspection, and 65 that haven’t, which gives it a 18 per cent pass rate. I was also one of top ten lowest scoring counties.

 The tool includes an interactive map element, which allows you to click on areas of England for a statistical report of care homes that have and have not passed CQC standards. The results include the county’s ranking, so you can make a rational judgement on the quality of care compared to other counties in England

Life expectancy and affluence

Astonishing results have also been revealed with the life expectancy and affluence elements of the tool. Surprisingly, those living in less affluent areas, such as Dorset, as more likely to live longer than those in better-off areas, such as Hertfordshire. In Dorset, where the mean salary is just £24,464, the average life expectancy is 85.3 years for females and 81.1 years for males. In Hertfordshire, where the mean salary is £33,831, males are expected to live to 80.4 years and females are expected to live to 83.8 years. In West Sussex  the average income is £26,453 and the average life expectancy is 81.6 years.

Simple search

The intuitive tool allows users to simply enter their chosen county into the search bar and uncover the truth about care in that area. The tool is likely to be used by those seeking care for loved ones who are looking for impartial advice. The simple elegance of the tool makes for fluid, intuitive searching where objective results are beautifully presented in seconds.

Five Steps To Navigating The Care Maze For Your Elderly Parents

My independent care consultancy Relative Matters, regularly receives calls from potential clients frustrated by the current care system for older people. The extent of the problem was highlighted by recent media attention to the confusion surrounding social care funding and advice, following an investigation undertaken by the consumer watchdog, Which. The organisation asked 30 people across the UK to keep a diary as they tried to organise social care support for their partners, parents or themselves, between November 2013 and January this year.

They identified a number of key themes:

  • People face a maze of confusing advice and information
  • People are sent from pillar to post to find the right support and information
  • Those with the most money (self-funders) all too often struggling to get basic advice
  • Families in distress as they try to make care arrangements
  • Relatives having to complain to get things done

The diaries revealed some people were forced to breaking point when trying  to arrange social care for themselves or a loved one. It was found that the situation was made worse by the lack of relevant information, confusing jargon and some services leaving people to work it out for themselves, resulting in unnecessary distress for families. 

People don’t realise how complex the care system is until they are faced with trying to work their way around it, often at a time of crisis when the older person or their carer become ill or have an accident. People who are not eligible for state funding find it especially difficult to even obtain simple information and advice in some areas, and practical support from a social care professional is minimal or non-existent in most.

Discuss future care early

Most of us hope to maintain our independence in our old age and not need help from anyone else. Sadly this is not always possible and it will be so much easier if you plan for a future that includes care with your elderly parents. Most people avoid the topic until a crisis occurs and then hurried decisions have to be made. So have a conversation as soon as possible with your parents before they need help. Ask them to imagine they need care and support some time in the future. What would be important to them? Would they prefer to be cared for at home, with live in care or in a care home? If their needs are such that they have to move into a care home what would be important to them about the care environment and the way they are cared for?

Make a list of their needs

For my own parents, I put together a list of the information likely to be needed for a professional assessment. This reduced the likelihood of us forgetting important information when speaking to a professional. The list included mental and physical health conditions, communication and mobility issues, daily living challenges, medication, what had changed to make them need care and support, what challenges they faced on their worst day, how they liked to spend their time, the things that were important for giving them a better quality of life, their support network and what concerns or worries they had.

Obtain a professional assessment

Contact your parent’s local authority and ask for the Social Services Department for adults to request an assessment of your parent’s needs. They have to assess anyone who appears to be in need of care whether they are at home or in hospital and regardless of their finances. Make sure the assessment looks at their quality of life and not just personal care needs and ask for a copy.

Financial assessment

The Local Authority should only assess your parents’ financial situation once they have undertaken a needs assessment and agreed the services and support to meet them.

Try and be with your parent when the assessment is undertaken and make sure they have their bank details, savings and investment information, pension and any other income to hand.

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Explore options

Once it has been decided what care and support your parent needs and what might be available from the Local Authority you can begin to look at options. This is a very important stage and it is important to consider the whole range of options before a decision is made. For example, if your parent is assessed to need 24 hour support, live in care maybe an option rather than them moving into a care home, special equipment may be helpful to maintain independence and keep support costs down. If your parent is eligible for social care funding, a social worker will help them explore these options but if they have to pay for their own care and support they will have to rely on you to help them.

For more information my recently revised and updated book Relative Matters – The essential guide to finding your way around the care system for older people is available on Amazon. I will also answer any questions you post on Twitter, Facebook or LinkedIn

The Growing Cost of Health and Social Care

The aging population is having a considerable effect on public services. According to the government, the majority of public spending is spent on older people.

There are over 10.5 million older people in the UK. It’s estimated that there will be 5½ million more elderly people in 20 years’ time and the figure will almost double by 2050.

The fact of the matter is that we are living longer. Nowadays we have better healthcare, we have much more knowledge when it comes to healthy eating, exercise and habits like alcohol and smoking; and we take better care of ourselves.

However, this comes at a price. The number of older people needing care is growing at an alarming rate. There are three million people over the age of 80-years-old in the UK alone.

What does all this mean though?

  • Rise in State Pension age

The age at which British people receive the State Pension has recently changed. For years it was 65 for men and 60 for women but the pension age will rise to 66 for men and women by 2020. What’s more, it will start to increase again in 2026 to 67. The women’s state pension age will move to 65 by 2018 and then hike to 66 two years’ later.

  • Public spending

According to the Department for Work and Pensions, 65% of benefit expenditure goes to people over working age. This is equivalent to one seventh of public spending and an additional spending of £10 billion a year for every additional one million people over working age.

However, spending cuts mean that there will be less money for things like hospital beds and help towards care home fees.

  • Impact on the NHS

The Department of Health estimates that the average cost of providing hospital and community health services for a person aged over 85 years is three times greater than a person aged 65-74 years. The supply of state services has failed to keep up with the demand for care and support. Spending on the NHS has risen by £25 billion since 2004 but spending on social care has only risen by 0.1% per year in real terms.

Resources cannot be stretched even further. The result is that costs are rising and the eligibility criterion is getting tighter.

  • Care

By 2050, it is predicted that there will be three times more people of working age looking after two billion ageing family members. Caring for a family member can have a big impact on the economy with adults juggling work with care. The cost to individuals as well as the economy is huge as a 2011 survey revealed that 31% of working age carers gave up work or reduced their hours to care for a loved one.

So what does the future hold? Authorities have given their expectations as to what consequences our aging population will have but only time will tell.

What matters is that we have a solid framework to plan a fruitful future that cares for our elderly loved ones. Failures in social care will only lead to stifled economic productivity and we can turn the challenges it brings into a driver for economic growth.

How do we go about doing it? Perhaps we look to other countries to see how they look after their elderly; alternatively, a new system should be put in place that offers more financial support. Mr Dilnot, Head of an independent commission into social care, has previously recommended a cap on how much people should pay for their own care of £25,000-£50,000.

Only one thing matters- older people should always be viewed as a blessing, not a burden!

This article is provided by Cheselden, the UK’s leading independent authority on NHS Continuing Healthcare.

Dementia Is Everyone's Business

Following the recent attention on dementia and the G8 Dementia Summit (check out my blog The G8 Dementia Summit – A Missed Opportunity) I have been reflecting on my short time as a Dementia Champion for the Dementia Friends Initiative.

Increasing prevalence of dementia

There are now over 800,000 people living with dementia in the UK and this will triple over the next 30 years. One of the most worrying statistics is that 1 in 3 of us will get dementia at some stage in our life and the rest will feel its impact from a friend, relative or someone they know who is living with dementia.

The UK is not alone. Dementia has become a worldwide problem and there has been a growing number of towns, cities and communities worldwide striving to better meet the needs of their older residents living with dementia.

Lack of awareness, fear, stigma and misunderstanding

I have found a lack of understanding about dementia and resistance to find out more about it with a slow take up of the one hour free information sessions I offer as a Dementia Champion.

I think this is because people are scared of dementia, which has replaced cancer as the disease that people fear most. This fear is fuelled by stigma and misunderstanding as well as the misguided perception that it ‘won’t happen to me’.

Unfortunately, dementia will not go away if we ignore it and I am on a mission to empower people about dementia and play a role in helping communities understand dementia so they can become more inclusive for the increasing number of people living with dementia. old-people-beauty-care

A personal and professional interest in dementia

My interest and passion for dementia comes from my mother who has lived with dementia for many years and the fact that 80% of my elderly clients are living with dementia too.

About Dementia Friends

As the brain gradually shuts down people with dementia sometimes need a helping hand to go about their daily lives and feel included in the local community.

Dementia Friends is about giving more people an understanding of dementia and the small things that could make a difference to people living in their local community.

The initiative is funded by the Department of Health and the Cabinet Office and championed by the Prime Minister

Dementia Friends is one part of Alzheimer’s Society’s work to create more dementia friendly communities – places that are more understanding and welcoming of people living with dementia. Their target is to recruit one million Dementia Friends by 2015.

Dementia friendly communities

The “dementia friendly communities” programme focuses on improving the inclusion and quality of life of people with dementia.  In these communities:

  • people will be aware of and understand more about dementia;
  • people with dementia and their carers will be encouraged to seek help and support;
  • people with dementia will feel included in their community, be more independent and have more choice and control over their lives.

And it’s great publicity for businesses that sign up. The Prime Minister’s challenge on dementia  includes an ambition to create communities that are working to help people live well with dementia. With the right attitude and approach people certainly can live well with dementia.

It will be a challenge to make our communities dementia friendly and neighbours, families, friends, companies, shops, taxi firms, banks, GP surgeries, dentists, professionals, hairdressers and other service providers need to become involved.

In a dementia friendly community:

  • people will be, aware of and understand more about dementia
  • people with dementia and their carers will be encouraged to seek help and support
  • people with dementia will feel included in their community, be more independent and have more choice and control over their lives

Publicity

And it’s great publicity for businesses that staff sign up to becoming Dementia Friends.

Living well with dementia

With the right attitude and understanding people can live well with dementia and we all need to accept social responsibility and play our part in making it happen.

Dementia should be everyone’s concern not just the government’s. Becoming a Dementia Friend will help you become informed and play your part so check out the Dementia Friends website now. Alternatively contact me via my website Relative Matters and I will be happy to help you.

The time to act is now

Old age is not about ‘them’ it is about all of us and dementia will touch all our lives directly or indirectly. The time to act is now and I urge you as an individual/business to open your hearts and minds and become a Dementia Friend.

The G8 Dementia Summit – A Missed Opportunity

Dementia presents the biggest health and social care challenge of a generation and replaces cancer as the disease that people fear most.

There are now over 800.00 people living with dementia in the UK and this number is set to treble over the next 30 years. 1 in 3 people over the age of 65 will get dementia at some time in their life.

Dementia does not only affect us Brits, it has become an international challenge resulting in much attention. To discuss the challenges presented by Dementia, a G8 Dementia Summit was held this week in London on 11 December 2013. It brought together G8 ministers, researchers, pharmaceutical companies and charities from around the world. Wow! what an opportunity I thought!

However the sole focus of the summit was on research, a travesty for all of us involved in promoting living well with dementia and the ‘person centred approach’, which has been at the heart of good dementia care, was conspicuous by its absence.Dementia is not a natural part of growing old

To make matters worse people, including those living with dementia were exposed to scaremongering rhetoric. We already know that people living with dementia are directly affected by stereotypes and negative attitudes to dementia. The widespread use of military style metaphors – time bombs, battles, victims and fights in addition to media promotion of the term ‘ suffering from dementia’ combine to increase fear of the disease and those living with it. This fear exacerbates the isolation and exclusion that people with dementia reportedly feel following diagnosis.

While we certainly do need to find a cure for dementia and more importantly, how to prevent it, we urgently need to look at how to support people who are living with dementia now. The way we support people living with dementia is as important as scientific research and medicine.

In a modern society people have a right to live well with dementia not merely exist. People can live well with dementia but it requires courage to think in a different way and do something different in practice and the myths and stigma that surround dementia, need to be challenged. The time to act is now.

As more and more families are touched by dementia I am hoping the imperative to change things will gain momentum. I plan to play my part by informing people about dementia and promoting dementia friendly communities, as a Dementia Champion (more about this next time) and also  in my work as an independent care consultant specialising in person-centred dementia services.

Keeping Older People Safe From Elder Abuse – Institutional abuse

Elder abuse has again caught media attention. It seems that far from improving, the situation has got worse. This post is part of a series on elder abuse to keep you my reader informed about the signs to look out for.

It is about institutional abuse which can occur in any setting where one or more people receive a service on a daily or residential basis, for example in a person’s own home, a day centre, care home or hospital ward. Places where we trust staff to care for our vulnerable elderly ones with care and compassion.We all have the right to feel and be safe, regardless of our age or circumstances. We therefore need to be vigilant to ensure older people, their property and belongings are safe and they are treated with the dignity and respect they have a right to and deserve.

What is institutional abuse?

Institutional abuse arises from repeated instances of poor care of individuals or groups of individuals. It occurs when there is poor professional practice as a result of routines, systems and policies within a care setting, which override the needs of the people it is there to support. The service may not meet the necessary professional standards or there is a training need for a more personalised approach.MP900178843

Examples of behaviour

These include: inflexible routines set around the needs of staff rather than people using the service, for example requiring everyone to eat together at specific times, limiting bathing to times that suit staff rather than the individual and no doors on toilets. These situations can arise through lax, uninformed or punitive management regimes. The behaviour is cultural and not specific to a particular member of staff.

Possible signs of institutional abuse are:

  • Set times for refreshments with no opportunity to make alternative arrangements outside these hours
  • Inappropriate approaches to continence issues such as toileting at prescribed times as opposed to when a person wishes to use the toilet
  • No evidence of care plans that focus on an individual’s specific needs
  • Staff not following care plans
  • Lack of privacy for example leaving the door open when someone is
  • taken to the toilet
  • Dehumanising language that does not treat a person with dignity and respect
  • Overuse and abuse of medication
  • Locking people in rooms
  • Failure to promote or support an individual’s religious or cultural needs
  • No access to personal allowance or personal possessions
  • Failure to knock on a person’s door before entering for example their bedroom or bathroom
  • A couple being prevented from living together.
  • Inflexible visiting times

Maisey’s Story

Maisey is confined to a wheelchair and lives in a care home. She needs to be taken to the toilet as soon as she feels the need to go, to avoid having an accident and does not like wearing pads. While this is made clear in Maisey’s care plan, staff regularly ignore her requests to use the toilet until it is too late. When she complains about this to staff she is told it’s because she always asks when they are busy and, while they respect her choice not to war pads, if she did so accidents could be avoided.

If you are concerned

If you have a concern about someone else involving harm or abuse and think the danger is immediate phone the police now on 999!

If it is less urgent, you can either:

Phone the police on 101 or

Contact the older person’s Local Authority Social Services Department

If you are not sure, ask yourself whether you would report it if it were a child. If the answer is Yes, report it

All Change For The NHS

Do you realise what a momentous change takes place today, 1st April?  Our beloved NHS, as we know it, will be abolished, just short of its 65th birthday. The Health and Social Care Act comes into force with serious consequences for us all, especially older people.

Last year I watched with unease at the health and social care bill during its turbulent passage through parliament and became increasingly concerned about its affect on older people.

Unfortunately very few of us understand its implications and  it will affect us all more than any legislation passed in our lifetimes. It is the final stage in the dismantling of the NHS, a process that began around 25 years ago without most of us realising what was happening. Law pic

The Government’s case for change is largely based on the assumption that the NHS is no longer affordable, particularly in the current financial climate, and that it needs to be modernised. I believe this assumption is false. Of course things have to change but research overwhelmingly shows that the NHS performs well in comparison to other healthcare systems internationally. It is also cost-effective and highly valued by patients.

Key changes in the NHS

  • From 1st April, Primary Care Trusts (PCTs) and strategic health authorities will be disbanded.
  • In their place Clinical Commissioning Groups comprising of local GPs among others, will control about £60 billion of the NHS budget and commission local services.
  • A new body, NHS England will oversee the NHS
  • Responsibility for public health, will transfer to local authorities who will take the lead for improving the health of their local communities.
  • Commissioning will take place through competitive tendering and NHS contracts will be opened to the private and voluntary sectors.
  • There will be huge profits to be made for private healthcare companies who can’t wait to get their hands on our NHS.

The government claims private providers will improve standards through competition and choice. However experience of the NHS getting into bed with the private sector, whether through private finance initiatives (PFI) cleaning contracts in hospitals or the takeover of the GP out of hours service – has been disastrous so far. Privatisation has driven up costs and produced worse results.

Competitive tendering fragments healthcare. Older patients often have several chronic conditions. In future things like eye screening and dietary advice could be provided separately by different providers, making it confusing for the older person and more difficult for their GP to coordinate.

The government consistently claims the NHS budget is protected while in reality, it is being forced to make cuts under the guise of efficiency savings. Across the country, accident and emergency departments and other services are being closed and thousands of jobs are being lost. Older patients with chronic and complex diseases will continue to lose services essential for their care and receive insufficient and poor quality care on hospital wards.  As a result of these changes, people will die.

My heart sinks when I think about the impact of the changes on older people I know and love. Local campaigns are joining up to fight back and I will be joining them. The Government and others with a vested interest may think the fight is over, but the battle to keep our NHS has only just begun, so watch this space!

The Francis Report and Older People in Hospital

My initial reaction to the Francis report into the failure of Mid Staffordshire hospital to provide safe, dignified and compassionate care leading to the deaths of hundreds of vulnerable older people is one of great sadness. I am also astonished that the people responsible are not being investigated for consideration of corporate manslaughter. bigstock-Sad-Elderly-Man-Sitting-With-A-6067493-1

Whenever front line staff are accused of a transgression affecting patient care they are quite rightly subjected to disciplinary investigation. Why on earth should this be any different for the people ultimately responsible for patient care at that hospital?

Poor practice in hospitals

The Francis report is the most recent in a long line of reports highlighting failures in patient care and I suspect it won’t be the last. 11 other hospitals are already being investigated for unexpectedly high death rates. I fear poor standards of care for older people on hospital wards is endemic, although I acknowledge there are pockets of good practice too.

Only the other week one of my elderly clients was discharged from our local hospital to a care home in a thin hospital gown with nothing on her feet on a freezing cold day. I alerted the Safeguarding Team which worryingly the manager had not done before I arrived. She told me bad discharges were the norm and despite raising it with hospital staff nothing seemed to change.Frequently I also find discharges delayed because my elderly clients are dehydrated (something which costs the NHS dearly as time in hospital is increased)

Recommendations made by Francis

I believe that if the recommendations made by Francis are to stand any chance of success there needs to be a robust action plan WHICH IS IMPLEMENTED AND MONITORED. So often good ideas and recommendations made after expensive enquiries and by so called Tsars who have been brought in to change things are unheeded by the Government and never translated into practice.

I believe the success of turning things around will ultimately involve breaking with tradition and involving patients, relatives and front line staff in finding successful solutions.