Posts Tagged ‘elderly care’

NHS pledge will appear in Autumn Statement but wider solutions need to be considered too

Thursday, November 27th, 2014

Deputy Prime Minister, Nick Clegg, believes that an additional £1.5 billion for the NHS  will appear in the Autumn Statement next week, according to an article in The Guardian. This pledge comes a month after the chief of the NHS called for an extra £8 billion from the new government over the next five years, and is an indication that the government is moving in the right direction toward addressing and fixing the challenges faced by the NHS and the wider health and social care sector.

The NHS has experienced increased pressure with an influx of 1.3 million more people going to A&E than in the last Labour government and is therefore something that needs to be addressed now. Clegg also noted that the impact of an ageing population, which is expected to increase by 15 million in 20 years’ time, is another major reason for additional money needing to be allocated.

One main issue facing the NHS as a result of the increase in the elderly population is bed blocking in UK hospitals. A recent Telegraph article talks about how hospitals are being forced to evict elderly patients who are well enough to go home but remain in hospital. This is because loved ones are ill-equipped or unable to look after their elderly family members who require some level of support but have been hit by Council cuts to providing care.

While the additional money being sent toward the NHS will hopefully help with this problem to an extent, by allowing hospitals to afford more beds and nurses to look after patients, additional solutions need to be considered.

Previous Prestige blogs have addressed the difficulties facing family members who cannot care for their loved ones due to job requirements or other family care commitments. Greater support from the community and introduction of community care is one possible solution. This would provide support to families and also counter the loneliness that many elderly people feel when living along. Alternatively, home care can offer welcome relief to families as this can ensure that their elderly parents or grandparents are being properly looked after and cared for.

Such a solution is often a cheaper option to care homes, and includes multiple benefits, highlighted in other Prestige blogs, such as prolonged independence. We therefore welcome any additional funding for the NHS but urge the government to consider a holistic approach to social care so that individual needs are considered and the best solution for that person adopted.

Overworked GPs putting patients at risk, alternative solutions required

Friday, November 21st, 2014

Recent inspections by the Care Quality Commission (CQC) have highlighted one in six GP surgeries as being at high risk of providing poor quality care, according to a recent article from The Guardian. Following an inspection of 7,661 surgeries, 1,200 were identified as being at risk or elevated risk of providing insufficient or sub-standard care.

The inspections uncovered that one out of ten practices were considered high risk because they failed to provide up-to-date vaccines and medicines, provided flu jabs to too few elderly patients, did not employ enough practice nurses, and made it difficult for patients to book consultations in a timely manor. The criteria used by the CQC, highlighted in an article in the Daily Mail, also examined the number of elderly patients ending up in A&E as a result of not enough support.

Each of these inadequacies heightens the possibility of future risk to patients, a fact that is even more relevant to elderly patients who are already vulnerable to medical complications. To put it bluntly, the present system in which care for the elderly is primarily the responsibility of point-of-contact medical centres is failing large swathes of Britain’s elderly population.

Issues about quality of care for the ageing population are not new. Previous Prestige Blogs  have already noted this negative and worrying trend in Britain’s care for the elderly, while stressing the importance of alternative solutions, such as home care in order to reduce the risks. However, these new findings by the CQC serve to further emphasize the importance of other solutions after demonstrating that GPs are increasingly overstretched and risking patient wellbeing.

Home care can provide retirees with quality one-on-one care in the comfort of their own homes. This ensures that proper attention is provided and monitored at all times. Additional benefits of at home care are noted in other Prestige Blogs, and include lower costs than residential care homes and the fact that elderly patents can remain independent for longer.

Providing basic day-to-day support can also put-off the time when greater support is required, essentially acting as a preventative measure. Policymakers would therefore be wise to consider the virtues of homecare when thinking about the future of the British healthcare system, and the dual advantages of cost effectiveness and patient wellbeing that it can provide.

The appointment of a commissioner to represent the “voice” of the elderly

Thursday, November 13th, 2014

Ex-Care Minister, Paul Burstow, has joined calls encouraging an appointment of an independent commissioner to represent the interests of the elderly in England. An article in The Telegraph revealed that ministers have been urged to appoint a new ‘Care Tsar’ as reports of poor quality care continue to surface. The commissioner would receive legal powers to acquire documents and conduct inquiries into any suspected social care failings. This would result in greater accountability for care homes, public institutions and future governments – a notable change from previous similar roles, in which elderly advocates were frustrated with the lack of real power they were granted.

The introduction of a commissioner would go some way to ensuring much needed consistency in holding failing care providers and institutions to account across the UK. It may also overcome the problem of watchdogs ‘backing off’ when legally challenged by unsatisfactory care homes so that quality standards are instead enforced efficiently.

A recent Prestige Nursing + Care blog highlighted that during the past two years, the number of complaints made by the public about social care provision has increased by 46%. This came with the admission by the chairmen of the Care Quality Commission (CQC) that the elderly and vulnerable were being failed by the organisation designed to protect them.

Furthermore, a report by the Older People’s Commissioner for Wales found that many older people are living an unacceptable quality of life. A BBC News article declared that individual needs and personalities are not being catered to while supposedly being cared for, and instead patients were being institutionalised. The appointment of a ‘Care Tsar’ could therefore go some way in addressing these failures, to regain society’s confidence in the social care system and put the needs of the elderly first.

Yet, despite the benefits of a ‘Care Tsar’, it is important that the responsibility doesn’t become overly reliant on one person alone. Most important is that attitudes to providing care across the wider community also change. In a previous Prestige blog, we examined the need for greater consideration of alternative solutions such as home care and community care, rather than an over-reliance on care homes and the NHS. The idea thatthe elderly should be treated as individuals rather than a collective is key if social care providers are to successfully cater to the needs of the ageing population.

Prestige blog: health and social care voted most fulfilling sector to work in.

Thursday, November 6th, 2014

In a boost to the industry, health and social care has been voted the most fulfilling job to work in, according to a recent survey carried out by Randstad, the recruitment agency. It found that almost a quarter of the population view social and health care as the most fulfilling professional sector, which those who work in the sector themselves agree with: 29% put it in first place and cite patient wellbeing as far more important than receiving praise from their boss.

While this is a hugely positive result for the sector, it is in stark relief to the many unanswered challenges the care industry continues to face in terms of recruitment and retention. Despite the huge number of workers in the social care sector – totalling 6% of the UK workforce – this profession continues to be overlooked by many.

With the ageing population growing at such a rapid rate, the social care sector is struggling to employ an adequate number of people. A big part of the problem is that those looking for careers often forget about the wide range of opportunities in social care.

Previous Prestige blogs have noted the recruitment and retention difficulties among adult care workers, but recently care providers have begun efforts to attract more graduates into this important sector. More than a million additional workers are required over the coming years to cope with the growing needs of an ageing population. This cannot be achieved without addressing the issues at the crux of the matter: poor pay, a lack of funding and the need to implement a consistent training standard across the industry.

The issue of retention is also a major problem that the sector is trying to fix. A separate article from The Guardian  highlights the importance of the growing sector while also addressing how current care workers undervalue the work they do. The sector hopes to eliminate this thinking by showing just how vital its staff are to the well-being of the communities they serve as well as the UK economy.

Providers like ourselves similarly believe that recruitment and retention among care workers can be improved by increasing the public’s knowledge about the job opportunities available, and by presenting it as a long term and valuable career for those already working in the sector..

There are many challenges to overcome to attract and hold on to the number of care and social workers that the UK so desperately needs. However, it’s great to see recognition – not only within the sector but outside – of the worthwhile and fulfilling career that awaits them.

Importance of home care for an ageing population

Friday, October 31st, 2014

An article in The Telegraph this week highlighted the importance of home care to support an ageing population. Jeremy Hunt, the Health Secretary, has pledged more than £5billion to ease pressures on hospitals by providing an additional 18,000 community workers and increasing the number of elderly people who are receiving home care to reduce needless hospital stays and visits.

As previous Prestige blogs have frequently highlighted, there are numerous benefits of home care for the elderly which are becoming increasingly clear to the UK population. These benefits include lower costs (than a residential care home), retained independence for longer, and perhaps most importantly the fact that home care allows elderly patients to receive the care they need in the comfort of their own home. It can also act as a preventative measure. By providing people with support for the tasks they find difficult it can delay more extensive care being required.

This comes as a welcome development, following the news that 350,000 will lose out on their help at home as tighter restrictions on the threshold for funding take their toll. When the benefits of home care are so clear to see, not only for the individuals in question but for the care and health system as a whole, it is critical that the government reforms and restrictions do not damage the positive impact of this service in the care sector. A more open-minded attitude should be taken to arrive at a holistic approach for improving health and social care, by incorporating home care, community care and others alongside the more traditional routes of NHS and GP services.

In order for home care to operate effectively there are a number of areas that still need to be improved. Currently, council cuts to funding have left providers struggling to offer enough care to those that require it. Pay and recruitment is another challenge with higher wages and greater levels of training needed to attract high quality staff and to encourage more people to view care as the long-term and worthwhile career it is.

The prospect of an influx of additional community workers is especially welcome as community care plays an invaluable role in supporting care and reducing the pressure on clinics and hospitals. They would also offer vital support to unpaid carers who face huge responsibility in caring for family members – as regular readers of this blog will be only too aware.

Social care reform for an ageing Britain

Friday, October 24th, 2014

People are living longer in Britain but little has been done to address how out of touch health and social care is with the needs of an ageing population.

Our current health and social care systems are not designed to satisfy the demands of an ageing Britain, as highlighted by this recent Guardian article. Britain’s welfare state was built during an era in which 48% of people died before the age of 65, which is clearly no longer the case. But it has failed to adapt its treatment of the elderly for an era in which over 80s are the fastest growing section of society, and radical action is called for. With ever more people living well into their late seventies and eighties, care requirements and costs have become far more pronounced – yet little has been done to alleviate the strain that this places upon services and families.

A recent study by Newcastle University showed that the average 80-something has four or five ailments requiring attention. This makes the present system in which GP clinics are designed to deal quickly with a mass of single-issue patients seem redundant, and suggests an alternative approach is needed. Just as important to structural reform, however, is an adjustment in society’s attitude to the elderly.

This societal lack of regard for the needs of the elderly is also apparent in matters of social care. It is vital that more is done to counter society’s attitude towards the elderly. Recently – as highlighted by this Prestige Nursing + Care blog – there have been suggestions that care home inspectors apply a ‘mum test’ and this sort of attitude could be encouraged throughout the sector. By treating the elderly more as individuals rather than a collective we should start to target some of negative sentiments or impressions of being a burden.

The largest concerns about how the care sector and NHS will continue to function come down to cost and lack of resources. An immediate way to counter this is by moving services into the community. For example, domiciliary care can provide an effective alternative. Not only can it significantly save money and increase available space and resources in hospitals, but it also offers a much more personable approach to those seeking care, therefore tackling costs, resources and attitudes. Understanding the needs of this ever-growing elderly demographic, and adjusting health and social care to tackle the challenges head on, is clearly necessary and will be beneficial for everyone.

New system of inspection to tackle failing care and lack of respect for elderly

Friday, October 3rd, 2014

The issue of standards in the provision of care and the role of the Care Quality Commission (CQC) has featured in a number of Prestige Nursing + Care’s blogs. Recent changes in the organisation have led to the Commission’s proposals of a new direction and system of regulation in order to counter past failings. The overhaul of how the quality of care is measured in the UK also aims to guarantee a certain level of protection for those receiving care and ensure that these failings do not happen again.

We fully welcome the admission from the CQC that the quality of care provided to the elderly – both in care homes and in their own homes –has not always been acceptable under its stewardship. In previous blogs we explored the inconsistency of standards across the UK and the need for this to improve.  The past two years alone have seen an increase in the number of complaints made by the public about social care provision increase by 46%, which is indicative of a growing disillusionment with the standards of care. Those receiving care should not be made to feel vulnerable, neglected or abused by those who should be helping them – especially in their own homes.

Attitudes within society towards the elderly are also critical – as demonstrated by this piece in The Telegraph – and the introduction of a ‘mum’ test to ensure better treatment of elderly patients may go some way to improving services. Furthermore, an OFSTED-style ratings system, where every provider of home care is ranked from outstanding to inadequate not only chastises the bad in the eyes of the public but also promotes those that provide excellent levels of care. Services deemed to be providing unsatisfactory levels of care will be given the chance to improve but those that fail to do so will be stopped or shut, with management held accountable and unable to work in the sector again. There will also be greater encouragement of feedback from patients and families as a way to add a further check on the system, which can sometimes appear poorly monitored.

While these reforms are clearly a step in the right direction, it is important that they are implemented effectively and efficiently by the Commission. In the past, multiple layers of bureaucracy have often stifled change and can lead to reforms being carried out inconsistently across the country. Consistent standards need to be at the heart of the issue so that any failing provider of care is penalised swiftly rather than allowed to continue providing sub-standard care unchallenged to the most vulnerable. These promises are therefore an encouraging start, but it would be premature to celebrate too much before they have been successfully implemented.

Council cuts making social care unsustainable

Thursday, September 18th, 2014

An article from the BBC recently brought to light the fact that 89% of councils now only offer care services to adults with needs classed as substantial or critical. The research from the Association of Directors of Adult Social Services (ADASS) shows that this figure has increased from 72% since 2010-11, neglecting those whose needs are deemed low to moderate.  As a result, thousands of people are struggling along without help

It is clear that the system has been affected by cuts that have ravaged social care budgets across the UK. ADASS estimates that over the past three years more than £3.5 billion has been wiped from social care spending, reducing the amount of care councils are able to offer to vulnerable individuals. While the government claims to have provided local councils with an extra £1.1 billion to help with the cost of social care, the fact remains that this figure alone does not make up the shortfall left in social care budgets by such hefty cutbacks.

As a result of these cuts many councils have had to make drastic changes to their social care budgets. Gloucestershire  County Council, for example, has recently announced its need to make an additional saving of £75 million on top of the £114 million savings it has made since 2011. Derbyshire County Council has also recently announced that it intends to cut its social care budget by £11 million this year alone, by raising its threshold for those who qualify for care and introducing means testing.

Ultimately these cuts will have the biggest impact on vulnerable individuals whose needs aren’t deemed serious enough to warrant council-funded care. Not only can this lead to financial trouble for those in need of care as costs continue to increase, but it can also lead to vulnerable individuals having their support taken away.

A previous Prestige blog examined the impact that council cuts have had on the number of elderly receiving care at home who are forced instead to attend A&E. It is clear that council cuts are damaging to the individuals who require assistance, place added pressure on GPs and A&E – who are ill-equipped to handle this – and ultimately end up costing more as those who fail to receive support at home have no choice but to go into residential care. Providing more funding for support at home would act as a preventative measure, postponing the time when permanent care is required.

Falling confidence in the care sector

Wednesday, September 3rd, 2014

A recent article from The Telegraph highlights growing concern in the care industry as only one in four voters believe they will receive proper care in their old age. New research involving 75 charities and voluntary organisations concludes that the care crisis could prove a decisive issue in next year’s general election, with the issue coming only second in priority to health.

It is interesting that old age care has become a top priority for voters and the public after what feels like many years of apathy. The issue has undoubtedly been brought to the forefront of people’s minds following devastating reports and investigations from the likes of Panorama into care home abuses. Combined with years of council cuts – 26% off care budgets in just four years – and tightened restrictions on those who qualify for care, this has left many unsupported and excluded, signalling the need for drastic reform and extra funding.

Previous Prestige blogs have examined various ways to address challenges facing the care sector, ranging from more robust monitoring and tougher inspections from trade bodies, improving the image and pay of nurses to increase retention and counter the growing nursing shortage while also considering the role those typically outside the sphere can play. An article in the Guardian inspired another Prestige blog which looked into the way that communities could help reduce loneliness and provide basic level support.

Community support is one way in which residential care can be postponed by providing basic needs early on. Another is home care. This offers a cheaper alternative to residential care – for which the average basic annual cost across the UK is now approaching £29,000 – while also allowing individuals to remain in the comfort of their own homes for longer. In doing so, it still provides an element of support and comfort, delaying the need for permanent care.

The recent overhaul of the care system – allowing people to defer paying care bills to avoid having to sell their homes and the introduction of the care cap – may be a case of too little, too late. Already senior care chiefs are warning that they may lack the ability to guarantee the safety of those in their care because of the financial squeeze. It is clear that more needs to be done, and quickly, to address the growing concerns and lack of confidence in the sector.

Care workers are underpaid and undervalued

Friday, August 29th, 2014

An article in The Guardian recently highlighted the lack of recognition offered to care workers for their commitment to caring for the elderly and unwell. Workers support care home residents in a multitude of ways, from helping with day to day basics right through to round the clock care, yet seldom get the recognition they deserve for their tireless work. Recent stories of neglect and abuse in nursing homes have dominated the headlines – as they rightly should – but the thousands of top quality care workers who have devoted their lives to helping the most vulnerable get little to no recognition.

Being a care worker is a physically and mentally draining job yet there is distinct lack of fair pay. Currently 78% of staff earn an average of £6.45 per hour, just 14p more than the minimum wage – an embarrassingly low sum for such an invaluable service. It is therefore not surprising that the number of care homes with low morale and high staff turnover continues to increase.

As a result, the Commission on Residential Care has recommended that residential care should become a living wage sector. This move would allow for better pay as well as encourage training and career progression – highlighting two key factors that would vastly improve retention within the profession. Moreover, establishing a minimum level of training would allow for a carers licence to be created. The implementation of a licence would serve to monitor skill, quality and achievement.

Previous Prestige blogs have also called for recruitment challenges to be addressed, at the heart of which lies – as mentioned above – pay and attitudes to the profession. If attitudes towards nursing and care workers as a profession were to change, this would encourage more people to work in the sector and start to fill the shortages.

Better pay and training along with the emphasis on career progression would see more people viewing this as a valued and long term career – encouraging greater retention. Benefits such as flexible working could also help in this regard while at the same time making care a viable career for those with fewer hours available.