Posts Tagged ‘Prestige Nursing and Care’

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.

Homecare can alleviate stress on retirement accommodation

Thursday, October 16th, 2014

A recent article in The Telegraph brought attention to the lack of construction of retirement homes in the UK, in the context of a rapidly growing number of elderly Britons who could struggle to find suitable housing. Living in a retirement village or assisted living accommodation can provide an alternative to moving into a care home, allowing elderly individuals to retain their independence and reduce costs.

According to the article, only 2.8% of housing being constructed at the present time has post-retirement individuals in mind. At the same time, Britain’s elderly population is set to explode over coming decades. The Government estimates that there are currently 10 million people in the UK over the age of 65, and this figure is set to rise to 19 million by 2050. The number of individuals over the age of 80 is also projected to increase from 3 million presently to 8 million by 2050 – at which age the likelihood of requiring care increases substantially.

While there is no doubt a need to address this situation and ensure that those who wish to move into such housing can do so, domiciliary care can also offer an alternative solution in the comfort of people’s existing homes. It is capable of alleviating many of the challenges elderly people face in later life and can provide invaluable support to the needs of many. Policy makers would be wise to look to it as a serious solution both in the long and short term.

Domiciliary care can certainly offer a cheaper alternative than residential care, with the cost of part time care at home averaging £11,000 a year – significantly cheaper than the £28,666 average cost of a room in a residential care home uncovered in recent Prestige Nursing + Care research. In addition to the savings benefits of domiciliary care, it can reduce the pressure that those with moderate care needs place on the care system and NHS, while also preserving independence as argued in a previous Prestige blog.

For many, care at home offers a number of attractions. Domiciliary care allows the elderly or vulnerable to remain in environments familiar to them, to stay a part of their existing community and also offers them greater control over the care that they receive.

Family carers struggling to balance work, life and care.

Friday, October 10th, 2014

More and more family or unpaid caregivers are struggling to balance their paid jobs with taking care of an elderly or disabled loved one.

According to a recent article from The Daily Mail, a third of employers are finding that an increasing number of staff members – referred to as the ‘sandwich generation’ – are taking time off to care for their children or elderly family members, all while trying to juggle a full time job at the same time.

Previous research from Prestige Nursing + Care shows that the number of caregivers has fallen in recent years, despite a rise in the number of people over the age of 65. With fewer paid caregivers available, the care gap has been bridged mainly by unpaid or family caregivers, most of who must also work full time to make ends meet. This places huge pressure and financial worries upon families.

Council cuts have also led to increased family members, especially women, taking on responsibility for providing care to their family, with a lack of alternative options available to them. Overall 5.8m people in England and Wales provide care to relatives – an increase of 600,000 since 2001 – raising serious questions about further increases as the ageing population continues to grow.

While one in six employers provide arrangements for an employee who has to leave work to provide care, only about 48% of those offer “carers’ leave.” The rest simply offer compassionate leave. It is clear that these policies do not go far enough to provide relief for these employees. Findings from Carers UK, highlighted in the Guardian, show that juggling work with caring for an elderly relative costs businesses £3.5bn a year, along with extra costs to families themselves in lost earnings and pensions.

One way to increase support for unpaid carers is to boost community care for the elderly. This idea has already been suggested by government officials as a solution to the growing NHS deficit. Community care and social programs for the elderly would also allow working family members to take comfort in the fact that their elderly family members are being cared for while they are at work.

At the same time it would tackle one of the biggest issues facing the elderly in today’s society – that of loneliness. By providing greater support across the community, this would not only provide family members with some much needed respite, but also improve the quality of life for the elderly.

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.

Reforming health and social care: how to stop the vulnerable from falling through the cracks

Thursday, September 11th, 2014

‘A new settlement for health and social care’, the latest piece of research from the King’s Fund, advocates a radical overhaul of the social care system in the UK, as highlighted by this article in The Independent. Proposed reforms would include the merger of the NHS budget with the social care budget, in addition to a vast reduction in the cost of prescriptions. The aim is to focus social care on the needs of the individual and to make it free at the point of use for society’s most vulnerable.

There can be little dispute that under the current system many Britons are being failed by local councils and health authorities who often shift the care needs of the vulnerable between one another, resulting in individuals “falling through the cracks.” By establishing local care service bodies commissioned by a central organisation, the King’s Fund argues that the care needs of all could be met.

Previous Prestige blogs have highlighted failings in providing a consistent standard of care, along with the need for stricter safeguards and implementation across the UK. It is possible that a central department dealing with social care may be better suited to delivering this. At present, social care falls under the remit of local councils, which can lead to inconsistency in the way that care is delivered.  The proposed creation of a central body could well improve this and the way care is provided nationally, benefitting those in need country-wide.

Most importantly, perhaps, is how the reforms would counter years of austerity cuts to reduce the burden on family and unpaid carers. It is clear that something needs to be done to address the increasing needs of an ageing population, and that the current set up – designed decades ago – is ill suited to meet this challenge.

Undoubtedly a venture of this magnitude would be expensive – with the King’s Fund estimating that the additional cost of the merger would be around £2.7 billion a year. However, research suggests that £1 billion a year could be put towards the programme through means-testing TV licence and winter fuel allowances for pensioners, as well as removing the national insurance exemption for people working past pension age

The report, therefore, provides a much needed rethink on social care in the UK. By bringing together health and social care, we could see a marked increase in the efficiency of social care delivery and an improvement for those being failed by the present system.


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.

CQC failure to protect care home residents

Tuesday, August 26th, 2014

David Prior, chairman of the Care Quality Commission (CQC) recently admitted in an article for The Telegraph that the elderly and vulnerable were being failed by the organisation designed to protect them. A watchdog team focused on exposing care homes offering unsatisfactory care were too quick to ‘back off’ when legally challenged, fearing the prospect of prosecution by owners of sub-standard homes. This tactic, however, often left the vulnerable elderly lacking the care and support they need.

CQC data suggests that 750 care homes providing care to elderly and disabled people have been failing to hit at least one basic standard for more than a year with potentially devastating effects for the elderly who are forced to continue living with substandard care. The Telegraph article revealed the plans of the CQC to change its approach to be much more robust when tackling failing providers of care. A previous Prestige + Nursing blog also called for stricter consequences for homes that fail to meet a certain standard, especially in light of Panorama revelations earlier on in the year.

However, a new stricter inspection regime is planning to take a tougher approach regardless of the potential repercussions in a bid to ensure greater protection for those in care, to hold care homes to account and to regain the public’s trust. Overall the new system should bring around change in the way care homes are assessed. It has been made very clear to providers the standards that are expected of them.

The regulator anticipates around 100 care providers a year are likely to go into special measures under tighter inspection rules, giving them a fixed time period in which to make the necessary improvements or close if they fail to do so. This should also prevent any repetition of past scandals for failure to act after warning from whistle-blowers and complaints from family members.

It is vital that the vulnerable and elderly do not suffer due to CQC fears of recrimination especially when a care home is noticeably failing. We’re pleased to see recognition of the need for stricter rules and safeguards, and hope that they are able to effectively hold care homes to account by implementing harsher and more immediate penalties on failing care homes.

Cost of a care home rises 54% more than pensioner incomes.

Wednesday, August 20th, 2014

As recent articles in The Daily Telegraph and The Daily Express highlight, new research from Prestige Nursing + Care has found the gap between pensioner income and care home costs has widened by 54% over the previous year. The annual fees for a room in a care home now average £28,666 across the UK, more than double the average pensioners’ income of £13,993. It leaves a shortfall of £14,666, placing untold pressure on individuals concerned about how they will cover this cost.

Even in the North East where care is cheapest, there remains a shortfall of more than £10,000 while in the South East this increases significantly to £17,526. The mismatch between incomes and costs leaves many with little choice but to sell their homes to cover this shortfall.

Previous Prestige Nursing + Care blogs have commented on the impact that council cuts have had on care funding over the last few years, having drastically reduced the number who are eligible for financial support. Liz Kendall, the shadow care minister, also expressed her concern on this matter during a speech in Ilford last week where she stated how cuts to social care are piling pressure on NHS hospitals and putting vulnerable people at risk.

Care at home can offer a viable alternative to residential care and can be used to assist elderly or disabled people with day to day tasks. Without this sort of support and assistance it could result in individuals having to move into a care home sooner. In essence, support at home can act as a preventative or delaying measure.