Posts Tagged ‘Prestige Nursing and Care’

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.

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.