Showing posts with label Care homes. Show all posts

Friday 3 April 2015

Care system gets 'biggest shake-up in 60 years'

England are being introduced in what is being dubbed the biggest shake-up for 60 years.

The Care Act 2014 includes rights for those receiving care and those who provide it to their loved ones.

It includes standards for access to services from care homes to help in the home for tasks such as washing and dressing.

Meanwhile, NHS and care budgets are being merged in Scotland.

The Public Bodies (Joint Working) Act has been described as the most substantial reform north of the border for a generation.

It effectively forces councils and the NHS to work together to provide more streamlined services.

That aim is also a major topic of debate in England in the election campaign with the Conservatives, Labour, Liberal Democrats, UKIP and Greens all having plans for greater integration.

Policy guide: Health and care

This issue includes NHS funding, GP access and social care, particularly of older people.

But the changes coming into force in England on Wednesday apply only to the care system for older people and younger adults with disabilities.

Four major changes are being introduced:

The creation of national eligibility criteria establishing for the first time when someone should be entitled to help - to date, it has been up to councils to set their own criteria
A duty on councils to offer schemes by which those who need to pay for residential care can get a loan from their local council, which is then paid back from their estate after death
Giving carers for the first time the same right to assessment and support as the people they care for; before, they had to provide "substantial care on a regular basis" to get an assessment
Those who pay for care themselves will be entitled to go to councils to get advice and information about the care system.

To help protect people's assets, a cap on care costs they have to pay for - set at £72,000 for the over-65s - will kick in from April next year. How the cap works for younger people has still to be finalised.

Today's changes, however, still mark a major milestone in care services, which experts say have hardly changed since the current system was created along with the NHS after the Second World War.

BBC Cost of Care project

The BBC has launched an online guide to the care system for the over-65s. The "care calculator" covers residential care and the support provided in people's own homes, for tasks such as washing and dressing.

Users can submit their postcode and find out how much each service costs where they live in the UK.

There is also a dedicated BBC Cost of Care website, with news stories, analysis and video.

David Pearson, president of the Association of Directors of Adult Social Services, said the changes were "probably the most significant development" since 1948.

But he said there were still issues to resolve on the underfunding of the system. Unlike the NHS, the care system budget has been cut in real terms this Parliament.

Izzi Seccombe, leader of Warwickshire council, who chairs the Local Government Association's Wellbeing Board, agreed with both points.

"Councils simply cannot afford any more financial burdens when social care services are already chronically underfunded," she said.

Janet Morrison, of the charity Independent Age, said the Care Act had the "potential to revolutionise" services.

But she said: "With a rapidly ageing population, we need an honest debate during and after the election about the true costs of care."

Friday 14 June 2013

multiple failings in the home care

CCTV footage reveals domestic care neglect

By Michael BuchananBBC News

Muriel's grandson says he feel guilty for employing the company

The BBC has obtained footage showing multiple failings in the home care provided by a company to one woman - as ministers warn the next abuse scandal may come in the sector.

The videos, recorded by the family of Muriel Price, 83, show carers failing to turn up for visits or turning up late, causing Mrs Price great distress.

The company involved say they were never informed the family had concerns.

They say the care of patients is of paramount importance to them.

Care minister Norman Lamb is hosting a summit with domiciliary care providers and carers on Thursday in an attempt to improve standards within the industry.

Mrs Price's grandson installed two CCTV cameras in her house in Blackpool, Lancashire, to monitor her movements and to provide help should she fall when she was home alone.

'Absolutely disgusting'

Instead they recorded carers failing to turn up when they should and behaving inappropriately on occasions.

One scene shows Mrs Price in great distress prior to her carer arriving. The grandmother, who is incontinent, had been in bed for 13 hours as her carer was nearly one hour late. She had tried and failed to contact her care company, carers, family and neighbours for help.

"Disgusting this is, absolutely disgusting," she is heard to cry out. "It's not good enough, I can't put up with it much longer."

One piece of video shows Mrs Price becoming increasingly distressed as she waits for her carer to arrive

She then quietly sobs before crying out for Les, her husband of 63 years. He was her primary carer prior to his death.

"I'll be here till 12 o'clock until the next one comes along, I bet. It's always the same."

Eventually a carer does appear, 55 minutes late.

“Start Quote

Mosaic go above and beyond their legal requirements when employing carers to ensure all staff are capable of delivering quality care to their clients. The care of patients is of paramount importance to Mosaic.”

Mosaic Community Care

In the footage seen by the BBC, which covers a period of nearly a month, carers turn up late or not at all on at least 12 occasions. Several other visits are much shorter than the one hour the carers are contracted for.

While some carers were professional, the footage shows examples of others who clearly were not.

The footage shows one carer sticking her fingers in food to check its temperature, another changes incontinence pads in full view of the street.

'No dignity'

And though Mrs Price is an insulin dependent diabetic with special dietary requirements, one carers admits to not being able to cook. "I can't fry an egg. I am really that rubbish at cooking. Why they send me to people at dinner time; it's beyond me," she can be heard saying.

"The way they treat old people is wrong, just wrong," says Mrs Price, looking back on her experience. "You'd be waiting for your tea and you didn't get any tea cause they never turned up, they never bothered. And you'd ring them up and they'd say we'll be sending someone along but they never did."

Her grandson, Darryl Price, who arranged for the care company to look after Mrs Price, looks back with regret.

"To see someone in your family treated with no respect, no dignity, you question yourself and in a way you feel guilty. You're the one who's put that home care company in there, you've trusted this company to look after them."

Another clip captures examples of poor care - including this carer, who was later disciplined by the company, who 'mooned' at the camera

The BBC showed the footage to Norman Lamb ahead of his meeting with domiciliary care providers and carers. He said the current system resulted too often in poor care, low wages and neglect.

"It's just shocking and depressing because this is neglect in your own home," said Mr Lamb in reaction to the videos.

Talking about the wider domiciliary care sector, he went on: "We know this is not an isolated case. There is some very good care, and we should celebrate that, but where poor care exists we should not tolerate it."

He later told BBC News: "In a way you're almost at your most vulnerable when it's behind a closed door, it's you and a care worker and potentially poor things, dreadful things can happen in those circumstances."

He said a number of companies were failing to provide a complete service and all too often councils were taking part in a "race to the bottom", choosing the cheapest bid when awarding contracts.

Norman Lamb: "I want to shine a spotlight on this whole sector"

The company who provided Mrs Price's care is Mosaic Community Care, based in Preston. The family say they repeatedly contacted the company with their concerns and have provided phone records to the BBC which indicate that calls were made.

But in a statement, Mosaic said it was an award-winning care provider.

It went on: "At no time were any issues raised with Mosaic by the family. Any concerns would have been dealt with via the appropriate channels.

"Mosaic go above and beyond their legal requirements when employing carers to ensure all staff are capable of delivering quality care to their clients. The care of patients is of paramount importance to Mosaic."

Referring to the telephone records, it says: "The length of a call does not provide conclusive evidence as to the content of the call."

Muriel Price is now happily living in a care home. "I'm lucky I have a family to look after me," she says. "Those that haven't got a family, God help them, poor devils."

Sunday 5 May 2013

Staff should help residents to eat

06 February 2009 today there is a crisis @ Ivybank care home ,lack of food,and the staff have problems with the
heating and they have not got the keys nor anyone to deal with the problem,i.e. it is very cold today.
John a member of staff @ Ivybank expressed that to me on the phone today, to help he is going to on my
request try and get my mother a take away meal delivered to her she will pay.
I was unable to obtain a reply from 0117 956 7890 begbrook office , however I have spoken to your office and
the lady I spoke to is aware of the above and was setting about dealing with this matter , I myself will
be doing all that is neccesary to help the situation within Ivy bank House.

Living in a Care Home
Food & mealtimes
Food preparation and the rituals of eating are important elements of cultural identity. Involving residents in planning and preparation and helping residents to enjoy their food wherever possible is a sign of a home that takes the concept of holistic care seriously – caring for the whole person rather than a collection of ailments and illnesses.
Food is, of course, essential to physical wellbeing and enabling residents to eat well is an important part of the job of care staff. Residents should have access to three meals a day and drinks and snacks in between. Thought should be given to the timing of meals with care taken to avoid big gaps particularly between supper and breakfast. If the evening meal is quite early then what is offered for supper would have to be quite substantial to take the resident comfortably through to breakfast. And it is important that residents are offered snacks and drinks. Staff should not rely on residents to ask as shyness, confusion or not wanting to bother staff may leave residents hungry or thirsty.
A helping hand
Staff should help residents to eat. They should not feed residents. The difference may be difficult to judge but it is an important one. Sitting next to the resident, maintaining eye contact, talking to the resident and going at their pace are all indications that the carer is helping rather than feeding. Carers should never be helping more than one resident at a time. Nor should they be talking to a co-worker or watching TV while they are doing it.
Going alone
After perhaps years of living alone or with a partner, getting used to communal eating may be difficult. It is common for residents to withdraw to their rooms and take all their meals there. Staff may try to
persuade your relative to join their fellow residents in the dining room. Although it is good to encourage residents out of their isolation, and try to address any reasons why residents may be reluctant to eat with others, ultimately the wishes of the resident must be respected. Residents must not be forced or coerced into changing their behaviour.
Private space
Eating with other people may become something of an endurance test and source of anxiety that could lead some people to withdraw from being with others as the only way of maintaining their dignity. When residents exercise their choice to stay in their room, for meals they have previously taken in the dining room with other residents, it may be worth thinking about what has caused this. It may have been an embarrassing episode – difficulty in eating, a row with another resident or member of staff, or failure to get to the toilet in time – that has caused a change in behaviour.
Remember
• A resident’s likes and dislikes should be recorded in their care plan and reviewed regularly.
• Food should be attractive, even if is liquidised.
• Discuss any problems your relative is having with eating with their key worker, the cook or the home manager
• If food is prepared or served in an unusual way ask why such steps are necessary and how the decision was reached.
• When helping a resident to eat, staff should sit, maintain eye contact and go at the resident’s pace.
• Drink should never be withheld from a resident in response to incontinence. It is likely to make matters worse.
At the care meeting nobody except Michelle Totanes spoke about mothers food and the filth she has been served, she is vegetarian, when I stated this at the meeting
Michelle Totanes stated that my mother was not a vegetarian , why,?First incident with michelle I received call

Care home companies face tougher financial checks

Nadra Ahmed, National Care Association: "It's not just the top 50 we need to look at"

Large providers of care homes in England are to have their financial records regularly scrutinised in future to spot potential business problems.

Under the government's plans, the Care Quality Commission and local authorities will also ensure care continues if a company does go bust.

It comes after provider Southern Cross collapsed, causing distress and anxiety to its residents and their families.

Care minister Norman Lamb said the move would give reassurance to people.

The Care Quality Commission (CQC) will start to make checks on between 50 and 60 of the largest care companies in England, including those that provide care in a person's home.

CQC chief executive David Behan said the measures - to be set out in new legislation - would provide early warning of potential company failures in the care industry.

The CQC will have the power to:

Require regular financial and relevant performance information
Make the provider submit a "sustainability plan" to manage any risk to the organisation's operation
Commission an independent business review to help the provider to return to financial stability
Get information from the provider to help manage a company collapse

The Department of Health said the powers would bring care in to line with other services such as hospitals and holiday operators, which have procedures to check on the "financial health" of organisations.

“Start Quote

The fear and upset that the Southern Cross collapse caused to care home residents and families was unacceptable”

Norman LambCare and Support Minister

In the case of the collapse of a national provider the effects would be felt in many parts of the country, so it would be unfair for local councils to have to deal with the problem, the department said.

Mr Lamb said: "Everyone who receives care and support wants to know they will be protected if the company in charge of their care goes bust.

"The fear and upset that the Southern Cross collapse caused to care home residents and families was unacceptable.

"This early warning system will bring reassurance to people in care and will allow action to be taken to ensure care continues if a provider fails."

Southern Cross, the country's biggest care provider, had thousands of elderly residents at more than 750 care homes across the UK when it collapsed in 2011.

The firm was brought down by having to pay a £250m rent bill as local authorities made cuts.

After its collapse, other operators had to step in to take over the care of more than 30,000 people.

BBC social affairs correspondent Michael Buchanan said in that case nobody had to leave their care home because other companies took them over, but the government has been keen to ensure such a collapse is not repeated.

A report earlier this week said the number of care homes going bust had almost doubled in the past two years, with the level of fees that local authorities were willing to pay being blamed.

Sunday 4 November 2012

Liverpool Care Pathway: Relatives 'must be informed

Liverpool Care Pathway: Relatives 'must be informed'

There will be a 12-week consultation on the proposed changes to the NHS constitution

Relatives of terminally-ill patients would have to be consulted before a decision to withdraw food or water is taken, under new government proposals.

It comes after some patients were placed on the Liverpool Care Pathway - designed to relieve suffering - without their relatives' knowledge.

The government wants to ensure families are told of life and death decisions.

The instruction will be included in a number of proposed changes to the NHS Constitution to be unveiled on Monday.

The Liverpool Care Pathway was developed at the Royal Liverpool University Hospital and the city's Marie Curie hospice to relieve suffering in dying patients, setting out principles for their treatment in their final days and hours.

Supporters say it can make the end of a patient's life as comfortable as possible and the method is also widely backed by doctors and many health charities.

However, critics argue it can be inhumane.

The government has now said that the rules needed to be stricter, meaning relatives of patients are always consulted before the technique is applied.

'New right'

A Department of Health (DoH) spokesman said the proposed changes would set out a "new right" under the NHS Constitution, which was established by the Health Act 2009, but he stopped short of describing the move as a "legal requirement".

However, the spokesman added: "Anybody providing NHS services is required by law to take account of it [the NHS constitution] in their decisions and actions."

Some reports suggested health trusts that failed to involve patients and families in decisions could be sued, while doctors could face being struck off.

The DoH spokesman said it was unlikely policy had been developed on this as the proposal was still at an early stage.

Health Secretary Jeremy Hunt will launch a 12-week consultation on the proposed changes to the constitution - the formal statement of patients' rights - on Monday.

Health minister Norman Lamb said this week that it was "completely wrong" for terminally-ill patients to be put on a "pathway" to death without relatives being consulted.

Mr Lamb has called a meeting of doctors and patients to discuss worries about the pathway.

Meanwhile, Conservative peer Baroness Knight called for an inquiry into claims some people might have survived had they not received this treatment.

Your comments (454)

Monday 29 October 2012

Care homes given five star ratings fail key standards

But critics say this is a "cheque book system" open to any home prepared to pay for a rating.

Care homes with five-star ratings are receiving premium fees despite not meeting essential standards set out by the care regulator.

Local authorities pay higher fees to care homes awarded top ratings.

The Care Quality Commission advises people to visit homes and check their most recent CQC inspection report before making a decision on care.

Care regulator the Care Quality Commission (CQC) stopped issuing its own star ratings in 2010 and now some homes pay independent ratings companies and consultants to assess them instead.

Gwenda Dunn was surprised to find that her aunt's care home had been awarded five stars by such a company.

"This is not a complaint against the home - it's a complaint as to how the home could be given five stars when it patently was not," she told the BBC's 5 live Investigates.

5 star failures

Mrs Dunn says her aunt's room was often cold and calls from her aunt for a commode during the night were sometimes ignored by staff.

Also, her aunt was frequently disturbed by another patient with dementia who often entered her room uninvited.

"I was there when the inspection was done. I spoke to the inspector and raised a fair amount of issues and then we found out within a week that the home had got five stars again," says Mrs Dunn.

"People who aren't in the know would take it as face value, not recognising the reality."

The home was rated by David Allen, an independent consultant who trades under Prestige Quality Ratings (PQR).

Mr Allen says the issues raised with him lacked substance and were misplaced. He also says other people at the home spoke very highly of the care provided and he saw no reason to downgrade the home.

PQR is one of three independent ratings companies recognised by Sefton Council. The others are RDB Star Rating Limited and Assured Care.

With the top five-star rating attached, families might believe a home is providing an outstanding level of care.

But the BBC has found that out of 80 homes given a four or five-star rating in the Sefton area, 14 are failing to meet one or more of the essential standards set out by the CQC.

This includes standards of staffing, standards of treating people with respect and standards of caring for people safely and protecting them from harm.

All of the homes had been rated by either RDB Star Rating, Assured Care or PQR.

The CQC is taking action against two of the highly-rated homes, demanding immediate improvements be made - although it is not known which company provided their rating.

All three ratings companies have defended their awards system.

"I always take account of what the CQC have to say… but the CQC doesn't have to be right every time," says Frank Watts of Assured Care.

David Allen of PQR insists that his company's ratings are "accurate reflections of the quality of the care provided at care homes at the time of the assessment".

RDB Star Rating told the BBC its assessments were "comprehensive and reliable".

Higher fees for homes

Sefton Council pays a quality premium to homes given a high rating by the companies - a residential or nursing home with five stars receives an additional £40 per week on top of the basic fee paid for each person in its care.A spokesman for Sefton Council said: "All the companies providing quality ratings use assessment criteria linked to outcomes in care home provision.

"We work closely with the CQC to ensure quality standards are closely monitored. If either party feel standards have reduced, through their own monitoring activity or inspections, we will decline or even suspend a particular rating and work with CQC in relation to this."

Sefton council is not the only one to pay a quality premium to homes awarded a four or five-star rating.

Redcar and Cleveland Borough Council says that since it introduced the RDB rating scheme in 2001, standards of care homes across the borough have improved.

But the BBC has learned that a quarter of its highly rated homes are failing to meet all the essential standards set out by the CQC.

"The council does feel that a new quality assessment tool would help to continue the drive to improve the quality of provision and therefore the RDB scheme will cease to be used at the end of this financial year," a council spokesperson said.

While the old Care Quality Commission rating system did have problems, critics say it was at least a system which was nationally recognised, independent, and easy for the public to understand.

"We maintain it is the responsibility of CQC as the regulator to assess the quality of care homes," says Nadra Ahmed, chair of the National Care Association which represents care homes.

"When the star rating system was scrapped by the CQC they consulted on the introduction of a system whereby assessments would be carried out by organisations independent of the CQC, which would be selected through a tendering process.

"The process was voluntary, so providers would pay to be assessed. The National Care Association felt strongly that this would be a cheque book rating system which enabled those who could afford it, to purchase a rating."

Bupa, the UK's second-largest care home group, is also critical of the CQC for abolishing its rating system:

"We would like to see them [star ratings] back so people can identify excellent care homes," said a company spokesperson.

"Other organisations, such as local councils and independent companies, are creating their own systems - but this could be confusing because there is no consistency."

The CQC warns people not to rely on ratings from outside companies when choosing a home.

"We do not endorse any external ratings systems," CQC operations director Amanda Sherlock told the BBC.

"We would recommend people look at a range of information includingour website to get the latest reports into care homes, nursing homes, hospitals and other care providers."

mengele plus

Friday 3 April 2015

Care system gets 'biggest shake-up in 60 years'

Care system gets 'biggest shake-up in 60 years'

Policy guide: Health and care

BBC Cost of Care project

Friday 14 June 2013

multiple failings in the home care

CCTV footage reveals domestic care neglect

“Start Quote

Sunday 5 May 2013

Staff should help residents to eat

Care home companies face tougher financial checks

Care home companies face tougher financial checks

“Start Quote

Sunday 4 November 2012

Liverpool Care Pathway: Relatives 'must be informed

Liverpool Care Pathway: Relatives 'must be informed'

Monday 29 October 2012

Care homes given five star ratings fail key standards

Care homes given five star ratings fail key standards

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More patients in Scotland given antidepressants

Friday 3 April 2015

Care system gets 'biggest shake-up in 60 years'

Policy guide: Health and care

BBC Cost of Care project

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Friday 14 June 2013

CCTV footage reveals domestic care neglect

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Monday 29 October 2012

Care homes given five star ratings fail key standards

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