Monday, 19 March 2012

Home care for elderly branded 'shocking and disgraceful'

Home care for elderly branded 'shocking and disgraceful'

Which? found cases of missed visits, food left out of reach, medication not given and people being left in soiled beds during its investigation.It concluded too many faced a "constant battle" to just get the basic help.The UK Home Care Association said it was never acceptable for people to experience rushed or inadequate care.Which? said the findings - based on a survey and diaries kept by the elderly - showed the system needed reform.
More than 500,000 people rely on help at home with activities such as washing and dressing.
Elderly personFunding squeeze
These include both people who get council-funded care and those who pay for it themselves.
While Which? said there were some examples of excellent care, it claimed too many were being poorly served.
The group asked 30 people to keep diaries over the course of a week detailing their experiences.One elderly lady was left alone in the dark for hours unable to find food or drink.
Another was left without a walking frame so she was unable to get to the bathroom and one man was not given vital medication for his diabetes.
The poll, of nearly 1,000 people, found one of the most common complaints was missed or rushed visits.
Nearly half of respondents said visits had been missed in the last six months with most not being warned in advance.
One daughter said: "They missed a day just after Christmas. I covered, but mum didn't contact me until early evening by which time she needed a lot of cleaning up.
"You wonder about the elderly with no relatives."
Which? said the situation was only likely to get worse as councils increasingly squeeze funding.
'Real crisis'
This report is just the latest in a series that has highlighted the struggle the elderly are facing.
At the end of last year the Equality and Human Rights Commission said standards were so bad they even breached human rights.
Which? executive director Richard Lloyd said: "Our investigation found some disgraceful examples of care with elderly people given little time or respect.
"The government can no longer claim to be shocked as report after report highlights the pitiful state of care for older people."
And Michelle Mitchell, of Age UK, said the system was putting the "health and dignity of older people at risk".
The UK Home Care Association, which represents the agencies which provide many of the services, said its members were increasingly under pressure to cut the length of visits by councils wanting to save money.
Mike Padgham, the group's chairman, said: "The report supports our growing concern over state-funded homecare.
"People and their families must be confident that they will receive dignified and effective care.
"They must look to government and local councils to place the needs of elderly and disabled people at the forefront in the current economic climate, to avoid the concerning picture described in today's report."
Councillor David Rogers, of the Local Government Association, said: "This research highlights the very real crisis this country is facing in providing care for the elderly and vulnerable.
"We know there isn't enough money in the system and without fundamental reform the situation is only going to get worse and stories like this will sadly become increasingly common."
The government has promised to publish plans this year to overhaul the system in England. One of the aims of the forthcoming changes is to create a fairer and better-funded system.
The other parts of the UK are also looking at their systems.
Even in Scotland, where care is provided free, services are having to be rationed to only those who are the most in need because finances are stretched.


The care worker's story

"I've been in this profession for 10 years. This agency doesn't pay for travelling time so it's rush, rush, rush and the time I spend travelling is taken from each customer."
"Fifteen-minute visits used to be check calls or to give medication. Now they're used to microwave a meal, empty a commode and travel to the next person. It's impossible."
  • Home care: 'So useless I told them to leave'

  • The daughter's story

    "A few carers are nice: they sing with mum, make her laugh and give good care. But mum's had some distressing hours. What can you do?
    "Starting with a new firm and having mum get used to strangers again is too much. I'd like to have confidence that when care workers are there, mum is safe and well cared for."
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Thursday, 1 March 2012

BBC News... Being compassionate should be as important as being clever


29 February 2012 Last updated at 08:42

Overhaul in approach to elderly care 'needed'

By Nick TriggleHealth correspondent, BBC News
Elderly patientNursing standards have been criticised in a series of reports

Related Stories

Being compassionate should be as important as being clever when it comes to the recruitment of staff to care for the elderly, experts say.
The recommendation was one of a series made by the Commission on Improving Dignity in Care for Older People to improve standards in hospitals and care homes in England.
The group said too many vulnerable people were currently being "let down".
The review comes after a series of critical reports into elderly care.
Cases of neglect have been documented by the likes of the Health Service Ombudsman and Patients Association in the past year.
And so the commission was set up by Age UK, the NHS Confederation and the Local Government Association to set out a blueprint for how the NHS and social care sector should tackle the issue.
Patronising language
In total, the commission published 48 draft recommendations which will be consulted on over the next month before a final action plan is published in the summer.
The measures cover issues such as making dignity a priority at board level, encouraging staff at all levels to challenge bad practice and ensuring patronising language, such as "old dear", is not used.
The report said language which denigrates older people should be as unacceptable as racist or sexist terms.
Another key recommendation involved the role of ward sisters, which the report said should be given the authority by management to take action when standards slip.
But it is the issue of staff training which there will be most focus on. There have been suggestions in the past that nurse training has become too academic.
Some places have started to trial ways of testing the emotional intelligence and bedside manner of students.
The commission said it should become commonplace for universities and professional bodies to take into account compassionate values as much as they do qualifications.
One of the authors of the report, Sir Keith Pearson, told BBC Radio 4's Today programme that dignity was "the essence of proper nursing".
He said: "There are pockets within the NHS and the care home sector where we are seeing excellent care. But you can go to hospitals...and you can see a couple of wards where dignity has broken down."
Sir Keith said there were clearly some nurses and professional carers who held old people "in contempt", adding: "Recruiting for values and then training for skills is enormously important."
He said people considering a career in nursing needed to be aware that 60% of patients in hospitals were over the age of 65 and they needed to be able to show compassion and kindness to elderly patients.
Sir Keith conceded that those nurses and carers who could not adapt to this "root and branch" change to the system would have to go.
But Peter Carter, general secretary of the Royal College of Nursing, suggested the most important factor when it came to standards was ensuring there were enough staff.
"It is absolutely critical that hospitals and care homes employ safe numbers of nurses with the correct skill mix. This is the key challenge that must be met."
Roswyn Hakesley-Brown, of the Patients Association, said the recommendations were a "step forward".
But she added without action on the ground it would be of no comfort to the people "who contact our helpline every day to tell us their loved ones are being left without adequate pain relief, are not being helped to eat and drink or who are left to lie in their own faeces because a nurse says she is too busy to help them to the toilet".
Care services minister Paul Burstow said the commission had made some good recommendations and he would be looking to work with the group to improve standards.

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Monday, 6 February 2012

Bird flu 'censorship'


Bird flu 'censorship' decision

Two scientific research teams have modified influenza strains to create mutant avian influenza viruses that can be transmitted efficiently between mammals. In one case, the virus remained highly pathogenic.A group which advises the US government on biosecurity has explained why it wants two research papers on H5N1 bird flu to be censored.
H5N1 under the microscopeThe US National Science Advisory Board for Biosecurity (NSABB) said publishing the work in full holds significant potential for harm.
The board explains that its main concern was that publishing the experiments in detail could help someone to develop viruses for harmful purposes.
But it acknowledges the work holds "clear benefits" in alerting humanity to the potential H5N1 threat, and that it could lead to greater preparation and potential development of novel strategies for disease control.
The board states that by recommending that the basic results be communicated without methods or details, the benefits to society will be maximised and the risks minimised.
Together with the release of this official statement, the journal Nature has also published a Q&A with the acting chair of the NSABB.
In it, he explains in more detail why they have recommended redaction for the paper in press at Nature even though the modified H5N1 virus that it describes is not highly pathogenic.
A copy of the NSABB Comment can be viewed on the Nature press site, and at: Policy Adaptations of avian flu virus are a cause for concern.
Nature's Q&A article is also on the Nature press site and is available here: Q&A Reasons for proposed redaction of flu paper Nature Nature Publishing Group.
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Wednesday, 1 February 2012

school

school
estelle morris
"School effectiveness research" 



School effectiveness research: a review of criticisms and 
some proposals to address them. 
by Andres Sandoval-Hernandez (A.Sandoval@bath.ac.uk) 
University of Bath, Department of Education
Educate~


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Thursday, 26 January 2012

cunfuion over sunlight


Concerns over vitamin D deficiency -

 A quarter of toddlers affectedThe chief medical officer for England, Dame Sally Davies, is to contact medical staff about concerns young children and some adults are not getting enough vitamin D.
Government guidelines recommend some groups, including the under-fives, should take a daily supplement.
However, recent research found that many parents and health professionals were unaware of the advice.
There has been an increase in childhood rickets over the past 15 years.
According to Dr Benjamin Jacobs, from the Royal National Orthopaedic Hospital, links to heart disease and some cancers are also being investigated.

“

The consultant paediatrician told BBC Breakfast that the hospital saw about one severe case a month of rickets - softening of bones through lack of vitamin D in childhood.
He said: "There are many other children who have less severe problems - muscle weakness, delay in walking, bone pains - and research indicates that in many parts of the country the majority of children have a low level of vitamin D."
The Feeding for Life Foundation report, published in October last year, suggested one in four toddlers in the UK is vitamin D deficient.
However, this may be an underestimate as only vitamin D from food was included, and not any vitamin D obtained through sun exposure.
Vitamin D supplements are recommended for all people at risk of a deficiency, including all pregnant and breastfeeding women, children under five years old, people aged over 65, and people at risk of not getting enough exposure to sunlight.
Vitamin D is mainly obtained from sunlight. However, too much sun exposure increases the risk of skin cancer.
According to one recent study, nearly three-quarters of parents and more than half of health professionals are unaware of the recommendations.
The Department of Health has asked the Scientific Advisory Committee on Nutrition to review the issue of current dietary recommendations on vitamin D.
Dame Sally Davies: "We know a significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood. People at risk of vitamin D deficiency, including pregnant women and children under five, are already advised to take daily supplements.
Free supplements
"Our experts are clear - low levels of vitamin D can increase the risk of poor bone health, including rickets in young children.
"Many health professionals such as midwives, GPs and nurses give advice on supplements, and it is crucial they continue to offer this advice as part of routine consultations and ensure disadvantaged families have access to free vitamin supplements through our Healthy Start scheme.
"It is important to raise awareness of this issue, and I will be contacting health professionals on the need to prescribe and recommend vitamin D supplements to at-risk groups."
It has long been known that vitamin D prevents rickets and children were once given food supplements like cod liver oil.
However, this practice was stopped in the 1950s because it was thought unnecessary.
In the last 10 years, doctors have been seeing more cases of vitamin D deficiency, leading to a debate over the use of food supplements and concern that many medical staff are unaware of the problem.
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Tuesday, 24 January 2012

mengele: Good communication reduces reliance on drugs

mengele: Good communication reduces reliance on drugs
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Sunday, 22 January 2012

Thorkil Sonne an extraordinary memory and a remarkable eye for detail.


Four years ago Thorkil Sonne realized that his young autistic son

 possessed an extraordinary memory and a remarkable eye for detail. Those traits are prevalent among people with autism, and Sonne saw an opportunity to help individuals with the disorder find productive employment. As the technical director of a Danish software venture, he knew those qualities were critical in software testers. So he went out on his own and launched Specialisterne, a Copenhagen-based software-testing firm that now has 51 employees, including 37 with autism, and revenues of $2 million.
You started your company to improve the lives of people with autism. Why not just create a nonprofit focused on research or job training?
I wanted to do more than just provide a sheltered workplace for people with a disability. My goal is to create opportunities for people with autism on an international scale. You might find money to support sheltered working environments in Scandinavia but not in Poland or Spain or Brazil. To extend its reach, our organization needs the kind of funding that only a profit-making venture can generate. It must succeed on market terms.
Is it hard to reconcile two missions—serving customers and aiding people with a disability?
We’re constantly asked whether we support customers or a cause. We want to do both, of course, but we’re always fighting against the suspicion that we’re just a charity. Our corporate social responsibility profile might open doors with CEOs, but executives in charge of software testing aren’t evaluated on CSR, only on getting the most for the company’s money. To wipe away their suspicions, we must exceed performance expectations every time.
All our business comes from the private sector. Because Denmark has no tradition of social enterprises, the government doesn’t earmark contracts for companies like ours or give them tax breaks. We have to compete head on.
How does managing autistic workers differ from managing other people?
Most of our consultants with autism have a mild form called Asperger’s and are high functioning. Still, because they’re often hypersensitive to noise, they can be uncomfortable in open-concept office spaces without doors or walls. They also have trouble working in teams and understanding social cues, such as gestures, facial expressions, and tone of voice. You have to be precise and direct with them, be very specific about your expectations, and avoid sarcasm and nonverbal communication. Though we expect employees to do their jobs well, we don’t ask them to excel socially or to interact all the time with others. We just find them the right role. That takes tremendous stress off them. I think normality is whatever the majority decides it will be, and in our company people with autism are the norm.
What about the relationships between customers and your autistic consultants?
About 70% of our work is done at customer sites. The customer appoints a contact—someone who’s good with special people, who will select the right tasks and a comfortable place for them. We also give our clients a short introduction to autism and to our firm’s unique culture. After working with our consultants, the customers start being more direct with their own colleagues and stating their expectations more clearly. That’s helped them improve in an area that many companies struggle with.
In what other ways might firms benefit by adopting your techniques for managing autistic employees?
Companies sometimes unknowingly employ autistic people because the condition often goes undiagnosed. But people with autism aren’t the only employees who don’t thrive in open offices or in the traditional management system, with its emphasis on teamwork and unclear instructions like “Figure out on your own how to deal with this.”
You have to get the most from employees, especially when labor is scarce. Our sector is crying out for manpower, but Specialisterne has many job seekers knocking on the door. The key is to find situations that fit employees’ personalities and ambitions, not force everybody into one mold. That just causes stress, and workplaces already produce too much of that.
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Thursday, 19 January 2012

NHS plans: Unions move to 'outright opposition



The unions representing nurses and midwives have joined others in stating their "outright opposition" to the government's NHS plans in England.
The Royal College of Nursing and the Royal College of Midwives had expressed concerns in the past, but said they were willing to work with ministers.
Surgeons operating
However, now they want the entire bill covering the changes to be dropped.
Health Secretary Andrew Lansley said the unions wanted to "have a go" at government about "pay and pensions".
The colleges' stance comes after a similar move by the British Medical Association last year.
It also mirrors the stance adopted by Unison, which represents a host of administration and support staff, such as porters.
But what impact this intervention has remains to be seen.
The Health and Social Care Bill is still working its way through Parliament, and the bill is in the Lords at the moment.
In many ways it is over the worst political hurdles and it seems the only way it could be stopped would be if the Lib Dems blocked it when it returns to the Commons - but that is considered unlikely.
On the ground, changes are already being made to pave the way for the new system to kick in, in 2013.
For example, while the doctors union is against it there has still been enough GPs coming forward to pilot the new plans in 97% of the country.
Anger
Under the plans, GPs are being put in charge of much of the NHS budget, while the health service is being opened up to greater competition from the private and voluntary sector.
In June the government announced a series of changes to the original proposals in the face of mounting opposition.
These included giving health professionals other than GPs more power over how NHS funds were spent, as well as watering down the role of competition.
The health unions initially gave the changes a cautious welcome, but they have been left disappointed by the finer details that have emerged during the parliamentary process.
One of the key developments was the news, which emerged just after Christmas, that NHS hospitals would be allowed to do 49% of their work in the private sector.
Peter Carter, general secretary of the RCN, which represents 410,000 nurses, midwives, support workers and students, said: "The RCN has been on record as saying that withdrawing the bill would create confusion and turmoil, however, on the ground, we believe that the turmoil of proceeding with these reforms is now greater than the turmoil of stopping them.
"The sheer scale of member concerns, which have been building over recent weeks, has led us to conclude that the consequences of the bill may be entirely different from the principles which were originally set out."
Cathy Warwick, of the RCM, said: "The government has failed to present sufficient evidence that its proposals are necessary. They have failed to present evidence that the upheaval will result in an improvement in services to the people of England.
"And they have failed to answer the concerns of the people who fear for the future of the NHS under these plans."
Savings plans
Both unions also expressed concerns that the changes were compromising the ability of the NHS to make the £20bn of savings it has been asked to make by 2015.
Mr Lansley said that nurses had previously been "right at the heart" of the process of planning reforms to the NHS to deliver better care for patients.
"The only thing that has happened in the last few weeks that has led to this situation with the Royal College of Nursing, is that the two sides of the Royal College of Nursing have shifted," he told BBC Breakfast.
"They used to be a professional association that was working with us on professional issues, and will carry on doing that, but now the trade union aspect of the Royal College of Nursing has come to the fore.
"They want to have a go at the government - and I completely understand it - they want to have a go about things like pay and pensions."
A Department of Health spokesman said: "The bill is needed to empower doctors, nurses, and other front-line healthcare workers across the NHS to take charge of improving care.
"We will continue to work with nurses and all other health professionals to ensure that the NHS delivers the best possible care for patients."
Shadow health secretary Andy Burnham said it was time to scrap the bill.
"A reorganisation on this scale needs a professional consensus for it to succeed. A year since the bill was introduced, it is abundantly clear that the government's plans do have failed to build that."

Analysis

The move by the two unions is unlikely to see the bill stopped in its tracks.
But it is clear the government's relationship with NHS staff is fracturing, possibly beyond repair.
Some inside government were saying the move by the royal colleges was being driven by their dissatisfaction over pensions.
That has undoubtedly played a role. So too has the drive to make £20bn of savings by 2015 - the equivalent of 4% of the budget a year.
This is putting more and more pressure on hospitals and waiting times in particular.
It means there is a toxic cocktail brewing inside the health service - and this spells trouble for the government.
It came to power saying - in private at least - that the NHS was its good news story, but all too often it is finding the headlines are negative.

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