Bettercaring blog

Talk is cheap when it comes to fuel poverty

2008-11-10T16:33:00.000Z

Imagine being forced to live in a single room as spiralling fuel costs make heating your home impossible. For many pensioners, such a frightening thought is a sad reality as they are left with no choice but to make drastic cutbacks just to stay alive over the winter.

In fact, a new report by the British Gas Help The Aged Partnership estimates that 4.5million elderly people will heat a single room – and 25 percent would climb into bed as a way of keeping warm.

But what is alarming is that we hear the same year after year and nothing has been done apart from a few token payments to alleviate the pressure of fuel poverty on the elderly. Winter fuel payments are set to increase – a much needed start for sure – and a sign that the government is at least looking at the problem.

But what are organisations like British Gas and E.ON doing to help their elderly customers?

Not a lot in the case of one lady I spoke to.

Widow Noreen Binz lives in South Shields and is on a tariff run by E.ON Age Concern, which she hoped would have her best interests at heart. Instead she’s faced gas and electric bills over the summer totalling more than £300. Confusing bills have compounded the problem – and forced her to consider cancelling her direct debit to the company until she knew how much she had to pay.

“I’m frightened of the costs,” she says. And who can blame her? Her suppliers have certainly done very little to help – and instead of cutting costs continue to pressure the government to increase winter fuel payments.

Reports like this raise awareness of the plight of many pensioners but lack credibility coming from an industry content to bleat about the Governments inactivity but doing little itself.
But at least the report has one use; On top of an open fire, as much needed winter fuel…

Alzheimer’s Run

2008-09-22T10:36:00.000+01:00

Should people with dementia be put down? Well that’s what Lady Warnock, the ‘veteran’ medical ethics commentator, believes.

She is quoted in a recent article in the Daily Telegraph as saying that people with dementia are a burden. “If you’re demented, you’re wasting people’s lives – your family’s lives – you’re wasting the resources of the National Health Service,” she said.

She went on to say that she hoped people would soon be “licensed to put others down”.
This is eerily redolent of Logan’s Run – the 1976 film where anyone over the age of 30 is killed – and raises potentially disturbing questions.

If Lady Warnock’s idea is given credence – and I can see some people thinking it’s a good idea – then where do you stop?

Why not euthanise other people with terminal degenerative conditions, such as motor neuron disease or Parkinson’s? After all, they will become a burden to their family and the NHS too.
Heck, anyone needing care could be got rid of; it would solve the funding problem in the NHS and allow everyone to get on and enjoy their own lives without having to care for loved ones.

Perhaps as soon as someone is diagnosed with a condition, or even comes to retirement – the end of their ‘useful’ life and when people most need the NHS and care services – they could be terminated painlessly thereby solving any problems before they start.

Of course my dystopian vision of the future won’t happen, but neither should Lady Warnock’s ideas ever get beyond opinions in newspaper articles either.

A person has a right to life and just because they’re ill doesn’t mean they have no value and should be dispensed with. After all, there are about 6 million carers in this country, and hundreds of thousands employed in the industry. Many of them enjoy looking after others and make a positive difference to their quality of life.

A person with dementia is someone who has lived and loved; treating them like diseased cattle is not an option. We need to understand the condition and treat it – and one day even cure it.

Animal magic

2008-09-10T11:56:00.000+01:00

At Bettercaring we take great delight in all things offbeat and decidedly oddball. So we jumped at the opportunity when a note arrived inviting us to an exotic ‘jungle safari’ at a nearby care home.

By the time we got there, all manner of creepy and cuddly critters were being paraded in front of excited care home residents. These included a fruit bat, an albino Burmese python, a rhesus monkey, ring-tailed lemur and penguin.

As the exotic creatures were passed around by specialist handlers, the home’s residents gasped in wonder and not a little awe; proving that even the frailest and most dependent people can raise the roof when they’re having a good time.

Of course, there was a serious side to the afternoon – it gave residents much needed stimulation – but it also pushed back the boundaries and challenged preconceptions of old people in care.

One lady loved snakes and had grown accustomed to them after spending time in Africa – yet never expected to see a live one again. Filled with questions about the python – and eager to give it a stroke, she showed no fear. And although others were less keen on the snake (one resident, for example, shrieked at the mere mention of the word ‘snake’), all were willing to overcome their trepidations and give it a pet.

It was a similar story for the other animals. Indeed, the penguin and rhesus monkey proved so popular the event over-ran by an hour-and-a-half.

But what really struck me was the attentiveness of the residents – especially towards the animals. I expected the day to be a trying test of patience, with the residents bored and disinterested. In fact, they couldn’t wait to see what was next.

Even after the animals had gone, the home was still buzzing with excitement. The activities co-ordinator was pleased; the day had been a roaring success and she was looking into hosting another animal safari day…despite the penguin’s insistence on messing everywhere and the monkey escaping into the manager’s office.

In fact, the only grumpy face in the building belonged to Buster the Shih Tzu pat dog – who must’ve been feeling like an endangered species himself.

Car park rage

2008-09-03T17:30:00.001+01:00

Good news for people in Scotland and Wales that have loved ones in hospital; no more will you have to pay for the privilege of parking at the hospital to visit them.

But for those that reside in England, the charges – often equivalent to multi-storey car parks – remain in place.

It doesn’t seem fair – wasn’t the NHS set up to be free for all? Even if you purchase a weekly or season ticket, it is still not cheap to park.

I’ve written before on the practice of charging for car parking – basically, I think it’s immoral – but this rubs it in.

While the Scottish Government and Welsh Assembly should be applauded for getting rid of these charges, the UK government should be condemned for not following suit.

The government is not going to follow either. Health Minister Ben Bradshaw said he did not believe it was a “sensible use of limited resources” to subsidise car parking at hospitals in England.

However, I’m pretty sure that the Welsh and Scottish branches of the NHS aren’t swimming in excess cash, but they still seem to have found the money to do it, so I don’t buy that excuse.

I also don’t believe another comment from Bradshaw. He added that hospital trusts set their own charges to cover the cost of running and maintaining a car park. If so, how it can cost that much - £3.30 for 2 hours at one hospital in Birmingham - to look after a bit of tarmac with some white lines painted on it is beyond me. Even with a few CCTV cameras and a security guard or two, the cost is not that high – certainly not high enough to justify the charges.

It feels like yet another way that taxpayers are being fleeced through no fault of their own.

Nobody should have to pay to visit their loved ones. My advice is to find the nearest side street to the hospital, park there and walk in.

Alzheimer’s breakthrough gives real hope

2008-07-30T14:08:00.001+01:00

When I first heard about a potential breakthrough in finding a treatment for Alzheimer’s disease last night, I was sceptical.

I’ve banged on about this in previous blogs, but in recent weeks it seems every day has brought new stories of potential treatments for Alzheimer’s or ways to stop it developing in the first place. From properties in blood pressure or cholesterol control drugs (promising), through tomatoes and tea (doubtful) to a helmet that bathes the user in infra-red light (downright odd) it seems anything and everything could be the key.

So many theories left me jaded and cynical; it seemed no-one really had any concrete clues as to what could treat the condition.

But this changed last night.

British scientists say a drug called rember can stop Alzheimer’s progressing by as much as 81%. There are hopes it could even stop the condition in its early stages, before symptoms appear.

Crucially, rember targets the ‘tangles’ in the brain of someone with Alzheimer's that destroy nerve cells and lead to a deterioration in memory and can bring the worst affected parts back to functional life. While not reversing the condition, it does seem to virtually halt its progress

By addressing the tangles, seemingly with success – although the trial was only on 321 people – it goes to the crux of the condition and genuinely seems to offer an effective treatment that could extend the functional life of people with Alzheimer's by years.

While my optimism is tempered by the facts that it could still be several years before the drug is ready to bring to market, and even then there is no guarantee it will be available on the NHS – remember NICE’s decision on Aricept [see Dementia: restricted access to drugs ] - it is nonetheless the most concrete evidence yet that finally the trauma of dementia could be on the way to being beaten.

Are you running the risk of dementia?

2008-07-11T16:57:00.000+01:00

If newspaper reports from the past 7 days are to be believed, women who had low IQ as children, now have high cholesterol and blood pressure and regularly eat tofu are destined to be struck down with dementia.

Meanwhile, men over the age of 90 who eat plenty of tomatoes and fish are in great shape to avoid the condition.

Some of it we know already, such as the memory benefits provided by fish; others are new. But the constant reportage makes for information overload. Throw in recent genetic breakthroughs and you’d think we’re on the cusp of a genuine breakthrough in treating the disease.

The problem is, we’re constantly on the cusp – and waiting for a cure for Alzheimer’s is like waiting for a bus that’ll never arrive. Although I’d like to be proved wrong.

More potential causes will come and go over the next few weeks. We’ll continue to be told what is good and bad for us to eat – potentially scary if you’ve spent a lifetime eating the ‘wrong’ food – and never even known.

Take the latest culprit, tofu. A supposed ‘superfood’ - many healthy and committed vegetarians swear by it – yet now their being told it could cause dementia.

This theory may be debunked over time, while the search for other causes continues relentlessly.

There’s no doubt such findings are needed - but shouldn’t the boffins keep the results to themselves until they find a cure? Or at least make a genuine breakthrough?
By Robert Mair

Hope of deliverance

2008-07-01T15:30:00.000+01:00

Yesterday was a good day for people like pensioner Margaret Coates.

She made headlines in March because she faced blindness after her local PCT refused to fund the drug treatment needed to combat her wet age-related macular degeneration.

Bromley PCT said it would only fund treatment for those with unusual or unique clinical factors, and Mrs Coates had neither.

But the kind of issues affecting the pensioner could be a thing of the past in England if the recommendations in Lord Ara Darzi’s review of the NHS are put into practice.

One of the key tenets of Lord Darzi’s review is to ‘personalise’ – that word again – services to make them fit for everyone’s needs, “includ[ing] those people traditionally less likely to seek help or who find themselves discriminated against in some way”.

In addition, Lord Darzi says the NHS should “guarantee patients access to the most clinically and cost effective drugs and treatments” where the clinician recommends them.

Reading between the lines, this should mean that older people such as Mrs Coates will be able to get the treatment they need.

There was more good news in Lord Darzi’s report. The commitment to preventative healthcare should help pensioners and people with learning disabilities to remain in their own homes for longer.

A focus on quality rather than targets is also welcome. Putting the emphasis on providing quality, individual care and improving standards harks back to the earlier days of the NHS and is long overdue.

But while Lord Darzi’s report on the future of the NHS makes for heartening reading, it is up to the government to deliver on it and as ever this is the potential sticking point; neither he nor the government has made any mention – that I can find – of how this will be paid for.

This is worrying. The NHS is underfunded and implementing the recommendations of the report will not be cheap.

Where the extra money will come from to make good on these commitments is a mystery to me and without a coherent strategy for funding it I can see Lord Darzi’s report falling flat. That would be a great opportunity missed and people like Mrs Coates will still not receive the treatment they need.

Carer’s Strategy – a step forward?

2008-06-12T15:24:00.001+01:00

The government’s much-vaunted update of the Carer’s Strategy was launched earlier this week and, as ever, while it contains some help for those in need, it doesn’t go far enough.

The new Carer’s Strategy certainly makes some bold commitments. For example, it says that by 2018 ‘carers will be able to have a life of their own alongside their caring role’ and will be ‘respected as expert care partners and will have access to the integrated and personalised services they need to support them in their caring role’.

But cut through the raft of rather woolly but well-meaning objectives and there is little concrete detail of how this will be achieved. I assume this will come later, possibly around election time, if you’ll excuse my cynicism.

Nevertheless, there are positives; the measures that have been announced, such as establishing a helpline and website for carers and launching a training programme for carers, seem to be a move in the right direction. I often hear carers saying that information is at best difficult to come by and anything that will help them cope with their responsibilities better is a good thing.

The move to double the amount of respite time available is also good news; it is now becoming acknowledged that carers – and the people they care for – need to have breaks from each other.

But the real bugbear is that the Carer’s Allowance, which currently stands at a frankly pathetic £50.55 a week – or £2,682 a year – has been left untouched.

The benefit, which is the lowest available, is often not worth the hassle and can tie carers into a poverty trap; if they earn more than £95 per week or study for more than 21 hours per week they can no longer receive it.

But rather than give any immediate increase in the benefit, the government has chosen to lump it in with the wider review of care funding and benefits, which is currently in a 6-month public consultation process and the review won’t be released until some time next year.

Until then, the new strategy will not affect many carers’ lives and no matter how many platitudes are trotted out, it will be the pound in their pocket that many carers will be most interested in and will make the most difference to them.

Social care cuts: a worrying story

2008-06-10T15:57:00.001+01:00

Now, only 4 councils provide care for the neediest in society, according to a report on the BBC’s Politics Show.

Good news if you live in Calderdale, Sunderland, Darlington or on the Scilly Isles – but worrying for the rest of us. Over 75% of local authorities now provide social care for elderly and disabled people who meet the criteria for ‘substantial’ needs. For those with ‘moderate’ or ‘low’ needs, they are left to face the challenges on their own.

And the situation’s unlikely to improve any time soon.

An estimated £6 billion budget shortfall over the next 20 years, caused by an ageing population and more demand for services, will further restrict the opportunities for those at the lower end of the care spectrum.

The much-touted personal care budgets will do little to ease the situation and simply shift the burden away from social services and onto the families, who will struggle to fill the gaps in the care services.

But at least there’s one solution in the short-term; you could always move to Sunderland…

The future’s not bright

2008-05-23T15:51:00.001+01:00

Ageism, neglect, poverty, isolation and deprivation; if that is all that the UK’s pensioners have to look forward to, it is no wonder that a quarter are making themselves sick with worry about it.

Help the Aged’s report ‘Spotlight 2008’ paints a grim picture for the nation’s elderly, claiming that ageism is rife, 21% of pensioners live below the poverty line and one in five do not always get treated with dignity in hospital.

As a result, nearly a million more older people are making themselves sick with worry than this time last year, the charity reports.

So much for retirement as the “golden years”.

Inevitably, Help the Aged has outlined a list of policy demands for the government to adopt, including a ban on age discrimination in the upcoming Equality Bill and establishing a targeted strategy to reduce pensioner poverty.

These are all laudable aims but whether the government will listen is another matter. There was precious little in the last Budget for older people – bar an increase in fuel payments, which will not cover the hike in prices – and it has steadfastly ignored all calls to raise the basic state pension and recently fudged the reform of the social care system.

The government’s ambivalent attitude to an increasingly large section of society seems to be percolating down to other areas, with ageism in the workplace and in general seemingly on the rise.

If this is to be addressed, the government needs to take the lead and put in place measures to ensure that pensioners do not have to struggle in poverty and are treated with the respect that anyone – regardless of age – deserves. The recent appointment of Sir Michael Parkinson as a ‘dignity ambassador’ is a step in the right direction, but more needs to be done.

After all, the power of the “grey vote” should not be underestimated. A few pensioner-friendly moves could bring Labour much-needed extra votes whenever the next election rolls around.

Social care funding: who cares?

2008-05-13T12:03:00.002+01:00

So what is all this hogwash from the government about giving people a fairer deal on social care?

It’s the old tale of Nero fiddling while Rome burns, and all that...

Ever since New Labour stormed to power, the government has promised to review the care system with a view to reforming it. It’s a story that started in 1997 just as Tony Blair moved into 10 Downing Street.

This week, some 11 years later, Gordon Brown announced to a population weary of government obfuscation that six months of public consultation on social care is to begin in earnest. Meanwhile, a Green Paper on social care, first earmarked for publication in April, is not even on the horizon.

This is a typical government fudge designed to kick the social care agenda into touch until the run up to next general election. At that point Brown, or whoever else is running the Labour party, will issue a new social care manifesto amid much fanfare and vote catching headlines: “They care after all”. The government has probably already booked a slot in 2009 on the Andrew Marr Sunday show. Election 2010: you read it here first.

Meanwhile, back on planet earth, a brace of surveys has damned the way social care is organised in England and Wales. People are worried about how to pay for their care, worried about moving into care homes and very worried about the current means-testing system. One survey by Caring Choices found 90% of people want to see the back of it.

And as the government procrastinates, the malaise in the social care system intensifies making reforms more difficult to implement. Local authorities become more cash-strapped, cutting off vital services and politicians continue to obfuscate where possible because they have no answers –and because they can.

And while Nero fiddles and all that… real statistics on social care relating to real people’s lives will continue to do the rounds. Some facts to date: by 2028 there will be a £6 billion shortfall in care funding; at the same time a quarter of the UK’s population will be over 65 years old and those over 85 years old will have doubled. Meanwhile more than 1 million will have dementia. Who will be caring for all these people and how is that going to be paid?

Remember, we’re not talking here about your mums, dads or grandparents – the next generation is you and me.

By Andrew Chilvers

All stars?

2008-05-09T16:05:00.000+01:00

This week, the Commission for Social Care Inspection has launched its much-vaunted star ratings system for care homes. But are they a useful guide for the public or just a waste of time?

The theory is that the system of awarding care homes stars gives the public an at-a-glance guide to how good a home is; 3 stars means it’s an excellent home for you or your mum, 0 stars means it should be avoided and possibly be closed down.

So far, so good – after all, it works in the hotels industry, among others. But moving into a care home is a much more complicated business than looking for a hotel and should not be viewed in the same way – it is more like buying a house and should be treated with the same thorough research.

So for this reason, I wonder whether the star ratings will really make a difference. People looking for care homes are increasingly savvy and many already know of and use the freely available CSCI reports on care homes. These go into much more depth about the conditions there, judging it over 7 categories and listing what the home does well and does badly, rather than just an overall star rating.

For me, the star ratings will only be useful at the outset of a search for a care home. If someone is skimming a list of homes in an area, it will most likely mean that homes with poorer ratings will instantly be discounted.

But this will not save that much time because about 70% of care homes have received a 2 or 3-star rating so far and only 3% given a zero rating. While this is good news – it shows that the vast majority of care homes do provide a good service – it will not narrow the field down much for many people. So they will still have to complete the time-consuming legwork to find the right home for themselves or their loved one.

Dementia drug appeal victory gives hope

2008-05-02T08:59:00.001+01:00

It seems odd that while potential treatments or cures for Alzheimer’s disease are heralded in the media virtually every week, access to a readily-available drug that is proven to help people with the condition is restricted.

Yet this is the case with Aricept, a drug that many people with early-stage dementia say has changed their lives – although hardly anyone can now get it on the NHS.

But this could be about to change, thanks to a Court of Appeal ruling.

The ruling relates back to November 2006 when the NHS advisory body, the National Institute for Health and Clinical Excellence (ironically referred to as NICE), decided it was not cost-effective to give Aricept to people with early-stage dementia and reversed its earlier guidance to issue it as standard.

The decision came as a shock to many people with the condition. Anecdotally, many have sung the praises of Aricept and the way it has given them their life back – few can fathom NICE’s decision.

Moreover, nobody understood the decision because few if any details of how NICE reached that verdict were made public.

As a result, Eisai, the manufacturer of Aricept, challenged the process that NICE went through to arrive at its decision to restrict access to the drug. The case went all the way to the Court of Appeal – after the High Court rejected Eisai’s case – which sided with the manufacturer. Giving NICE a rap on the knuckles, the Court of Appeal insists that in the future it should be more transparent in the way it makes decisions.

Eisai will now be able to see how NICE came to its decision and comment on it. NICE will then have to go away and consider those comments carefully, which could lead to another review of Aricept’s availability.

So what’s in it for all those people with dementia? Some 100,000 or so people denied Aricept and other such drugs will hopefully get the review they’ve been pushing for and a positive decision will be made for them sooner rather than later.

Stop talking start acting

2008-04-28T14:03:00.001+01:00

I’m getting a sense of déjà vu.

In the news today MPs have urged the government to clamp down on the “dangerous over-prescribing” of antipsychotic drugs to people with dementia in care homes.

MPs say about 105,000 people with dementia are given prescriptions they do not need because antipsychotic drugs have no benefits and could even worsen residents’ conditions.

These drugs have been associated with an increased risk of stroke, social withdrawal, accelerated cognitive decline – especially verbal skills – and severe sensitivity reactions. Essentially, they can leave a person with dementia in a zombified state.

Haven’t we heard all this before? This story seems to keep coming back into the headlines about once every couple of months – indeed, I blogged about it back in February [http://bettercaringblog.blogspot.com/2008_02_01_archive.html]. Panorama also had a programme on it late last year.

Last time I wrote about this, I said it was good that the issue was being revisited because it should prompt something to be done. But it seems that – still – nothing is being done, except a lot of hand-wringing and points-scoring soundbites about how “the government must end this needless abuse”.

Various people in parliament and beyond have been saying this for months. Surely the time for talking has ended, there needs to be action to stop this drugging of care home residents now. Even if it is a directive to care homes and doctors telling them to stop prescribing antipsychotics unless they are a last resort, it would be something.

But this is not going to happen. While it seems that action will be coming, it will only be once the government’s much-vaunted National Dementia Strategy is published sometime later this year.

For some people, you can’t help feeling that it will be too late by then. For the 100,000 or so people still stuck in a zombified state – or even ushered to a quicker grave by needlessly prescribed antipsychotic drugs – time is something they do not have.

Tomorrow’s world

2008-04-23T14:55:00.000+01:00

The so-called ‘iPad’ promises plenty for the pensioners of the future – but is it more a pipedream than a panacea for loneliness?

If the Life Trust Foundation is to be believed, the granny flat of tomorrow will be an Aladdin’s cave of webcams, wall-to-wall plasma TVs and intelligent appliances.

This will help tackle loneliness and allow grandparents to ‘virtually’ baby-sit their grandchildren from the comfort of their plugged-in palace. Combine this with email, web-chat and social networking, and the pensioners of the future will never need to leave home to stay connected.

Sensors underneath cookers and baths will be able to tell if they’ve been left on, making it a safe environment for people to live in. Only those with serious needs will require social care – and even then, care homes will be replaced by ‘boutique hotels’.

So, on paper the future looks good. But isn’t this just papering over the problem of loneliness? Viewing your grandchildren through a TV screen does not compensate for the real thing – unless they’re monsters fed on a diet of violent games and virtual experiences.

And then there are there is the problem of the technology itself.

If the doom-mongers are to be believed, the Internet will come crashing down within 10 years because of the public’s hunger for downloads, Internet TV and content streaming.

Although that’s the worst case scenario, how will a 73-year-old – a little unsteady and living miles from the family – cope in the digital age when the Internet decides to serve its last Google search? Given the dependence on technology, it could be a disaster as people are forced to go out and do things themselves – possibly for the first time in generations.

Despite this, the granny-flat of the future offers plenty of opportunities for isolated and lonely individuals – especially if it is done correctly.

And you’d hope, with all that expensive kit inside, it would have an ingenious way of alerting you to the bogus salespeople who come knocking…

Stop the charges

2008-04-21T16:18:00.000+01:00

My partner was recently admitted to the local county hospital and while her stay was mercifully brief and she received excellent care, there was one notable downside; parking charges.

Without wishing to sound Scrooge-like, I only went to this hospital four times but still ended up shelling out about £15 in car parking fees. A stay of a little over two hours (the length of visiting time) cost a whopping £3.30.

Many hospitals have been charging car parking fees for several years now. While they tended to start fairly cheap – 50p, no matter how long you stay, for instance – prices have jumped in recent years and are now on a par, if not more, than your average city centre multi-storey.

To me, this is morally wrong. It is unfair to penalise anyone visiting a relative or friend who is sick, even more so if it is a long-term condition. Imagine a pensioner having to visit his wife who has a broken hip. She will not be going anywhere for some time, and if he wants to visit her every day – a not unreasonable desire – the cost will quickly mount up. While you can get discounted weekly or season tickets, it would still take a significant chunk of the basic state pension.

These charges are essentially a licence to print money, taking advantage of a captive market. There is no way out of them.

The excuses hospitals give for introducing charges do not wash, such as deterring commuters parking in hospital car parks and cutting congestion. These are minor problems at worst and the end does not justify the means.

It wouldn’t be so bad if all the money from the charges went towards patient care, but often it doesn’t, especially in those hospitals that outsource the running of their car parks to a private company.

Hospital car park charges should be scrapped; it’s morally wrong for people visiting sick relatives or friends – especially those needing long-term care – to have to pay for the privilege. There is no need for it and it only succeeds in putting more stress on people at a time when their energies should be focused on the person in the hospital bed.

A Lidl bit of what you fancy…

2008-04-18T10:34:00.003+01:00

Just imagine doing your weekly grocery shop and picking up a grab rail alongside your grapes, or packing a bath seat next to your tins of beans.

Ten years ago, such a thought would have been ludicrous, but supermarket chain Lidl is now offering customers the chance to purchase home aids as they peruse the shelves.

This move has enormous benefits for elderly shoppers, particularly those on low incomes. For starters, it is cheap; a Lidl grab rail costs £4.99 compared to B&Q’s that will set you back £9.98.
It is also far more convenient to buy these things in a supermarket than having to make an effort to go to a DIY store. And if you haven’t had a needs assessment but feel you require some help getting around the house, it provides a cost-effective solution.

Obviously, there may be differences in the quality of the products offered by specialist manufacturers and DIY stores compared to Lidl’s modest range of big-buttoned telephones and leg pillows – but it is a welcome addition to a largely-untapped market.

Hopefully the bigger supermarkets will follow Lidl’s lead and offer similar products in-store, instead of shunting them to the website, where they remain hard-to-find.

End in sight for postcode lottery?

2008-04-16T14:41:00.000+01:00

Finally.

After years of grumbling by people in the care system, the government has finally announced that the eligibility criteria governing older and disabled people’s right to receive care services is to be reviewed.

In theory, this review could see the end of the unacceptable ‘postcode lottery’ of care services. But we should not get too excited – the credit crunch could see any reform stymied.

One of the most common gripes I hear is the unfairness of the care services system, where someone in one area is denied – in some cases life-saving – drugs, while elsewhere they’re available.

The Commission for Social Care Inspection has been asked to undertake the review and report back to Care Services Minister Ivan Lewis in the autumn. CSCI’s brief is to focus on national definitions of need and the application at a local level.

At least the review is focusing on the right area. A set of national guidelines for eligibility, which are not open to interpretation at a local level, is crucial. All too often local officials have their own take on the rules and this needs to be stopped. Access to care services should not rely on the luck of where you happen to live.

But much of the postcode lottery is borne out of a lack of adequate funding for social care services. Many councils have ramped up their eligibility criteria in recent years to save money and plug huge holes in their budgets.

And with the credit crunch and resulting economic downturn, it is unlikely the government will start pouring extra cash into council budgets to fill those holes.

So while this review is to be welcomed, how much effect will it really have? If any major reforms happen, they will be down to the economic situation and the prospects for the moment are looking grim.

Do you feel lucky?

2008-04-11T16:53:00.000+01:00

Continuing care should be given to everyone when they need it. But the current system is hampered by a postcode lottery, depriving many because of where they live – and this is only going to get worse.

New government guidelines have increased the eligibility for access to ‘Continuing NHS Healthcare’ by more than 5,000, Age Concern says. Yet in many areas of the UK vulnerable people are seeing reductions in the services offered.

If you live in Mid Essex, Sandwell and Wandsworth, the situation can’t get much worse.

All three authorities have reduced the continuing care services offered by more than 80%. East Riding, meanwhile, halved the number of people receiving continuing care – some achievement considering they had the second-lowest number of service users in the first place.

The gap between the worst Primary Care Trusts and the best is one that deserves much consternation and head-scratching, and is evidence of the postcode lottery facing people who access healthcare.

If you live in Coventry and Plymouth you’re in luck – both have reported a growth in the number of people using the service. Better still, Derby, which had the lowest number of people accessing continuing care in 2007 – 1.5 people per 50,000 – has grown to 25 people per 50,000.

How some PCTs can offer such extensive continuing healthcare while others fail is a mystery, but by naming and shaming Age Concern has successfully highlighted the inequalities found throughout the UK.

In the case of some – particularly Derby – it’s great to see moves being made in the right direction, and the PCTs should be praised for raising the standards. But this still remains a postcode lottery that needs cracking.

Where has all the money gone?

2008-04-10T13:26:00.000+01:00

That was the question asked by Age Concern recently when it reported that an estimated 2.2 million pensioners had not claimed council tax benefits. Elsewhere, 1.7 million were not claiming Pension Credit, and 310,000 were not receiving Housing Benefit. Total all this up and it amounts to some £2,000 a year per household in unclaimed benefits.

There may be a stigma attached to claiming benefits, but £2,000 is a lot of money – especially for pensioners who may be funding care, may still have a mortgage to pay, or may be caring for somebody else.

But, above all, can government do more?

In a sophisticated modern state like Britain, it’s disquieting to think there’s not a central database that contains all this information. Government is eager to catch tax dodgers, but seldom eager to pay out when it should.

Moves are being made in the right direction with the initiative on self directed support, a buzzword that means people will be given the freedom to choose their own kind of care out their own personal budget, supplied by the local authorities. This will also give people the right to question the benefits system – and hopefully encourage them to take the benefits that are on offer.

Nevertheless, self directed support will take years to roll out across the country and each local authority will have its own idiosyncrasies regarding services. It’s certainly not a quick-fix panacea and, meanwhile, older people will continue to lose out on essential benefits.

So what’s the answer?

If you can, go to your local social services, speak to your social worker and demand to know what benefits you are eligible for. This really is essential; it could be the difference between a cosy, heated home or days spent under covers in the bedroom during the latest cold snap.

Care home attitudes need to change

2008-04-07T17:30:00.000+01:00

When many newspapers recently carried stories about hundreds of illegal immigrants working in care homes, one question was left unasked: why are so managers willing to employ them?

The answer, it seems, is that most British people don’t want to work in care homes.

Recently I attended a conference where I was told that the available social care workforce in one English town dropped by 10,000 after a Morrison’s superstore opened up nearby. To put it bluntly: most British people would rather work in a hypermarket stacking shelves than help to care for the elderly and disabled.

Unfortunately, it’s a scenario that has been repeated across the country and should surprise no one in the caring industry.

Working in social care requires dedication, but it’s low paid, the hours are long and the media publicity is almost wholly negative. It’s hardly an incentive to want to join the industry.

To state the obvious: a sea change in the perception of care homes and care home workers is needed. But the question is how to achieve it.

A good start would be to emphasise the positive work that goes on in many residential homes. For example, schemes such as Art for Age, in Kidlington in Oxfordshire, a joint project between the Glebe House care home and Beckley Primary School, showed what can be achieved. The public display of artwork late last year was a great success. See www.bettercaring.com/editorial/channel3.aspx?id=370 for the full story.

Highlighting the tireless work that many care home workers and managers put in to the job would also help the industry. This could help restore a sense of pride in their work.

As well as this, pay rises for care home workers would help to retain the best staff and provide an incentive for others to progress.

Many care homes, especially those run by the local council, operate on tight budgets, with little in the pot for pay increases. With the government showing little sign of increasing funding for social care, staffing concerns and adverse media publicity are probably set to continue.

Benefits system needs continuing reform

2008-04-04T15:56:00.001+01:00

With a benefit called ‘continuing health care’, you would expect it to be paid out to all those with long-term serious healthcare needs. But apparently not.

Currently, more than 400 people are suing various health authorities after they or a family member were refused continuing health care. They allege they were not given proper assessments and had to pay out hundreds of thousands of pounds in some cases for nursing care as a result.

While the plaintiffs are seeking compensation, it highlights the confusion around what constitutes social care – which is means-tested and carries a charge – and health care, which is provided free by the NHS.

The distinction between the two has been muddled for years, and has often come down to the local Primary Care Trust’s interpretation of government guidelines.

Unsurprisingly, it has led to some frankly baffling decisions. I have heard anecdotally of a man with the later stages of dementia – he could not walk, barely talk, was doubly incontinent and needed help for the most basic of tasks – refused continuing health care.

How a man with such care needs, and who’s health clearly won’t improve, does not warrant continuing health care funding is beyond me.

This provides another example of the urgent need to reform care funding. The guidelines for awarding benefits such as continuing health care need to be clearly set out and the distinctions between the various benefits need to be made clear to all.

If this happens, it could stop people being wrongly forced to pay for their care. Estimates in the press speculate that if the judge were to rule in favour of the 400, thousands of pensioners could be in line to claim refunds from the government – a bill that could run into hundreds of millions.

It is a bill the government could ill afford, but may help galvanise ministers into action to ensure that such cases do not occur again and that the care funding system is finally made simpler and, for many people, fairer.

Bogus nurses: a care home conundrum

2008-04-02T16:43:00.001+01:00

If fighting against perceived poor standards and public perception weren’t enough, care home managers now have to contend with fake nurses.

This goes far beyond poorly qualified staff and involves people pretending to be registered nurses to work in a care home.

The story of 49-year-old Carol Dabbs is one that should alarm every care home manager – and the families of anybody who lives in a care home.

Dabbs is alleged to have lied about being a nurse, and worked at a couple of care homes in Wales between 1992 and 2006. She was allowed to administer drugs and care for vulnerable frail people with no qualifications or training.

She now faces criminal charges of deception, supplying class A and class C drugs and wounding. A helpline has been set up for people who may have been treated by her.

At Bettercaring we hear of numerous cases of people unqualified to do the job, but few are as serious as this.

That Dabbs got away with it for almost 15 years is frightening and astonishing, and part of the blame must lie at the doors of Neath Port Talbot Social Services and the two care homes in question for not vetting the staff appropriately. Even the Care and Social Services Inspectorate Wales (CSSIW) should face an inquiry for such an enormous lapse.

But it begs the question – how easy is it for someone to get a job in a care home without the right qualifications?

I recently spoke to Diane Smith, the manager at Cantelowes House in Barnet, and was impressed with the standards of recruitment in the home. She refuses to use agency staff and ensures there is a paper trail associated with every member of staff.

New members of staff don’t start work until all of the checks have been carried out, and this paper trail makes it impossible to falsify records – training and experience. It’s an almost foolproof system.

Diane admits it’s a long process, but it means there are no false nurses on the books – and she can sleep easy when CSCI come to visit.

A little perspective

2008-03-31T15:37:00.000+01:00

When allegations surfaced of dementia sufferers being neglected at Bamburgh Court Care Centre in South Shields, the ‘Fourth Estate’ went on high-alert.

With reports of residents being forced to sleep on filthy mattresses on the floor, mouldy food left rotting in the cupboards and faeces smeared on the walls, it’s no wonder many older people fear going into a care home.

These shocking allegations about Bamburgh Court Care Centre appeared last week in the Daily Mail and this story will no doubt heighten fears about the standards of care in residential homes.

But from what we have seen at Bettercaring, these cases are few and far between and the vast majority of people in care are well treated and lead happy lives.

In truth, nobody knows how prevalent abuse is in care homes, which is why the announcement of a £2 million study by the Department of Health and Comic Relief into the risk of abuse in care homes and the infringement of dignity on NHS wards is timely.

The research, which, crucially, will take in the views of older people, should finally show how widespread – or not – abuse is in care situations.

The results of this research – slated to come out in 2011 – will hopefully demonstrate that abuse in care is rare and that cases such as Bamburgh Court are the exception rather than the rule.

But more importantly, it should help to change perceptions about the industry.

In the meantime, the government has announced plans to strengthen protection for vulnerable elderly people in care homes and ensure those that do suffer abuse can bring the perpetrators to book.

The government plans to make people who have publicly-funded care in private homes subject to the Human Rights Act, which should safeguard them from such things as unfair eviction. Also, self-funders will be able to refer complaints to an independent adjudicator from later this year.

These are all positive steps and should, in time, help to rebuild the industry’s reputation, which has been consistently tarnished in recent years by stories such as Bamburgh Court. It will take a long time to change the public’s perception, but these are steps in the right direction.

Entertaining residents isn’t child’s play

2008-03-28T17:38:00.004Z

Bingo. A spot of telly. Maybe even a singsong for the lucky few. Or that’s the common misconception of activities in care homes. But having spoken to numerous experts over the last week it’s heartening to see the importance placed on stimulating entertainment.

Yet it wasn’t until I spoke to Sheila Searle – a woman seemingly obsessed in her desire to change care home activities – that the passion of the dedicated activity coordinators became obvious.

Disillusioned by the lack of support, resources, time and poor pay, Sheila gave up her role as an activities co-ordinator in a Buxton care home to set up inspiritbuxton. An online resource for activity coordinators it combines best practice, hints and tips and lots of ideas for activity staff as they aim to improve the service they offer to their clients. It’s a great idea, and should prove to be very successful.

But activity staff are at the coalface of an industry in flux – and are the first to find their services slashed come budget cuts. The result is fewer resources and less time to plan an effective activity programme that stimulates all of the senses.

Having visited a number of care homes now, it’s apparent to me just how hard-working and under-valued activity staff are. They’re the unsung heroes in the care homes. Their work isn’t ‘necessary’ like health or nursing care, nor does it enable the homes to run effectively, like the administrators.

Yet they have more interaction with the residents than anybody else. They’re the ones who make them smile, or challenge them to tr something new, and they’re the ones who break up the monotony and ensure residents aren’t force-fed ‘Cash in the Attic’ day after day.

However, in this world of profit-driven care it’s easy for companies to look over this devotion when the balance-sheet must be pleasing on the eye.

There will be more information on Sheila’s story and inspiritbuxton on Bettercaring shortly.