Elderly care

Coronavirus/COVID-19

We have continued to provide high-quality homecare to our customers throughout the lockdown period. All our carers have all been trained in Coronavirus infection control and our operations policies and procedures are continually reviewed to deliver the latest Government advice. The safety and well-being of our customers and carers is always our top priority.
For latest guidance, information and updates on the Coronavirus visit GOV.UK Public Health England.

Time to talk about funding

I was recently asked to consider writing to my Local Authority to respectfully ask them to reconsider their responsibilities under the Care Act, and consequently to increase their fee rates for homecare work.
For me, there is an obvious and predictable direct link between inadequate pay rates and poor quality care. A high percentage of public sector savings are being made at the expense of vulnerable elderly people. This is clearly wrong, but I do not believe that asking the Government to allocate more money to Local Authorities for care will solve this crisis.
Local Authorities have already taken choices over where to allocate funds and clearly they have failed to prioritise elderly care. Cynically, I fear that even if the money was “ring-fenced for social care” the percentage of funds that ended up actually spent on elderly care would not make a significant difference. Social Services Directors would still line up to justify flying 15 minute (or less!) visits and select providers solely on price without reference to quality of care.
But there is another reason why I don’t support asking the Government for more money. That is because I believe that this type of initiative reinforces the misconception that homecare can be defined as that type of service funded by Social Services. It clearly isn’t! Homecare needs are not mitigated by a nominal line in the sand drawn at assets of £23,500. Elderly with more than this figure still need care and still want to remain at home!
Sadly, Halcyon Home Care have experienced more than one exhausted 85+ year old who has been abandoned by the system. After “failing” the financial evaluation, they were left to contact and arrange care (normally from an out of date list of providers) for their spouses at a time of extreme emotional distress. They call us without any understanding or experience, uncertain what it will cost or where they will find the funds, or even what service to expect. Simply, they need someone to assist them through the process.
I believe a lack of understanding of the scope of who might be affected and the costs involved is one of the key reasons that the crisis in homecare has been allowed to develop. Too many people think it isn’t going to affect them and if it does, then, social services will look after them. By the time they find out the truth it is too late.
If things don’t change it will only get worse and the scale of the failings of the system will become a catastrophe in our own society. We do need a discussion about funding… and one part is about social services funding … but the bigger debate is about funding for care for all our elderly regardless of the £23,500 assets cap… and it needs to happen now!

Dementia Alone Cannot Dominate Ageing Debate

The Prime Minister’s latest strategy, picked up extensively in the news media, is a drive aimed at pharmaceutical companies to focus their efforts on dementia drugs with a hope that, by 2025, significant inroads can be made. There is a plan to build on G8 commitments and further rally all the world’s major powers around the need and importance of this work.  With neither of these things do we disagree – but there is much, much more to this problem.

Dementia does not equal Ageing

Dementia is frequently treated in the news as an illness which is effectively analogous with ageing. That is wrong: it is not an inevitable consequence of age even though its incidence correlates to a high degree.  Neither is it not the only issue which accompanies ageing, which has a range of effects on our lives, as well as bodies.

The number of people in the UK aged 65+ is projected to rise by nearly 50% (48.7%) in the next 20 years to over 16 million, and they will make up a higher percentage of the population than they do today (22.4% by 2032, versus 17.2% today).  Consider this: just 1% of those over the age of 65 are likely to suffer from dementia, while 100% will experience other difficulties of ageing, such as declining general health and mobility.

Broader Ageing Research Required

More money absolutely does need to be put into dementia research. The question is where that research should focus, and what priority is placed on it relative to other aspects of ageing.

I would like to see as much focus, research and effort into understanding the causes of dementia , in pursuit of prevention, as well as pharmaceutical management of the outcomes. However, I believe we must additionally extend all kinds of gerontological research – and, if we understand how to manage the full breadth of aspects of ageing better, we may well directly improve our dementia management.

Dementia Home Care is Critical

Much of the recent news agenda around ageing has been overtaken by stories around residential care home practice and failings, and it has crept in to dominate much of the accompanying political debate around the Care Bill.   It is a worrying distraction – because there is simply no practical or economical way that residential care can be the dominant model going forward. Home care, in close alignment with health and community care, must and will become the main environment within which we help people manage the challenges of old age. That means that dementia care in the home will be vitally important.

The Bradford Dementia Group has made a number of important research contributions in the area of helping and caring for those living with dementia, and those who must support them.  I would like to see much more research of this kind, focused on caring for those with dementia who remain at home.    There needs to be recognition that caring for someone in a specialist care home environment is very different from care at home. The care skills and expertise required for good dementia home care are specialised, and all carers need better researched practical exercises and advice. They need help in shaping the home environment to facilitate the lives of those living with dementia.

This is the most important challenge that exists today – and it will continue long after drugs to alleviate the symptoms have been developed.  We must not let the focus on dementia distract us from the bigger challenge that awaits. We have a vast ageing population issue approaching which will create a tidal wave of pressures on our economy, our communities and our families.

I sincerely hope that there ARE huge steps forward in dementia drug treatments and, in particular, those drugs which can delay onset or minimise the symptoms of dementia for those who need it. However, the stark reality is that no drugs, no amount of righteous politicking, can hold back the tide of ageing health and welfare issues which faces Britain and many other countries.

Sources: Alzheimers UK and National population projections, Office for National Statistics, 2011

Dementia Friends Simply Can’t Cope

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It’s nice to see a flurry of interest in Dementia across the media recently, as the PR machine publicising the new Dementia Friends campaign did it’s job.

Of course we strongly support the idea that the whole country and whole community should get involved in helping to support those with Dementia, a debilitating and distressing experience for individuals and their relatives alike.  Greater education and awareness, encouraging volunteering and community support for those with Alzheimer’s is undoubtedly vital. It’s wonderful that people like Sir Terry Pratchett are helping to spearhead change, along with a vast array of kind, well-meaning stars.

We do feel it sad, however, that it takes the glitz of media and music simply to make the subject interesting to the media, unless, that is, they are salivating over some dreadful care home shock story. We also worry that — as good an idea as Dementia Friends is — it rather glosses over the far more pressing problems that surround our country’s planning for an ageing society.  It is not only support for the 800,000-plus people living with dementia today that we should be worrying about; it is the million-plus who will be living with it by as early as 2021, with those numbers destined to rise further.

We are glad to see that some smart reporters and channels are giving it a wider consideration too, but suspect such stories will receive much less discussion and debate.  We love the article by the Telegraph’s Laura Donelly, for example, which highlights a shocking statistic that over 50,000 people in Britain must give up work in order to care for a Dementia sufferer, because there is no other choice or support.

Jeremy Hunt, Secretary of State for Health, is vocal on this issue at present, but is failing to make the next logical connection in his arguments. We should not be looking only to communities and carers to fill the gap without also re-examining the entire fabric of how we deliver care to the elderly population.  It is simply not possible or fair to expect families, volunteers and communities to shoulder the entire burden of an increasingly aged, infirm and less able population. Dementia is becoming more and more discussed, but often as a form of ‘shorthand’ for old age, and there will be even greater numbers of those who are simply old who are not even being considered. Handling the challenges even of old age can be upsetting, as people decline in health, strength and energy.  Advanced dementia, though, is a serious and very hard-to-manage condition – viewers of the latest BBC ‘Protecting our Parents’ programme will have seen some examples of this.

Untrained volunteers, well-wishers and harassed relative carers simply cannot cope adequately with this condition, and certainly  not without a firm underlying foundation supported by the establishment. To cope with both the dementia and overall ageing challenge that faces Britainn, the systems that we have bear a serious rethink. It won’t be possible, and it isn’t right, to shuffle millions of elderly people into residential care as a default option: the ONLY logical way forward is to look at ways to enable them to live in their own homes and communities. But doing so will mean much, much more than volunteers can deliver, fresh approaches to managing limited public resources, and many, many more trained carers who must be attracted, trained, supported and with pay commensurate with this vital work.

Until the government wakes up to the need for a more holistic ageing strategy, and assigns someone to take real and active responsibility for it in the form of a minister for the Elderly, initiatives like today’s Dementia Friends launch will, sadly, remain only a patch and a PR exercise, unsupported by a real and workable social care framework. We need a strategy for dementia care AND we need an overarching strategy for the interests (and care) of the elderly. It’s time to stop assuming someone else will take care of it, and us, all.

 

 

Just STOP!

stopElderly care is all over the media – again! There’s a BBC series under way ‘Protecting our Parents.’ It’s all about shocking stuff – again!

I want to put it into perspective. The media must stop skewing the issue by focusing only on the sensationalist, negative side of the elderly care story. Well done, you are contributing to the collapse of social care. It is becoming almost impossible to recruit into care, which is exacerbating the already squeezed resources that are constrained from a financial perspective.

While awareness of issues is good, programmes like this and recent exposes unfortunately can harm more than they help. They can focus unfairly on carers in homes who are overstretched, and on the homecare businesses so thinly spread that they accept 15-minute calls even when they know it’s wrong (we refuse these however). All of them have fewer and fewer carers to call on, and little or no ability to cover no-shows, illnesses and absences – regardless, all face a scaling challenge in terms of demand. It’s not simply about zero hours contracts. It’s not just about substandard carers abusing elderly. It’s about a system that has too few resources, who are overstretched, overtired and underappreciated, too little money and no political will to change.

What will it take to find the way forward? Media to stop making it worse? Stop using stupid analogies and comparing the cost of care to the cost of hotel rooms? Social and healthcare need to stop fighting against each, and shuffling elderly people around like unwanted packages. There also some need for us as citizens to change our expectation. Everyone needs to wake up to the realities: every citizen of this country, especially those who are approaching the end of their earning years, must either adjust expectations of the quality of life and care that they might receive, or recognise that they will have to contribute more. The idea that somehow, sometime, the government will find a way to fund elderly care more is a pipe dream.

Local Authorities must stop demanding greater and greater care resource for less and less funding: they have already hit the barrier below which care can no longer be delivered. The politicians must stop avoiding the responsibility and appoint a senior minister for the elderly. They need to stop looking at this solely as an election issue and take a long-term view. By failing to do this they are helping perpetuate the fairy tale of what our future will really look like if we don’t take action now.

Longer life is an inevitability. UK Office for National Statistics tells us that the number of centenarians in the UK has risen by a staggering 73 percent over the last decade and that the number of people over 85 in the UK is predicted to double in the next 20 years and nearly treble in the next 30. Unless we do something now, it will be a longer life, but one of lower quality, less choice, less dignity and poorer health.

A Filing Cabinet and a New Chair

There are some business milestones they never teach you on a management course. I don’t recall any lecturer saying how the purchase of a filing cabinet and a new chair requires a reflection on the progress of the business.

But the new filing cabinet spoke to me today and said “Boy, do we desperately need more space for the information on the growing number of customers and staff we now have.”

So, why do we need more filing capacity? Because it appears that our past and present customers are telling others about the quality of the care we’re providing and our services.

And how are we achieving this reputation? Well, the only answer is to be found in the carers we employ and what they do. We make huge promises in our Care Plans when we commit to care for someone, but that’s all they are “promises” until we actually start to deliver. Our carers have to adjust to a different elderly person’s home environment in every call. There are general standards that we deploy but they have to adjust to a different care regime, different preferences with or without medication, with or without mental or physical capacity, in each call — and we recognise this. We have always acted upon a belief that the only way to look after our customers is through looking after our staff, by paying the best in the area, by nurturing their career ambitions and by trying to develop them as best we can. It didn’t take me too much strategic analysis to see that our staff are the reason why the business needs more filing space and is growing rapidly across Maidenhead, Windsor and Ascot!

Oh, and the new chair? Well, that was in homage to Zig Ziglar and his comment that “You don’t build a business. You build people and then people build the business.” Our success is Tracy’s. She controls the standards and the systems within which our carers operate, and she deserves a new chair … even if there was another two years left in her old one!

Paul Dunn-Sims

Our growth news coincides with CQC Inspection update

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Good management of a domiciliary care agency takes more than just ticking boxes

The CQC inspectors have just returned our annual inspection report and we are delighted to announce that a great CQC report coincides with the news that we have just exceeded 400 care hours per week, and now employ 25 people  — a significant milestone we set out to achieve and are now surpassing.

We’d like to share some of the CQC findings with you. It just goes to show once again that boxes can be ticked, but to really come up to scratch you have to see the evidence in the comments behind the boxes. So we are happy to report that not only are we meeting all the standards, but have surpassed expectations in certain areas.

We were found to have met the standard for Respecting and Involving people, Care and Welfare of people, Safeguarding people from abuse, Supporting workers, Assessing and monitoring the quality of service provision — and we would expect nothing less. What really matters is what both our customers and their relatives, and our carers and their managers, told the CQC about us.

Here’s a summary of what they found:

From our customers:

“People were wholly complimentary about the quality of the service they received with one person describing staff as ‘really lovely’ and said staff went ‘beyond the scope of what they need to do.’

Other people described staff as ‘respectful’ and ‘very well trained.’

One person said the manager was ‘very particular about the staff they employed.’”

This is exactly one of our top priorities and it’s good to know it’s being noticed.

From our staff:

“Staff felt supported and one, who was new in the post, found the support helpful in making them feel comfortable in their role. Staff were also motivated and said they enjoyed their work.”

And here are some first-hand remarks that support our top priorities — the report highlights that we keep our promises.

Involving people in their care plan, giving them control and respect:  “We saw there was a clear schedule of support the person had planned with staff and the times this was to be delivered. The schedule was supported by detailed individualised care plans. People we spoke with said they had been involved in their care planning and were able to request changes and we saw these requests were acted upon.”

Treating people with dignity:  “Staff spoke with confidence about how they ensured people were treated with respect and dignity and gave examples of how they did this when supporting people with their personal care needs. People using the service, and relatives, said staff were always respectful and showed regard for people’s dignity and independence.”

Keeping people safe from abuse:  People who used the service told us they felt safe with the care staff allocated to provide their support. Staff told us they were up to date with their safeguarding training and we saw records of certificates, in staff files, to confirm this. The information provided, together with our observations demonstrated that people were protected against the risk of abuse.”

Regular vetting and training of staff:  “We saw that staff were regularly assessed. Managers carried out regular checks to assess staff performance and also to offer support and guidance to staff. Staff said they had enough time to carry out their duties effectively and we saw that staff always stayed at a person’s home for the allocated time to ensure they were providing the most effective care they could.”

It’s great when a homecare agency can be upfront about its operations; none should have anything to hide.

 

 

Will my carer help me with just the small jobs? I don’t want a full home care package

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Some elderly people don’t want a full care service – what they really want is a bit of everything. This is sometimes difficult to articulate.

We know that the little things make all the difference, so no job is too small. It could be help with shopping, collecting pills from the pharmacy or surgery, helping them get upstairs at night, or just making a cup of tea and having a chat. Obviously, at the other end of the spectrum we have experience in dealing with customers suffering with severe illnesses, disabilities and dementia.

None of our commissions are the same. We build our care plans around what the individual wants and needs, and the home environment that they live in.

 

Am I at risk with a home carer?

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There is always the fear that strangers coming into the home bring risk. An elderly person may be concerned that they don’t know them; that the carer doesn’t know what they like or don’t like; that they might even abuse the situation and steal from them or invade their privacy without consent.

Our care assessment is focused on identifying what someone wants and if possible providing an introduction to them as a person. As our CQC Inspection noted, our care plans are very detailed even down to telling the carer where to find the hoover or where the tea bags are kept.

A good, reputable carer agency, like ours, recruits staff that are good at getting to know our customers really well in terms of their personal tastes and expectations. This is their top priority. And we check, vet and train our carers very carefully. When interviewing we are looking at the values the candidate has in answer to the question: can you show complete respect for the person you are caring for and build lasting , trusting relationships?

This is the most important question to us because we are confident we can train them to effectively perform all the care tasks.

Does having care at home mean people will assume I can’t cope?

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For many elderly people, they don’t want carers turning up at their door every day in case people think they can’t cope.

Having home care visits doesn’t say that at all – it tells others, including family, that the person is fully aware and taking charge, staying independent and in control of their own needs.

Does taking your car to a garage mean that you shouldn’t be on the road?