Happy New Year!

I hope that everyone has had a happy and restful break. I certainly did, but have had to cram a couple of weeks work into five days in order to catch up!

Hence the lateness of the greeting.

One of the things that makes Christmas for me is the BBC.

It all starts with the Christmas Radio Times, and then Carols From Kings, The Reith lectures, The Royal Society Christmas Lectures and delightfully this year Terry Pratchett and Neil Gaiman’s Good Omens!

The Reith Lectures by Professor Atul Gawande were a huge pleasure this year and I can highly recommend them.

Click here to go the BBC website to listen to them

The first lecture explores the topic of why doctors fail, and explores the factors which affect medicine, Ignorance (lack of knowledge) and Ineptitude (failure to use existing knowledge).

The second lecture is titled the century of the system,  and interestingly describes some simple systems that care and nursing homes would do well to copy.

Lecture three is about the problem of hubris and looks at the issues of aging and death and how society has a problem recognising the limits of what professionals can do.

The final lecture the idea of wellbeing is for me the highlight, and explores ideas around end of life care and assisted dying.

If nothing else, for me, the whole series re enforces the importance of the fact that people providing care need to care. A simple concept,but one that’s often overlooked.

Registered Care Home Managers

Here’s a story that’s close to my heart. Having been a Registered Manager for several years, managed the work of a group of Registered Managers as Responsible Individual, and having gained the qualification as a Registered Manager (RMA NVQ4) I feel my opinion comes from a well informed stand point.

I often say to clients that the Registered Manager accounts for 90-95% of the quality of a home. So it is important to-

1-Make sure the home or service has one.

2-Check on their qualifications and experience.

3-Find out how long they have worked in the home or service.

It’s good to see the issue being debated nationally, the headline story being that a proportion of services providing care do not have a manager registered with CQC.

This despite recent efforts by CQC to improve this figure.

Here is what the piece in the Telegraph of 10th October has to say-

More than 2,000 care homes looking after elderly or disabled adults have no registered manager, according to figures to be published this week.

The results mean that 12 per cent of all care homes in England lack the leadership required to ensure that vulnerable people, including frail pensioners with dementia, are cared for properly, according to a study to be presented at the Liberal Democrat conference on Tuesday.

Paul Burstow, the Lib Dem MP and former health minister who obtained the figures, said the figures showed that “a revolution” in care homes was needed.

There are a number of factors underlying these figures and I would like to unpick them here.

The main one in my experience being turnover of managers. The position has changed over the last decade or so, and the focus of the job is diluted by the various stakeholders that the registered Manager finds themselves pulled between. A clear example is the needs of owners to run a profitable business weighed against the needs for care. On the surface one would expect owners to be in care business out of altruistic motives, indeed this was more the case in the past. However more and more the ‘owners’ are venture capital companies more interested in the bottom line. Care decisions are overidden by financial constraints. This leads to the high turnover of registered Managers in the sector, the majority of whom come from a caring background as opposed to a business background.


Lack of support
for registered managers is another factor that influences the lack of candidates for the sector. The old saw ‘it’s lonely at the top’ is never more true than it is now for the Registered Manager. As well as the pressures from divergent stakeholders as outlined above, there is the lack of peer support due to the business model of care provision. How can one go to another registered Manager locally for support when they are in fact business rivals? The same is true of the sharing of good practice in care throughout the sector.

Finally where do these managers come from? The skill set required to be successful in these posts is quite unique. A mix of care professional, business manager, HR professional, diplomat, carer supporter, pharmacist, CQC inspector-I could go on! There is a case for the industry taking along hard look at where it recruits from, what skills and knowledge it’s looking for and how these are developed and accredited. Yes I know Skills for Care do a good job of this, but they do it from outside the industry with one foot in the political camp of the current government regulators. Does anyone tell Costa where to get their manager from and what qualifications they must have? No the market decides that, however in the market of care, the qualities needed to manage aren’t clear.

Here’s The Telegraph piece on the story

Listen to the You and Yours item here.

CQC Sandwich Generation Survey

I covered this story briefly earlier in the month when it was featured on BBC Radio Four’s You and Yours.
It’s a really useful piece of work though, so I thought I would cover it in further depth.

CQC commissioned Mumsnet and Gransnet to carry out a survey of the users of their sites. They were in particular looking for those that are described as the Sandwich Generation.

These are people who described as juggling caring for children and older relatives.

Eight out of ten people surveyed identified choosing care as major source of stress. Going as far as describing it as more stressful than divorce, separation, choosing a school, getting married or buying a house!

I have always described the process of finding good quality care as minefield. This survey clearly re enforces this.

Whilst I take no satisfaction in the fact that finding good care is so hard, clearly all care should be good! It is refreshing to see the CQC tasking steps to gain views and improve the information they provide. The infographic they provide shows what people want to now about care providers. All of which are included in one of my reports.

www.scotting.org/services.html

If you need some help and advice call my freephone line 0800 0016694 always happy to help .

sandwich-generation-survey-infographic-011014

Heres a link to the report on CQC website.

http://www.cqc.org.uk/content/sandwich-generation-carers-say-choosing-care-one-lifes-most-stressful-events

 

 

 

You and Yours 7th October 2014

You and Yours have been producing some good coverage of the care sector for some time now. I particularly liked todays episode as it repeats one of my key messages to people. Always get good advice when looking for care. Odd to see CQC taking this position, but also refreshing to see them taking a real world view of the whole picture.

How easy did you find it to get good quality care for your elderly parents or relatives? The Care Quality Commission says it is one of the most stressful things we’ll face in life.

We’ll ask why is it so difficult and what can be done to make it better.

Guests will include the Care Quality Commission and Carers UK.

Web users click here for full story

For those reading in print the programme can be found at- http://www.bbc.co.uk/programmes/b04kbjhx

And don’t forget advice, help and information is available on my website-www.scotting.org

The News at Ten

Actually it was eleven when I started typing, but i thought the title might get your attention.

I was just updating my news stories, when it occurred to me that there are a limited amount of subjects that are reported on, when it comes to care.

I monitor the news on a daily basis for stories about care, that will inform my work, and help to advise people looking for good care.

Stories tend to fall into a few categories-

1-Care scandals, these are the ones that make national news, and usually involve criminal behaviour. Orchid View being the lastest example.

2-Failing care service. Usually reported in local papers with the a headline like-“Care Watchdog slams poor care” These are the stories about CQC inspections of services.

3-Stories promoting services. Again usually promoted in local press, but occasionally national when there is a special event on, such as National Care Home Open Day. Local stories tend to be of the Garden party/100th birthday variety.

4-Good care stories. These are the hens teeth ones, and are so few and far between that it’s not possible to spot a trend.

5- Finally there are the Government Policy type stories, such as the recent Care Act/Care cost Cap.

So what can we conclude from this?

Is the lack of good news stories a result of media bias, or a drought of good news in care?

I would like to think it’s media bias, but sadly I think the Bad news stories outweigh the Good.

There is clearly a need for the providers of care to pull their fingers out and focus on care quality and promoting the benefits of good care.

Listening to The Archers last night, I wonder if part of Peggy’s current unhappiness isn’t the worry about going into a care home.

Many people in later life that I speak to worry about care. Part of this worry is well founded, but part is also due to the media delight in reporting bad care.

As always I would say get some sound advice before buying any care service.

www.scotting.org/free_advice.html

I love Radio 4

I can’t lie, my day is not complete without Radio 4 on in the background. I have it on in the office and in the car.

I love turning the radio on and being surprised, educated, entertained, informed etc…

Its not very often I switch on and wonder “what on earth am I listening to?”

Todays crossing Continents gave me pause to ask just that.

The subject-

Prostitution involving people in later life in South Korea.

I had very mixed feelings as I listened.

The news that one can still be sexually active in later life is not new, and is welcome. However I’m in two minds about the morality of what is going on in Korea.

Listen for yourself and let me know what you think.

http://www.bbc.co.uk/programmes/b006qt55