Hospital admissions from care homes

Hospital admissions from care homes.

Some strong words and sobering facts in this article from the British Geriatric Society blog.

Residents of care homes have complex healthcare needs, reflecting multiple long-term conditions, significant disability and advanced frailty. Care provided to this complex cohort of people is often fragmented. Day to day care services are delivered to a variable standard often with high staff turnover and limited support from the wider health system.

I would like to know about the figures for admission compared to the general population. I think they need unpicking more to allow for the possible increased vigilance and potential risk aversion of care home staff. Both of which could contribute to the higher rates of admission.

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.

CQC State of Care report Video!

Sorry for those reading offline, but I will be covering this in print next week.

For now though here’s the video from CQC.

Welsh report is uncomfortable reading.

The Older People’s Commissioner for Wales, review into the quality of life and care for older people living in care homes, A Place To Call Home, says that many people living in care homes have an “unacceptable quality of life”

Care homes are seen as places of irreversible decline, by staff, relatives, residents and commissioners.

This is a worry for many of my clients, who dread moving into a home and wish to avoid it at all costs. Such a shame when good care is out there and will enhance people’s lives.

The commissioner in her introduction says:

When older people move into a care home, all they are
doing in effect is moving from one home to another. The
word ‘home’ should mean something special, a place that
we hope will be filled with friendship, love and laughter.

Sadly this isn’t the case for the majority in Wales, and the rest of the UK.

The full report can be found here:

http://www.olderpeoplewales.com/Libraries/Uploads/A_Place_to_Call_Home_-_A_Review_into_the_Quality_of_Life_and_Care_of_Older_People_living_in_Care_Homes_in_Wales.sflb.ashx

CQC to publish guidance on using CCTV in care homes

There has been a lot of noise about this issue in the press for some time, and last week it blew up again with CQC announcing the possibility of publishing of guidelines on the use of CCTV in care homes.

Here’s the headline from The Daily Mail 6th October:

Families given official green light to spy on care home staff if they fear their elderly relatives are being abused

I think the CQC position is more nuanced than that, but in effect will sanction families and employers using cameras to spot abuse.

I have made my thoughts on this clear several times since it was first mooted. In a nutshell they are-

1-CCTV will not prevent abuse.
2- CCTV is useful in gaining convictions where abuse is suspected.
3-Better recruitment, retention, training and pay will reduce abuse.

My views are echoed elsewhere, The Guardian on the 8th October ran a piece with the title

CCTV in care homes: secret cameras are not the way to improve care

Rather than allow covert filming, the Care Quality Commission should focus on driving up standards

The main thrust of the article is about the underlying causes of bad care, and I would agree, these need to be addressed as opposed to using CCTV to spot the symptoms.

The full article can be found here-

http://www.theguardian.com/social-care-network/2014/oct/08/cctv-care-homes-secret-cameras-improve-care

The CQC statement can be found at-

http://www.cqc.org.uk/content/statement-about-use-cameras-monitor-care

Local Government Ombudsman finds council top up fee policy to be illegal

The subject of third party top up fees is one I’m often asked about.
More often than not the people involved in working out who owes what to who, do not have enough information and experience to work it out correctly.
This story shows how one council got it wrong, by effectively requiring a lady to top up her own fees, which is against the law. (National Assistance Act 1948)
Underpinning the argument here is the basis of funding for health and social care. Health care-Free at the point of delivery. Social care-Means tested. This political hot potato is one that the political parties have been juggling at their conferences in recent months.

http://www.communitycare.co.uk/2014/10/03/ombudsman-criticises-council-forcing-resident-pay-unlawful-care-home-top/ For the full story

http://www.scotting.org for more on paying for care

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

Elderly woman died after suffering burns in nursing home bath

This is a very sad story, and my heart goes out to this ladie’s family.

However I can’t help feeling it further shows up the defficiencies in care and nursing home regulation.

The story has been reported by the Health and Safety Executive, after a now dissolved company was found to be negligent.

http://press.hse.gov.uk/2014/elderly-woman-died-after-suffering-burns-in-nursing-home-bath/?ebul=hsegen&cr=15/29-sep-14

The worrying element is that highlighted by the magistrate. The directors of the company have walked away from this with a £5,000 fine. Which may or may not be paid by the company, as its now dissolved.

So what is to stop these clearly unsuitable people starting up a new home, if they haven’t already done so?

NOTHING!

My Care Service Report and Select-a-Home service will always look into the Directors of care companies and their past. www.scotting.org

 

 

 

The Living Later Life Conference

AgeUK Somerset are holding a free one day conference on 26th October at Taunton Racecourse.

Their website says:

This conference will tackle the issues that matter most when it comes to ensuring  a good quality of later life: housing, mutually-supportive relationships, retaining independence and control, enjoying an active lifestyle, health and social care services, living well with long-term conditions and much more.  It will encourage us all to envisage and plan for how we want to live our later life.

 

Listen to a number of high-profile speakers, including:

 

• Sir Andrew Dillon, CEO, National Institute for Health and Care Excellence
• Professor Ann Bowling, Professor of Health Sciences, University of Southampton
• Dr Chrystalina Antoniades, Department of Clinical Neurology, University of Oxford
• Tony Watts, OBE, Chair of South West Forum on Ageing and Founding Editor of Mature Times
• Conference Chair – Clinton Rogers, Somerset Correspondent for BBC Points West

To book online and for more details visit their website:

http://www.ageuk.org.uk/somerset/activities–events/north-somerset1/

I look forward to seeing you there 🙂

The Smell Test

I always tell people not to rely on the smell of a home as an indicator of quality. Yes an overall odor is unpleasant and a sign of something not being as it should be. However it may be passing odor, and quality of care may still be good.

That said, I visited a home in Southport on Merseyside for a client recently, and the smell at the door was in fact an indication that all was not well when one dug deeper.

Clearly the owners of the establishment hadn’t invested in the business for some time. Sadly a symptom of the financial, political and regulatory system in which care for the elderly is provided.

That’s not to exonerate the owners, who are making a profit, at the expense of the care and comfort of the residents. It’s just a hobby horse of mine about how care is provided in the private sector. Whilst there are standards in law below which the standard of care should not fall, there are no standards which cover how the care should be financed. This allows unscrupulous providers to put profit before care. The decor is an example of how excess funds available after what are seen as unavoidable costs (staffing, food) are seen as fair profit for the owners. Allowing corners to be cut.

The smell and decor alone, still did not provide the full picture of poor care though. Talking to the staff on duty, residents and relatives. It was clear that care was poor, with not enough staff for residents needs, poor nutritional care, and signs of corporate incompetence.

What do CQC think of this home? They list it as compliant, sad but true.

I have made my findings available and reported concerns to the local authority safeguarding team.

Remember that free advice is available to help you find the best care for you and your loved ones.

http://www.scotting.org/free_advice.html