Dementia care support vs. Local Authority care & accommodation strategy: Its all about perception!

Dementia has become a media buzzword over the last decade as the appreciation for the difficulties those who suffer with the disease has become more prominent and the understanding has increased. Many local authorities have continually identified the need for increases and improvements in the care of those with Dementia and related illnesses. Yet the real course of action is the polar opposite of this analysis. With ever decreasing care funding and the hands off approach to social care offered from Central Government officials, with the obvious downgrading of Social Care as a concern (with the greatest respect) by recent cabinet changes since Brexit – it all seems to be media lip service to a genuine social and community issue we are facing right here right now!

 

Multiple national campaigns are out there from sources such as Alzheimer’s Society and Dementia Friends as a subsidiary, focusing on some of the main points:

 

The bottom line

 

·       Dementia is a major global health problem; in the absence of a cure there is increasing focus on risk reduction, timely diagnosis, and early intervention

·       Primary and secondary care doctors play complementary roles in dementia diagnosis; differential diagnoses include cognitive impairment due to normal ageing and depression

·       Cost effective drug and non-drug interventions such as cognitive stimulation therapy exist that help to delay cognitive deterioration and improve quality of life; information provision and practical support are also important

·       Discussions about a person’s wishes for future care should occur at an early stage of illness while the person has mental capacity

·       Family carers of people with dementia are at high risk of physical and mental illness as a consequence of caring and they require equal attention and support

 

With all this in mind and the wide understanding of Dementia as growing concern in that is in the public minds the 2 issues to do have a clear synergy. The truth is that the private sector and specifically residential environments such as Care Homes and Extra Care facilities will be the ones that will and are being innovative to ensure a positive reaction to the ever growing elderly population.

 

Society will need to embrace the private care sector fully because there is simply not enough focus on how this will be funded or how the growing numbers of people that will need support. Innovative solutions are out there in every county but access to them is not evidently understood. Embracing the funding opportunities and the need to ensure that long term care financing is available is becoming a reality and not an after thought. All of us at some point will need to consider how and whom we will be paying for our care for loved ones or ourselves. The after thought that “don’t worry the government will pay” is not the case and hasn’t been for sometime. More needs to be done to aid the understanding at public level about the affordability and access to financing care in later life. With ever increasing demands being pressed and austerity measures in place as publicly indicated the overall landscape is not necessarily clear to all who are not in the sector on a day to day basis.

 

Many local authority accommodation strategies are contradictive by assessing the need for people to stay in their own homes but this is a dangerous method putting too much emphasis on time & task home care agencies who are pushed to their limits of capacity.  The fundamentals of Dementia and the needs of care in this area are around support, companionship and the need to always being available in many cases the need for one 2 one support is paramount. The question here is how can this be achieved when people are isolated in their own homes with the prospect of causing themselves more harm as their illness begins to debilitate them further over the coming months and years,

The stigma of care homes and care environments publicly needs to change dramatically with many private sector care organisations offering excellent care services and facilities which include not only tangible offerings such as bistros, ensuites, cinemas and medical equipment. But also the intangible benefits of 24/7 focused staff teams who are experienced in this area support backed up with external schemes offered by organisations such as Oomph! (http://www.oomph-wellness.org ) and Ladder to the Moon (www.laddertothemoon.co.uk) – who work with Care Groups to develop meaningful measured human engagement designed to enhance lives and deliver true humanistic benefits in reminiscence and responses.

These types of access to facilities and services are simply not available to those who are almost advised to stay in their own homes. These individuals simply miss out on the life enhancing benefits being offered in outstanding care environments across the UK. This is the ultimate conundrum – as gone are the days of the old fashioned residential home – care homes are multi purpose care services with an innovative edge focused on the person not the purse. Obviously the financials need to be right when addressing where people may spend their time living but this should not have a cost when all is considered.

The Care Quality Commission (CQC) the regulatory body of the are care and health services across the UK consistently backed these types of services with the increase in Outstanding services evidencing the use of innovative people engagement services in the care being delivered. Having accessing to multiple services when dealing with Dementia and associated conditions are only going to help improve the quality of life of individuals and this is clearly being demonstrated across the care sector with extreme valour. So why is it that this not common knowledge.

The theory I have deduced (albeit an opinion) is that professionals and government officials have not been keen enough to ensure the wider public understanding that Health and Social Care are two completely different fields. We live in a country where we are fortunate to have a National Health Service, which defies logic everyday offering FREE healthcare to all that need it. Which sadly blurs into the fact that also Social Care is an extension of health. Indeed, maybe it should be but realistically this simply is not the case. Social care is the long-term support function for health and this is becoming ever present as we develop bed-blocking problems within the NHS hospital services. Social Care can be the shining light that picks up the long-term issue and encourages development in care scenarios.

As discussed in an article that supports this statement by Paul Burstow at the Guardian: Why has this been explored more as a major political issue? Most MPs acknowledge that social care is unfinished business, but this has not translated into sufficient political pressure. At a basic level, this is because most people make no distinction between social care, care and support and what the NHS does. It still comes as a shock to many families that social care is not free. Most people make no care plans because they have discounted the chances of ever needing it.

Today the most visible advocate for social care funding is the NHS England boss, Simon Stevens. He told the NHS Confederation conference earlier this year that social care, rather than the NHS, should be at the front of the queue for financial aid. Of course there is a healthy dose of self-interest in this. Health and social care are two sides of the same coin – underinvest in one and you undermine the other.

But this is clearly down to the perception the public is given, the care sector itself and government departments must embrace social care services for what it can do but in the same breath encourage those who need to use it how it can accessed more efficiently. Private social care enterprises will be the ultimate problem solving body in this conundrum and soon everyone will need understand it!

The 1st Annual Kent Care Awards 2016

KiCA presents

The 1st Annual Kent Care Awards 2016

in Association with the Great British Care Awards

Get your best gown and tuxedo at the ready because the new annual Kent Care event is here… The 1st Annual Care Awards will take place in 2016 to celebrate the work carried out in our great Care sector in Kent. This is a chance to reward the people you work with, work for you or simply people you know in the sector who have been superheroes and delivered something awesome this year and every year.

As Care businesses in Kent this is our opportunity to reward those that really matter  – so lets celebrate the successes of our staff and grow our appreciation for the work they do for in this sector. This is the 1st of Annual Kent Care Awards were we all will celebrate the care sector in this great county of Kent and have an evening to remember.

The Executive Board at KiCA want to hear your nominations for all the awards that will be given out to celebrate great care work in Kent. Your votes truly count and it is important we all engage to build on a successful year so far.

The judging of the awards will take place on 8th September 2016 with a plethora of independent selected judges from the sector. The deadline for nominations is 31st August 2016 so get them in now on our nominations page is live RIGHT HERE!

There are 12 Categories for awards all are linked to Care Homes, LDMH and Home Care Services in Kent so if you have team members who you wish to celebrate and promote their excellent work then let us know we want to hear from you:

Categories for Awards are:

  • The Care Home Worker Award
  • The Home Care Worker Award
  • The Care Home Registered Manager Award
  • The Home Care Supervisor/Leader Award
  • The Ancillary Worker Award
  • The Dementia Carer Award
  • The Care Trainer Award
  • The Care Innovator Award
  • The Care Assessor Award
  • The Nurse Care Award
  • The Putting People First/ Personalisation Award
  • The Care Nutrition Award

So please go to our nominations page and make your nominations NOW!

Remember all winners of the awards will automatically be entered in the nominations for the Great British Care Awards South East section in Brighton in November – we are officially linked to this awards to find out more about them at http://www.care-awards.co.uk/ 

Let the celebrations begin as the winners will be announced at the 1st Annual Kent Care Awards Gala Evening – Get out your best gown and black tie for the gents – as we are going to celebrate our sector in Kent in Style.

The Awards Gala will be held on Friday 7th October 2016 starting at 7.00pm.

Venue: The Ramada Hotel, Dover, Kent

http://www.ramadadover.co.uk/contact/Location-of-Ramada-Hotel/

We hope you invite your teams and your nominees from your businesses as this is their night and an evening for us all to get together and enjoy the great work we all do for the care sector in Kent.

Your Tables include the evening festivities, Food (Buffet Style), Awards & Late night DJ through to 1am. With prize draws and charity donations.

So to find out more about tables and booking your table for the evening now please get in touch with us at info@kica.care or check out the website here

For more information or details on the nominations process, the evening or is you wish to get involved with organisation and sponsorship contact us on marketing@kica.care - all queres and questions are welcome.

We hope to see you all there we hope it will be a night to remember and the beginning of a special event which will run year on year.

Our thanks form all the KiCA Executive Board.

In conjunction with our principal sponsors Kieran Lynch & Co – The VAT Specilaists

KiCA’s New media sponsor check for information and content on the sector in partnership with the KiCA & the Care Association Alliance.

Vascular Dementia – Helpful questions and answers

What is Vascular Dementia?

Vascular Dementia (VD) is a condition caused by a lack of sufficient oxygen and nutrients to the brain, causing the cells within the brain to eventually die. The blood vessels that carry blood to the brain become diseased – they are often weakened and leak, or can become blocked, decreasing their effectiveness in delivering vital oxygen and nutrients to the brain. Of the various identifiable types of dementia, VD is the second most-common form, with approximately 150,000 sufferers in the UK.

Here is a useful video that providers a brief outline of what Vascular Dementia is.

How is it caused?

There are two primary reasons why the condition may develop.

Cause 1 – The most common cause is the degeneration of tiny blood vessels deep within the brain, this is called Subcortical Dementia.  The tiny bloody vessels can thicken, which in turn reduces the blood supply to those cells, causing them to degenerate and eventually die. The nerve fibres around the affected blood vessels are also harmed, reducing their effectiveness. The disease of the tiny bloody vessels can also affect other areas of the brain, including the base, if blood vessels are blocked here it could cause small infarcts – also known as an ischaemic stroke.

Cause 2 – The second most common cause of VD is following a stroke. Strokes occur when the blood supply to the brain is suddenly cut-off, this can be as a result of a blood clot (an ischaemic stroke) or less commonly, where a blood vessel ruptures and bleeds into the brain (a haemorrhagic stroke). Around 1 in 5 people who suffer a stroke will develop dementia on top of the side effects of the stroke itself. Most people who have suffered a stroke will have another and therefore the risk of developing dementia increases with each stroke event as more of the brain becomes damaged.

How can it affect someone?

The symptoms of VD can vary from person to person, often dictated by the root cause of the dementia, whether it be as a result of vascular disease, or following a stroke. The speed in which the symptoms can take hold can also vary, the damage following a stroke is often instantaneous, whereas the effects of vascular disease can develop over time.

Early symptoms and effects can include:

  • Problems concentrating on tasks – this could be shown in activities such as planning, making decisions or problem solving.   They may also struggle to follow instructions, and their thought process may be slower.
  • Mild memory loss.
  • Problems with articulating what they want to say – their speech may become less fluent as they concentrate on finding the words.
  • Easily frustrated – this is often a result of the issues highlighted above.
  • Depression and sudden changes in mood – the depression is often as a result of the sufferer becoming aware of the cognitive effects (listed above).
  • Weak bladder – this is associated with subcortical VD sufferers, and can be accompanied by a weakness on one particular side of their body.
  • Dizziness or tremors.

As the disease progresses (stroke-related VD often will become worse following each new stroke episode; whereas subcortical VD will worsen gradually), long term symptoms and effects include:

  • Severe confusion and memory loss – day to day tasks become harder and sufferers are likely to need support on a daily basis.
  • Problems with communication and comprehension.
  • Changes to their personality and behaviour – they can become aggressive, irritable and easily agitated.
  • Suffer delusions and hallucinations.

What treatments are available?

Sadly the brain damage caused by VD cannot be treated to stop the degeneration, nor can it be reversed. However, with careful and managed support an individual with VD can continue to live well.

Caring for a loved one with VD can be hard, but these simple tips can help you support your loved one and give them some much-needed structure when they need it:

  • Establish a routine – this will help them feel less agitated.
  • Keep them occupied – it is important to help keep their mind and body active (where possible), whether it be a short walk, social activities or something as simple as tending to plants. This helps add structure to their day to day lives, as well as providing a sense of purpose.
  • Don’t be afraid to communicate with your loved one – though they may struggle to comprehend you, it is important they do not feel isolated and a smile or arm around the shoulder can help you both feel comfortable.

As well as taking on the care yourself, there are many different types of external support available, and family and friends of those with the disease are encouraged to explore these options. UK Care Guide was founded to offer honest and reliable support for anyone needing care for themselves or a relative – and our website contains a wealth of information about ongoing care, the costs of care (including our handy Care Calculator) and your options for care for your loved one.

Thanks to the UK Care Guide for their recent Blog Article.

Social care industry at breaking point due to planned increase in national living wage

TV viewers fell in love with Derek, the kind care worker portrayed by Ricky Gervais, who looks after the elderly residents of the Broad Hill nursing home.

Yet Kent care bosses say jobs for people like the loveable Channel 4 character are under threat from cuts to funding and an increase in labour costs from the national living wage due in April next year.

The county’s care industry is at breaking point according to Adam Hutchison, who represents about 200 care providers across the county as an executive board member of the Kent Integrated Care Alliance.

He said private care homes will close if local authorities do not provide more money and claims the cost of caring for residents allocated through social services has been underfunded for more than a decade.

Mr Hutchison, who is director of Belmont Sandbanks Care Group, which operates homes in Romney Marsh and near Hastings, said his company receives £408.48 per patient per week from Kent County Council.

Yet his private fees for residential care range from £550 to £650 per week.

In East Sussex care homes receive £496 a week while in Hampshire the figure is £574.

In west Kent, the figure increases to £440.30.

The situation has been made worse by increases in the cost of workers.

“We need to increase what is funded by central and local government to accommodate the increase in labour costs forced on us by government...” - Adam Hutchison, Kent Integrated Care Alliance

Over the last 10 years the national minimum wage has gone up from £5.35 in 2006 to £6.70 last month, an increase of 25%. Another 6% increase will be introduced in April when the government introduces its £7.20 national living wage.

However, the Kent County Council rate for supporting residents in care homes has risen by only 5% since 2008 – with the additional cost swallowed by private businesses.

The latest increase in the national minimum wage at the start of October is expected to cost Mr Hutchison’s business £26,000 in increased labour costs. The introduction of the national living wage in April is due to up that by another £70,000.

He claims government payments need to increase by £20.52 per week per person just to stand still, with that due to increase once the living wages comes into effect.

Mr Hutchison, who employs more than 75 people, said: “As a sector we are all for the national living wage because people don’t get paid enough.

“However, how are we able to fund that? We are constantly under pressure to improve quality but we are at breaking point in care.

“The private market subsidises the social services market. Those who pay privately will have to pay more than those who come through social services.

“We need to increase what is funded by central and local government to accommodate the increase in labour costs forced on us by government.”

“We have got the national living wage and all the pressures it brings, which is probably more than the impact of the amount which can be raised through council tax..." - Cllr Graham Gibbens

“If this doesn’t happen, the short term result is independently run businesses in Kent, small family-run providers,will begin to exit the market and decide to build houses on their land or look at another form of business on the site.

“Then there will be a knock on for employment, with the long term effect larger national providers will come in and be able to charge what they want.

“We’re not trying to plead poverty but we are under pressure as a business sector.”

In the Autumn Statement on Wednesday, Chancellor George Osborne announced plans to allow councils to put council tax bills up by 2% provided all the money was used to help fund social care.

Kent County Council cautiously welcomed the move.

Cabinet member for adult social care & public health Graham Gibbens said: “The announcement was only recent and it is too early to give a forensic analysis.

“The big issue is how the 2% is going to be used but I do welcome it.

“The Government has recognised that social care does need to be funded.

“We have got the national living wage and all the pressures it brings, which is probably more than the impact of the amount which can be raised through council tax.

“One of the big things we need to do is encourage people to stay at home as long as they can and avoid going into residential care..." - Cllr Graham Gibbens

“As a local authority we have a duty to ensure there’s a vibrant social care market and we have a duty to ensure there’s appropriate funding to the sector.”

He said he would have been “very disappointed” if funding was cut and hopes to be able to increase funding in the future.

He added: “One of the big things we need to do is encourage people to stay at home as long as they can and avoid going into residential care.

"We have been quite successful at keeping people out of residential care but as people get older many do not have any other option.

“How we manage that is an issue.”

He has also approved plans to force KCC to pay the same amount to social care providers wherever they are in the county, which comes into force next year.

Paying for your care costs – Be cautious about giving away your property

A blog by Dr Brian Sloan, a legal academic specialising in family and property law.  In this blog, Brian comments on the delayed cap on care costs and cautioning against giving away your property prior to going in to care.

The delay in the cap on care costs

The Care Act 2014 facilitates a cap on the amount that any one individual in England is expected to contribute towards his or her social care costs. This would be a contrast to the current situation, whereby someone with assets (sometimes including a home) of more than £23,250 can be expected to meet the full costs of care. In July 2015, however, the Government announced that the cap would be delayed until April 2020.

Limitations on the effect of the cap on care costs

It is important to realise that there were to be several significant limitations on the cap’s effect even before it was delayed, as I discuss in this paper. These are:

1 – the cap was to be set at the high level of £72,000 in April 2016.

2 – it was to cover only the cost of meeting ‘eligible needs’, broadly equivalent to ‘critical’ or ‘substantial’ needs under the pre-Act system, and not ‘low’ or ‘moderate’ ones, leaving much to depend on the outcome of local authority assessments.

3 – costs counting towards the cap were likely to be based on what it would cost the local authority to provide the relevant care, which may be below what an individual would pay for that care.

4 – the cap would exclude ‘general’ or ‘daily’ living costs in a care home, which were likely to be around £12,000 per year.

Your property

Whatever the cap’s limitations, it would have left some people with more property to leave to their family and dependants, and might have reduced the risk that the social care system would impose an ‘individual and excessive burden’ in a particular case, breaching the European Convention on Human Rights’ protection of the right to peaceful enjoyment of possessions.

The Local Government Association have said, however, that ‘local government funding will…be under enormous pressure in the coming years as Departments make…savings as part of the Government’s deficit reduction plan’, and any diminution in the funding entering the care system risks prejudicing those who cannot afford to pay for care.

The significant continuing liability to pay for social care might tempt people to give away their property in anticipation of care costs.

Be wary of giving away your property before you go in to care

But, as I suggest in this paper, caution is required. Aside from the need to ensure that a potential care recipient keeps enough property to support him- or her-self, local authorities have wide powers to reverse the effect of disposals of property for the purpose of reducing liability to pay for care.

They can do this either by deeming a care recipient still to have property of which he or she has deprived herself, or by pursuing the recipient of such property. While the Government’s guidance to local authorities considers it ‘unreasonable to decide that a person had disposed of an asset…to reduce…charges for their care…if at the time…they were fit and healthy’, this is not obvious from the legislation itself.

If you are looking for ways to pay for your care costs, there is a useful guide here as to the alternative options to property you can consider.

What will happen next?

It remains to be seen whether and when the cap on care costs will be implemented. Even if it is given effect, however, it will not remove the controversy surrounding paying for social care in a context where health care is generally provided free at the point of delivery.

@briandsloan and http://www.law.cam.ac.uk/people/academic/bd-sloan/409