Archive for February, 2013

More than 320,000 of the 400,000 people living in care homes in England, Wales and Northern Ireland now have dementia or severe memory problems, the Alzheimer’s Society charity estimates.

It said the figure was almost 30% higher than previous estimates because of the rise in the ageing population and improvements in data collection.

Of 2,000 adults surveyed, 70% said they would be scared about going to a home.

Another two-thirds felt the sector was not doing enough to tackle abuse.

And just 41% of 1,100 family members and carers surveyed thought their loved ones’ quality of life was good.

Alzheimer’s Society chief executive Jeremy Hughes said: “Society has such low expectation of care homes that people are settling for average.

“Throughout our lives we demand the best for ourselves and our children. Why do we expect less for our parents?

What is dementia?

  • Dementia is an umbrella term describing a serious deterioration in mental functions, such as memory, language,      orientation and judgement.
  • There are many types, but Alzheimer’s disease, which accounts for two-thirds of cases, is the most well-known.

“We need government and care homes to work together to lift up expectations so people know they have the right to demand the best.”

David Rogers, of the Local Government Association, which represents councils, said: “This report shows the lack of confidence in a care system which is buckling under the weight of rapidly growing demand and years of underfunding.

“Local authorities want to offer a service which goes beyond a basic level of care but this is becoming increasingly difficult as our population ages, costs climb and the already significant funding shortfall becomes even more severe.”

Around one in three people over the age of 65 will develop dementia in their lifetime.

It is estimated that there are around 800,000 people in the UK who have dementia, but many have not yet been diagnosed.

The number of people with dementia is increasing because people are living longer.

By 2021 the number of people in the UK with dementia will have risen to almost 950,000, experts believe.

The government is looking to improve dementia care by building greater awareness and understanding of the condition, as well as pumping more money into research to find new treatments and hopefully a cure.

In October 2012, Health Secretary Jeremy Hunt announced dedicated funding of up to £50m to NHS trusts and local authorities to help tailor hospitals and care homes to the needs of people with dementia.

There are around 20,000 care homes in the UK.




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David Jones*, a residential child care worker, shares a dilemma he’s faced at work – how to protect an angry looked-after teenager in public

I’d been shopping in the city centre with a 15-year-old lad who’d become increasingly agitated after dropping and damaging his mobile phone on the way back to our car.

I told him we could go back into town and get it mended when he suddenly started swearing at passers-by. He refused to get into the car and shouted “paedophile” at me. Initially I ignored him, thinking he would stop, and explained how dangerous it could be if he used such a word in public.

Two men then approached me and asked what was going on. I explained I was a residential child care worker and showed them my identification, but they were clearly suspicious. “Anyone can make a false ID,” one of them said. His posture and tone of voice were threatening and he became verbally aggressive towards me. I felt extremely ill at ease. At this point the boy – who is very vulnerable to sexual exploitation – started to walk off.

I had to consider my own safety’

With or without the unwanted attention of two members of the public – whose concern I could, nevertheless, appreciate – I’m not allowed to physically stop a young person from walking or running off. What do I do? On previous occasions I’ve followed a young person and persuaded them to return with me – and attracted some very uncomfortable looks from people in the process – but this kid was continuing to shout abuse at me and I had to consider my own safety.

I actually surprised myself when I firmly told the two men that I really was a residential child care worker and that I had a duty of care to this kid. Whether the phrase “duty of care” surprised and registered with them, I don’t know. But they backed off and I went after the kid.

I lost him in the crowd though and returned to the car. I rang a colleague and told him what had happened. He said I’d done everything I could and should return to the home. In the meantime, he would check the kid’s risk assessment.

I knew it required a search of the home’s surrounding area – not relevant in this case – and phoning the boy’s mum, aunt and the parents of his best friend to let them know what had happened and to contact us if he came to them. And because of the kid’s high-risk status, we wouldn’t categorise him as an ‘unauthorized absence’ and give him the time to return before contacting the police, as detailed in his risk assessment.

‘There’s only so much we can do’

Instead, my colleague would report him missing to the police immediately, giving a description of what he was wearing, his height and build, and explain any allergies, drug usage, risk of sexual exploitation and whether he had any money on him. Careline would then be informed. An hour later, the boy returned safe and well to the home.

In regular supervision with a senior colleague, staff are reminded that there’s only so much we can do to protect a child in public when they want away. And also that we do have a duty of care to ourselves. Sometimes you can persuade a young person to return, and sometimes you can’t.

And even if you keep them in sight, whether on foot or in a people carrier, the kid will only double their efforts to lose you. And then of course there’s the possibility that a member of the public might request a word with you. You do your best.

*Name has been changed



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Care service passes quality inspection

A CARE service has welcomed a positive report from a Government watchdog.

Wetherby-based Home Instead Senior Care, which supports people in their homes in Wetherby and north Leeds, was judged as meeting all standards during an unannounced inspection by the Care Quality Commission (CQC).

Margaret Brennan, who owns and runs the Wetherby office, said: “We are pleased to have received the stamp of approval from the CQC after our latest inspection.

“Amidst reports in the media that care organisations are lacking in crucial areas of care, it is really important that people are able to access information about quality providers in their area to give them peace of mind.

“All CQC reports are available on their website and I would urge anyone looking for care to visit the site before deciding on a provider.

“We place our clients’ needs and wishes at the centre of everything we do and I was particularly pleased that people thought that our caregivers were very caring and would ‘go that extra mile’.”

She added: “At Home Instead we see these standards as a bare minimum.

“For us it is about the comments that clients and staff members make which evidences that we are at the forefront of the quality care sector.”

During the inspection, the CQC spoke to staff, clients and their relatives.

The report stated: “We saw systems were in place to regularly monitor the quality of the service.

“We also spoke with two relatives and one person who used the service and they were very complimentary about the service.”

One relative said: “I am so pleased with the service – they support my mum so well.”

Margaret added: “Unannounced inspections are an effective method of gauging the standard of a service.

“The essential standards span 16 areas from respect and involvement through to record keeping and staff support.

“At Home Instead we see these standards as a bare minimum, for us it is about the comments that clients and staff members make which evidences that we are at the forefront of the quality care sector.

A link to the full CQC report has been posted on the website www.homeinstead.co.uk/wetherby.



St Francis Hospice welcomes ‘five out of five’ from Care Quality Commission inspection

The unannounced visit, which saw an inspector checking records and speaking to staff, patients and relatives, happened at the end of January – and last week the hospice found it had passed all five “key standards of care”.

These are: the respect and involvement of patients; their care and welfare; safeguarding people from abuse; making sure there are enough staff; and managing risks.

Director of patient care Jane Sutherland said: “Our priority at St Francis Hospice is to deliver the best care and support to patients and their relatives, and I’m delighted the latest Care Quality Commission inspection demonstrates we are achieving this.

“The staff and volunteers deserve credit for the hard work they put in each day to ensure patients and families receive first-class care.”

Chief exec Pam Court said: “While it’s fantastic to receive such a positive report for our services, it was satisfying to learn about the wonderful comments made to the inspector by patients and their families.”

Patients said the service had met or exceeded their expectations, while relatives told the inspector “nothing was too much trouble” and said they were kept well informed.

To find out more about the hospice, visit http://www.sfh.org.uk or call 01708 753319. To read the inspection report, visit http://www.cqc.org.uk/directory/1-107318660.



Let’s raise our glasses to all those fabulous people who work really hard in the Health and Social Care Sectors.

I would like to hear your stories on all the GOOD things that the NHS and/or the Social Care system have done for you or someone you know.

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Liverpool Care Pathway

If you want to give your thoughts on the use of the LCP you can email them directly to liverpoolcarepathwayreview@dh.gsi.gov.uk

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Parents of Down’s syndrome woman, 21, can NOT have her sterilised, rules judge

  • 21-year-old described as ‘tactile and ‘affectionate’
  • Parents feared she could easily fall pregnant
  • Judge said other forms of contraception should be considered

The parents of an ‘affectionate’ 21-year-old woman with Down’s syndrome have been forbidden from having her sterilised despite their concerns she could fall pregnant.

In a landmark ruling at the Court of Protection in London, Mr Justice Cobb concluded that such a procedure would be ‘disproportionate’.

He said the case engaged important human rights considerations and that the woman, referred to as K, lacked the capacity to understand and weigh up the options for herself.

The parents feared their daughter, who does not have a boyfriend and had expressed no interest in having one, could easily be taken advantage of.

But Mr Justice Cobb said there were less restrictive methods of ‘achieving the purpose of contraception’ which should be tried first.

He added it was in the woman’s best interests that he should ‘bring as much clarity to medical treatment issues’ as he could.

He wrote in a statement: ‘The issue which divides the parties is whether I should declare in these proceedings at this stage that it is not in the woman’s best interests to be the subject of a sterilisation procedure’.

‘No-one can doubt the seriousness and significance of a sterilisation procedure. Further surgery would be required to reverse it, and then only with a moderate prospect of success.’

Mr Justice Cobb said the woman was part of a ‘loving’ and ‘supportive’ family and said he had read ‘nothing but praise’ for her parents.

The parents, referred to in court as Mr and Mrs K, had gone to see a specialist who had originally supported the idea of sterilisation but a second expert had suggested other forms of contraception.

The judge added: ‘Although Mr and Mrs K expressed concerns that K is occasionally ‘tactile’ and ‘overfamiliar’, that she has begun to be more aware of the ‘opposite sex’, and is vulnerable to sexual exploitation.

‘I note that K is well-supervised at home and at college; there is no evidence she is seeking a sexual relationship.’

The judge said the local authority had begun proceedings in the Court of Protection, which is part of the High Court and analyses issues surrounding the care and treatment of sick and vulnerable people.

He said he had made a declaration under the provisions of mental capacity legislation after the woman’s parents disagreed with a local authority – and medics – about the best way ‘to achieve contraception’.

He added: ‘I have sought to achieve the right balance between protection and empowerment.

‘It is my judgment that sterilisation would be a disproportionate (and not the least restrictive step) to achieve contraception for the woman in the future.’

The judge said risk management was ‘plainly’ better than invasive treatment and less restrictive.

Mr Justice Cobb added: ‘It is in the woman’s best interests that I should make this declaration now; I do not believe that it is in her best interests that this issue should be left unresolved.’

And the judge said the woman’s parents had concerns about how pregnancy would affect their daughter.

‘Have become increasingly concerned that as K becomes older their ability to control and supervise aspects of her life will be reduced,’ he added.

‘Were she to become pregnant at any time in the future they believe this would have a seriously adverse effect upon her.’

Read more: http://www.dailymail.co.uk/news/article-2279562/Parents-Downs-syndrome-woman-forbidden-having-sterilised-despite-fears-taken-advantage-of.html#ixzz2L4QtiRH3
Follow us: @MailOnline on Twitter | DailyMail on Facebook

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Bonka Kostova was on a night shift when she physically and verbally abused a 73-year-old – denying him his dignity and screaming that he was “like an animal”.

The Nursing and Midwifery Council found proved the allegations against her, ruling her fitness to practice was impaired and today striking her off the register.

The professional body have absolutely no power to prevent the Bulgarian working as a carer. However, she was today suspended from her job while bosses investigate her conduct.

She did not attend the central London hearing, but in an email said: “’I don’t want to practice as a midwife, I am quite happy to work as a carer only.”

She is the first person before misconduct panel since the damning Francis Report was released which exposing catastrophic standards of care at the trust, leading to at least 1,200 needless deaths


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Short breaks are a vital service for families caring for people with a learning disability, but too many are still not accessing this, and it is pushing some to breaking point, says Mencap’s Dan Scorer:

Too many families caring for people with a learning disability are at breaking point because they are not getting the short breaks support they so desperately need. When we talk about short breaks, we’re not referring to a long weekend away, but to the time off from caring that families greatly need, sometimes for as little as one evening a month.

For many, caring for a loved one is part of the fabric of their lives, but without the right support the personal cost of caring can be high. Mencap’s Short Breaks report, launched today, reveals just how high these personal costs can be.

An overwhelming 8 in 10 family carers told Mencap that they have reached or felt close to reaching a point of crisis because they don’t get enough short breaks. Shockingly, 3 in 10 carers we surveyed had never even had a short break. Without the lifeline of temporary outside care for their loved one with a learning disability, the physical and mental health of family carers is being put on the line.

The Government has recognised the demand for high quality, safe short breaks for people with a learning disability and their families, with a recent investment of £1.2 billion. But our report found that this money is not actually being spent on the services that families desperately need. In fact, at the same time as demand for short breaks is on the rise, many councils across England have closed short breaks services or cut spending on them.

If these cuts to short breaks services continue, family carers could be left unable to carry on, with devastating impacts on them and the loved ones they care for. This short breaks crisis could also leave the state footing a huge bill, with family carers at breaking point putting greater demand on health, welfare and social care services.

The availability of short breaks has been at a critically poor level over the past decade, with no real improvement since Mencap launched its Breaking Point campaign in 2003. At the present rate, a bad situation is in danger of getting far worse, unless the government takes urgent action.

They need to show support for families by ring-fencing the money for short breaks, so that it is actually spent on improving these services. Councils must also intervene early so that no family carer is left to reach a crisis point due to a lack of short breaks.

We must act now to make sure that every family carer who needs a break gets a break.

Dan Scorer is senior campaigns and policy manager at Mencap


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CQC: Most home care good but missed visits blight some services

Late or missed calls, lack of care worker continuity and inadequate support for staff leading to poor care in minority of providers, but most are performing well, finds regulator.

Home care services are generally good but late or missed calls, inadequate support for staff and a lack of care worker continuity for clients are leading to poor care from a minority of providers.

That was the Care Quality Commission’s verdict on the sector in a thematic report today that drew on the findings of 250 inspections and feedback from over 4,600 service users or carers.

The CQC’s probe follows a series of reports that have raised concerns about the quality and safety of home care services, notably the Equality and Human Rights Commission’s 2011 report into human rights breaches in the sector.

Good services overall

However, the CQC found that 74% of the services inspected met all five of the standards CQC inspected them against: meeting care and welfare needs, respecting and involving service users, safeguarding them from abuse, monitoring service quality and supporting staff. On safeguarding and involving service users, 96% and 97% of services, respectively, were meeting standards.

Practice was good where service users had continuity of care worker, staff were trained in understanding clients’ medical conditions, care plans were regularly updated through staff accurately completing daily logs, and service users and their families were involved in decisions about care.

However, the CQC raised concerns about poor practice in a minority of services and highlighted late or missed calls by staff as the most significant problem, as it left clients feeling “vulnerable and undervalued”.

Lack of travel time

A key cause was a lack of travel time between visits for staff; inspectors found “numerous examples of rotas that did not allow time for staff to travel between visits”, and were told by staff that it wasn’t unusual for them to have to cover an additional visit during a day, meaning other visits were cut short. Late or missed calls were a particular problem at weekends.

Though it said this was an issue for commissioners and providers alike to address, it criticised some providers for failing to investigate late or missed calls and take action to reduce their occurrence, and for not informing service users where rotas were changed unexpectedly.

Service users interviewed by the CQC also expressed concerns about a lack of continuity of care workers. It said providers needed to ensure that there was a small team of staff working with each service user and ensure new staff were personally introduced to clients before their first appointment.

Lack of support for staff

While 88% of providers met the standard for supporting staff, “many staff” told inspectors that they could be better supported, while service users and carers interviewed said new staff often did not appear to be adequately trained.

The CQC found that appraisal and supervision were not being delivered in line with company policies in some agencies while others did not have a documented policy on supervision; many staff files were incomplete and did not include records of supervision.

Providers’ reaction

The United Kingdom Homecare Association welcomed the report for highlighting “the positive impact that high-quality services have on the lives of older people in England”.

Regarding the issues raised about late or missed visits, it said: “Home care providers have a duty to constantly monitor this essential requirement and act without delay. It is vital that people who use services are kept informed about delays to their expected service and know if the care worker they expect has been unavoidably replaced.”

However, the association stressed the role of councils commissioning care in slots of 30 minutes or less in causing late or missed calls.

“This inevitably creates a system lacking in flexibility, where the need to respond to urgent and unexpected events may delay a care worker’s subsequent visits during the day and threatens providers’ ability to fund training and supervision of the workforce,” it added.


The CQC made the following recommendations:

  • Commissioners and providers of home care services must work together to address the issues of timings      and length of visits and the travel times required for staff between visits, to ensure that people have the appropriate length of time needed for their care;
  • Providers should try to ensure that there is a small team of care workers for each person receiving care, to reduce the risk of them having a visit from someone they don’t know;
  • Staff caring for people with dementia should have access to relevant training and be able to develop their knowledge and expertise in this area;
  • Staff must be able to regularly see other care workers and meet with managers to discuss the needs and progress of the people they provide care for;
  • Providers must give staff  enough information to allow them to identify and record people’s preferences and choices about how they would like to receive care in their own home.

See more at: http://www.communitycare.co.uk/articles/13/02/2013/118910/cqc-most-home-care-good-but-missed-visits-blight-some-services.htm#sthash.P7AX7Zmc.dpuf

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Social worker killed herself after restructure caused workload to increase

Fear of losing the transitions co-ordinator job she had worked so hard to get put Julie Dugdale in a “highly stressful” situation, the coroner said.

A social worker committed suicide after her department was restructured and the pressures of her job reached unbearable levels, an inquest has heard.

Julie Dugdale was found hanged at her home in Clitheroe, Lancashire, where she lived with her husband and two children, in November last year.

Dugdale joined Lancashire council’s transitions service in 2010 as a newly qualified social worker. Last summer, her department was re-organised and she was required to reapply for her job as a co-ordinator.

She was successful, but the inquest last week at Blackburn Coroner’s Court heard that, after her department was restructured, her workload intensified and became more reliant on IT systems.

Her husband told the inquest his wife became “noticeably preoccupied” with her job after retaining her post. He also said she had been having problems with a remote access IT system that had been introduced.

“She wasn’t able to get through her workload without putting in extra work at home and then, with the problems with IT, her hands were tied,” said Mr Dugdale. “She wasn’t able to sleep for the last five nights of her life.”

Dugdale went to her GP, was put on a course of medication and given two weeks off work. But the next day she was found dead by family members.

Deputy coroner Elaine Block said: “The catalyst in this case was her situation at work. Her home life was stable, but she found it very difficult to cope with the situation, her workload and the problems the workload was bringing.”

Block said the fear of losing the job she had worked so hard to get put Dugdale in a highly stressful situation. “It seems to me that Mrs Dugdale was a sensitive and conscientious person who had worked hard to get where she was and when she got there it was as though she had everything taken away from her. She took the situation she found herself in very much to heart.

“This was not a cry for help, it was an action she meant to have consequences and the only verdict I can return is that she killed herself while the balance of her mind was disturbed.”

Lancashire council, which has criticised the coroner’s office for refusing to provide a transcript of the inquest because it could be used to learn lessons, said the restructuring had not increased Dugdale’s caseload in terms of numbers, but had resulted in her having a “wider monitoring role”.

Her department had not been at full strength in the months before her death because a colleague was on maternity leave and another staff member was in the process of being recruited. It also confirmed Dugdale had problems using her laptop to access information remotely.

Mike Banks, head of active intervention and safeguarding, said: “We were all shocked and deeply saddened by Julie’s death and our thoughts remain with her family and friends at this very difficult time.

“We know social work is often a stressful job, so we keep a careful eye on our social workers via regular supervisions sessions, team meetings and through developmental work, to help them deal with the everyday pressures of what can be difficult and challenging work.”

A council spokesman said Dugdale had received appropriate supervision together with developmental support and guidance: “We follow the recommendations of the Social Work Task Force. Where appropriate, we carry out individual stress risk assessments and continue to look at other ways to help reduce pressures in response to the health check surveys we conduct with our social workers.”

– See more at: http://www.communitycare.co.uk/articles/12/02/2013/118909/social-worker-killed-herself-after-restructure-caused-workload-to-increase.htm#sthash.VUddnaRz.dpuf

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Frank Lampard signs children’s book deal

England and Chelsea footballer Frank Lampard is to write a series of children’s books, publisher Little Brown has announced.

The midfielder, whose contract expires at the end of the season, will pen five books, called Frankie’s Magic Football, for children aged five and above.

The stories will follow the adventures of a school boy, Frankie, his football-loving friends, and pet dog Max.

Lampard said the stories were “loosely based on friends and team mates”.

The 34-year-old will publish his first book, Frankie Versus The Pirate Pillagers, in June, followed by two more this year and another two in 2014.

“I first had the idea of Frankie and his Magic Football when reading stories to my own children,” he said in a statement.

“Sport and reading are two essentials for us at home, so I decided to make up my own football stories and adventures.”

‘Wacky adventures’

Lampard has two daughters, aged five and eight, with his former fiancee, Spanish model Elen Rivas. He is currently engaged to TV presenter Christine Bleakley.

The vice-captain of Chelsea FC, Lampard currently earns £150,000 per week. He started his career in 1994 at West Ham United, where his father, Frank Lampard Sr, had also played.

He has represented England more than 90 times, scoring 27 goals – but he may be best remembered for a shot he took in a 2010 World Cup match against Germany.

The ball crossed the line, and players and fans believed Lampard had scored a goal – but it was disallowed. The resulting furore prompted football’s world governing body, Fifa, to investigate the introduction of goal-line technology, which was used for the first time in a Club World Cup match last December.

Lampard’s book deal was brokered by Neil Blair and Zoe King, who also represent JK Rowling. They said the books were “full of loveable characters on wacky adventures” and destined for “great things”.

He is not the first footballer to write fiction – Arsenal star Theo Walcott has written a series of children’s books and former England manager Terry Venables co-wrote a series of crime novels.


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