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Posts Tagged ‘dignity’

GREAT NEWS! My book, ‘Beyond My Control: Why the Health & Social Care System Need Not Have Failed My Mother’ is shortlisted for THE PEOPLE’S BOOK prize.

If you think my book is a worthy winner please vote before November at http://www.peoplesbookprize.com/section.php?id=2 Thank you.

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Dementia

‘UK’s dementia care betrayal: Nine in ten care homes and hospitals fail patients, says damning report

  • CQC review finds widespread neglect, lack of care and poor training
  • They found that 90% had some aspect of poor or inconsistent care.’                                                                                                                                    Daily Mail 13th Oct 2014

Reading this is worrying but not a surprise. We’re hearing more now about poor care. It can be very stressful if you need to find a care/nursing home for your loved one with dementia, a care/nursing home that provides care and support with a dedicated staff team.

But as we read above, there is ‘a staggering 90 per cent of the care homes and hospitals inspected found to have aspects of variable or poor care’. So where does this leave us for who are trying to find a good care home for our loved one. And why is this happening?

I have seen great staff across the country who genuinely care for those they support. They are dedicated and provide person centred support, and many a time work long hours due to staff shortages/sickness. I have also seen staff that have delivered poor care. Sometimes, it’s not their fault. The staff/client ratios in these large homes are minimal and it would be helpful for the Care Quality Commission to bring in a minimum number of clients to staff ratio. The former Commission of Social Care Inspection [CSCI] had this.

Dementia is a specilised area and need staff who are trained to support people with dementia. It is not good enough to receive training on how to support older people, training is needed on how to support individuals with dementia. People can live well with dementia, but only if staff have the knowledge on how to support the individual to do this.

Is a care/nursing home needed for the individual with dementia or can they be supported at home, with a Personal Budget? [Personal budgets give you flexibility in how your care needs are met.]

What is needed in a care/nursing home to enable a person with dementia to be cared for, and be safe? As a minimum this is needed:

The care assessment completed prior to going into the care/nursing home needs to give an accurate full description of the individual’s needs.

We need to get the right quality of care. Staff to be recruited who genuinely want to care and support others [not those who see it as ‘just a job’].

High turnover rates lead to lack of continuity. Do the managers carry out an Exit Interview with staff to see why they’re leaving? If they did, this may help them see the reasons and if the reasons are to do with the Home then the manager can look to rectify this.

Money available to train staff in this specialised area and this money to be used for training and nothing else.

Time for staff to complete training.

Staff to discuss with their supervisor/manager afterwards to see if the training met their need.

Good client staff ratio on shifts.

Time for staff to carry out best practice [and not cut corners due to short staffing].

Senior on shift to lead the shift, monitor, observe and discuss poor practice if apparent.

Staff to receive regular 1-1 confidential supervision sessions where training needs are identified, performance discussed, feedback given and concerns shared.

Staff to be able to express their concerns without fear of reprisal or losing their job.

What makes a good care/nursing home?

Many care/nursing homes can look grand from the outside, and sometimes on the inside too. But this doesn’t necessarily mean that they pay the same amount of time cleaning the place to supporting the people who live there.

Some of the things I feel should be in place:

Care/support plans are individual to the person [and not the same as everyone elses]. The plans should take in the uniqueness of the individual, their interests, abilities, needs and preferences.

Staff must treat individuals with dignity and respect.

Systems should be in place to help the individual with choices. This can be objects to refer to or pictures/photographs.

Dedicated and trained staff team.

Keyworker system in place.

Good leadership and support for staff.

Clients and family are listened to.

House meetings where the people living there are able to express opinions and make suggestions for their home.

Happy, relaxed atmosphere.

Activities for the individual to choose if s/he wishes to participate.

Useful websites:

Alzheimer’s Society http://alzheimers.org.uk/

Age UK http://www.ageuk.org.uk/

Health Watch http://www.healthwatch.co.uk/

The Silver Line http://www.thesilverline.org.uk/

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‘By 2015 there will be 850,000 people with dementia in the UK, and today’s social care systems are not equipped to cope

We are all living longer and that is something to celebrate. A third of babies born today are expected to reach their 100th birthday. But are older people living well? Already that is debatable, and the future is clouded with uncertainty.

Our health and social care systems are antiquated and no longer fit for purpose, with vulnerable older people drawing the short straw. When the NHS was set up it was there to treat outbreaks of tuberculosis and measles, to see women through childbirth and children with whooping cough. Today, the majority of service users are older people with multiple long-term conditions. Seven out of ten people with dementia have another long term condition and require care and support from a range of different professionals.

Today the NHS is too often seen as just the hospital – the visible sign of health care in the town. But the community support that should be there to help people live well at home is hidden. We take an overly reactive approach, rewarding crisis admissions to hospital rather than delivering on the outcomes that matter most to people.

Alzheimer’s Society recently published new research which brought the disparity between the services we have and those we need into sharp focus. It found that by 2015 there will be 850,000 people with dementia in the UK, more than ever before. The cost of this unfolding epidemic has hit £26bn a year, a price tag which is set to rise alongside the rising numbers. Most striking of all this is that people with dementia, their carers and families are shouldering two-thirds of this cost themselves.

The post second world war settlement of cradle to grave health care which is free at the point of delivery must remain. But today’s needs are as much about social care. We need new and flexible models of delivery where the emphasis is on building services around individuals, not institutions. For decades the closer integration of health and social care has been a goal of public policy, but we have yet to see its effective translation.

Fundamental to living well in older age is maintaining health and independence. This winter the crisis in NHS funding will once again be centre stage. But for many years, there has been a crisis in social care. Make no mistake: the services that support older people, often the most vulnerable, are on the verge of meltdown.

This is why the Ready for Ageing Alliance has created a manifesto calling on policymakers in government and beyond to start engaging seriously with the trend towards longer lives. The alliance formed in 2013 following publication of the Filkin report and its conclusion that we as a country were nowhere near ready for an ageing population. The aim of members Age UK, Alzheimer’s Society, Anchor, Carers UK, Centre for Policy on Ageing, the International Longevity Centre – UK , Independent Age and Joseph Rowntree Foundation is to make the case for action to ensure that our society makes the most of our ageing population.

The manifesto sets out detailed recommendations for public policy covering housing; health & social care; the economy and communities and calls for government to take the lead.

It calls for us to stop seeing ageing as being just about older people – if we wait until we are 60 or 70 to prepare we’ll have left it too late. We believe everyone aged 50 should be sent a pack giving information and advice.

At the core of the failings of our health and social care system is ageism. Older people are too often treated like second class citizens. Legislation has gone some way to preventing discrimination on grounds of age, but bizarrely financial services are exempt and hidden discrimination remains in many walks of life.

It’s vital we stop operating hospitals on a model designed for the past. Staff and patient ratios on hospital wards for older patients are often lower than on general wards. This makes little sense given that older people often need more help and care. Two thirds of hospital beds are currently occupied by a person with dementia. People living with the condition have even further complex needs which must be taken into consideration.

2015 is the year of a general election. While the question of who will be in government remains to be decided, one of the greatest challenges that they face is already set. By 2051 we can expect to have two million people with dementia in the country. Now is the time for government to wake up and realise prevention can be the best cure.’

http://www.theguardian.com/social-care-network/2014/sep/16/services-supporting-older-people-verge-meltdown

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Improve the standard of residential, domiciliary and hospital care of older, vulnerable people

I would like the best, both for me and my family and friends. What about you??

Join me in being PRO-ACTIVE in helping prevent abuse of older, vulnerable people. Please do not do nothing and wait for more abuse to happen and organisations to go into the homes/hospitals after the abuse has happened.

This is what I am asking you to read and sign. I hope that you will read it through and click on the link at the end where you can sign your name to say you support this petition. Please do not worry, myself or the public do not see any of your details, not even your name.

 

We call upon the government to improve the standard of residential, domiciliary & hospital care of older, vulnerable people, to:

•Ensure that all staff in residential, domiciliary & hospital care receive regular 1-1 supervision sessions where training needs are identified, receive positive/constructive feedback on practice, & concerns on poor practices are shared & actioned

•Require all care staff [& HCA’s] to complete & pass a nationally accredited course of training

•Set a mandatory staffing ratio of carers/nurses

•Ensure that all supervisory staff in homes & on wards receive training on leadership •Introduce maximum lengths of working hours & shifts; & increasing the minimum hourly rate of pay for care staff, nurses & HCA’s

•Establish a national register of care staff & HCA’s

•Ensure that managers/home owners are accountable for failings •Create tougher penalties for those guilty of abuse of those in their care •Ensure protection for all ‘whistle-blowing’ staff.

Improve the standard of residential, domiciliary and hospital care of older, vulnerable people, click on link and leave your name.

Thank you for your support. It is greatly appreciated. http://epetitions.direct.gov.uk/petitions/66065

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As you will recall, I was invited by Dallas Dixon, in America, to write a piece for his blog, on Elder Abuse. I would like to share this comment someone left on it-
‘Prevention begins with awareness. Books and articles like Suzan’s really do make a difference. How amazing that in the midst of her own pain of losing her mother, Suzan is reaching out to help others through spreading awareness about elderly abuse. I enjoyed reading this blog, and appreciate Dallas Dixon for making this information available.’  http://goo.gl/QavPgo

 

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I was invited by Dallas, over in the USA, to write a piece on Elder Abuse http://goo.gl/QavPgo

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Tomorrow, Sunday, I am being featured as ‘Author of the week’ on the radio with the fab Tracey Edges  on Sirenfm. Hope you can listen in, 9-11am. And  ‪#‎Koolandthegang and ‪#‎Elviscostello will be on there too!

Me! On the same show as Kool and the Gang and… Elvis Costello…?!

If only Mum and Aunty Ann were here, they would be so proud!

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A complete stranger, a reader, got in touch with me via my website.

‘Hello Suzan, You don’t know me, but I have read your book – ‘Beyond My Control: Why the Health and Social Care System Need Not Have Failed My Mother’ and wanted to tell you how much it has helped me.

My mother was in a care home and there were so many things that caused me anxiety and anguish about her care, I really didn’t know who to turn to at first, however, after reading the advice in your book I was able to get things moving.

There were so many issues we had to address that I was always expressing concern when things were not right for any of the residents, let alone my mother.  Eventually, they realised that I was not going to let them get away with bad care.  Again, we followed the advice in your book-we didn’t always visit at the same time or on the same day. And we saw different things happening, not all good!

I told the homes managers of my concerns. She was useless, so I did what you say in your book, I put my concerns in writing and I kept a copy. I thanked staff when they did well and told them when I knew [after reading your book] that things were not right, i.e. expecting mother to sleep on a wet, urine stained mattress [which smelt awful!] and be put to bed after tea time [although she didn’t always eat her tea, which meant she had to go right through until 7am the next morning to have something to eat]. She was put to bed at 6.30pm and lights out].

Similar to the good nurse in your book, this home had one excellent carer. She gave excellent care, empathy and understanding. She was with us at the end of mothers life having just completed a 14 hour shift, but didn’t go home as she could see that mother was nearing the end.

Thank you for sharing your story; it helped us at a time when we really needed it. The book helped my mother have a dignified death. Thank you. I am so sorry your mother did not have a dignified death. She would be proud if she knew what you were doing to help others. I will be thinking of my mother and your dear mother tomorrow, on Mother’s Day. I am shedding tears as I write. God Bless xx’

[Names omitted to protect identity].

My mum left me with a mission. A mission to ensure that no one will ever, ever suffer the way she did. A mission to get the message out there on what is good care and bad care and to raise awareness on how to report concerns if you or your loved one is receiving poor care, in a care home, nursing home, hospital or receiving care at home. ‘Beyond My Control: Why the Health and Social Care System Need Not Have FailedMy Mother’ is available in Kindle and Paperback and can be bought from various websites including:BMC jpeg

Amazon http://goo.gl/8wq4wo

My publisher’s website, Hammersmith Books ow.ly/uFIxW

4/5* reviews on Amazon ☆’Beyond My Control: Why the Health and Social Care System Need Not Have Failed My Mother’ ☆http://goo.gl/dYiXJl

But you know it’s not about how many copies is sold. It is about getting the message out there, so why not ask your library to get copies in

Beyond My Control: Why the Health and Social Care System Need Not Have Failed My Mother

ISBN no: 978-1781610282

 

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The Equality and Human Rights Commission found widespread human rights breaches in the home care sector in its 2010-11 review. It has now issued commissioners with a guide to improving this situation.

Many home care service users are having their human rights breached because of disregard for their privacy or dignity, tasks not being carried out by staff because of lack of time and inadequate support to eat or drink.

That was the conclusion of the Equality and Human Rights Commission’s 2010-11 inquiry into home care for older people, which attributed the failings in large part to commissioning practices that reflected a lack of understanding in councils of their human rights obligations.

It has published a guide for commissioners to ensuring the home care services they pay for respect and promote human rights, written in collaboration with the Association of Directors of Adult Social Services (Adass) and British Institute of Human Rights.

Here are some of the key messages from the guide.

What the Human Rights Act 1998 requires

As public bodies, all councils are bound by the Human Rights Act 1998, which incorporates the European Convention on Human Rights into UK law. The guide points out that many of the convention rights are qualified, meaning they can be restricted in the public interest or to protect the rights of others; however any such restriction must be a proportionate response to a genuine social need that has its basis in legal rules. Qualified rights include the right to respect for family and private life (Article 8 of the convention).

The guide suggests deciding that a person with dementia whose condition deteriorates can no longer be cared for at home would be a legitimate restriction of her Article 8 right if it is a best-interests decision that is compliant with the Mental Capacity Act and is a proportionate response to her health needs.

The guide also points out that councils have positive human rights obligations as well as duties – qualified or absolute – not to breach convention rights; these obligations, established by case law, include a duties to prevent breaches of human rights, take effective action to deter conduct that would breach human rights, respond to such breaches, for example with an investigation, and provide information and advice to people at risk of having their rights breached.

The duties to prevent and respond to breaches could provide the basis for a safeguarding investigation into alleged abusive treatment by a home care agency, for example.

What does this mean for home care service users?

The commission has developed a framework setting out the rights of home care service users that should be promoted and respected, drawing on the European Convention on Human Rights and the United Nations Convention on the Rights of Persons with Disabilities, to which the UK is also a signatory.

The framework comprises rights to dignity and security, including freedom from physical, sexual or financial abuse or neglect, bullying or disrespectful treatment; autonomy and choice, including self-determination and support for decision-making; privacy, including respect for personal space, correspondence and modesty; and social and civic participation, including maintaining relationships and participating in the community.

It says councils should apply this framework to the way they consult and involve service users, assess needs and contract with providers.

Service user involvement

The commission says engaging and involving service users in the design of home care is central to human rights-based commissioning, on the basis that this will promote autonomy and self-determination.

As examples of good practice, it cites an authority that trains older people as “citizen assessors” who talk to service users about their experiences of home care and feeds their findings into the commissioning process.

Getting providers on board with human rights

The guide praises councils who engage providers in adopting a human rights approach and a shared understanding of what respecting rights means. Some councils put on free or low-cost training on human rights in home care delivery to provider staff, which has led to providers understanding and accepting why commissioning managers set strict targets on practices that impact on human rights, such as late care visits.

It advises that commissioners include explicit human rights targets in their service specifications, invitations to tender (ITTs) and pre-qualification questionnaires (PQQs) for providers bidding for work, and recommends using the commission’s human rights framework for home care as a basis for this.

It advises including an opening statement about the relevance of human rights and the expectations on providers in this regard, and setting out service outcomes that are focused on protecting and upholding human rights.

It suggests PQQs should quiz providers on issues such as how far care staff have received human rights training and invite organisations to explain how they promote a rights-based approach in delivering care.

Move away from purely task-based approaches

It warns that service specifications purely based on delivering certain tasks, such as toileting, bathing or preparing food, are unlikely to result in services that achieve human rights outcomes.

It also advises incorporating human rights clauses into contracts. This should include specifying that care providers promote service users’ choice and control over their daily routine, such as the times they wish to eat, go to bed and get up.

It says the contracting of home care in short visits at specified times not chosen by the service user can put people’s rights to privacy, dignity and autonomy, under Article 8, at risk. This is in line with the government’s ambitions to end the contracting of short, rushed visits that compromise service users’ dignity.

Fair treatment of staff

The commission’s inquiry found that high staff turnover and low pay exacerbated threats to older people’s human rights, and the guide encourages councils to design contracts to ensure better terms and conditions for staff.

It cites positively a council that has introduced a framework agreement for home care providers that includes a “fair rate” of pay for staff, well above the minimum wage, with payments for travel time. This has resulted in fewer late care visits and, reportedly, lower staff turnover.

Using care reviews to identify human rights issues

The guide also advises using care reviews to identify human rights issues by asking service users how well their dignity, security, autonomy and privacy are being respected. This could include questions such as:

  • Do you get enough home care to do the things you want and need to do each day, and to do these things safely?
  • If you need help to go out to social events, do you get this if you want?

It cites a local authority that undertakes face-to-face reviews whose feedback is given to the quality monitoring team and informs provider risk assessments.

Source: Community Care

http://www.communitycare.co.uk/2013/05/23/how-commissioners-can-ensure-home-care-respects-human-rights/

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