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Posts Tagged ‘good values’

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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Government orders review of Deprivation of Liberty Safeguards

Move comes just three months after officials insisted that there was ‘no fundamental flaw’ in Dols scheme

The government has ordered a review of the Deprivation of Liberty Safeguards (Dols) less than three months after it told peers there was no need to rethink the legislation.

The Dols legislation, which applies to care homes and hospitals, will now be added to a Law Commission review of frameworks for authorising deprivation of liberty, the commission announced today. Deprivation of liberty cases in settings not covered by the Dols, notably supported living, require authorisation by the Court of Protection.

The Law Commission project had been restricted to drafting a new legal framework to cover deprivation of liberty in settings not covered by the Dols, notably supported living. But recent changes in case law, notably a Supreme Court ruling in March that has led to a surge in deprivation of liberty cases, and consultation with stakeholders prompted the Department of Health to request that the project be extended to cover the Dols, the commission said.

The project will publish a consultation paper next summer and a final report in 2017.

The move to extend the commission’s review to include the Dols marks a significant change in stance from the government.

In June, in its official response to a highly-critical House of Lords committee report that described the Dols as “not fit for purpose”, the government insisted there was no “fundamental flaw” in the Dols legislation. It rejected the peers’ call for the Dols to be scrapped and replaced with a system that was simpler and more grounded in the principles of the Mental Capacity Act.

Nicholas Paines QC, the Law Commission project lead, said “The department’s decision is very welcome.  Our timetable for the project remains unaffected.  We expect to publish a consultation paper in the summer 2015 and our final report and draft legislation in summer 2017.”

In response to the announcement, the Department of Health said: ”We are committed to making sure that the Mental Capacity Act is used to protect and empower people receiving care and support. We are looking at the potential impact of the Supreme Court judgement on local authorities and will consider findings in the autumn.”

http://www.communitycare.co.uk/2014/09/08/government-orders-review-deprivation-liberty-safeguards/?cmpid=NLC|SCSC|SCNEW-2014-0910

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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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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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Care and Compassion

by Yvonne Newbold

In writing the book, I also had to do a fair bit of research, and I wanted to read other books on similar topics. Apart from anything else, having books to read gave me an excellent distraction at times from the task in hand of getting my book finished, holy moley, any excuse! It was a brilliant excuse really, a completely guilt-free one, because it was “research” rather than “procrastination”!

So I bought 5 or 6 books covering similar, but not identical issues, and surrounded my laptop with them on the dining room table. If you ever came to my house you would wonder how I ever got anything written at all with the constant comings and goings, dramas, crises, interruptions and Toby’s screamingly loud Barney the Purple Dinosaur videos inches away from my ears. That’s not to mention the constant stream of family and friends and Uncle Tom Cobbley and all that pop in to help or for a chat or a cuppa. Piccadilly Circus is an oasis of calm compared to my dining room.

There was one book that kept disappearing. I found it on the sofa, in the other room, on the stairs, even in the loo once, in our kitchen …. people just kept picking it up and wandering off to devour it’s contents. I now have a long list of people who want to borrow it, and most of them have now gone off and bought their own copies because they are impatient to read it and finish it.

Eventually, it stayed still long enough for me to get hold of it and read it too. That was a mistake…. because I couldn’t put it down, and I finally finished it in one sitting at 5am in the morning.

It’s called “Beyond My Control” by Suzan Collins. It is a truly harrowing read, but also essential reading for anyone, like most of us, who may at one time or another, have someone we care about dependent on hospital inpatient care.

It details the story of Suzan’s mother, an elderly lady with a physical disability but who was mentally still as sharp as a pin, and how a catalogue of appalling neglect, incompetence, apathy, poor nursing practice, cover-ups and error after error caused her completely unnecessary death following months of equally unnecessary agonising pain, misery and a total loss of dignity. It shines a spotlight on what is actually happening in many of our hospitals, how management has lost it’s way, how it’s all about shifting blame or covering up rather than taking responsibility to ensure it doesn’t happen again, and how ward staff often can’t see what is so blindingly obviously neglect that they are inadvertently delivering instead of care.

The most shocking aspect of all of this is that Suzan herself has worked in the Care Sector at a very senior level for over 30 years. This is a daughter who understands the system, who knows what constitutes basic standards of care, and who is intelligent and articulate and still, despite all of this, she was powerless. Suzan did everything she possibly could to help her mother access the level of care and concern that she both needed and deserved, and yet it got them nowhere, such is the size of the machine that the NHS has become. It begs the question, if Suzan couldn’t right the wrongs, what hope have the rest of us got when it’s our own vulnerable relatives in hospital?

Well, the book addresses this aspect too. Suzan has included advice and information about how to make the system work better for all of us to learn from. This is an essential book to read, and one that is best read when everyone in your family is well and healthy, please don’t wait until there is someone you care about already in hospital and falling through the cracks where the care should be.

Reading the book certainly got me thinking about the whole issue of care, compassion and how they are so often missing from everyday life on a hospital ward. Sadly, the nursing staff almost universally entered their profession because they cared so passionately about helping people, and lightening the load of the sick, the injured, those in pain and their families. On many wards up and down the country there are still huge numbers of caring, hard-working committed teams of nurses who strive to attain these ideals. What is hard to understand is that so many of these teams are working within an NHS culture that isn’t supporting them in their efforts to care compassionately about their patients. In some areas of the NHS, nurses are finding it just impossible to care properly because the culture is blocking their best efforts. It’s not the fault of the individual nurse, it’s the fault of the system, which seems to have sometimes lost sight of what the priorities should be.

I know from my own experience with Toby having been in hospital countless times, how a good nurse can make all the difference. A smile, a pro-active approach to pain management, a comforting word here and there, the time to stop and talk and make you feel like you matter – these are all things that reduce fear and engender trust and confidence, and once that happens patients are happier, and happier people actually get better quicker because their immune systems are stronger. It’s a no-brainer, really, but somehow the system often makes it impossible for even the best nurses to do these things that they can do so well, and that simply is unacceptable.

Until the priorities change and nursing staff are allowed to care for our families and friends in the way they want to, and have the time to notice when things are amiss, and their management adopts a more open approach to admitting failures and mistakes and working hard to putting them right rather than compounding them by pretending they never happened, it’s up to us to ensure the on-going safety of our hospitalised family and friends. We all need to be aware of what may go wrong and what steps we can take to put them right. Suzan Collin’s book, “Beyond My Control” may make you weep buckets as you read it, but it may also give you the skills you’ll need to advocate effectively on behalf of a loved one. Let’s just hope what happened to Suzan’s mother never ever happens again, and that things can and will significantly improve for everyone, patients and nurses alike.

http://yvonnenewbold.blogspot.co.uk/2014/01/care-and-compassion.html?spref=tw

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‘Honoured to have read and reviewed Beyond My Control. Very moving and yet incredibly informative.’

http://pettywitter.blogspot.co.uk/2013/12/beyond-my-control.html

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