Elderly Care Costing Family and Friends £1.7 Billion
In 2017, friends and family spent up to £1.7 billion from their own pockets on care for their elderly loved ones. This figure could increase to £2.8 billion by 2050 due to the growth of the UK’s ageing population. This growth will mark 2020 as the point at which the 65+ population will outweigh under 15s, putting significant pressure on ‘the squeezed middle’. Those defined as ‘the squeezed middle’ are under pressure to support offspring whilst also caring for their elderly relatives. Working class families feeling the financial pinch of family life, defined as the squeezed middle, are under pressure to support and care for their elderly parents or grandparents. In 2016, there were 1.31 million new requests for care and support from people aged 65+ yet only 46.5% received some form of short or long-term care, leaving 700,850 people requiring help*. This responsibility commonly falls to friends and family, according to a report by Benenden Health, which quantifies the potential financial and emotional impact of the ageing population on friends and family between 2016 and 2050. On average, someone caring for one elderly loved one is spending over £2,500 (£2505.30) per year, in addition to funds provided by the individual, which may have reached more than £1.7 billion spent in total last year. This is equivalent to more than £10.6 million spent every hour from public pockets. In a survey conducted by the healthcare provider Benenden Health, of over 1000 friends and family attending caring duties, almost one quarter (24%) have used their savings and/or pension to fund the cost of care, whilst one third (32%) expect they will need to do so in the next five years. And it’s not just financial support they’re providing, as one person usually spends 14 hours per month caring, or 168 hours per year. That is equivalent to paying themselves £14.91 per hour; comparable to the average £15 hourly rate for an at home carer**. In a year, that’s equivalent to around 118 million hours spent by friends and family caring for aging loved ones. As a result, one third of those surveyed said caring responsibilities also have an impact on their working lives. Some are unable to work as many hours as they’d like or have had to reduce their working hours (30%) whilst others change their shifts regularly (13%) and/or frequently have to leave work unexpectedly (10%). Other impacts include experiencing mental health issues (12%), struggling for money (14%) and not having enough time for friends, family or themselves (65%). www.benenden.co.uk
New approaches to funding, commissioning and regulation needed to meet people’s health and care needs
The Care Quality Commission (CQC), has today (Tuesday 3 July) published a report bringing together key findings and recommendations for change, following the completion of 20 local authority area reviews exploring how older people move between health and adult social care services in England. Many older people have complex needs, and meeting these needs usually requires more than one professional and more than one agency to work together. CQC’s local system reviews provide a detailed insight into the journey through health and social care for people who use services, their families and carers – and identify where there are gaps which mean that people experience fragmented or poor care. ‘Beyond Barriers’ highlights some examples of health and care organisations working well together – and of individuals working across organisations to provide high quality care. But the reviews also found too much ineffective co-ordination of health and care services, leading to fragmented care. This was reinforced by funding, commissioning, performance management and regulation that encouraged organisations to focus on individual performance rather than on positive outcomes for people. The lack of a shared plan or vision resulted in people not receiving the right care in the right place at the right time – with consequences ranging from care being provided at greater expense than necessary, to increased pressure on services, to people’s quality of life being significantly diminished. In one example, an older lady was living at home independently with the support of her son and services from a domiciliary care agency. One Friday evening she fell, bumped her head and was taken to hospital. After a night in hospital she was ready to go home – but because the right staff were unavailable over the weekend she could not be discharged. On the Monday morning she was ready be discharged, but because her home care support was no longer available, she couldn’t go home. She stayed in hospital for over a month, her condition deteriorated and eventually she was moved into a residential care home. She never saw her home again. As the NHS approaches its 70th birthday, genuinely person-centred coordinated health and care cannot just be a long-term ambition – it is an urgent and immediate requirement for meeting the changing health and care needs of people living longer with increased complex conditions. The NHS and social care are two halves of a whole, providing support for the same people and there must be a shared vision and performance measures at a local and national level that recognise this. The report sets out a number of recommendations designed to encourage improvement in the way agencies and professionals work to support older people to stay well, including: • The development of: ‒ an agreed joint plan created by local leaders for how the needs of older people are to be supported in their own homes, helped in an emergency and then enabled to return home; supported by: ‒ long term funding reform – involving national care leaders as equal partners – in order to remove the barriers that prevent social care and NHS commissioners from pooling their resources and using their budgets flexibly to best meet the needs of their local populations; underpinned by: ‒ a move from short-term to long-term investment in services, and from an activity-based funding model towards population-based budgets which encourage collaboration between local systems. • A single joint framework for measuring the performance of how agencies collectively deliver improved outcomes for older people. This would operate alongside oversight of individual provider organisations and reflect the contributions of all health and care organisations – including primary, community, social care and independent care providers – rather than relying primarily on information collected by acute hospitals. • The development of joint workforce plans, with more flexible and collaborative approaches to staff skills and career paths. National health and social care leaders should make it easier for individuals to move between health and care settings – providing career paths that enable people to work and gain skills in a variety of different settings so that services can remain responsive to local population needs • New legislation to allow CQC to regulate systems and hold them to account for how people and organisations work together to support people to stay well and to improve the quality of care people experience across all the services they use. Sir David Behan, Chief Executive of CQC, said: “Our findings show the urgent necessity for real change. A system designed in 1948 can no longer effectively meet the complex needs of increasing numbers of older people in 2018. People’s conditions have evolved – and that means the way the system works together has got to change too. “We have seen the positive outcomes that can be achieved when those working in local health and care organisations have a clear, agreed and shared vision together with strong leadership and collaborative relationships, and we met some outstanding professionals, working across organisational boundaries to provide high quality care. However, their efforts were often despite the conditions in place to facilitate joint working, rather than because of them. We need incentives that drive local leaders to work together, rather than push them apart. “These twenty local system reviews highlight both the barriers that prevent collaboration – and the real impact that this lack of collaboration has on older people. Today we are calling for those barriers to be broken down. We are making specific recommendations to local and national leaders and government on new approaches to funding, commissioning, performance measurement and regulation, designed to encourage local systems to work together more effectively to deliver personalised care to the people who rely on their services, and to safeguard quality of care into the future.” Care Minister Caroline Dinenage said: “This report confirms what we already know – the provision of NHS services and social care are two sides of the same coin and it is not possible to have a plan for the NHS without having a plan for social care. “There are good examples of
Southern Care Maintenance Ltd
With so much equipment now requiring routine testing and servicing, it is increasingly difficult to have all the paperwork, inspection certificates, LOLER certificates etc up-to date and readily available when needed. It is all too easy for these to become lost, or filed away in the wrong place. Two years ago, SCM, Southern Care Maintenance Ltd introduced a new on-line and secure customer portal, mySCM, which has been providing a real benefit to their customers. This provides, free of charge to all customers who have a service contract, a central repository which is available 24/7 and stores all this information together in one place. Copies of job sheets, certificates and invoices can easily be retrieved and printed out again should the originals become misplaced providing peace of mind. Continuing with the technological advancements of the modern day, it is now possible to upgrade an old Fire Alarm System and Nurse Call System in under a week. Gone are the days of engineers installing cables and being present on site for a number of weeks as, with the new Radio Nurse Call, a call point can be fitted in a resident’s room within a matter of minutes. Flexibility is a real benefit with the new Radio Nurse Call as units can easily be repositioned when necessary, and multiple displays can be positioned around the care home to ensure staff never miss a call which further improves efficiency. SCM have two divisions which between them cover a huge range of equipment and systems for both supply and servicing, from Hoists, Fire Alarm Systems and Nurse Call. They operate throughout the south-east, including Kent, East and West Sussex, Surrey, Essex and South London postcodes. For more information follow the link to mySCM from www.southerncare.co.uk . You can also use the Live Chat there or ring 01580 890089.
Involving residents with infection prevention in the care home
By Josie Winter- Clinical Director, Advanced Clinical Solutions. Infections in care homes pose a potential threat to residents, as it is a shared living environment residents will inevitably share micro-organisms. Residents can often be more susceptible to opportunistic infections, due to health conditions and older age. Both healthcare staff and capable residents can play a crucial role in preventing the spread of infection. Some of the most common infections seen in care home are listed below: – Respiratory infections Most respiratory illnesses are spread by droplet or contact transmission, one of the most common respiratory infections within care homes is Influenza. Urinary tract infections UTI’s can occur when bacteria enter the urinary tract, leading to growth in the bladder. Catheter-associated UTI is also a common occurrence in the care home setting made more difficult with challenges in hydrating some residents. Skin infections Skin infections can be caused by a variety of micro-organisms. One common example in the care home setting is cellulitis. Gastrointestinal Infections Gastrointestinal infections are defined as an inflammation of the gastrointestinal tract. Symptoms range from diarrhoea and vomiting to abdominal pain. Common GI infections in care home residents are Clostridium difficile (C. difficile) and Norovirus.Both can be highlycommunicable and pose more risk in closed environments such as care homes. Taking a multi-faceted approach to infection prevention & control in the care home is key to meeting statutory and regulatory requirements in Infection prevention and control. Environmental Cleaning & Management Care homes can pose distinctive infection prevention challenges, as the environment is designed to be more like ‘home’. Carpets and soft furnishings can cause challenges with effective cleaning and decontamination. Multi use items, such as commodes, should be cleaned, labelled and stored correctly before use with the next resident. Cleaning schedules and records can help to ensure this is happening with each use. Hand hygiene Transmission of micro-organisms via hands is a major contributing factor in the spread of infection. It is well documented that effective hand hygiene in care homes can reduce outbreaks. Both staff and residents can participate in training sessions on the importance of hand hygiene, including teaching the correct hand hygiene technique (Ayliffe) and adoption of the ‘WHO’ 5 moments of hand hygiene. Continuous Quality Improvement & Clinical Governance Regular audits of infection prevention measures, such as cleaning, environmental management, invasive devices, hand hygiene and aseptic technique can provide useful insight into potential improvement measures needed. In addition to mandatory training, additional skills in root cause analysis, horizon scanning of new clinical evidence and clinical audit, can deliver a broad skillset to deal with IPC on a day to day basis. Having a lead to provide oversight of all IPC programmes within the care home can be beneficial to offer support and advice to both staff and residents. Help & Support Educating everyone from managers to residents about the importance of IPC allows for improved knowledge in factors such as respiratory precautions, adequate hydration, the importance of skin care and hand hygiene. Advanced Clinical Solutions offer a specialised package of services for Infection Prevention and Control which include Clinical Audit, Training for staff and residents, outbreak advice line, root cause analysis and post outbreak decontamination (in association with Q-Shield) for more information call 01633 415 427 or visit www.advancedclinicalsolution.co.uk
Flexible, Versatile, Wheelchair Accessible Minibuses
Red Kite manufacture, supply and service, safe, reliable 9 –17 seat minibuses across Great Britain. For over 35 years your safety and the safety of your passengers has been at the forefront of our supply process. Working from your instruction or with our ‘Specialist Vehicle Option Team’, customers can choose their new or pre-owned accessible vehicle from any of the leading manufacturers. Choose your new Red Kite accessible minibus from any of the leading manufacturers: The Peugeot Boxer accessible minibus range offers 1 – 4 wheelchair positions with the option of a fully tested third point cant rail fixing for wheelchair passengers, complemented by flexible seating plans to suit your particular requirements. The Ford Transit Accessible minibus range offers 1 – 4 wheel chair positions third point cant rail fixing not available on this model, flexible seating plans to suit your particular requirements. The Iveco range of Accessible minibuses offers 1 – 6 wheel chair positions with the option of a third point cant rail fixing, flexible seating plans to suit your particular requirements. Comprehensive customer choice: Designed to carry single or multiple wheelchair occupants in comfort and safety B Licence and D1 Licence Driver options Powered tail lifts or ramp systems Exterior and interior finish to your specification All vehicles meet or exceed current safety regulations 9, 10, 12, 14, 15 and 17 versatile seat configurations Internal seats can be easily adjusted or even removed Hideaway, rear under floor wheelchair lifts Lowering suspension option if required Both manual and electrically powered side step options Additional grab handles and stanchions High visibility internal finishes available Optional accessories available include: Livery, Reverse sensor/camera, Dash Cameras and WiFi, Tachograph, Tracker system, High visibility, easy maintenance, Innotrax flooring system Dedicated storage for walking frames and non-occupied wheelchairs Removable and/or folding seats can be specified with three or four point seat belts For a quotation, demonstration or to talk through your particular requirements with our experienced team, contact us now on 01202 827678 or email sales@redkite-minibuses.com www.redkite-minibuses.com
Immediate Funding of Adult Social Care
Care England, the largest representative body for independent providers of social care, has welcomed the report from the joint inquiry by the Health Select Committee and the Housing, Communities and Local Government Select Committee into the long term funding of adult social care. The joint report calls for the introduction of a ‘Social Care Premium’, either as an additional element of National Insurance, or with the premium paid into dedicated not-for-profit social insurance fund that people would be confident could only be used for social care. It describes the social care system as “under very great and unsustainable strain”. Ahead of the Government’s Green Paper, which is now expected in the autumn, it highlights the urgent need to plug a funding gap estimated at up to £2.5 billion in the next financial year, before introducing wider funding reforms at both a local and national level to raise extra revenue with a long-term aspiration of providing social care free at the point of delivery. Professor Martin Green OBE, Chief Executive of Care England, who was summoned to give evidence to the inquiry where he reiterated the sector’s calls for fairer funding, says: “The inquiry identifies the substantial funding gap and recognises that it needs to be made up now with an immediate cash injection. If the Government can find the funds for the NHS, we believe that social care should have an equal opportunity. Given the intrinsic link between health and social care it is nonsensical to resource one without the other”. The report is based on six principles for funding social care that the Committees recommend should underpin the development of social care policy. · Providing high quality care · Considering working age adults as well as older people · Ensuring fairness on the ‘who and how’ we pay for social care, including between the generations · Aspiring over time towards universal access to personal care free at the point of delivery · Risk pooling – protecting people from catastrophic costs, and protecting a greater portion of their savings and assets · ‘Earmarking’ of contributions to maintain public support. Professor Martin Green continues: “The inquiry identifies a number of very helpful long term solutions, but even if enacted they will not deliver soon enough to stop crisis and closures of care homes across the country. We hope that the Government will embrace the urgency of the present moment and press ahead with all the necessary partners to provide urgent support to a sector that is struggling”. www.careengland.org.uk
Abbeyfield House Celebrates Alnwick’s History
Residents at an Alnwick care home have partnered with local school children to commemorate 100 years of life in the town and the new-found friendships have led to some amazing revelations. Abbeyfield House, a well-established and popular care home which accommodates 25 people in a purpose-built facility just outside Alnwick town centre, successfully bid for a £10,000 Heritage Lottery Fund Grant to unite young and old people by celebrating the town’s rich culture and history. Freda Snaith, Activities Organiser for Abbeyfield House arranged a number of sessions with school children from Swansfield School where the elderly residents were able to share their memories of past times with the young schoolchildren. Stories, music, dance and art were used to explore the last century of life in the town. The children learnt songs of the period and shared them with their older friends, many of which were very familiar to the elderly who joined in the singing with enthusiasm. The year-long project has brought many benefits to young and old alike as Freda Snaith explains: “The grant has allowed us to forge a relationship which will continue into the future with Swansfield School. Being a part of the project has given the residents a huge amount of pleasure and also given them a sense of worth knowing that they still have a lot to give to other generations. It’s been a tremendous year of education, friendship and fun between two very different age groups.” The project has brought a number of surprising moments too. “Many surprising memories came to light during the sessions from the residents,” said Freda. “One lady was able to share with us that she was a direct descendant of Florence Nightingale and we even discovered that one of our ladies had actually flown a Spitfire. It’s amazing what you can find out about people if you simply ask.” The relationship between the elderly and the very young has also brought about some poignant moments too including the session where a young boy with a speech problem teamed up with a lady who had suffered a stroke which greatly affected her speech. The two were able to converse for long periods of time together with little embarrassment on either side. “Projects like this are good for our residents, the young people and the townsfolk of Alnwick. It’s great to celebrate our heritage and history but even better to create new friendships and relationships,” said Freda. A lasting reminder of the project is now on display in Abbeyfield House, a wall hanging created by the children and residents depicting a collection of poppies in tribute to those who lost their lives from Alnwick in the Great War. https://www.abbeyfield.com/northern/a/abbeyfield-house-m28-3je/
How the introduction of new technology has improved patient safety
Claire Buckle, Manager at Coach House Care Home for the Elderly, discusses how the introduction of new technology has improved patient safety within their care home Care home residents take on average 7.2 medicines per day and with each additional medicine comes an increased risk of errors when prescribing, monitoring and administering to residents. Reports show that 70% of care home residents have experienced at least one error in their medication regime. Recently Coach House Care Home for the Elderly introduced new technology to tackle this serious issue and improve the safety of their residents. In February 2017 Coach House had a CQC inspection which revealed gaps within our medication administration records and worryingly inspectors witnessed one resident receiving the wrong dosage of medication because it had actually been intended for another resident. The report also revealed that: Medication audits by the home had not identified any of the concerns found during the inspection by the CQC. Medicines were not safely stored and administered. Notes of missed medications were not routinely recorded on the back of the MAR. PRN (as required) medicines were not given routinely and there was no guidance to help staff understand in which circumstance they should be offered. Care and treatment was not provided in a safe way for people using the service because there was no safe management of medicines. We decided to implement Omnicell eMAR as a simple solution to ensure that our residents were taking the right medication and dose at the right time as well as to address all the issues found within the CQC report. The eMAR system gathers information, provides prompts and accurate instructions for staff. It also gives managers real-time medication administration data at the touch of a button. Each individual medication is identified through a barcode applied in the pharmacy. Medication can then be tracked at all stages from check-in at the care home or administration to the resident, to unused items that are disposed of or returned to the pharmacy. The system uses on-screen photograph identification and provides an important medical history for each resident. This includes a simple alert and verification system to minimise the risk of making medication administration errors in the home. Each of our staff members has their own log-in details which enables robust auditing. We are really pleased with the system and the risk of human error during medication administration has been taken away since implementation. The system prompts you and tells you exactly when the resident had their last dose of medication, removing the risk of overdose. It times the rounds to ensure people get their medicines at the correct time intervals and confirms that all the medicines have been dispensed at the end of the round. The system will also inform you of any safety issues involved with the medicine being administered. There have been no incidents of missed medication or errors since implementation. The audit trail is now much clearer as we no longer rely on a paper-based system. In the event of discrepancies we can see straight away what has happened and why it occurred. Stock counts are also much more accurate and completed more quickly. Staff are much more confident when administering medication to our residents. They make sure all patients have correctly taken their medication before signing it off in the medication register. As soon as the system was installed our staff received thorough training and the team at Omnicell were incredibly helpful. One member of staff said “It’s [eMAR has]been brilliant, we all support each other but we also have someone we can speak to on the end of the phone, they have been so helpful.” After installing the system we had another CQC inspection in November 2017 and were delighted to see the difference eMAR had made on our feedback from the commissioning review. Medicines are now administered and stored safely, meeting legal requirements. We are amazed by how well the system works and don’t know why we didn’t install it sooner. Technology is imperative to bring the care service into the 21stcentury to protect residents and staff from the risk of medication errors. Omnicell is once again this year implementing a SAFE (safeguarding against frontline errors) campaign amongst key opinion leaders within secondary care, care home and pharmacy settings in order to raise awareness of the impact of medication errors. The campaign aims to drive change and understanding the role of technology in tackling the problem. Show your support by using the hashtag: #BanishMedErrors or visit www.omnicell.co.uk for more information.
Infection Prevention Show 2018
Sunday 30th September – Tuesday 2nd October Scottish Event Campus, Glasgow, Scotland The Infection Prevention Society (IPS) is pleased to announce that registration for its annual conference, Infection Prevention 2018, is now open! The conference will begin on the changed date of Sunday 30th September and close on Tuesday 2nd October in the Scottish Event Campus, Glasgow. The IPS conference, now in its 11th year, promises to offer delegates the latest in infection prevention and control research, education and expertise, with inspiring speakers and informative sessions. The programme has been awarded 14 CPD credits from the Royal College of Pathologists and will be mapped against the IPS Competences. In addition, the conference can count towards your participatory learning for NMC revalidation. The three-day conference will welcome many world leading experts to impart their knowledge and share what they’re doing to tackle current issues relating to infection prevention and control. If you are a healthcare professional with an interest in any aspect of infection control then you will benefit from attending this conference. In addition to the main conference programme, there will also be one-day conferences dedicated to Infection Prevention in Care and at Home and Infection Prevention and Antimicrobial Resistance. Delegates can register for these events for only £95 each or if you register for the full conference, you can choose to attend these specialist sessions. Brand new and as part of Infection Prevention 2018, the Infection Prevention Show will allow the audience to discuss the challenges we are increasingly facing in a financially challenging time and provide a platform to showcase the latest innovative infection prevention technologies and products. This event is free to attend and will take place on Monday 1st October at the SEC in Glasgow. Highlights of the show include a session from Dr Phil Hammond, NHS Doctor, BBC Broadcaster, Private Eye Journalist and Comedian. Show delegates will also be given access to the UK’s largest infection prevention and control exhibition offering you the opportunity to view new and innovative products and discuss your requirements with company professionals. To view the programme, submit an abstract and to register, visit: www.ips.uk.net/conference
