Misconceptions about dementia are putting lives at risk
Dr Emer MacSweeney, CEO and medical director at Re:Cognition Health, talks to Care & Nursing Essentials Magazine about the work of the dementia clinic and how misconceptions about cognitive decline can lead to the early signs of Alzheimer’s being missed… How does Re:Cognition Health support people with dementia? Can you give some specific examples as to the most effective support? Re:Cognition Health is an industry leader with a team of expert cognitive consultants and clinical professionals who work, collaboratively, to diagnose and support individuals showing symptoms of cognitive decline. Using the latest medical research and evidence based treatments, the Re:Cognition Health team are passionate about transforming and optimising cognitive performance through education, clinical excellence and provide early access to the most advanced treatments available, worldwide. The Re:Cognition Clinics in London, Surrey, Birmingham and Plymouth are also major centres for international trials of disease-modifying and new symptomatic drugs for Alzheimer’s disease and other neurological conditions. For example: medications which include monoclonal antibodies and BACE inhibitors to reduce further accumulation of toxic abeta amyloid protein in the brain, are designed to slow progression of disease and symptoms in Alzheimer’s disease. How are clinical trials advancing in order to help the medical world understand how to treat and prevent neurological diseases? Clinical trials are essential for advancing our understanding of medicine and improving the healthcare and quality of life for everyone affected by dementia and cognitive impairment. By participating in an international clinical study, individuals can gain the potential personal benefit of early access to a new treatment, whilst also having an important global impact on our ability to treat a given condition. Results from clinical trials are always encouraging, bringing us ever closer to treatments to slow down or, ideally, halt the progression of the disease and to improve its symptoms. With the introduction of new biomarkers to detect evidence of Alzheimer’s disease at its earliest stage, there is reason for cautious optimism that new-generation medications will delay the progression of disease and also boost cognition. Just as research through clinical studies has improved our outlook for numerous diseases including previously fatal infections and certain forms of cancer; the same action is being taken today for Alzheimer’s disease. Why do you think the public have misconceptions about dementia and its link to death? This is due to lack of accurate information; despite all efforts to date, there is still a massive requirement for education for the public to enable every one to be alert to the early symptoms of cognitive impairment. Today there is still a massive ignorance about the symptoms of dementia, not to mind early decline in cognition. In a recent YouGov survey commissioned by Re:Cognition Health, it was found that 49% of those questioned didn’t realise that the disease is fatal, despite dementia being the leading cause of death in England and Wales and the only cause of death, globally, that is still on the rise. In the survey, it was also revealed that 11% of Britons are not able to identify, accurately, the common symptoms of dementia. The Re:Cognition Health team are passionate about educating the public on symptoms of early cognitive decline and dementia as an early diagnosis, today, can give the individual a chance to change their future. Early symptoms of dementia include: · Short-term memory loss · Repeatedly asking the same questions · Changes in behaviour – unexpected/uncharacteristic anger and changes in mood · Confusion · Getting lost in a familiar environment · Forgetting words/problems with speech and language · Loss of sense of direction/disorientation · Difficulty in performing everyday (seemingly normal) tasks · Misplacing items · Difficulty making decisions and planning · Issues with balancing and spatial awareness · Becoming passive and disinterested · Problems with calculating How can clinical trials help an individual suffering from dementia? Involvement in clinical trials enables individuals to receive the next-generation emerging medications, free of charge, before these medications are licensed for global use. Participants receive outstanding medical care and are monitored regularly throughout the study by a team of cognitive experts. All medical costs are covered by the pharmaceutical company, so the very best care and medical facilities are provided at no cost to the individual. Enrolling in a clinical trial provides you with the opportunity to gain an early and accurate diagnosis and early access to new generation medications, designed ideally to halt or at least slow progression of disease and symptoms. Medications available currently, through your doctor, do not work by slowing progression of disease and symptoms but are designed to just boost cognition temporarily. For more information about Re:Cognition Health, see www.recognitionhealth.com
Finance company supports care agency with £250k funding boost
A care and nursing agency has been able to win additional contract work thanks to a £250,000 funding boost. Independent Growth Finance, the leading commercial finance provider for SMEs, delivered the factoring facility to Gabriels Care and Nursing Agency, a provider for the elderly, people with learning and physical disabilities, patients with dementia and those in need of palliative care. In September 2016, Gabriels was appointed as a first-tier NHS care provider, which allowed the business to win new contracts and expand into providing residential care. As a result, cashflow at Gabriels was affected due to higher associated wage bills and increased agency hours. The business therefore sought a flexible financier to support its growing order book and to support with the costs of NHS contract compliance. The agency was formed in 1999 as a small trading partnership owned by Paul Thompson and his wife Evreth. It provides over 100 nurses and 147 healthcare professionals to residential care homes and hospitals across Berkshire, Hampshire, Wiltshire and Oxfordshire. ‘IGF was able to provide our care agency with a larger funding facility than other providers’ Paul Thompson, CEO at Gabriels, comments, “Winning the NHS contract was a great success story for us. It has allowed us to expand the business, but with this came costs. Thankfully, IGF was able to provide a larger funding facility than other providers were prepared to offer, and this flexibility was crucial to our needs at such an important time of growth.” Aman Gill, regional sales director at Independent Growth Finance (pictured), adds: “Recent reductions in the government’s social spend means that competitive pricing now plays a vital role when pitching for new contracts in the industry. For Gabriels Care & Nursing Agency, this financial pressure came at a time when the company had the potential to win additional contract work. We were delighted to be able to support the business with the funding it needed to succeed.” Independent Growth Finance is an independently managed commercial finance company specialising in the small- and medium-sized business market, particularly companies with a turnover of £100,000 to £100million per annum.
Digital care support services expanded by retirement housing provider
Digital care services including a video call system have been introduced in a retirement housing provider, setting new standards in supported living. Housing & Care 21’s investment – in partnership with Appello, a leading provider of smart living solutions – is part of an overall plan to deliver the best modern care and support services possible for its residents. Following the success of the first Appello digital care system in 2015, Housing & Care 21 has committed to an extensive programme of installing digital solutions in all of its developments over the next few years. Sixty of Housing & Care 21’s developments are already live with digital care services, with a further 40 developments planned for installation by April. The developments will all benefit from a digital call system that replaces the more traditional analogue system. Residents will have faster call connection to emergency careline services, reduced from around 90 seconds to four seconds on the new digital system. Feedback from residents already using the new digital systems has been overwhelmingly positive, with 83% stating that they feel greater reassurance from the reduced connection speeds and that the video option is less intrusive than a visit from a carer. A modern tablet replaces the traditional alarm units, while the improvement of social inclusion with video enabled room-to-room calling has allowed better security and a less intrusive lifestyle monitoring of residents. As a result of the upgrades, more than half of those surveyed saying they felt their wellbeing had improved as a result of the installation of Smart Living Solutions. The digital care system allows providers to offer an absent-until-needed service Tony Tench, chief operating officer at Housing & Care 21, says both his company and Appello have been keen to push for an appropriate digital care solution to address the growing challenge of caring for older people in their homes. He adds, “Appello has provided a number of services to us for many years now, including call monitoring. At Housing & Care 21, we decided not to invest in analogue systems going forward as these are yesterday’s technology. We are committed to providing a more contemporary service, fit for modern times, and going digital allows us to look at new service models. “A retirement housing environment can seem quite intrusive, especially as part of our service typically includes contacting residents to make sure they are OK. A digital system allows us to provide a lifestyle monitoring arrangement where people’s normal routines are understood and supported discreetly, with an absent-until-needed service. “In the future, we’re looking to invest more heavily in digital care platforms. We’re spending more year-on-year and we have established a programme that will see around 40 new installations delivered over the next 12 months.” Tim Barclay, CEO at Appello, comments, “Housing & Care 21’s enthusiasm and passion for providing digital care services has given Appello the opportunity to work in partnership with them and continue to develop the best technology for residents of Retirement and Extra Care Housing. Housing & Care 21 has really set a benchmark for other housing organisations, demonstrating how beneficial digitisation is for residents and for housing providers in enabling the best care and service possible.”
Care home cook Judy to retire aged 74
A CARE home cook of 74 is set to retire after more than two decades caring for elderly residents. Judy Wilson has been working at Ingleby Care Home, in Stockton-on-Tees, for 22 years – as a domestic worker, then care assistant and eventually cook – but has decided that now is the right time to retire. Five years ago, at 69 years of age, Judy moved into the kitchen to prepare home-cooked meals for the residents at the home, which is part of the Hill Care Group. “At 74 years old, I think it’s time I had a rest” Judy said: “It was good to make a change to cooking. I’ve always enjoyed it. I found it was an opportunity to make sure the residents had lovely things to eat, especially if they arrive at the home feeling poorly as we have to build up their strength.” Judy is now passing on the torch to daughter Alison Rogan, who works at the home as a night-time care assistant, and added: “At 74 years old, I think it’s time I had a rest.” Carol Singleton, home manager, said: “Judy will be missed by the residents and staff alike. She’s a dedicated worker and friend to everyone at the home. You couldn’t find a more caring, loyal person.”
Mental health funding gap widens further
A report into funding for the treatment of mental health has revealed that investment in NHS hospitals has taken priority over NHS services. The King’s Fund has found that the gap between spending on NHS acute hospitals and NHS mental health providers widened further last year, with 84 % of mental health trusts – which provide the great majority of mental health services – receiving an increase in funding last year. This is a significant increase on previous years – however funding for acute and specialist hospitals has continued to grow more quickly. The charity’s report suggests that this is because the Government has given priority to reducing financial deficits and improving performance in A&E. As a result, income for mental health trusts rose by less than 2.5% in 2016/17 compared to over 6% for acute and specialist trusts, continuing a trend of a growing gap between spending on mental health and acute trusts. Since 2012/13, funding for mental health trusts has increased by just 5.6% compared to an increase of 16.8% in funding for acute hospitals. Squeeze on NHS has left mental health services struggling The King’s Fund found that the squeeze on NHS mental health providers funding, together with a lack of available staff, has put huge pressure on the workforce and left mental health trusts struggling to staff services safely. The number of mental health nurses has fallen 13% since 2009, while one in 10 of all posts in specialist mental health services are currently vacant. Analysis of Care Quality Commission inspection reports for all 54 mental health trusts identified an increased risk to patient safety as a result of problems with staffing in more than half of trusts. This included an increased risk of suicide and self-harm on inpatient wards, delays in treatment and reduced access to care and bed closures. Examples drawn from a review of board papers of a small number of trusts also highlighted difficulties staffing services on a day-to-day basis, a reliance on bank and agency staff and “substitution” of staff, for example health care assistants stepping in for registered nurses. Helen Gilburt, report author and fellow in health policy at The King’s Fund, said: “The NHS is in the very difficult position of trying to deliver parity of esteem at the same time as it is under huge pressure to reduce deficits and improve performance in acute hospitals. “While the great majority of local clinical commissioning groups have met their commitments to raise spending on mental health, the overall spending gap between mental health trusts and acute and specialise trusts has widened because national funding has focused on relieving pressure on acute hospitals. “Unless funding grows more quickly, mental health providers may end up implementing improvements to some services at the expense of others. Despite the commitment of national leaders, the funding gap between mental health and acute NHS services is continuing to widen, while growing staff shortages are affecting the quality and safety of care. “As long as this is the case, the Government’s mission to tackle the burning injustices faced by people with mental health problems will remain out of reach.”
Take on the challenge of re-shaping care sector
Students are being invited to help re-shape the future of the care sector. The Care Innovation Challenge is a competition devised to kickstart new ideas and solutions. It will take place on 17th and 18th February. Students from a range of disciplines are invited to think broadly on ways to create positive change. Their ideas are showcased over a creative weekend of idea generation and prototype trialling. “We need great ideas and innovation from dynamic and driven people” The CIC invites the teams of two to three people, ideally from the same academic institution, to compete at the London event. Starting with 12 teams, the weekend will end with teams presenting their projects to a judging panel of industry experts. The event will also see expert speakers offering their advice to students in order to inspire a new generation of industry professionals. Prize for shortlisted teams in care competition Five teams with the highest quality ideas will be selected to go through to the next round of the CIC and each project will be awarded a £500 project fund, £100 personal prize for each member of the team and the support of an experienced mentor. Vic Rayner, the executive director of the National Care Forum said, “Person-centred services are at the heart of adult social care. This means that each and every provider and member of staff are working to identify bespoke solutions and services that are tailored to individuals needs. In order to do this effectively there is a constant demand for new ideas and innovations which will have a real impact and change lives. The social care sector is changing, and there is a great appetite to embrace the latest thinking.” And Ben Allen, chief executive of Oomph! Wellness, added, “The care sector will be responsible for the health, wellbeing and quality of life of an increasing number of older adults in the decades ahead. In order to undertake this challenge we need great ideas and innovation from dynamic and driven people who build mission-led organisations that create positive change.”
Outstanding rating for home care service
Staff at a domiciliary care agency are celebrating after being rated outstanding by the Care Quality Commission. SweetTree Home Care Services – which is based in Swiss Cottage, north-west London, but provides home and live-in services across the capital – was judged as being well-led and responsive. It was rated good for being safe, effective and caring. The agency provides support to a range of people from the elderly and people living with dementia, to those with brain injuries and learning disabilities. Debbie Ivanova, CQC’s deputy chief inspector of adult social care, said: “It is always good to see a well- run care agency such as SweetTree Home Care Services. SweetTree’s hard-working staff and management thoroughly deserve the outstanding rating. “This is a fine example of quality care” “What has made this agency outstanding has been the well thought-out management arrangements. There is an advisory board, a multi-disciplinary team of service directors and managers, a charter and newsletter plus investment in staff with an awards scheme and staff support. People using the service are involved in agreeing their care arrangements and they told us how much they appreciated the service. This is a fine example of quality care.” At the time of the autumn inspection, SweetTree provided care to approximately 380 people and employed 500 staff. The CQC said the agency was exceptionally well led with strong leadership at all levels. The senior management team had been actively involved in all aspects of service provision and had very good knowledge about the business needs of the service provided and the satisfaction level of people who used it. Staff said they were well supported by the management team and they thought they could approach them with any issues related to their professional roles and responsibilities. Training workshops and academy offer quality CPD for care workers There were a number of partnership initiatives including the development of a National Dementia Carers’ Day in partnership with the Alzheimer’s Society and Dementia UK. In addition, the development of a series of training workshops for those professionals who wished to increase their knowledge and understanding on care related subjects. The agency had also worked with the University College of London on implementing Cognitive Stimulation Therapy that aimed at the reduction of the cognitive decline of people with mild to moderate dementia. Since the beginning of 2017, the agency had also started hosting quarterly Registered Managers Forums where representatives of various agencies in the area could share their experience and good practice of service delivery. SweetTree has its own training academy to provide CPD accredited training to all staff members employed by the agency and also employs an Admiral Nurse – a trained nurse specialising in dementia who has worked with 80 families providing support and working with staff. The CQC also found that common interests, culture, religion, gender and languages spoken were taken into consideration, ensuring positive relationships between staff and users of the service.
Health professionals respond to pressure on NHS
After the NHS faced an unprecedented demand over the winter months, we take a look at how services coped and explore how improvements can be made to protect the public. Theresa May faced a backlash when, once again, hospitals struggled to cope under increased demand over the winter. Many routine operations were cancelled, with reports of people dying in hospital corridors. The crisis was so serious, 68 A&E doctors from across the country wrote to the Government with their concerns. Figures released at the beginning of January stated that 95% of NHS hospital beds in England were full. The statistics showed that in just one week, 16,690 patients waited inside ambulances at A&E for over 30 minutes. In England during the same week, only 20% of ambulance services managed to meet their target of reaching critically ill people within seven minutes. And just as the Aussie flu crisis struck, bed closures were made due to norovirus or diarrhoea and vomiting, leaving 944 beds unusable. Hospital admissions for flu was around 2.5 higher compared to the same time last year, according to figures for the week ending 31 December. Meanwhile, the CQC took the decision to pause some routine inspections of NHS acute services, GP practices and urgent care services planned for January. Sir David Behan, Chief Executive of CQC, said at the time: “As we highlighted in our State of Care report, the entire health and social care system is at full stretch – now an increase in respiratory illness and flu has further intensified this pressure. Supporting the NHS system “To support the system as much as possible, we are rescheduling some routine inspections of services. This is to allow frontline staff and leaders to focus on continuing to ensure that people receive safe, high-quality care during this period of increased demand.” Sir David said that inspections scheduled in response to concerns about quality or safety would go ahead as planned, adding, “It is important to reiterate that these pressures do not originate with and are not restricted to Emergency Departments, or to NHS acute trusts. As we set out in the interim findings from our first six local system reviews, this is a whole-system issue, which demands a whole-system response.” A joint report by the Health Foundation, the King’s Fund and the Nuffield Trust recommended that an extra £4billion should be injected into the NHS next year – the Government pledged just £1.6billion more, bringing the total budget to £126billion. So how can the NHS avoid a meltdown next winter, as it faces a tight budget again? Sir David recommended that the long-term solution “must be for health and care providers and commissioners to collaborate to provide health and social care services that meet the needs of their local population, with a stronger focus on keeping people well and helping them stay out of hospital, and on reducing variation that can inhibit people’s access to and choice of services”. Richard Murray, director of policy for The King’s Fund, said, “Despite the phenomenal efforts of NHS staff, the proportion of patients seen within four hours at major A&Es in December is the lowest for well over a decade. This reflects the intense pressure on the NHS and once again highlights that this winter is proving to be the most difficult for many years. Emergency admissions are at their highest ever level for a single month and 4.5 per cent up on December last year, underlining unprecedented demand for hospital services. “The data, while not fully validated, suggests these pressures have continued into the new year. The decision to cancel planned operations will have a significant impact on patients and is a last resort, but the figures for bed occupancy show that hospitals are effectively full. “Despite the welcome additional funding for the NHS in the last Budget, the service has reached the limit of what it can deliver within current funding levels. A new funding settlement is needed for the NHS and social care, building on the recommendations of the Barker Commission.” Janet Morrison, chief executive of Independent Age, the older people’s charity, expressed concern about the elderly being released too early from hospital in order to free up beds, adding, “The increases in A&E attendance, emergency admissions and NHS 111 calls are a stark reminder of how important it is to make sure people are only discharged from hospital when they have the right support and care in place, so they don’t find themselves back in hospital days or weeks later. With so many people being discharged into a care home, it’s also essential that there are places in high-quality care homes available, so people don’t find themselves simply moved from a hospital bed, to a bed in a care home rated inadequate by CQC and then back into the over-stretched NHS.”
Care homes’ fire system upgrade
A fire alarms specialist has upgraded systems at two leading care homes, using the latest technology to keep residents and staff safe. Two care homes in the north of England decided to improve their fire safety systems and called on a local firm who opted for innovative yet user-friendly equipment: Taktis Fire, Kentec’s highly acclaimed fire alarm control panel, which has been designed with protecting vulnerable people in larger buildings in mind. The unique risks posed by safety critical locations – like hospitals, schools and care homes – demand fire safety systems of the highest pedigree, performance and reliability, which is why leading specialists JJ Group (Contracting) Ltd opted for a flexible open protocol system built around the sophisticated features of the new Taktis Technology Platform. Systems ideal for larger buildings such as care homes The fire safety system at Elmhurst, Ulverston has been upgraded with a Taktis 2 loop fire control panel while at Brampton’s Moot Lodge a new addressable system incorporating Apollo addressable loop powered devices was installed. Kentec’s Taktis is ideal for installation in larger buildings as it has the capacity to be networked with up to 128 panels and repeaters. Talking about both installations, Karl Danz of Carlisle-based electrical contractors JJ Group (Contracting) Ltd. says that Taktis is the ideal replacement panel for updating care home fire systems such as these. Karl says, “It not only has a huge internal battery capacity but its multi-protocol facility allows both Apollo and Hochiki addressable devices to work on one fire control panel.” The Government issues clear advice on how care homes should be meeting strict fire safety regulations. The document Regulatory Reform (Fire Safety) Order 2005 is produced alongside the Chief Fire Officers’ Association. This short guide to making your premises safe from fire is available from qcq.org.uk.
