Posts Tagged ‘choice and control’

Do we need an “Amazon” style rating system for care homes? Part One

Wednesday, November 10th, 2010

The simple answer is yes. This conclusion was prompted by one of the many emails I receive asking for help and advice. With the writers consent and personal details changed I will be publishing our correspondence and the discussions I have with relevant care organisations over the next few weeks. Finding a specialist dementia care home which exemplifies best practice is a serious challenge which is being confronted by an ever increasing number of people who care for older relatives and friends. 

My parents belief in social justice has been a guiding force in my professional and personal life. The care they received at the end of their life was important to me, my family and our friends. With over thirty years experience in the care sector I was able to navigate and understand what often seem to be very complex systems and information. I hope that these  posts will help the many people confronting a similar dilemma about finding good quality residential care for people who have been affected by Dementia and Alzheimer’s.  

 I am currently developing the Click Guide to Personalisation which brings together online resources for professionals supporting adults receiving care services. For the benefit of carers, relatives and social entrepreneurs developing new services, the Guide will now include further information about how adult social care services work, and the roles of the various national, regional and local bodies.

Dear Shirley,

I am the sole carer of my mother who suffers from Dementia with Alzheimer’s.  After several years of caring for her in her own home I find myself physically and emotionally exhausted and in my forties I can see the rest of my life mapped out for me if I don’t take action now.  I am looking for an outstanding home to care, engage and love her. I have explored all publicly available sites for information but only two places have inspired me in their approach which are Spring Mount in Bradford and Merevale near Birmingham, both of which are full to capacity and have waiting lists.  Those homes that I have visited do not cut the mustard or are protectionist and will not signpost me to good practice elsewhere.  So I am hoping you can help.
My mother is in good physical health, is involved in daily tasks of life and living and is a creative, gentle spirit.  We live in London but ultimately I’m willing to place her outside London if this ensures she gets the best possible care and am willing to travel.
I do hope you can help to sign post me in the right direction. If you are unable to do so, perhaps you know of someone who can help me, with unbiased information that I can research further? Its a mine field and I’ve discovered that the CQC rating is a pile of crock.  In helping me you will go a long way to supporting my duty of care towards my mother, who you can imagine is the most precious person in my life and who deserves the best care possible.  She is Asian too so any culturally specific places could be worth exploring.  I’ve looked at a few in XXXXXXX which are very institutionalised.

Kind regards and in anticipation,
K

Dear K,
Thanks for your email and I understand the challenges you are facing. My mother had dementia, she was precious to us all and we loved her dearly. We fought long and hard to find the right home for her when she could no longer be cared for at home. In my experience the care provided is very dependent on the manager and we eventually found a place for my mother at XXXX (NB The name of the home has been deleted following my discussions with the Care Quality Commission which will be reported in the next post). A brilliant home with a committed manager and an excellent example of best practice. We did have to fight with the local authority who were more concerned about a single room being available and the cost rather than the philosophy and approach underpinning the care.
 
I believe that as our knowledge and expectations increase about what is appropriate care for people with dementia we, as a society, have to challenge inadequate and bad practice. But I also see the potential for conflict with the budget cuts being used as an excuse for justifying the lack of improvements which need to be addressed by strong leadership, staff training and supervision.
 
I would have recommended Spring Mount in Bradford and Merevale near Birmingham but since they were highlighted in TV programmes I guess it is understandable that they now have long waiting lists. Have you been in contact with the national charities representing people who have dementia and carers?
 
You may have picked up that I am a keen advocate of the potential of social networking to improve care standards. With your consent and without identifying you or your mother I would like to post the content of your email across a number of professional networking forums and on my website to highlight the issues you raise in your email and to see what homes would be recommended. Do let me know whether this is an idea you would be happy for me to pursue.
 
As a matter of professional curiosity can I ask why you contacted me?
 
With all good wishes
 
Shirley

I would really welcome feedback about the issues raised in this post, recommendations for care homes which provide “person centred” dementia care and thoughts about any websites which provide an “Amazon” style ratings system locally, regionally, nationally or internationally.

About Shirley Ayres Consulting

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Radical proposals in the new health White Paper

Tuesday, July 13th, 2010

The White Paper ‘Equity and Excellence: Liberating the NHS’ published yesterday reveal that power will be devolved from Whitehall to patients and professionals.

Patients will get more choice and control, backed by an information revolution. Services will be more responsive to patients and designed around them, rather than patients having to fit around services.  The principle will be “no decisions about me without me”. 

Under the new plans, patients will be able to choose which GP practice they register with, regardless of where they live, and choose between consultant-led teams.  More comprehensive and transparent information, such as patients’ own ratings, will help them make these choices together with healthcare professionals.

Local authorities will be given statutory responsibility for bringing health and social care together under the radical NHS reforms announced by health secretary Andrew Lansley. It is planned that primary care trusts and strategic health authorities will be abolished by 2013.

The health White Paper aims to create the largest social enterprise sector in the world by increasing the freedoms of foundation trusts and giving NHS staff the opportunity to have a greater say in the future of their organisations, including as employee-led social enterprises.

Consortia of GP practices will take on responsibility for commissioning most health services from PCTs while councils will take on PCTs’ public health functions and be charged with leading the integration of health and social care locally. GP consortia will commission most health services with a few exceptions, including dentistry, community pharmacy and large-scale specialist services.

The government also announced a wide-ranging review of health and social care regulation with a view towards significantly reducing the burdens on commissioners and providers.

The health White Paper will mean a change in the role of the Social Care Institute for Excellence (SCIE), with some of its functions in promoting and disseminating good practice in social care being transferred to a strengthened National Institute for Health and Clinical Excellence (Nice). The White Paper states that  ”The Health Bill will put NICE on a firmer statutory footing, securing its independence and core functions and extending its remit to social care”.

Closer integration of social care and health has been on every government agenda for many years. Putting People First and the Children’s Trusts have actively encouraged collaboration and partnerships. I hope that these radical proposals will build upon the many excellent examples of integrated working already in place which include the private and third sector. I am particularly concerned that the invaluable and innovative elearning developed by SCIE for the care sector over a number of years is maintained and further developed.  

The health White Paper is the start of an extensive consultation that will take place over the coming weeks.  The Department of Health will shortly be publishing a number of consultation documents to seek views on the more detailed proposals.

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