Looking to the Future

Research from Care England, the largest representative body for independent providers of adult social care, has shown that almost half of Brits (47%) have a holiday fund as opposed to only 3% that have a care home fund.  Furthermore almost three quarters of Brits (73%) have no idea how much the average weekly cost of a room in residential care is and 56% of Brits have no idea as to whether they would be entitled to state funding for a stay in a care home. 

Professor Martin Green OBE, Chief Executive of Care England, says:

This new research from Care England comes at a time when social care is high on the political agenda.  It shows that we as a sector need to do more to inform the public and dispel the myths that have evolved.  We hope that communities will engage with Care Home Open Day on Friday 16 June as a means to celebrate their connections with their local community”. 

Care Home Open Day takes place on Friday 16 June www.carehomeopenday.org.uk and it will focus on the importance of friendship thereby building on Care England’s research that 57% of people think that greater intervention with the local community can combat isolation.  In addition, 6 in 10 people believe that making visiting hours more flexible would be helpful.

Care Home Open Day is yet another opportunity for care homes to be positioned at the hub of the community. 

More Fantastic Family Feedback - Madeira Lodge Care Home, Kent

With all the negativity surrounding the care sector good news should be shared and travel faster! Here is a great testimonial for our Care home Madeira Lodge in Kent sent in by a family member after a recent trip to hospital.

"Once again Sarah and the team make me smile and happy that mum is with them. Mum had to spend 3 days in hospital last week not the best time of her life but that is another story. Sorry to say I have felt the need to complain strongly about the way she was treated whilst in their care (the hospital). As soon as I was able to obtain her discharge and return her back to Madeira Lodge the change was almost instantaneous.  Once in the lounge one of the girls called her name and asked if she wanted a cup of tea there was a smile back on her face. I’m sure you hear it time and time again but the teams you have at Madeira are worth their weight in gold. There is genuine care and affection and I cannot praise them high enough.  They take the time to really get to know each client, their little ways and what makes them tick.  This all adds up to a proper home environment for them.  Dementia is one of he most cruel diseases and appears to be on the increase.  So long as there are places such as Madeira where suffers can go it will make their life happier.  This happiness then flows out to the relatives who can feel that they have made he right decision for the person who is in the care of Sarah, Jacqui, Angela, Bev, Nicola, Lena, Danielle ALL the team, I do try to memorise all their names!"

This is certainly what it is all about and we thank our teams for all the hard work they do making peoples lives better 

Well Done Madeira Lodge!

Edendale Care Home - Continues with another "GOOD" CQC Rating

Belmont Sandbanks Care Group congratulates manager Theresa Toal and her fantastic team at Edendale Care Home in Hastings, East Sussex. This week receiving "Good" in all 5 main areas for the 2nd consecutive CQC inspection. Edendale has know been through the new methodology on 2 separate occasions in 2015 and now 2017 receiving 5 Good ratings on both occasions.

This is a credit to the leadership of Theresa Toal as manager and the high level of care support she receives from all the team on every shift at Edendale Care Home in Hastings.

The home cares for people over 65 with Dementia and other related illnesses and offering a wide range of community support.

This report is a credit to the staff at the Care home who work tirelessly to create a safe and valued environment for those in need.

WELL DONE EVERYONE!!

Check the inspection report here on our website 

EDENDALE CQC REPORT

Care Home Renovations to support clients needs

In the current climate of constant bad news around the care industry its sometimes great to hear about the Good News stories helping to effect and change the lives of those in Care. Dementia has long been a subject at the forefront of peoples concerns - At Belmont Sandbanks Care Group sites in New Romney Kent the group has taken to focus on creating exciting reminiscence spaces.

These innovative spaces are to help clients have greater daily experiences and bring some of the memories from their past into the care home space. Currently we have created the following experiences which are now open:

  • Hair Salon @ Madiera Lodge 
  • Barber Shop @ Sandbanks Care Home
  • London Postbox Scene @ Sandbanks Care Home
  • Beach Hut Scene @ Sandbanks Care 

The next steps to add to the above schemes is the create of our Vintage Tea Rooms and Community Cinema at Madeira Day Centre in New Romney the service will have access available all week to the facilities and enable all people from the community to use the space for a few hours or all day. 

The day centre will hold events and community wide film screening for people in and around the Romney Marsh so watch this space as the Day Centre renovations will be complete in Early may 2017.

We hope you visit soon 

The Belmont Sandbanks Care Team

Belmont Sandbanks becomes Supporter of the Care Workers Charity

In 2017 Belmont Sandbanks Care Group MD Adam Hutchison became a board of trustees member for the Care Workers Charity - formerly the Care Workers Benevolent Fund. 

As part of this Belmont Sandbanks Care Group has become a Gold Supporter of the charity and the services in which it is supporting now and in future years. This is a fantastic charity which supports the basic welfare of current, former and retired care workers. There are nearly 2 million care workers in the UK, contributing to one of Britain’s largest workforces, and caring for some of the most vulnerable people in our society. Early starts, long hours, mentally draining work; it’s all part of the job. But add an injury, illness or other unforeseen circumstance and all but too easily things can take their toll, and push beyond financial limits.

The good people of the care sector make a massive contribution to peoples everyday lives. The Care Workers Charity helps current, former and retired workers on their rainy day.

To view more information about The Care Workers Charity and its team, please visit the About Us page.

To find out more about the charity nd what you can do go to http://www.thecareworkerscharity.org.uk/ 

Local Care group employee wins award for new local service. (Press Release)

 

Kent and East Sussex based Belmont Sandbanks Care Group, have recently been acknowledged for their excellent contribution to the local community in New Romney, Kent. The care provider focuses on support for vulnerable adults with Dementia and related community support schemes.

 

These awards are focused on frontline staff members and not the businesses. This is about promoting fantastic community services which take place everyday in Kent and Medway. Having had 4 nominations in this year’s Kent Care Awards (www.kica.care), which took place on 7th October 2016 in Dover. Over 250 people attended the awards involved all care providers across Kent and Medway with the awards ceremony. Independent judging for the awards took place in Ashford in early September 2016. 

Belmont Sandbanks eventually ended with 3 runners up in the awards for:

·      The Care Home manager award (Sarah Pennington) for Madeira Lodge Care Home in New Romney,

·      The Ancillary Worker Award (Kevin Beale) for Madeira Day Care Centre also in New Romney

·      Putting People First & Personalisation Award (Janice Dye) also at Madeira Day Care Centre also in New Romney

And finally Mary Kendall – Was the Winner of the Home Care Worker Award for Belmont Home Care Services in Romney Marsh and surrounding areas – this was for her overall contribution and Hardwork in supporting people in their own homes. Having only set up the service in the last 12 months due to the lack of availability for those in need in the Marsh and surrounding areas. By winning this awards Mary is now entered into the South East and London regional finals in London on 26th November 2016 with a chance to advance further to the national finals of the Great British Care Awards (www.care-awards.co.uk) which take place in the Spring of 2017. These national awards have been running for 8 years.

The judges of the awards commented that “Home Care provision was a relatively new offering for the business and Mary was the first employee to begin supporting people in their own homes. Not only did she aid in the initial grounding of the service but her passion and desire to continue to offer an excellent level of service to all new clients being introduced to the service. Mary works tirelessly to the point where she sometimes she has to be told to stop and take a rest. Her passion for care and excellent skills with being a companion to those in need is second to none” 

To find our more about their services visit their website at www.belmontsandbanks.co.uk

 

Dementia care support vs. Local Authority care & accommodation strategy: Its all about perception!

Dementia has become a media buzzword over the last decade as the appreciation for the difficulties those who suffer with the disease has become more prominent and the understanding has increased. Many local authorities have continually identified the need for increases and improvements in the care of those with Dementia and related illnesses. Yet the real course of action is the polar opposite of this analysis. With ever decreasing care funding and the hands off approach to social care offered from Central Government officials, with the obvious downgrading of Social Care as a concern (with the greatest respect) by recent cabinet changes since Brexit – it all seems to be media lip service to a genuine social and community issue we are facing right here right now!

 

Multiple national campaigns are out there from sources such as Alzheimer’s Society and Dementia Friends as a subsidiary, focusing on some of the main points:

 

The bottom line

 

·       Dementia is a major global health problem; in the absence of a cure there is increasing focus on risk reduction, timely diagnosis, and early intervention

·       Primary and secondary care doctors play complementary roles in dementia diagnosis; differential diagnoses include cognitive impairment due to normal ageing and depression

·       Cost effective drug and non-drug interventions such as cognitive stimulation therapy exist that help to delay cognitive deterioration and improve quality of life; information provision and practical support are also important

·       Discussions about a person’s wishes for future care should occur at an early stage of illness while the person has mental capacity

·       Family carers of people with dementia are at high risk of physical and mental illness as a consequence of caring and they require equal attention and support

 

With all this in mind and the wide understanding of Dementia as growing concern in that is in the public minds the 2 issues to do have a clear synergy. The truth is that the private sector and specifically residential environments such as Care Homes and Extra Care facilities will be the ones that will and are being innovative to ensure a positive reaction to the ever growing elderly population.

 

Society will need to embrace the private care sector fully because there is simply not enough focus on how this will be funded or how the growing numbers of people that will need support. Innovative solutions are out there in every county but access to them is not evidently understood. Embracing the funding opportunities and the need to ensure that long term care financing is available is becoming a reality and not an after thought. All of us at some point will need to consider how and whom we will be paying for our care for loved ones or ourselves. The after thought that “don’t worry the government will pay” is not the case and hasn’t been for sometime. More needs to be done to aid the understanding at public level about the affordability and access to financing care in later life. With ever increasing demands being pressed and austerity measures in place as publicly indicated the overall landscape is not necessarily clear to all who are not in the sector on a day to day basis.

 

Many local authority accommodation strategies are contradictive by assessing the need for people to stay in their own homes but this is a dangerous method putting too much emphasis on time & task home care agencies who are pushed to their limits of capacity.  The fundamentals of Dementia and the needs of care in this area are around support, companionship and the need to always being available in many cases the need for one 2 one support is paramount. The question here is how can this be achieved when people are isolated in their own homes with the prospect of causing themselves more harm as their illness begins to debilitate them further over the coming months and years,

The stigma of care homes and care environments publicly needs to change dramatically with many private sector care organisations offering excellent care services and facilities which include not only tangible offerings such as bistros, ensuites, cinemas and medical equipment. But also the intangible benefits of 24/7 focused staff teams who are experienced in this area support backed up with external schemes offered by organisations such as Oomph! (http://www.oomph-wellness.org ) and Ladder to the Moon (www.laddertothemoon.co.uk) – who work with Care Groups to develop meaningful measured human engagement designed to enhance lives and deliver true humanistic benefits in reminiscence and responses.

These types of access to facilities and services are simply not available to those who are almost advised to stay in their own homes. These individuals simply miss out on the life enhancing benefits being offered in outstanding care environments across the UK. This is the ultimate conundrum – as gone are the days of the old fashioned residential home – care homes are multi purpose care services with an innovative edge focused on the person not the purse. Obviously the financials need to be right when addressing where people may spend their time living but this should not have a cost when all is considered.

The Care Quality Commission (CQC) the regulatory body of the are care and health services across the UK consistently backed these types of services with the increase in Outstanding services evidencing the use of innovative people engagement services in the care being delivered. Having accessing to multiple services when dealing with Dementia and associated conditions are only going to help improve the quality of life of individuals and this is clearly being demonstrated across the care sector with extreme valour. So why is it that this not common knowledge.

The theory I have deduced (albeit an opinion) is that professionals and government officials have not been keen enough to ensure the wider public understanding that Health and Social Care are two completely different fields. We live in a country where we are fortunate to have a National Health Service, which defies logic everyday offering FREE healthcare to all that need it. Which sadly blurs into the fact that also Social Care is an extension of health. Indeed, maybe it should be but realistically this simply is not the case. Social care is the long-term support function for health and this is becoming ever present as we develop bed-blocking problems within the NHS hospital services. Social Care can be the shining light that picks up the long-term issue and encourages development in care scenarios.

As discussed in an article that supports this statement by Paul Burstow at the Guardian: Why has this been explored more as a major political issue? Most MPs acknowledge that social care is unfinished business, but this has not translated into sufficient political pressure. At a basic level, this is because most people make no distinction between social care, care and support and what the NHS does. It still comes as a shock to many families that social care is not free. Most people make no care plans because they have discounted the chances of ever needing it.

Today the most visible advocate for social care funding is the NHS England boss, Simon Stevens. He told the NHS Confederation conference earlier this year that social care, rather than the NHS, should be at the front of the queue for financial aid. Of course there is a healthy dose of self-interest in this. Health and social care are two sides of the same coin – underinvest in one and you undermine the other.

But this is clearly down to the perception the public is given, the care sector itself and government departments must embrace social care services for what it can do but in the same breath encourage those who need to use it how it can accessed more efficiently. Private social care enterprises will be the ultimate problem solving body in this conundrum and soon everyone will need understand it!

THE BIG C - COMMUNICATION

So when you begin to look at communication, why so late on? Well its because communication between employers and their employees is almost the final string of the bow as many of the initial tasks become a working reality. If you were to ask any employee about a key challenge within their current work environment most often communication issues will top of the list - or maybe 2nd behind benefits. There is so much available on the subject out in the ether but not all seemed to be adhered to sadly. So why do businesses still face issues when it comes to communication? Especially in the sometimes unvalued Care Sector.

Many believe this is in fact because it is always reviewed from the communicators / business owners point of view rather than that of the listeners / employee’s point of view. Any communicator must understand the needs and perspectives of those in which they wish to communicate with. So the information in which is being shared with any individuals must be of interest, useful or simply relevant to their daily activity. We go to that word “engagement’ again - is the communication engaging employees to listen and process effectively, or sadly are they just switching off.

Some points for communication can include these following 4 steps heavily discussed in Dale Carnegie's training on Leadership and management.

1.     Entertain - Make the verbatim interesting to listen to, be humorous or include interesting facts related to the subject matter. I personally have always found video a great way to engage during communication especially in large groups. With multiple clips on any subject matter available on YouTube it is always a good engagement tool to link in a pithy video into your communications. During sales briefings on getting the most out your day - I would always refer to a clip from the Will Smith film “In the pursuit of Happyness” the film has great moment about selling and how to achieve more in less time. It worked overtime to get people on board to next part of the communication.

2.     Inform - Once people are engaged make sure it is then informative in the next steps. The last thing you need is a meeting for meetings sake; this gets your and your teams nowhere and essentially wastes time.

3.     Convince - Make sure that the people your are engaging with listen and take on board the specifics of your communication. Compelling people to act on the communication, or indeed encourage the additional input with the current meeting. Remember discussion is good.

4.     Communicate to Action - This is the next step, the energy behind the communication. Always having an outcome in mind before communicating is essential to allow some measurement on whether the communication was successful and whether it needs changing for the next attempt. A goal must be communicated for the individuals to achieve.

More often than not what happens is that an action or measurement is never identified by the communication. What will likely happen is a disappointment from the communicator / presenter because the goal they wanted is not achieved. Furthermore frustration from the employees as they are confused by the communication as not demonstrating a benefit to them or their work environment. The next steps must be clear and concise, well planned in advance of the communication. This preparation will bring more valuable outcomes for all concerned.

There are risks still with communication with a desire to always avoid telling or what I call one-way contact. I was brought up with this and from the very first paragraph it has been discuss that you can’t order people around and expect the best results. You always have to be concerned about who is listening and what are their perspectives in the communication. Some may think this is a lot to put into a message but you have to look at the risks of not doing it properly, poor delivery of communication will only lead to one definite outcome - no passion for delivery, poor outcomes and a frustrated workforce. So like or not you have to engage with employees on their level getting them to buy into whatever you are selling.

So communication is business critical for a businesses success, as business leaders everyone can continually improve their focus and purpose of communications. Always presenting an ideal of why the communication is important, clear concise points, which benefit those who are listening in a way which achieves an outcome. 

In your next meeting follow a couple of simple new steps and see how you get on this time with what return you gain:

First, actually plan the discussion, pinpoint your outcomes and engage them with the listeners. Second, find some interesting content whether it be video or event quotations from well known outlets (these are easy to find on the internet) and finally engage in discussions on the goals for the listeners allowing them to buy in to the message at hand. This will work for every meeting, 1-2-1 or presentation you intend on communicating in.

Care Act for carers: One year on

We welcome the findings of the Carers Trust’s new report ‘Care Act for carers: One year on’.

This shows that there are some carers who are getting good support under the Care Act, as well as some examples of good practice.

It also shows what needs to improve. Too many carers were unaware of their rights. Practitioners need to understand that a carer’s right to support is independent of the person they care for.

Andrea Sutcliffe, Chief Inspector of Adult Social Care said:

“I welcome this report and was very pleased to be invited to provide evidence. Support for carers is an important feature that CQC has to see in order to award a Good or Outstanding rating. The best services we see value the contribution that carers can make and proactively consider their needs as well as the needs of people using services.

“Carers’ organisations are involved in our coproduction meetings that develop the way we work and I am grateful for their contribution.”

The 1st Annual Kent Care Awards 2016

KiCA presents

The 1st Annual Kent Care Awards 2016

in Association with the Great British Care Awards

Get your best gown and tuxedo at the ready because the new annual Kent Care event is here… The 1st Annual Care Awards will take place in 2016 to celebrate the work carried out in our great Care sector in Kent. This is a chance to reward the people you work with, work for you or simply people you know in the sector who have been superheroes and delivered something awesome this year and every year.

As Care businesses in Kent this is our opportunity to reward those that really matter  – so lets celebrate the successes of our staff and grow our appreciation for the work they do for in this sector. This is the 1st of Annual Kent Care Awards were we all will celebrate the care sector in this great county of Kent and have an evening to remember.

The Executive Board at KiCA want to hear your nominations for all the awards that will be given out to celebrate great care work in Kent. Your votes truly count and it is important we all engage to build on a successful year so far.

The judging of the awards will take place on 8th September 2016 with a plethora of independent selected judges from the sector. The deadline for nominations is 31st August 2016 so get them in now on our nominations page is live RIGHT HERE!

There are 12 Categories for awards all are linked to Care Homes, LDMH and Home Care Services in Kent so if you have team members who you wish to celebrate and promote their excellent work then let us know we want to hear from you:

Categories for Awards are:

  • The Care Home Worker Award
  • The Home Care Worker Award
  • The Care Home Registered Manager Award
  • The Home Care Supervisor/Leader Award
  • The Ancillary Worker Award
  • The Dementia Carer Award
  • The Care Trainer Award
  • The Care Innovator Award
  • The Care Assessor Award
  • The Nurse Care Award
  • The Putting People First/ Personalisation Award
  • The Care Nutrition Award

So please go to our nominations page and make your nominations NOW!

Remember all winners of the awards will automatically be entered in the nominations for the Great British Care Awards South East section in Brighton in November – we are officially linked to this awards to find out more about them at http://www.care-awards.co.uk/ 

Let the celebrations begin as the winners will be announced at the 1st Annual Kent Care Awards Gala Evening – Get out your best gown and black tie for the gents – as we are going to celebrate our sector in Kent in Style.

The Awards Gala will be held on Friday 7th October 2016 starting at 7.00pm.

Venue: The Ramada Hotel, Dover, Kent

http://www.ramadadover.co.uk/contact/Location-of-Ramada-Hotel/

We hope you invite your teams and your nominees from your businesses as this is their night and an evening for us all to get together and enjoy the great work we all do for the care sector in Kent.

Your Tables include the evening festivities, Food (Buffet Style), Awards & Late night DJ through to 1am. With prize draws and charity donations.

So to find out more about tables and booking your table for the evening now please get in touch with us at info@kica.care or check out the website here

For more information or details on the nominations process, the evening or is you wish to get involved with organisation and sponsorship contact us on marketing@kica.care - all queres and questions are welcome.

We hope to see you all there we hope it will be a night to remember and the beginning of a special event which will run year on year.

Our thanks form all the KiCA Executive Board.

In conjunction with our principal sponsors Kieran Lynch & Co – The VAT Specilaists

KiCA’s New media sponsor check for information and content on the sector in partnership with the KiCA & the Care Association Alliance.

Belmont Sandbanks is discussed on Channel Radio - Listen Again...

This week Director of Belmont Sandbanks Care Group - Adam Hutchison discusses the care business and the Kent Integrated Care Alliance on the business bunker / Kent Business Radio on Channel Radio. Discussing working in the industry, the perception and the joys of working in the care sector.

Download and Listen Again Here

http://www.kentbusinessradio.co.uk/category/shows link for the show here

See more on our Twitter page

Could music projects cut the cost of dementia care?

Sheer embarrassment was dementia care worker Lynda Kelly’s overwhelming emotion the first time she sat in on a  orchestra music therapy session at the residential home where she works; but the lasting change she saw in the residents in response to the musicians was so great that she is now running weekly improvisation sessions at the home.

Kelly, the activities coordinator for Acacia Lodge – a 60-bed residential home in New Moston, Manchester – reports seeing a mute female resident with advanced Alzheimer’s sing Swing Low, Sweet Chariot at top volume with all the words in one of the first Camerata sessions. Two other former non-speakers now communicate with staff as though they had never stopped and many more display greater confidence, increased activity levels and more cooperation with their carers.

“The first music session I went to, I did not know where to put myself with embarrassment – I was not used to seeing people sing and express themselves like that,” says Kelly, who has since then been involved in three music and dementia projects with the chamber orchestra over the past three years, including a 10-week course for Acacia Lodge residents. “But the impact has been amazing and I realised within two weeks that music was getting to them in a completely different way.”

Manchester Camerata orchestra’s Music in Mind (MIM) projects, which involved 7,200 people in care homes and community projects acrossGreater Manchester last year, have had such dramatic effects on participants that academics at Manchester and Lancaster universities are backing a research student to create the world’s first in-the-moment, multi-sensory assessment tool to quantify that effect.

Manchester Camerata’s head of educational outreach, Nick Ponsillo, says: “This is all about helping people with dementia to communicate and to feel part of the community, but we need to know that we are really getting to the guts of a patient’s experience.”

The Camerata – whose reputation with audiences is built on concerts of Mozart and Beethoven in venues such as the Bridgewater Hall – now hosts Manchester University PhD student psychologist Robyn Dowlen to carry out research in collaboration with Lancaster University. She is attempting to measure the effect of music on people who may not be able to communicate it in words.

This is about coming up with the proof that there is more to music in a dementia context than just entertainment. According to the Alzheimer’s Society, there will be 1 million people with dementia in the UK by 2025 and one in six people over the age of 80 currently have it. Alzheimer’s is a massive health and social care challenge to which management approaches are needed in a cash-strapped world.

Camerata’s projects – led by a professional music therapist and specially-trained musicians from the orchestra – involve working directly with patients with degenerative brain disease and their carers. It is about encouraging them to sing, play instruments and create music – and even to perform in public, in sessions before Camerata concerts.

Dowlen’s supervisor, Prof John Keady, who leads the dementia and ageing research team at Manchester University, is excited about the MIM projects, which he sees as confirming his view of dementia as a loss of self and social identity, rather than the more common view of it as a loss of creative and cognitive skills.

He hopes that Dowlen will be able to produce a means of measuring an individual’s experience of connection, so that the circumstances can be reproduced when people engage in other activities.

Evaluation of MIM projects in Rochdale and Tameside by New Economy paints a consistent picture of better communication, happier and more cooperative patients, and even suggests that music participation may lead to a reduction in the amount of NHS treatments and anti-psychotic medication required. Numbers are small, but it is an area researchers want to investigate.

Keady is even asking himself whether the right kind of music projects actually cut the cost of dementia care.

Ponsillo has noticed a change in attitude from health and social care sectors since work on projects began in 2010, from lack of interest to a desire for collaboration. Rochdale has had projects in two care homes and two community centres last year, and Tameside Public Health is currently funding 30-week projects in four care homes – plus music training for carers to help them continue the work themselves – despite enduring budget cuts. Four other projects are also ready to start next month in central and north Manchester.

Angela Wild, programme officer for Tameside Public Health and dementia champion, is clear: “This work is leaving a lasting impression. The money Tameside is spending on 30 sessions is money well spent. Everyone should be doing it.”

Ponsillo has just returned from Japan, where he was invited to address cultural organisations keen to learn from the Camerata’s experience about how to set up music schemes for people with dementia, given the ever-growing elderly population.

Creative music projects can clearly benefit those with dementia, but other performing arts are making an impact too. West Yorkshire Playhouse has won awards for its work in the field with drama, and Liverpool-based Indian traditional dancer Bisakha Sarker has witnessed powerful effects with movement.

Given David Cameron’s launch of the prime minister’s challenge on dementia 2020, the public health minister, Jane Ellison, is keeping an eye on what is happening in Manchester. She said: “For many people with dementia, music and other arts-based activities can make a real difference to their sense of wellbeing and quality of life. We are working to create more dementia-friendly communities. Manchester Camerata’s work is great example of what can be done to help people live well with dementia.”

Life stories in dementia care: we all have a story and cannot be understood without it

In Jonas Jonasson’s book The Hundred-Year-Old Man Who Climbed Out of the Window and Disappeared, the protagonist faces scepticism when he recounts the tale of his daring escape across the Himalayas. “You crossed the Himalayas? At a hundred?” exclaims the prosecutor. “No, don’t be silly,” responds Allan. “You see, Mr Prosecutor, I haven’t always been a hundred years old. No, that’s recent.” 

Jonasson uses the life story of the 100-year-old man as a vehicle to tell a story about 20th-century history, but I read this novel while immersed in a research project looking at the use of life story work in dementia care. For me the message was clear: we all have a story, and no one can be understood by how they appear today out of the context of that story.

Life story work typically involves helping people to make a record of some aspects of their life, most often in a book or template, although more creative approaches do exist, including the use of IT and stop frame animation. Increasingly, life story work is being promoted as an important tool for enhancing person-centred dementia care. However, when it comes to specifics, there is little agreement.

A care home may ask a resident’s family to write a summary of their life using a list of prompts, while a community team works with an individual to make a collage about their life, and both could call it life story work. Perhaps the most important distinction is that when some people talk about life story work they mean an activity that is led by the person with dementia, to celebrate and preserve memories. Others mean a process led by professionals with the aim of aiding communication and increasing staff understanding.

Not everyone wants to be reminded of their past, and different people may come up with alternative accounts of the same person’s history. Life story work has many complexities, and when you add dementia into the mix things can get tricky. However, enthusiasm for life story work is high and claims for its positive effects are increasing.

To explore these claims, the Social Policy Research Unit at the University of York conducted research into the potential costs and outcomes of life story work in dementia care. This is not easy when there is such variation in practice. We collected information from six care homes that were all introducing life story work for the first time. Even with the same training, each care home did it differently.

When we asked people with dementia, family carers and professionals about good practice, the first thing that struck us was that, despite the hype, not everyone wants to make a life story. They may also have different views from staff about what their life story book/film/collage is for. It was felt that beginning the process early could enable people with dementia to take a more active role and communicate how they would like their story to be used. If staff were involved, one suggestion was that they could try making a life story document of their own to see how this feels and what issues arise.

Improving the quality of care and making it more person-centred often has associated costs. The greatest cost to the care homes introducing life story work was staff training, ranging from £950 to almost £1,600. After this initial outlay, however, the average cost of actually creating and using a life story book was relatively small: we estimated around £37 per resident over 16 weeks. Of course, costs will vary with different approaches.

The most significant effect we detected was an improvement in staff attitudes towards people with dementia in care home that introduced life story work, together with a hint that residents themselves felt better. However, the work was intentionally exploratory and to understand the full implications we recommend reading the final report, which will be published later this year and will be available through the SPRU website.

The key message from the people we spoke to was that whether life story work enhances dementia care depends to a large extent on what the people involved want to get out of it. If it’s intended to improve understanding in care settings, staff need the time and opportunity to use the information. If it’s about celebrating life and preserving identity, people with dementia need support and opportunities to do this their own way.

This article presents independent research funded by the National Institute for Health Research. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

Carers – The UK’s unsung heroes – What can we give back?

The UK’s 7m unpaid carers are amongst the most giving people we know.

They are all around us, caring for mums, husbands, daughters, sons, brothers, grans, friends….the list is endless, and they do this free of charge and unconditionally because they have an emotional connection with the person they care for.

Anyone can be a carer, a 7 year old boy helping his mum with her cancer treatments, a 90 year old woman supporting her husband with dementia, a 30 year old dad caring for his daughter born with cerebral palsy or a 60 year old woman caring for her dad who is old and frail.

3 in 5 of us will be a carer at some point, carers are all around us, propping up our health and social care systems, preventing winter deaths, keeping people out of our stretched A&E departments, providing a wide array of nursing and personal care tasks and ensuring people with care needs don’t become lonely and isolated.

Along with caring, unpaid carers have their own lives to lead at school, at work, with family and in the community, but they just keep on giving, sometimes at great personal cost to their own health and wellbeing. In fact the economic value of their gift is estimated at around £135bn every year, and its growing as our demography changes and we all live longer.

So, we should all ask ourselves, what can we give back to carers?

This blog was produced by @LuenThompson, who is the Director or Marketing and Communications at the @CarersTrust.

Vascular Dementia – Helpful questions and answers

What is Vascular Dementia?

Vascular Dementia (VD) is a condition caused by a lack of sufficient oxygen and nutrients to the brain, causing the cells within the brain to eventually die. The blood vessels that carry blood to the brain become diseased – they are often weakened and leak, or can become blocked, decreasing their effectiveness in delivering vital oxygen and nutrients to the brain. Of the various identifiable types of dementia, VD is the second most-common form, with approximately 150,000 sufferers in the UK.

Here is a useful video that providers a brief outline of what Vascular Dementia is.

How is it caused?

There are two primary reasons why the condition may develop.

Cause 1 – The most common cause is the degeneration of tiny blood vessels deep within the brain, this is called Subcortical Dementia.  The tiny bloody vessels can thicken, which in turn reduces the blood supply to those cells, causing them to degenerate and eventually die. The nerve fibres around the affected blood vessels are also harmed, reducing their effectiveness. The disease of the tiny bloody vessels can also affect other areas of the brain, including the base, if blood vessels are blocked here it could cause small infarcts – also known as an ischaemic stroke.

Cause 2 – The second most common cause of VD is following a stroke. Strokes occur when the blood supply to the brain is suddenly cut-off, this can be as a result of a blood clot (an ischaemic stroke) or less commonly, where a blood vessel ruptures and bleeds into the brain (a haemorrhagic stroke). Around 1 in 5 people who suffer a stroke will develop dementia on top of the side effects of the stroke itself. Most people who have suffered a stroke will have another and therefore the risk of developing dementia increases with each stroke event as more of the brain becomes damaged.

How can it affect someone?

The symptoms of VD can vary from person to person, often dictated by the root cause of the dementia, whether it be as a result of vascular disease, or following a stroke. The speed in which the symptoms can take hold can also vary, the damage following a stroke is often instantaneous, whereas the effects of vascular disease can develop over time.

Early symptoms and effects can include:

  • Problems concentrating on tasks – this could be shown in activities such as planning, making decisions or problem solving.   They may also struggle to follow instructions, and their thought process may be slower.
  • Mild memory loss.
  • Problems with articulating what they want to say – their speech may become less fluent as they concentrate on finding the words.
  • Easily frustrated – this is often a result of the issues highlighted above.
  • Depression and sudden changes in mood – the depression is often as a result of the sufferer becoming aware of the cognitive effects (listed above).
  • Weak bladder – this is associated with subcortical VD sufferers, and can be accompanied by a weakness on one particular side of their body.
  • Dizziness or tremors.

As the disease progresses (stroke-related VD often will become worse following each new stroke episode; whereas subcortical VD will worsen gradually), long term symptoms and effects include:

  • Severe confusion and memory loss – day to day tasks become harder and sufferers are likely to need support on a daily basis.
  • Problems with communication and comprehension.
  • Changes to their personality and behaviour – they can become aggressive, irritable and easily agitated.
  • Suffer delusions and hallucinations.

What treatments are available?

Sadly the brain damage caused by VD cannot be treated to stop the degeneration, nor can it be reversed. However, with careful and managed support an individual with VD can continue to live well.

Caring for a loved one with VD can be hard, but these simple tips can help you support your loved one and give them some much-needed structure when they need it:

  • Establish a routine – this will help them feel less agitated.
  • Keep them occupied – it is important to help keep their mind and body active (where possible), whether it be a short walk, social activities or something as simple as tending to plants. This helps add structure to their day to day lives, as well as providing a sense of purpose.
  • Don’t be afraid to communicate with your loved one – though they may struggle to comprehend you, it is important they do not feel isolated and a smile or arm around the shoulder can help you both feel comfortable.

As well as taking on the care yourself, there are many different types of external support available, and family and friends of those with the disease are encouraged to explore these options. UK Care Guide was founded to offer honest and reliable support for anyone needing care for themselves or a relative – and our website contains a wealth of information about ongoing care, the costs of care (including our handy Care Calculator) and your options for care for your loved one.

Thanks to the UK Care Guide for their recent Blog Article.

Social care industry at breaking point due to planned increase in national living wage

TV viewers fell in love with Derek, the kind care worker portrayed by Ricky Gervais, who looks after the elderly residents of the Broad Hill nursing home.

Yet Kent care bosses say jobs for people like the loveable Channel 4 character are under threat from cuts to funding and an increase in labour costs from the national living wage due in April next year.

The county’s care industry is at breaking point according to Adam Hutchison, who represents about 200 care providers across the county as an executive board member of the Kent Integrated Care Alliance.

He said private care homes will close if local authorities do not provide more money and claims the cost of caring for residents allocated through social services has been underfunded for more than a decade.

Mr Hutchison, who is director of Belmont Sandbanks Care Group, which operates homes in Romney Marsh and near Hastings, said his company receives £408.48 per patient per week from Kent County Council.

Yet his private fees for residential care range from £550 to £650 per week.

In East Sussex care homes receive £496 a week while in Hampshire the figure is £574.

In west Kent, the figure increases to £440.30.

The situation has been made worse by increases in the cost of workers.

“We need to increase what is funded by central and local government to accommodate the increase in labour costs forced on us by government...” - Adam Hutchison, Kent Integrated Care Alliance

Over the last 10 years the national minimum wage has gone up from £5.35 in 2006 to £6.70 last month, an increase of 25%. Another 6% increase will be introduced in April when the government introduces its £7.20 national living wage.

However, the Kent County Council rate for supporting residents in care homes has risen by only 5% since 2008 – with the additional cost swallowed by private businesses.

The latest increase in the national minimum wage at the start of October is expected to cost Mr Hutchison’s business £26,000 in increased labour costs. The introduction of the national living wage in April is due to up that by another £70,000.

He claims government payments need to increase by £20.52 per week per person just to stand still, with that due to increase once the living wages comes into effect.

Mr Hutchison, who employs more than 75 people, said: “As a sector we are all for the national living wage because people don’t get paid enough.

“However, how are we able to fund that? We are constantly under pressure to improve quality but we are at breaking point in care.

“The private market subsidises the social services market. Those who pay privately will have to pay more than those who come through social services.

“We need to increase what is funded by central and local government to accommodate the increase in labour costs forced on us by government.”

“We have got the national living wage and all the pressures it brings, which is probably more than the impact of the amount which can be raised through council tax..." - Cllr Graham Gibbens

“If this doesn’t happen, the short term result is independently run businesses in Kent, small family-run providers,will begin to exit the market and decide to build houses on their land or look at another form of business on the site.

“Then there will be a knock on for employment, with the long term effect larger national providers will come in and be able to charge what they want.

“We’re not trying to plead poverty but we are under pressure as a business sector.”

In the Autumn Statement on Wednesday, Chancellor George Osborne announced plans to allow councils to put council tax bills up by 2% provided all the money was used to help fund social care.

Kent County Council cautiously welcomed the move.

Cabinet member for adult social care & public health Graham Gibbens said: “The announcement was only recent and it is too early to give a forensic analysis.

“The big issue is how the 2% is going to be used but I do welcome it.

“The Government has recognised that social care does need to be funded.

“We have got the national living wage and all the pressures it brings, which is probably more than the impact of the amount which can be raised through council tax.

“One of the big things we need to do is encourage people to stay at home as long as they can and avoid going into residential care..." - Cllr Graham Gibbens

“As a local authority we have a duty to ensure there’s a vibrant social care market and we have a duty to ensure there’s appropriate funding to the sector.”

He said he would have been “very disappointed” if funding was cut and hopes to be able to increase funding in the future.

He added: “One of the big things we need to do is encourage people to stay at home as long as they can and avoid going into residential care.

"We have been quite successful at keeping people out of residential care but as people get older many do not have any other option.

“How we manage that is an issue.”

He has also approved plans to force KCC to pay the same amount to social care providers wherever they are in the county, which comes into force next year.

Paying for your care costs – Be cautious about giving away your property

A blog by Dr Brian Sloan, a legal academic specialising in family and property law.  In this blog, Brian comments on the delayed cap on care costs and cautioning against giving away your property prior to going in to care.

The delay in the cap on care costs

The Care Act 2014 facilitates a cap on the amount that any one individual in England is expected to contribute towards his or her social care costs. This would be a contrast to the current situation, whereby someone with assets (sometimes including a home) of more than £23,250 can be expected to meet the full costs of care. In July 2015, however, the Government announced that the cap would be delayed until April 2020.

Limitations on the effect of the cap on care costs

It is important to realise that there were to be several significant limitations on the cap’s effect even before it was delayed, as I discuss in this paper. These are:

1 – the cap was to be set at the high level of £72,000 in April 2016.

2 – it was to cover only the cost of meeting ‘eligible needs’, broadly equivalent to ‘critical’ or ‘substantial’ needs under the pre-Act system, and not ‘low’ or ‘moderate’ ones, leaving much to depend on the outcome of local authority assessments.

3 – costs counting towards the cap were likely to be based on what it would cost the local authority to provide the relevant care, which may be below what an individual would pay for that care.

4 – the cap would exclude ‘general’ or ‘daily’ living costs in a care home, which were likely to be around £12,000 per year.

Your property

Whatever the cap’s limitations, it would have left some people with more property to leave to their family and dependants, and might have reduced the risk that the social care system would impose an ‘individual and excessive burden’ in a particular case, breaching the European Convention on Human Rights’ protection of the right to peaceful enjoyment of possessions.

The Local Government Association have said, however, that ‘local government funding will…be under enormous pressure in the coming years as Departments make…savings as part of the Government’s deficit reduction plan’, and any diminution in the funding entering the care system risks prejudicing those who cannot afford to pay for care.

The significant continuing liability to pay for social care might tempt people to give away their property in anticipation of care costs.

Be wary of giving away your property before you go in to care

But, as I suggest in this paper, caution is required. Aside from the need to ensure that a potential care recipient keeps enough property to support him- or her-self, local authorities have wide powers to reverse the effect of disposals of property for the purpose of reducing liability to pay for care.

They can do this either by deeming a care recipient still to have property of which he or she has deprived herself, or by pursuing the recipient of such property. While the Government’s guidance to local authorities considers it ‘unreasonable to decide that a person had disposed of an asset…to reduce…charges for their care…if at the time…they were fit and healthy’, this is not obvious from the legislation itself.

If you are looking for ways to pay for your care costs, there is a useful guide here as to the alternative options to property you can consider.

What will happen next?

It remains to be seen whether and when the cap on care costs will be implemented. Even if it is given effect, however, it will not remove the controversy surrounding paying for social care in a context where health care is generally provided free at the point of delivery.

@briandsloan and http://www.law.cam.ac.uk/people/academic/bd-sloan/409

Searching for a Home Care Provider

With the costs of residential care being very high, more and more people are looking to receive specialist, and paid for, care in their own home. This is often delivered by specialist care provider agencies, who employ carers with specific training and expertise in providing care in the home.

Picking a  specialist, and paid for, home care provider can be a difficult thing to do. That is why we have created a search facility to allow you to find a specialist carer in your area. Just put in details below of where you are and what kind of home care you are looking for.

Advantages and disadvantages of receiving paid for care in the home

Deciding whether to have care in the home, from a specialist care provider, can be a big decision, and there are a number of advantages and challenges that you need to think through.

Advantages of receiving care in the home

Financial benefit – Receiving care in the home is significantly cheaper. Average costs for care in the home are about £11,000 per year if you have a part-time carer, compared to about £30,000 per year if you lived in a residential care home.

Maintain your independence – Living in your own home allows you to maintain some independence and remain in familiar surroundings.

Friends and family – Being close to friends and family allows you to receive regular visitors in an environment they are familiar and comfortable with

You retain control – you remain in control over the support that you need and the areas where you want the carers to help you

Challenges with receiving care in the home

Be with other people – One of the advantages of a residential care home is that you are with other people and have the ability to interact with others on a daily basis. If you are living alone, you may find this lonely, especially if family and friends are not close by.

Risk of being on your own – Even though your carer will visit you on a regular, if not daily basis, it can still be a risk for you being at home, especially if your health is not what it used to be.

Value of your home – Another point that often gets missed until later, is that you may need to make modifications to your home to make it easier for you to get around. However, when it comes to selling your home, these modifications can negatively impact on the value of your home as any potential buyer may need to remove your changes and put the house back to ‘normal’.

Who Cares about the Care Sector?

The results of a National Care Association survey of independent Care provider members has shown that 24% of care providers could exist the market.

The very people the care sector relies on to provide high quality care are being squeezed to the point where many are considering and exit from the sector, which could create a serious bed shortage and have serious repercussions for the wider NHS.

The National Care Associations predicts – due to the £375 m black hole in state funding – such an exit could equate to the loss of 40,000 beds in the independent social care market. and the worsening of the bed blocking crisis already in evidence across much of the NHS.

The NCA points to a critical shortfall in the average council funding of about 8% for a typical care home placement care home placement as the significant contributory factor in the likely exodus of care providers. This underfunding together with the impact on Care Sector overheads of the introduction of the NLW National Living Wage in April 2016 is seriously eroding the viability of many care homes businesses.

Without increasing funding from local councils in recognition of the true cost of care the predicted market crash will spell the end of the road for many independent care homes … In short under very real threat is a UK support service which is essential to local government and NHS care provision.

More detail of the reports can be found in the following Links

100 days and counting

Impact of Budget Survey 2015

George Osborne MP