care in the uk - a disgrace

[mojo pixy]

If it ends up working, great. I think that's a big ''if'' though because it's obviously only feasable for self-funders (great piece of newspeak that is).

 

[mojo pixy]

Also, this crisis in social care is usually talked about as something that concerns elderly people, which is fair enough because it does - but people with learning disabilities and / or serious mental health needs barely figure in the conversations. Self-funders (that expression, seriously!) are rare in that sub-sector, but problems with funding are just as severe.

 

[treelover]

Nor do many people with long term chronic conditions, M.E, M.S, MND, many who are also losing their mobility cars, etc as the purges continue.

 

[SpookyFrank]

In other news, Mitie have just sold their entire social care division for a whole £2.

That says it all, for me.

Won't be long before private providers start giving up the care sector en masse IMO. If the funding isn't there then there's no profit to be had no matter how badly you treat your staff or your service users. And what's plan B if the private sector bails on social care?

 

[Dan U]

Also, this crisis in social care is usually talked about as something that concerns elderly people, which is fair enough because it does - but people with learning disabilities and / or serious mental health needs barely figure in the conversations. Self-funders (that expression, seriously!) are rare in that sub-sector, but problems with funding are just as severe.

The LD market in particular is dominated by private equity, about 40 pc of residential care is currently controlled by some form of private equity, hedge fund, foreign pension fund or investment bank.

They keep their heads down for the most part because it is an extremely lucrative sector still and one that is still subject to a lot of corporate transactions, unlike the OP sector, which is largely fucked for a whole host of well rehearsed reasons.

Yes they sign the stuff from care England about living wage pressures etc but when Priory Group/Craegmoor gets sold for over a billion to a US health care firm it's a difficult message to cry poverty. And that's just one recent example

 

[treelover]

I'm trying to think if there has been one large scale national protest on these issues in the last 25 years.

 

[StoneRoad]

How incompetent can a care company be ?
I've just had a call from the care-giver, to ask about the tablets my elderly father takes, is there some more ? the box is empty ...
so why didn't they get the repeat prescription organised at the beginning of the week ...
the previous care company always managed to do this without a problem ...
so now, I've got to organise *something* over the easter weekend. And I'm currently the best part of 300 miles away ...
The SW is about to get an email.

 

[hash tag]

Sorry to hear this StoneRoad. Sadly, and no comfort to you, this is no surprise

 

[StoneRoad]

Thanks hash tag ! yeah, this situation really sucks.
I've done almost all the legwork on this - rang the out-of-hours GP service and had two, no, three calls back; making arrangements for a 'script to be available. Last call was 0620 this morning, very polite O/O GP at the local hospital unit about the 'script.
It was only this morning that I got my call back - at last ! - from the area manager, somewhat apologetic, to sort things out. Why the repeat prescription was not put into the local pharmacy on Monday is to be investigated
... should get a text to confirm all is ok later.
What I didn't say was that I also emailed the social worker to put this on record, I wasn't happy that the previous company bailed and the changeover was only not a shambles because I did legwork then (supplying a crib sheet for details of cupboards and meals etc).
Bah, still very not happy ! It is just as well that the medication involved is not actually life-critical !

 

[StoneRoad]

hmmmm.

Just after I posted the above (249) I got a passive-aggressive call from the boss of the care company "denying" responsibility for situation, "It isn't in the care plan" ... being used as the cop out, plus other "excuses", despite the previous care company adapting as needed !

 

[coley]

Sheltered roles have changed dramatically over the years. These days, sheltered housing, where staff still exist, are a lot more hands off. Also, the client profile in sheltered these days seems to be much younger than ever before, which can be a good thing. I know a few areas, where there are no sheltered scheme based staff anymore. Where once schemes had live in staff, some now have 9-5 officers and some have staff who visit occasionally.
"we're being made redundant in the autmn". Sorry to here this. Richmond have combined with Wandsworth; who knows where that will lead.

Another element in the pass the parcel (pass the cost on to any agency other than mine) is the 111 service. Doctor tells patient see how it goes and if there is any change Etc. call 111 (because it will save my budget). Patient calls 111 who invarably decline to send a doctor or district nurse, instead opting to send an ambulance. 9 times out of 10, these people do not need to go to hospital, they need decent home care or they need some sort of supported housing which has been severly delayed because of the enormous pressure on social services. I can't tell you ow many times I have had ambulance crews saying to me it should not be down to them and they are acting in some sort of social care role.

And as frequently happens in our brand new, purpose built A&E, the ambulance crew arrives and has to sit with their patient (often for two hours or more) waiying for their patient to be triaged and admitted, two highly trained people and their very exspensive ambulance literally sitting there doing nothing.

 

[coley]

hmmmm.

Just after I posted the above (249) I got a passive-aggressive call from the boss of the care company "denying" responsibility for situation, "It isn't in the care plan" ... being used as the cop out, plus other "excuses", despite the previous care company adapting as needed !

Wouldn't your pharmacist give you enough meds to cover until Tuesday?

 

[coley]

Won't be long before private providers start giving up the care sector en masse IMO. If the funding isn't there then there's no profit to be had no matter how badly you treat your staff or your service users. And what's plan B if the private sector bails on social care?

Budgets ain't it, the longer someone is sitting there in hospital the more money social services save, ditto keeping 'people in the community' though I do think some care companies are taking the piss, saying they can't manage to provide care for £14 ph.

 

[yield]

Sheltered roles have changed dramatically over the years. These days, sheltered housing, where staff still exist, are a lot more hands off. Also, the client profile in sheltered these days seems to be much younger than ever before, which can be a good thing. I know a few areas, where there are no sheltered scheme based staff anymore. Where once schemes had live in staff, some now have 9-5 officers and some have staff who visit occasionally.
"we're being made redundant in the autmn". Sorry to here this. Richmond have combined with Wandsworth; who knows where that will lead.

Another element in the pass the parcel (pass the cost on to any agency other than mine) is the 111 service. Doctor tells patient see how it goes and if there is any change Etc. call 111 (because it will save my budget). Patient calls 111 who invarably decline to send a doctor or district nurse, instead opting to send an ambulance. 9 times out of 10, these people do not need to go to hospital, they need decent home care or they need some sort of supported housing which has been severly delayed because of the enormous pressure on social services. I can't tell you ow many times I have had ambulance crews saying to me it should not be down to them and they are acting in some sort of social care role.

Due to the lack of general needs council housing there are some younger over-sixties moving into sheltered housing. A mix of people threatening with homelessness as their private rent keeps going up faster than housing benefit. And "under occupiers" those give up their council houses as their kids have left home.

There are a few remaining resident scheme managers. The "internal consultants" are pitching to remove daily check calls. Which will be a problem if it happens as we often find tenants on the floor or after a stroke etc. And I regularly have to chase up missed carer calls for people with dementia etc without capability to do it themselves.

Completely agree about pass the parcel and NHS 111. A call can only be passed directly to the District Nurses, for instance, if they're known to them and that's not always clear on their case history. It's not joined up at all and a lot of LAS time is wasted. Not to mention all the "failed discharges" where someone is readmitted to A&E within 24 hours.

 

[likesfish]

Meanwhile Sodexho just bought Prestige Nursing Care as an

The issue is the people you expect to do the actual work get minimum wage if they are lucky that tends to rapidly destroy peoples desires to give a fuck the good ones fuck off the worse ones stay and get even more bitter . The private companys arn't making huge amounts of profit

 

[StoneRoad]

Wouldn't your pharmacist give you enough meds to cover until Tuesday?

"No-one open", apparently.
Problem is trying to get this to work at almost 300 miles range !
Will be ringing the local GP on Tuesday morning and probably one of the neighbours, as well.
It could be that by Tuesday, my elderly (98) father has been without the medication for as many as five days.
I still haven't had confirmation !

hmmmm.

Just after I posted the above (249) I got a passive-aggressive call from the boss of the care company "denying" responsibility for situation, "It isn't in the care plan" ... being used as the cop out, plus other "excuses", despite the previous care company adapting as needed !

And I've emailed the SW to ensure that the updated care plan does include the requirement to activate and collect repeat prescriptions in future, amongst other things. The previous company didn't need the specifics spelt out in such detail; their staff showed outstanding initiative, volunteering to wash bedding etc. "part of the job" said one of them, when I thanked them for their efforts.

 

[coley]

"No-one open", apparently.
Problem is trying to get this to work at almost 300 miles range !
Will be ringing the local GP on Tuesday morning and probably one of the neighbours, as well.
It could be that by Tuesday, my elderly (98) father has been without the medication for as many as five days.
I still haven't had confirmation !



And I've emailed the SW to ensure that the updated care plan does include the requirement to activate and collect repeat prescriptions in future, amongst other things. The previous company didn't need the specifics spelt out in such detail; their staff showed outstanding initiative, volunteering to wash bedding etc. "part of the job" said one of them, when I thanked them for their efforts.

What happened to the 'previous company' .if you don't mind me asking?

 

[hash tag]

And I've emailed the SW to ensure that the updated care plan does include the requirement to activate and collect repeat prescriptions in future, amongst other things. The previous company didn't need the specifics spelt out in such detail; their staff showed outstanding initiative, volunteering to wash bedding etc. "part of the job" said one of them, when I thanked them for their efforts.[/QUOTE]

Hey, guess what; next time round you will probably find that our fathers case has been passed to another SW, without notes and it will be back to he needs a review, but I cant et to him yet as I am too busy!

 

[StoneRoad]

What happened to the 'previous company' .if you don't mind me asking?

They were having staffing problems, because of the usual high turnover but temporarily not matched by recruitment (and dbs delays) they were not able to supply enough care-givers to provide the level of service they wanted to supply. The group my father was in needed a minimum of four staff, and they had three, one of whom then gave no notice of leaving, another was ill and the intended new staff member had their dbs "stuck" at the met. So they handed a group of people back to the council. (I think it was last year that another local council wanted their services, but drastically cut the amount payable per hour, so that relationship broke down).

This medication thing is still annoying me. According to helpful neighbour, the 'scrip is in the house with a note for "someone" to arrange collection ... local chemist is open tomorrow (Tuesday), will see if they would do collection / delivery for regular medication if I can't trust the carers.
My OH doesn't "trust" the new company ... they seem to have *some* of the poor/bad habits of the first company back in 2012/3.

SW is part of a stable team (it wasn't a few years ago) and at least I have an email address and the contact details for duty officer ! The notes system seems OK, as well. The community nurses, heavily overworked as they are, are good. They successfully got him to have a 'flu jab this last couple of years, after usually refusing. They also weigh him every three to four weeks and do a quick look over. The air mattress (anti-pressure sores) was their doing, as well. I shall have to ask for another check in case the new carers aren't doing the barrier / emollients cream applications.

 

[hash tag]

I would have thought the script would have gone straight from GP to chemist and be delivered by chemist?

 

[mojo pixy]

Yeah, if a medication is present (for a week, a month or a year) then suddenly isn't, I'd be making a couple of calls to find out why. If a medication is due to change then the change should be detailed in the care plan, in the appointment records at least. If no change is listed the correct assumption is that there is no change due; if a change then happens anyway it ought to be checked.

tl;dr - sounds like someone dropped the ball and arses are now desperately being covered.

 

[StoneRoad]

Well, having been thoroughly p!55ed off with the collective arse-covering, and it still not sorted (I should have had a text confirming), tomorrow I shall be setting up a direct repeat prescription delivery with the local pharmacy.
And I think a formal complaint is very likely (depends on the response from the SW team) ... which may get escalated to the CQC.
Not that I want to, but if this medication had been life-critical I could now be arranging a funeral ! as it is, it will take several days for the medication to be effective again after a break of four / five days, in the meantime, the acid reflux will be damaging the back of his throat, again, and the poor fella will be coughing up over a sore throat, which could well end up bleeding ... which it does, sometimes, already.

 

[mojo pixy]

I'd complain in writing and cc your letter / email to CQC. That ought to make someone sit up and pay attention.

 

[hash tag]

If you are doing a letter of complaint StoneRoad now is certainly the time to write to your MP and Sarah Woolaston come to that.

 

[hash tag]

It's no wonder he was praying Care staff who found resident dead on floor lifted him back into bed and told family he 'died in his sleep'

 

[hash tag]

Thinking of you StoneRoad and hope normality has been restored.

"simply inhumanity" says Judge Sir James Munby in separating couples. I would not hold my breath for any improvements in the near future Judge criticises 'inhuman' separation of elderly couples - BBC News

 

[StoneRoad]

Thanks hash tag - normality has, more or less, returned. However, the "new" care company staff don't seem to be particularly proactive. It will be interesting to see if the details in the updated care plan are actually being implemented. Basically having to "train" them in the foibles of the house and elderly resident (which may take a while). One of the main carers in the team has just had a couple of weeks annual leave, so there will have been a range of "stand-ins" doing the visits. Not looking forward to the weekend, catching up the slack ...

 

[Dan U]

https://www.adass.org.uk/media/5994/adass-budget-survey-report-2017.pdf

worth a read for anyone interested in the sector

 

[friendofdorothy]

Terrible CQC report all over the front pages of the papers last week, damning a quarter of care as 'unsafe'.

This was in the Times from 6/7/17

One in three nursing homes is inadequate, condemning tens of thousands of elderly people to substandard care, an overview of inspections has found.

Elderly care is “precarious” with homes deteriorating as qualified staff leave over poor pay and conditions, inspectors say. Families face a “Russian roulette” with one in four social care services, including home care, not safe enough, campaigners warned.

Inspectors found residents going weeks without showers, falling repeatedly, missing medicines and being woken at dawn for the convenience of staff.

After inspecting all 24,000 social care services looking after a million people in the UK, the Care Quality Commission said the system risked tipping into disaster.

Andrea Sutcliffe, chief inspector of social care, said: “It appears to be increasingly difficult for some providers to deliver the safe, high quality and compassionate care people deserve. . . With demand for social care expected to rise over the next two decades, this is more worrying than ever.”

A fifth of all social care was rated as requiring improvement or inadequate overall, rising to a quarter on safety.

Problems were particularly severe in the 4,000 nursing homes that look after 221,000 of the most vulnerable people, with 32 per cent not good enough overall, rising to 37 per cent on safety.

Almost one in ten nursing posts is vacant, leaving many homes short-staffed or reliant on agency workers.

Gary Kirwan of the Royal College of Nursing said: “Since the government cut funding to local authorities, attracting and retaining social care staff has been extremely difficult. It is poorly paid and carers work under considerable pressure . . . The few remaining registered nurses are overstretched.”

Inspectors returned to 1,830 services and found a quarter of those ranked “good” had to be downgraded. Four of the eight ranked “outstanding” fell to “requires improvement”. “That shows the fragility in the sector — good quality care is precarious,” Ms Sutcliffe said.

Caroline Abrahams of Age UK said: “When significant numbers of previously effective providers are unable to sustain a quality care service you know the system’s in serious trouble.

“Older people are effectively playing Russian roulette when they need care.”

The CQC warned in the autumn that social care was approaching a tipping point and ministers have promised a £2 billion injection, but the fate of long-term reform remains unclear after they backed away from plans for a “dementia tax” during the election campaign.

 

[hash tag]

This is a care thing is as much as this person is having his benefits slashed by 42% and will lose some of his care. This has been playing on my mind for days now. Some shit face of a tory was on the radio last week taking about this and PIPs and stuff "well of course some people will get their benefits cut a bit, but you will find that those really in need will get more". It is difficult looking at this case to understand what really in need really means.
I did not vote for this nasty evil party!

Disabled man Luke Davey's care cuts appeal dismissed - BBC News