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New Social Care Measures

Discussion in 'ARCHIVE FORUM: Support discussions' started by TinaT, Dec 1, 2007.

  1. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    I’ve just got back from attending a conference organised by Skills for Care North West. I was lucky enough to have the conference fee paid for by my Local Authority. I say lucky as there were very few places taken up by people who were not paid professionals working in the Caring Industry.

    The conference centred on a new Government Green Paper which has not yet been published which will push forward a massive caring in the community programme. This will transform the ways in which we as carers are going to be supported and will have huge implications for budgeting and staffing changes within the Health Service and Local Authorities.

    The new initiatives will place finances into the hands of the people who need help so that they can then build their own care package. I attended a lecture concerned with the needs of older people as recipients of individual budgets and how this will empower the elderly to be able to stay living independently in their own homes. It seemed to me that the private agencies supplying care packages will be the main beneficiaries of these new measures. I have some experience of the direct payments system and buying in care for my husband. On the whole it worked very well because I was able to both supervise the carer and take control of the finances on a daily basis. My major problem was the way in which the private agency sent me invoices. They were complex and almost impossible to keep a careful eye on. If they overcharged on one bill, then instead of the next bill being reduced, I was sent a credit note. I would have needed a mathematical degree and many hours of spare time – neither of which I had – to be able to sort these invoices out. How I would have fared if I was using more than one agency, I hate to think!!

    I have to say at the end of the conference I was left with more questions than answers. How will buying in services work for us carers with all our differing circumstances? How can we help to manage these budgets and ensure that the right care package is in place? Will some elderly dementia sufferers who do not have relatives living near enough have the new guardianship law implemented? How will we ensure that the workforce coming into a dementia sufferer’s home is properly supervised and trained? Many of us have experiences of trying to put things right in care home situations and the problems, stresses and strains this puts on us. How will such disputes be resolved correctly if things do go wrong with the care package?

    The new Government Green Paper seems set to revolutionise Social Care. We need to be able to add our input to the way things are going. Anyone out there any ideas how we can do this?
     
  2. Margarita

    Margarita Registered User

    Feb 17, 2006
    10,824
    london
    #2 Margarita, Dec 1, 2007
    Last edited: Dec 1, 2007
    I also went to a meeting like that some time a go this years , but it was us telling them what was needed to help the elderly stay independently in their own homes , going toward this Government Green Paper



    Elderly people they where concern that if was only a way in cutting back services saving money , but they tried to reassures people they that it was not due to that , I just keep an open mind, but it did make me wonder

    we had to sit in group and they come around to each table asking us
    question if this or that happen what was needed to help that person ,and if we come up with idea in what gap they had miss and was needed then writing in all down , then moving to next table then someone asking us another set of question we had about 15 with each person asking a set of question and us asking telling them what was needed and how they can help
     
  3. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    68,719
    Kent
    Dear Tina.

    Your Post caused Alarm Bells to ring. :eek:

    IMHO
    Care in the Community is a misnomer for Passing the Buck
    Private Agencies coincided with the start of infection by MRSA


    I echo your concerns.

    Just one short anecdote about so called Care in the Community.
    A young man with Downs Syndrome, who shared a house with others with similar disablilities, so they could live independently under the umbrella of Care in the Community, died on his way to work. It was the middle of a very cold winter and no-one had been there to tell him to put his coat on.

    If the heating is on in the house, and the sun is shining outside, Dhiren feels nice and warm and doesn`t think he needs a coat either.

    You ask for suggestions. My first thought would be to copy your post and send it to

    Our own MP

    Ivan Lewis,

    Secretary of State for Health
    The Rt Hon Alan Johnson MP

    Secretary of State for Communities and Local Government
    The Rt Hon Hazel Blears MP

    Refer them to their own Policy Document http://www.labour.org.uk/families_and_pensioners
    in particular
    Tina.
    If I have your permission to copy your post I will do it this week. If anyone else would like to send their own letters and own personal comments, it would add strength.
     
  4. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,419
    I'm used to all this "it's cheaper if we farm it out to private agencies" talk here in the USA - they seem to believe private enterprise is always cheaper and better, but I'm depressed to find that that attitude is increasingly the norm in the UK as well. At ground level it may be, but you need a massive army of bureaucrats to ensure that these piecemeal approaches work (or you do if you want to ensure that they DO work).
     
  5. CraigC

    CraigC Registered User

    Mar 21, 2003
    6,630
    London
    Hi Tina

    In my humble opinion, the problem with farming the work to outside agencies is the additional work that will be needed to monitor standards and make sure basic quaility measures are adhered to. As far as I can tell a lot of the work if farmed out already and the NHS use a lot of agency staff already. Sometimes these staff are monitored well, but at least the butt stops with the NHS if things go wrong and that ensures a certain level of quality.

    Don't know enough about the green paper, but I don't think a massive shake up is needed, just a lot more funding and training and a shake up of the management ensuring that responsibility is always picked up somewhere.

    What also concerns me about this concept is continuity in care. The older you get the more you hate having strangers in your home. A good care package would include a request to have regular visits from the same staff (where possible). When you start using agencies this just does not happen (in my first hand experience).

    Have you got any links to any documentation on the green paper please? I appreciate it wouldn't be the most rivetting read, but it would nice to scan over it to feel a bit more informed.

    kind regards
    Craig
     
  6. Margarita

    Margarita Registered User

    Feb 17, 2006
    10,824
    london
    My daughter gave me this link


    http://www.communitycare.co.uk/Articles/2007/02/06/49763/adult-green-paper.html
     
  7. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,419
    I think this must be an entirely different green paper though - Tina said it hadn't been published yet, and it's definitly not on dh.gov.uk which is where is would be.

    One of the problems that never seems to be adressed in these things: it's one thing to set up a system that "empowers" users of services but that's fairly pointless when such users suffer from dementia - what they need is timely care not empowerment. Carers - yes, they need far more input, but a lot of people who are carers are too worn down, too tired, too involved with caring to be able to make these decisions (if they want to, which some don't). Carers are a truly random group of people - every walk of life, every educational level - we couldn't BE more random, so one size will never fit everyone.
     
  8. 117katie

    117katie Guest

    Continuity Of Care

    I couldn't agree more, Craig, and the total lack of "continuity" of care is something that I have been struggling with for two years now.

    My 83-year old (81 at the start of her needing help for the first time ever in her life, Good Girl!!!) had - at one point - 18 different 'support workers' entering her private domain within the space of one week. That was supposed to be helping someone with dementia??? Most of them she could not even understand due to their total lack of anything that could be described as a 'working command of English' - but that is another debate altogether. I thought then, and I am still convinced to this day that is one of the reasons she gradually began to "resist care" or "decline care" or "withdraw". They were all words used by her social worker and by the consultant (who only ever met my Aunt 3 or 4 times, I think, in 2 years) to describe the fact that they felt her dementia was progressing at a more-rapid-than-expected rate - whereas I used to say "she has never had so many different people entering her flat in her lifetime within the space of one week; how on earth is she to be expected to accept it quietly and calmly now, and how is it helping her"???? Of course it bothered her - as it would bother me, if I had that many "strangers" entering my home today.

    They were also all 'agency workers', but I never understood why, even after my Aunt moved into sheltered housing. If anything, it got worse after she moved into "extra care sheltered housing" (so-called, but I had my doubts!). I overheard on the telephone the Senior on Duty ordering up her staff for the MONTH AHEAD: the conversation went along the lines of "on the 3rd I need 7; on the 4th I need 9; on the 5th I need 4; on the ......" and so on. Not once did I hear the Senior on Duty say "and please ensure that at least one of those 7/9/4 people have experience of someone who has dementia/disability/deafness/no speech .... Yes, I was horrified. But that is, I suppose, all attributable to the fact that, when the Manager ASSURED me that the reason for so many agency workers was because of sickness/holidays/staff absences, I was left thinking "You cannot be serious!!!"

    I too would relish scanning this paper, so please supply references/links if poss.

    Katie
     
  9. Lucille

    Lucille Registered User

    Sep 10, 2005
    542
    Craig and Katie I couldn't agree more. I feel very cynical about the government proposal mentioned. The problem is that they don't ever think they will be old or ill and so it's just another initiative. Instead of inventing something else, why not concentrate on what's already out there? As discussed, staff training is an absolute for dealing with sufferers of dementia.

    I am sceptical about more agency involvement. I think it's just an excuse for some people to make vast amounts of money without having to answer for what they are doing. Katie, your point about numerous carers is a valid one. My mum also (rightly enough) takes issue with the different people coming in and out of her property (as would I). Whenever I call the agency to say I'm visiting or another friend/relative is, so they won't need to call, messages are never passed on, the carers are annoyed because they've had a wasted journey and, of course, we still get charged!

    I have decided not to opt for Direct Payments for my mum as because of the distance, I've been informed that it might be difficult for me to manage if someone goes sick etc as I would need to find alternatives asap. This on top of the withdrawal of mum's CPN and support worker support does not give me confidence in current or future arrangements for elderly care. They need to start talking to the people that are experiencing it every day, not have civil servants patting each other on the back because of their latest 'good idea' that might get them votes. (Sorry to be political, but it applies all parties). We are dealing with human beings here. Everyday we are regaled with stories about the 'aging population', isn't it time someone actually took responsibility for them?
     
  10. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,419
    One of the things I've noticed in the time I've been on this board is this absent social worker thing. As it stands, in many areas if you're self-funding you're left to get on with it on your own, and if there's one thing a new carer of someone with dementia needs it's guidance and a helping hand. I never objected to using my mother's money to pay for help, but I did (and still do) resent the fact that "social services" who I always thought were for the benefit of all simply didn't want to know and if you have dementia but it is one for which there are no drugs available you are ignored by the elderly mental health teams as well. CPN - I never knew there was such a thing before I came here.
     
  11. cynron

    cynron Registered User

    Sep 26, 2005
    429
    east sussex
    Jennifer
    I was only given a social worker after i insisted on a carers assessment.This was only in the last year of my husbands life.

    When i was in the system i at last got some help,with respite and day care. I was self funding and they were reluctant to help me:eek:

    Cynthia
     
  12. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    One of the advantages of the free personal care in Scotland is that we do get support from SWs, but only when we ask for it. For example, we're also self funding, but I didn't have to pay for Crossroads, or for the emergency help before John went into hospital.

    The downside is that we don't get CPNs unless there is challenging behaviour. I'm fighting to get this changed. I feel very strongly that if I had had a CPN, John's UTI would have been picked up much earlier, and the massive neurological damage might not have happened. I didn't need regular visits, but it would have made such a difference if there had been someone I could call on in an emergency.
     
  13. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    Anyone can of course use my comments on this thread to copy and send to MP's etc. I am only sorry that I can't give any more info regarding websites to visit regarding the new Green Paper but believe me it IS coming and will cause a major shake up!! I will put SOCIAL CARE NATIONAL POLICY into the search engine and see what comes up. Perhaps our local MP's are the only ones who can supply us with information on new initiatives. What an excellent idea for us all send to our MP's regarding this and demanding that our voices are heard. Carers need to be approached NOW as we are the ones on the 'chalk face' with experience and first hand knowledge.

    I wonder if our Alzheimer Organisation has been approached? If MP's are seriously concerned with devising and implementing a new national care strategy I would think that MIND, MENCAP, and other such organisations must be consulted.

    I agree totally with all the comments made on this thread. It is a serious and most worrying direction for the Government to be taking and one more step down the privatisation at all costs road - and this from a Labour Government!! The old Labour politicians who set up the first National Health Act must be turning in their graves xxTinaT
     
  14. 117katie

    117katie Guest

    Hi All!

    Back from moving my Aunt into her new home and clearing her flat - which contained some 100 plus dresses (all elegant!), 120 sweaters and cardigans (mostly gorgeous!), numerous dressing gowns, shoes ... and so on! So am fairly exhausted, and not doing a lot this afternoon!

    Been trying to find this Green Paper, and the best I can come up with so far are the links below. Haven't had a chance yet to read in detail, but shall come back and let you all know that I've found the wrong links, if that turns out to be the case! Unless of course, you do that first!

    Bye for now, Katie

    http://www.communitycare.co.uk/Articles/2007/02/06/49763/adult-green-paper.html

    http://www.dh.gov.uk/en/Publication...ions/PublicationsPolicyAndGuidance/DH_4106477
     
  15. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,419
    Katie - these are not the green papers that Tina referred to in her first post. As she pointed out her conference focused on an as yet unpublished green paper. At the time it is published , it will be posted on the dh.gov.uk site and there will be a mechanism to comment on it, but until that time there won't be anything on the web (unless it's leaked). I have no doubt that if it is as major a shake-up as reported, this will be widely covered in the press when it is published. Don't forget the green paper mechanism is specifically designed to be a trial balloon: a proposal inviting comment rather than firm government policy (although how much note they take of such comments is another matter).
     
  16. 117katie

    117katie Guest

    Sorry, Jennifer,

    thought I might have found something which related to the so-called NEW SOCIAL CARE measures. But I guess not. Thanks for clarifying that for all of us.

    Shall look further, and perhaps send email to local MP to ask what he knows about these new plans.
     
  17. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    Think I have a RED FACE

    I think I have made a boob and led everyone on a wild goose chase!! Having read through the green paper which everyone else on the thread has found - it sounds remarkably like the one I was hearing about at the conference. OOOoops!! this leads me to think it must be the green paper referred to at the conference!! I thought I heard the words - new - not yet published - but now I am not so sure!!! So RED FACE and possible apologies to everyone. Still the general principle is that Social Care in England will be massively changed in the direction of more privatisation funded by individual budgets.

    Please accept my humble apologies if I heard wrongly. xxx TinaT
     
  18. 117katie

    117katie Guest

    Dear TinaT

    No need to apologise! You have "painted your life with colour" which is the important thing. Red, green or white!! Who cares.

    I know there is a distinction between a "white paper" which I always understood was proposed legislation, and a "green paper" which I thought was a "discussion document", for want of a better description. And the "discussion" bit takes a long time in this world of ours - thank goodness, because the longer the discussion, then hopefully the more opinions will be gathered along the way. Before such time as anyone "proposes legislation" and the white paper.

    So, thanks for drawing our attention to the plans, which I certainly would otherwise not have found.

    Ta muchly!
     

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