@CareQualityComm State of Care Report: Reform is Overdue

Last week the Care Quality Commission (CQC), the Health and Social Care regulators said in its 2020 State of Care Report that the COVID crisis has both exposed and exacerbated existing problems in adult social care. The CQC recognise that the sector which is already fragile, faced “significant challenges” around access to PPE, testing and staffing, and that coordinated support was less readily available to social care providers than for the NHS.

The State of Care Report says the long-standing need for reform, investment and workforce planning in adult social care has been thrown into “stark relief” by the pandemic. They have called for long-term funding and a new deal for the care workforce, which develops clear career progression, secures the right skills for the sector, and better values staff. There is also a need to invest in their training and support.

Ian Trenholm, Chief Executive of CQC, said:

“Failure to agree a funding solution continues to drive, year on year, instability in the market, and COVID has exposed and exacerbated that, particular in terms of funding. Money has been made available by the government, but it’s all short-term funding. What is required is a longer-term funding solution But it’s not just about money, it’s also about staffing and professionalising the adult social care workforce, making sure that working in adult social care has the prestige that it deserves. … every year we talk about social care being fragile. Now is the time for action. COVID has pushed social care even closer to the edge and we need to make sure that action takes place now.”

Boris Johnson said in his first speech  as prime minister, in July 2019 that his government would fix the crisis in social care once and for all, but no reform has yet been proposed despite more than 15,000 people dying from Covid-19 in England’s care homes. Covid-19 has also exposed further the inequalities in the service that exist for people from black and minority ethnic backgrounds, people with disabilities, and people living in deprived areas who have suffered more severely from its impact. The CQC press release about the report can be read here.

Another report on a similar topic, has been released by Skills for Care on thier Workforce Intelligence Website. They have released their report, “The State of the Adult Social Care Sector and Workforce in England” which amongst other things indicates that the vacancy rate is 7.3% (equivalent to 112,000 current vacancies). Their findings with a really useful infografic summary are available for access Here

@ScotHumanRights Call for an Immediate Return of Social Care Support

I think I am getting a bit more random about when I decide to post to my Blog. I’ll need to get back to being a bit more consistent especially now I have new students looking at it. However today I couldn’t ignore this.

Research published on the 6th of October 2020 by the Scottish Human Rights Commission has shown that a considerable proportion of people who use social care support at home have experienced either a reduction or complete withdrawal of support during the COVID-19 pandemic.

The new monitoring report details how the removal of care plans during COVID-19 has had a direct and detrimental effect on people’s rights, including potential unlawful interferences and non-compliance with rights contained in the European Convention on Human Rights and the United Nations Convention on the Rights of Persons with Disabilities. Rights affected include people’s rights to physical and psychological integrity, private and family life, and to independent living in the community.

Evidence from research participants showed how the reduction or withdrawal of care and support at home has led to circumstances in which people were left without essential care, such as assistance to get up and go to bed, to wash and use the toilet, to eat and drink, and to take medication.

The report sets out 24 recommendations for action, including:

  1. The Scottish Government and the Convention of Scottish Local Authorities (COSLA) should jointly commit to the return of care packages and support at pre-pandemic levels, as a minimum.
  2. The Scottish Government should immediately establish data collection mechanisms to monitor the nature and extent of the reductions and withdrawals of care packages.
  3. The Scottish Government and COSLA should develop an emergency decision making framework for social care which is grounded in rights-based principles of inclusion and participation in decision making, and transparency. This should also meet critical human rights standards.
  4. The United Nations Convention on the Rights of Persons with Disabilities (CRPD) should be incorporated into Scots law and therefore into policy design and delivery so that this situation never happens again

Judith Robertson, Chair of the Commission, said:

“Social care is an essential investment in realising people’s rights, particularly those of us who are disabled, older or provide unpaid care. Delivered properly, social care should enable people to access their rights to family life, health, education, employment and independent living in the community, among others. That’s why the Commission is deeply concerned about the reduction and withdrawal of social care support to people during COVID-19, and the impact this is having on their rights.

While the report is concerning I am absolutely sure that what is documented here is probably occurring across the UK. Concerning times for all and only goes to show that we need to “…build back better” as this report highlights.

To access the full report CLICK HERE

Apps You Might Want to Try Out

One good thing about the current COVID restrictions is that it has led to a bit of a mini explosion in providing Apps that make getting useful online resources to your ‘phone and tablet easier. September saw a number of these being launched that you might want to look at.

So to start with Alzheimer Scotland now have their own Alzheimer Scotland App See https://www.alzscot.org/alzscotapp

This App contains Handy information, contact numbers, support and services, with an alert function to keep you up to date on changes in your local area. 

Purple Alert, the community app which helps to find people living with dementia if they are missing has undergone an upgrade. This is a major rebuild of the old app following it’s milestone of reaching 10,000 users. The new version adds functionality that tailors it to your local area.  You can either download it to set up a profile for someone you care about in case they go missing, or to be a member of the community who helps to look out for someone when an alert is raised.  If you have the old version of Purple Alert, you should visit the app store and download the new app, listed as Purple Alert Scotland.

See https://www.alzscot.org/purplealert

ADAM (About Digital and Me); https://meetadam.co.uk/ is not an App but a platform connecting people with dementia with the right technology at the right time, based on their aspirations.  The products which are suggested in the catalogue have all been tested by families living with dementia and Alzheimer Scotland’s Digital Leadership Team, to ensure their relevance. Please spread the word about these products, and particularly encourage people across Scotland to download Purple Alert and become part of the community.

Another I came across is from the UN. Released by ActNow, the United Nations campaign for individual action on climate change and sustainability. The campaign and the App encourages every one of us to do our part to help limit global warming and build a better future in line with the UN’s 17 Sustainable Development Goals — the world’s blueprint for a more peaceful, more equitable and greener world. The App is called AWorld (because there is no Planet B) and can be downloaded at https://site.aworld.org/

Sign up to United to Prevent Suicide @TalkToSaveLives

Yesterday, Thursday 10th of September was World Suicide Prevention Day.
See https://www.iasp.info/wspd2020/

It was also the day that Scotland launched United to Prevent Suicide, its new unifying identity for suicide prevention in Scotland.

This new identity marks a new approach to preventing suicide as set out in Scotland’s National Suicide Prevention Action Plan.

While the number of suicides is Scotland are reducing, 784 people still died as a result of suicide in Scotland in 2018. That is two people a day.

Each of us is more likely to encounter someone who needs a suicide intervention than CPR.

United to prevent suicide invites everyone in Scotland to sign up to get practical information on how to talk about suicide.

Funded by the Scottish Government and led by the national suicide leadership prevention group, the campaign will also introduce a new dedicated service for people bereaved by suicide.  United to prevent suicide includes a new approach to crisis care for people with suicidal thoughts, and will use digital technology to improve suicide prevention.  It will work at both national and local community levels.

Julie Paterson, the Chief Executive of the Mental Welfare Commission, said: “Every suicide is a tragedy. For the individual, for their family and friends, and for the wider community. One of the main messages we can all learn from this campaign is that talking about suicide – saying the word – isn’t a trigger. It can help save a life. The campaign recognises that this can be hard to do, so in a very practical way, it guarantees that everyone who signs up will be sent a pack of information, including information on listening and talking about suicide.”

Suicide is the leading cause of death among young people, and also older men.

If you live in Scotland, take action and sign up to the movement today at https://unitedtopreventsuicide.org.uk/

Everyone who signs up will receive their own suicide prevention pack loaded with information on talking about suicide and how to support the campaign.

@BloggersNurse Challenge: Future Nurse

Well what’s my big idea for the future? Strangely I was asked to think about this as an introductory lesson for one of my School’s Open Day events about 2 years ago. So my thoughts on this are already been recorded.

So when I did this I used a presentation format called Microsoft Office Sway precisely because it is a an easy medium to share. So here are my thoughts in a nice neat presentation.

So I called in ‘Future Nurse’ and what it does is spell out some trends that have become unavoidable and may now have been speeded up by the COVID-19 outbreak.

 Regarding SWAY (this presentation format). Once you click on the link to view it scroll down the page or click the “open to full screen” symbol. When you do that you will see in the right hand corner a menu for other viewing options. Pick what you prefer. Note that anything that is underlined is an active internet link. Anything that has a “play” arrow on it is a video. To access the presentation click the link below

https://sway.office.com/EGEhA8KZTviZkkTy?ref=Link

The future in summary. All care should be care within and by the community and we need to grasp this concept now.

What will #Scotland #Socialcare Look Like in the Future?

Last weekend the first part of a Scottish Social Care Special Report on the future of social care Post Covid-19 by Pennie Taylor, the former BBC’s Health Correspondent. It went out on Sunday’s @BBCWeekendGMS between 9.30 to 10am. In the report insiders shared their experience of working in what has become a a very pressurised system.

The report featured Annie Gunner Logan, Chief Executive of the Coalition of Care & Support Providers in Scotland, and Dr Donald Macaskill, Chief Executive Officer of Scottish care, the representative body of the independent care sector which includes private, voluntary and charitable organisations and #HighlandHomeCarers. In the report those interviewed discuss many aspects of the current commissioning system, which seems to be encouraging a ‘race to the bottom’ rather than the person focused care that everyone would like to see. They also begin a discussion on what a ‘National Care Service’ might look like and why it is not the panacea that many think it might be.

You can listen in to the report by going to this link within BBC sounds

https://www.bbc.co.uk/sounds/play/p08ns8b3

or alternatively by clicking here on the Good Morning Scotland listen back programme page https://www.bbc.co.uk/programmes/m000lspv

If you use the second link the special report begins at 1.32.20 and continues to 2.o2.59.

My favourite quote from the programme

“There is something wrong with a system when you can earn more for walking a dog in the city Edinburgh than you can for caring for a human being”

The second part is on next Sunday and I’ll be tuning in.

Dealing with the #PsychologyOfLoneliness

Loneliness is seen by many as one of the largest health concerns we currently face because it is reckoned that loneliness, living alone and poor social connections are as bad for your health as smoking 15 cigarettes a day. (Holt-Lunstad, 2010); is worse for your health than obesity (Holt-Lunstad, 2010) and lonely people are more likely to suffer from dementia, heart disease and depression (Valtorta et al, 2016; James et al, 2011; Cacioppo et al, 2006).

There are 1.2 million chronically lonely older people in the UK and half a million older people go at least five or six days a week without seeing or speaking to anyone at all (Age UK, 2016).

So this week the Campaign to End Loneliness has published a new report called The Psychology of Loneliness, which looks at how psychology can change how lonely people think and feel.

We know a lot about the factors that can lead to older people feeling isolated and excluded and the life events that can contribute or trigger loneliness in later life. However, we know much less about the ‘internal’ factors that can shape someone’s experience of loneliness and cause loneliness to become more severe. As loneliness is a subjective emotional response we need to understand its impact on individuals if we want to tackle it.

Understanding how psychological approaches can help ease feelings of loneliness and shape our response can help us improve support for older people who are lonely. The new report looks at how we can use psychology to help the millions who feel lonely. You can access the full report by CLICKING HERE.

Let’s make it #FairerforCarers

A good news day for care homes. Visiting to Scotland’s care homes can resume and the UK Government announced that for people who are living & working in care homes in England will receive regular COVID-19 tests from Monday 6th. July. The new testing regime will see Staff tested for the virus weekly while residents will receive a test every 28 days. These new measures will be in addition to intensive testing in any care home facing an outbreak or an increased risk of a surge in cases.

Too late you might argue, when you consider a study from the London School of Economics last month found that care home residents in the UK were more likely to die than in any of the other major European country, apart from Spain. The proportion of residents dying in UK homes was a third higher than in Ireland and Italy, about double that in France and Sweden, and 13 times higher than Germany. At least its a positive step in the right direction.

So how about another positive step in the right direction. Today, alongside 91 other organisations Carers UK have written to both the Work and Pensions Secretary and the Chancellor, calling on the government to urgently raise Carer’s Allowance as part of their #FairerForCarers campaign. Carer’s Allowance is the lowest benefit of its kind at just £67.25 a week in England and Wales. It’s slightly higher in Scotland at the equivalent of £76.10 per week so even the whole country matching this would be an improvement.

You can find out more about the campaign at https://www.carersuk.org/news-and-campaigns/campaigns/fairer-for-carers

Is it perhaps time to write or e-mail your MP about this?

See https://www.parliament.uk/get-involved/contact-an-mp-or-lord/contact-your-mp/

Under Attack: #UKStatePension

It was being reported this weekend that the UK Government is considering breaking a manifesto pledge on the triple lock for state pensions. The triple-lock was introduced in 2011 by the Conservative-Liberal democrat coalition government to check the decline in the real value of the state pension. Under the triple-lock, the UK’s state pension rises by a minimum of either 2.5%, the rate of inflation or average earnings growth, whichever is largest. In 2019, the Conservatives election manifesto said that they would keep the triple lock, which retains the value of the state pension ands also gradually increases its value in line with the UK economy.

Depending upon the circumstances, the UK’s 12.7 million retirees receive a state pension of between £134.25 and £175.20 per week – i.e. in the range of £7,000 and £9,110 a year. In comparison, the national minimum wage for someone over the age of 25 is £8.72 per hour i.e. around £17,000 a year. Many retirees therefore are living on almost half of the minimum wage.

The UK state pension is around 29% of average earnings, the lowest amongst industrialised nations, compared to the average of 63% in OECD countries. One method used by the OECD to compare the value of state pensions across the world looks at Pension Replacement Rates. This measures income from State Pension as a percentage of people’s pre-retirement take home pay. Figures from the OECD Pensions at a Glance for 2019 put the UK at the bottom of the table on this measure.

The proportion of retirees living in severe poverty in the UK is five times what it was in 1986. This is despite the UK requiring employees to save for their retirement through work related pension schemes. Inevitably, low wages have had the result that there are low savings made via private pensions. This has meant that for poorly paid employees, the state pension remains likely to be the biggest source of income in their retirement.

The trigger for possible abandonment of the triple-lock is the current furlough scheme under which the government is paying 80% of wages, up to a maximum of £2,500 a month, for around 9 million employees. When the scheme ends, and employees return to their jobs average earnings may dramatically increase which would trigger a big rise in state pension. It is claimed that removing the triple lock could save the government £10bn over 48 months. Although this sounds a lot, last year the government provided a subsidy of £7.1bn to privatised railways companies.

A big rise in the state pension in line with expected post-COVID wage rises could dramatically reduce pensioner poverty. Removing the ‘triple lock’ makes this a lot less likely.

We could afford to keep the triple-lock in place. The state pension being paid out of the UK’s National Insurance Contributions (NIC) which are accumulated in the National Insurance Fund (NIF). On the 31st. March 2019, the NIF had an accumulated surplus of £30bn. Maybe it is time to start spending some of this surplus. HM Revenue and Customs (HMRC) also admits that it fails to collect around £34bn-£35bn each year due to tax avoidance, evasion and errors. Other studies  put the amounts at between £58.6bn and £122bn a year. A focus on tax avoidance/evasion could easily raise plenty to provide decent pensions.

Rather than damaging an already poor state pension scheme, the government needs to ensure that eradication of poverty and a decent pension are part of the UK’s recovery plan. We need to take action now to ensure that current and future UK pensioners do not continue in potentially worsening poverty.

It’s time to write to your MP’s.

And I have not even mentioned the plight of WASPI Women.

#CarersWeek 2020 #MakingCarersVisible

Her Royal Highness, Princess Anne, the Princess Royal; possibly my favourite Royal because she follows the Scotland Rugby Team, through all their ups and downs; has recorded a special message of thanks and support for unpaid carers to mark this year’s Carers Week. The Princess Royal, who is President of Carers Trust talks about the indispensable role of unpaid carers supporting people who cannot look after themselves because of an illness, disability or mental health problem. She also highlights how hard is for the public to see, far less recognise, just what a difference unpaid carers are making every day to improving the lives of others. You can watch her video below just click on the play arrow.

 

New figures released this Carers Week  (8th – 14th June 2020) show an estimated 4.5 million people in the UK have become unpaid carers as a result of the Covid-19 pandemic. This is on top of the 9.1 million unpaid carers who were already caring before the outbreak, bringing the total to an estimated 13.6 million.

2.7 million women (59%) and 1.8 million men (41%) have started caring for relatives who are older, disabled or living with a physical or mental illness since the outbreak began.

You can read the full report here.

I might not be a fan of her political views but this video from Angela Rayner Chair & Deputy Leader of the UK Labour Party and Shadow first Secretary of State contains the message that I would like all current carers to here.

As Angela states I also have had many experiences of being a unpaid carer a well as a paid carer like many nurses and healthcare workers. In times of family distress it is often us that our families turn to with some expectation that we will take control and help no matter what’s going on elsewhere. If you are one of these paid and unpaid carers you have my best wishes, admiration and support. Almost always it’s the paid caring role that’s the easiest.

Carers ARE amazing, but it’s because they HAVE to be! So don’t just be sympathetic and  inspired by what they do take action to ensure carers are visible, valued & supported.

You could star by making a pledge for Carers Week at https://www.carersweek.org/

Matt Hancock the Health Secretary posted a video as well but for me adding that one would be a step too far…