@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

#WorldMentalHealthDay Mental #HealthforAll

Today, Saturday 10th of October is World Mental Health Day. This day was created as a programme for the World Federation for Mental Health and was observed for the first time on 10 October 1992. Prior to COVID-19 we already faced a world where mental health conditions on the rise. In 2001, about 450 million people lived with mental disorders. One person in every four will be affected by a mental disorder at some stage of their lives while mental, neurological and substance use disorders exact a high toll on health outcomes, accounting for 13% of the total global burden of disease (WHO, 2012).

The World Health Organization (2018) highlighted that every 40 seconds someone dies by suicide. Annually, this represents over 800,000 people that die by suicide, which is more than people dying by war and homicide put together.

This bleak picture necessitates that we ensure that mental health is prioritised now more than ever before. The WHO and UN drive for universal health coverage a key target in the sustainable development goal for good health and wellbeing. Universal health coverage has to means that all people have access not just to quality physical health services it has to include access to mental health services when and where they need them. 

The World Federation for Mental Health have released a report today that looks at Mental Health for all and calls for greater investment and greater access to mental health services. You can download the report from here

There is lot to read and think about in here but for my students there is a section by Professor Benjamin Wright, on ‘Investing in psychological therapies – the UK model’


@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

World Alzheimer’s Month #WAM2020; Its World Alzheimer Day on 21st!

September is World Alzheimer’s Month and tomorrow the 21 September each year is World Alzheimer’s Day. There are a number of events taking place across Europe, see https://www.worldalzmonth.org/events-in-europe Strangely the UK events aren’t on this list.

So on the 21st of September Alzheimer Disease International will release its annual report for 2020. This year the report called Design, Dignity, Dementia: dementia-related design and the built environment will look at design progress to date, best practice, pioneers and innovators across multiple environments including in home/domestic settings, day and residential care, hospitals and public buildings and spaces. The report as always will take a global perspective of dementia related design that takes a cross cultural approach, reflects regional and economic differences and low- middle- and high- income countries, and will consider urban versus rural settings. It will highlight the role of innovation, entrepreneurship and the importance of aesthetics. To find the report visit this page tomorrow: https://www.alz.co.uk/

So what else is going on across the UK. BBC Radio Scotland is running a series of radio programmes looking at Dementia beginning with the Afternoon Show tomorrow and watch out for #MemoryRadio with Bryan Burnett.

The Alzheimer Society World Alzheimer Month Page is at https://www.alzheimers.org.uk/get-involved/world-alzheimers-month

You might also want to follow #WAM2020 and post out your likes, tweets and retweets across themonth

Dementia Alliance International a collaborative established in January 2014 of like-minded individuals diagnosed with dementia provide a unified voice of strength, advocacy, and support in the fight for individual autonomy for people with dementia; are also posting daily to their Blog across the month; see https://www.dementiaallianceinternational.org/blog/

Play your part this month and #LetsTalkAboutDementia

@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.

@TheLancet Dementia Commission Update 2020

At the end of July, the Lancet Dementia Commission published its update to their 2017 Lancet Commission on dementia, prevention, intervention and care report. The Lancet Commissions original paper highlighted 10 things everyone needed to know about Dementia See my original post about that paper from 3 years ago at https://raymondsolderpeopleblog.wordpress.com/2017/07/21/ten-things-we-need-to-know-about-dementia/

This time Lancet Commission report emphasises the need to be more ambitious in our views about dementia prevention and expands the number of known modifiable risk factors from 9 to 12. Now included are head injuries in mid-life, excessive alcohol consumption in mid-life, and exposure to air pollution in later life.

The Commission estimates that 40% of dementia cases could be prevented or delayed by targeting the identified 12 modifiable risk factors. Surely it is worth trying to reduce the worldwide impact of these diseases.

The 2020 Commission update also lays out a set of policies and lifestyle changes to help in this goal. To get a copy of the full report go to https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30367-6/fulltext

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/

@BloggersNurse Challenge: My Best Days in Nurse Lecturing

I am posting for the challenge at the last minute again. I have to say that this is one of the most difficult topics for me to write about. As a Nurse Lecturer I often think the best days are behind me and that I was probably more effective when I was working in Acute Care. My students probably think the same most of the time, even though they are too young to remember me from those earlier career days.

So I am not attempting a history/reminiscence lesson here. I am going to be quite predictable and pick my student’s graduation days. They are a once a year reminder of why I do my current job.

It’s not about me at all; the day is all about them and how they feel when they are finally awarded their Master’s Degrees. Nothing makes me happier in work than seeing how proud they are when they finish. Many have overcome many obstacles to get to the end of their programmes. These can include, family hardships including deaths within the close family, financial concerns, acting as carers to their children and often a carers to their parents as well. Many deal with personal illness and in some cases are also faced with a lack of support for all their effort within their workplaces, that I sometimes fail to understand.

They all show great perseverance to get to the end no matter what good or ill befalls them. (More about this whole topic at another time when I finally get to the end of my own Doctoral studies.) So the picture I have chosen to head the article is my favourite picture from last year’s graduation and I am not even in it.

For the sake of balance I thought I’d better show a few more successful students with my colleagues. You know who you all are (and a big sorry to the students who are not here!)

2019
2018

For those of you who don’t know, I am the Programme Leader for the Gerontology Programmes at the University of the West of Scotland. You can find out more about our MSc in Gerontology (with Dementia Care) programme by CLICKING HERE

You can also find out about the other work I am involved in by following @AlzScotCPP on Twitter or going to the Facebook page of the Alzheimer Scotland Centre for Policy and Practice. You can get to this by CLICKING HERE.

Please ‘Like’ us when you get there!