Comments for http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html en-gb 30 Sat 01 Aug 2015 08:26:19 GMT+1 A feed of user comments from the page found at http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html Mtwain2011 http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=97#comment44 First of all the growing need for care homes puts a lot of shame on human life. The first question to be asked here is "WHEN YOUR PARENTS / GUARDIANS CAN HELP YOU IN THE FIRST PHASE OF YOUR LIFE (infancy), WHY IS NOT POSSIBLE FOR YOU TO HELP THEM IN THE LAST PHASE OF THEIR LIFE ?”Here we are talking about improving the conditions of the care homes, surprise inspections, localism and other stuffs. What in the world could be more important for a man than nursing his ailing parent? Is it not high time for the NHS to bring awareness on this aspect. Refer : http://www.nhscashback.co.uk/ After all, they (parents) are the ones that have brought us to what we are and where we are today. Let us all work together in keeping them happy and I am sure there wouldn't be a single person on Earth who would regret on doing it. Let us all have a united feeling and make all those care homes be extinct in the future. Fri 18 Mar 2011 12:11:02 GMT+1 PaulRM http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=95#comment43 Abuse, through absence of care, seems sytemic to me in the "caring" sectors of our society. Last week a friend's 90+ year old mother (with dementia) was being discharged from hospital following treatement for a broken hip that occurred at her nursing home. Transferred to hospital, they resolved her physical needs eventually, and told her daughter she would be ready to collect at a certain date and time. The daughter arrived and found that she had badly soiled herself, and was in a very distressed state. It transpired that, for medical reasons, it was necessary to apply a supository to "get things moving" before she could be transported. The medication had been administered, but she was then left unsupervised. The daughter having found her in a state, immediately sought out a nurse to help. She found two close by nattering away. When asked to attend she was told "we're busy", and that they would be along in due course.I can reapeat similarly stories of absence of care for my mother (still living) and my father-in-law (now deceased). During a stay with me, my mother had a catastrophic attack of pain sickness etc and an emergency dash to the hospital at 3am. The consultant, and his entourage, subsequently examined my mother and one of the students suggested the problem may be with the gall baldder. The consultant prompltly dismissed this, and diagnosed indigestion and discharged her 24 hours later with instructions to buy Gaviscon. Following a further occurrence of symptoms when back home, some bright spark realised something serious was going on, and the the result was thet her gall bladder had to be removed. My father-in-law, suffering from advanced Parkison's, was frequently admitted to hospital towards the end of his life, usually as a result of infections missed by his GP that were left to fester until they became life threatening. Because the Parkinson's was very advanced, his prescribed medication needed to be administered at precise intervals. However, the hospital failed to provide him with the specific drugs he needed and that worked for him, preferring to use generic alternatives. Further, they failed to administer them in a timley fashion, or on some occasions, not at all. On one admission, we were give dire warnings that his blood pressure was dangerously low, they were treating it but with limited success, and that we should prepare for the worst. The joke of it all was that my father-in-law had had unusually low blood pressure all his life, and this detail was documented in his notes that the hospital were notionally working from. When we told them this they looked at us is we were barmy and couldn't possibly know what we were talking about. Nevertheless, surprise surprise, the medication to lift his blood pressure was suddenly discontinued. On his penultimate addmission we were treated to an overhead convestation where the paramedics were told, in no uncertain terms, that this patient was too far gone to merit treatment, should not have been admitted, and should have been allowed to die at home. Instead, because he was now in a hospital bed, they would have to waste their time treating him AGAIN!, and that in no circumstances should that that be allowed to happen in future.I have little faith that the fundamental day-to-day personal care that we believe is being afforded to our most vulnerable patients in our hospitals and care/nursing homes up and down the country is anywhere close to what we thinks it should be - but how do we know when things are going wrong, as by definition, the most vulnerable are frequently not in a position where their voices can and will be heard.To abandon statutory oversight and rely on the "Big Society" as a means of monitoring the quality of services provided by these "caring" institutions is to create a legion of net curtain twitching nosy neighbours intent on sharing their opinionated misery with the rest of us. Not good enough. Tue 15 Mar 2011 23:55:40 GMT+1 yellowsandydog http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=93#comment42 How can a care home resident with no visitors to keep an eye on his or her standard of care, who may not be able to leave the home alone and who may be suffering from dementia, be able to complain about the care he or she is receiving? Tue 15 Mar 2011 18:18:02 GMT+1 General_Jack_Ripper http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=91#comment41 Peter_Sym wrote:Problem is what do you expect for the money paid?To be treated like a human being, at the very least.I don't get paid to work at our local youth club yet I still manage to treat the children with respect, care and compassion. I don't get paid to look after my neighbours but I still manage to treat them with respect, care and compassion. Regardless of how little care workers get paid the absolute minimum I expect from them is that they treat the people in their care with respect, care and compassion.My wife was a nurse and spent her entire life being paid a pittance, working very long hours, rarely had the resources to cope with the number of people in her care and had to deal with a lifetime of staff shortages yet she still managed to treat her patients with respect, care and compassion. I can remember when I first met her when I was staying in hospital and even though the nurses were under staffed, under resourced and had far more patients to deal with than the hospital was designed for she and all of her colleagues did everything they could to make the patients feel comfortable and we were treated with great respect at all times.It isn't a question of money or resources, it is basic respect and human compassion and these are free and limitless resources that are often ignored, and in some cases actively discouraged, by certain sections of the care industry that see old people as nothing more than a revenue stream to be exploited. Mon 14 Mar 2011 16:59:53 GMT+1 Peter_Sym http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=88#comment40 #38. Actually by confiscating all possessions, businesses, bank accounts and extracting gold teeth from the dead the Nazi's did make concentration camp victims pay.... Problem is what do you expect for the money paid? To stay in a cheap hotel room will be £50 a night without any sort of food or medical care. Who has £350 a week to spend for years in old age? The staff in care homes are being paid the same as burger flippers. Its not surprising they don't especially care about the job.Put me down for a Swiss clinic too. Mon 14 Mar 2011 16:01:09 GMT+1 Peter_Sym http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=86#comment39 My father does no private work at all. He gets a salary. He doesn't (and cannot) 'bill' for an operation. In fact he did a theatre list on boxing day effectively unpaid (as he'd booked it as holiday but had to go in for an emergency operation at 10 mins notice). At 61 he's still working 60 hour+ weeks. He sees approx 600 new patients a year and in clinic sessions has about 4 minutes per patient to talk to relatives. He doesn't have time for a game of snap, never mind golf during the day. He works in a cancer unit that serves 1 million people (of which 1 in 3 will get cancer) and which has 5 consultants. Do the maths.Nor is the money paid to private care homes paid from the NHS budget. Its paid by your local council. Hence the article "The council suggested a place: it had two-stars on the government rating and the leaflets looked promising" COUNCIL!!!!! Not NHS. My local council invested £50m in an icelandic bank. You don't need to tell me about council efficiency.I agree with you about agency staff (more or less) however. Mon 14 Mar 2011 15:26:44 GMT+1 Peter Galbavy http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=84#comment38 ----"Firstly care homes are usually either privately run (Dragons Den Dragon Duncan Bannatyne made his first fortune running them) or local authority. They have nothing to do with the NHS. Read the article again "The council suggested a place: it had two-stars on the government rating and the leaflets looked promising" thats not NHS. Its a private care home, probably with the costs part funded by the council."----The money is "paid" by the NHS to a private company. The residents very rarely have any say in the matter. Some, whose families care as in the story, have someone to stand up for their rights - many don't. Private companies are very often run by ex-NHS staff and doctors who understand the "system" and how to play it.----"Secondly, my father is an NHS cancer consultant, my mother was a midwife, my sister an NHS psychiatrist & my wife draws up theatre lists. None of them has 'siphoned off' so much as a penny. Do you think a midwife can rip off the hospital budget? If anything the opposite is true... the working time directive means junior doctors stop being paid after 48 hours of work a week but cannot go home if no-one else is available for 'on call' so end up working for free."----Ah, "consultants". Never an unnessary treatment or operation billed for, never an appointment abandoned for a game of golf but still "on the clock". Of course. Then look at the cosy relationship between "agencies", their useless staff many of whom would never pass an exam in this country, and those who hire them and not permanent nurses and midwives. There is plenty of corruption but for reasons of political correctness and collusion much of it isn't ever looked at. Whistleblowers are fired or even prosecuted to ensure the system is kept running. Mon 14 Mar 2011 14:38:13 GMT+1 General_Jack_Ripper http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=82#comment37 What's the difference between Auschwitz and a UK care home ?The Nazi's didn't charge their victims rent.Care homes for the elderly in the UK should be legally obliged to rename themselves as "Abuse Homes" as in many, if not most cases, this is all they deliver.I'm fast approaching the time in my life when I will no longer be able to stay at home, given the choice I'd rather commit suicide than go into a care home. Mon 14 Mar 2011 14:32:54 GMT+1 Peter_Sym http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=80#comment36 34. At 11:52am on 14 Mar 2011, Peter Galbavy wrote:When you break the link between the provision of a service and who pays for that service you very rapidly get what we have in the NHS. Uncaring, greedy and corrupt management running incompetent, greedy and corrupt staff. The few that are trying to do the right thing are usually rapidly sidelined by the gravy train passengers that revel in a complete lack of accountability and huge sums of money they can siphon off with no-one of any power noticing. My experience is that this applies in all areas of the NHS and not just the provision of care homes as in this story.________________________Firstly care homes are usually either privately run (Dragons Den Dragon Duncan Bannatyne made his first fortune running them) or local authority. They have nothing to do with the NHS. Read the article again "The council suggested a place: it had two-stars on the government rating and the leaflets looked promising" thats not NHS. Its a private care home, probably with the costs part funded by the council. Secondly, my father is an NHS cancer consultant, my mother was a midwife, my sister an NHS psychiatrist & my wife draws up theatre lists. None of them has 'siphoned off' so much as a penny. Do you think a midwife can rip off the hospital budget? If anything the opposite is true... the working time directive means junior doctors stop being paid after 48 hours of work a week but cannot go home if no-one else is available for 'on call' so end up working for free. Mon 14 Mar 2011 14:02:19 GMT+1 stracepipe http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=77#comment35 Years ago, my Mum let out her spare rooms to some men, from Wolverhampton, working on short term contracts in Essex. They were of Pakistani origin. During a conversation over our evening meal, I remember one of them saying "English people mock us because we cram three generations in the same house, but when elderly people die of hyperthermia, in winter, not one of them is Asian". I had to accept that he had a point. My great Aunt lived in a home for blind ladies, in St Albans (St Rapheal's - a really lovely place). We visited her regularly and she came to stay at least three times a year for holidays and Christmas. Most of the other residents never got visitors, or taken out, yet I bet their relatives fully expected to inherit. When my Mum was in hospital last December, in the last few days of her life, my brother & I stayed with her for three days (sleeping in our chairs). Of the five other ladies on that ward, only one had a visitor in all that time. Relatives moan about the care their 'loved ones' get but the reality is that too many can't be bothered to care for their 'loved ones' themselves. Mon 14 Mar 2011 12:52:59 GMT+1 Peter_Sym http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=75#comment34 8. At 9:52pm on 10 Mar 2011, Eamon Sloan wrote:Caring for the elderly? That's what I thought children were for. Honestly sending your parents to a home is practically abandoning them, sure home help can assist, but when it comes down to it care "homes" should be a utter last resort.__________________I work 40+ hours a week (as does my wife) to pay the mortgage on a starter home that is 2 bedrooms in name only. I can barely afford a pension, we certainly can't afford kids too. Our parents live 2 hours drive away (in different directions). I doubt if my situation is that unusual. I'd love to have the income that would let me own a house large enough to have my parents move in & for only one of us to have to work but that is never going to happen. Mon 14 Mar 2011 11:55:12 GMT+1 Peter Galbavy http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=73#comment33 When you break the link between the provision of a service and who pays for that service you very rapidly get what we have in the NHS. Uncaring, greedy and corrupt management running incompetent, greedy and corrupt staff. The few that are trying to do the right thing are usually rapidly sidelined by the gravy train passengers that revel in a complete lack of accountability and huge sums of money they can siphon off with no-one of any power noticing. My experience is that this applies in all areas of the NHS and not just the provision of care homes as in this story.If the genuine power to pay (or to not pay, which is maybe more important) the charges of a care home were placed in the hands of caring and competent relatives of the residents things would improve immediately and immensely. For those who sadly have no one who qualifies to manage this then it's important to find someone to stand-in BUT also to ensure this person or orangisation cannot benefit themselves from this involvement - wolves dressed as sheep-dogs guarding wolves disguised as lambs is not a good idea. Mon 14 Mar 2011 11:52:25 GMT+1 Mamacarole http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=71#comment32 Care homes are big business. I have looked at many and was appalled at the lack of staffing, quality of food and general cleanliness. I did complain to the relevant authorities but was told they are complying to the MINIMUM STANDARDS allowing fat cat owners to cream off mega profits - many staff are paid national minimum wage and food produced can be cheap and substandard.HOWEVERnot all homes are the same, my mum is currently in, what I consider the best, lots of friendly staff they know everyone's names residents and visitors, lots of activities, excellent food, encouragement to be in the lounges and not alone in your room, generally a fantastic place.My advice visit at mealtimes, take a note of the staff you see, what is the norm for the residents. The Government or local authority must take some blame for substandard care homes as they only give MINIMUM STANDARDS - if that is all they have to provide then thats all that will be provided especially as many owners of these homes own several.As for inspections, anytime without notice, if you are good you have no cause for worry! Sun 13 Mar 2011 09:26:19 GMT+1 newshounduk http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=68#comment31 As with most things involving the government the issue is money. Consequently, provision and monitoring is to a price not a standard.Whenever,governments find that something is too expensive they invariably scrap it and put in place a cheaper but inferior replacement.In an ideal world every family would have the resources and inclination to look after their elderly relatives but in the real world for one reason or another that is not always possible.In the past the government via councils did provide homes for the elderly but increasing costs of building upkeep,staff wages etc meant that in general these were kept to a minimum. Instead the baton was passed to profit-seeking companies and standards of provision became more varied.Ever rising costs meant that councils were forced over to the "Care In The Community" model with teams of carers serving a number of clients in their own homes.Though this model preserves the client's independence and dignity, it is not a sustainable model as the number of elderly is increasing faster than the birth rate and the cost and availability of transportation from the homes of carers to the homes of clients is affected daily.Eventually there will be not enough carers to look after the increasing number of available clients or there will be insufficient funds to employ them. Similarly if the cost of petrol/derv became unaffordable or indeed we ran out of fuel the carer service to clients would be seriously compromised or indeed rendered unworkable.Each of us needs to save and plan carefully for the time when we become elderly and strive to maintain our health, fitness and independence. We also need to see a return to the national community spirit of the past where old and young alike work together to support each other.As individuals we can do a great deal but as a team with a plan we can do so much more. Sun 13 Mar 2011 08:10:12 GMT+1 holly_bush_berry http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=66#comment30 I have always believed the notion of "care in the community" to be a piece of political doublespeke. Hospitals, long or short stay, have always been a part of the community too, and the fanciful idea people somehow get a better deal in smaller units than they may do in larger ones is at best naive.So was this tactical switch from one form of community care to another form of community care just a defensive ploy against the sharp attacks from the divided family, from the increased stress in the workplace, at home and in life generally? Has it failed because caring for the very frail and infirm, physically and mentally, is costly in terms of effort and, therefore, price?I have witnessed at close quarters the so called professional approach to the most vulnerable in our society and it is hardly endearing of human beings and their methods. At best there is wonderful care from people who have deep compassion for others but at worse, which is where the measuring needs to be done, it is a job just like moving heavy cardboard boxes around a warehouse and if a box gets stuck you just kick and shove it until it moves. How do you cure this? Make human beings less mercenary and more aware of what they may face when they too get old. Sun 13 Mar 2011 07:24:40 GMT+1 audra http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=64#comment29 8. At 9:52pm on 10 Mar 2011, Eamon Sloan wrote:Caring for the elderly? That's what I thought children were for. Honestly sending your parents to a home is practically abandoning them, sure home help can assist, but when it comes down to it care "homes" should be a utter last resort.Your post has such an accusatory tone to it. I am sure the individual in this article DID use a home as a last resort. And I don't know if you have ever tried caring for an elderly parent or even a grandparent, but it's not that simple. When my great grandmother was no longer able to care for herself, my mother brought her home to live with us. It was nearly impossible to care for her with school and jobs, etc. It was heartbreaking, but a home and 24 hr a day care was what she needed. You need to be less judgmental of others! Sat 12 Mar 2011 04:18:25 GMT+1 jon112dk http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=62#comment28 28. At 8:09pm on 11 Mar 2011, BluesBerryI agree with you in the normal course of events, but please consider the good people who genuinely can not keep their loved one at home.There are over 600,000 people with dementia for example and some of the people really do present issues which genuinely can not be managed at home. (See #13) Fri 11 Mar 2011 21:04:52 GMT+1 BluesBerry http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=60#comment27 Rethinking the type of soceity that we want to live in:I blame a lot of this sort of stuff on our societal structure. e.g. What kind of a man lives with his aging parent? What sort of woman marries such a man?My mother is 95 years old and she lives with me. There is no reason for her to be in an old age home home. (She cooks better than I do!)Yes, I have to do some things for her which have to do with incontinnency and a lack of balance, but it's not that hard. When I take her hand to go up ther street, I feel the intensity of the bond between her and me.My mother has had the oppirtunity to hold her first great grand-daughter, rock the child to sleep, and come to know the new feisty little personalty.I believe that my mother has lived as long as she has because she feels needed, does what she can for herself & others, has companionship, and must feel a part of the great circle of life: You get born; you likely give birth; you live out your life and you die.But where on earth did the west get the idea that old people are always, except perhaps in the case of dementia or other severe handicap, throw-aways - best kept at a distance, best thought about rarely. In this way, you won't feel their death as part of the cycle of your life.Is it little wonder that young people have lost touch with older people, lost respect, find them boring and senile? Where do the young learn to respect the old, be gentle with them, learn from the old?I hope to have my mother with me for many years to come; I hope she has the opportunity to tell my grand-daughter what things were like when she was young.I believe in the creation of Old Folks' Homes we may have gone overboard; these homes should be restricted for those who cannot care for themselves - even on a temporary basis - but essentially older people belong to their families just as their families belong to them. Fri 11 Mar 2011 20:09:01 GMT+1 PaulRM http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=57#comment26 Echoing #25, the idea that one should rely on word of mouth, whilst notionally attractive, is fundamentally flawed. Firstly, think of the challenge of finding skilled tradesmen (eg - plumbers, electricians, etc). One is encouraged to ask friends and neighbours for advice, but a brief analysis shows how problematic this can be. There are countless individuals, small firms, and conglomerates that offer such services. Most of us have an infrequent need to call on such tradesmen, and may only have knowledge of one or two providers at best. On reflection, one can hardly refer to one's experience as extensive or comprehensive. The best one can say is that A was better than B, or that C was absolutely terrible and should be avoided at all costs. Hardly a wholly reliable route. Ultimately, it's a punt in the dark, and a hope for the best. Imagine translating this process into a care home environment where the scope for recommendations is so much more limited, and by definition second hand, and you have a recipe for sleepless nights and anxiety. Short of installing a webcam, one has no real idea what is going on, especially if the care home resident is intellectually challenged and significantly dependent on others for their day-to-day care.Secondly, consider the options for self-regulation. Independent of the state, the care home industry decides to create its own rating system. This raises the question as to who will police it. As with the aforementioned trades, and along with many other industries most notably hospitality, a number of "overseers" emerge to provide a notional management of standards and behaviour. The problem is, one rarely finds a single source for such information. In hospitality, of which I have direct knowledge, one has three independent primary bodies responsible for assessing standards and awarding "national" gradings. Added to this are numerous other organisations, usually publishers, adding their three pennyworth to the process. The thing one always has to remember is that each of these grading bodies is a standalone business, and their purpose is to make a profit. They do that via the subscriptions of their members, without whom they have no business. So, the first lesson one discovers about these bodies is that their loyalty is to their members, without whom they would disappear. Further, by the very existence of multiple awarding/grading bodies one creates competition. I have direct knowledge of one hospitality grading body offering to increase my grading if I would award them exclusive assessment rights. Small beer when compared with the potential life and death risks if one chooses the wrong care home, but nevertheless it amply demonstrates the inherent dangers/temptations of self-regulation.Thirdly, consider the creation of something like TripAdvisor for care homes as a means of widening the net of consumer experience. The idea may seem superficially attractive. However, those posting opinions do so from a highly personal, and potential irrational, viewpoint. How often does one look at something like TripAdvisor and see the same provider graded as both 5* and 1* on the same page. Without a coherent set of measurable standards, such ratings are effectively meaningless. And let us not forget, TipAdvisor is open to abuse - both by users and providers. Users who feel miffed for whatever reason will mark a provider very poorly. I had one individual complain bitterly about my Guest House and the level of service. Our crime - we discovered he had taken items from the mini bar with the intention of not paying for them. Having placed the items on his account, the "guest" became extremely aggressive and offensive when asked to pay for the "overlooked" items. On top of this one has competitors writing bad reviews simply to lower one's overall score, or conversely owners using false identities to log highly favourable reviews. If you think I am making this up, people should be aware that TripAdvisor is currently being challenged via a class action over potentialy defamatory entries that have found there way onto their system. In matters involving the health and well being of our societies most vulnerable citizens, the minimum oversight required is a statutory body with a clearly defined and measurable set of standards that are applied to all members of the care home industry, with sanctions and penalties commensurate with the responsibilities they discharge.Will it happen under this administration - what do you think.PS - to those who think one's children should carry thr burden of care for their parents when in their dotage, consider those without children - if there is nobody is there to care for them, should they be euthansed? We are after all, bent on cutting costs no matter what, aren't we? Fri 11 Mar 2011 19:45:02 GMT+1 kaybraes http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=55#comment25 Whatever happened to children taking responsibility for the care of their ageing parents ? Problems this brings aplenty, but it is sad that there appears to be no sense of moral duty of care in families in this country nowadays. In most other countries and some of the poorest , the old are venerated and in the main, cared for by their children. Britain has developed a culture of " let somebody else do the dirty work , it's not my responsibility ". Fri 11 Mar 2011 17:01:35 GMT+1 U14810892 http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=53#comment24 Finding the right care and support can be extremely challenging, especially because it is normally being done at a time of crisis.For a number of years I have been working with local authorities on the provision in their areas and it is clear to me that while the bulk of it is excellent there are inevitable areas where it is much more patchy.Perceived and regulated quality are really important factors when looking for care, so it is important that people always look for the latest rating from the Care Quality Commission (or other regulatory bodies where possible) and check the latest reports. Although far from perfect, these are the best indicators of quality currently available. Feedback from other users of the facility can be helpful but can be open to abuse. The use of an independent search system to find the right care and support for specific needs is by far the best way to go. Fri 11 Mar 2011 16:09:57 GMT+1 John Ellis http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=51#comment23 Westminster council to cleanse Westminster of the poor the sick and the unemployed.http://www.westminster.gov.uk/services/housing/housingoptions/hphoptions/housing-benefit-changes-april-2011/ •If you do not make up the shortfall in your rent, take insufficient action to resolve the situation and are evicted for rent arrears, you could be considered intentionally homeless. You should do everything you can to avoid this, including contacting HOS before it gets to this stage, so we can advise you how best to resolve things.http://www.westminster.gov.uk/services/housing/housingoptions/hphoptions/homeless/Intentional homelessnessYou may be intentionally homeless if you lost your home as a result of something you have deliberately done, or failed to do. It is impossible to list all the ways you could become homeless intentionally, however one of the most common is if you are evicted from your home because you did not pay your rent when you could have. Another is if you give up your home when it is reasonable for you to continue living there. Fri 11 Mar 2011 15:49:21 GMT+1 jon112dk http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=48#comment22 20. At 1:01pm on 11 Mar 2011, MarnipJust the same old rhetoric again: labour left no money, snooty has to make cuts.Sorry, not buying that one either.The tories are using the economy as a pretext for ideologically motivated cuts. Let's not pretend they love the public sector and are doing all this with a heavy heart. 'Once in a generation opportunity' is another way of describing it.The level of anger is steadily increasing and people are starting to react. My response is simple ...1) Tory government makes cuts - they take responsibility for outcomes.2) I don't work for free under a tory government. Fri 11 Mar 2011 15:35:24 GMT+1 JunkkMale http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=46#comment21 'relying on residents and their families alerting the authorities to problems.'Not much use if there is no accountability at the end of it. Presuming inspections are competent in the first place.I am at Parliamentary Ombudsmen (typically, even by this point, there are duplicating, competing and hence gap-strewn oversight systems staffed up the whazzoo) stage of a complaint that is now in its second year.Interestingly, with scores of folk and hundreds of man-hours consumed not 'learning lessons' that could be devoted to better care, the sheer complexity of the backside covering systems have caught up with them, and all oversight bodies are scrambling to explain how the owner of the care home also happened to be the senior partner of the GP surgery that 'looked after' the residents.Seems none of those involved in yet more systems and gold stars, etc had ever heard of, or considered things like 'conflict of interest'. Fri 11 Mar 2011 14:46:46 GMT+1 yttrium http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=44#comment20 It would be useful to know exactly how long the outgoing inspection based system had been in place so the readers could judge for themselves if this was an adequate time period for it to "bed down". It would also be useful to know if Judy Downey's assertion about whether old systems of self regulation v top down inspection are borne out by the statistics.There is also a difference in that over the last ten years the internet has changed everything and people are now far more willing to give their opinions and trust advice given by other people. Maybe this form of localism hasn't worked in the past, but communication and attitudes have changed significantly since 1997.Ironically the Relatives and Residents Association is in a prime position to affect real change on the providers of care because the system will be looking for feedback and alerts from users of the services rather than being a deaf bureaucratic bunker answerable only to Whitehall. Fri 11 Mar 2011 13:36:40 GMT+1 Marnip http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=42#comment19 Yes, always Tory dogma. You see, the problem with accusations of dogma is that it's the go-to option for stupid people. It consists of ignoring the possibility that people espouse what they honestly believe to be correct, instead choosing to label it as something with conspiratorial and cult-like undertones.It's just so easy to hide behind when those pesky facts don't say what you want them to.The public services need a vast overhaul, whether you like to admit that or not. a decade of living outside our means, a decade of adding to the debt, and even after the next 4 years of hard times we won't even have begun to lower the debt; rather we will have increased it by less and less. That's what perhaps your ilk don't get. We're actually slowing down the growth of the debt, not paying it off. If you consider the measures being imposed unnecessary after having it presented to you in that way, you simply will never get it.Who suggested coaching childrens' football teams made up for billions of pounds worth of cuts? The point you keep avoiding is that those billions of pounds worth of cuts have to be made. They would have to be made if I sat on my backside and did nothing, which incidentally seems to be your preferred option.And here come the excuses; volunteering is unethical in current circumstances. Sorry, but that doesn't even dignify a response.I hate to have to point it out to you again, but that money that paid for that person to have that job and earn a living was BORROWED. Do you not understand this? We could not afford that job. The money that pays the public sector all comes from taxes, and when running a deficit of 150bn a considerable proportion is simply on credit card.Now, if you think it's justifiable to bankrupt the country so that the public sector can provide jobs, you might as well join the Labour party you spend your time pretending not to like, whilst espousing their precise economic model. You are the Labour Party, and what a surprise, you don't have any ideas different from the past.Just provide jobs, provide services, borrow the money you need, ignore any long term problems. Fiscal irresponsibility. Fri 11 Mar 2011 13:01:27 GMT+1 jon112dk http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=40#comment18 17. At 11:56am on 11 Mar 2011, MarnipJust more tory dogma.You are simply repeating the same old message - tory government is enforcing the biggest destruction of public services for decades, but they are not responsible for any of the outcomes. Unfortunately for you tory types, no one is falling for it. You've done a few football games for kids? Excuse me while I laugh if you think that is going to make up for billions of pounds lost from services and hundreds of thousands of full time jobs cut.But beyond the ludicrous practical failings of BS, there is a point of principle.Previously I would have been happy to volunteer and have done so. In the current context I regard it as unethical. I will not do for free, work which used to provide a job for a real live person and a livelyhood for a whole family. Particularly when it is clear that any savings are to be transferred to an unethical government's rich backers.BS is a scam. If the tories make the cuts, then the tories take accountability for the results.Tories: taking labour's mess and making it worse. Fri 11 Mar 2011 12:20:53 GMT+1 Tom http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=37#comment17 People on benefits and very low income can get legal aid to challenge cuts. If the ladies life expectancy is likely to be reduced by the conditions at the care home it is very likely she would get legal aid. The Government has cut resources for monitoring care homes. The court would consider if adequate consultation took place before the cut and if the cut is appropriate. A charity called Public Law Project who have Big Lottery funding can advise on this, how to get the legal aid and which solicitors have specialist knowledge and a track record of success. Fri 11 Mar 2011 12:13:21 GMT+1 Marnip http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=35#comment16 16. At 10:33am on 11 Mar 2011, jon112dk wrote:"I don't think tories are subhuman - I think they are closer to psychopaths: an enduring inability to care for others."Yet, the PM lost his father and son in recent years. I'm sure he didn't bat an eyelid. It's this kind of attitude that makes me question your relationship with reality."BS not a cover up?"Nope. I didn't think it was secret that it was a plan to help ease the effects of the cuts. Not only that, but it's a good thing to encourage at any point in time. Or did volunteering suddenly become a bad thing? No one's forcing you to do it, either."To shut down services for vulnerable people then make some vague comments about local people will step in to do it for free is truly BS - in all it's senses. Likewise localism: central government make the cuts, local government cops for criticism."No, central government sets the budgets, local governments make the cuts. As you can see through Liverpool Council, who chose to cut their chief exec's salary by 3% whilst the overall cut was 8.8% across the council - then had the audacity to claim they couldn't possibly be more efficient without cutting the front line.No, they are liars, and it's not an opinion, it's a mathematical fact that the Labour controlled Liverpool Council introduced regressive measures. They won't be the only one, and they're the ones full of the BS thanks to their nice high salaries."With either one, I'm not falling for it, and a lot of other people are coming to the same conclusion."Otherwise known as believing everything you read from the sources you already have a bias towards. Poor reporting, and people like you spreading misinformation, when there is objective mathematical fact behind my accusation that councils are implementing regressive measures."If you're so keen, lets make YOU redundant and you can live in poverty while you work looking after local old folk for free."If you're so keen, why don't YOU give up the majority of YOUR wage to help the poorest members of your community? Get down off your high horse; you can't argue with the financial facts so you make up some ideological claptrap that isn't there. For your information, I just started working as it was so difficult to find a job. Why? Because the private sector was crowded out by the last government expanding the public sector. They kept people happy, bribing them with their own money until it couldn't be done any more.And we all fell for it. Wakey wakey, time for something new."Please tell me if you are willing to volunteer. If not, then stop expecting other people to do it."Indeed I am. Again, no one is being asked to, it's simply encouragement but you make it sound like forced labour. Actually, I've volunteered as a football coach for kids times a few times, zero salary, despite me paying for the FA badge I have out of my own money.Now, exactly what problem do you have with volunteering, given the cuts have to be made as we are borrowing every single year (and will be for the next 5)? Fri 11 Mar 2011 11:56:50 GMT+1 jon112dk http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=33#comment15 14. At 09:37am on 11 Mar 2011, Marnip wrote:Seriously, some of you need to grow up. Obviously you want to take shots at the Conservatives for anything you can possibly find, because Tories are sub-human. Tories don't have families including elderly relatives, or children. Cameron only cares about himself and the banks, and has a cold, black heart.=============================I don't think tories are subhuman - I think they are closer to psychopaths: an enduring inability to care for others. Of course all these issues have not started with tories (see #6). Labour left a mess and the tories are making it worse, not better.BS not a cover up? To shut down services for vulnerable people then make some vague comments about local people will step in to do it for free is truly BS - in all it's senses. Likewise localism: central government make the cuts, local government cops for criticism. With either one, I'm not falling for it, and a lot of other people are coming to the same conclusion. If the tories make the cuts then the tories are accountable for the outcomes.If you're so keen, lets make YOU redundant and you can live in poverty while you work looking after local old folk for free. Please tell me if you are willing to volunteer. If not, then stop expecting other people to do it. Fri 11 Mar 2011 10:33:29 GMT+1 mr beige http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=31#comment14 If you remove oversight then taken to its inevitable conclusion there would be no need for any government department at all! That said surely it is up to the users of any system to moan and complain if they are not getting the service they deserve and as other s have noted on here, inspections can mean whatever you want them to. Though I understand this would be awkward for the many people, after all they are old and vulnerable, surely their children who are regular visitors (unless treated as orphanages for the old and a dumping ground for families who don't care less) can monitor standards properly - let's face it old people don't fit conveniently in our modern lifestyle choices of today! Fri 11 Mar 2011 10:21:07 GMT+1 Marnip http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=28#comment13 13 years of a Labour government, and suddenly people are acting like these problems began with the Coalition under a year ago.Seriously, some of you need to grow up. Obviously you want to take shots at the Conservatives for anything you can possibly find, because Tories are sub-human. Tories don't have families including elderly relatives, or children. Cameron only cares about himself and the banks, and has a cold, black heart.So incredibly disingenuous. Failures in policy initiatives tends to imply you're using the wrong ideas, so perhaps you should switch.As for the Big Society being a cover for cuts, it's not. It's quite clearly to make up for cuts; there's no covering up anywhere. The cuts are being made whether you like it or not, because they have to be. Now, you have a choice of the government offering no encouragement on how to reduce the impact, or the government promoting helping out in your own community.What exactly is your problem with the suggestion that people should be involved in the place they live in? Is this evil? No, there's nothing wrong with it whatsoever, and should have been encouraged for the past 14 years rather than paying someone else to do it - as per Labour.Stop pretending there's some conspiracy. The BS is to cushion the effects of the cuts, and there's not a damn thing wrong with that. Fri 11 Mar 2011 09:37:46 GMT+1 jon112dk http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=26#comment12 8. At 9:52pm on 10 Mar 2011, Eamon Sloan wrote:Caring for the elderly? That's what I thought children were for. Honestly sending your parents to a home is practically abandoning them, sure home help can assist, but when it comes down to it care "homes" should be a utter last resort.========================================If you are one of the people who do care for dependent relatives: well done. But the way you phrase that, I don't think you are.For the people who can actually get into a care home, caring for them is a full time (24/7) job.Example: old chap with dementia. Attempt to keep him with wife in his home. He has no sleep pattern - up all night to no sleep for the wife. He no longer knows who she is so he resists her care. He is incontinent so needs changing and cleaning up from both urine and faeces multiple times per day. All those clothes and bed clothes need washing/drying. He wanders out of the house, gets lost, is at risk on the roads. In the house he leaves the gas rings on without lighting them. He leaves flamable materials on top of the cooker and the electric fire. He need literally constant supervision - but this is supposed to come from one old lady.Would you care to take that on? In your own home? Would you be willing to give up your job and live in poverty to do it?All of the things in that description need professional help and in some cases they need residential care. Fri 11 Mar 2011 09:30:03 GMT+1 Jules http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=24#comment11 Reduce crime by ending drug prohibition, increase trust. Job done. Politicians listening? Fri 11 Mar 2011 01:35:13 GMT+1 Kiki http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=22#comment10 More power to Dave, I'm pleased he found somewhere safe for his Mum. The point is not every elderley or disabled person has interested relatives to fight their corner. I've worked in homes and the number of residents with visiters was much less than half. Combine that with a large proportion of the residents suffering some kind of degenerative cognition and you have a group of people who are unable as well as unwilling to voice any concerns. Horror stories abound. When in one home I noticed a woman crying, when I went over and asked her what was wrong she said I was the first person to speak to her for 2 months - she had been washed, dressed and fed every one of those days. I have also cared for relatives at home. My father-in-law had dementia and caring for him was a full time job for both me and my partner. It required both of us to move him, change him and wash him and we took shifts to watch him as he had forgotten he couldn't walk any more and would try to, leading to injuries. We then had to care for his mother, who has MS. We both lost our jobs over it, despite remonstrances to the council. Social Services had obviously decided that if they offered a 'care package' that was terrible enough, my partner and I would have no choice left but to quit work and care full time.Caring, both privately and professionally, is one of the hardest, most draining activities I have ever experienced, yet we expect it to be done for 'love' in the case of relatives, or minimum wage professionally! Until we start to appreciate the weight of the burden of care and reward those who undertake it appropriately, we will continue to face the horror stories we're are all used to hearing as underskilled, undertrained and mismanaged care homes and care packages remain the norm. Fri 11 Mar 2011 00:10:07 GMT+1 PaulRM http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=20#comment9 It is obscene what this government will do in the name of "localism" which is just another way of saying "cut costs when it involves the weak and the vulnerable" as by definition, they are ill equipped to fight back.Without an overarching indepenent assessment methodology all is hearsay and muddle. It comes down to A's word against B. Just how will the individual be heard, or more to the point, achieve redress when things go wrong. The individual has no access to records, data, and the plethora of paperwork that is used to hide what really goes on - and obtaining access is something any good solicitor working for the care home can redact and withold indefinitely. The individual citizen will always come off worse when dealing with organisations like councils and large (and anonymous) corporations providing services to the public. Such bodies are well practised in the techniques of obfuscation, deflection and delay - they are, after all, inherently places of bewildering bureacracy staffed by those with a penchant for annoying people because they can. For councils it often appears such behaviour is their raison d'etre, with the public they serve having no right to know anything.When dealing in matters involving the physical and mental care of people we already have a splendind example in the NHS of how the rights of the individual are easily lost in the arcane practises of medical negligence complaints. I have the unhappy benefit of knowing a solicitor whose job it is to "represent" health professionals and their associated organisations in such matters. The watch word in these cases is delay - delay as long as you possibly can, especially where a successful complaint could involve large sums of compensation, and hope that the complainant will give up or, more satisfyingly from the defence teams point of view, die. We are not in this together, we never were and never will be. In the battle between David and Goliath, Goliath will always win out. Thu 10 Mar 2011 23:55:31 GMT+1 meninwhitecoats http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=17#comment8 Things have not been perfect for a long time even with the CQC, care providers have been able to offer substandard care and there have been many horror stories.With regard to home care the CQC used to send out surveys to care users or their relatives to freely express their opinions of the provider, perhaps a similar system could operate for homes, coupled with a board of independent governers with responsibility to monitor that standards are being met.I do agree that children should take more responsibility for their parents care but there are undoubtedly circumstances when this is not possible and residential care is the only option. Thu 10 Mar 2011 22:36:03 GMT+1 Eamon Sloan http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=15#comment7 Caring for the elderly? That's what I thought children were for. Honestly sending your parents to a home is practically abandoning them, sure home help can assist, but when it comes down to it care "homes" should be a utter last resort. Thu 10 Mar 2011 21:52:09 GMT+1 CASTELLAN http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=13#comment6 This is nice as I have been advised well in advance of who you are and what can be gained through a mutual and convenient process of dialogue with the minimum amount of fuss and inconvenience. With no further concerns upon reputation because a organised and structured oversight authority makes regular checks throughout the entire network of these trusted and publically owned resource at regular intervals under constant official scrutiny and indemnity.With the cost of a accident and professional negligence we all see a rise in accountability and the trust is still the same by any name. And you all live to trade for another care free day away from the watchful gaze of the madam guillotine upon such is life without liability. Thu 10 Mar 2011 21:47:46 GMT+1 jon112dk http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=11#comment5 Mark - I think my opinion is already clear on localism: a scam to cover up cuts.But this one is not just down to the tories.I think people need to realise that a lot of what you describe as 'regular national inspection' is in fact form filling - much of it 'self assessment'For example a local hospital got top marks for financial governance. If you look into that, it just means they have a policy for X, a clearly nominated person responsible for Y etc, It has nothing to do with how they actually manage the money.The assessment is made by the trust 'self assessing' - they fill in a form and tell the CQC they have those policies.If you know the inside story you learn that this hospital is near bankrupt. They are crippled by PFI payments. The last chief exec got the push due to that PFI deal and the financial state the trust is in. They had a recruitment freeze for three years, not a single nurse to replace those leaving by natural wastage, leading to real decline in clinical standards. ... and yet they got top marks for financial governance.We need to go back to the old model. Investigate complaints: yes. But also good old fashioned inspections by teams of experienced clinicians. No tick boxes: experienced people know what is right and wrong. Thu 10 Mar 2011 20:31:28 GMT+1 studentforever http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=8#comment4 I am single with no family living nearby - there are times when a cyanide pill to hand in case of emergency seems essential. There are good homes, relatives have been in them, but it can be difficult to find one if you have to go in as an emergency and, even if you know where you would prefer to go, there is no guarantee of a vacancy. Scary, scary prospect. Thu 10 Mar 2011 20:19:33 GMT+1 watriler http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=6#comment3 "balance of power is shifting dramatically - away from the centre and towards councils managing their own future, and empowered local communities holding them to account." But not with the resources provided by central government! If you believe their tosh you will believe anything. The provision of social care was not exactly in an ideal state under the last government when privatisation seemed to be the watch word at least at local authority level. The guardians are employing other guardians to keep an eye on the former and this is reflected in the gradual demise of the district audit service who soon will not have the audit commission to keep an eye on them.The agenda behind the Big Society is the dismantling of the welfare state and Cameron is the Attlee of the right wing! Thu 10 Mar 2011 19:56:14 GMT+1 bugsy60 http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=4#comment2 Why haven't you named this sub-standard care home and the individuals responsible. My mother has recently left UK because she is 80 and frightened of how she will be treated in a care home. The treatment given to the lady in the article is indicative of government attitude to the elderly. There is a quote somewhere which says that you judge a society by how it treats its old people. Well , we fail miserably. After 40 years of working and saving the govt will take away what you have strived for to pay for your 'Care!'. You may pay care home staff more but if they have this intrinsic lack of respect for the helpless then nothing will change. The fact is we have a regime at several levels which pays more attention to Foreign Policy, being something in the world than about its own citizens. If we spent as much on care as we do on killing we would be making a very valid public statement. Thu 10 Mar 2011 19:22:23 GMT+1 John_from_Hendon http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=2#comment1 Sound's like a job for 'Big Society'! All care homes should be unable to refuse entry and inspection by anybody at any time - a nosy neighbours charter! They should put the fear up em all! No well run home would resist. These random visits should be reported to the local MP for action. Thu 10 Mar 2011 19:10:12 GMT+1 Have your say Rejected http://www.bbc.co.uk/blogs/thereporters/markeaston/2011/03/care_and_the_community.html?page=0#comment0 I worked in the care industry for over a decade. Inspections were a joke, what's the point in having an announced inspection. Inspections consisted of a couple of announced inspections a year and if you was lucky an unannounced one would not happen for years. On top of that, if you pay people peanuts you get monkeys(they still get paid peanuts), which is exactly what happened in care before the last Government introduced NVQ's in care, they attempted to make it a profession which people could respect. This has knock on effects for the people in care, if the staff feel valued then they do a better job, and the service users get better treatment, but conversely if you treat them like scum and pay them minimum wage then they will have no respect for their job or the service users. The best way to improve the standards for service users is improve the working condition for the staff. Who would you want looking after your mum, a 18 year old(no offence too 18 year old's, some were great at their jobs) on the minimum wage or a professionally trained health worker on a decent wage. Thu 10 Mar 2011 18:48:54 GMT+1