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Blog

Adam Hutchison's Blog - just a little space in the world were i air my thoughts on anything and everything i am either involved in or enjoy. Many of you may wish to skip by and ignore my meandering thoughts but others may find them informative...

 

Filtering by Tag: Care Sector

Dementia care support vs. Local Authority care & accommodation strategy: Its all about perception!

Adam Hutchison

Dementia has become a media buzzword over the last decade as the appreciation for the difficulties those who suffer with the disease has become more prominent and the understanding has increased. Many local authorities have continually identified the need for increases and improvements in the care of those with Dementia and related illnesses. Yet the real course of action is the polar opposite of this analysis. With ever decreasing care funding and the hands off approach to social care offered from Central Government officials, with the obvious downgrading of Social Care as a concern (with the greatest respect) by recent cabinet changes since Brexit – it all seems to be media lip service to a genuine social and community issue we are facing right here right now!

 

Multiple national campaigns are out there from sources such as Alzheimer’s Society and Dementia Friends as a subsidiary, focusing on some of the main points:

 

The bottom line

 

·       Dementia is a major global health problem; in the absence of a cure there is increasing focus on risk reduction, timely diagnosis, and early intervention

·       Primary and secondary care doctors play complementary roles in dementia diagnosis; differential diagnoses include cognitive impairment due to normal ageing and depression

·       Cost effective drug and non-drug interventions such as cognitive stimulation therapy exist that help to delay cognitive deterioration and improve quality of life; information provision and practical support are also important

·       Discussions about a person’s wishes for future care should occur at an early stage of illness while the person has mental capacity

·       Family carers of people with dementia are at high risk of physical and mental illness as a consequence of caring and they require equal attention and support

 

With all this in mind and the wide understanding of Dementia as growing concern in that is in the public minds the 2 issues to do have a clear synergy. The truth is that the private sector and specifically residential environments such as Care Homes and Extra Care facilities will be the ones that will and are being innovative to ensure a positive reaction to the ever growing elderly population.

 

Society will need to embrace the private care sector fully because there is simply not enough focus on how this will be funded or how the growing numbers of people that will need support. Innovative solutions are out there in every county but access to them is not evidently understood. Embracing the funding opportunities and the need to ensure that long term care financing is available is becoming a reality and not an after thought. All of us at some point will need to consider how and whom we will be paying for our care for loved ones or ourselves. The after thought that “don’t worry the government will pay” is not the case and hasn’t been for sometime. More needs to be done to aid the understanding at public level about the affordability and access to financing care in later life. With ever increasing demands being pressed and austerity measures in place as publicly indicated the overall landscape is not necessarily clear to all who are not in the sector on a day to day basis.

 

Many local authority accommodation strategies are contradictive by assessing the need for people to stay in their own homes but this is a dangerous method putting too much emphasis on time & task home care agencies who are pushed to their limits of capacity.  The fundamentals of Dementia and the needs of care in this area are around support, companionship and the need to always being available in many cases the need for one 2 one support is paramount. The question here is how can this be achieved when people are isolated in their own homes with the prospect of causing themselves more harm as their illness begins to debilitate them further over the coming months and years,

 

The stigma of care homes and care environments publicly needs to change dramatically with many private sector care organisations offering excellent care services and facilities which include not only tangible offerings such as bistros, ensuites, cinemas and medical equipment. But also the intangible benefits of 24/7 focused staff teams who are experienced in this area support backed up with external schemes offered by organisations such as Oomph! (http://www.oomph-wellness.org ) and Ladder to the Moon (www.laddertothemoon.co.uk) – who work with Care Groups to develop meaningful measured human engagement designed to enhance lives and deliver true humanistic benefits in reminiscence and responses.

 

These types of access to facilities and services are simply not available to those who are almost advised to stay in their own homes. These individuals simply miss out on the life enhancing benefits being offered in outstanding care environments across the UK. This is the ultimate conundrum – as gone are the days of the old fashioned residential home – care homes are multi purpose care services with an innovative edge focused on the person not the purse. Obviously the financials need to be right when addressing where people may spend their time living but this should not have a cost when all is considered.

 

The Care Quality Commission (CQC) the regulatory body of the are care and health services across the UK consistently backed these types of services with the increase in Outstanding services evidencing the use of innovative people engagement services in the care being delivered. Having accessing to multiple services when dealing with Dementia and associated conditions are only going to help improve the quality of life of individuals and this is clearly being demonstrated across the care sector with extreme valour. So why is it that this not common knowledge.

 

The theory I have deduced (albeit an opinion) is that professionals and government officials have not been keen enough to ensure the wider public understanding that Health and Social Care are two completely different fields. We live in a country where we are fortunate to have a National Health Service, which defies logic everyday offering FREE healthcare to all that need it. Which sadly blurs into the fact that also Social Care is an extension of health. Indeed, maybe it should be but realistically this simply is not the case. Social care is the long-term support function for health and this is becoming ever present as we develop bed-blocking problems within the NHS hospital services. Social Care can be the shining light that picks up the long-term issue and encourages development in care scenarios.

As discussed in an article that supports this statement by Paul Burstow at the Guardian: Why has this been explored more as a major political issue? Most MPs acknowledge that social care is unfinished business, but this has not translated into sufficient political pressure. At a basic level, this is because most people make no distinction between social care, care and support and what the NHS does. It still comes as a shock to many families that social care is not free. Most people make no care plans because they have discounted the chances of ever needing it.

Today the most visible advocate for social care funding is the NHS England boss, Simon Stevens. He told the NHS Confederation conference earlier this year that social care, rather than the NHS, should be at the front of the queue for financial aid. Of course there is a healthy dose of self-interest in this. Health and social care are two sides of the same coin – underinvest in one and you undermine the other.

But this is clearly down to the perception the public is given, the care sector itself and government departments must embrace social care services for what it can do but in the same breath encourage those who need to use it how it can accessed more efficiently. Private social care enterprises will be the ultimate problem solving body in this conundrum and soon everyone will need understand it!

Social care industry at breaking point due to planned increase in national living wage says Kent Integrated Care Alliance

Adam Hutchison

TV viewers fell in love with Derek, the kind care worker portrayed by Ricky Gervais, who looks after the elderly residents of the Broad Hill nursing home.

Yet Kent care bosses say jobs for people like the loveable Channel 4 character are under threat from cuts to funding and an increase in labour costs from the national living wage due in April next year.

The county’s care industry is at breaking point according to Adam Hutchison, who represents about 200 care providers across the county as an executive board member of the Kent Integrated Care Alliance.

He said private care homes will close if local authorities do not provide more money and claims the cost of caring for residents allocated through social services has been underfunded for more than a decade.

Mr Hutchison, who is director of Belmont Sandbanks Care Group, which operates homes in Romney Marsh and near Hastings, said his company receives £408.48 per patient per week from Kent County Council.

Yet his private fees for residential care range from £550 to £650 per week.

In East Sussex care homes receive £496 a week while in Hampshire the figure is £574.

In west Kent, the figure increases to £440.30.

The situation has been made worse by increases in the cost of workers.

“We need to increase what is funded by central and local government to accommodate the increase in labour costs forced on us by government...” - Adam Hutchison, Kent Integrated Care Alliance

Over the last 10 years the national minimum wage has gone up from £5.35 in 2006 to £6.70 last month, an increase of 25%. Another 6% increase will be introduced in April when the government introduces its £7.20 national living wage.

However, the Kent County Council rate for supporting residents in care homes has risen by only 5% since 2008 – with the additional cost swallowed by private businesses.

The latest increase in the national minimum wage at the start of October is expected to cost Mr Hutchison’s business £26,000 in increased labour costs. The introduction of the national living wage in April is due to up that by another £70,000.

He claims government payments need to increase by £20.52 per week per person just to stand still, with that due to increase once the living wages comes into effect.

Mr Hutchison, who employs more than 75 people, said: “As a sector we are all for the national living wage because people don’t get paid enough.

“However, how are we able to fund that? We are constantly under pressure to improve quality but we are at breaking point in care.

“The private market subsidises the social services market. Those who pay privately will have to pay more than those who come through social services.

“We need to increase what is funded by central and local government to accommodate the increase in labour costs forced on us by government.”

“We have got the national living wage and all the pressures it brings, which is probably more than the impact of the amount which can be raised through council tax..." - Cllr Graham Gibbens

“If this doesn’t happen, the short term result is independently run businesses in Kent, small family-run providers,will begin to exit the market and decide to build houses on their land or look at another form of business on the site.

“Then there will be a knock on for employment, with the long term effect larger national providers will come in and be able to charge what they want.

“We’re not trying to plead poverty but we are under pressure as a business sector.”

In the Autumn Statement on Wednesday, Chancellor George Osborne announced plans to allow councils to put council tax bills up by 2% provided all the money was used to help fund social care.

Kent County Council cautiously welcomed the move.

Cabinet member for adult social care & public health Graham Gibbens said: “The announcement was only recent and it is too early to give a forensic analysis.

“The big issue is how the 2% is going to be used but I do welcome it.

“The Government has recognised that social care does need to be funded.

“We have got the national living wage and all the pressures it brings, which is probably more than the impact of the amount which can be raised through council tax.

“One of the big things we need to do is encourage people to stay at home as long as they can and avoid going into residential care..." - Cllr Graham Gibbens

“As a local authority we have a duty to ensure there’s a vibrant social care market and we have a duty to ensure there’s appropriate funding to the sector.”

He said he would have been “very disappointed” if funding was cut and hopes to be able to increase funding in the future.

He added: “One of the big things we need to do is encourage people to stay at home as long as they can and avoid going into residential care.

"We have been quite successful at keeping people out of residential care but as people get older many do not have any other option.

“How we manage that is an issue.”

He has also approved plans to force KCC to pay the same amount to social care providers wherever they are in the county, which comes into force next year.

http://www.kentonline.co.uk/kent-business/county-news/living-wage-will-close-homes-47170/

The Care Sector – Where it’s at in the UK…

Adam Hutchison

The UK care sector is staring at a massive tsunami coming its way. A combination of factors such as budget cuts in local authorities, the new living wage and direct payments have made the traditional care business models unsustainable. Most large care providers expect as many as 50% of their existing contracts to become ‘unprofitable’ in the next 18 months. Just to set some perspective, collectively these contracts are worth more than £5 Billion per year and employ more than 500,000 care workers. Imagine the consequences of half of these contracts becoming unprofitable in 18 months!

While the funders especially local authorities have had a role in this, care providers also have to share some of the blame for the situation they find themselves in. Care organisations haven’t really moved with the times. Improvement opportunities are everywhere – be it back office admin tasks, front office productivity, invoicing process, working capital management or offering new and innovative services. It is no surprise that margins in this industry are as low as 2-6%.

Apart from rota planning and invoicing most other organizational functions in the care sector are literally run on paper. Most newcomers in this industry are surprised to see tons and tons of paper lying everywhere. Buried in the paper are staff timesheets, care records, staff reviews, complains, audit reports etc. Paper not only adds a massive overhead, it also reduces organisation’s capability to react to the changes in the market environment. It takes heroic micromanagement to ensure these records are kept up to date, processes are being followed and all stakeholders engaged. However, leaders in most care organisations will accept that their service records are woefully inadequate; often risking the lives of individuals being looked after. Centralised, accessible and analysable service information is absolutely essential to start modernising this sector and it also is the key to unlocking the new opportunities that will emerge in near future.

New world – new opportunities:

No one can predict the future. However here are some fundamental trends that are shaping the care market. Providers serious about their future should take note.

Privately funded care:
As local authorities raise the bar for social care funding, more and more individuals will be funding their care themselves. To be successful in the private pay market care organisations have to become more ‘consumer’ centric. Next of kin are as much customers here as the service user. Apart from delivering great service, keeping customers engaged – sending notifications and updates after every visit – is going to be very important. Organisations looking to grow their private pay business need to think hard about the investments in systems and processes needed to deliver high quality services without significantly increasing their cost overheads.

Complex care
While the overall number of individuals receiving social care is decreasing, more money is being spent on the most vulnerable. The economics of keeping people of out of hospitals or discharging them earlier is well known. This is an opportunity especially for organisations willing to ‘upgrade’ from low value social care to higher value health care services.

Looking after individuals with complex needs brings its own set of challenges. There is a much greater level of scrutiny and care records tend to be exhaustive and critical to the service. It is also important to keep all stakeholders completely connected with real-time access of ‘what is going on’ with a package. A complex care environment needs organizational flexibility to adapt to the needs of the service. Information systems need to be flexible and should be able to handle the forms, business rules and role based access required to deliver a tailored service which is at the heart of complex care.

Low touch care
As people live longer, a number of them will be healthy enough to look after themselves with some reactive care when needed. This can be in the form of a phone or video link to provide companionship combined with the option to get in personal care whenever requested (within agreed parameters). This type of service can also be enhanced by installing a bunch of assistive devices spread all over the service user’s home. These devices would constantly collect data about the health and wellbeing of the individual without being intrusive. Information captured will be relayed back to a “hub” where the staff will be alerted if something is not right. This is a dramatic shift from the current model and if deployed correctly has the potential to unlock significant value by channeling resources towards the once with greatest need.

This is by no means an exhaustive list of future opportunities. However, no matter what new opportunities emerge one thing is clear – care providers have to become a lot more lean and efficient, create real-time connections with service in the community and evidence the outcomes and quality of services to the payers. They have to start looking beyond sending the right person at the right place and capturing time, to actually knowing what happened during service time. Organisations who can capture, share and market the latter will be the once well places to ride the massive wave coming their way!