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Welfare Reform on the Web (July 2000): Care of the Elderly - UK

BACK TO COLLEGE FOR RESIDENTIAL HOME MANAGERS

L. Green

Community Care, no. 1317, 2000, p. 12

National standards proposed for residential and nursing homes propose that all care home managers have a NVQ level 4 in care home management. Proposals have been broadly welcomed, but there are concerns about the cost of getting people through the qualification.

THE CHOICE IS YOURS? AN ACCOUNT OF THE PRESSURES FACED BY OLDER PEOPLE LOOKING FOR CARE HOMES

C. Argyle, L. Bright and A. Clarke

London: Counsel and Care, 2000-06-29

Argues that there is an urgent need for the government to appoint a regulator for the residential care home industry and claims that frail elderly people are getting a "raw deal" from large multiple home owners and some local authorities.

EVERY LITTLE COUNTS TOWARDS BEST VALUE

H. Davis

Working with Older People, vol. 4, Apr. 2000, p. 23-25

Describes how Southampton City Council's Best Value pilot brought about positive change for older people through its 'Every Little Counts' initiative.

'FEELING SPECIAL': QUALITY CARE FOR NURSING HOME PATIENTS

Registered Nursing Home Association

2000

Challenges the value of national standards proposed by the Centre for Policy on Ageing as being a set of meaningless bureaucratic rules. Suggests that any new national standards should reflect the following factors: the protection of individuals' rights to receive the type and level of care for which they are independently assessed by qualified nurses; respect for patients' dignity at all times; development of individualised care plan; changes to care packages being made only when justified on the evidence of positive benefit to the patient's health and well-being; and emphasis on people, participative leadership, and flexible and innovative approaches to work organisation.

FUNDING LONG-TERM CARE: RESHAPING THE DEBATE: INTERIM REPORT FROM THE KINGS FUND LONG-TERM CARE FINANCES PROJECT

L. Easterbrook

London: Kings Fund, 2000

Analysis of the findings of three recent enquiries into the funding of long-term care reveals significant agreement on the shortcomings of the present system, the characteristics of a future system and the areas for reform. However, while problems have been clearly identified, no consensus on solutions has arisen. Report identifies four issues requiring exploration: incentives and fairness, the impact of high level policy decisions on individuals' behaviour, and a new compact for care in old age, which would make explicit what the state will provide and what people must provide for themselves.

'GREY ARMY' TO INSPECT CARE HOMES AND HOSPITALS

R. Sylvester and C. Hall

Daily Telegraph, May 8th 2000, p. 1

Following allegations that elderly patients are being abused in hospitals and care homes, government is developing plans to recruit pensioners as lay inspectors.

HEALTH BEGINS AT HOME: PLANNING AT THE HEALTH-HOUSING INTERFACE FOR OLDER PEOPLE

L. Harrison and F. Heywood

Policy Press, 2000-07-03

Presents an analysis of community care plans and Director of Public Health reports in three health regions from the year 1996/97. Housing issues affecting the majority of older people were not usually mentioned in community care plans, nor was there normally any attempt to consider the scale of the remedies needed. Projects linking health, housing and social care agencies were not routinely mentioned in community care plans. While there was some evidence of good practice, overall level of provision was inadequate in relation to the scale of the need. Less than a third of all authorities made use of health monies available for care in the community for housing projects.

THE HEALTH SERVICE NEEDS TO COME TO TERMS WITH THIS AGE-OLD PROBLEM

J. Neuberger

Times, May 10th 2000, p. 20

The King's Fund calls for a new Compact for Care in Old Age. Government should make clear what citizens can expect the state to provide and what they will have to fund for themselves. It should construct a system of care that would offer high quality services to keep older people in good health for as long as possible, to treat health problems effectively and to provide appropriate care for those who cannot recover from illness.

'INSTITUTIONAL CARE DEMEANS THE INDIVIDUAL'

D. Hinchcliffe

Working with Older People, vol. 4, Apr. 2000, p. 17-19

Institutional care of older people cannot meet individual needs but the combination of market forces and unlimited public subsidies to private care led to a massive expansion of the care and nursing home industry. Calls for more joint working between housing, health and social services at local level to deliver integrated care support and housing services to enable older people to remain independent.

IT'S A STICK UP

D. Powell and E. Peile

Health Service Journal, vol. 110, Apr. 27th 2000, p. 24-25

A joint-working scheme aimed at keeping older people out of hospital with improved home support has reduced emergency admissions and cut the length of hospital stays. The initiative, involving four GP practices, a health authority a community trust and a social services department, included the appointment of a nurse co-ordinator and six support workers offering a 24-hour service. The scheme is now being extended by two primary care groups.

A MATTER OF DEFINITION

L. Green

Community Care, no. 1318, 2000, p. 12

The Health Secretary has hinted that the government will finance free nursing care for older people. This has sparked a round of speculation about how the government will define nursing care.

PRIMARY CARE AND SOCIAL SERVICES: DEVELOPING NEW PARTNERSHIPS FOR OLDER PEOPLE

K. Rummery and C. Glendinning

Radcliffe Medical Press, 2000

Central argument of the book is that a primary care-led NHS has to engage with social services in developing effective collaboration. The shift from a hospital-led pattern of healthcare to primary care will not happen unless community support arrangements are in place, and those require social services involvement. The authors are enthusiastic about the potential for collaboration following the Health Act and see an imperative to joint-working at a senior level which was previously lacking. Partnership and Prevention grants are further levers to the development of joint strategies.

REGULATION OF NURSING AGENCIES PROVIDES ADDITIONAL SAFEGUARDS

M. Witton

Caring Times, May 2000, p. 18

Reports that a late amendment includes the regulation of nurses agencies in the Care Standards Bill. However the inclusion of nurses agencies in the new legislation does not reduce the responsibility of care home owners and managers to ensure that suitable staff are on duty at all times.

SHADOWLANDS

C. Vellenoweth

Health Service Journal, Apr. 13th 2000, p. 30-31

The healthcare of 200,000 people living in nursing homes will not be regulated by the Commission for Health Improvement or by the proposed healthcare division of the National Care Standards Commission under current proposals. This is despite the fact that patients in nursing homes are highly dependent and many would previously have been cared for by the NHS. It is not acceptable that the current NHS quality initiatives should ignore this sector.

WINNING THE GENERATION GAME

Performance and Innovation Unit

London: TSO, 2000

Economic inactivity amongst the over-50s is costing the country £16bn per year. In order to encourage/coerce them into continuing to work, the report recommends

  • raising the age at which people can start claiming an occupational or private pension from 50-55;
  • forcing older people to actively seek work until they reach retirement age by cutting benefits if they fail to do so;
  • upgrading the skills of older workers through lifelong learning;
  • improving volunteering opportunities;
  • introduction of age discrimination legislation if the current voluntary code of practice is found to have been unsuccessful;
  • reviewing the civil service retirement age with a view to raising it to 65.
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