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Welfare Reform on the Web (April 2011): Care of the elderly - UK

The abandonment of self-funders

G. Carson

Community Care, Feb. 24th 2011, p. 22-23

Older self-funders occupy 40% of residential care places and 48% of nursing home beds. However, they and their relatives remain largely unsupported by councils, receiving little in the way of information and advice. Councils should consider contracting external organisations to provide advice services, as Essex has done with the Relatives and Residents Association.

Cost of care after 65 rises to 50,000

D. Brindle

The Guardian, March 21st 2011, p. 11

The cost of care in old age has reached 50,000 according to research for a government inquiry into funding reform. Almost one in five people who need residential care after the age of 65 face a bill of more than 100,000, the study found, and for one in 100 costs exceed 300,000.

A cure for bed blocking

J. Dunning

Community Care, Feb. 10th 2011, p. 22-23

There are concerns that delayed discharges of older people from hospital have been rising. This article describes the system in Portsmouth, where the council, the primary care trust and the acute trust have worked together to reduce delays. Two key changes have been made to the system: 1) the establishment of an integrated discharge bureau involving both health and social care; and 2) the streamlining of some social work processes.

Cuts undermining care for elderly, says watchdog

M. Beckford

Daily Telegraph, Mar. 30th 2011, p. 8

In its annual report on the state of health and social care in Britain, the Care Quality Commission has expressed concern that councils are finding it challenging to help older people live independently because of budget cuts and are unable to keep up with rising demand for person-centred support. The number of people receiving publicly funded services in 2009/10 fell to 1.7m from 1.78m in 2008/09. The number of older people who had repeated emergency admissions to hospital, indicating that they needed better support at home, rose by 4% to 292,522.

An evaluation of the impact of community-based interventions on hospital use: a case study of eight Partnership for Older People Projects (POPP)

A. Steventon and others

Nuffield Trust, 2011

This evaluation looked at eight preventive schemes set up as part of the Partnership for Older People Projects initiative. The approaches evaluated included support workers operating alongside community matrons to manage people with long-term conditions and an intermediate care scheme to help people discharged from hospital. There was no evidence that any of the eight had cut emergency hospital admissions for elderly patients despite the fact that four were strongly expected to do so. These findings will come as a disappointment to those working to redesign services along these lines.

Housing or care workers? Who is supporting older people with high support needs?

J. Manthorpe and J. Moriarty

Journal of Integrated Care, vol. 19, Feb. 2011, p. 16-25

Over the past decade there has been a significant expansion of extra care housing for older people, but little is known about the people working in the sector. This article presents an overview of what is currently known about the extra care housing workforce and the extent to which it is prepared to assist older people with high support needs. It is concluded that knowledge of the housing with care service workforce is so limited that it might be helpful to see them as approximating closely to the care home sector and intensive home care support services. There is little evidence that housing with care providers have their own specialist workforce, and no consensus on what specialism might be prioritised.

Old age and new speak

J. Downey

Journal of Care Services Management, vol.5, 2011, p. 23-28

Legislation and guidance over the past 25 years have put greater emphasis on users' rights, but standards of residential care for older people can still vary widely and are often inadequate. This article explores the meaning of the newly fashionable concept of personalisation for residential care users. It appears that 'personalisation' has become the coded manner of referring to direct payments and individual budgets. The new jargon could further obscure the deep rooted problems of inadequate budgets, lack of skilled staff, and ineffective regulation and accountability that afflict residential care

People who pay for care: quantitative and qualitative analysis of self-funders in the social care market

Institute of Public Care, Oxford Brookes University and Melanie Henwood Associates

Putting People First Consortium, 2011

It is calculated that 170,000 places in care homes for older people, or just under 45%, are self-funded - 39.6% for residential care and 47.6% for nursing homes. Estimating numbers of people purchasing their own domiciliary care is more complicated, but it is agreed that numbers will rise steeply in the coming years, possibly to more than 400,000 by 2030. Little in the way of information and advice about purchasing care home places is available to self-funders and their families from local authorities. People who approach their local council for advice typically experience little sympathy and receive minimal information, often just a list of local care homes. With local authorities facing severe financial constraints in the coming years, there is little hope of their putting resources into improving their performance on this front. The alternative is expansion of the patchwork of voluntary and commercial organisations claiming to offer advice and information in this field. This approach will lead to huge local variation in service availability, greater inconsistency in quality, and more uncertainty about what is available free.

URL: http://www.puttingpeoplefirst.org.uk/_library/Resources/Personalisation/
Localmilestones/People_who_pay_for_care_-_report_12_1_11_final.pdf

Protecting my mother

K. Rees

Journal of Adult Protection, vol.13, Feb. 2011, p. 46-52

This article offers a moving account of a daughter's experiences of her mother's placements in long term care and her exposure to poor care and/or abuse. It exposes the ineffectiveness of the Department of Health's No Secrets policies and guidance in eradicating the abuse of frail older people in long-term care.

(For comment see Journal of Adult Protection, vol.13, Feb. 2011, p. 53-56)

Southern Cross could be forced to close elderly care homes

Z. Wood

The Guardian, March 15th 2011, p. 26

Southern Cross, the UK largest operator of care homes, has said it could be forced to close some of its facilities, creating uncertainties for tens of thousands of elderly residents. Chief executive Jamie Buchan said the company was going to breach loans agreements with its bankers and was seeking urgent talks with landlords as its rent bill was described as unsustainable.

(See also The Independent. March 15th 2011, p. 32)

The use of telephone befriending in low level support for socially isolated older people: an evaluation

M. Cattan, N. Kime and A.-M. Bagnall

Health and Social Care in the Community, vol. 19, 2011, p. 198-206

There is increasing policy recognition that alleviation of social isolation and loneliness in older people should be prioritised. Despite a lack of evidence, telephone befriending has been considered an effective low-level method of decreasing loneliness among older people. This study evaluated the impact of a national befriending scheme for isolated and/or lonely older people, involving eight project sites across the UK. The purpose was to assess the impact of different models of telephone-based befriending services on older people's health and well-being. This paper reports on the findings of 40 in-depth interviews with older service recipients. Results showed that the service helped older people to gain confidence, re-engage with their community, and become socially active again.

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