Two L&H group care homes have obtain five stars each for food hygiene from their local authorities.  The five-star hygiene rating is the highest rating obtainable.
Cranwell Court in Grimsby obtain its inspection in January, whilst Ashley Court in Lincoln received its inspection in February.
Sally Eddom, Manager at Cranwell Court, said,“Everyone works extremely hard to ensure that residents receive the best service possible and receiving this is a wonderful tribute to the dedication of our staff.”

Jim Kelsey, Manager at Ashley Court, said, “We are delighted to have received such a high rating. We pride ourselves on having excellent services and gaining this accreditation is great encouragement for our staff’s hard work.”

If you know of these or any other care homes in your area, why not write a review of them in order to help others to make an informed decision regarding their care choices?

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An elderly care show designed to highlight all of the option available to the elderly will be coming to Bradford at the end of the month.

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Care workers at a care home in Kenley, Surrey, staged a sit-in after being told last Thursday that it would be their last day at work and the last day for which they would be paid.

According to the care workers, the sudden termination of their care jobs was an attempt by the care operators, RSM Tenon to prevent a backlash over redundancy payments.
All eight of the care workers, one of whom had been working at the care home for twenty-fours years, indicated that they were holding the day long protest in order to gain advice on receiving redundancy pay.

The sit-in prompted an emergency meeting later in the day when a representative from RSM Tenon arrived at the care home, where the care workers believed they were being treated ‘like criminals’.
The stand-off resulted in a promise to pay the care workers a month’s wages, but they claim to still not know where they stand in terms of redundancy payments.

A spokesman for RSM Tenon said that "Those workers made redundant as a result of the closure of the home can make a claim for outstanding notice and redundancy pay from government funds, as is normal in such situations."

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The Carebase group of care homes recently treated their chefs to a special training day at the Manoir Aux Quatre Saisons Cookery School and restaurant.

The training day which incorporated the use of fresh ingredients from the grounds of Le Manoir Aux Quatre Saisons, emphasised creating meals and menu plans that can be specifically designed for those in elderly care.

A total of nine chefs from the Carebase group of carehomes were invited to the day, including Linda Barney of Brooklands care home in Drayton, Norfolk who said that ‘the day was absolutely amazing.  I thoroughly enjoyed the experience from beginning to end.’

Carebase place a great deal of emphasis on hospitality and nutrition in their care homes.  Managing Director of Carebase, Nicola Coveney added, ‘ we have a great team of chefs at Carebase and wanted to do something special to thank them and enhance their skills’.

We are aware that carehomes up and down the country, as well as those in the Carebase group of care homes are doing great things to enhance the lives of their residents.

If you would like us tell the world about the great things happening in your care home, please feel free to email us at enquiries@whereforcare.co.uk with your news story. 

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A new £7 million care home for people with general nursing needs and those living with a dementia is set to be built in Dunbarton.
 The new care home, which is to be built for the Bupa care homes group in Bearsden, will help to create 90 new care jobs for the area and will provide 64 bedrooms with a wing purposely designed for those living with a dementia. 
This new care home with facilities designed for those living with a dementia has already been named as Mugdock House Care Home.

 

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A ‘world class’ dementia care centre could soon be built on the outskirts of Caernafon.The scheme, which has been submitted to Gwynedd Council by the owner of Pendine Park. Mario Kreft, will provide a purpose-built dementia care centre on the site of the former Ysbyty Bryn Seoint Community Hospital in Pant Road .Mr kreft, who already owns 6 care homes in the area as well as a domiciliary care service and a care training facility has said that “Our vision for Canolfan Gofal Bryn Seiont is to provide a world class community based resource for people with dementia who need high-dependancy care not currently available in the area,”The new dementia care centre will offer 24/7 dementia care services, as well as respite care services and dementia day care services, and would be linked to the company’s care teaching centre.It would very much be modelled on the dementia care programme currently offered at Pendine Park, which has been developed in conjunction with leading dementia expert Bob Woods of Bangor University, and the Alzheimer’s Society.The local council, social services and Betsi Cadwaladr University Health Board had also been consulted in planning the scheme.

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The Operations Director for Cambridge Care Home in Wanstead is on the shortlist for the National Care Awards 2011 ‘Care Innovator’ award.Tayvanie Nagendran has been shortlisted because of her plans to change a four=bedroom building on the site of Cambridge Care Home into an activity suite for the care home which will include a training room, library, spa and hair salon.Ms Nagendran commented, “Nursing homes should be encouraged to improve their facilities and I’d be delighted to win the award on behalf of Cambridge Nursing Home.  We would like to invite other care homes to use our facilities when they’re finished – we want to move away from the idea that nursing homes are institutions, we want to increase transparency and let people lead an active life.The shortlisted entries for the National Care Awards will attend judging at the Hilton Metropole Hotel in London towards the end of October, with the winners beings announced at a Gala Black Tie dinner on 25^th November at the same venue.

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HC-One, the newly formed care company by Dr Chai Patel’s Court Cavendish group and NHL, one of the largest landlords of Southern Cross Care Homes, is currently on a recruitment drive to recruit more care staff.

The newly formed HC-One company, who will now be managing 246 care homes, are looking to recruit care staff in positions ranging from regional care managers through to care staff responsible for the quality of care delivered in the carehomes, and even staff interested in training and development of other care staff.

Many of Southern Cross Care Homes’ 758 care homes will be handed over to new management on the 1^st of October, with the remainder moving to new management on the 1^st November.  Dr Chai Patel has promised to invest in these care homes and improve standards across the board in care homes that have seen a huge lack of investment over the past few years.

The deal will witness the demise of Southern Cross Care Homes completely, previously the UK’s largest care homes provider which cared for more than 33,000 people across the United Kingdom.

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Over 300 care homes throughout the UK have been showing their wils side recently after being visited by a mobile zoo.The carehomes, all of which are part of the BUPA Care Homes Group, have been visited by mobile zoo’s throughout the UK.One of the carehomes involved, Brierton Lodge Care Home in Hartlepool has been working on a project to encourage more wildlife into the carehomes’ gardens.  Amongst the initiatives that Brierton Lodge have focussed on are putting bat boxes up and creating a wonderful butterfly garden.The manager of Brierton Ldoge Care Home, Carol Barnard, said: “It’s great everyone can get involved, we’ve all got a real sense of pride that we’ve played our part in creating new habitats and keeping the gardens of Britain alive.”Involving plants and animals as on-going therapy for care home residents is a well-proven technique and is a mainstay of the Eden Alternative, a recognised form of therapy for dementia.

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GP’s are trialling a ten-minute test for Alzheimer’s which might be made available in the UK to patients as young as 50.

The test, known as the ‘Cantab’ test and  which uses technology such as I-pads and touch-screens to differentiate between general forgetfulness and the early signs of Alzheimer’s is currently being piloted in several GP surgeries.

The Alzheimer’s test been developed by the University of Cambridge, and if found to be successful, could be rolled out to GP surgeries throughout the country within the next year.

Patients found to have the early signs of Alzheimer’s could then be referred to an Alzheimer’s  memory clinic where changes in diet, exercise, and possibly even the introduction of the drug Aricept might be used to counteract Alzheimer’s

Professor Barbara Shahakian, co-founder of the Cantab test said that, ‘You want to detect Alzheimer’s disease before the damage is done, before you can’t work any longer and before you can’t hold down your family responsibilities and relationships.’ 

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Birch Hall Care Home in Darwen, Lancashire, is hoping to imorove the lives of residents living with a dementia by designing a 40's inspired reminiscence room.
The 40's inspired room, which should help those residents living with a dementia with reminiscence therapy, wherein they can recall events and places from their youth.
Items such as an old-fashioned telephone box, flying ducks on the wall and flowered curtains have all been kindly donated by local businesses.
Birch Hall Care Home can accomodate up to 81 residents including 12 residents living with a dementia.

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In a further blow to stricken care homes group Southern Cross, it has emerged that as many as a third of their carehomes have been highlighted as delivering sub-standard levels of care by the CQC, (Care and Quality Commission).

Southern Cross, who currently manage 581 care centres across England, have been asked to make improvements on the standards of care delivered at 164 of them.

Although the nature of the failing at these 164 carehomes have not been revealed, it is believed that they refer to issues such as medicines management and cleanliness and hygiene in the care of it’s residents.

It is only days since Southern Cross announced plans to axe 3,000 jobs in their attemots to stave off administration, insisting that such job losses will not affect the quality of care delivered for their 31,000 residents.

The government, although refusing to ‘bail out’ the ailing care home group, have insisted that all of their 31,000 residents will be cared for should Southern Cross fall into administration.

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In a move designed to stave off bankruptcy, Southern Cross, the embattled care homes group is to return 132 care homes to their landlords.
Southern Cross are the UK's largest care home provider, with more than 750 homes throughout the UK.
Earlier this week, it announced plans to cut more than 3,000 jobs in an attempt to alleviate what it describes as the 'critical financial condition' it has found itself in, which has led to a £311 million loss in the first 6 months of the year.
Southern Cross, whose financial difficulties have arisen due the the fact that it sold the freehold to its carehomes several years ago, allowing investors to make billions of pounds in the process, now has 80 different landlords overseeing its carehomes and is 'keen to work with them' to enable those carehomes to move to alternative care home operators.

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Scientists who have been working on developing treatments to cure Creutzfeldt-Jakob Disease, commonly known as CJD or ‘mad cow disease’ have announced that the treatments might be a positive breakthrough in the fight against Dementia.The treatments, which prevent a protein called amyloid beta from forming in the brain and damaging nerve cells.  Drug trials were due to start on humans for the treatment of Creutzfeldt-Jakob Disease next year, but given the impact that it could have on the treatment of dementia, this trials might be pushed sooner.

Dementia current affects more than 700,000 thousand people in the UK, with the number set to double over the nest twenty years- such a treatment could be the breakthrough in the treatment of dementia that has so far eluded scientists.

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A recent report by the Alzheimers Society has revealed that exercise such as walking, swimming and cycling, can help to stave off the onset of dementia.
The report, which was welcomed by Professor June Andrews, Director of the Dementia Services development Centre at the University of Stirling, said that physical activities could help to keep at bay dementia which can result in almost 50,000 people per year being admitted into care homes.

"This report confirms what those of us in the field find every day. There are things that you can do to help yourself stay well and out of care," states Ms Andrews.
The report also highlighted that almost a quarter of a million people a year are living with inadequate support systems.

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Six Trafford care homes have been awarded a ‘Dignity in Care’ Award by Trafford Council.  The care awards, which recognises care homes in Trafford which maintain the highest quality in dignity for their residents were awarded to Bickham House in Bowdon, The Conifers in Old Trafford, Handsworth Methodist Home in Bowdon, Kilpeacon House, Altrincham, the Knoll Urmston and Shawe House in Flixton from Executive Councillor Michael Young.

The dignity in care awards have been instigated in order to recognise those care home providers who understand that treating care home residents in a dignified, respectful way is an essential element in providing quality carehomes.

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A test designed to indicate the likelihood of someone contracting Alzheimer’s disease could be available with two years, new research has indicated.

The test, which would be administered at GP surgeries, would allow those in the 40’s to be made aware if they are likely to develop Alzheimer’s Disease and take steps in their lifetime to help prevent the onset of Alzheimer’s Disease.

Such steps could be as simple as increasing exercise levels or changing diets which have been shown to make an impact upon the development of Alzheimer’s Disease in much the same way as they do for those at risk of heart disease.

Alzheimer’s Disease currently affects more than 800,000 people in the Uk with that number expected to double in the next 10 years.

The test will not suit everyone however, with some people preferring not to know what their future health might bring.

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According to a new report issued today, dementia now accounts for 1 in 6 deaths in the elderly. 
The report, from the End of Life Care Intelligence Network highlights the fact that the majority of these deaths occur in nursing homes and dementia is now being cited as a main cause of death rather than a contributing factor.
Chief Executive of the Alzheimer's Society, Ruth Sutherland said that this figures were just 'the tip of the Iceberg'.

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Escalating costs of dementia care can be contained if the government spent more wisely, they say.

Smarter use of state funds will include the ever escalating costs of providing appropriate services to dementia, it has been claimed.

Britain's aging population creates a "time bomb cost" of funds dementia, according to Alzheimer Society.

Charity Council and care recently announced that through smart spending strategies to 3billion pounds could be saved between 2011 and 2015.

Alzheimer Society supports these comments and added that providing better support in the early stages of dementia can save large amounts of cash later.

'With the number of people with dementia to reach one million in 15 years dementia has been described as a bomb', but with proper planning and better use of resources, costs can be contained, "said Ruth Sutherland, by Acting chief executive power charities.

According to the Alzheimer's Research Trust, has currently about 820,000 people living with dementia in Britain.

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Health Secretary Andy Burnham has announced plans to offer ‘free’ residential care to the elderly in what is seen as being a first step to create a national system of care.  The system will entitle the entire elderly population to free care, funded by compulsory contributions from all.

The £1 billion plans are designed to ensure that those needing to go into residential care will not have to use their savings or sell their home in order to fund their residential care, with those people having been in residential care for tow years or more being entitled to free care funding for the rest of their lives.

The Health Secretary Andy Burnham is likely to disappoint a number of  key elderly care charities however, by revealing that the plans will not be proposed unless the current Labour Government retain their position in Government and key funding decision are unlikely to be made until sometime after that, once a cross-party commission is set up.

For current information regarding funding elderly care, please click here

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Actor James Nesbitt has revealed his heartbreak regarding his mother who is suffering from Alzheimer’s disease, know ing that on each visit to her care home it becomes less and less likely that she will recognise him.

Nesbitt, who has been spending a great deal of time recently filming in Belgrade, was describing how, not having seen his mother since Christmas because of his hectic filming schedule, upon seeing her on Mother’s Day, her deterioration becomes more pronounced on each visit.

Describing her care at the specialist dementia care home in Northern Ireland where she has been resident for two years as ‘magnificent’, he described how his family, especially his 81 year old father Jim, were slowing coming to terms with her condition.

On his last visit, she failed to recognise him, but did recognise her husband Jim, with whom she has enjoyed more than 50 years of marriage for which he is extremely grateful.

James Nesbitt felt the need to speak out over this issue in the hope that he can offer some relief to other families experiencing the same high and lows that carting for a person living with dementia can bring.

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Staff at Scarborough and North East Yorkshire Healthcare NHS Trust are set to receive specialist dementia care training to help them to better cope with those people suffering from early stage dementia and their families.

The training, entitled SPECAL (Specialised Early Care for Alzheimer’s), is a radical approach to dementia, offering a different way of managing the condition for those people with dementia and their families.

The training forms part of a project launched last year in conjunction with the Department of Health Sciences at the University of York entitled ‘Supporting individuals with dementia in general hospital settings’ and is designed to help hospital staff better understand the needs of those with dementia when they arrive at hospital.

The training, which the North east Yorkshire NHS trust have implemented as part of their initiative to implement the governments’ dementia care strategy, is designed to help staff understand the communication issues, needs and adjustments to medical care that can help hospital stays to be a more positive experience for those people with dementia.

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A Workington nursing home is being investigated by social services and police following complaints of neglect, it has emerged.
Details of the investigation into Branthwaite Care Home, part of the Executive Care Home group, have yet to be revealed, but Cumbria County Council, who pay some of the care home resident's fees, have temporarily suspended admissions whilst the investigation is carried out.

As well as offering care of the elderly services, Branthwaite Care Home also offers services for up to 57 residents requiring dementia care, care for physical disabilities and mental health care.
Police are investigating as part of their signup to the Adult Safeguarding Partnership, but are not treating this as a criminal case.
The Care Quality Commission (CQC), the inspections system for nursing homes and care homes, which eight months ago in April 2009 rated the home as 'good', its' second highest possible rating, is also carrying out its own investigation.

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Local residents in Newton Aycliffe came together last night in a public meeting to discuss Durham County Council’s plan to close the only council-run care home in their community in a bid to save money.

The care home, Shafto House care home in Newton Aycliffe, is one of seven across the county that Durham County Council are considering closing in a bid to cut costs.

Local councillors have pointed to the fact that the government are encouraging local councils to spend no more than a third of their elderly care budgets on residential care, whilst they currently spend two thirds and are looking to the future and what provision they might look to provide within the county in terms of elderly care.

However, acclaimed human rights lawyer Yvonne Hossack who has fought many battles against care home closures around the country has stated that it is not the concern over future recipients of elderly care funding that is of concern, but rather those who are currently residents in these care homes. "There are lives at risk," said Mrs Hossack. "It can cause strokes and it can cause heart attacks when people are moved from their home under trauma and this is an involuntary transfer."

Other care homes controlled by Durham County Council and being considered for closure include Hackworth House, in Shildon; Glendale House, in Blackhall; Manor House, in Annfield Plain; Stanfield House, in Stanley; Lynwood House, inLanchester; and East Green, in West Aucklandare.

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Smoking has been banned in care homes in Camden whilst an investigation is carried out into the death of a pensioner in a Gospel Oak care home last month.

Alex Andrews, 68, died at the Wellesley Road care home last month after a fire, believed to have been started by a cigarette, was dropped.

Camden Town Hall have since imposed a temporary smoking ban whilst their adult social care and health and safety teams investigate further before determining whether a permanent ban should be imposed.

Nursing homes and care homes are not subject to the smoking ban imposed on hotels and restaurants and it is generally up to an individual care home whether or not they allow smoking in residents' bedrooms by carrying out a risk assessment.

A spokesman for Camden Town Council said, "the council is currently reviewing the policy and a decision will be made on whether residents can smoke in their rooms once that is completed"

WhereforCare is the care homes and nursing homes ratings and reviews website where those who have experience of care homes and nursing homes write about their 'word of mouth' experiences on the internet to help those looking for good care.

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In a recent survey carried out amongst Britain’s 46 local councils, it has emerged that the need to cut costs and reduce budgets could lead to the slashing of as many as 25,000 jobs over the next five years.

As well as potential carehome closures, there is also the possibility that jobs would be lost in libraries as well as in specialist disability services across the country, and even in childcare.

Each of the 46 councils across the country is looking at a potential 10% workforce cut form the 256,000 workers that they currently employ in order to be able to manage budgets not improved by the recession.

Many of these cuts have already been witnessed in care of the elderly, with carehomes up and down the country being closed as councils aim to cut their spending despite the levels of care in many of them being described as good or excellent by CQC, the care and Quality Commission whose role it is to inspect carehomes and nursing homes.

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In the most bold re-interpretation of the Shakespeare classic to date, Shakespeare's 'Romeo and Juliet' is to be set in a care home with 76 year old legendary actress Sian Phillips playing the part of Juliet.

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Actor Kevin Whately today launched a new leaflet presented by the Alzheimer's Society to help hospital staff top better manage the care of persons with dementia when they arrive in hospital.

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A SENIOR Tory visited Thundersley to talk about his party’s new policy for care homes.

Shadow health minister Mike Penning was at Godden Lodge, in Hart Road, yesterday, to talk to residents about their experiences.

The Conservatives want to reform the current law, which forces anyone with assets of more than £23,000 to pay for their own care home fees.

They want to create a voluntary insurance scheme which would allow people to pay £8,000 at any point in their lives and know their fees will be taken care of.

Rebecca Harris, the Conservative’s parliamentary candidate for Castle Point, who accompanied the shadow minister on his visit, said the scheme was a great idea.

She added: “This scheme would lift a major worry from older people and their families, especially in Castle Point, where more people own their own homes than almost anywhere in the country.”

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This article from Channel 4 gives a more balanced viewpoint of 'care home tube feeding' than the previous one from The Guardian.

Artificial feeding is being used inappropriately in care homes and hospitals, says a joint report from the Royal College of Physicians and British Society of Gastro-enterology.

In some cases the procedure has been employed to ease the workload of staff.

But one care home owner has told Channel 4 News he is "incensed" by the report's findings - and he and several others claim the allegations are unfounded.

Care home owners say they have done nothing wrong. None of the 41 residents at the home Channel 4 News visited today - Queens Court Care Home in Wimbledon - are currently being "peg-fed". The procedure involves artificial feeding through a tube inserted into the stomach.

The manager says she has only had three residents who have been fed this way in the last year.

Tube feeding is meant to be a last resort - used mainly for elderly people with dementia who cannot swallow anymore.

But today's report suggests it is increasingly being used for other reasons: saving time for hard-pressed staff, freeing up hospital beds and even for financial gain.

Some health trusts pay care homes more for residents who are peg-fed because they are seen as needing a higher level of care.

But the authors of the report have now backed down on earlier claims that increasing numbers of homes are refusing to take patients unless they are fitted with feeding tubes.

Read the original artlce here http://www.channel4.com/news/articles/uk/report+condemns+care+home+tube+feeding/3490647

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Thousands of dementia sufferers told they must have surgery to gain entry
Thousands of elderly people are being forced to have tubes fitted so they can be artificially fed if they want to be admitted to a care home, a major report warns today.

There is no evidence that tube feeding prolongs life, and it deprives patients of the pleasure and social contact involved in normal eating and drinking, says a Royal College of Physicians working group which recommends that artificial nutrition should only be used as a last resort.

The report found that many care homes across the country are making it a condition of residence that people, often in the advanced stages of dementia, have a tube fitted into their abdomen.

"This is an invasive procedure with a risk, so it should not be undertaken lightly," said Dr Rodney Burnham, chair of the working group. "One of the concerns we had was that we felt in many places there were cases where this was done without proper thought.

"This is a widespread problem. Many care homes say they will not take a patient until they have had a gastrostomy. There is no reason for them to do that. They should have nursing support."

With time and care, elderly people with swallowing difficulties can be helped to eat and drink normally, says the report.

Produced with the help of the British Society of Gastroenterology, the report aims to guide healthcare professionals, who are sometimes at odds over the merits and ethics of the situation. There is a misguided belief, it says, that tube feeding keeps patients alive longer. But the evidence does not support this.

A recent national confidential inquiry into patient outcomes and death (NCEPOD) investigation found 19% of those undergoing the procedure had it fitted inappropriately. "They described it as futile," said Burnham. Almost half of those who died (43%) did so within a week.

While a nasal tube is safer than a device fitted in the abdomen, a so-called PEG, the best option for patients is normal feeding wherever possible. "'Nil by mouth' should be a last resort," says the report.

It calls for agreement between the patient, relatives and healthcare professionals about the aims of artificial feeding. "Such decisions should never be based on the convenience of staff or carers. Nor should artificial feeding ever be required as a criterion for admission to any institution providing care," says the college.

All trusts and care homes should ensure there are enough staff to help those with difficulties take longer to eat, especially at meal times. "People in the later stages of dementia have complex end-of-life needs and it is vital that the use of artificial nutrition or hydration not be used in place of good quality care tailored to their specific needs," said Neil Hunt, chief executive of the Alzheimer's Society, which believes that "the quality of life should be considered a priority over length of life in the later stages of dementia".

The numbers of people in the community fitted with tubes for artificial feeding has risen steeply. One survey showed a growth of 11.6% between 2006 and 2007.

A Department of Health spokesperson said: "The use of intrusive interventions, such as tube feeding, is a clinical decision and should only be used when necessary, based on the circumstances of the person concerned, and with their or their representative's agreement. We would expect services to allow maximum choice and control wherever possible and to respect people's dignity and human rights right up to the end of life."

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The building of five new care homes could be delayed to help Highland Council cut millions of pounds from its budget.

Highland faces having to make £60m in savings over three financial years starting next April.

Councillors will be asked to review the business cases for the homes planned for Inverness, Fort William, Muir of Ord, Tain and Granton-on-Spey.

Tenders for three of the homes were due to go out next month.

The cost of constructing the care sites at Inverness, Fort William and Muir of Ord was estimated at £18m.

Building new care homes was a key policy of the former SNP-Independent administration. It is now controlled by Labour, Liberal Democrats and independents.

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PENSIONERS protested against plans to close a popular care home in Birmingham city centre yesterday.

Staff and supporters joined residents to oppose proposals to close Edwin Arrowsmith House, in Handsworth.

The home is due to shut in February and is one of 29 being closed by the council.

Iris Farmer, aged 82, whose close relatives and friends had all recently died, said: “I don’t want to go. The care workers, managers and even domestic helpers are like a family to us.”

And Colin Mitchell said the home was “vital” for his mum Aletha Campbell, aged 76, who has dementia

“She needs that stability and familiarity the home has provided for the past three years,” he said.

“Any movement could be traumatic – some of them may not recover.”

Mary Campbell, who has worked at the home for 17 years, said staff had been told they would all lose their jobs once the home was taken over.

The care assistant said many of the workers had only stayed in their jobs to “support the residents” after the council-run home announced its first phase of changes.

She claimed that alternative jobs offered to some staff were unsuitable.

“We’ve just been offered a few jobs to calm us down.

“One offered to me was only part time, whereas I work full-time. There are no good jobs really.”

The protestors were joined by union representatives and people from the Handsworth community.

A council spokesman said the closure was part of a process to improve the standard of care in the city. She said 180 staff will be made redundant but could not say which homes they would be from.

A meeting is due to be held in two weeks between staff and council representatives.

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A Las Vegas adult group care home has come under fire by state health investigators, who have banned admissions to the home and intend to issue sanctions.

The 150-bed licensed home, Chancellor Gardens of the Lake, came under state scrutiny in September when state inspectors heard complaints that residents were not receiving medications and staff threw medicines away because they did not have time to administer them to patients.

Staff members confirmed to the Nevada State Health Division's Bureau of Health Care Quality and Compliance that failing to administer medications and throwing them away were common practices, said Richard Whitley, administrator of the health division.

The staff also reported that every resident was missing one or more medications at the home, located at 2620 Lake Sahara Drive, which is south of Sahara and west of Durango Drive.

During the investigation, state inspectors learned three patients had been hospitalized after not receiving their prescription medicines.

The bureau staff sampled 23 residents and found that none had received their prescription medications, Whitley said.

While the home's administrators agreed to provide all medications through a pharmacy, the state continued to receive complaints in October involving the same issues. During the second investigation, 28 residents sampled had not received their prescribed medications, Whitley said.

The group home then agreed to have a physician examine all patients without a doctor and to supply missing medications. Two registered nurses have been hired to distribute the prescriptions and a consultant is on premises to assist them.

Since the investigation, Whitley said the executive director of Chancellor Gardens of the Lake has resigned and the administrator has been reported to her licensing board.

The state's action includes limiting all new admissions for a minimum period of 72 hours. The ban will be lifted when the home demonstrates that its practices have improved and deficiencies corrected, Whitley said.

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Ambitious plans to reform care for the elderly in Lincolnshire have been criticised by Unison – who say the county council is shirking its responsibilities.

The public service trade union says the move to close the remaining council care homes would make private care the only option for the elderly.

Lincolnshire County Council responded to these criticisms yesterday as it launched the three month consultation period for the proposals.

Executive Councillor for adult social care Graham Marsh: "I would invite Unison to become involved in the consultation period because they doubtless have some good ideas.

"This has never been about cutting the budget or passing on responsibilities.
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"We are giving people more choice about how they receive their care.

"Extra care housing allows people to stay in their own little domain but have all the care they need on hand.

"We have highly trained and efficient staff and I want to make sure that as many of them as possible continue working in adult social care in some form."

Under the reforms, the eight remaining homes, which predominantly provide temporary and respite care, would be closed and private and voluntary sector homes would be provided as an alternative for short stays.

Extra care housing be provided, meaning people would have a self-contained flat in a complex where 24 hour care was available if needed.

Lincolnshire Branch Secretary of Unison John Sharman said: "Over a period of years the county council has divested itself of all direct care provision.

"We will certainly be getting involved in the consultation period and putting forward the views of our members."

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A FORMER old people's home could be sold off and the future of a day centre reviewed as part of a shake-up of elderly care provision in the Moorlands.

The ruling administration on Staffordshire County Council is looking at how care is funded at a series of consultation events, including one in Leek next week.

Opposition leaders fear that could lead to people being forced to fund their own care.

They are also concerned that Springhill Hostel in Leek, a home for people with learning difficulties, could be under threat.

Care home Kniveden Hall in the town was closed by the county council last March as part of the authority's controversial Changing Lives programme.

The council had originally promised to provide extra care facilities on-site, which would have enabled older people to live independently within a sheltered complex.

Now, it has revealed it is costing £150,000 a year just to secure the site, sparking fears it will be put up for sale.

Moorlands MP Charlotte Atkins said: "Those of state pension age and older make up 24 per cent of Moorlands residents, nearly five per cent higher than the UK average.

"This £1 million purpose-built facility is being stolen from the people of the Moorlands at a time when adult social care has never been more needed.

"The future of the Leek Day Centre is already being reviewed by the county council. The social care of our most vulnerable citizens is of vital importance to us all and should not be trifled with."

A county council spokesman confirmed a decision had been made to decommission Kniveden, but said it would be retained until a long term plan for the site had been drawn up.

County councillor Steve Povey, whose father had an eight-week respite stay at Kniveden, said £1.5 million was spent on refurbishing the building to accommodate Leek Day Care Centre.

But on the day it was due to move in, it was announced Kniveden could close.

He said: "I cannot believe they are decommissioning this building after spending so much money. Worryingly, Springhill is also mentioned in a letter sent out to councillors and it is obvious that they are also looking at the future of that site.

"Reading between the lines, I think are going to end up paying for their own care."

County councillor Matthew Ellis, cabinet member for adults and wellbeing, said: "Local authorities are finding it impossible to meet fast growing demand for care.

"It is vital to hear the views of people across all age groups and circumstances."

The consultation meeting will be held on Tuesday from 10.30am until 12.30pm at the Churnet Room, Moorlands House, Stockwell Street, Leek.

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MORE than a 100 jobs could go in a major reorganisation of Devon's care homes.

Bosses at County Hall have revealed they are looking to reduce the number of staff in Devon's residential care homes by up to 130.

Devon County Council says the decision has been a difficult one but claims the move will save around £5m — money which the authority says will be injected back into front-line services for the elderly.

The announcement comes just days after the county revealed that it would be shedding up to 500 public sector jobs in a bid to cut costs.

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RELATIVES of an elderly woman who died at a Bromsgrove care home earlier this year have thanked staff with a special donation.

Valerie Rowlands, from Lickey, and her sister, Diane Nicholson, presented Tutnall Hall Care Home, in Tutnall Lane, with a bench in memory of their late aunt, Dot Carter.

Dot, who was 94 when she died, lived at the care home for five years, following a stroke.

Dot’s two nieces visited the home on October 27, along with other family members, to officially present the garden bench to staff and residents.

Valerie said they wanted to show their gratitude for the care she received during the time Dot was there.

She said: “She remained at Tutnall Hall until she died in July and received excellent, loving care during those five years.”

Gwen Cruickshank, from the care home, said everyone was really appreciative of the donation.

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 A HIGH Court judge has refused a last ditch attempt to save two care homes in Southampton.

Families of elderly residents living at Birch Lawn in Sholing and Whitehaven Lodge in Millbrook have branded the decision a “death sentence”.

Solicitors acting on behalf of the residents worked through last night to apply for a further injunction at the Court of Appeal this morning.

An initial injunction was put in place as Southampton City Council considered closing just one of the homes and they have written to the council with the same appeal again.

As reported in the Daily Echo, the High Court rejected an initial application for a review earlier this year.

Southampton City Council’s Councillor Ivan White, Cabinet member for health and social care, said: “We have put no specific time scale on the closing of the two homes and will work closely with residents and their families and friends to help them to make the transition to a new home in the best possible manner.”

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A LETHAM woman is calling for a face-to-face meeting with the chairman of the Balhousie Care Group after having a number of complaints she raised against the group upheld by the Care Commission.
Tina Peddie spoke out after chairman Tony Banks appeared on the popular television series "The Secret Millionaire", distributing over £120,000 to various projects in the Anfield area of Liverpool.

The programme, screened three weeks ago, featured
Tony visiting the home of an elderly resident - later paying to have her garden professionally landscaped.

However, Mrs Peddie has hit out at the level of care given to her elderly mother in the Balhousie Lisden Care Home in Kirriemuir.

She became so distressed about her mother's treatment in the home's dementia unit, her loss of weight and the laundry facilities at the home that she contacted the Care Commission earlier this year.

Care Commission officers visited the home, unannounced, in July this year to investigate four specific complaints - all of which were upheld.

These included Mrs Peddie's mother's care plan which is not detailed enough to meet her needs.

The officers found that, while the care plan reflected her physical needs, it did not provide a holistic picture of someone with social/emotional needs and who has dementia.

Stimulation

They also upheld the complaint that the elderly resident did not receive enough stimulation from staff in the home and was often left unoccupied.

The officers found staffing levels in the dementia unit were not high enough to allow individual members of staff to take time to be with her, and staff in the unit seemed unsure of good practice around working with people with dementia.

They upheld the complaint that the level of staffing in the EMI unit (high dependency) of the home was not sufficient to meet the needs of the residents. This includes support for eating at meal times and for promotion of fluid intake.

Observation and discussion with staff suggested staff on duty only had enough time to address the physical needs of residents.

All staff interviewed during the inspection felt they did not have enough people on duty to meet all the needs of residents, and visitors interviewed about their experience of the dementia unit felt that, although the service was good, there was sometimes a need for more than two staff on duty.

Mrs Peddie also claimed the home's system of laundry management failed to prevent her mother's clothes going missing and, although her own clothes were clearly labelled, she had been found dressed in clothes clearly marked with other residents' names.

Again, this complaint was upheld

Sucked in

Mrs Peddie, who is in the process of having her mother moved from Lisden, wanted to warn others not to be "sucked in" by the glossy brochure, attractive website and initial appearance of the Balhousie Lisden Care Home.

She said: "I was, but have found things are completely different. Other people have also come to me with their own horror stories.

"At present there are 12 residents in the EMI unit. We were told they need one-to-one care but there are only two staff for 12 people. These people need help to eat and drink, they can't do it themselves. My mother has lost so much weight she is now down to seven stone as they do not have enough staff to go round.

"I have found her dressed in dirty clothes, in other people's clothes. That was one of my complaints and that was upheld.

"I would now like to have a face-to-face meeting with Tony Banks to put various questions to him. He came across as quite a charitable character on "The Secret Millionaire". Maybe he's not aware of what is going on at Lisden."

When contacted regarding Mrs Peddie's allegations, Lorne Findlay, the Care Commission's regional manager for Central East Scotland, said: "We received a complaint earlier this year from a relative of a resident at the Lisden Care Home in Kirriemuir, which highlighted a number of issues and concerns at the service.

"These included:

· A complaint that the resident's care plan was not detailed enough and that this resident did not receive enough stimulation from staff and was often left unoccupied.

· A complaint that staffing levels in the dementia unit were insufficient to meet the needs of residents - including insufficient support for helping residents eat at meal times or drink enough fluids.

· A complaint that there was insufficient management of laundry at the service, resulting in the resident's clothes going missing and staff being forced to dress her in another person's clothing instead.

"All of our work is focused on meeting the needs of people who use care services, to ensure they are safe and well looked after. After thoroughly investigating these issues regarding Lisden Care Home, we have upheld all of the complaints and have made a number of requirements and recommendations in order to improve the standards of care at the service.

"Since our investigation, Lisden Care Home has presented us with a detailed action plan highlighting how they will make the necessary improvements needed to address these issues and improve the standards of care provided to residents.

"We have also carried out a subsequent inspection at the service and are satisfied that all of the issues raised by the complainant have been addressed, or are currently in the process of being addressed.

"We will continue to monitor the service to ensure that all of the requirements are adhered to and that residents can expect to receive the correct standards of care."

A spokesman for the Balhousie Care Group, which owns Balhousie Lisden Care Home, said: "We are naturally concerned that anyone, be they resident or relative of a resident, should have any worries about the level of care and individual attention we provide, as this is an area that we and our staff pride ourselves on.

"As a result of the issues raised by Mrs Peddie, we have carried out an investigation into all the relevant facts and circumstances and believe that the majority of the appropriate procedures and processes to protect residents' health and safety were all in place.

"Documentary evidence of this exists, as does an audit trail of procedural compliance. We have, however, instigated additional processes, including the initiating of a new tagging system for personal items of clothing and a review of staffing operations and staffing levels in the unit. Additionally, the handful of issues raised by the Care Commission in recent inspections have also been fully addressed.

Regular meetings

"There have been regular meetings with Mrs Peddie, the care home manager and the Balhousie Care regional manager to resolve the issues Mrs Peddie raised.

"No request has been made for a meeting with our chairman, Tony Banks. However, we would be pleased to arrange one if required and he would be pleased to have the opportunity to discuss any remaining concerns with her.

"Balhousie Lisden received prior notice of the findings of its annual Care Commission inspection in August, and while the report has still to be officially received, previous reports have awarded the care home scores of 4 and 5 (good and very good) and we expect the latest results to be similar.

"All of the management, nurses, carers and other support staff at all Balhousie Care homes are truly committed to the positive, supportive and caring experiences of our residents and we will continue to work together to achieve our aim 'to become the most admired and respected provider of residential care in Scotland'.

"However, we do take any feedback or concerns very seriously and enthusiastically and openly respond to them in the most appropriate and timely manner."

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A £4m centre of excellence for people with dementia will create more than 100 jobs in Wrexham.

Work on the project from care organisation Pendine Park has started. It is due to open next year and will work on new approaches to the way people with dementia are looked after.

The new centre, to be called Bodlondeb, will look after 64 people with dementia who need day care, respite care or residential services.

The concept has been developed in conjunction with academic experts from Bangor University, the Alzheimer’s Society and other leading organisations.

The centre has been designed by the Wynn Rogers Partnership in Denbigh and it’s being built by Wrexham-based Rofft Developments.

Pendine Park is run by Mario Kreft and his wife, Gill, who first started providing residential care nearly 25 years ago because they could not find somewhere suitable for their grandparents. The centre will be managed by Ann Chapman.

Wrexham AM Lesley Griffiths said: “This centre is something that we really need here in Wrexham because dementia is an increasing problem.

“Although we want to keep people at home and live independently for as long as possible, there is going to be a greater demand for places like Bodlondeb.

“In relation to the local economy, the timing of the development could not be better because it is going to create valuable jobs that will help Wrexham come out of the recession.”

Mr Kreft said: “We are passionate about giving people the best possible care in a home environment.”

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When Gwen reached the age of 94 she expected to be treated with a certain level of respect.

After suffering a stroke she was left unable to walk but mentally she was still sharp. She chose to move into a care home near her daughter and sister, and joined in all the activities with enthusiasm.

Within months, however, she became reclusive and refused to go to bed at night. Her GP prescribed a sedative but it didn’t seem to help.

Some of the staff thought she was being recalcitrant. Finally, Gwen told her sister Helen that one of the male care workers had touched her inappropriately. She didn’t want to go to bed because that is when the abuse took place. Incredibly distressed, she insisted that she didn’t want her daughter to know.

“There are some things you just don’t discuss with your children,” she said.

Unfortunately, the police interviewed Gwen in front of her daughter and she felt unable to talk about what had happened. The investigation was dropped.

The home took disciplinary action but the worker resigned before his hearing.

Gwen is one of hundreds of people in Scotland over the age of 60 who have suffered some form of abuse, but the evidence to date has tended to be anecdotal and the issue often remains hidden.

However, figures obtained by The Herald suggest it is a growing problem and one that is unlikely to go away – with dramatic rises in the elderly population predicted in the foreseeable future.

It was generally accepted that abuse took place, but the extent was unknown and unquantified. Statistics from the Care Commission indicate there has been a 54% increase in complaints about neglect and abuse in care homes since 2004.

There has also been a 563% increase in complaints relating to neglect and abuse made against care at home services, a minority of which may relate to younger adults.

In 2007 research commissioned by the charity Action on ElderAbuse, found that more than one third of a million people in the UK over the age of 66, which amounts to 4% of that population, have experienced some sort of abuse, ranging from financial fraud to physical assault.

The survey funded by Comic Relief and the UK Department of Health excluded those living in care homes and people with dementia. It found that in Scotland, the problem is particularly acute. The percentage of those over 66 who have been victimised is higher than the UK average and second only to Wales.

While 3.9% of elderly people in England and 3% in Northern Ireland reported being victims, in Scotland it was 4.3%. In Wales it was as high as 6%.

Overall, 2.1% of men and 5.4% of women were victims. However, in Scotland, men were more likely to be abused than women. In England the percentage of women who experienced some form of abuse was 5.6% compared with 1.6% for men. In Scotland 3.6% of women reported being victims against 5.2% of men.

Among the findings was the fact that an estimated 342,000 people in the UK have experienced some form of abuse. About 42,000 were in Scotland.

As the population ages, the problem is expected to get worse unless there is a dramatic shift in attitudes and approach.

Daniel Blake, head of policy for Action Against Elder Abuse, said it receives around 18,000 calls a year from those who have suffered some form of abuse. He added: “The figures that we see are merely the tip of the iceberg. Financial abuse in particular is growing in prevalence.

“It’s a myth to assume that the vast majority of abuse goes on in care homes. The majority of abuse goes on in people’s own homes. It is the last taboo in abuse that society is only gradually coming to terms with having faced up to domestic abuse and child abuse. Domestic violence does not magically end once people reach the age of 65. As a society we have struggled to accept that.

“We recognise children are groomed and have to realise the same applies to older people – professionals and relatives spend time gaining their trust and partly as a result older people may not realise they have been a victim.

“We are also concerned about the very low level of prosecutions and convictions against such people. With the growing population there is clearly the potential for this problem to increase and unless we get this right and change attitudes and approaches, there will be a lot more people put at risk.”

Scotland has now put in place new legislation to try to curb the trend, but experts say attitude change and greater awareness raising of the problem is still required.

Under the Adult Support and Protection Act 2007, introduced 12 months ago, local authorities have far greater powers to help identify “adults at risk”, provide support to them when they need it, and to provide the means to protect them from harm. The legislation, which is still bedding in, gives local authorities the power to intervene and even issue “banning orders” if they have serious concerns about abuse.

There have been prosecutions but charities believe many more cases go unreported.Charities say older people need to be given more support when they do come forward and that general societal attitudes towards older people need to change.

“Why do we refer to the population projections as a demographic timebomb? Asked Mr Blake.

“We need to recognise older people as individuals in their own right who still have a great deal to offer.”

The issue of elder abuse raises incredibly uncomfortable questions, not just about how we allow the older generation to be treated - including our own parents and grandparents - but how ultimately we wish to be treated ourselves.

Names have been changed to protect identities.

 

    * Scottish Helpline for Older People: 0845 1259732

       

       
    * Action Against Elder Abuse UK freephone number: 0808 808 8141

       

       
    * Care Commission can be contacted on: 08456030890 or www.carecommission.com

       

       

       

      Highlighting the isolation and dangers faced by those in care

       

      Joseph Sinja, 32, a Kenyan who had been allowed into the country to study at a Bible college, was jailed for six years and eight months for sexually assaulting a 76-year-old woman in the care home where he was working.

      Sinja had been put in care of elderly people at the home run by Edinburgh City Council after training that consisted of “four days of following someone round”.

      The case in August prompted a call for an inquiry.

      Often the sensitivities of the problem and the isolation and vulnerability of those involved means they are understandably reticent about reporting problems.

      A report published in May by the Care Commission and Mental Welfare Commission, revealed that there are some 67,000 people in Scotland have dementia and about 40% of them are in care homes or hospitals.

      It states: “The nature of the illness means they need a lot of care and support and they are more at risk of having their rights overlooked.

      “Where others may be more involved in their care, be able to express their wishes, ask others for help, or exercise their right to make a complaint, people with dementia have often lost many or all of these abilities.

      “Around 70% of people living in the care homes we visited had varying degrees and types of dementia.

      “Around half of all people never went out of the care home and there was very little planned activity outside the care home.

      “Activity was not tailored to individual interests and activity co-ordinators were not always trained or supervised in their role.”

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Private payers now account for 41% of care home places and while fee increase are predicted to remain “modest” in the short term, specialist IFAs are warning that they remain significant.

New research from independent analyst Laing & Buisson shows that fee inflation reported by care homes has slowed to an average of 1.9% for nursing care and 3.2% for residential care. However, advisers are warning that many self-pay residents find they exhaust sources of funding, leaving cash-strapped families and local authorities to pick up the tab.

It is “very, very common” for care home residents to run out of money, according to Nicky Cave, managing director of Eldercare Group, who points out that care home providers often end up accepting a reduced fee paid by the local authority, having previously failed to assess the ability of the resident to keep up payments.

According to Andrew Dixson Smith, managing director at Care Fees Investment, local authorities are increasingly asking families to top up the cost of care, something “very few” are able to do.

“Averages are very dangerous in this area,” says Chris Horlick, managing director of care at Partnership, the care fees payment plans provider. “People talk about the average residential care home fee but we all know you would be struggling to find that in the South East of England. They are very often double that and more.”

With local authorities struggling with finite sources of funding, central government admitting that public spending cuts are inevitable and the number of people aged over 75 set to increase by 55% in the next 20 years, advisers are urging all three political parties to take urgent action.

AWARENESS

Research suggests that the public is ill-prepared for the reality of funding their care in old age. In a survey conducted by Saga half the respondents (46%) said they believed that the state should pay for the care needs of older people, rising to 58% of people over 50.

“When people phone us up some do expect a lot more help from the government so we have to explain the rules to them and some of the positives,” says Alex Edmans, care funding adviser at Saga. “If you have your own assets and savings and capital, it does seem unfair but at least you have the choice of being able to afford care you want in the setting you want for the rest of your life.”

Cave says she was “disappointed” by the failure of the government’s recent green paper to address the needs of those currently entering care and suggests one proposal could have been a mandatory requirement for people to get a quote for an immediate needs annuity. “Forty per cent of those that get a quote – if their profile fits the product – take it up,” she points out. “That’s 40% who would never become social services users.” Liz Faye of Palm Financial Services claims that a third of quotations come to fruition, with many clients attracted by the promise of peace of mind.

“The problem we have is that immediate needs annuities are very little understood,” says Chris Horlick, He argues that local authorities should direct self-funders to independent financial advice and suggests that the government should amend the Charging for Residential Accommodation Guide (CRAG) to signpost people accordingly.

EXHAUSTED FUNDS

Advisers agree that many care home providers fail to carry out due diligence when accepting new residents.

“At the moment they don’t typically look for a guarantee,” says Cave. “They ask no questions and then what happens is that they run out of money and social services step in, paying maybe £400 instead of £600. I would suggest the vast majority [of providers] take the hit, and do nothing about it so the business owner takes a £200 a week loss. That is the journey we are on, to educate business owners and build processes in.”

Dixson-Smith says that a key objective of the Society of Later Life Advisers is to ensure that more care home providers work with IFAs to conduct checks on prospective residents and ensure that they receive specialist financial advice. According to Faye, half of the homes she works with have taken up her offer to vet potential residents (with their permission).

“They and their families don’t mind,” she says. “They expect people to do due diligence. I think that is where an IFA comes into their own. You can make sure families are not missing out on funding.”

RISING FEES

While Laing & Buisson predicts that 2010/11 will see a continuation of “relatively modest” fee and cost increases, advisers stress that care home fees tend to rise above the rate of inflation. Cave has seen one group increase fees by an average of 7%. Horlick predicts fees will rise by between 3-3.5% over the next 12 months.

Simple measures can be taken to cover the cost of rising fees, for example by building in an escalation option to an immediate needs annuity, linking it to RPI or at a fixed percentage such as 5% per year. Cave has persuaded three provider groups to agree to limit care fee increases for clients with an annuity in place, pointing out they benefit from residents with a guaranteed source of funding.

With one in four of us likely to require care the need for specialist advice is set to soar. Horlick would like to see more advisers enter the market, confident that they can find business from their existing client bank. Often this will mean clients with parents facing the prospect of going into care.

SOURCES OF ADVICE

	Percentage of people
Source: Partnership
BANK/BUILDING SOCIETY	4%
FINANCIAL ADVISER	12%
THE CARE HOME REFERRED ME TO SOMEONE	15%
INTERNET	16%
FRIENDS	13%
LOCAL AUTHORITY	66%
HEALTH PROFESSIONAL	34%
OTHER	9%
DIDN’T KNOW	1%

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PLANS to convert one of Watton's oldest buildings into a 40 room care home could be in doubt because of serious objections to the scheme.

An application was submitted in early September to convert Beechwood House in High Street into a retirement complex.

The plan, which has been put forward on behalf of a company called Jetspark, would see the historic house kept but the current side wing and outbuildings demolished to make way for a C-shaped extension.

The application states the complex would comprise of 40 suited resident rooms, oversized principle resident lounges, a dining room, and secondary quiet rooms.

But documents contained in the planning files held at Breckland Council reveal Norfolk Property Services, acting on behalf of Norfolk County Council, has raised serious concerns about the proposal.

In a single page letter Ann O'Leary, development manager for care homes at Norfolk Property Services, states: “Analysis of the provision of care homes in March of this year indicates that there is no shortage of long stay care provision in Watton and the surrounding area with their being 124 places registered to provide personal care (excluding the Norfolk County Council care home) and an additional 30 to provide nursing care.

“The people most likely to be looking for residential care in the future are people with significant levels of dementia.

“There are guidelines for designing care settings for people with dementia to promote their wellbeing and the individual and communal internal and external space and layout of the proposed scheme is not in keeping with these. Nor is it in keeping with the county council's aspirations for the standard of future residential care accommodation.”

The letter goes on to question whether the care home would be appropriate for short term care and states “Watton is possibly not the most appropriate location in Breckland”.

The response follows an objection from Watton Town Council in September in which councillors expressed a number of concerns including “the excessive number of small rooms”.

The application is due to be decided by the planning authorities at Breckland in the coming months.

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A campaigning lawyer has saved the lives of thousands of vulnerable and frail people in care homes, a tribunal heard yesterday.

Yvonne Hossack, 53, saved at least 80 care homes by representing their powerless residents.

She successfully argued the effects on those being moved are so traumatic that they can prove fatal.

But she told the Solicitors' Disciplinary Tribunal yesterday she faces being struck off for giving a voice to frail and elderly clients.

Asked what she would do if there was a conflict between her client's interest and the rules, she said: 'It's hypothetical, because I don't think it's ever happened.

'But if somebody was falling off a cliff, and they were blind and deaf, I would ignore the rule that says "keep off the grass", in trying to grab them back.'

She added: 'Very rarely will a solicitor be dealing with a case involving saving the life of another human being rather than saving their property, but I have saved hundreds if not thousands of lives.

'I do it pro-bono and I do it at risk of local authorities trying to make vindictive claims for wasted costs against me.

'I risk my home and my health trying to protect my clients from death and suffering.

'There is no one in the whole of the country who believes that I have brought my profession into disrepute - apart from the four people from councils who have complained.

'The people who have a direct interest in these proceedings are the local authorities, who may otherwise face challenges to their cuts to services for disabled people.'

Giving evidence at the tribunal she said: 'If my client's life is at risk then my overriding duty is to try and save my client from death. If there is ever a conflict that duty must be paramount.'

She added: 'It is notable not one single person of all the thousands affected directly nor indirectly by my work have ever made a complaint.

'The only persons making a complaint are the solicitors representing those I have acted against.'

Mrs Hossack, from Kettering, is accused of six breaches of rules governing solicitors' conduct, including accepting instructions from third parties without seeking clarification of the position, and providing confidential information to third parties.

She denies all charges. The tribunal heard separately from two of Mrs Hossack's clients, who said her intervention had stopped them from committing suicide.

Eugene Hyde, 76, from Stone, Staffordshire told how he had tried to kill himself because his residential home faced closure.

He said: 'To lose Yvonne as a solicitor would be a grave loss and injustice to the elderly, and there would be nobody to fight for those who can't fight for themselves.'

Accountant Andrew Norman, 45, who is in a wheelchair because of muscular dystrophy said Mrs Hossack had battled to get proper care for him.

He said: 'She spoke to me in such a way that made me realise that although it seemed the Local Authority clearly did not care about me, there was someone who was willing to help me. She helped save my life.'

The tribunal will give its verdict tomorrow.

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The dementia affecting hundreds of thousands of Britons may be a legacy of the Second World War, a scientist has claimed.

Research presented at a conference in York yesterday suggested that traumatic stress can trigger Alzheimer's and other conditions.

More than 700,000 people suffer from dementia in the UK and Dr Karen Ritchie, from France's National Institute of Health and Medical Research, believes that many of today's cases could have been caused by armed combat, or by the Blitz.
Lasting legacy: A scientist has claimed that Dementia may have been caused by armed combat, or the Blitz

Lasting legacy: A scientist has claimed that Dementia may have been caused by armed combat, or the Blitz

Her claims are based on studies of French citizens forcibly expelled from Algeria in the 1950s.

Known as the 'pieds noirs', they had crossed the Mediterranean and many had settled in the coastal district around Montpelier, where the research was conducted.

She said: 'They had suffered extreme stress, losing their homes, and having their lives threatened, sometimes by people who were once their neighbours.

'The ones who had the worst symptoms (of dementia) now were those who had suffered most at the time.

'These people needed help when they were ten or 20, not when they were 65.'

Dr Ritchie continued: 'Although research has not been carried out on Second World War veterans it is fair to assume that a lot of the dementia we have here in that age group is a result of the war.

'There are people around the world still suffering the trauma of war and other disasters and they too could be part of future generations of dementia.

'We in the post-war generation are lucky to have escaped that kind of large-scale trauma, but it does raise the question of how we would cope if we were faced now with that kind of situation.'

She added: 'We are all a bit like Russian dolls. It may be the child inside us that carries the risk factor.'

Dr Ritchie told the conference of the Dementia Services Development Centre that today's UK troops would not suffer the same way because they were trained in advance to deal with traumatic situations.

However other causes of trauma, including child abuse, could lay the foundations for dementia in later life.

At the same time other risk factors based on lifestyle, such as obesity, smoking, poor diet and low educational attainment could be modified.

'Prevention of dementia should start in the teens and twenties,' she said. 'By the time the symptoms appear it is too late.'

Other important factors include depression and certain drugs - especially in women - and heart disease, strokes, and diabetes, which were more likely to affect men.

 

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A council-run care home is on the verge of closure because there will soon be no elderly residents left there.

The few remaining pensioners at Greenholme, in Haltwhistle, are being left with no other option than to move away from the town that they were born and bred in, according to their families.

They now fear the home will be forced to close in the foreseeable future.

The town’s oldest resident, Maude Thompson, aged 102, has lived at Greenholme for the past 14 years. But arrangements are being made by her son, Barrie Thompson, to find alternative accommodation for her.

She has always lived in Haltwhistle. She was brought up at Ashcroft Terrace, before moving to Tyne View Road in 1937.

Once Mrs Thompson leaves, it is understood that only two residents will be left in Greenholme. The home employs 32 staff.

Mr Thompson said: “My mum is really upset about it and wants to know what is going to happen to her.

“My mother will probably, in the near future, be by herself in Greenholme. When I realised the situation I had no choice but to look at other homes.”

A statement issued by Northumberland Care Trust indicates that although assessments of Greenholme residents were taking place, no decision has yet been made about its future but that the situation was being closely monitored.

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AFTER investing more than £500,000 and training staff 'above and beyond' requirements, a frustrated care home owner lashed out at Rotherham Council this week, asking: "Why are you letting this place go to ruin?"

All 33 elderly residents at Highfields in North Anston were evacuated last September, after Rotherham Hospital raised concerns over pressure sores on one resident.

Embattled owner Selva Bala said he co-operated throughout the subsequent 10-month safe-guarding investigation - in which the home was cleared of abuse - but still the Woodsetts Road home lies empty.

Independent health regulator The Care Quality Commission is satisfied with the improvements, which has everything from beds and bathrooms to crockery and cutlery replaced, as well as specialist training on care plans and end-of-life care.

"After all we have done and achieved, the council has terminated my contract," said Mr Bala.

"Why is that? I want them to justify what they have done."

The 40-bed home was granted EMI status three years ago. An inspection less than 12 months before the mass evacuation praised the home's choice of meals and care plans, but suggested there ought to be more activities.

Staff claim the elderly lady, whose visit to hospital triggered the events last Septmber, had a history of pressure sores.

But RMBC still took the unprecedented step of shipping out all the residents because of 'serious concerns' about management and care.

"When they removed all the clients, it was said to be temporary," said Mr Bala, who also runs a high occupancy home in Great Yarmouth.

"But it's become clear they want this place closed down. The CQC inspected, and they are happy with all the improvements and repairs. And, at the same time, the police said there was no cause for further action."

"We have tried to communicate with the council, but they have failed to do this in many ways. I was never interviewed, and it feels as though I've been kept in the dark."

"They could have easily come back and said 'Let's work together and get these people back home.' It could have all been done months ago. I still don't have the reasons for what's happened, it's very frustrating."

Thirty members of staff had be laid off in June, after completing the necessary training only to find Mr Bala was still unable to regain his contract in order to bring in clients.

Almost a third of the residents who were moved out passed away within three months. Staff at Highfields believe this would not have been the case without all the upheaval.

One staff member said: "The council preaches about dignity and respect, but on the morning all the residents were taken, the were piles of black plastic bags in the corridors, full of their belongings. How is that dignity and respect?"

"Most of them were crying, because they had built up relationships here with the staff. And later, the council stopped us from visiting any of the residents in the homes they had been moved to, saying it was upsetting them."

"It's such a homely home and, at the moment, such a waste of resources, especially while they are short of beds elsewhere in Rotherham."

A spokesman for the CQC said: "It is up to the council to decide, as the commissioner of services, whether or not a contract is awarded."

"We will go in to make sure we are happy that everyone is treated with dignity and respect, well looked after, well fed and safe. These are judged on a sliding scale, from zero to excellent, and from there it is down to the local authority to make the decisions."

CQC reports on Highfields are expected to be published before the end of August.

A spokesman for Rotherham Council confirmed that the authority will not be lifting the suspension of placements at Highfields.

She added: "During a four-day period last September, 33 residents of the home were relocated, following a multi-agency decision due to a severe risk of abuse being experienced by residents. Sixteen cases of abuse were investigated."

"The outcome of the case conferences concluded 'substantiated abuse/neglact' in 15 of the 16 cases. It was then agreed by cabinet member in July not to commission further residential placements at the home and the contract with the owner will be terminated as soon as possible."

"Throughout this whole process the authority has been communicating with the owner and his solicitor about the decisions made."

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Environmental health officers uncovered a catalogue of hygiene worries at a Northampton care home prior to its temporary closure last month, it has emerged.
Inspectors visited Green Park Residential Nursing Home, in Wellingborough Road, in Abington, on April 20, just eight days before an unannounced inspection by the Care Quality Commission (CQC) found "serious issues" with the standard of services at the home, rating it "poor" and giving it zero stars.

Officers from Northampton Borough Council looked at the home's kitchen, cellar, store cupboard and staff facilities and judged them to be of "poor" quality, giving the home just one star out of a possible five.

One inspector said: "I am very concerned that the practices seen during my inspection, together with a lack of staff awareness of food safety systems, indicates a lack of management controls over food operations."

Inspectors noted that food stored in the fridges was being kept at too high a temperature, leading to a risk of food poisoning. The extractor canopy and filters in the kitchen were reported to be dirty and greasy and the wash hand basin in the kitchen had been used to wash up dirty equipment and crockery.

The owner of Green Park Residential Nursing Home, the Msaada group, based in nearby Kettering Road, informed the CQC it wanted to deregister the home's nursing category last month, following the commission's inspection and zero -star rating.

Inspectors visited the home after concerns from a number of organisations, including environmental health. The home's 17 residents were placed in other homes by Northamptonshire County Council, working alongside Northamptonshire Primary Care Trust.

A spokesman for Msaada Group said: "We wish to reiterate that the home has not been shut down and that we are working closely with all agencies and authorities concerned to reopen Green Park.

"We have almost completed all works required in accordance with the Environmental Report and are looking forward to re-opening the home and providing the highest standards of service and care to the Community.

"We are hoping to have all works completed by the beginning of August."

e home, rating it "poor" and giving it zero stars.

Officers from Northampton Borough Council looked at the home's kitchen, cellar, store cupboard and staff facilities and judged them to be of "poor" quality, giving the home just one star out of a possible five.

One inspector said: "I am very concerned that the practices seen during my inspection, together with a lack of staff awareness of food safety systems, indicates a lack of management controls over food operations."

Inspectors noted that food stored in the fridges was being kept at too high a temperature, leading to a risk of food poisoning. The extractor canopy and filters in the kitchen were reported to be dirty and greasy and the wash hand basin in the kitchen had been used to wash up dirty equipment and crockery.

The owner of Green Park Residential Nursing Home, the Msaada group, based in nearby Kettering Road, informed the CQC it wanted to deregister the home's nursing category last month, following the commission's inspection and zero -star rating.

Inspectors visited the home after concerns from a number of organisations, including environmental health. The home's 17 residents were placed in other homes by Northamptonshire County Council, working alongside Northamptonshire Primary Care Trust.

A spokesman for Msaada Group said: "We wish to reiterate that the home has not been shut down and that we are working closely with all agencies and authorities concerned to reopen Green Park.

"We have almost completed all works required in accordance with the Environmental Report and are looking forward to re-opening the home and providing the highest standards of service and care to the Community.

"We are hoping to have all works completed by the beginning of August."

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Almost 200 Birmingham care home workers facing redundancy feel let down and betrayed by the city council, union leaders said last night.

Unison attacked plans to axe the jobs of up to 180 men and women employed in old people’s homes, claiming the decision made a mockery of a pledge by council leaders to protect the long term interests of its workforce.

In what is believed will be the first compulsory redundancies at the council for more than 50 years, the cabinet agreed yesterday to a £2.8 million compensation package for the threatened staff – the average redundancy payment will be £8,000.

The decision reflects a determination to press ahead with a shift toward more social services provision by the independent and voluntary sectors.

All 29 council-run old people’s homes are in the process of being closed.

In a statement, the council’s Unison branch said workers facing the sack were predominantly low paid women a majority of whom were black.

The statement continued: “There has been no discussion on minimising the negative impact on this group. The work to minimise the potential has been negligible with a big focus on looking for work in the private sector where wages and conditions are inferior.

“Most of the staff affected have given the best years of their lives to maintain the highest standards of care to some of the most vulnerable people in our city.”

The union said the likelihood of redundancies broke the terms of the council’s employee bargain introduced last year, which promised to try to find alternative employment within the local authority for anyone willing to retrain and switch jobs.

Unison added: “We believe that in an authority this size, the largest in Europe, we should be able to refigure services without the need for compulsory redundancies.”

The council said that more than 200 people employed in the adults and communities directorate, whose jobs are in line to disappear, had already been found alternative employment within the local authority.

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Beverley Co0ttage care home in Burnham-on-Sea and owned by Brunelcare is due to clodse in July.
The reasons being cited for this are the increasing competition amongst care homes in Burnham on Sea and an inability to generate the levels of fees needed to keep the home viable.

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Plans for a care home, business centre and 18 houses on the outskirts of a north-east village were unanimously rejected by councillors yesterday without discussion.

Local firm Osprey Homes sought consent for the plans, which included three affordable homes, on the western edge of Tarves, near Ellon.

Business owner Jim Benton claimed they were popular with locals and he was disappointed by the decision of Aberdeenshire Council’s Formartine area committee.

The developer has been refused permission to build at the site before.

In April 2008, a Scottish Government reporter dismissed an appeal by Osprey Homes to build 15 houses and three affordable homes.

And last month a Scottish Government reporter refused an appeal to build a business centre, care home, 15 houses and three affordable homes after a public local inquiry.

Both appeals were made on the grounds of non-determination by the council.

A report to councillors raised fears that the developer would not build the care home or business centre once the other properties were complete.

The report added that, under the application which was refused by a Scottish Government reporter last month, the developer proposed that the construction of the business centre be funded by the sale of the houses.

But the developer no longer wanted them to be linked.

The report added: “The business centre and care home were crucial elements to this planning application and without a section 75 agreement to ensure construction of them, they may never be built.”

Planning officials said the application was against both Aberdeen Structure Plans and Aberdeenshire Local Plan policies and recommended refusal.

Councillors unanimously agreed to block the plans without debating them.

After the meeting, Mr Benton said: “We are disappointed at the loss of the 45 to 47 permanent jobs which would have been created in Tarves between the care home and business centre but will not be applying again.”

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A CARE home for elderly people suffering from dementia is being shut down after independent assessors voiced serious concerns over patient care.

A probe was launched into privately owned Pangbourne Residential Care Home in Hartlepool by Hartlepool Council last week.

Council officials stepped in and placed their own manager and social care staff in the home while the full investigation was carried out.

A council spokesman said there was no suggestion that anyone had been abused at the 17-bed home on Park Avenue.

The home is run by Dr Samarendra Mahapatra, a specialist registrar in psychiatry.

Nicola Bailey, the Council's Director of Adult and Community Services, said today: "Following a recent meeting with the council, the owner of Pangbourne has decided to close the home.

"The priority now is to relocate the residents to alternative accommodation and where there is a desire for residents to stay together, we will clearly try to achieve this.

"In the meantime, our investigation is still ongoing but we hope to conclude it soon."

Mrs Bailey said that the authority had kept residents' families fully informed throughout and would continue to do so.

Last Wednesday Hartlepool Council announced that it was conducting an investigation into the running of it after serious concerns were expressed by independent assessors and the authority's own social care staff.

Pangbourne is featured on Hartlepool Council website as one of three residential care homes in the town for adults with mental health needs and is rated good by independent social care inspectors.

The manager's description reads: "We are a small, friendly home with a home from home feel. All our staff are qualified to NVQ Level 2 or 3. We are a short walk or bus ride from Hartlepool town centre. We have rooms which overlook the beautiful Ward Jackson Park."

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 A CARER recognised for her tireless work which improves the quality of life for people with dementia has scooped an award for her determination.

Audrey Wilds was a clear winner at the Care Awards ceremony, being crowned the champion of dementia care.

Audrey, a night care team manager at Hyde Valley House in Welwyn Garden City, impressed judges with the high quality of care she provides for her residents.

The 56-year-old from Stevenage said: "I never thought I would be rewarded for the work I do. It was such a shock.

"I am really honoured to receive the award. I love caring for dementia patients, it is so rewarding to see the difference you can make to their lives."

The third annual Care Awards ceremony was hosted by Quantum Care, the operators of Hyde Valley House.

Maria Ball, chief executive of Quantum Care said: “We created these awards as we wanted to be able to identify and thank those members of staff who are committed to excellence and best practice.



“We are extremely proud of our staff and this is a great way to publicly thank them for the fantastic work they do in ensuring our residents get the highest quality of care.”

She added: “Our congratulations go to Audrey, and we are really delighted to be able to present her with this well-deserved award.”

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The elderly will never be treated with the dignity they deserve until society learns to celebrate old age, Sir Michael Parkinson declared yesterday.

Sir Michael, 74, said his experience with his mother, who endured mixed-sex wards after being diagnosed with dementia, had shown the NHS often provided 'care that was careless'.

Calling for a return to old-fashioned manners, he suggested society needed to ask: 'What's wrong with a wrinkle?'

Sir Michael, the NHS's 'dignity ambassador', spoke out as a survey revealed a fifth of hospital patients are not getting the help they need to eat their meals  -  putting them at risk of malnutrition.

Around one in ten are having to
spend nights in mixed-sex wards, 13 years after Labour pledged to end the practice.

Addressing the Royal College of Nursing conference in Harrogate, Sir Michael said of the treatment of the elderly in hospital: 'In terms of manners and the social lubricant that makes our society work, it's different and it's not like it used to be.

'It's time we reminded ourselves of the old-fashioned virtues.

'Old people should be treated as younger people are treated, they should not be neglected and shoved into a corner.'
Sir Michael, who received a standing ovation from the nurses, told heartfelt stories about his mother's final months in a nursing home.

He said Freda Rose, who died at the age of 96, was fully independent until things began to go ' skewwhiff' when she turned 94.

Sir Michael said she would sit in a chair at the window of the nursing home and imagine a playground full of children and a post office. ' Eventually she lost touch with me. She began to believe I was her son Tom.'
He continued: 'Then we found her dressed in somebody else's clothes, then one day with purple nails and done up like Bette Davis in Whatever Happened To Baby Jane? That was worrying.'

But Sir Michael also said there were amazing moments in the middle of all the 'despair'. He said conversation had become 'impossible' with his mother but on a car drive one day she knew all the words to a Frank Sinatra CD. 'She sang every song word-perfect,' he added.

His voice cracking with emotion, Sir Michael  -  whose father died in 1975  -  told the nurses: 'These stories make you want to cry and laugh at the same time.'

Sir Michael said that while some of the care his mother received was good, on other occasions there was 'care that was careless'. He said that while some nursing homes were optimistic, well-run places, others were little more than ' waiting rooms for death'.
He also criticised NHS bureaucracy and targets, which he said were overriding 'common sense' and preventing nurses from caring for patients properly.

Yesterday, a report found 18 per cent of patients don't get the help they need to eat their food in hospital. Some 43 per cent said their meals were only 'fair' or 'poor', according to the survey of 72,000 patients by the Care Quality Commission, an independent watchdog.
The Daily Mail has highlighted the problem of malnutrition among older patients as part of its Dignity for the Elderly campaign.

Around 11 million meals are taken away uneaten every year  -  either because they are too unappetising or because nurses do not help the frail to eat.

The survey also found around one in ten patients had still been treated in mixed-sex wards.

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A quarter of stroke patients are still not given best treatment - a stay in a dedicated stroke unit - an audit shows.

The Royal College of Physicians found improvements in stroke care in England, Wales and Northern Ireland.

But it also found many patients were still not receiving the rapid attention and diagnostic tests recommended to minimise the risk of serious damage.

A government expert said the National Stroke Strategy, introduced in 2007, needed more time to take full effect.

    
Services remain patchy and in some parts of the country the chances of getting good care is low
Dr Tony Rudd
Royal College of Physicians

It is well established that prompt and expert medical care is crucial to minimising the impact of a stroke.

But the audit found only 29% of patients were admitted to a stroke unit on the same day as their stroke, and only 57% within two days.

However, this was a big improvement since the last audit in 2006.

Only 17% of patients are admitted to an acute stroke unit within four hours of admission.

Assessment

Use of the FAST test (Face, Arm, Speech Test) by ambulance staff was recorded in only about a quarter of patients' notes.

    
FAST TEST FOR STROKE
An assessment of three specific tell-tale signs of a stroke:
Facial weakness: Can the person smile? Has their mouth or eye drooped?
Arm weakness: Can the person raise both arms?
Speech problems: Can the person speak clearly and understand what you say?
If there are signs of problems then, it is Time to call 999

Only 21% of patients had a brain scan within three hours where appropriate to determine the extent of damage, and likelihood of further problems.

Again this was an improvement on 2006, but way short of what experts consider to be a desirable level.

The audit also found over a quarter of patients were not screened for swallowing difficulties within 24 hours, 20% have no record of visual field testing and 15% no record of sensory testing.

The researchers also expressed concern that too many patients are being moved too quickly into nursing homes directly from hospital.

They warned that access to intensive rehabilitation in care homes can be limited, and patients may be denied this vital part of their treatment, which they should expect to receive before going into residential care.

However, the audit said there had been marked improvements in some areas, including the speed of assessment by therapists after admission to hospital.

Patchy care

Dr Tony Rudd, who worked on the audit, said: "Since the last time we looked at quality of stroke care two years ago there have been some very gratifying improvements.

"However, services remain patchy and in some parts of the country the chances of getting good care is low."

Joe Korner, of the Stroke Association, said the audit showed signs of encouraging improvement.

But he said: "We need to see acceleration in the progress that is being made, and a step change in those areas which are still not providing the quality of treatment that everyone who has a stroke deserves."

Professor Roger Boyle, National Director for Heart Disease and Stroke, said many improvements had been put in place, including local stroke networks.

But he added: "The national stroke strategy is a 10-year plan, and there are no simplistic quick-fixes to the improvements we want to see - there is still a long way to go."

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A row over corporate governance has erupted at Southern Cross Healthcare, Britain's largest nursing homes operator. Shareholder activist group Pirc is recommending that investors vote against the remuneration report because the company rewarded finance director Richard Midmer with a £385,000 bonus for negotiating a debt restructuring package with the company's lenders.

At the end of last year, Southern Cross, which was owned by Blackstone private equity before it floated in 2006, said it had successfully refinanced its debt after breaching banking covenants and issuing a profits warning. Pirc says of Midmer's bonus that it "rewards [him] for his role in a transaction which could only be seen as a success in our view if it forms part of a longer-term pattern of creating financial value for shareholders".

The pressure group is also opposing the grant of "golden hello" share options to both Midmer and new chief executive Jamie Buchan, saying that it cannot "support the use of recruitment bonuses". The duo have been awarded share options over 2.5m and 3m shares respectively.

Buchan and Midmer joined Southern Cross after their predecessors left following a rocky period in which the firm struggled to sell a portfolio of care homes that it bought with borrowed money. It posted a loss in December and axed the final dividend. But chairman Ray Miles has insisted the company is "firmly back on track".

Southern Cross floated two and a half years ago with a price tag of about £400m, since then shares have fallen from 538p to 74p in 18 months. After Blackstone paid £162m for Southern Cross in 2004, the group tripled the number of homes it operated to overtake Bupa as the largest nursing care homes company in the UK.

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Promises of personalised care have not been fulfilled, says watchdog

Too many older and vulnerable people are still not receiving the help they need to lead healthy, dignified lives, the social care regulator warned today. .

People are being unfairly denied support, too many care homes are inadequate and government promises of personalised services to suit individuals' needs have not been fulfilled, according to the Commission for Social Care Inspection's (CSCI) report on social care in England in 2007-08.

Dame Denise Platt, its chair, said there was "a significant gap" between the government's ambition that everyone should receive a personalised package of advice and tailored support – outlined in last year's Putting People First strategy – and the reality, which is that too many councils have made too little progress in delivering care in this way.

That lack of progress was most marked for those with multiple and complex needs, such as those with a learning disability, people who have trouble seeing or hearing, and those with a mental health problem, she added.

Social care includes care homes, help which people receive in their own homes to get washed or dressed, and a visit from a nurse to dispense medication or change a drip, for example. Around 1.75m people in England of working age and older used care services in 2007-08, said the CSCI.

Councils spent £16.5bn on adult social care, with older people who did not qualify for free care spending an estimated further £5.9bn privately. Despite the ageing population, though, council spending was just 1.2% up on the previous year and far below the 4% and 8% rises in the two previous years.

The commission's final annual report before it is merged into the new Care Quality Commission in April voiced concern about some care homes. In late 2007, one in five places paid for by councils, about 7,000 in all, were in care homes which it rated as "poor" or merely "adequate". Likewise, 24% of care in nursing care in homes for older people was of a similar standard.

However, the standard of care services generally has risen for six years running. According to the regulator's quality ratings, 69% are "good" or "excellent", and 80% of voluntary sector services earned the same ranking. Similarly, 87% of councils received two or three stars, the CSCI's top mark, for the care services they provided, said Platt.

Phil Hope, the care services ministers, said the report proved that social care was "better now than it has ever been". But he said that further improvements were needed and the government was providing more than £500m to ensure that services were better tailored to individual needs.

However, the charity Help the Aged said far too many older people were forced to endure second-rate care "Vast numbers of older people are being denied care because their needs are not considered a priority. All too often they are left to fend for themselves or rely on family ands friends", said Help the Aged spokesperson Paul Cann.

Social care is suffering a labour shortage, the regulator found. The number of vacancies reported to job centres almost doubled between 2003 and 2008. The wages on offer are a key reason for a high "churn" rate that the system is struggling to cope with, said Platt. She added: "There aren't enough resources in the system."

One million extra care workers would be needed by 2025 to deliver high-quality care to the growing number of elderly people, said Helga Pile of the trade union Unison.

John Dixon, president of the Association of Directors of Adult Social Services said the report was broadly "fair, encouraging and optimistic". But it was too gloomy in its assessment of local councils' progress in preparing to deliver truly personalised services, he said.

Dot Gibson, vice-president of the National Pensioners Convention, said: "Social care in England is in crisis: underfunded and overlooked, with vulnerable older people suffering the effects of years of neglect by successive governments. It is a shocking state of affairs. Yet year after year, the CSCI reports and, year after year, the government fails to act."

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This is an interview with keri Thomas, the NHS end of life care champion.
Assisted suicide overshadows the debate about how we die, but the NHS end of life care champion Keri Thomas tells Mark Gould why making plans for how we want to end our days might prevent impersonal hospital deaths

So often, the harsh reality is that death can be an ugly, unequal struggle of medicine against mortality. But as national clinical lead for the Gold Standards Framework (GSF) - an NHS-funded project hailed by the government as a vital element of its end of life care strategy - Keri Thomas is determined to ensure that it doesn't have to be so.

The framework has the ambitious aim of ensuring that everyone nearing the end of their life can die in the place they want, receiving the care and treatment of their choice. And there is an even more profound objective: getting British people to stop being afraid of the inevitable and think about death as being a natural part of life, and to plan accordingly.

"We make plans for money, wills and finances, so why not for our deaths?" she says. "If we live in the context of our dying, we can live better."

But euthanasia is in the headlines - from the family of a paralysed young rugby player escaping prosecution for helping him go to a Swiss assisted suicide clinic, and a death at the Dignitas clinic being controversial screened on British TV, to Julie Walters' dramatic portrayal in last Sunday's TV drama of Dr Anne Turner, who in 2006 chose to go to Switzerland to die. So isn't there a danger that the suicide debate overshadows Thomas's role?

Frightening

Thomas, a committed Christian, is opposed to any notion of legalising physician-assisted suicide and tries to distance herself from the subject. "There is an innate assumption that people in healthcare are there to support life, and once you take that idea away it becomes frightening," she says. "There are around 1,400 deaths a day in the UK and the issue of suicide doesn't alter the fact that we are not able to live and die well in this country."

In November, a National Audit Office report supported this view. Of the 530,000 people who die in England every year just 20% get their last wish of dying at home, said the report. It described wide variations in funding end of life services, poor co-ordination of services and poor training.

More than 250,000 people die in hospital. But in many cases these are inappropriate places to die and a waste of NHS resources. Thomas says hospital admissions are often at the behest of frantic relatives who feel the NHS must "save" a dying loved one. More prosaically some care homes fearful of litigation simply cover themselves by sending dying patients to hospital.

Thomas says this unplanned approach results in horribly impersonal deaths with the loved one swathed in tubes and apparatus. Even worse they may die in transit: "One of the terrible indictments of our society are the trolley deaths. It's a hidden terror. People die in transit on a trolley in casualty or outside in the ambulance which is not the way we would like the end to be."

Around 1% of every GP's patients die each year. Thomas says the framework that she devised 10 years ago while working as a GP in West Yorkshire enables doctors, district nurses and care home staff to identify who those patients will be, and to ask them: "What do you want to happen when you are dying?".

Knowing what a patient wants means that community services can be tailored to individual needs. For example a 24-hour rapid response team can administer drugs to keep a patient pain- free at home. That way the patient and their family are happier and the hospital has a free bed.

While the moral case for better end of life planning is clear, there is also a cost incentive for reducing the number of people who die in hospital. "If we do nothing hospitals face a 40% rise in costs over the next 20 years," says Thomas. "But a 10% cut in hospital admissions for patients close to death would save £104m a year."

Thomas, the GSF team and a network of facilitators based in primary care trusts, have introduced the framework for end of life care plans into 60% of GP practices in England.

"We use what is called the 'surprise question', coined by professor Joanne Lynn [a US end of life care expert]," she explains. " That is 'would you be surprised if this patient died within a year?'. If the answer is no, what things would you have in place for them?"

Patients get a physical needs assessment and are asked about advanced care planning. This is a formal discussion with the patient, their carers and relatives about what they wish to happen to them when they become unwell, whether they want to be cared for at home and what sort of treatments they want.

One of the big challenges is establishing the framework in care homes, which often have a high turnover of staff who do not have English as a first language. But research by Birmingham University shows that in the 600 care homes that have completed a 12- month framework course there was a 12% reduction in hospital crisis admissions and an 8% decrease in hospital deaths.

"If a crisis happens and the family say 'mother needs to go into hospital', you can say, 'remember the conversation we had, we know that we can look after her here, she doesn't need to go into hospital' and then you can fulfil her wishes," says Thomas.

In the longer term, she hopes these discussions would become automatic when a patient is given a terminal diagnosis or moves into a care home. But she also feels it could happen a lot earlier, at pensionable age or retirement, for example.

Early discussion

One of the barriers is that district nurses, who do a lot of work caring for the dying, are being squeezed. Thomas says: "Not every area has access to a nurse 24 hours a day. That's an amazing situation, like going into hospital and at six o'clock all the nurses going home. You have to have a system that covers all bases, otherwise people are going to bounce into hospital."

Drawing on her experience in palliative care, Thomas stresses the importance of the time just before death. "People see their lives in a very different way," she says. "They can give an awful lot back to their families. There are things that are said or brought to a conclusion."

She does not want society to lose those opportunities for reconciliation. "We are typically controlling in this generation. We say we want to give birth now, and think we can do the same with death. But life and death are not like that."
Curriculum Vitae

Age 52.

Status Married; five children.

Lives Walsall.

Education St Joan of Arc convent school, Rickmansworth; The Royal London Hospital Medical School, MBBS, MRCGP, DRCOG, MSc (palliative medicine).

Career 2001-present: national clinical lead, Gold Standards Framework; hon professor in end of life care, University of Birmingham; author of Caring for the Dying at Home; 2004: national clinical lead, primary care, Cancer Services Collaborative; 2001-04: Macmillan GP adviser and facilitator; 1998-2005: GP and specialist in palliative care medicine, West Yorkshire 1989-2002.

Interests Tennis; theatre; interior design.

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The government's main adviser on its dementia strategy for England has said the condition must not be regarded "as an inevitable part of growing old".

Professor Sube Banerjee said dementia was a "horrible brain disease" which should receive a top priority.

He confirmed part of the strategy, expected soon, would focus on trying to reduce admissions to care homes.

Care services minister, Phil Hope, said he shared campaigners' frustration about delays to the strategy.

    
The current system allows anybody to make a diagnosis of dementia - so in fact nobody ends up doing it
Professor Sube Banerjee
The plan was originally due to be published last October.

Professor Banerjee, who runs services in Croydon, said although dementia services around the country varied, in general the level of provision was "vanishingly small".

The amount of prescribing of drugs to treat dementia was in the same region as that in Poland and the Slovak Republic.

Different approach

He told a seminar in central London: "I want to explain why the shiny piece of paper we'll generate soon will be different to the other shiny pieces of paper that have gone before it.

"The NICE guidelines on dementia contain a very long list of stuff that we don't do.

"Why is that? The evidence base has become firmer in the last five years - but the messages haven't been understandable to people who are commissioning the services, or to the professionals.

"The current system allows anybody to make a diagnosis of dementia - so in fact nobody ends up doing it."

Professor Banerjee's research has revealed that the amount of people with dementia in the UK will double in the next 30 years.

He said: "The amount spent on people with dementia in care homes is £7bn a year.

"There are excellent homes - but people generally don't want to go into a home.

"If we accept a possible decrease in admissions and are able to instead spend more time in improving the quality of life for people with dementia, the plan will be cost-effective."

But Bupa's head of mental health, Dr Graham Stokes, warned that care homes should not necessarily be seen as a last resort.

He said: "I can't see how all the aspirations of the dementia strategy are deliverable.

"We need a dedicated service for people with dementia."

In a statement, Mr Hope said: "I share the frustration with the delays in publishing the strategy. But we cannot afford to get this wrong."

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People with diabetes are about 50 percent more likely to develop different types of dementia such as Alzheimer's disuse. But, a new study finds, blood-sugar problems in diabetics may cause milder memory problems during late middle-age. Diabetes could cause memory problems in middle age

The study in Diabetes Care found that each increase in blood-sugar resulted in a slight decline in performance on all types of mental tests.

Experts say diabetics can improve their blood-sugar levels by eating a healthy diet, exercising regularly and strictly following their physician's orders about all medications.

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A campaign has been launched to try to raise awareness of abuse of the elderly in Northern Ireland.

Uniting against Elder Abuse, which is funded by a range of charities, has produced a DVD to highlight the issue.

They say a reported 10,000 older people have been abused in Northern Ireland, but that the problem could actually be much worse.

The project's Claire Keatinge said some pensioners do not report abuse because they fear they will not be believed.

She said other victims may rely on their abuser for care, while those with dementia might be unable to fully understand and communicate what is happening to them.

"Make no mistake about it, elder abuse is happening in Northern Ireland and we all have a responsibility to familiarise ourselves with the facts and to make sure that older people in our society are protected against all forms of abuse and receive appropriate help and advice when it is reported," said Ms Keathinge.

"Thirty-five per cent of adults in Northern Ireland have not heard of the term 'elder abuse' and 21% do not know if they would be able to recognise if an older person they knew was being abused.

"It is therefore vital that our awareness of elder abuse and its indicators is increased."

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Violet Smith was taken to hospital with severe burns to four per cent of her body after a registered nurse and two care assistants tried to treat her constipation and haemorrhoids by placing her over the water, Leeds Crown Court was told.

Andrea Garrick, 38, Jodie Atkinson, 22, and Danielle Schofield, 22, are charged with wilfully neglecting Mrs Smith, who had been a patient at the Charlton Centre for Alzheimer's and Dementia, on Carlinghow Hill, in Batley, West Yorkshire, since 2000.

Peter Moulson, opening the case for the prosecution, said Mrs Smith was admitted to hospital the day after the incident, in January 2008, with burns to her bottom, thighs, genitals and anus.

He said she was assessed as having suffered third degree burns to some four per cent of her body surface, which deepened to become full-thickness burns within two days.

Mr Moulson told the court the burns were found to be consistent with either immersion in hot water or being placed over a confined area of steam from "exceptionally" hot water.

One burn to Mrs Smith's right buttock was deeper than the other injuries and was possibly as a result of direct contact with hot water, the court heard.

The jury of eight women and four men were told the injuries were unlikely to have been caused by water of a temperature less than 45 degrees centigrade.

Mr Moulson said Garrick, a registered general nurse, was in charge of care assistants Atkinson and Schofield and told them Mrs Smith's problems should be dealt with by sitting her over hot water.

Garrick, of Bevor Crescent, Heckmondwike, West Yorks, got hot water from a kettle while the assistants prepared the commode for Mrs Smith, whose condition meant she was unable to communicate.

The staff noticed reddening, blistering and peeling skin after removing Mrs Smith from the commode after a number of minutes.

Mr Moulson said a medical expert had assessed the procedure used on the elderly woman as "entirely unjustified".

He said: "It did not reflect acceptable practice, it resulted in significant injury and fell well below the standard of care he would have expected in a nursing home providing care for people with dementia."

Mr Moulson said Garrick tried to treat Mrs Smith with a cold cloth and cream but rang a colleague after her condition worsened.

A doctor was called six hours after the incident and Mrs Smith was admitted to the burns unit at Pinderfields Hospital the following day.

Plastic surgeons said it was highly unlikely that the injuries could have been caused by temperatures below 45 degrees celsius. The appropriate treatment should have been surgery but doctors were unable to operate because of her condition.

Mr Moulson said Garrick tried to cover up what had happened and told Mrs Smith's son the injuries were caused by a burst hot water bottle.

When interviewed by the police, Garrick said she switched the kettle off before it had boiled but admitted she did not check the temperature of the water.

Atkinson, of Doubting Road, Dewsbury, West Yorks, who had worked at the home for around four months, told police she had questioned the procedure being used to treat Mrs Smith and said Schofield had checked the water temperature.

Schofield, of Thornton Road, Dewsbury, who had worked at the centre for 11 months after being employed at three similar homes previously, said she thought the water from the kettle was only lukewarm and told police she had put cold water in the commode first. She said Mrs Smith had shown no signs of distress.

Both care assistants claimed to feel intimidated by Garrick.

All the defendants deny the charge.

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A Government blacklist of nurses and care workers deemed unfit to work with children and vulnerable adults has been ruled unfair by the House of Lords.

The Royal College of Nursing has campaigned to end the provisional list - nurses put on the list are immediately banned from working with children or vulnerable adults without the right to any kind of hearing. The Law Lords yesterday rejected a Department of Health appeal of the decision.

Dr Peter Carter, chief executive of the Royal College of Nursing, said: “Until now, nurses placed on the list provisionally were banned from working in any care setting – sometimes on the flimsiest of evidence or on the basis of malicious accusations, without the fundamental right to a hearing.

“Public and patient safety is of course always absolutely paramount, and there should be a mechanism to protect vulnerable people when they are in the care of nurses and care workers. However, these mechanisms must be simple, understandable and above all fair."...

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The approach has become increasingly popular in the Chicago area. The Care Trak system is used in about 20 Illinois communities and hundreds across the country, according to the company based in Murphysboro, Ill.

Nationwide, about 2,000 people wearing the devices have been found—all of them safe—since Care Trak began tracking people in 1986, officials said. The average rescue time is 30 minutes, company Vice President Michael Chylewski said.

It's estimated that 60 percent of the nearly 5 million Americans with Alzheimer's will wander off at some point, according to the Alzheimer's Association.

But fewer than four out of 100 are able to return home without assistance. If not found within 24 hours, the person has a roughly 50-50 chance of dying or suffering serious injury, the association said.

The water-resistant transmitter has a band that can't be tampered with and weighs about an ounce. Worn on the wrist or ankle, it puts out a constantly pulsating radio signal 24 hours a day.

Police use a hand-held directional antenna that picks up the signal and guides them to the person who is lost. It has a range of about a mile.

If the signal can't be picked up, a helicopter may be used. The higher vantage provides searchers with a broader, 5-mile range.

Care Trak's sister company, Wildlife Materials, began tracking endangered animals in 1970, Chylewski said. The company won approval from the Federal Communications Commission in 1986 for a medical frequency to track humans.

The wristbands cost about $250, and officials say there are ways to cover that expense if families can't afford to pay. The tracking equipment used by police is about $5,000.

McHenry County's program will be administered by the county's Mental Health Board. Officials there estimate between 25 and 50 families will sign up. The devices may ease the worries of harried family members who care for children and adults with cognitive disabilities. They'll still need to remain vigilant, but sleep should come a little easier at night.

Edward Demers, 60, who has Alzheimer's disease, left his home for a walk in October 2003 and never returned.

"We don't know what happened to him, or where he is, or anything," said his daughter, Tina Demers. "My mom's obviously devastated. She blames herself for not being there, because she was at work when he went for his walk."

News of the tracking system made Tina Demers think of what might have been.

"This could have saved our family a lot of grief," she said, adding how happy she is that other families might not have to suffer the pain hers went through.

Her father lived in Johnsburg, not far from where Bloomquist now resides with Hollenberg.

Hollenberg took in her mother about five years ago, when the devastating symptoms of Alzheimer's became impossible to ignore. The wandering incident last year was terrifying, she said. The transmitter will be a comfort.

"It'll give me peace of mind," Hollenberg said. "We live in a bolt-locked house. We have boards across the stairs. We have hung bells on the doorknobs. But if I forget to lock a door, then I know there's a backup."

Linda Betzold is anxious for backup too. Her 13-year-old son, Beau, has autism and can wander off unaware of his surroundings, she said.

Even if his exploration just took him down the block, Betzold knows that he would never be able to ask for help, or find his way home alone.

Her nightmare, she said, would be for him to get outside unsupervised.

"That's what I dream about at night, and I wake up in a cold sweat."

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People caring for family members with dementia commonly abuse them with behavior such as swearing and shouting, researchers said on Friday in a study that shows a more widespread problem than previously thought.

"The study shows abusive behavior is very common and not something doctors are regularly asking about and therefore finding," Claudia Cooper, a researcher at University College London, who led the study, said in a telephone interview.

A third of family caregivers said their abuse of the person they were looking after was significant, including frequent insulting or swearing, and half said they occasionally screamed or yelled at the person.

The researchers, who found few cases of physical abuse, say their study -- published in the British Medical Journal -- highlights the need for governments and health officials to widen efforts aimed at tackling elder abuse.

"This is the strongest evidence so far about the prevalence of abusive behavior from family carers of people with dementia," said Cooper.

"These were the sons and daughters, and husbands and wives."

An estimated 24 million people worldwide have the memory loss, problems with orientation and other symptoms that signal Alzheimer's and other forms of dementia -- a number some researchers believe will quadruple by 2040.

With rising costs and under-pressure health care systems worldwide forcing many family members to provide their own care, the findings highlight the need to tackle abuse and register it is probably more widespread than thought, Cooper said.

The researchers surveyed 220 family caregivers of various socio-economic and ethnic backgrounds whose family members were recently referred to psychiatric services and living at home.

While acknowledging the strains of giving round-the-clock care and of watching a relative slip into a condition in which they no longer recognize a loved one, Cooper said, "All types of abuse can be distressing and harmful for an older person."

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ALMOST half of those who care for relatives with Alzheimer’s get no help from social services, an investigation by Channel Four’s Dispatches programme has revealed.

A YouGov survey carried out for tonight’s hard-hitting edition, Mum, Dad, Alzheimer’s and Me, fronted by Welsh television star Fiona Phillips, also found:

half of carers get little or no respite care and frequently feel threatened by the sufferers they look after;

27% of sufferers waited three years or longer for an official diagnosis;

a further 17% never received a diagnosis.

The 48-year-old former GMTV presenter, who grew up in Haverfordwest, Pembrokeshire, resigned after her 74-year-old father Phil was diagnosed with the early stages of Alzheimer’s, one of the leading causes of dementia.

Two years ago, she lost her mother Amy, 72, to the same condition.

She has now moved her father out his home in Haverfordwest into accommodation in Portsmouth with his brother Barry, less than an hour from the London home she shares with her 50-year-old GMTV editor husband Martin Frizzell and their children Nathaniel, nine and six-year-old Mackenzie.

Wales currently has 37,000 dementia sufferers with around 750,000 in the UK as a whole. Carers often refer to it as “the hidden epidemic” with just £11 spent on research per sufferer each year, compared with £289 per cancer patient.

In the programme Phillips talks about her own family’s heartache as a result of the condition. She said: “Dad has been diagnosed, but I don't think he realises what is happening. He keeps forgetting words and it's so sad because he was such an active, intelligent man with an opinion on everything. But he’s in a much happier state than mum, who was just crying all the time.

“Dementia is a huge and pressing crisis, which the Government claims to be addressing.

“But my investigation reveals the scandalous reality of families around Britain left alone to shoulder the burden of care for their loved ones.

“These half a million unpaid carers do a heroic job, and save the Government £6bn a year, but too often have to fight their way through NHS and local government bureaucracy to get even the smallest bit of help.

“The shocking findings of our survey of carers revealed that many got little or no respite care and more than half received no help at all from social services. In addition, I discovered that some victims never get a formal diagnosis.”

“Even if you are lucky enough to get an early diagnosis, depending on where you live, there's the struggle to get the drugs that can help slow down the ravages of the disease.”

She said that thanks to a controversial ruling by the National Institute for Clinical Excellence (NICE), people in the early stages of Alzheimer's were currently unlikely to get access to drugs.

“On current Government budgets there simply isn't enough social care to go round – which is why I have to supplement care for my dad from social services by paying a charity to help look after him, so he can retain some independence for as long as possible.

“I can afford it but thousands can't, leaving them drained of funds, being forced to give up work, and socially isolated.”

Ian Thomas, director of the Alzheimer’s Society, Wales, said he was delighted at the programme.

He said: “Celebrities have tremendous capacity to raise awareness of issues that are too often kept in the shadows. Fiona’s decision to speak out about her parents’ dementia will strike a chord with thousands of families across Wales who face a daily battle with its devastating impact.

“One in three people over 65 will die with a form of dementia. Dementia is not a natural part of ageing; it is caused by diseases of the brain and robs people of their lives.”

The Alzheimer’s Society says while there are currently 37,000 people living in Wales with dementia this number is expected to rise to 50,000 over the next 20 years.”

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This article relates to the closure of two care hoes in Sheffield.
TWO Sheffield care homes are facing closure as part of a review by the city's largest provider of residential care for elderly people.
Consultations have begun with a view to shutting Roewood on Firshill Rise in Firshill, and its Primrose View site on Whitehouse Lane in Walkley, with 54 residents to be offered alternative accommodation.

Charity SheffCare says it is responding to
a reduction in numbers of people going into care homes against a national background of people preferring to stay in their own homes as long as possible.

At the same time, it is preparing to spend more than £7 million on some of its other 11 premises.

Three will be rebuilt to cater for people with dementia and three will be redeveloped in partnership with a housing association to offer sheltered housing.

Sheffcare says its overall occupancy rate has dropped from 92 per cent to 70 per cent, when at least 90 per cent is needed to break even.

Roewood has 10 of its 40 places unfilled, and Primrose View 14 out of 34.

Chief executive David Roulston said a national debate has been held over how care and support services should be provided, and a Government Green Paper will be published in the spring.

He said: "The need for SheffCare to review the way it provides care and support stems from three main elements – the fact that people prefer to stay in their homes for as long as possible, the Government's move towards personal budgets, which will be given to individuals to spend on their own care and SheffCare's need to replace or decommission its ageing buildings."

The two homes earmarked for closure are both small and on hillsides, difficult to rebuild. Both are in areas relatively well-served for alternative accommodation.

Pauline Grainger, who chairs SheffCare's board of trustees, said: "Doing nothing is not an option. All the trustees support the decision to close both homes but it was not something done lightly.

"It is traumatic for older people. The impact on residents will be dealt with in the main by managers at the homes. They will be looking to move groups of friends or people who have been on the same corridor to ensure they stay together."

Mr Roulston added that it was intended, wherever possible, to avoid staff redundancies.

He said: "Many of our staff have worked for SheffCare for a number of years and we will work alongside them and their trade unions to identify alternative posts within SheffCare."

Consultations have been launched with residents, relatives, the council and the NHS with a view to the closures taking place by March.

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Almost £60m is to be invested in health care in Fermanagh and Tyrone over the next three years.

It is part of a total investment of £570m for health and social care in the area over the next 10 years.

An acute hospital in Enniskillen and a local hospital in Omagh are planned, as well as a mental health inpatient unit and a health centre.

Cuts to health services are planned, however, and protests have been held to try to keep care homes open.

On Monday, a petition with more than 1,200 signatures was given to the Western Health Trust in Enniskillen in a protest against the proposed closure of the Drumhaw residential care home.

It is one of four homes facing closure under the trust's plans.

The Department of Health has planned a series of investments across Northern Ireland, while it also seeks to make "efficiency savings" of £344m over the next three years.

Health Minister Michael McGimpsey said the 10 year investment plan "is another example of how I am investing in our health and social care services".

"As well as the major projects in Omagh and Enniskillen, Lisnaskea is to get a new health and care centre and at Altnagelvin further developments are planned including a new radiotherapy unit," said the minister.

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The area in the UK with the most beds for the elderly is the south-east, with 61,122 care home beds available, according to  the general union GMB.

There were a total of 420,962 beds in the UK across care homes residential homes and nursing homes, with an average occupancy of 91% across the country.

The representative for care workers and GMB national officer Sharon Holder said her union wished to see sustainable long-term funding for the care sector across the country, with proper wages and conditions being delivered to all workers.

She continued: "Above all, GMB has told the government that this service cannot be provided on the cheap and that the postcode lottery that the current funding regime entails is not fair and cannot deliver the standards that are needed."
One in every 32 people working in the UK  form part of the GMB, a total of
nearly 600,000 people. 

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highland officials give assurances despite estimated costs soaring by £6million

Council chiefs gave an assurance yesterday five planned care homes will be built in the Highlands, despite estimated costs soaring by £6m.

In June council chiefs estimated that the cost of building the care homes in Inverness, Muir of Ord, Tain, Grantown and Fort William would be £21.5million.

But yesterday Highland Council’s housing and social work committee heard that the likely costs are now estimated at £27.26million.

Director of housing and property Steve Barron said the increase was the result of factors including inflation in building costs – which are estimated to rise by £3million by 2011 – demolition costs and external works. However, he stressed to councillors that these were only estimates.

And he added that the current costs did not include a number of extras such as decanting, IT equipment and cabling, land acquisition and legal fees. Designs are being produced for the developments at Burnside, Inverness; at Caol; and at Urray House, Muir of Ord – which are hoped to be complete by spring 2011. Negotiations with NHS Highland and the adjoining landowner are continuing over the development at Craighill Terrace, Tain.

Outline planning permission has also been lodged for the development which, it is hoped, will be completed about six months after the first three. However, discussions with NHS Highland are continuing over the funding of the care home at Grantown. In six months the health authority will confirm whether funding will be available in 2012 for a joint facility. If funding is denied, then councillors will be asked to look at developing the town’s Grant House as a care home.

Despite the costs increases, councillors remained confident in the programme.

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ELDERLY people could be facing an uncertain future after a residential home went into administration.

The financial situation at Amber House in Brunswick Village, Newcastle, has got so dire owners Helpcare Ltd and Carestream Ltd can no longer continue looking after the premises.

More than 20 residents, many of whom suffer dementia and Alzheimer’s disease, could be affected as new owners are sought.

Chris Stevens, from the business recovery service Vantis plc, which took over the property yesterday, said: “It is business as usual as the home continues caring for its residents at the highest level. Together with the management team, we are committed to identifying buyers to secure the future of the home and safeguarding jobs.

“We do understand residents’ families will be concerned, but the home will remain open and we do not foresee any problems with finding new owners soon.”

It was breakfast time as usual at Amber House this morning as staff tried to put on brave faces despite the news.

The peaceful and homely building, covered inside by photos of happier times, seemed to be carrying on in the face of adversity.

And staff said they are hopeful that no residents will be forced to move out and no-one will lose their jobs.

One staff member, who did not wish to be named, said: “We have been told everyone will be staying here. Families will be informed later today.”

A care home crisis has condemned elderly and vulnerable people throughout the region to a worrying future.

As the Chronicle reported earlier this year, Vantis plc came to the rescue when Lismore Care Home, in Kirton Park Terrace, North Shields, also went into administration.

In March the last residents left Essendene care home in Ashington.

A month before, 30 residents of Pembroke Court sheltered housing complex in Newbiggin-by-the-Sea learnt the Anchor Housing Group planned to close their centre.

And more than 100 workers and 21 residents in Meadway House, Forest Hall, and Annitsford House, Annitsford, were shocked as North Tyneside Council closed their homes.

Charity Age Concern said closures could have serious health consequences.

Karen Evans, regional development officer for Age Concern North East, said: “There is a loophole in the law that means people in privately-run homes do not have the same rights as those in council-run homes.”

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Motion sensors, video-monitoring

"This is a biggy," says Mark Barnett of Aged Care Direct, an Australian not-for-profit that provides technology information to aged care providers and suppliers. "We want to know that mum is taking the tablets she's meant to be taking and having the food she's meant to be having, and that she's not lying on the floor in the bathroom for three hours and we didn't know about it. These sorts of communication technologies are becoming an important part of aged care."

Barnett says people are receptive to this technology. "Those over 65 are number two on the list of high users of technology. We all think of our kids of being No. 1 - and they are - but retirees are big users."

The technology is commercially available but, as Seamus Small from the TRIL Centre in Dublin, says: "There's no basic retail product that you could pick up on the high street, you would need to invest some time and know-how to implement it."

Remote monitoring

Certain vital signs can easily be remotely monitored with the readings transmitted wirelessly back to health care staff. For example, the e-Health Research Centre in Brisbane is conducting a clinical trial of heart rate devices and gait-measuring monitors (accelerometers) embedded in mobile phones to assist patients recovering from strokes and heart attacks, and cut down the time they have to spend returning to the hospital for rehabilitation. "Most people are very keen to try anything that will improve their health, especially after a major event like a stroke or a heart attack," says Dr David Hansen, a principal research scientist at the Centre.

Robot carers

Meet the uBot-5, a wheeled contraption with bendable arms and a computer monitor on its shoulders, which looks a bit like Johnny-5, the robot in the soon-to-be-remade Short Circuit movie. It can dial emergency services, pick up objects, remind people to take their medication and facilitate "virtual visits" from family and health care professionals via the built-in web cam. The device is in the research and development phase at the University of Massachusetts, and its creators plan to commercialise the technology over the next few years. They aim to bring the cost of your very own domestic robot carer down to a few thousand dollars. There are similar robots in development with child-care applications.

Within residential aged care

Professor Bruce Barraclough, the medical director of the e-Health Research Centre in Brisbane, says there is a lot of potential for use of information technology in aged care facilities. Monitoring people's movements may help dementia patients who tend to wander, he says, while medication management is another field with potential. As is incontinence management: "It's possible to get monitors to identify when beds are wet - if the bed is wet for any amount of time they get pressure ulcers," he says.

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Elderly people in care homes will suffer as a result of changes to new immigration rules, bosses have warned.

Homes are likely to close and fees rise because of employment restrictions on workers from outside Europe, they said.

Martin Green, chief executive of the English Community Care Association, said his "worst fears" about the list of jobs available to non-European Economic Area workers had been confirmed.

Only the most highly skilled care workers earning more than £8.80 an hour are included on the shortage occupation list.

He warned the industry needed workers from places like India and the Philippines because similar skills were not available in Europe.

"We're going to get closures because local authorities won't pay more," he said.

"At the end of the day vulnerable people will suffer."

Heather Wakefield, national officer at Unison, warned social care would "collapse" without migrant workers and said the ageing population meant the situation was likely to get worse.

Ministers touted the new list as a toughening of the rules. Immigration minister Phil Woolas said there were 200,000 fewer posts available via the shortage occupation route.

But the Migration Advisory Committee (MAC), which drafted the list after examining labour market shortages, has said only 7% of the jobs were actually taken by non-European Economic Area workers last year.

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A Bristol care home manager has been jailed for assaulting a vulnerable resident in his care.

Danny Purgaus, who owned Overnhill House residential home in Downend, was sent to prison for three months for attacking 80-year-old Ronald Thomas.

A court heard how he grabbed Mr Thomas by the collar, pulled him from his seat and dragged him across the home’s lounge floor to an electric fire after he complained of being cold and asked for a heater to be turned up.

Magistrates said the attack was “an abuse of trust and power”, describing it as a “vindictive and cowardly” attack on a frail gentleman in his care.

The home was closed down by an emergency court order in January after deputy manager Margaret Byrne blew the whistle on Purgaus’ treatment of residents.
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Mrs Byrne claimed patients suffered at the hands of Purgaus, 59, incident reports were not filed and the home did not conform to regulations set out by the Commission for Social Care Inspection (CSCI).

Mrs Byrne, 49, who worked at Overnhill House for five and a half years, said: “It was a really good place to live and work when I first started, the residents were happy, and I had a good working relationship with Mr and Mrs Purgaus.

“But 12 months prior to closure things started to turn bad. Paperwork wasn’t up to scratch, and incidents of falls weren’t logged.

“Mr Purgaus had an anger management problem and would shout at staff about small things, like washing not being put away or dishes tidied up.

“He didn’t have the social skills to realise that elderly people and their needs have to come first all the time. He had no patience.”

Mrs Byrne claimed that Purgaus, who ran the home with his wife, Pat, for 13 years, would bully residents.

Mrs Byrne called the CSCI in October 2007 to raise her concerns and inspectors visited the home.

She said: “You could see the anxiety and anger in the residents’ faces when he was around – I think they lived in fear of him. On a bad day everyone knew about it.”

But Mrs Byrne contacted the CSCI again in January after allegations that Purgaus has assaulted two patients in December and January, and the home was closed down within 48 hours of her call.

Purgaus was cleared of attacking Henry Ham at North Avon Magistrates’ Court last month, but was convicted of  assaulting Mr Thomas. In a  statement read out in court, Mr Thomas said Purgaus had a “split personality”, and that dragging him across the floor  had made him feel like “a second-class citizen”.

In mitigation, Purgaus’s lawyer Garry Crowther said that his client had a “lifelong history of caring”, and that he had continued to do voluntary work since the home’s closure.

But magistrates took a dim view of his actions, saying that it had been a “degrading, cowardly and vindictive” attack on a vulnerable and frail man, and that Purgaus had abused the trust of Mr Thomas, the other residents, their families and his staff.

Purgaus, who was in tears during the hearing, called out to his former members of staff as he was led away, saying: “I hope you are very happy with what you have done.”

Speaking after the sentence, Mrs Byrne dismissed Purgaus’ emotion as “crocodile tears”, and said that she and her colleagues shed a few tears of their own when the sentence was read out.

She said: “It is a hollow victory as, once again, care homes are making the news for all the wrong reasons.

“But Mr Purgaus gave us no choice. We weren’t happy with his behaviour, and we had to make a stand. The majority of care homes are good and staff do a good job, so we have to stamp out the bad apples.

“We want people – staff and residents – not to be afraid, but to speak up if they know of any abuse taking place.”

“It has been very important for us to be here and see it through and have some closure.”

Imelda Richardson, South West regional director for the CSCI, said: “We are glad there has been a clear outcome to this case and hope it gives Mr Thomas and his family, as well as other former residents of Overnhill House, a sense that justice has been done.

“It shows how important it is for people to come forward with information about any forms of abuse or neglect, whether they are care workers or relatives of those who rely on care services.

“In this case the information we received enabled the commission to work with the council to protect the safety and welfare of the residents at Overnhill House.”

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THE death of a severely-disabled man who fell from a hoist has resulted in the company running his care home being prosecuted in court.

The Health and Safety Executive (HSE) took MacIntyre Care to St Albans Magistrates Court following the death of Mark Westbrook, aged 56, of Crosby Close Care Home in the city in March 2007.

The company, which has its head office in Milton Keyes, was fined £10,000 and ordered to pay full costs of £2,476 after pleading guilty to breaching Section 3(1) of the Health and Safety at Work Act 1974.

Mr Westbrook fell from his hoist after being lifted by an inexperienced carer at the care home in February last year. A cerebral palsy sufferer who was both blind and deaf, he had been living at Crosby Close for eight years.

He broke his right femur and elbow in the fall and after a short stay in hospital he returned to the care home. But he was taken back to Hemel Hempstead Hospital a short time later.

He was diagnosed as suffering from severe pneumonia which later developed into a blood infection which killed him.

At the inquest in January, Herts coroner Edward Thomas said that on the balance of probabilities, the fall at the care home was a secondary cause of death.

Recording a verdict of a narrative death, he said he would be writing to the Commission for Social Care Inspection to recommend that they made sure all care homes used two carers to operate a hoist.

HSE Inspector Rubeena Surnam said after last week's court hearing: "This was a needless death. I hope it demonstrates to care home employers that they need to take positive steps to identify the risks in their workplaces and manage them.

"Employers must be sure they adopt safe systems of work and care staff are trained in the use of equipment such as hoists and aware of the potential risks involved.

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Local councils which perform well on safeguarding against abuse and neglect tend to have a greater number of home care agencies and care homes in their area which are performing well too, says a new study by the Commission for Social Care Inspection (CSCI).

'Safeguarding: A study of the effectiveness of arrangements to safeguard adults from abuse' looked at arrangements in place in England to help prevent the abuse of adults and to support those who experience abuse.

The study found:

·    Prevention of abuse is variable within and across council areas and within care services
·    Disabled and older people who are abused get a varied quality of support due to uneven progress by councils and care services in developing effective safeguarding arrangements
·    More needs to be done to ensure people who direct their own support are able to benefit from safeguards
 
Councils rated as good by CSCI were also those that had more care services in their area with effective safeguarding arrangements in place. Care services that receive a good or excellent quality rating from CSCI were also more likely to have effective safeguarding arrangements in place.

Paul Snell, CSCI's chief inspector, said: 'The study shows that in the best councils and services there is a commitment to good safeguarding practice that starts at the top.

'Although it confirms the rising profile of work to safeguard adults from abuse across the country, there is significant variation in the degree of priority shown to safeguarding adults, and more work is required to bring all services up to the standard of the best.'

Neil Hunt, Alzheimer's Society chief executive said: 'The abuse of vulnerable adults is an unacceptable violation of their human rights and can be prevented. Care staff need specialist dementia training, guidance on safeguarding people and strong leadership. There must also be a robust regulation system in place.'

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However, the unnamed invention from technology giant Honda could transform the lives of the growing numbers of elderly people around the world.

Robotics experts say the powered leg frame takes all the strain out of walking, with a design created to support body weight, reduce stress on the knees and help with climbing steps.

The system, unveiled by Honda in Japan yesterday, has a computer, motor, gears, battery and sensors that allow it to respond to body movements.

Although the price and launch date are yet to be decided, Honda will start testing a prototype with its assembly line workers this month before deciding on its commercial future.

To wear the device, the user straddles the seat, puts on the shoes, pushes the "on" button and starts walking.

Lindsay Scott, spokesman for Help the Aged in Scotland, said: "This does look to be a hugely exciting development, particularly because it seems to support the body weight and relieve pressure on the knee joints.

"The Japanese are at the forefront of this kind of technology as Japan has one of the most rapidly ageing societies in the world and it'll be fascinating to see how this develops.

"Whether it is successful or not will probably come down to how much it costs, but if the Japanese can mass-produce it, it may be commercially viable."

A major study published this year revealed Scotland's elderly population could rise by as much as 81 per cent over the next 25 years. The Scottish Government has been warned the cost of providing free personal care for the elderly could treble to £813 million by 2031.

Japan has about 27 million elderly people and the largest proportion of over-65s – 21 per cent – of any country.

Engineer Jun Ashihara, who unveiled the device at Honda's Tokyo headquarters, said the machine would also be useful for people standing in long queues and those who run around to make deliveries.

"It should be as easy to use as a bicycle," he said. "It reduces stress and you should feel less tired."

Honda has been carrying out research into mobility devices for more than a decade, introducing the Asimo humanoid in 2000. It recently unveiled a belted device boasting motors hooked to frames strapped to the thighs, that help the walker maintain a proper stride.

That device is already being used in rehabilitation programmes for disabled people in Japan. The country is also a world leader in robotics technology for industrial use, entertainment and companionship.

Massive market for sons of the Sinclair C5

EVER since the unveiling of the Segway human transporter in 2001, there has been fierce rivalry between inventors and technology companies competing to tap into the potentially lucrative "personal transport" maket.

The Segway, a scooter-like vehicle which was in development for more than a decade, is powered by batteries but controlled by body movements.

Best known for flummoxing US president George Bush when he fell off one during a test drive in 2003, the Segway has sold some 250,000 units.

Its success inspired British inventor Sir Clive Sinclair, whose electric car proved a disaster in 1980s, to create the A-bike in 2006.

Last year saw the unveiling of a robotic suit to help people who had been partially paralysed.

Earlier this year, the Toyota Motor Corporation unveiled a Segway-like ride designed for elderly people.

Japanese robot firm Cyberdyne has recently begun renting out the Hal – a device with mechanical braces that strap to the legs and which reads brain signals to aid movement.

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Staff will discuss the proposals at public meetings in affected areas

Highland Council is giving care home residents and their families a chance to learn more about plans for new care homes which will replace existing council-run homes at Fort William, Inverness and Muir of Ord.

Outline planning consent has been granted for the proposed care-home developments at the BMX-site, Caol – to replace Invernevis House, Fort William – at Burnside, Inverness – to replace Ach an Eas and Burnside, and at Urray House, Muir of Ord – to replace the existing care home there.

Council staff will be available to discuss the proposals, firstly at meetings in the existing homes with residents, their families and staff, and later at drop-in sessions in the communities.

Representatives of the social work and housing and property services will be on hand to explain the proposals to people on an individual or small group basis.

The council also proposes to replace care homes at Grantown (Grant House) and Tain (Duthac House) and similar sessions will be held there as and when the sites and planning permissions have been agreed.

Councillor Margaret Davidson, chairwoman of the housing and social work committee, said: “These new care homes will greatly improve the facilities for everyone and ensure that all modern standards are met.

“We want to meet with residents, their families and staff as well as the wider community to share the progress we are making and to hear people’s views.”

The public meetings are as follows: Muir of Ord: Wednesday, November 12, Muir of Ord Village Hall, 2pm-4.30pm; Muir of Ord Pavilion, 5pm-7.30 pm.

Inverness: Thursday November 13 , Inverness Town House 3pm-7.30pm.

Fort William: Tuesday November 18, Caol Community Centre 2pm-7.30pm.

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A care home rated one of the worst in the country has managed to turn around its fortunes in just six months.

The Roseland Care Home, in Draycott Avenue, Kenton, was rated 'good' in a recent report and fulfilled 12 out of the 13 recommendations required in a previous inspection.

In a recently released report by the Commission for Social Care Inspection (CSCI), an independent group set up by the Government to inspect adult care homes, the home was awarded two stars out of three.

Tony Lawrence, the lead inspector, said: "Prospective residents and their representatives should be confident the home will meet their identified care needs."

As reported in the Observer in May, the home had been deemed a fire hazard and awarded no stars. In the previous report the inspector saw fire doors were wedged open and bedroom doors did not have door closers, meaning in a fire smoke would spread easily through the building. The bathrooms were also described as 'bare and institutional'. Even the owner, Jerome Manuel, stated he was reviewing his involvement in the business and considering selling the home.

Fast forward six months and the home has been transformed by the staff. The home has refurbished one of its bathrooms and is set to have another one redone by January 2009. The bedrooms were also described as having a good standard, and being clean and hygienic. An action plan was developed to improve fire safety standards.

Manager Coral Lake said: "We are over the moon. We did a fire risk assessment on the whole building and property and put in all the things we needed to make it up to fire standards.

"All the relatives have been really pleased, but they were happy before. They were really shocked at the story, as they saw all the work the staff and I do."

Mrs Lake said the care home had completed the recommendations in the previous report, which had included performing risk assessments for residents who smoked and providing automatic door closers to improve fire safety.

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The number of people suffering with dementia will double over the next 30 years with costs to the economy expected to triple to reach £50bn by 2050, Government scientific advisors have warned.
 

Prevention, early detection and timely treatment will be vital in the battle against cognitive decline, the 400-page Foresight report said.

It means the way new treatments are evaluated for use on the NHS must be changed to take into account the wider benefits to families, carers and society of keeping older people healthier and independent for longer, it said.

Currently the National Institute for health and Clinical Excellence has a remit, set by Government, to analyse the costs and benefits of a new treatment to the health service. This has led them to determine that certain drugs such as Aricept for Alzheimer's disease is only cost effective in the moderate and late stages of the disease.

The Foresight report said: "A priority should be to develop and use treatments to slow or arrest decline in the early stages before quality of life suffers substantially and before sufferers become dependent on families and the state."

Chris Riley, an independent economic consultant, said care costs need to be taken into account and the wider economic benefits including the fact that people whose health improves are more likely to be employed, have higher earnings and less days off work. He said there is 'scope' for a fuller analysis than Nice is currently doing.

The increase in dementia is forecast primarily because of the ageing population.

The means the number of people with dementia could double to reach 1.4m over the next 30 years, consistuting an 'expenditure time bomb' with costs to the UK economy expected to triple from £17bn today to £50bn a year by 2050.

The report also recommends extending treatments that are already recommended by Nice to all dementia sufferers to deliver economic benefits in excess of £1bn a year. It says: "The extra treatment costs would be vastly outweighed by higher Government revenues and reduced benefit payments."

The report, Mental Capital and Wellbeing, covers all areas of life from pre-birth, through childhood, adolescence, working life, and old age, and documents what impacts on mental health and what can be done to improve wellbeing.

As well as diagnosing and treating dementia earlier, people in middle age should be encouraged to be active and continue learning as this has been shown to delay symptoms of cognitive decline.

Prof Barbara Sahakian, professor of clinical neurology at Cambridge University, said 40 new treatments for dementia were in the pipeline including drugs that will improve memory and thinking abilities in Alzheimer's patients and also protective agents that will stop damage done to the brain by the disease.

It was also suggested that internet access could be installed in older people's homes in the same way as stairlifts and bathrooms aids are now, so the elderly can remain socially and eoncomically active, get involved in social networking online and encourage continued learning.

Care Services Minister Phil Hope said: "This report confirms that much of our work on improving mental health services, increasing access to psychological therapies and creating the first dementia strategy is on the right track.

"It comes at a very important time, as we start to develop a new mental health policy framework that will help shape services for the next 10 years.

"We will use this report to see how we can go further and faster towards creating a healthier, more contented society."

Neil Hunt, Chief Executive of the Alzheimer's Society, said: "Thousands of people with dementia and their carers will welcome this report. They are the experts who know that early access to treatments can have huge benefits not just to the individual but to carers and families. This report adds to evidence that NICE need to change the way it decides who should have access to drug treatments.

"As the number of people with dementia rises to more than a million people in less than twenty years, the healthcare system in future can only work if it works for people with dementia."

 

   
  

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Social care lead bodies line up to urge more cash for dementia strategy

ADASS, LGA, NHS Confederation among bodies responding to dementia consultation with cash appeal

More funding needed to kick start dementia strategy

The government must find significant extra funding if its national dementia strategy is to succeed, health and social care leaders have said.

The Association of Directors of Adult Social Services, Local Government Association, Alzheimer's Society, English Community Care Association and NHS Confederation used their responses to the strategy consultation, which closed last week, to call for more investment.

Most respondents backed the objectives laid out in the consultation paper, published in June.

These included:

● The creation of early diagnosis and intervention services in all areas.

● Core training in dementia for all care staff working with older people.

● Comprehensive home support services.

● Improved access to mental health services for care home residents.

● A regulatory requirement for all care homes to be able to provide dementia care.

In a joint response, Adass and the LGA said each of these would require additional resources over the course of the strategy, from 2009 to 2014.

On the workforce front, it said there was currently "little incentive for staff to remain in this difficult and challenging area when better paid alternative employment is readily available".

The associations also pointed to the fact that many people with mild dementia were excluded from council-funded social care because they fell below eligibility thresholds.

When care services minister Ivan Lewis launched the consultation, he said additional resources would be available but did not specify a figure.

The only costed plan in the consultation paper was for early diagnosis and intervention services, which would require £220m a year.

Adass vice-president Jenny Owen, who co-chairs the working group on developing the strategy, said that with government spending limits for 2008-11 already set, significant extra investment may have to wait until 2011-14 with the first two years of the strategy being more preparatory.

Alzheimer's Society head of policy Andrew Chidgey warned efficiency savings should not be relied upon in the first years of the strategy as "we are starting from such a low base in dementia".

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 INSPECTORS are swooping on care homes across Somerset from next week as part of a major health and safety blitz.

And they are warning they will come down hard on any rogue home owners found to be flouting the rules.

The unannounced, targeted visits by a team of six inspectors from the Health and Safety Executive are being carried out in the fortnight starting on Monday.

They will be checking on issues relating to hot water, hot surfaces, unguarded windows, legionella, manual handling, latex, bed rails and migrant workers.

Inspectors from local authorities and the Commission for Social Care are also carrying out visits during the same period.

HSE inspector Trudi Smyth, who is co-ordinating the initiative, said: “This inspector blitz should give both us and the local authorities a good overview of the standards of the health and safety in care homes across the county.

“Our findings will help to inform our pro-active work with the homes and we will be holding a series of health and safety awareness days, together with the local authorities, across the South-West in the New Year, prior to our next inspection campaign.”

She warned owners though that the exercise was not just about collecting data.

She added: “Over the next two weeks, inspectors will robustly challenge any owners or managers of homes where employees, residents and visitors are being put at risk because of health and safety failures and we will not hesitate to take enforcement action to secure improvements.”

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Elderly people and their families face paying billions more for personal care services like cooking and cleaning, MPs say today.

Because Government spending on personal care for the elderly is growing more slowly than the number of people needing help, a £6 billion "funding gap" will emerge, the MPs say.

More than 1 million people use council care services in order go on living independent lives, paying fees that can vary widely between council areas. Ministers are reviewing the care system and have promised a green paper next year.

In a report published today, the Work and Pensions Select Committee say that without major reform of the current unpopular system of means-tested care services, the old and their families will end up shouldering even more of the burden.

Private care spending is around 57 per cent of total care expenditure, but on current trends this share will grow to 66.5 per cent by 2022, the MPs say.

"Those who need care will be expected to pay more of the cost," the report says.

It adds: "Currently state funding for social care is growing at a much slower rate than the demographic changes require. This means the Government is heading for a funding gap of an estimated £6 billion, unless the system is changed."

The number of people over 65 using council care services is forecast to more than double over the next 40 years.

Last year, the Commission for Social Care Inspection, the Government's watchdog, showed that responsibility for paying for care was shifting from local councils to the families of society's most vulnerable citizens.

Anyone with assets over £21,000, including property, has to pay for their own social care whether they live in a nursing home, their own home or warden-controlled sheltered housing. For those under that level the state pays for care.

The means-testing of care services has meant many more elderly people having to pay for their own care. The number of households receiving social care help from local authorities fell from 479,000 to 358,000 between 1997 and 2006 even as the number of pensioners rose.

"State support is means-tested, which is especially disliked by older people who have saved hard for their retirement," the committee says.

An ageing population means that over the next generation, almost everyone in the UK will either need care or become a carer, according to the King's Fund, a health think-tank.

In their report, the MPs also call for a fundamental change in the benefits system for carers.

People who provide unpaid care for relatives and friends save the taxpayer an estimated £87 billion each year and have only limited access to benefits through a complicated system of entitlements, the committee says.

At £50.55 a week, Carer's Allowance is the lowest-paid benefit of its kind.

Ministers have promised to review the benefit, but the committee calls for a wider change, recommending the introduction of two distinctive types of support for carers: an income replacement support for carers unable to work full-time; and compensation for the additional costs of caring for all carers.

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This article is related to the percentage of care homes receiving excellent or good ratings in their Commission  for Social Care Inspection Reports.

More than 80% of care homes are providing good or excellent quality care according to the latest CSCI star ratings statistics.

 

A search of the regulator's website shows that out of just over 15,000 rated care homes, there were 2,384 three-star and 9,733 two-star rated homes.

 

Only 384 care homes, or 2.56%, were failing to provide services to the required standards.

 

Currently 3,408 care homes are yet to receive a CSCI rating, while 33 have had their rating suspended as CSCI acts to remove their licences.

    
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A CARE home that left the bodies of pensioners dead in their beds must be shut down, a leading politician has said.

Catherine West, leader of Islington Council's opposition Labour group, wants independent inspectors to take action over Lennox House - which only opened in August last year.

Her calls come as the home's suspended manager has now handed in her resignation.

As first revealed in the Gazette, 97-year-old Winifred Staines and 68-year-old Elsie Walford were left in their beds for around two days after dying at the care home in Durham Road, Holloway.

Bosses at private company Care UK, which runs the home under contract from Islington Council, has since summoned relatives for urgent meetings.

But Councillor West, who met with council chief executive John Foster on Monday, said: "He admitted the council has serious concerns - about care plans for each individual resident and about end-of-life care.

"I am looking into the immediate closure of this home right now - and I am asking the Commission for Social Care Inspection to investigate a possible closure."

Meanwhile, more complaints about Lennox House have surfaced.

Irene Clarke believes her 83-year-old diabetic aunt Winifred Bone was failed.

The dementia sufferer, a retired dressmaker from Newington Green, was rushed to hospital on December 8 after Lennox House staff found her in spasm. She died later that month.

An independent investigation criticised the home for an "absence" of the clinical expertise and communication required.

It found that the diabetic woman's blood glucose level had not been tested on December 7. And even when Miss Bone's urine was tested later that night - for only the second time since her admission - doctors were not called despite the abnormal result.

Ms Clarke, 62, a television production manager, said: "I think Win Bone was absolutely, desperately failed. I would like to send Lennox House into outer space."

And Maria Hogan wants to move her 68-year-old father - who has dementia - from the home.

The 31-year-old single mum said: "Their medication ends up not being taken or on the floor. No member of staff helps them eat their food. And my father's room really, really smells of urine - but he has a catheter on 24 hours day."

Care UK said the 87-bed home was rated "adequate" when CSCI inspectors visited in June - and that the company was not aware of any calls for its closure.

A spokesman said: "Care UK can confirm that a letter of resignation has been received from the suspended manager.

"Care UK is grateful for and has been heartened by the support of many relatives of residents. They have praised the standards of care provided by our hardworking, diligent staff.

"We recognise from time to time we need to initiate improvements when mistakes occur."

Councillor Terry Stacy, deputy leader of Islington Council, said: "Lennox House is under new management and is still working to make specific improvements we have demanded as part of a remedial action plan

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The "Bank of Mum and Dad" becomes the "Bank of Sons and Daughters" later in life, a new study  claims to show.

According to the study, 47 per cent of adults do not realise how much long-term care for their elderly parents will cost.

When informed that expenditure generally ranges from £25,000-£30,000 a year to fund the care, a total of 36 per cent said that they would have to make significant sacrifices to meet these costs.

Ironically, it will have been this group which is currently taking advantage of their baby boomer parents' comparative wealth, by raiding the "Bank of Mum and Dad" for help with mortgage deposits and current living costs.

A spokesman said: "The cost of care is not always something people think to talk to their parents about, but it is vital to start planning as early as possible. As this research reveals, there are a huge number of people who are relying on an inheritance from their parents, though underestimate the cost of long-term care.

"By not discussing the issue and making provisions, they are neglecting the fact that their parents may be facing a situation where they will be forced to turn to their children for financial help. With careful planning this can be avoided."

for further information, please see our 'funding information' section

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Southern Cross, the troubled care home group, today reported a 18 per cent rise in revenue after raising the weekly fees it charges to its elderly patients.

The company said revenue for the 14 weeks to July 6 rose from £207.6 million to £245.6 million, while earnings before interest, tax, depreciation and amortisation (Ebitda) rose by 6.9 per cent to £24.4 million.

Over the period, Southern Cross's average weekly fee rose from £506 to £530.

In June, the healthcare group issued a profit warning and announced that it was seeking an extension to its loan facilities from its banks, which it has now secured until October 30.
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Southern Cross also announced that its finance director, Jason Lock, had resigned and was replaced by Richard Midmer.

Mr Midmer worked with Bill Colvin, chief executive at Southern Cross, at NHP, another care home group.

Southern Cross's problems arose after a deal to sell the property assets of some care homes acquired with borrowed money fell through.

As the value of commercial property decreased due to the downturn, it became more difficult to sell the assets.

The company said this morning that it is in discussions with several potential purchasers of the assets, adding that "the board is encouraged by the progress made to date".

Shares in the company rose 3 per cent to 127.75p today, but are trading well below their peak of 599.5p of nine months ago.

Despite an ageing population, the care homes industry has suffered as a result of local authorities finding it cheaper to keep elderly people at home.

Average occupancy of Southern Cross homes was down to 89.2 per cent for the 14 weeks to July 6, compared with 89.6 per cent during the first half of the year.

Despite its problems in selling property, the company bought an additional 145 beds during the 14-week period and hopes to add another 304 by the end of the year.

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The Alton Centre, in Irchester Road, Knuston, was suddenly shut when an inspection found there to be "serious and urgent" concerns.

After a weekend of uncertainty about their future, residents are expecting to be told today where they will live from now on.

But still no reason has been given why the home was closed and what was found to be wrong.

Leslie Weatherley, whose sister Christine has lived at the Alton Centre for four years, said: "To know why this has happened would put a lot of people's minds at rest. A lot of people are very disgruntled. It was really traumatic for the staff and residents."

The Alton Centre, which looks after 40 people with learning or physical disabilities, was closed on Thursday after an inspection by the Commission for Social Care Inspection.

Residents were taken away in ambulances so their needs could be assessed and decisions made about future care.

In a joint statement, Northamptonshire County Council and Northamptonshire Primary Care Trust confirmed an order had been made by magistrates following an application by the inspectors.

The statement read: "We know our colleagues at CSCI only take such urgent action when new concerns emerge that seriously affect the health and welfare of vulnerable people.

"As soon as we were informed of CSCI's intension to seek closure we began working to ensure the safety and welfare of residents."

But residents and their relatives, said there was bewilderment at the closure.

It is understood inspectors found something wrong but residents and care home staff say they do not know what.

Mr Weatherley said: "We do worry. There weren't any guarantees that residents would end up in Northamptonshire and they said they were looking at neighbouring counties.

"It's such a shock to see it close so quickly. We wouldn't be happy with Christine moving to another county."

He said his sister, who has Down's Syndrome and had a stroke before being admitted to the home, had been well treated.

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Care for elderly, infirm and disabled people could be stripped from local authority control under radical new government plans in an effort to end the so-called "postcode lottery" that sees wildly different standards of care across the country.

Social services chiefs have been warned they will lose their responsibility for care unless they step up improvements in their performance over the next three years.

More than 370 nursing and care homes have been given "no star" ratings after the independent Commission for Social Care Inspection (CSCI) assessed their services as "poor". A further 31 have been sent legal notices stating the CSCI plans to cancel their registration and move their residents elsewhere.

Last week it obtained a court order to cancel the registration of a residential nursing home in Brackley, Northamptonshire, after a random check found the safety and welfare of its elderly residents were "at serious risk". Several residents of the home were taken to hospital for treatment. Two subsequently died after inspectors shut the home.

The reputation of the sector has also been damaged by repeated revelations of abuse and neglect of residents in some of the 10,000-plus private homes across the country. Some 150 local authorities across England spent £14.2bn on social care for all adults last year including elderly people, residents with dementia and young people with learning difficulties. Their role is already under threat, however, from reforms designed to give individuals "personalised" control over their own care, including control of a personal budget under the Government's Putting People First programme.

The health minister Ivan Lewis has warned that the Government is prepared to go further, and remove local councils from the system if their performance does not improve. He said: "If at the end of three years, local government has not delivered on those building blocks, I think there will be some really big questions to be asked about its capacity to commission these services in the future."

Department of Health insiders said the warning could mean the worst-performing councils being stripped of their powers – or, in extreme circumstances, the power over commissioning care being handed to a new body altogether. In an interview with Community Care magazine, Mr Lewis said the postcode lottery was one of the "big, big concerns".

Age Concern gave a cautious welcome to the Government's proposals. A spokesman said: "We have been concerned about councils being in charge of assessing people's needs and then deciding how much should be spent on them. There have been concerns about the quality of care offered to older people, in particular. At least threatening local authorities with sanctions if they do not improve can be of benefit."

But the Local Government Association (LGA), a cross-party organisation representing councils in England, insisted that local authorities still had a vital contribution to make. "Councils are best placed to make decisions on providing care and support to local people, thanks to their knowledge of what's available in each area and how best it can be managed," a spokeswoman said.

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Care home practitioners and old age psychiatrists have been warned that they could face long jail sentences if they allow a patient with dementia to have sex even with a long-term partner.

The warning, delivered by Professor Peter Bartlett, Professor of Mental Health Law at Nottingham University to the Annual Conference of the Royal College of Psychiatrists, follows widespread concern within care homes that staff might be at risk of prosecution under the Mental Capacity Act which came into force at the end of 2007.

"Take the case of a husband who comes visiting on a Saturday afternoon and closes the door of his wife's room, leading to staff making the assumption that they are having sex. It may seem perfectly acceptable at one level. But because someone with dementia does not understand what sex means, the encounter is sexual assault and therefore extremely illegal."

Professor Bartlett, who has investigated the problem after numerous requests for clarification from health care practitioners, said that hundreds of care homes face this dilemma every single day: whether they should prevent a married couple from having sex while also attempting to provide patient-centred care.

He said: "The Mental Capacity Act provides the opportunity for people to document their wishes in an 'Advanced Directive' in advance of suffering from dementia. But sex is rightly considered too personal a decision to be included in such a directive. The husband may assume a continuing consent to sex based on the long-term relations he has had with his wife. But I find it difficult to find a reason to make this assumption. One major problem is: how do we know whether the person is liking it?"

Professor Bartlett said that people with dementia living at home with a partner presented an even more complicated scenario. "Technically they should be on the vulnerable adults at risk register. It is somehow easy to understand how this law can be applied to children who lack the capacity to understand the meaning of the sexual act. We should not behave differently when it is an older person who lacks capacity."

Speaking after the meeting, Dr Peter Jeffreys, consultant old age psychiatrist at Northwick Park Hospital in North London, said there was an 'iceberg situation' with an urgent need to clarify how clinicians can manage sexual activity among dementia patients while protecting against abuse. "If a person lacks capacity, a clinician or care home staff member could be seen as colluding in a criminal act. Opportunities for intimacy are clearly an important aspect of quality of life but sex may be a step too far in residential care," Dr Jeffreys said.

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This article is related to the delayed closure of a care home in Derbyshire.

SOLICITORS taking legal action against Derby City Council's decision to close a care home said they would not pursue the case if the home was kept open for at least 18 months.

The decision to close Bramblebrook House in Mickleover was taken when the previous Labour administration was in place.

The closure was being fought by residents in the home through Smith Partnership solicitors. A judicial review was due to be heard this year, which would mean a High Court judge would rule whether the council had made the right decision to close the home.

But last month, the new cabinet member for adult services and health, Liberal Democrat Ruth Skelton, announced she would propose to the council's cabinet that the home should be kept open for at least 18 months.

She said that would allow the council to carry out a review of all care provision in the city before it made a final on decision on which home, if any, should be closed.

Simon Richardson, of Smith Partnership, said if the cabinet agreed to her proposal when it meets on Tuesday he would not continue the legal action.

“However, there are side issues I want looking at, such as exploring the use of Bramblebrook for other specialist care,” he said.

“Also, if the decision is taken at the end of this review to close Bramblebrook, then it will be up to the residents if they want to challenge that decision with a separate action.”

The number of permanent residents at Bramblebrook when its closure was announced was 38. That has now gone down to 20 due to deaths and some residents accepting places at other homes.

The former cabinet member for adult services, Labour councillor Fareed Hussain, said the cabinet should take into consideration whether keeping the home open made financial sense with the number of residents declining.

He said: “I know when I was the cabinet member the cost of running the home each year was more than £700,000.

“With just 20 residents, that means the cost per person there is high and if that number reduces further, then that cost will be even higher.”

Michael Foote, corporate director of adult services, said that if the number of residents at Bramblebrook went down considerably during the next six months then the council may have to look at the situation again.

“We will look at the situation at the end of the review but it is unlikely there will be so few residents there,” he said.

Under the proposals, residents who have moved to other homes because they believed Bramblebrook was going to close this year will be able to move back, as long as they accept that their return may not be permanent as the review could still conclude the home should close.

The money from the sale of Bramblebrook, in Rough Heanor Road, would have gone to make the Arthur Neal site in Mackworth an extra care complex.

If the Mackworth site becomes an extra care home, residents would be able to live in individual flats while also having 24-hour specialist care staff on hand.

The cabinet will have to consider on Tuesday whether to carry on with work to develop the Arthur Neal site while the review is carried out.

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This article is related to the development of a new care home in Sutton Coldfield despite protests from local residents.

A controversial back-garden development, which will involve demolishing four detached houses in order to build a 61-bed private care home for elderly people, has been given the go-ahead in Sutton Coldfield despite a protest campaign by people living nearby and the local MP.

Birmingham planning committee has given permission for the scheme in Penns Lane, Wylde Green, after being told that refusal would be contrary to Government policy requiring local authorities to provide more high-quality accommodation for people in their 80s and 90s.

The committee’s legal adviser warned the city council would probably lose an appeal, and face substantial costs, if the application was turned down.

Members also approved the construction of 11 four and five-bedroom houses next to the care home on the same site.

The application, by Warwick-based Sandstone Group, was a scaled down version of a previous bid to build a 124-bedroom care home on the land. That proposal was rejected by the committee last year and is to be the subject of an appeal at the end of this month.

The council received almost 100 letters of objection to the latest proposal along with two petitions from local residents, who were supported by Sutton Coldfield MP Andrew Mitchell.

Their objections were based on the amount of additional traffic likely to be generated on Penns Road, noise and disturbance from the care home, over-development of a small site and inadequate parking arrangements.

Sutton councillor Margaret Waddington, who voted against the application, said there were more appropriate sites in Birmingham for a care home.

Coun Waddington (Con Sutton Trinity) added: “Maybe a care home is needed in Sutton Coldfield, but this is not the place.

“Penns Lane is an extremely fast road and this will cause serious traffic problems. The proposal is completely out of keeping with the surrounding area.

“And with 60-odd old people flushing their loos every hour, I don’t know how Severn Trent can say there is no problem with the drainage.”

Committee chairman Peter Douglas Osborn admitted residents were concerned about the loss of four “beautiful” houses, which will be knocked down to make way for the care home and new housing. But that was not a matter over which the council had any control.

He recognised concerns about additional vehicles on the roads from families occupying the new houses, but did not believe this would warrant rejecting the application.

A written report by council planning officers concluded: “The scheme provides a care home and 11 family houses. It is recognised, by the Government, that there is an established need for both of these land uses and that national planning guidance gives this a high priority.

“There is an established need for further quality care homes in the area which can provide a range of services within a modern facility. It is also recognised that national guidance strongly advises against asking for more on-site car parking than the applicant considers necessary.”

The report adds: “The proposed care home is larger than most other plot sizes and footprints of buildings in the area. However, it has been designed in such a way that there are several recesses and projections in the elevations to break up its scale and massing.

“As such, it would be more in keeping with the character of the area than the previously refused scheme.”

John Culligan, assistant director of planning, said: “We feel that this scheme has been very carefully designed to fit in with the character of the surrounding area. I wouldn’t be optimistic about our chances of successfully defending a refusal at an appeal.”

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This article is related to the alleged abuse of a resident in a care home in Clackmannanshire, Scotland.

A CARE nurse faces being struck off over claims she physically abused an 80-year-old woman.
Molly Moswate, 42, is accused of grabbing the pensioner by the face and shaking her head because she was having difficulty eating.

The carer, from Botswana, is also alleged to have "screamed in the face" of another woman aged 93 and suffering from
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dementia, at the Hillview Court Care Home, Sauchie, Clackmannanshire, in autumn 2006.

Yesterday, a panel of the Conduct and Competence Committee in Edinburgh heard how the 80-year-old woman, known only as Resident A, was left with fingerprint bruising to her face in the September incident.

Mary Walker, a care worker, reported the attacks, saying she was worried that residents would have heart attacks.

She told the hearing: "The resident had taken her food out of her mouth which was normal as she needed to take her time.

"But Molly just leapt up and bolted across the room, grabbing the lady's jaw, she shook her head and screamed 'stop it' twice."

Pam Shrowder, a staff nurse, said that the following month, on the evening of 13 October, 2006, she heard Miss Moswate shouting "shut up" at Resident B in what she described as an "extremely loud voice".

Miss Shrowder said: "I went through and could hear Resident B's voice was trembling. She asked Molly to stop treating her like a child, she was distressed and fidgeting in her seat."

The care home launched an investigation into the complaints in November and manager Jean Nelson said disciplinary action was taken.

Miss Moswate was not present at the hearing.

The hearing continues and a verdict is expected today.

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This is the opinion of Neil Hunt,Chief Executive of the Alzheimer's Society on the proposals related to dementia care provision in the nex stage of NHS 'reformation'.   Lord Darzi's ambitious vision could have enormous benefits for people with dementia.

Creating 'polyclinics' could potentially give people greater access to memory services and the specialist support they require, perhaps removing the need for hospital visits and ensuring that people get access to an earlier and accurate diagnosis.

Speeding up evaluations of NHS treatments and giving people the universal right to approved treatments can only be positive. Changes must also ensure that that the wider benefits of treatments to society, particularly carers, are considered.

Delaying the onset of dementia by five years can halve the number of deaths. The proposed 'Reduce you Risk' campaign could help identify people at risk of dementia and greatly reduce the burden of dementia on society.

England's record on dementia care is damningly poor. Currently only a third of people ever receive a formal diagnosis and if they do they are then shunted between a health and social care system that fails to meet their needs. The NHS must wake up to its responsibility to care for this incredibly vulnerable group of our society.

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MORE than 30 enforcement notices have been issued to a group of Welsh nursing homes after problems were found with the use of bed rails.

The Health and Safety Executive also repeatedly raised concerns about the management of legionella risk at the homes.

A series of inspections at 28 nursing homes in Wales was carried out during March and April.

Three quarters of the homes were issued with at least one enforcement notice – 31 in total – to make urgent improvements.

Steve Scott, an HSE inspector, who led the initiative, said: “The sample is a small percentage of the total number of nursing homes in Wales, and we must stress that not every nursing home we visited was issued with an enforcement notice.”

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This article relates to an EU initiative to enable the elderly to remain independent for longer.
Companies are to receive European funding to develop technology that helps older people continue living independently at home.

The European Commission wants to see Europe developing as a hub for ICT for older people through the development of smart home technologies, electronic alarm systems and remote health facilities, for example.

It is hoped that smart devices, mobile technologies for monitoring vital signs and user-friendly interfaces for people with impaired vision or hearing will improve the quality of life of elderly people, their carers and families.

"There is no reason for older people in Europe to miss out on the benefits of new technologies," said Viviane Reding, EU Commissioner for Information Society and Media.

"The solutions and services resulting from this programme will help them to remain active in society as well as staying socially connected and independent for longer."

The proposal is part of the European Commission's goal to save on health and social care expenditure.

A quarter of the EU population will be aged over 65 by 2020, and spending on pensions, health and long-term care is expected to increase to eight per cent of GDP in the coming decades.

The new proposal will see an additional €150m in funding to a new European Joint Research Programme, resulting in a total investment of around €600m.

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Department of Health ministerial advisers have called for more than £200m a year to be invested in an early diagnosis and intervention service for people with dementia.

The idea is the one costed proposal in a government consultation launched last week to transform services over the next five years in England through the first ever national dementia strategy, due in October.

Jenny Owen, vice-president of the Association of Directors of Adult Social Services, who co-leads on the strategy, said the early intervention model was not a "prescription" but pointed to its success in Croydon, south London.
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Few diagnosed

The proposed service would address the fact that only 30% of people with dementia receive a diagnosis, often in the later stages or without sensitivity or adequate information. This is despite evidence early intervention can make a big difference to quality of life and prevent or delay entry to residential care - the fate of one-third of people with dementia.

Owen said: "We need to look at where we are spending money in order to stop people going into residential care unnecessarily."

Early intervention model

Under the plan:

● Teams of nurses, doctors, psychologists and care managers would handle diagnosis and provide information and care (£95m a year).

● Capacity would be increased in older people's community mental health teams (£70m a year) and adult social care (£55m) to handle knock-on referrals.

● Assuming 10% fall in annual residential care admissions for people with dementia, service would cost society £950m over 10 years.

● Improvements in quality of life would make it cost effective.

The draft strategy said GPs and primary care services are reluctant to diagnose because of a perception that nothing can be done to help and because some feel insufficiently competent. Also older people's psychiatric services are too focused on severe and complex cases.

'Like military tribunal'

Speaking at the consultation launch, Ken Clasper, who has dementia and is an ambassador for the Alzheimer's Society, emphasised the importance of sensitive diagnosis, having undergone the process twice.

He said his first diagnosis "was like a military tribunal" where he was not told anything about the condition, while the second was "much better, much more informal", and involved being given information and advice on managing dementia.

Other proposals included:

● People with dementia to have an adviser as a single point of contact for care information.

● All staff working with people with dementia to be trained to an agreed set of standards.

● All care homes to be registered to provide dementia care and receive ongoing input from specialist mental health services. This would include assessments for residents on admission and six-monthly reviews.

Anti-psychotic drugs

The lack of mental health support has been linked to the inappropriate prescription of anti-psychotic drugs for people with dementia, which care services minister Ivan Lewis said would be reviewed.

Owen said the review team's key priorities during the consultation will be examining the commissioning and workforce implications of the proposals with stakeholders. She added this would help ensure "we have some real levers" to implement the strategy.

Lewis said the final strategy would include proposals for increased investment in dementia care.

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This article is related to the sale of a council-run care home in Melton Mowbray, Leicestershire to the private sector.
A county council care home in Melton will be under new management before the end of the year after it was sold to the private sector.
The sale of Catherine Dalley House will come as a blow to residents and their families who mounted a strong campaign to keep it under local authority control.

Campaigner Sara Dickinson, whose 90-year-old grandmother Laura is a resident at the Scalford Road home, collected more than 1,000 signatures opposing the sale, fearing the transfer would affect the quality of care and prompt an exodus of good staff.

She said she was disappointed but described County Hall's decision to chose Warwickshire Care Services and the Housing Solutions Group, a not-for-profit consortium, as the successful bidder was the 'best-case scenario'.

The home, its residents and staff, are due to transfer to the new owners in December alongside five other county council care homes and neighbouring Silverdale, a learning disability hostel.

Residents at Silverdale are moving into other accommodation in Melton, supported by staff to live more independently, and the old site will be redeveloped.

The consortium has pledged to meet with residents, families and staff 'very soon', and all sides were keen to stress that the deal includes guarantees over working conditions and standards of care.

The sale will save the county council £650,000 and allow it to set up two sheltered housing schemes with 24-hour care.

County councillor Joe Orson (Con, Asfordby) said: "This is good news for Melton and will mean improved older person provision and the prospect of new extra care provision for Melton. It is pleasing that the successful bidders were also the preferred choice of the staff representatives."

Matthew O'Callaghan (Lab, Melton North) said: "Although I am still opposed to the privatisation of Catherine Dalley I recognise the county has taken care in selecting the successful bidder and not just sold to the company that offered the most money.

"I welcome the extra investment the company will put into the care sector in Melton and will monitor staff conditions, keep in touch with the relatives to ensure the well-being of the residents is maintained and see that the plans minimise the impact on surrounding properties."

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Help the Aged has welcomed the Law Commission's decision to undertake a thorough review of the law governing Adult Social Care.

Head of Public Affairs at Help the Aged, Kate Jopling, said:

'Some of the most vulnerable people in our society rely on our care and support system to maintain their quality of life. There are about 1.75 million clients of adult social care services in the UK, and the numbers are rising everyday. Expenditure on these vital services is approaching 20 billion a year.

'But the law surrounding adult social care is at best confused, at worst chaotic and totally impossible for most lawyers even to understand!

'We very much welcome the Law Commission's decision to review this vital area of law. Most people come up against the care regime in a crisis and the system is a nightmare of complexities

'Law reform should sit alongside broader social care reform, which needs to make the whole system more transparent.

'We must ensure the system provides fair and accessible support for all who need it.'

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This article is related to the first care home Olympics which is set to take place in Sheffield on June 19th.

It is hoped that the event can showcase how essential and enjoyable physical activity can be for elderly people and also raise the profile of the work done by health workers in Sheffield, reports 24dash.com.Teams from nursing homes across the city will compete in events such as bowling, skittles, target throwing and dominoes. The care home Olympics will be sponsored by the British Heart Foundation.Steve Ayris, Sheffield city council's cabinet member for independent and healthy living, told the website of the importance that people keep active "no matter how old we are"."We know that physical activity, at the right level, can bring health benefits to even the frailest of older people. It is also great for meeting people and socialising," he added.In other news, runners from Sheffield have raised money for the Bluebell Wood Children's Hospice.The funds raised from the Jane Tomlinson's Run For All has allowed a specialist nurse to be employed at the centre, reports the Sheffield Star.

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This article is related to the development of six new care homes across Cumbria

THE results of a consultation on plans to build six new care homes across Cumbria will come before councillors next week.

Care home residents, their families and members of the public have voiced their opinions on the new homes for elderly people, which would be built alongside community hospitals in Wigton, Keswick, Millom, Alston, Penrith and Brampton.

The new homes would replace ageing council-run facilities in the same communities.

Those who participated in the consultation say they would like to see accommodation for married couples and a “homely” atmosphere included in the new plans.

Respondents would also like to see the homes take their place as an integral part of the local community, with shops and other shared facilities.

Many bedrooms in existing council-run care homes are small with people often having to share bathrooms because of a lack of en-suite facilities.

All the new homes would have bigger bedrooms and more space for wheelchairs, lifting-hoists and other essential equipment

The council’s proposals have been drawn up with the help of Cumbria Primary Care Trust and older peoples charity Age Concern.

The three-month consultation ended on April 28 and findings will be discussed by Cumbria County Council’s cabinet next Tuesday.

Councillors will be asked to consider different funding options before deciding whether to give the new homes the go-ahead.

One funding option is Community Ventures – a scheme created by the Government to provide capital funding to help pay for shared health and social care facilities.

Coun Bill Wearing, cabinet member for Adult Health and Wellbeing, said: “Staff in council-run homes are well trained and provide the best care they can, but the homes themselves – the bricks and mortar – often let them down. Residents and their possessions are often squeezed into cramped bedrooms with up to seven people sharing one bathroom.

“This is not acceptable in this day and age when people expect and demand more privacy.

“These new homes would enable us to provide older people with more choice and independence while preserving everything that is good about the here and now"

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This article is related to the effects of light therapy on those with Dementia.

Exposing dementia patients to about nine hours of daily bright light improved their brain function as well as some Alzheimer's medicines, a study of Dutch nursing-home patients found.

Treatment slowed the pace at which patients lost their ability to carry out ordinary tasks including bathing, dressing and eating by more than 50 percent, compared with those exposed to dim light, according to the study appearing tomorrow in the Journal of the American Medical Association. Memory difficulties were reduced 5 percent.

The study is the first controlled trial of how light affects mental functioning in dementia patients, the researchers wrote. Effects were similar to those of drugs such as Pfizer Inc.'s Aricept and Novartis AG's Exelon, they said.

``On the whole, light treatment could have clinically beneficial effects,'' the authors said in the paper. ``The long- term application of whole-day bright light did not have adverse effects, on the contrary, and could be considered for use in care facilities for elderly individuals with dementia.''

The ceiling-mounted lights, more than three times brighter than those the study used for comparison, also reduced depression 19 percent. Moreover, the researchers found that melatonin, a hormone, improved sleep and that the lights reduced melatonin's side effects.

The study was conducted at 12 group-care facilities in the Netherlands with 189 patients. Ninety percent of the patients, whose average age was 86, were women. About two-thirds probably had Alzheimer's disease, the authors wrote. The disease can't be diagnosed with certainty until after death.

Alzheimer's and small strokes are the two main causes of dementia, according to the U.S. National Institutes of Health.

Lighting

The authors, led by Rixt F. Riemersma-van der Lek of the Royal Netherlands Academy of Arts and Sciences in Amsterdam, didn't assess the costs of installing and powering the lights. Philips Lighting Holding BV, a division of Netherlands-based Royal Philips Electronics NV, supplied lighting. Cambridge Neurotechnology Ltd., a U.K. company, provided equipment for the study at reduced cost. No installation fees were charged.

The patients were exposed to the lights with intensity measuring 1,000 lux from about 9 a.m. to 6 p.m. over an average of 15 months, the authors wrote. Patients in the comparison group were exposed to 300-lux lighting and given a placebo instead of melatonin. Most indoor lighting ranges from 100 to 800 lux, according to the University of Montana's Web site.

Melatonin reduced the time it took patients to fall asleep an average of 19 percent compared with those who took the placebo. Melatonin without bright lights was associated with withdrawn behavior and aggravation. In combination with the light therapy, it reduced aggressive behavior 9 percent, compared with the placebo group.

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This article relateOne in five care homes is failing to treat its elderly residents with dignity and respect, according to a study by an independent watchdog today.

The report by the Commission for Social Care Inspection (CSCI) found nursing homes where vulnerable pensioners were treated like objects or patronised as if they were children. In some, staff laughed at the disabilities of the elderly or gave them drugs so they would sleep all day.

The survey of 100 care homes also discovered lonely residents who had no one to speak to, and were prevented from walking around the wards by nurses. Referring to the terms of the Human Rights Act, the report concluded: "One in five of the homes we inspected did not meet the requirements of the law in terms of affording people dignity and respect."

The CSCI issued half of the homes it surveyed with "statutory requirements", meaning they must improve their services in order to comply with official regulations. However, the true number of failing care homes is likely to be far greater, as the CSCI focused on those which it had previously rated "good" or "adequate".

The survey found that more than a third of the homes did not meet government guidelines for allowing patients to draw up plans for their care. Many homes did not give residents any choice in what they ate or what they could do during the day.

Staff must be given training in how to look after dementia sufferers and that care homes must be funded properly, the report concluded.

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Britain's ageing population poses as big a threat to the country as climate change, a Government minister has warned.

Ivan Lewis, the health minister, claimed elderly care would become "the new child care" for families in the 21st century as they are forced to cope with looking after their parents long after they have retired.

And he said doctors must start to treat dementia as seriously as they do cancer and heart disease, with a million Britons expect to suffer from the debilitating condition within a generation.

His comments come just days after the respected King's Fund think-tank said the cost of caring for people with mental illness will double to £47 billion within 20 years

By then, one in four adults in Britain will be pensioners, increasing the burden on the benefits system and health care as well as their families and carers.

Mr Lewis spoke at the launch of a new campaign by the Alzheimer's Society and the NHS to raise awareness of dementia, to highlight the fact that as few as one in three sufferers are ever diagnosed with the condition.

He said: "As a society we've got to reflect on the fact that elderly care is the new child care, and that demographic change is every bit as much of a challenge as climate change.

"Dementia belongs with cancer, heart disease and stroke care in terms of importance, and bringing dementia out of the shadows is not simply a strategy but a moral imperative.

"There's an increasing number of people, especially women, who are balancing jobs with bringing up children and caring for their elderly parents. Some people are discovering their partner has got dementia but still have to be at the school gates every afternoon to pick up their grandchildren, because the parents are working."

As part of the new campaign, the Department of Health is spending £500million on putting leaflets in every GP surgery in the country urging people to consider whether everyday memory loss could be warning signs of dementia conditions such as Alzheimer's.

Doctors themselves will also be sent CD-Roms with information on the condition to help them spot danger signs in patients, as currently only one in three believe they know enough about it to make an accurate diagnosis.

Ministers and campaigners believe if sufferers are diagnosed early enough, they can be given support and treatment to improve their quality of life and live for longer.

Mr Lewis said: "It's bad enough to live with the symptoms of the condition. To live with the anxiety of believing you have a problem but being told you haven't can accentuate your mental health problems."

But he denied doctors would be put under more pressure by increasing numbers of patients asking if their forgetfulness could be a sign that they are suffering from Alzheimer's disease, or that medics are being accused of ignoring symptoms.

Mr Lewis said: "There is already an agreement that dementia is something GPs ought to be conscious of.

"This is not an attack on GPs - this is one of the new challenges that the health system faces."

Neil Hunt, chief executive of the Alzheimer's Society, added: "Dementia is one of the greatest health challenges confronting our society as we face an ageing population.

"Yet there is an acute lack of awareness and understanding of dementia amongst the public, including those who are affected by it, as well as those in health and community services."

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A report from the King's Fund predicting a large increase in the cost of mental healthcare shows the economic need to address mental illness, according to Mind.

The charity said the economic case to invest in mental health is "robost".

"We've got the clinical evidence, we've got the economic evidence, have we got the will to make this work?" said Mind chief executive Paul Farmer.

"This is the chance of a generation to put mental health care on a level with physical health - a way to truly celebrate the 60th anniversary of the NHS."

Commenting on the King's Fund call for people with mental health needs to be supported back into work, Mr Farmer said: "If people with mental health problems get the NHS and social care help they need, then they can manage their health while working and living full lives in society."

He added: "We support this call for expansion of evidence-based treatments in primary care for people with depression and anxiety, greater investment in crisis in the community and early intervention for people with more severe mental health problems."

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This article is related to the lack of early onset dementia care provision in Coventry, but is a direct reflection of the UK as a whole.

A HUGE gap in services for younger Alzheimer's sufferers has been identified by carers and service users in Coventry.

Coventry's Young Onset Dementia Focus Group wants to bring about a change in how health and local authorities support the 90 patients under 65 in the city, and their carers.

Younger people with dementia, they say, are falling between two services - adult and older people's services.

Chair of the group Ian Darnell, aged 58, of Baginton Road, Styvechale, Coventry, who cares for his wife Carol aged 62, who has Alzheimer's, said: "I find it extremely worrying that for this group there is no local, appropriate nursing or respite provision in Coventry.

"Only the Alzheimer's Society provide limited day care in the city - one day a week and that is for eight people.

"Those sufferers under 65 have a completely different set of needs to those who are elderly and yet that 'older people's provision' is what we are offered.

"If my wife Carol was a Class A drug user or an alcoholic she could access more resources. That's what is funded."

Plans initiated several years ago to open a six-bed specialist ward for early onset dementia patients at the Caludon Centre had to be scrapped last year due to lack of funding from Coventry Teaching Primary Care Trust (PCT).

Many young Alzheimer's sufferers, like Bill Wilson, aged 58, of Coundon, Coventry, are in their early 50s when they develop dementia. He sees the loss of this specialist provision as a backwards step.

Bill, a member of the focus group and Coventry's Alzheimer's Society, said: "You would not want to see me on a bad day. What happens when I throw a wobbler? There is nowhere for me to go. This unit, the Spencer Ward was specially created for younger people with dementia."

Ian added: "Coventry and Warwickshire Partnership Trust never had any money to open it. It lay vacant."

Coventry has no specialist in-patient or long-term care for younger dementia patients and is spending thousands of pounds per week sending people outside of the city for respite and long-term care.

Carers are having to travel miles to see their loved one.

Retired police inspector Ian was asked to attend a recent Adult Mental Health and Wellbeing strategy consultation for Coventry as a carer - and was shocked that "there was no mention of dementia".

He said: "If dementia care costs Britain £17billion a year, more than cancer, heart disease and stroke combined, why is it that we appear not to have a pathway of supported care which is transparent to carers and users?"

Ian continued: "I am told Coventry is who are elderly and yet that 'older people's provision' is what we are offered.

"If my wife Carol was a Class A drug user or an alcoholic she could access more resources. That's what is funded."

Plans initiated several years ago to open a six-bed specialist ward for early onset dementia patients at the Caludon Centre had to be scrapped last year due to lack of funding from Coventry Teaching Primary Care Trust (PCT).

Many young Alzheimer's sufferers, like Bill Wilson, aged 58, of Coundon, Coventry, are in their early 50s when they develop dementia.

He sees the loss of this specialist provision as a backwards step.

Bill, a member of the focus group and Coventry's Alzheimer's Society, said: "You would not want to see me on a bad day. What happens when I throw a wobbler?

"There is nowhere for me to go. This unit, the Spencer Ward was specially created for younger people with dementia."

Ian added: "Coventry and Warwickshire Partnership Trust never
ahead of the game because it has a Young Onset Dementia Team - one of the first in the UK - where patients under 65 are referred to.

Although they do good work the work is limited because there are no resources available.

"Dementia is still not seen as a pressing priority by the PCT.

"There is a gap in services. Whether this is a wilful omission or an oversight, we do not know."

Sandy Taylor, chief executive of Coventry and Warwickshire
Partnership NHS Trust, said: "Ian has been in touch with me relating to a number of issues. We are aware of the situation he describes.

"We are working with Coventry Teaching Primary Care Trust (PCT) looking at how we can take forward services for people with early onset dementia."

The patient's story

AS LONG as he is able to Bill Wilson feels it is his duty to speak out for younger dementia patients in Coventry.

Diagnosed in his mid-50s he has been appointed a national ambassador for the Alzheimer's Society.

Ex-Marine and former athletics coach Bill, aged 58, from Coundon, Coventry, lives with his wife Pat, aged 61, and his 86-year-old disabled mother, Edith.

A father-of-two he has two children, Zoe, aged 32, and Ian, aged 30.

Bill said: "I tell the truth and it hurts people. On a recent trip to House of Commons I talked to MPs about
Alzheimer's.

"I followed Tony Robinson, Baldric in Blackadder, whose late mother had Alzheimer's.

"I walked into the room and said: 'Sit down and shut up because I am the professional; and you are going to learn what it's like to have Alzheimer's'.

"All of a sudden there was silence and then from the back of the room one woman started clapping.

"The more I can talk to people, the more people are going to learn Alzheimer's isn't just an older person's disease.

"There is a terrible stigma and it's still out there. The words 'dribbling, drooling and idiot' come to mind.

"This strengthened my resolve to become an ambassador."

Bill feels his condition may have been triggered by a heart condition.

He said it was a relief when he was finally diagnosed with Alzheimer's in his mid-50s.

"I accepted what I have, which saved me. Alzheimer's has given me a new lease of life.

"I have my highs and lows - but what is going to be there for me when I deteriorate, when I am not able to be coherent?

"My mind is still going to be full of all the things I have done.

"If I am in a bed alongside an 85 or 90-year-old patient it's totally wrong. If I am going to go out let me go out with dignity."

The carer's story

RETIRED West Midlands Police Inspector Ian Darnell has been caring for his wife since she first became ill with a rare form of dementia six years ago.

Carol was a healthy 56-year-old when one Sunday in June 2003 she suddenly fainted at the bottom of the stairs. It happened again. And again.

Carol began to suffer from "the wobbles" - little seizures - five or six times a month.

This began the start of a three-year journey from cardiologist to neurologist trying to find out what was the matter, before she was referred to the memory clinic.

Ian said: "She was fitted with a pacemaker. It took seven months to get an appointment with the memory team.

Carol Darnell, who is now 62, was eventually diagnosed with Alzheimer's in 2006.

Ian said: "Carol has tablets for epilepsy, which appear to stop her having seizures but not "the wobbles" as we call them.

"My wife is very friendly tactile person and the illness has affected her communication.

"She finds it very frustrating. Alzheimer's affects everyone differently. We rely on Bill to speak on her behalf.

Every week Melanie Smith a leisure worker for younger dementia patients employed by the Alzheimer's Society takes Carol out on trips to the gym, bowling and for walks in the park.

Ian said: "Mel was a breath of fresh air when she came here because everything else was elderly driven. They would do things that a normal younger person would do and it was appropriate to Carol's needs.

"The council is now providing funding for the service to continue but it will be jointly run alongside older people's services."

Ian, aged 58, and Carol, have two daughters - Amy, aged 29, a financier, and Sally, aged 27, a health visitor/midwife.

Through Coventry City Council's Carers funding Carol now receives nursing care by Care Associates five mornings a week, and is taken out for three hours on three days.

Because of heart problems, Ian who has taken medical retirement, needs to go to the gym for cardiac rehab three times a week - and this respite care allows him to do this.

Ian explained: "When Carol first got ill there was a nine-month wait for help. There is difficult behaviour.

"I needed help to get her up in the mornings. Medication has helped. She is articulating more, and more aware.

"In the early days after Carol was diagnosed we used to have a sitting service, which was primarily for the elderly.

"The lady sat down, did some knitting and made a drink. Carol said to me: 'Is she here for me or am I here for her?'"

On a Monday, Carol is lucky enough to have a place at a day centre provided by the Alzheimer's Society in the city between 10am until 3.30pm - but there is a long waiting list.

"It is a godsend," said Ian. "As a carer your life is geared around the person you care for."

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In this article written in The Guardian in response to Gordon Brown's suggestions for care reform, Plooy Toynbe looks at the possible ways in which we can manage to deliver good quality care for an ageing society.

Every year that passes, the crisis in social care threatens to crash into the political headlines. It hasn't quite yet, but the desperate state of the old and their carers is a gathering thundercloud. Gordon Brown yesterday began a public consultation, saying care was "at the heart of our ambition for a fairer Britain". Indeed, it raises deep equality questions. It's the right subject at the right time, as each party's manifesto will offer a remedy that reflects their true political nature.

Every day there are scandals hidden away in private: the old man struggling alone to wash, feed and dress his wife who has Alzheimer's, the mother in her 70s caring for her 50-year-old disabled son, the old woman sinking into degradation on her own while a council judges her needs insufficiently "critical". It's probably happening to someone in your street right now. Polls show most people blithely expect care to be there and to be free - but everyone discovers another truth when they need a care service. Then they find services vary wildly in a postcode lottery while the lottery of life decrees whether care costs eat up a family's last savings.

Reality started to bite once the all-powerful baby boomer generation began caring for its parents. By the time they need care, demands will explode. They, the have-it-all generation, always had it good (and that includes me). Sixty years ago, the new free NHS brought them into the world, as child benefits and the Butler education act were followed by new plate-glass universities to educate them. Their teenage years dominated the cultural scene - and oddly still do. They have the last good occupational pensions. Already, 85% of people between 54 and 70 own their homes as wealth is sucked up the age ladder, leaving the young struggling harder than they ever did. There are now more people over 65 than there are children - and they will live long. Look at this: the over-60s own £932bn in property, and the shortfall for care is just £6bn.

Current low care standards will not be good enough for them. Be warned. With their demands for good care and good pensions, they risk trampling on the impoverished generations that come after, making the employed pay for what baby boomers have failed to fund in their own working lives. They have not paid into insurance schemes but have accumulated privately. They, the grasshopper generation, must not demand that the hardworking young ants pay for their retirement.

But money must be found, care must be better and it must be paid for more fairly. Care is one of the most flexible areas of local authority discretion: it's the easiest to cut when councils want to reduce council tax. In theory, everyone is entitled to an assessment of their needs and a statement of what is available locally - but even that is often hard to get. Care homes and home care services are inspected by the Commission for Social Care Inspection, which now gives 0-3 star ratings for quality. Labour is rolling out personal budgets, letting those entitled choose what care they buy.

But after that, what you get varies, from excellent in Sunderland, where people with mild needs still get help, to other councils, mainly Tory, where only extremely critical needs are met. People with assets of more than £22,500 have to pay all their care costs. If they need to go into a nursing home at £500 a week, they will lose their house to pay for it, as more than 70,000 do every year, causing rage and distress to families. In other words, care is like health was before 1948: random, ramshackle, expensive and unfair.

All kinds of better options will be put forward in the coming months. Stephen Burke, director of Counsel & Care, points out that all care could be free with a levy of just 2.5% paid on every estate over £10,000 after death. Wouldn't everyone like free care and only pay once dead? It has been impossible for private insurance companies to sell policies to cover care costs: younger people still in work don't want to think about the day they might get Alzheimer's, so the products bombed. Besides, with a mortgage and a pension, care insurance is the last straw. Paying beyond the grave seems a much better option. Everyone involved in the care quandary despairs at the way the government rushed to give £1.7bn to the richest 6% of families by raising the inheritance tax threshold for trivial political gain, without making any link to care costs. Hypothecating inheritance tax for care is one obvious solution.

James Lloyd of the International Longevity Centre has produced an ingenious social insurance scheme the Department of Health is studying with enthusiasm. The joy of this scheme is that it is voluntary: payment only applies to the over-65s, when people really are thinking about care, and people can choose how they pay. This is the proposal: at 65 everyone with the money or property to afford it is asked to pay £15,000 as a lump sum to an independent national care fund. Or they can pay a set sum a month. Or they can have it taken from their estate after death. (The state would pay into the fund for pensioners with no assets.) Everyone would pay automatically unless they opt out, which they can but only after a one-to-one session warning them that they will pay all their care themselves, at a far higher private cost.

Gamblers can calculate the odds. Half of women and a third of men will need intensive long-term care: residential care costs about £22,000 a year. Many others will need expensive extra care in their own home. So most wise families would opt in: inertia would favour it, anyway. The sum of £15,000 assumes current care standards, but it might be quite a lot more if the public demands higher universal standards. But the scheme guarantees the same minimum level wherever people live; and administratively, one fund entirely independent of the Treasury would save the current cost of 185 councils each trying to chase the private assets of each well-off pensioner to recover care costs. Best of all, this takes only from the already retired.

This voluntary, late-in-life or after-death payment scheme ticks every box. Above all, it reminds people, as the NHS did in 1948, that paying collectively to insure against financially crippling risks is the wisest as well as the fairest way. If Labour has a shred of political sense left, it will use some such scheme to demonstrate how social democratic solutions, organised universally and spreading risk between all, are cheaper, safer and fairer than leaving everyone to sink or swim alone with private co-payments.

polly.toynbee@guardian.co.uk

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This article is specifically related to a care home in Hemel Hempsted.

AN ENQUIRY has been launched at a Hemel Hempstead care home.

New admissions have been halted at the Alexandra Nursing Home while a 'review of some procedures' takes place.

Mystery surrounds exactly why the review is taking place but the home has been criticised by inspectors in the past.

The care home, in Alexandra Road, looks after 76 elderly people including 26 people who suffer with dementia.

The ban on admissions has been imposed by social services at Herts County Council.

"We can confirm we are not putting forward any new admissions to the care home," a spokesman said.

Meanwhile the Commission for Social Care Inspection (CSCI) will carry out an unannounced inspection and will release a report on its findings.

Last Friday (April 25) a spokesman for Southern Cross Care Homes, which owns the home, said the ban had been in place for two weeks.

He said: "The management is working with social services, which has put a block on new admissions while they carry out a review of some procedures.

"Hopefully the embargo will be lifted within the week."

Following an inspection by CSCI last October the care home was found to be below standard in nine out of 24 areas and was particularly weak at providing suitable care for its clients with dementia.

The report said concerns were raised by residents at the way they were required to get up or go to bed earlier than they would like.

One woman was woken, washed and dressed at 5.30am and was still waiting for her breakfast at 7.50am.

The report said there was evidence the operational requirements of the home and convenience of the care staff was given unreasonable priority over the wishes and preferences of the people living there.

The care home was given until the end of last year to complete seven jobs to bring it up to the national minimum standard.

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Alzheimer Scotland welcomes this landmark review which endorses the policy of free personal care for older people.

Jim Jackson, Chief Executive, Alzheimer Scotland, said: "There is no cure for dementia, but the provision of personal care is as necessary for the health and well being of people with this devastating illness as medical treatment is for cancer patients. Dementia is a progressive illness which eventually means that the individual becomes incapable of looking after themselves. It is a matter of principle that they should be afforded equity within our health and social care system.

We are delighted that the main concern we raised with the Review Group has been clarified. Many councils thought they could ration free personal care to those deemed to be at highest risk. This left thousands of carers at home struggling to provide care 24 hour care themselves with little or no support from services, leading in some cases to early admission to a care home. It came as a shock to many carers, who were hit again by rationing and found they were having to pay care home fees until the council said they had funds available. The Review confirms the Government's intention that free personal care is an entitlement for all older people on the basis of assessed need, not at the Council's discretion. This will be a great relief to carers who have been living with uncertainty for a long time. However, we continue to have concerns about waiting times, while the report says that these must be clearly stated, currently it is not unusual for people to have to wait for services for two to three months in some areas and this is totally unacceptable. Services must be provided as close to the point of assessed need as possible.

Funding has been a thorny issue and we support the call for government to provide additional resources to meet the shortfall over the coming 5 years and for local councils to award proper priority to care for people with dementia. It is imperative that Councils, the NHS and government, in partnership, respond positively and immediately to the Sutherland recommendations."

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This is an excellent article written by Mervyn Kohler, a special adviser to help te Aged on how we should be planning now for an ageing society.
PEOPLE in Britain are living longer then ever before and this means that increasingly a greater proportion of our population is to be found in the 65-plus age bracket. This has the potential to present real challenges, but also opportunities, if the correct steps are taken to prepare for this profound demographic change.
At a national level, the serious financial challenge is to provide adequately for the greater volume of pensions which will be required. This is being tackled both by legislation which, from 2012, will automatically enrol employees into a national pe

nsion scheme with support from their employers, and by gently raising the state pension age to 67 by the mid 2040s.

But the task of creating those extra jobs cannot be plucked out of thin air by Acts of Parliament. Employers in Yorkshire and elsewhere will need to be thinking seriously about age-friendly workplaces and planning for a workforce which will include a higher proportion of older workers. Too many employers still take a rather negative view about training and supporting older employees, and that will have to change. Organising packages of work which permit part-time employment will have a new importance.

Promoting the independence and well-being of older people outside the workplace will require a range of significant actions at a local level, starting with housing provision. By and large, our housing stock was built by young people for young people, and we must ensure that new-build and refurbishment programmes give us much more "age-proofed" accommodation. The Lifetime Homes Standard, which is not mandatory, describes the sort of features which would enable older people to function more independently and successfully in their own homes – and most are not rocket science.

These include wide access doors (for wheelchairs – and baby buggies), adequate banisters and grab rails (particularly in bathrooms), minimising internal steps and stairs and providing for stair lifts or even through-floor lifts as possible adaptations, walk-in showers and large-button power switches.

They might include parking spaces for electric scooters, lighting sensors which follow a person's movement around the house, and enough cabling (available at waist level) to support the smart home technologies which are already in the market. Planners, builders and architects must focus more closely on design which takes account of potential frailties and disabilities.

If active ageing is our leitmotif, people also need to be able to function in a community, not just within their own homes. The building blocks here are things like public transport, public seating and
toilets, safe and attractive open spaces, decent pavements and
street lighting and access to sporting and leisure facilities.

An economically successful local community is vital too – one which can support flourishing convenience stores, postal services, pubs and hairdressers for example.

Town halls have a major role to help shape vibrant local communities which will provide for an ageing society, and the provisions in last year's Local Government Act point in that direction. Unfortunately, the funding settlement for local government, providing for only a one per cent increase in real terms in each year from 2008-2011, will make this a particularly hard challenge.

Health and social services clearly need to be sharper, not just to provide for the sick, but to help prevent people becoming dependent. Social care, not just in Yorkshire, has become an ambulance service for the most ill and the most poor, with virtually no provision to support the person who only needs a little bit of help to carry on living independently. There will be more telecare and telemedicine to drive that forward, and older people will need help to use these new technologies, but we also need to be honest and recognise that we have been under-funding our care services badly for decades.

A measure of future care needs can be drawn from looking at dementia, which affects more than one in five people over 85, but our over 85 population will have grown by 57 per cent in 2022, and by 123 per cent in 2031. A recent report from the House of Commons Public Accounts Committee showed how poorly we are providing dementia services. Family carers, who already provide the backbone of care, will need more support and access to respite care for their relatives – particularly since those carers will also be expected to carry on working.

Adjusting to an ageing society will not be cheap, but it need not be cripplingly expensive. We need to stop thinking of ageing as an illness which needs to be managed, but as a condition in which people will flourish given the right environment and support.

The key is to provide, in the round, for fit and active ageing. If you ask older people what they want, most will give the answer that far from being a burden, older people want to have the opportunity to play a real part in society. What they need, is the environment and support to be able to do this.

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This article is related to the recently highlighted issue of the use of anti-psychotics in the treament of those with dementia-related conditions.

Ministers should step in to stop the inappropriate prescribing of powerful anti-psychotic drugs to Alzheimer's patients, say an influential group of MPs.

Up to 105,000 people with dementia in the UK are wrongly being treated with the drugs, which are used to control behavioural symptoms such as aggression, they claim.

Research has shown that the medications have side effects that can accelerate mental decline, triple the risk of stroke, and double the chances of premature death.

They are intended for psychotic patients suffering from serious symptoms such as delusions, paranoia and hallucinations. Yet the drugs continue to be used as a first resort solution for challenging behaviour from sufferers of Alzheimer's disease and other types of dementia, according to the MPs.

A report from the All-Party Parliamentary Group (APPG) on Dementia demanded Government action to address the problem and urged the health watchdog the National Institute for Health and Clinical Excellence (Nice) to carry out a thorough review.

The report, entitled A Last Resort, lists five steps for reducing the use of anti-psychotics in the treatment of dementia. It points out that currently no audit or regulation of the prescribing practice exists.

Jeremy Wright, chairman of the APPG on Dementia, said: "A Last Resort shines a light on one of the darkest areas of dementia care. Anti-psychotics can double risk of death and triple risk of stroke in people with dementia, heavily sedate them, and accelerate cognitive decline.

"The Government must end this needless abuse and make the five-point plan a key element of the National Dementia Strategy. Best practices are not enough - safeguards must be put in place to ensure anti-psychotics are always a last resort.

"We need to include families in decisions, give people with dementia regular reviews, and equip care staff with specialist training."

The inquiry was told that an estimated 150,000 people with dementia were prescribed anti-psychotic drugs in UK care facilities. Psychiatric experts said around 70% of these prescriptions were inappropriate, a total of 105,000.

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This article is related tothe growing problem of obesity in the elderly.
Among the growing number of obese older adults, those who are moderately and severely obese, but not those who are mildly obese, run a significantly increased risk of having disabilities serious enough to need long-term care, according to a study that will be presented here, at the American Geriatrics Society's Annual Scientific Meeting, on May 1. The meeting is the premier conference on aging research.

Since the 1980s, rates of obesity among older adults have been rising dramatically. Obesity can boost risks of numerous health problems, including high blood pressure, arthritis, heart disease, diabetes, and stroke.

To determine how rising obesity rates among older adults affect risks of disability and demand for long-term care services, researchers at Purdue University studied more than 4,600 older adults. The adults, whose average age was 76, lived in the community, rather than in nursing homes or assisted living facilities. Of the adults, 39% were normal weight, 39% were overweight, 15% were mildly obese and 6% were moderately to severely obese. (The study excluded underweight older adults, who, research has found, also run increased risks of certain health problems).

Among the older adults, those who were moderately and severely obese were significantly more likely than those of normal weight to have difficulty carrying out activities of daily living (ADLs) -- such as feeding themselves, dressing, getting into or out of a bed or chair, bathing, or using the toilet, the Purdue researchers found. People who can't carry out these everyday activities independently typically need personal care or other long-term care services. In fact, 33% of the moderately or severely obese seniors in the study reported using either paid or unpaid personal care services.

Older adults in the study who were mildly obese or overweight, however, were not significantly more likely than normal weight peers to have difficulty with ADLs. Only 22% of the mildly obese and 20% of the overweight seniors used personal care services.

"We expected a higher rate of ADL disability among (all) obesity categories, but found that only the moderately to severely obese respondents were at significantly higher risk of this," says lead researcher Laura P. Sands, PhD, a professor of nursing at Purdue. "These findings suggest that most obesity-related increases in need for long-term care in the coming decade will be attributable to moderate to extreme obesity."

About AGS

Founded in 1942, the American Geriatrics Society is a nationwide, not-for-profit association of geriatrics health care professionals dedicated to improving the health, independence and quality of life of all older people. The Society supports this mission through activities in clinical practice, professional and public education, research and public policy. With an active membership of over 6,700 health care professionals, the Society has become a pivotal force in shaping attitudes, policies and practices in geriatric medicine.

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The Transport and General Workers' section of the Unite union is campaigning for a fairer deal for private care workers.

They say there needs to be more accountability over wages for workers employed by organisations contracted to the DHSS – and that there should be greater balance with pay and conditions of those working in public sector homes.

The union's call was taken up in the House of Keys on Tuesday by Peter Karran (LibVan, Onchan), who called for the details of contracts awarded to private care providers to be made public.

Mr Karran claimed Manx taxpayers were subsidising the private care providers' UK operations. 'We must be talking at least £1 million of public money as far as these contracts are concerned,' he said.

But Mr Teare insisted that the contracts had to remain confidential.

He said: 'There is no question of the department attempting to do something on the cheap.

'Contracts are a matter between the department and the service provider – we do run the risk of, in effect, dissuading or not encouraging companies from coming forward to tender services.'

Mr Teare pointed out there was conflict there in that the major component of care home operating costs tended to be salaries – and if wages were to rise, then fees charged to residents would rise too.

He said that individual contracts were subject to certain terms and conditions and 'one size did not fit all' but the DHSS was looking to move towards fixed term, fixed price contracts which offered more 'certainty'.

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This article is related to a new hospital which might also include the building of a residential home in the Highlands.
BRAND new hospital is being lined up in Grantown as part of big money plans to bring health care provision under one roof in the town.

The purpose-built centre which is being proposed could also become home to a new public-sector residential care home for the elderly and a surgery for the town's GPs.

Talks over the ambitious multi-million pound project involving Highland Council, NHS Highland and local doctors have been taking place behind the scenes, it has emerged. All parties involved have now agreed it is something they would like to take forward.

Highland Council's SNP/Independent administration pledged last summer to improve residential care facilities for the elderly locally, presently provided at Grant House in the town and the Wade Centre in Kingussie.

NHS Highland bosses believe this has opened the door for the construction of a joint facility to replace Grant House, which needs to be modernised, and the ageing Ian Charles Hospital.

Local GPs who work out of a surgery by the hospital have also been involved in talks about incorporating their premises into any new building.

"We believe there is a lot of potential in this idea, and everyone involved is very keen to get it off the ground," said Nigel Small, general manager of NHS Highland's South East Highland Community Health Partnership.

"I would stress that we are at the very early stages of discussions, but Highland Council has committed to developing Grant House and it seems very sensible, given the proximity to the hospital, to look at combining the two. It is too good an opportunity to pass up."

Mr Small said any new facility would not mean a reduction in services currently being offered locally, and added: "We are looking at what economies of scale could be involved, and any cash freed would be used to develop services further."

He stressed that he and his colleagues did not want to centralise all services for the area to one location, and revealed they were interested in creating similar shared health projects in both Aviemore and Kingussie.

No decision had yet been taken on private sector involvement in the construction. However, work has already started on a similar replacement of Nairn's Town and County Hospital and two local GP practices.

After several years of planning and negotiations with the private sector healthcare developer Prime plc, Morrison Construction started work on the scheme last month.

Jaci Douglas, Highland councillor for Badenoch and Strathspey, who has been involved in the Grantown talks, said she was excited to hear that a stage had now been reached where staff and patients could be informed.

"As a concept, the NHS and Highland Council are working together to make something bigger and better for the community," she said.

"It would benefit from shared budgets, shared space and shared expertise.

"This is a great opportunity, and I hope everyone can get around the table to find a way of moving this forward. It could be a model for the whole of the Highlands and even Scotland.

"This is a perfect example of joined-up working by the public sector."

Ms Douglas, who lives in Grantown, added: "At the moment we need to explore every option to make sure we get a building which offers the best possible facilities for the community."

Jim Beveridge, chairman of Grantown Community Council, was more cautious in his welcome.

"On the face of it, this sounds good, but we will need a lot more detail before we can say if it is what we need," he said.

"It would certainly be good for Grantown to have everything under one roof, but we need to know if the authorities are going to honour their pledge to put extra beds in Grant House and if the hospital will be bigger."

Brian Robertson, Highland Council's area community care manager, said the new facility could help allow more elderly people to remain in their own homes for longer instead of being forced into residential care.

"In keeping with recent Scottish Government announcements, Highland Council has committed additional resources to support the increased use of telecare and care at home," he said.

"If we can work together to link these homecare services with a new health and social care facility in Grantown, there is the potential for the Grantown area to be a centre of excellence for joined-up working, and this could only bring huge benefits for patients, service users and the wider local community.

"There is a lot of discussion required, but we may be at the start of something very exciting."

The discussions were also welcomed by superintendent physiotherapist Fiona Grant, NHS Highland's Badenoch and Strathspey locality clinical lead.

"This could be wonderful news for local people," she said.

"It makes sense to put all of these services under one roof so the organisations that are caring for people are talking to each other regularly.

"It would lead to more flexible ways of caring for the local population. It is still early days, but I am really keen that we explore the potential of this idea."

An official spokesman for NHS Highland confirmed discussions with the Highland Council were now underway and that the decision had been taken to inform the surrounding community about the project.

"Although these are just exploratory discussions, staff, residents and members of the community are being informed of this possible opportunity to improve facilities and link health and social care professionals more closely for the benefit of patients, residents and public."

The oldest part of the hospital, which was paid for by Ian Charles, 8th Earl of Seafield, and his mother Caroline Stuart, Countess of Seafield, was opened in 1884.

Highland councillors meeting in Inverness in July last year agreed to build and run the new care facility in Grantown, ending 18 months of uncertainty for Grant House patients and their families. It is scheduled to be constructed some time between 2008/09 and 2012/13.

The facility had been one of six council-owned residential care homes in the region controversially proposed to be transferred to the private sector by the previous council administration.

Following the U-turn, the capital costing of building the five new care homes in Grantown, Inverness, Fort William, Muir of Ord and Tain was estimated at £21.5 million.

There are plans for the Wade Centre in Kingussie, the other affected facility, to have its care beds incorporated into the new larger premises to replace Grant House.

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This article is related to a nurse who has been found guilty of misconduct by the Nursing and midwifery CouncilA care home nurse who silenced an alarm system so he could watch football in peace has been struck off.

The Nursing and Midwifery Council (NMC) was told a dementia sufferer wandered outside the nursing home while Peter Helps, 44, of Oswaldtwistle, Lancashire, watched World Cup matches with his feet up in the lounge.

Helps was found guilty of misconduct over his treatment of residents at Mapleford Residential Nursing Home in Huncoat.

The nurse, who did not attend the hearing in London, withheld cigarettes from residents for no apparent reason, spent long periods of his shift sitting in the lounge watching TV and silenced the call buzzer.

On the weekend of June 17 and 18 in 2006, this led to a male resident leaving the building without anyone noticing.

The Fitness To Practise hearing panel was told the patient was found in a neighbouring garden following an extensive search.

It was fortunate that he had not turned in another direction and walked on to a main road, the panel heard.

Evidence was given that Helps did not even bother to take part in the hunt for the missing resident and continued watching TV. Helps previously received a caution in 2003 for unauthorised alterations to a methadone prescription.

The panel considered suspending Helps but ruled the only appropriate sanction was a striking off order.

Panel chair Rachel O'Connell said: "We have concluded the misconduct is fundamentally incompatible with continuing to be registered with the NMC. This was a serious breach of his duty of care and abusive of vulnerable residents."

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This article is related to research regarding likley triggers for Alzheimers.
People who have more than two alcoholic drinks a day develop Alzheimer’s disease five years earlier than those who do not drink, a comprehensive study linking the condition to lifestyle has found.
Those who smoke are affected by the illness two years earlier than non-smokers, while those who smoke and drink are likely to hasten the onset of the disease by seven years.

People who suffer from high cholesterol in middle age are one and a half times more likely to go on to develop Alzheimer’s.

The impact of lifestyle on the development and the advance of the disease, which affects more than 400,000 people in Britain, was disclosed in two separate studies presented at the annual meeting of the American Academy of Neurology’s Anniversary in Chicago.

Dr Alina Solomon, of the University of Kuopio in Finland, who worked on one of the studies, said: “Minding heart health might protect the brain as well. People need to be aware of 'the big picture’, not focus only on the heart or only on the brain.”

Alzheimer’s causes loss of memory, personality changes and is terminal.

The Alzheimer’s Society has warned that in half a century up to 2.5 million people in the UK could have dementia unless steps were taken to encourage more healthy lifestyles.

Dr Ranjan Duara, of Mount Sinai Medical Centre in Miami Beach, Florida, studied nearly 1,000 people with possible or probable Alzheimer’s.

He said smoking and drinking were “among the most important preventable risk factors”.

Heavy drinkers — classed as those who had more than two drinks a day — developed Alzheimer’s 4.8 years earlier than those who were not heavy drinkers.

Heavy smoking — defined as 20 cigarettes per day — brought on the disease 2.3 years sooner.

The study also looked at people with a genetic variant called APOE linked with the disease and found that they developed the disease three years sooner than those without the variant.

Those who had all three risk factors developed Alzheimer’s at an average age of 68.5 years.

Those with none developed the disease at an average age of 77.

The second study, by Dr Solomon with Dr Rachel Whitmer, of the Kaiser Permanente care organisation in California, found that people with high cholesterol in their early 40s were more likely to develop the leading cause of dementia than those with low cholesterol.

The study involved 9,752 men and women in northern California who underwent health checks between 1964 and 1973 when they were between the ages of 40 and 45 and who remained with the same insurance company until 1994.

From 1994 to 2007, researchers obtained the participants’ most recent medical records to find 504 people had a diagnosis of Alzheimer’s disease.

The study found people with total cholesterol levels between 249 and 500 milligrams were one-and-a-half times more likely to develop Alzheimer’s disease than those people with cholesterol levels of less than 198 milligrams, considered normal.

People with total cholesterol levels of 221 to 248 milligrams were more than one-and-a-quarter times more likely to develop Alzheimer’s disease.

Dr Solomon said: “It would be best for both physicians and patients to attack high cholesterol levels in their 40s to reduce the risk of dementia.”

Dr Dermot Neely, Royal Victoria Infirmary, Newcastle, for the cholesterol charity Heart UK, said: “This research strengthens the conclusions of earlier studies linking common cardiovascular disease risk factors and Alzheimer’s disease and confirms what we already believe to be true - that control of these risk factors is important not only in preventing heart disease and stoke, but also in preventing age related cognitive decline.

“There enough evidence to recommend risk factor reduction, especially treatment of high blood pressure and stopping smoking, but there is not yet enough evidence to recommend statins to prevent Alzheimer’s, however.”

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This article is related to elderly residents in Wales having to sell their homes to pay for care.

HUNDREDS of elderly residents face having their homes repossessed if they fall ill, a Neath councillor has warned.

Coun Martyn Peters made the stark claim ahead of a public meeting on the issue tomorrow (Thursday).

He revealed that two women in his Dyffryn ward are threatened with having their homes taken away to pay for their care.

One of the women is in her fifties and had recently suffered a severe stroke.

Coun Peters could not reveal their identity because their cases are the subject of a legal challenge.

But the Plaid Cymru councillor believes they are just the tip of the iceberg and many more people are at risk in Neath Port Talbot.

He said: “There are two people in my ward affected, but we don’t know how many more are out there – there could be hundreds of them.

“This is a very serious concern. People are not aware that this could happen to them. We need to get things moving.

“If you are in hospital then the NHS will look after you. But if you do not get better and go to a care home then they won’t pay.”

Coun Peters said the system is unfair because assessment is based on financial considerations – not on the level of illness.

Criticism of the current means-testing has been growing in recent years.

Many believe it punishes those who have saved, bought their own home and contributed towards a private pension.

Others consider the system flawed because it discriminates against certain types of illness which require full-time care, such as dementia and strokes.

Tomorrow’s public meeting has been called to raise awareness of the issue and offer advice.

It will be held at Dyffryn Clydach Memorial Hall, Longford, at 2.30pm

Bleddyn Hancock – who successfully took the government to court over miners’ compensation – will be at the meeting.

Mr Hancock has previously challenged and overturned decisions on care payments.

With him is Dr Dai Lloyd AM who is also expert in this field.

“We are expecting a high turn-out at this meeting as it is something that pressures families at a time when they have to take difficult and upsetting decisions,” added Coun Peters.

“This is an issue that affects people right across Wales and is sure to worsen with the poor uplift in local authority budgets.

“When elderly people are in the time of greatest need they end up being stripped of their hard earned assets.”

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This article is related to the positive impact implementing community nursing and physiotherapy can have in a nursing home environment.
Bringing a community nursing and physiotherapy team into residential care homes for older people improves quality of life and reduces hospital admissions, according to a new evaluation study's reports published by the Joseph Rowntree Foundation.

The research, undertaken by the University of the West of England, Bristol (UWE) and the University of Warwick, found that savings made through reduced hospital admissions and delayed transfer to nursing homes offset any potential costs of the scheme. The study suggests that the overall cost ranged from an added £2.70 a week per resident to a more likely weekly saving of £36.90.

The two-year pilot scheme was set up in a group of local authority residential homes caring for 131 long-term residents as a joint initiative between Bath & North East Somerset (B&NES) Local Authority and the local Primary Care Trust. In tandem with providing nursing and physiotherapy to residents, the dedicated team also developed the nursing skills of designated care home staff through a training programme funded by Skills for Care.

Researcher Deidre Wild from UWE said, “Allowing people to remain in their care homes by bringing in specialist care during episodes of illness was greatly valued by both residents and staff. Staying in a familiar environment gave care home residents a greater sense of security during challenging times.”

The dedicated team (known as 'the in-reach team') was able to detect and deal with undiagnosed illnesses, producing long-term benefits for residents' health and quality of life. This was especially important in cases where, due to conditions such as dementia, residents found it difficult to communicate their symptoms to staff.

Professor Ala Szczepura of Warwick University reported that, “During the two year study, between 80 and nearly 200 potential hospital admissions were averted, and 20 early discharges made possible. Beyond the clear benefits cited by residents and staff, we estimate that investment in such a service could produce savings of up to £250,000 per annum to the Primary Care Trust and Local Authority.”

Commenting on the research, Jane Ashman, Strategic Director of Adult Social Services and Housing, B&NES said: ”This has been a really important project for the Council and the Primary Care Trust looking at an often neglected area, the health needs of people in residential care homes. We are now looking, with the PCT, at how to take the best learning from this and build it into our future joint community provision. Meeting the health needs of people in care homes is as important as for those in their own homes in reducing hospital admissions as well as improving quality of life.”

This research emerges at a time of change in health care provision with increasing emphasis on the integration of health and social care by community services so that hospital trusts can concentrate on providing acute care. It highlights the need for more detailed health assessments of residents in care homes than is currently carried out.

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This article is related to the easeof access to dental care for residents of Carmarthenshire care homes.
Residents in Carmarthenshire's care homes are able to get their pearly whites checked in the comfort of their own abode thanks to a new scheme from Carmarthenshire Local Health Board.

The LHB is working with several dental practises in different areas of the county in order to offer a care home dental service that includes health promotion and oral cancer screening in the county's 86 homes.

This includes both residential and nursing homes and equates to approximately 2,000 patients.

Carmarthenshire LHB's Head of Primary Care Rhian Bond said: "More elderly people are retaining their teeth than ever before but as people age they become susceptible to oral disease, which can affect their health and quality of life. Therefore, it is extremely important that we reach out to the elderly community, especially those in care homes."

Chairman of Carmarthenshire LHB Ken Jones said: "The Board is committed to improving the dental health of the whole community and I am sure that this scheme will have a huge impact for the individuals involved and the health community in the long run."

Homes have been contacted directly about the service, but anyone needing more information should contact Anna Evans on 01554 744463.

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This article is related to a Nottinghampshire Care Home.

RELATIVES and residents at a Retford care home have told of their relief at a three-year reprieve before its doors close for good.
St Michael's View will shut as part of Notts County Council's £19million overhaul of elderly care.

But the possibility of a brand-new £5million home in the town sweetened the news, and relatives say they were satisfied with the council's extensive three-month consultation process.

"From my point of view, it was all explained very well," said Jeanie Harrison, whose 87-year-old mum Eunice Dernie lives at the home, on Hallcroft Road. "When they announced it, I understood what they meant and what they are trying to do."

"They answered all our questions as best they could. I'm very pleased that they will look at the situation in Retford in three years time."

"It does feel that we have made some ground on the matter. What's needed is exactly what we have here, but with a new building and facilities."

Mrs Harrison, 57, said her main concern now is where a new home might be constructed in the future.

"It will be a major shame if the county council was to sell off land that's available now for a new building. In three years, the land they could have used might not be available, so it just seems the wrong way round to do it."

Mrs Dernie, who attended day and weekend sessions at the home before becoming a full-time resident, said the staff at the 34-resident home are wonderful, adding: "I would sooner be here than anywhere else I have seen."

Mavis Parsons, 86, has been 'really happy and content' in her two years at St Michael's View. Daughter Susan Hayes said feelings of disappointment over the closure had now turned into relief at knowing care in Retford is not being ignored.

In 2011, a county council review will determine the need for a new 35-bed home. St Michael's View will only close once the residents have been re-housed in beds the council deem to be up-to-scratch.

Joan Gardiner's mum Edith Hodgson was also introduced to St Michael's View through the respite care sessions, before she moved in full-time 18 months ago.

"It has been hanging over us for a while now," said Mrs Gardiner. "We were wondering exactly what the outcome would be, but I'm happier now."

"They have given us this three-year reprieve and will be reviewing the needs of residents along the way. The county council have been really informative, professional and clear with us, and if they stick to their word it gives us time to really get our heads around it all."

The five-year plan for care for older people in Notts will see the number of beds in care homes fall from 682 to 568, with homes in Sutton-in-Ashfield, Mansfield, Kirkby-in-Ashfield and Eastwood also heading for closure.

But this is to be offset by 160 'extra care' places - an enhanced sheltered accommodation scheme where the resident lives independently but has access to round-the-clock care as needed.

"The reaction was
really quite positive," said county council project manager Cherry Dunk, who was at St Michael's View to deliver the news last Tuesday.

"There had been a few people who were cynical at the beginning of the consultation, assuming the decisions had already been made when they clearly had not."

"We held meetings in all 15 council homes and people have been really helpful in talking to us about their local area's needs."

"Extra care is the way forward and there is a lot of support for that," she added. "There will always be a need for residential care but people are keen on this alternative."

Mrs Dunk was keen to point out that the involvement of residents and relatives would continue throughout the plan.

"This is just the start. Over the next five years there will be lots more meetings and discussions about the future and local residents will be very much involved."

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This article refers to a care home in Halifax.

THE reading appetite of elderly residents has stunned care home staff.
Rastrick Hall residential home in Close Lea Avenue opened in July last year complete with library.

But its books have already been devoured by those living at the 40-bed home.

Home manager Peter Ruickbie said residents were still hungry for more reading material and he has appealed to the community for help.

"We have a library but the residents have read most of it," he said.

Mr Ruickbie had a big box of old books in his attic so he brought those into work as reinforcements.

"They have gone through almost all of those already," he said.

Reading favourites vary but include Victorian novels and the paranormal.

Mr Ruickbie is appealing for anyone with old books lying around at home to help meet the reading demand of residents. Rastrick Hall can be contacted on 0845 6037752.

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This article is related to the increase in Herefordshire County Council's council tax rates.

INCREASED council spending on elderly people is to hit taxpayers in the pocket.

Partly caused by an overspend on social services, Herefordshire Council is putting up council tax by 4.4%.

The increase - approved by councillors at the Shire Hall last Friday and down on earlier projections - means the average resident will pay an extra £47.67 to Herefordshire Council next year.
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A Band D homeowner currently pays £1,083.46 to the council, rising to £1,131.13 with the increase, which does not include claims from parish councils and service authorities.

The county's growing elderly population is a key cause of the increase, with an extra £871,000 being earmarked in the budget for adult services.

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This article is related to a North Wales Care Home

THE boss of a care home for disabled people who stole £6,000 from a vulnerable resident yesterday escaped a jail sentence.

Judge Mr Justice Davis let Marilyn Taylor walk free with a suspended sentence – despite noting that he could not be sure Taylor was remorseful.

Taylor, 65, was the service manager for the Leonard Cheshire Home, Cartref Dyffryn Ceiriog, Dolywern near Llangollen.

She was responsible for the care and financial affairs of 34 people with disabilities.

But she emptied the bank account of one young woman whose condition was such that she was not aware of day-to-day matters, Mold Crown Court was told.

Taylor, of Beresford Gardens, Brook Street in Oswestry, admitted five charges of theft between April 2005 and June 2005, amounting to £6,000.

A further seven charges of theft and false accounting, which she denied, had been dropped by the prosecution at an earlier occasion.

She received an eight-month prison sentence suspended for 15 months, and was ordered to carry out 150 hours’ unpaid work.

The judge also set down a time table under The Proceeds of Crime Act and a financial hearing will be held to determine how much, if any, can be confiscated.

Taylor claimed that while she had taken the money, it had been spent for the benefit of the victim and other residents at the home.

But her barrister Dafydd Roberts said that she had to accept that she could not prove that, and could not positively put that assertion before the court.

Mr Justice Davis said that it was not just a personal tragedy for her, but a matter which involved serious criminality.

“You were sufficiently trusted to be promoted at the Leonard Cheshire Home – people relied upon you and you abused that trust in a significant way,” he told her.

The judge said that he was not sure that the defendant was remorseful for what she had done and she could not account for where the money had gone.

“It is because of people like you, what you have done, that people lose faith in entrusting their relatives to care homes,” the judge said.

The public had to know that when people committed such a serious breach of trust then they would be punished by imprisonment.

But he said that he was of the opinion that in view of her guilty plea and her good character, she had done enough good in her life that the inevitable prison sentence could be suspended.

Prosecutor John Philpotts said that Taylor began working at the home as a bank nurse in 2001, became a nurse there full time, became care supervisor and in 2003 was appointed service manager.

She was authorised to withdraw cash on behalf of residents and it was alleged that she had spoken to another member of staff that some residents had too much money in their accounts.

The defendant decided to refurbish the room of the victim, although she was not authorised to make such a decision.

A member of staff became concerned about some of the receipts that had been provided, and when Taylor became aware of that she said that some old receipts should be archived.

She was suspended when concerns were expressed to the area manager and it was discovered that the defendant’s account had been emptied, and there were no invoices to cover it.

Mr Philpotts said that the prosecution did not accept that the money she had taken had been spent in the home for the benefit of residents.

Dafydd Roberts, defending, said that it was a tragedy for a woman such as Taylor to be in court on such serious offences. She was now retired and was unlikely ever to be in court again.

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This article is related to the closure of 6 care homes in the London Borough of Bromley.

A COUNCIL-OWNED care home will close at the end of the month - the first of six set to shut.

Anne Sutherland House, Thesiger Road, Penge, will close on March 31 as part of Bromley Council's reorganisation of care homes.

Relatives of the 42 residents have already been contacted about the closure.
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Moving dates to alternative accommodation have been agreed and began on February 18.

Consultation meetings were held in April and May last year with relatives and 268 residents at all six homes set to close.

The other homes involved are Bellegrove, Mickelham Road, St Paul's Cray; Isard House, Glebe House Drive, Hayes; Kingswood House, Mays Hill Road, Shortlands; Manorfields, Avalon Road, Orpington, and Sheila Stead House, Bushell Way, Chislehurst.

There are proposals to build three new care homes on the Anne Sutherland House, Manorfields and Sheila Stead House sites.

A fourth new home will be built on the site of Leeson's Day Centre in St Paul's Cray, which shut last December.

Bromley Council has earmarked the other three care home sites for extra care housing.

Adult and community care portfolio holder Councillor Graham Arthur said: "We have to close down Anne Sutherland House because it now doesn't reach requirements of the Care Standards Act.

"We will be creating four new state-of-the-art homes and we have been looking at best practice elsewhere."

One way Anne Sutherland House falls short is it cannot offer all residents their own room.

The new care homes will do this and also offer en-suite facilities.

Cllr Arthur added: "We will have four really beautiful homes we can be proud of within the next three to four years.

"People in Bromley demand the best and this is what we are giving them."

A council spokesman said: "We will now be contacting the relatives and residents in the remaining homes to ensure they are as involved as possible."

Director of Bromley Age Concern Maureen Falloon said: "The council had to take this initiative.

"Some of the buildings are very old. To have something purpose-built has to be welcomed by all.

"Change is difficult but the new homes will offer new facilities.

"The council consulted with residents quite closely."

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This article is related to a new extension to a Furness care home.

CIVIC dignitaries helped unveil a £750,000 extension to a Furness care home.

Six rooms with en-suite facilities have been created by the addition of the Bechshaw Wing at Staveley House, Dalton.

The revamp also saw an additional lounge and bathroom created.

The existing dining room was extended and the kitchen facilities were improved. Construction to the Bechshaw Wing began last April and was completed just after Christmas.

The mayors of Barrow and Dalton joined the Lord Lieutenant of Cumbria, James Cropper, who officially opened the wing yesterday.

Mr David Stewart, treasurer of the executive team involved in the project, said: “Through assistance with Furness Enterprise this new extension will provide a number of new jobs as well as provide accommodation to look after more elderly people.”

The name for the new wing came from a valuable contributor to the project. The late Mrs Beatrice Shaw left a request in her will to donate money to Abbeyfield Furness Extra Care Society in order to construct new care homes.

And Staveley House, run by the society, is the first to benefit.

The first part of the name came from Mrs Shaw’s parents, Mr Marius and Mrs Hilda Bech.

Her father was of Danish decent and involved in the textile industry.

Funding was also provided by Cumbria County Council.

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Plans for a £4m centre of excellence in Wrexham to care for people with dementia have been given the go-ahead.

The new centre, to be called Bodlondeb (place of contentment) will look after 64 people with dementia who need day care, respite or residential services.

The centre, at Pendine Park, will build on dementia care already provided there and may create up to 75 jobs.

A recent independent report highlighted the need for extra facilities to help deal with rising levels of dementia.

Planning permission for the project had been won by the Pendine Park care organisation.

Planning officers had originally recommended that councillors refuse plans for the centre because it was being built on a "green barrier" on the town's outskirts.

But councillors overturned the recommendation and agreed the building be positioned 40m (131ft) closer to an existing care home.

People as young as 20 or 30 can develop dementia although most younger people with dementia would be in their late 40s or in their 50s. Professor Bob Woods

The centre will be divided into eight small, family-like units so residents receive as much individual care and attention as possible while benefiting from the back-up of a larger organisation.

The aim is to build on the specialist dementia care already provided at Pendine Park.

Mario Kreft from Pendine Park said he hoped the expertise and training offered would be of benefit to the whole of the care sector.

"We're going to ensure that the very latest thinking and research informs the services that we provide at Bodlondeb so that we hopefully become the benchmark for best practice," he said.

"It is much needed. There is no question we need more facilities both in the community and in care homes and within the NHS for people with dementia."

'Devastating'

Professor Bob Woods, who runs the dementia services development centre at Bangor University, said the Wrexham centre would have major regional importance.

"In north Wales, we're looking at an increase of 33% in the number of people with dementia over the next dozen years.

"Although there is a big emphasis on supporting people at home, we are going to need high quality alternatives to care at home for people with severe dementia.

"People as young as 20 or 30 can develop dementia although most younger people with dementia would be in their late 40s or in their 50s.

"It's devastating for a family when that occurs and their dementia can often progress rather more quickly than it would if it were happening in an older person."

 

 

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This article is related to Matlock Close Care Home in Barnet.

A Barnet care home has been forced to pay back £14,000 it took from a disabled resident after invoicing him for expenses with no receipts.

Matlock Close Care Home, in Matlock Close, was investigated by independent auditors Enpeyz after the father of 40-year-old resident Christos Kypriotis, discovered discrepancies in his son's bank statements.

Over a six-year period, rental payments were erratic and sometimes up to two-and-a-half times the agreed amount.
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There was also a series of large "unidentified expenses" listed in the son's bank records, such as £1,381 in July 2002 and £1,200 in March 2004, which could not be accounted for.

In total, the auditors discovered £13,903.60 in "unsupported expenditure", citing "lack of adequate financial records" as the main reason for its findings.


When Adepta cleared themselves of any wrongdoing in an internal investigation two years ago, he turned to Barnet Council, which recommended Enpeyz as independent auditors.

Mr Kypriotis, whose son suffers from epilepsy and has been a resident at the care home since it opened in May 1995, said the ordeal has left him tired and depressed.

"Having a son in that condition, you're not interested in money. We just wanted to see our son somewhere secure. That's why my ex-wife and I entrusted his account to them. We completely trusted them.

"This has been a huge pressure on me over the past six years. Now I'm tired and depressed. It's been a long struggle."

Mr Kypriotis's investigation prompted Barnet Council, which has a duty of care towards people it places in private homes, to commission a further independent investigation into the remaining six Matlock Close residents' finances. This is underway and is due to be concluded shortly.

Adepta denied any misconduct with any of its residents' finances and said it would not discuss individual cases.

It said the repayment was not an admission of wrongdoing.

A spokesman added: "Adepta has fully complied with all aspects of the complaint and met all the recommendations that came out of this process, including the repayment of some monies as a gesture of goodwill. Adepta takes the responsibility for supporting vulnerable people very seriously."

Along with the financial complaints, Mr Kypriotis has also lodged a number of complaints about the quality of care provided by Matlock Close over the past few years, which he claims have not been addressed by the home.

In its most recent Government inspection, in December 2007, the Matlock Close home was judged to be "poor", scoring the lowest grade in five out of eight criteria. These criteria included "personnel and healthcare support", "complaints and protection" and "conduct and management".

The report, by the Commission for Social Care Inspection, stated: "The people who use this service continue to live in a home that has not been as diligently well managed, either internally or externally, as it should be.

"The delays by the registered provider in taking the urgent actions necessary in response to serious concerns is something that causes ongoing concern to the commission."

The council said it would not be referring any more of its residents to Matlock Close until the financial investigations are complete and standards are improved.

A spokesman said: "We are monitoring extremely closely how Adepta brings standards up to what they should be and have been providing training for Adepta staff at the home. We expect Adepta to make the necessary changes quickly."

However, Mr Kypriotis refused to "run away" by removing his son from the home. "It is not for me to take my son away from this service, it is for this service to put its house in order," he said. "I'm not going to run away. I want justice for everyone."

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This article is taken from the Liverpool Echo and discusses care home standards.

ABOUT 420,000 older people are living in a care home in the UK, with average costs for private care homes hitting £452 per week and for care homes with nursing £640 per week.

It is expensive, all right, but what sorts of standards can people expect when living in these homes? And what legal rights do you have?

To help people make the right choices national charity Counsel & Care has updated its useful guide, Your Care Home – Is It Up To Standard?

"Care homes should be exactly what they say they are – both caring and homely," says John Burton, the man who produced the guide.

"If residents, their families and friends are clear about what they have a right to expect from their care home, they'll feel more confident about asking for it.

"And that makes everyone's job easier and it's how care homes improve and maintain high standards."

Stephen Burke, chief executive of Counsel & Care, said: "While most care homes are of a good standard, callers to our advice service are still concerned that many older people are not receiving the standard of care they are entitled to."

The book costs £9.99, including postage, from Counsel & Care, Twyman House, 16 Bonny Street, London, NW1 9PG. Telephone on 020 7241 8555.

Counsel & Care advice service is on 0845 300 7585 (Mon-Fri 10am-4pm, except Wed afternoons)

For more details visit the website at www.counselandcare.org.uk

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Best-selling fantasy author Terry Pratchett is to donate $1m for research into Alzheimer's disease.

The creator of the Discworld series was diagnosed with a rare early-onset form of the disease in December.

Pratchett, 59, will announce the pledge of about £494,000 at the Alzheimer's Research Trust annual conference.

Telling leading dementia specialists of his determination to find a cure, he will say: "I intend to scream and harangue while there is time."

    
Personally, I'd eat the arse out of a dead mole if it offered a fighting chance
Terry Pratchett

There are 15,000 people in the UK with early-onset dementia, which strikes under the age of 65 years.

Pratchett has a rare form of the disease called posterior cortical atrophy, in which areas at the back of the brain begin to shrink and shrivel.

The author will tell the conference he is prepared to go to extreme lengths in order to beat the disease.

He will say: "Personally, I'd eat the arse out of a dead mole if it offered a fighting chance.

"I am, along with many others, scrabbling to stay ahead long enough to be there when the cure comes along.

"Say it will be soon - there's nearly as many of us as there are cancer sufferers, and it looks as if the number of people with dementia will double within a generation.

"In most cases, alongside the sufferer you will find a spouse suffering as much.

"It is a shock to find out that funding for Alzheimer's research is just 3% of that to find cancer cures."

Lack of funds

In total, an estimated 700,000 people in the UK have Alzheimer's disease.

However, the Alzheimer's Research Trust estimates that just £11 per patient is spent annually on research into the disease - compared with £289 for each cancer patient.

Rebecca Wood, chief executive of the Alzheimer's Research Trust, said the trust currently had to turn down two out of every three research projects due to lack of funds.

She said: "Whilst we were deeply saddened to learn of Mr Pratchett's diagnosis, we are delighted that he has chosen to speak out about his experiences with Alzheimer's disease, to raise awareness about its impact and the desperate need for more research.

"Research is the only way to beat this disease and help people like Terry - to prevent them losing their thinking skills and keep them doing the things they love."

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This article is related to plans for a new care home in Whitchurch.

Up to 100 new jobs could be created in Whitchurch with the opening of a new £6.5 million nursing home. Work is scheduled to start later this year.

Coverage Care Services has outlined plans for a 75-bed facility to be built in Liverpool Road.

The home, which will occupy more than an acre of land, is aimed at being a hotel-style care home, with en-suite rooms, IT suites, restaurants and day centres.

An outline planning application for the development has been submitted to North Shropshire District Council, the local planning authority. A decision on the scheme is expected by the end of May.

Coverage Care chief executive David Coull said the home will set a new standard for residential care in Whitchurch.

“For us it’s really good news,” he said. “We operate 12 care homes across Shropshire and Whitchurch is the only gap on our map, so we are delighted.

“With 75 beds, we will need to employ about 100 part-time and full-time staff and it’s going to be a significant development for the town; it’s going to start off some good quality choices for older people in Whitchurch.

“The home will be for older people with health needs and some may have some signs of memory loss, so it will be a safe environment.”

Work on the project, which is estimated to cost about £6.5 million, is expected to be completed by April 2010.

* About 10 jobs are also set to be created at a nursing home in Prees.

Work to create eight new beds at Elmhurst Nursing Home is due to start next month, with the overall aim being to bring the care home’s total capacity to 40.

Maggie Allen, resource manager for the Learning Disability Care Group which own the home said the project will cost about £600,000.

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This article is related to residential care homes in Norfolk.

Fears have been raised that residential care homes for the elderly could be in jeopardy if new plans for caring for people in their own homes go ahead.

Norfolk County Council's Adult Social Services department has been given the go ahead to launch a public consultation and feasibility study on the future of council-run care homes.

The proposed strategy involves looking at the long term needs of elderly people in 16 localities in the county with the council with a study looking at the long term viability of each care home.

There are currently 7364 care home places in Norfolk with 848 being provided by the Council. There are 580 housing with care units, which are usually blocks of flats, with the Council directly providing the care into 519 of them and purchasing care within the remaining units.

The number of people aged 65 and over in the county is projected to increase from 169,200 in 2005 to 238,100 in 2020 - an increase of 40pc. The council said this situation has prompted them to make changes to services but health campaigners say it needs to be about care and not cost.

Phil Wells from Age Concern Norwich said: “There are worries that some residential units could close because housing with care is cheaper.

“We acknowledge the council has to act on the fact that there is a rising number of elderly people but some people need residential care.

“Housing with care is cheaper because a person has less needs and is more independent when they live on their own. Some people are better off directing their own lives but some need residential care. There should be more widespread options on care and it should be all about care and not budgetary options.

“This is a concern.”

North Norfolk MP Norman Lamb said: “When this has been tried in the past, they have met with massive opposition.

“These care homes are much loved and there will be people who are very concerned about their future.

“As a general principle, we should be doing what we can to enable people to remain in their own homes and provide proper support for them in doing so, but not everybody is able to achieve that. We have to ensure there is sufficient good quality capacity to meet the need beyond that.”

The council has come under increasing pressure to improve the environment of its care homes from the national Commission for Social Care Inspection. Backlog refurbishment and maintenance currently stands in excess of £15m.

At the county council's Cabinet meeting yesterdayHarold Bodmer, director of adult social services, spoke about the launch of the consultation and members agreed to recommend it. He said: “We are looking at a new housing with care scheme which would involve transferring elderly people from residential care into housing with care to maximise a person's independence.

“This is the preferred model throughout the county but it is at very early stages so we want to launch a public consultation and also a feasibility study.”

He said there was no “definite decisions” and no plans to close care homes.

It is proposed the consultation period will last for about six weeks and will be held during April and May. It will be part of a larger consultation exercise within the department and will focus on services to older people and carers.

It is proposed the feasibility study will be undertaken by NPS Property Consultants to review the current standards of the Council's homes and to assess which homes are “fit for purpose”.

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Interesting article from OnMedica on the effects of Cannabis in slowing down the onset of dementia.

Israeli researchers’ animal studies provide evidence that cannabis could be a viable option for treating patients with Alzheimer’s disease.

Around 24.3 million people have the condition globally, with varying quality of care and treatment. In England this fact has prompted the Government to put together a national dementia strategy, which will be launched later this year.

At a conference in London today, Professor Raphael Mechoulam of the Hebrew University of Jerusalem will demonstrate work with mice that has shown memory loss can be slowed down by some of the chemicals in cannabis.

Prof Mechoulam will announce that human trials will follow during his presentation at the Cannabis Medicines Symposium, held by the Royal Pharmaceutical Society of Great Britain.

Investigators in Spain, Italy, the UK and the US have also found an effect of cannabis in mice with dementia. They have shown that cannabidiol, a major non-psychoactive component of cannabis has positive effects in counteracting the disease effects.

In 1997, the BMA passed a motion at its annual representatives meeting that certain cannabinoids should be legalised for wider medicinal use and published a book on therapeutic uses of cannabis.

A year later, the Royal Pharmaceutical Society launched protocols to demonstrate its therapeutic effectiveness. This prompted trials exploring the medicinal benefits of cannabis for patients with multiple sclerosis and severe pain. Since then cannabis products have been developed and are used in Canada.

"We have come a long way in ten years and there is still a lot of research ground to cover," said Professor Tony Moffat, conference chairman.

"There is currently considerable interest in the medical benefits of cannabis and related compounds for a range of conditions including arthritis, multiple sclerosis and neurological pain. Although recent press coverage has focused on the abuses associated with the plant, cannabis-derived medications may offer novel opportunities in drug discovery."

Professor Clive Ballard, director of research for the Alzheimer’s Society commented:

"The quest for treatments for people with dementia is a critical area of research. There are encouraging findings from studies with animals suggesting that some cannabis derivatives may help protect nerve cells in the brain. We therefore look forward to robust clinical trials into potential benefits of non-psychoactive components of cannabis."

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This article was written by Ann Ferguson, public affairs manager of Age Concern Scotland, and although is in particular reference to one home in Scotland, does contain some interesting points regarding Care of the Elderly.

MOVING home is stressful for most people but when that move involves leaving not only the home you live in but also the people you live with this compounds the impact.
Add to this an unwillingness to move but having it forced upon you and you have the situation residents of Cockenzie House Nursing Home are facing.

When these residents moved into the nursing home they expected to be there for the rest of their lives. They formed bonds with staff and other residents and settled into what became over time comfortingly familiar routines. The loss of friendships, as different residents and staff move to different homes, will mean that mutual support mechanisms will be lost and the older people will be cut adrift in unfamiliar surroundings with strangers around them. For people who have dementia the familiarity of surroundings, people and routines is particularly important.

This does not mean, however, that homes which fail to provide the required standard of accommodation and care should escape the intervention of bodies like the Scottish Commission for the Regulation of Care. Where a service fails to meet the Commission's standards and has been given an opportunity to improve but failed to do so, it is absolutely correct for the Care Commission to take enforcement action, even if residents and their families are generally happy with the home. It is also quite correct for local authorities to stop placing older people in homes which fail to meet standards and for them to review the future needs of existing residents. To do anything less would be a serious breach of their duty of care.

It is important, however, that all options are considered in relation to the future of failing care homes, including steps to support such homes to make the necessary improvements. There is also a need for an early warning system which will alert local authorities and others to the possibility of failure with a view to avoiding closure and disruption to residents.

Where all reasonable steps
have been taken and closure is unavoidable careful planning is required to support residents. Their wishes must be central to the process and they must be supported in what will be a very overwhelming situation.

The residents of Cockenzie House Nursing Home held out hopes for staying where they were, despite the damning reports, which says a lot about their dread of moving. The temporary stay of closure will at least remove the need for some residents to move twice, first into a temporary place and then on to where they will hopefully be settled for the rest of their lives. It begs the question, however, why multiple moves were ever considered and why it took so long to hear what the residents were saying. This is not just about money or regulations, it's about people who deserve better.

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This article has been taken from 'The Argus' and is particularly relevant to East Sussex
The number of people with dementia in East Sussex is expected to top 17,000 over the next 20 years.

Health experts believe about ten per cent of the population aged 65 and over will have some form of the condition by 2028.

The increase is believed to be because more people are living longer and are therefore more susceptible to age-related illnesses such as Alzheimer's.
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However, the condition can also start to emerge at an earlier age with some people living for many years with a form of dementia.

This means more people will find themselves becoming carers for their relatives, neighbours or friends as they succumb to the disease.

The figures have been released as part of an awareness campaign featuring the experiences of people living with dementia and those who look after them.

Dementia covers a number of different brain disorders that trigger a loss of brain function. These conditions are all usually progressive and eventually severe.

There are more than 100 different types of dementia, with Alzheimer's the most common.

Symptoms include memory loss, confusion and problems with speech and understanding.

A number of people have spoken to The Argus about their experiences but have asked for their surnames to be withheld.

Marilyn lives in East Sussex and cares for her husband Bob, who has early stage dementia.

She said: "It's a common misconception that dementia is something that only happens to you in your 70s or 80s.

"For a very small minority - including my husband - dementia starts in your 50s, or sometimes even younger.

"It is hard. You have to deal with the sense of continual loss as you lose someone little by little.

"After years of supporting each other, and being a team, I can no longer rely on my husband in the same way I used to. This change takes a while to register.

"That said, you have to confront the situation, accept that life is different now and get used to doing things differently.

"We go out with other couples and families that have dementia.

We're both young still and want to have a social life."

Bob said: "New places have become very difficult to manage - they require all of my concentration.

"If I bump into a passer-by, they will automatically assume I'm drunk. I've had a few experiences of that.

"The illness is cruel because it takes away your confidence and you're not always sure what is happening.

"It's good to be able to raise awareness and tell people about dementia."

A range of services and support is available to people with dementia and their carers including social services and the Alzheimer's Society.

Those with a recent diagnosis are urged to contact East Sussex's social care department to ask for a care assessment.

For more details about care assessments call 0845 6080191 or email socialcaredirect@eastsussex.

gov.uk.

The Alzheimer's Society has branches in Eastbourne and Hastings and can be contacted on 01323 727127 or 01424 720640.

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This article is taken from OnMedica, the website for doctors in the U.K.
Having two parents with Alzheimer’s disease appears to double an individual’s risk of getting the disease themselves, suggests a small retrospective US study.

No one cause for the disease has as yet been identified although age, genetic inheritance, environmental factors, diet and general health are all linked, says the Alzheimer’s Society.

This study had no comparative group but it does appear to show a greater link to inherited factors than first thought.

A team from the University of Washington, Seattle examined 111 families where both parents had the disease.

Of the 297 adult children, 67 (22.6%) went on to develop Alzheimer’s themselves. In the general population the likelihood of developing it is 6-13%.

The team found the risk increased with age and was 31% in those over 60 and almost 42% in those over 70. Most of the sample children (79%) were under 70 so risk was likely to increase in future years, the authors said.

But having other members of the family having the disease did not change the risk of it but did reduce the median age at onset in offspring affected. ‘The apolipoprotein E 4 allele played an important part in this phenomenon but did not explain all cases of AD in the children,’ their report in the Archives of Neurology notes.

Last week, Neil Hunt, chief executive of the Alzheimer’s Society told delegates that lack of public awareness, problematic assessment and diagnostics and variable quality of care were the three main problems with dementia care in the UK.

‘The British public is still woefully under informed on the illnesses that lead to dementia, he said, ‘and GPs feel very uncomfortable on how they can handle this,’ he said at a long term care conference in London

These issues would be the main focus of his recommendations into the English Government’s national dementia strategy, which is due to be published in October.

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THE owner of a nursing home facing closure has offered to lease it to the council free of charge to make sure the elderly residents do not have to move.
Cockenzie House Nursing Home had been expected to shut its doors next weekend as its manager said restrictions on new admissions meant he could no longer afford to pay staff.

This article has been taken from the Edinburgh Evening News.
As reported in the Evening News last month, there were fears the upheaval could prove too much for some of the residents.

Relatives also fear 37 residents could have nowhere to go. East Lothian Council is currently refurbishing Greenfield Park, a nursing home in Musselburgh, but work is not due to be completed until March 20.

Now Cockenzie House owner James McDonald has offered the council free use of the home for the next two months. The council is understood to be considering this offer.

In a letter to the council's chief executive, Alan Blackie, he wrote: "I do not wish my residents to go to a hospital ward that is rightly meant for other people, and then will probably have to move again. That would be inhumane.

"To prevent this I offer East Lothian Council the use of Cockenzie House Nursing Home free of charge until more suitable arrangements can be made."

He added: "Unfortunately their contingency plans are in disarray. Greenfield Park will not be ready in time. Some residents would effectively have two moves. I've offered to keep the home open for another two months to dig them out of a hole.

"They could stay here till May. If the Care Commission were to lift the ban, they may not need to be moved at all."

Mr McDonald has previously rejected a council offer to buy the premises at a price to be fixed by the district valuer.

A ban was imposed on new admissions at the home after a damning report by the Care Commission. They said that Cockenzie House has failed to meet acceptable standards, including poor hygiene and infection control.

They have recently completed a further inspection of the home, and are expected to produce a final report this week.

But East Lothian Council is currently trying to find alternative accommodation for most of the 37 remaining residents.

It is understood that 21 of them have expressed preferences for being moved to Greenfield Park. Ano
ther two could be cared for in Belhaven Hospital, in Dunbar.

A council spokeswoman said: "We're still working towards the home closing on March 31. Some residents have already moved to alternative accommodation.

"Greenfield Park is progressing extremely well. Extensive renovations are ongoing and every room is being redecorated.We're aiming to finish by March 20.

"In Belhaven Hospital, there's a variety of care provided. NHS Lothian has offered two individuals who have a connection with Dunbar possible accommodation in a long-term care ward."

But relatives and community leaders have warned that moving residents could have a serious effect on their health.

Jim Elder, of Musselburgh, whose 87-year-old aunt Sarah is in the home, said: "I think there's every chance her health will suffer if she moves. You wouldn't treat an animal the way my aunt Sarah's being treated."

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This article is taken from the leader comment section fo The Scotsman.  
AT FIRST sight, the conviction of the nurse Colin Norris for murdering four of his elderly women patients by injecting them with insulin can be dismissed as just another of those macabre but random incidents that life throws up.
It would be easy to pigeonhole Norris as merely another twisted mind who used the accident of a career in the medical profession to wreak human misery – similar to Dr Harold Shipman, who was convicted of murdering 15 of his mostly elderly patients, though the real total was probably over 200.

But we have to ask ourselves why it seems so comparatively easy for people such as Norris and Shipman to go on killing without suspicion arising earlier. Part of the explanation is that Norris and Shipman preyed on the elderly, and our society is too ready to assume that the death of an older person is probably "natural". Of course, chronically ill people in their late eighties stand a higher risk of natural death than people in their twenties. But there is another hidden social calculation being made: are we not sometimes thinking that the life of the elderly is less important?

Worse, there is a growing problem of physical and mental abuse of the elderly – especially the elderly in care. Colin Norris's pathological hatred of the elderly is merely an extreme example of a twisted culture that is becoming all too prevalent. Last year, a House of Commons inquiry estimated that as many as 500,000 elderly people in Britain are being abused by relatives, carers or strangers. An earlier survey, by the Community and District Nursing Association, found that nine out of ten nurses working in the community have come across cases of abuse of an elderly person – most often by the chief care-giver.

No doubt Colin Norris is an aberration, but the lack of dignity we afford our older people in the care system contributes to the ability of such freaks to kill without being discovered quickly. We may never be able to stop the odd psychopath from killing, but we can create a better system of p
rofessional care for the elderly that gives them better protection.

Unfortunately, the trend is in the opposite direction. Last year, the Scottish Commission for the Regulation of Care, the independent regulator established by Holyrood, reported a significant rise in complaints against care homes for the elderly. One reason may be that care for the elderly can be regarded (socially and politically) as a necessary chore. Yet by 2031, more than a quarter of the population of Scotland is going to be over 65.

Most of us will be elderly one day. The elderly deserve respect and they deserve civilised treatment. We need better training of carers, coupled with a rigorous regulatory regime that fines agencies which breach the commonsense rules for looking after the elderly.

That may not prevent another Colin Norris or Harold Shipman, but it may ensure they are caught more quickly.


The full article contains 504 words and appears in The Scotsman newspaper.

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The Telegraph reports today on calls for radical change within the NHS on its treatment of the elderly.

The NHS has been forced to pay out more than £180 million in compensation to thousands of elderly people who were wrongly charged for care.

About two thirds of the pensioners had to sell the family home to meet costs which should have been paid for by the state. Some have already died.

The pay-out was confirmed by the Department of Health yesterday, and immediately provoked calls by charities and campaigners for a major rethink of the entire system of funding elderly care.

Mervyn Kohler, the special adviser at Help the Aged, said: "There are still many inconsistencies in practices. There is a total lack of clarity about what the NHS should pay for, and as far as means-testing goes, the benchmark is set terribly low before you are expected to meet all your costs yourself.

"The Government must bring about radical change."

The compensation follows a decision to allow people charged for "continuing care" from 1996-2004 to have their cases reviewed.

While the NHS pays for medical care, it does not pay for personal care such as help with feeding, dressing or washing, which is means-tested.

Many people were wrongly assessed as not having a medical need, which denied them funding that should have been available, and eligibility criteria differed across the country, creating a postcode lottery.

For example, dementia sufferers living in their own homes but requiring three visits a day from a nurse to help them take their medication and get washed were not regarded as having a medical need. Many were then forced to sell their homes to meet care bills.

Five years ago, the health ombudsman Ann Abraham ordered a review in a report, which exposed the care funding scandal.

Applications for compensation had to be submitted to primary care trusts or local strategic health authorities by November for the pay-outs, which could take "distress" into account.

This led to more than 13,000 claims and 2,000 payments, costing £180million. The average pay-out is around £90,000 per person.

The final NHS bill could exceed £200million, because 1,300 cases are still being assessed.

But even where redress is paid, the amounts are not uniformly calculated across the country, creating yet another postcode lottery.

A Department of Health spokesman said: "The NHS has paid restitution to the affected individuals or their families."

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The Priory is known best for helping celebrities such as Amy Winehouse, Kate Moss and Pete Doherty recover from drug and alcohol addiction. But the psychiatric hospital chain could soon be catering to more elderly and less glamorous patients as part of a planned shake up.

Philip Scott, Priory's new chief executive, said the company is looking to set up a chain of nursing homes to capitalise on the burgeoning UK elderly care market.

"Priory is an incredibly strong brand," he said in an interview with the Financial Times. "Unlike psychiatric care, the demographics behind the UK elderly care sector are extremely strong and there is less pricing pressure."

The move will see Mr Scott return to familiar territory. As chief executive of Southern Cross until late last year, the 44-year old Irishman was responsible for transforming a 4,000 bed outfit into the UK's largest nursing home operator, with 36,215 beds and 2007 sales of £731.9m.

Mr Scott aims to acquire 500 beds for the Priory by the end of this year and said he wanted sales from the nursing home division to account for 20 per cent of group revenue in three years.

The UK nursing home sector is estimated to be worth £12bn a year, according to Laing and Buisson, a healthcare consultancy. This may more than double over the next 30 years as demand from an ageing population rises and the number of homes available falls as older sites disappear.

The Priory runs 28 clinics and claims to be Europe's leading provider of acute and secure mental health services with an emphasis on rehabilitation.

In spite of its image as a celebrity hideaway, acute psychiatric care is its biggest source of revenue, making up 40 per cent of sales in 2005.

But the sector has come under pressure as the NHS moves towards more outpatient treatment and private insurers reduce psychiatric coverage.

Mr Scott insisted that Priory has turned a corner. The group, acquired by ABN Amro, now owned by Royal Bank of Scotland, for £875m two years ago, is understood to have £900m of debt

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First, horses were replaced with cars. Then carrier pigeons were put out of work by radios. Now it's dogs who may need to look over their shoulders.

They have reason to worry, according to a St. Louis University study that pitted a robotic canine against the real thing in a contest to see which was better at relieving the loneliness of nursing home residents.

In a final analysis likely to shock dog lovers — lovers of real dogs, that is — the two creatures finished in a virtual tie.

Among the shocked dog lovers is the study's author, Dr. William Banks, a professor of geriatric medicine at St. Louis University.

"I kind of assumed the live dog would do better," Banks said.

It doesn't make it any easier knowing it was his own dog, Sparky, a 35-pound, sandy-red, floppy-eared pooch, who failed to outdo the robotic Aibo, which was made by Sony until 2006.

And it's not like Sparky was a novice in this arena. The 9-year-old animal is a trained therapy dog. He's been taught to make people feel good.

"He's a pro," Banks said. "He's got this incredible personality."

But it wasn't enough to overcome a hairless robot programmed to mimic the behavior of real dogs. It barks, wags its plastic tail and learns basic commands. It can even chase a ball.

"It's really frightening," Banks said. "Whoever engineered the behavioral software — they must have some insight into the human psyche."

The study, published in the March issue of the Journal of the American Medical Directors Association, was done on a tight budget, with Banks and his wife, co-researcher Marian Banks, supplying the labor and both dogs.

Testing took place during six weeks of visits to a trio of local nursing homes. Banks would not reveal the names, citing privacy concerns.

The 38 residents were divided into three groups. One group received regular visits from Sparky, while another spent time with Aibo. The third received no visits from either Sparky or Aibo.

The residents receiving visits were asked questions about how lonely they felt and how attached they were to Sparky or Aibo.

In the end, both groups were less lonely and more attached.

But what does this all mean — beyond the notion that nursing homes would be happier places if robot dogs roamed the halls. After all, you can't even buy a new Aibo anymore, though you can snag a used one on eBay or another online auction site.

Banks sees a day when robots could be used to help older people remain independent longer. The machine could be programmed to follow you around, monitoring vital signs, reminding you when to take medicine, or even calling for help if needed.

His study, he says, provides evidence that people might adjust to the concept of a robotic companion.

"It could be," he said, "your own little personal R2-D2."

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Older people: facts and figures
There are over 11 million elderly people in the United Kingdom, according to the most recent census.

This breaks down into:

9,280,000 in England
968,000 in Scotland
602,000 in Wales
275,000 in Northern Ireland.

Poverty
16% of single older men and 22% of single older women, before housing costs, are in poverty; 13% of single older men and 17% of single older women, after housing costs, are in poverty, compared to 19% of all pensioners before housing costs, and 17% of all pensioners after housing costs.

Two million pensioners, before housing costs, and 1.8 million after housing costs are in poverty.

Poverty is defined as living in a household where the income is less than 60 per cent of the median income of the population as a whole. 68% of pensioner households depend on state benefits for at least 50% of their income.

Continuing care
Continuing care affects some of society’s most vulnerable people – those in need of ongoing care. People deemed eligible for continuing care receive free NHS care. Those denied it usually become the responsibility of social services – and their care is means tested. Seriously ill people are being assessed as only needing social care, which they must pay for. There is concern about inconsistency in the way eligibility for free NHS care is decided.

Dementia
Dementia mainly affects the over-65s and its prevalence increases with age. The Alzheimer’s Society says that more than 680,000 people have dementia in the UK, costing about £17bn a year in formal and informal care. It estimates numbers will rise to almost 950,000 by 2021, and more than 1.7 million by 2051.

Source- Age Concern

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A TEENAGER who put pensioners' lives at risk by starting two blazes in the nursing home where he worked has been jailed for two years.

Kitchen assistant Levi Love tried to shift the blame for the fires onto a frail resident in her 80s who was living at Church View, Oswaldtwistle.

And his actions were slammed by a judge, who said the 17-year-old could have killed one or more of the elderly people he was supposed to be helping to look after.
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Managers of the home have praised the quick actions of staff in leading residents to safety, without which the situation 'could have been a lot worse.' Suspicion initially fell on an old woman living at the home after matches were found beneath a burning pair of curtains, which had been set on fire in a corridor.

The day after, Love, formerly of Claremount Road, Accrington, set another fire in the pensioner's room using the same method so that she would take the blame for his actions, Burnley Crown Court heard.

But Love was eventually arrested after another member of staff became suspicious him.

Love was jailed for two years at Burnley Crown Court after pleading guilty to arson and being reckless as to whether life was endangered.

The teenager claimed that his actions were a cry for help because he was in abusive relationship with an older man.

Many of the residents at the nursing home are physically frail and some are mentally infirm.

And after the case, Kerry McLellan, general manager for Church View Homes, said that only thorough staff training had prevented the loss of life of vulnerable residents.

She added: "The alarm was going off and staff had to act very quickly and follow the procedures they had been taught in the event of a fire. Fortunately no one was injured or came to any harm - but it could have been a lot worse."

The court heard how Love had begun working at the nursing home about a month before the fires.

On November 17 last year he alerted staff to a small blaze in a corridor. The fire brigade found a box of matches near the seat of the fire and thought that it may have been deliberately started.

Blame fell on Mary Hindle, a confused resident in her 80s, and this was heightened when a fire broke out in her room the next day, the court heard.

Staff were able to lead over 30 pensioners to safety by escorting them to a different part of the Church Street building.

The fires caused over £3,000 worth of damage. Flames and smoke destroyed a window ledge, television, curtains and other property in Mrs Hindle's room.

Silvia Dacre, prosecuting said: "The defendant was interviewed and at first he denied involvement. He eventually accepted he had started both fires and said it was a cry for help."

Mrs Dacre said that Mrs Hindle was in the breakfast room at the time of the second fire, but a neighbour was in her own room and her frailty put her at risk.

She added: "He accepted his actions risked the lives of residents and staff and however miserable he may have felt it didn't justify his actions."

Kevin Donnelly, defending, said it was clear Love was a troubled individual and at the time he was suffering from some form of depressive disorder.

Mr Donnelly said the defendant had found himself in "a very dark place."

But Judge Andrew Woolman said Love could have caused death or serious injury to one or more of the residents.

He said: "Whatever your problems are, you are as things stand posing a high risk of reoffending in rather a serious way. The young offending team has clearly come to the conclusion that for the moment you are dangerous."

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OLD FOLK have been moved out of a residential care home because it does not have enough staff to look after them.

Barking and Dagenham Council decided to remove all 16 of the elderly tenants from the privately run Lisnaveane Lodge last week because of concerns over staffing levels.

The action follows an unannounced visit to the home in Lodge Avenue, Dagenham, by officers from the Commission for Social Care Inspection (CSCI) on January 28.

They found there were not enough staff on duty, which was affecting residents' welfare.

Two of them were upstairs and needed to use the toilet, but nobody was free to help them. Another asked for a cup of tea, but there was no staff member to get it.

But care home owner, Fiona Waddell, has answered the criticism by explaining that a member of staff had suddenly called in sick at 5am that morning.

The inspectors also raised concerns about cleanliness at the premises.

Their report states: 'From observation, it was apparent that many parts of the home were not clean, such as bathrooms, some bedrooms, the corridors and lounges. The health and safety and welfare of residents was compromised.'

The inspectors also found clinical waste bins that were split and overflowing, causing a health hazard.

Some residents complained that they felt cold, and several radiators were found switched off.

Inspectors issued four notices demanding immediate action on staffing levels, the disposal of clinical waste, on cleaning the home, and ensuring it was properly heated.

A council spokesman said transport had been provided to move the residents to other homes.

He said: "The council took the decision to advise the users and their families about moving to alternative care homes, as the staffing levels in the service for certain shifts could not be guaranteed.

"On the whole, the staff are dedicated and caring, but the registered manager was leaving the company, and no replacement had been found, which caused concern."

A CSCI spokesman added: "CSCI has worked closely with Lisnaveane's owner and the council for some time to address concerns about the quality of care at the home, the adequacy of staffing, and the safety of residents.

"The Commission earlier issued enforcement notices to ensure that essential improvements were carried out.

"The owner has complied with these requirements but has not continued to sustain acceptable standards in other aspects of care."

Owner, Fiona Waddell, told the Post that on the day of the Commission's visit, a staff member had called in sick, and there had been no time to secure an agency replacement.

Mrs Waddell said the council had decided to move some tenants before the inspection, and that some had already begun moving, which was the reason why the home was not clean at the time.

The clinical waste bin was kept outside, and was due to be taken away next day.

She said she did not believe the rooms were cold, but that a resident may have turned off the radiators.

Mrs Waddell added that the lodge was still open and fully staffed, with a new management team being brought in soon.

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THE level of care at a nursing home where an elderly woman died "fell far below what was expected", an inquest heard on Thursday.

Mary Quigley, 78, of Upper Street, Islington, who was being cared for at St Anne's nursing home in Durham Road, Holloway, died in February 2007.

St Pancras Coroner's Court heard that staff had delayed calling an ambulance to treat her severe breathing problems and she died within hours. When the ambulance arrived, a paramedic found that Mrs Quigley's oxygen mask - which she used 24 hours a day - was not connected to the supply.

The inquest also heard that Mrs Quigley's was only given a proper check-up on two occasions during her weeks at the home, whereas she should have been assessed every day.

The coroner also found that staff at the home had little or no knowledge of the symptoms she was suffering from.

The court heard that in an earlier incident Mrs Quigley would probably have died if staff from The Whittington Hospital's lung unit had not been in attendance by chance. They realised Mrs Quigley's condition was deteriorating and rushed her to hospital.

Jennie Williams, assistant director of nursing for Islington Primary Care Trust, carried out an investigation into the death. She said: "Basic requirements were not met to a standard I would accept. That is demonstrated by the lack of observations - I was only able to find a record of two observations being taken."

Thirteen complaints about the level of care were upheld against St Anne's.

Coroner Dr Andrew Reid recorded a verdict of death by natural causes, but reprimanded the care home. He said: "Mary Quigley died from natural causes - however on the evidence heard I am persuaded to add a narrative to the natural verdict. The symptoms [of her illness] were not always recognised by her carers."

Grieving daughter Denise McCormack said: "We take our elderly to these places in the hope they will be looked after."

A spokesman for Anchor Trust, which runs the home, said: "We have appointed a new experienced management team at the home. We became aware that certain areas needed improvement, which have been comprehensively addressed."

Islington Council had placed Mrs Quigley at St Anne's. Councillor John Gilbert, Islington Council's executive member for health and social care, added: "I was very sad to hear of Mrs Quigley's death and we extend our deepest sympathies to her family.

"Following her death in March 2007, Islington Council developed a comprehensive action plan with Anchor Homes and the PCT to improve standards at this home. This includes extra support and close monitoring, staff training and the appointment of a new management team.

"The regulatory authority has already recognised that standards at this home have improved. We will continue to work closely to support St Anne's to improve care for Islington residents. This commitment will continue as we recognise improvements need to be sustained in the longer term.

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Poor state funding is forcing some people to sell their own homes to pay for care fees. Alison Steed reports


Around 1.5m older people with a disability or impairment would be left to fend for themselves without the help of family and friends, but still have some shortfall in their care as government help is increasingly rationed.

Cash-strapped councils are limiting care to those who have "substantial" or "critical" care needs according to the Commission for Social Care Inspection (CSCI), and a lack of government funding has resulted in many councils now paying carers "by the minute" for the care they provide, rather than in 10- minute blocks.

Self-funders are those who have amassed too much money to qualify for state aid, which amounts to anyone with more than £21,500 in assets, including their home. The average annual fee for private nursing care in England in 2006 was £25,552, and £18,420 for a residential home, according to figures from Stephen Hadrill, director general of the Association of British Insurers.

Owain Wright, head of care funding services at Saga, said: "There is no panacea when it comes to paying for care. The most important thing is to understand which options are available and then pick one which seems to offer the best outcome and least risk to capital for your circumstances."

Those who miss out on state funding and have to fend for themselves are also being "lost to the system", and may end up being inappropriately placed in residential care, which could result in them having to sell their home to pay the fees.

Only those with assets below £12,750 will have all of their care funded by the state. The latest report from the CSCI has identified that the numbers of older people using state services has fallen from 867,000 people in 2003 to 840,000 in 2006 – that is despite the number of people over 75 increasing by 3 per cent. Those not receiving care in their own homes are left with a poor quality of life.

The postcode lottery to identify who qualifies for care funding means that not only is the experience different from council to council, but also within the same council, the CSCI said.

Dame Denise Platt, chairman of the CSCI, said: "In practice, the criteria can be interpreted in different ways by local staff.

"This is further convincing evidence about the very variable experiences, which people have when they are seeking care, particularly those outside the formal public care system. There is now an urgent need to create a fair and equitable social care system, which is sustainable and affordable."

Gordon Lishman, director general of Age Concern, said: "The latest CSCI report shows a widening chasm opening up between those who get council-supported care and those who don't. Fewer people are receiving care at home despite increasing needs, and the Government is saying these services are a priority. People are missing out both because of very tough means testing and increasingly restrictive and arbitrary assessments of people's needs.

"What is urgently needed is a substantial increase in care funding and fundamental reforms which should follow the green paper. A new partnership between the state and individuals must deliver better quality, improved access and a fairer way of paying for care."

Direct payments, where the state funding is paid to the individual to find and fund their own care arrangements, have increased from £1 in every £100 of care paid for in 2004/5 to £2 in in 2005/6. However, trying to get information out of the local councils about buying care facilities is not always as easy as it should be.

Many self-funders, or those receiving direct payments, are merely being given information about care homes in the area and then left to their own devices, said Philip Spiers of specialist care fees adviser NHFA.

He added: "Lot of people are missing out on thousands of pounds that they are entitled to. That means these people would be denied the 12-week property disregard for care fees funding [which means that for the first 12 weeks in a nursing home, the care fees would be paid for by the council giving the resident time to sell their property]. That is worth about £3,500 to every individual, and they are being denied that. It is an awful situation."

Other benefits, such as attendance allowance are also denied to self-funders, when it is a benefit they should receive. Previously, the minimum level of NHS care funding was £40, but this has risen to what is now a flatrate of £101 – only those already receiving the higher rate would stay on it, but even they would be reassessed. If you are concerned that you are missing out on benefits, you can contact an independent care adviser, or even Citizens Advice.

Even those who have received the increased NHS payments are not benefiting in some cases, as the payments are made direct to the care homes, and the fees are increasing by as much as the payment is, said Mr Spiers. So what would have cost £40 a week previously, now costs £101 a week.

Dealing with care fees yourself is not an easy prospect. But if you or a relative does have to sell a home to pay for care, then an immediate needs annuity can ensure that the money does not expire before the resident does.

HOW TO MINIMISE YOUR LONG-TERM CARE COSTS
# Claim attendance allowance. This is a non-means tested, non-taxable benefit paid weekly at lower rate of £43.15 if you need care by day or night or at higher rate of £64.50 if you need care by day and night.

# Make an NHS claim. Make sure you claim an NHS contribution towards your nursing home fees.

# If you are on the highest band of NHS contribution, make sure you are not entitled to full NHS funding.

# Check whether you are entitled to council tax exemption. If your property is left empty while you move into care, you should receive full exemption from council tax until it is sold.

# Ensure "12-week property disregard'' is upheld. The local authority must disregard the value of your property for the first 12 weeks of residential care and assist you with your fees if your other capital is below £21,500 in England and Northern Ireland.

# For people paying for care from a joint account, split the account into separate single accounts.

# Guaranteeing payment of care via a care fee or immediate care annuity. This is where a lump sum is paid to an insurance company, which promises to meet certain set payments for the rest of the policyholder's life.

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With the home due to close next month, East Lothian MSP Iain Gray is calling on Health Secretary Nicola Sturgeon to take urgent action in the interest of residents.

Efforts are continuing to find alternative care and accommodation for the home's elderly residents after owner James McDonald announced he would be closing the 70-bed facility on March 31.

The premises are currently running below capacity, with around 40 residents, after the Care Commission imposed a ban on new admission amid concerns about standards of care.

A bid by East Lothian Council to buy the facility at a valuation fixed by the District Valuer was rejected by Mr McDonald, who intends to sell on the open market.

Residents

The council — which has 34 residents placed at Cockenzie House — has since obtained the lease for the vacant Greenfield Park Nursing Home in Musselburgh.

It is already in the process of refurbishing the premises and hopes to begin relocating residents in the next two weeks.

But Mr Gray believes an "eleventh-hour" solution could still be found to allow residents to remain at Cockenzie and secure the jobs of its 85 employees.

He shares the concerns of relatives who fear for the lives of their loved ones if their care is disrupted by moving them to other homes.

Distraught

In a letter to Ms Sturgeon, Mr Gray states: "I do not write to you to apportion blame, and I realise this is not a straightforward story.

"I write because the residents and their care are suffering, their relatives are distraught, the staff are about to lose their jobs, and the community of Cockenzie is about to lose a longstanding local facility.

"Yet everyone involved is adamant that this is not their wish.

"No-one has been able to make the various players involved work together towards a solution which allows care for the residents to continue in Cockenzie, provided by the staff they know."

Mr Gray has also tabled a motion which he hopes will attract cross-party support in the Scottish Parliament.

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OLD people's residential homes in Leeds are in future to be inspected by the people who really matter – older people themselves.

In a pioneering move, pensioners are to be recruited to visit residential care homes and nursing homes throughout Leeds, to carry out an audit of how well people's dignity is promoted and protected by care and nursing staff.

The "dignity watchdogs" will interview residents and staff and make an assessment of how much respect and courtesy those being cared for receive, how their rights as individuals are upheld, how their privacy is protected and how people are able to complain without fear of reprisal.

It is all part of Dignity in Care, a national Government-led campaign to promote high-quality care services.

As part of the campaign, Leeds City Council, Leeds Primary Care Trust and independent care home owners have come together to work with Age Concern Leeds.

Age Concern will recruit, train and support a group of older people to visit care and nursing homes to conduct the dignity checks.

Carol Wardman, chief executive of Age Concern Leeds, welcomed plans being made for the audit.

She said: "We are delighted to be involved in this important project.

"Dignity in the care of older people is at the heart of all that Age Concern does. Respecting dignity, choice and individuality, often in the smallest of ways, can make all the difference to the quality of life of someone in residential care.

"I hope that this project will raise this issue to all those involved in choosing and providing care."

The dignity watchdogs will be trained to observe and record instances in which staff may be, for example, patronising towards residents, using first names without permission or delivering personal care – such as changin
g dressings – in a lounge rather than the privacy of the resident's own room.

The findings from the project will be used to develop better practice and to help plan better services for older people in Leeds.

Coun Peter Harrand, the council's executive member for adult health and social care, said: "Dignity and respect should lie at the heart of all services for older people.

"An audit of this kind has never before been done in care and nursing homes in Leeds and its findings will be carefully analysed so that, where changes in behaviour are needed, we will make them.

"The people who will be carrying out this audit will all be volunteers and who could do this job better than older people themselves?

"They will be making an important contribution to making sure people who are in care in Leeds are valued and treated with all the politeness and good manners they deserve."

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ACTION ON PENSIONERS' BILLS

The temperature plummeted to -9C in Britain over the last few nights - almost as cold as the Chancellor's heart.

While the energy companies - chief among them British Gas - ramp up their profits to obscene levels, old folk have to choose between eating or keeping warm.

Cold kills more than terrorists ever will, but it just doesn't figure in Government calculations.

Before coming to power, Labour promised "dignity in retirement" for pensioners.


Eleven years later, their only way to get warm is to set fire to Alistair Darling's eyebrows.

True, Gordon Brown reduced VAT on fuel and brought in the £200 a year fuel allowance for every pensioner household.

But that flat-rate payment hasn't increased for six years, and it now buys half the gas and electricity it used to.

No other benefit has seen such dramatic devaluation.

And failure to keep up with rising energy costs has devalued the lives of millions of OAPs.

Labour MUST find a way to index-link the fuel allowance to soaring power prices, to avoid this becoming an annual scandal.

Chancellor Darling let almost the entire winter go by without tackling this issue.

In less than three weeks, he presents his first Budget - a prize opportunity to remedy pensioner fuel poverty.

He should take it, because we shall keep his feet in the fire until he does the right thing.

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HAMPSHIRE care bosses are hailing the success of a £60m nursing home scheme but admit it is costing £5.2m more than predicted.

Greater levels of need from clients and changes to care rules have pushed up running costs.

The council has had to hire more staff and buy additional specialist equipment such as aids for moving clients, pressure relieving mattresses and incontinence products.
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It decided five years ago to team up with the NHS to build three new nursing homes and refurbish seven, including those in the New Forest, Eastleigh and Winchester.

However finance chiefs say the running cost of the homes at £47m is still £18m cheaper than the predicted cost of buying an extra 500 beds in the private sector.

The first new beds were opened in 2005 which has reduced waiting times for the transfer of the elderly from hospital.

However staff are still being recruited to open up 46 remaining ENHANCE (Extra Nursing Homes and Nursing Care Extensions) nursing beds.

The council says it is having trouble finding care assistants for Westholme in Winchester and Forest Court in Totton.

Nine out of the ten nursing homes have been given the top rating by the Commission for Social Care Inspection (CSCI).

Construction of the new homes came in on time and within the £60m budget and won project of the year at the Constructing Excellence London and South East Awards.

The county council buys a further 1,300 nursing care beds from the private sector. The council also pays for about 2,200 places for the elderly at residential care homes.

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A daily dose of one’s favourite pop melodies, classical music or jazz can speed recovery from debilitating strokes, according to a study published Wednesday.

When stroke patients in Finland listened to music for a couple of hours each day, verbal memory and attention span improved significantly compared to patients who received no musical stimulation, or who listened only to stories read aloud,the study reported.

Those exposed to music also experienced less depression than the other two control groups.

Three months after a stroke, verbal memory was boosted by 60 percent in music listeners, by 18 percent in audio book listeners, and by 29 percent in non-listeners, the lead author Teppo Sarkamo, a neuroscientist at Helsinki University, told AFP.

The differences held true after six months as well, said the study, published in the Oxford University Press journal Brain.

Sarkamo’s findings bolster a growing body of research pointing to the benefits of music and music therapy for conditions including autism, schizophrenia and dementia.

But this is the first time music alone has been shown to have a positive effect on victims of brain injury such as stroke, he said.

“Everyday music listening during early stroke recovery offers a valuable addition to the patients’ care, especially if other active forms of rehabilitation are not yet feasible,” Sarkamo told AFP.

Sixty victims of left or right hemisphere cerebral artery strokes were randomly divided into the three groups in a single-blind trial between March 2004 and May 2006.

Most of the patients, whose average age was just under 60, had problems with movement, as well as cognitive processes such as memory and focusing their attention.

Every day one group listened to at least two hours of self-selected music, most of it Finnish- or English-language pop. “The idea was to include only music with lyrics the patients could understand,” said Sarkamo.

A second group listened to audio books, and a third to neither.

The 54 patients who completed the study were subjected to a battery of cognitive and psychological tests.

Sarkamo speculates that three mechanisms in the brain account for the startling impact of song and melody.

One is an enhanced arousal of a part of the brain implicated in feelings of pleasure and reward that is stimulated by the release of dopamine, a hormone and neurotransmitter.

Previous research has shown that increased dopamine enhances alertness, speed of information processing, attention, and memory in healthy humans.

Music also directly stimulates the damaged areas of the brain, as well as the more general mechanisms related to “brain plasticity,” the ability of the brain to repair and renew its neural networks after damage.

Sarkamo cautioned that his findings should be replicated by other larger-scale clinical trials before music is systematically integrated into the recovery regimen of stroke patients.

And music listening may not work for all stroke victims, he cautioned.

But if validated, the study points to an easy and cost-effective therapy for recovering stroke patients.

“Stroke patients typically spend about three-quarters of their time each day in non-therapeutic activities, mostly in their rooms, inactive and without interaction,” Sarkamo said.

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A ten unit extra care housing scheme for older people was officially opened on Friday 15th February by Dame Denise Platt, DBE.

Cherry Tree House at Moreton, Wirral has been designed to help older people with dementia to remain independent for as long as possible.

The scheme has been developed to include assistive technology, for example door exit sensors to ensure that residents maintain a high level of independent living.

Dame Denise Platt, who is Chair of the Commission for Social Care Inspection, unveiled a garden bench and was given a tour of the scheme before joining the residents in afternoon tea.

The scheme, which is operated by Rodney Housing with 24 hour care provided by Housing 21, was developed in partnership with Liverpool Housing Trust and Wirral Council.

Key funding for the work was provided by the Housing Corporation.

It brings back into use a derelict building which was vacant for approximately three years.

Cherry Tree House has undergone complete refurbishment with major alterations, including a new build extension to the rear.

The previous use of the block had been 14 units with shared facilities for older people, which is now changed into much better self-contained units with communal facilities.

Housing 21 Chief Executive, Melinda Phillips, said:  “Cherry Tree House gives older people with dementia the opportunity to live independently with the security of round-the-clock on-site care staff.

“We are pleased to have worked in partnership with Liverpool Housing Trust, Rodney Housing Division and Wirral Council on this very important scheme.”

The generous sized apartments are equipped with an en-suite shower room, a fully fitted kitchen and emergency call facility. They are designed to Lifetime Homes Standard and full Wheelchair Standards.

Wirral Council’s Cabinet Member for Adult Social Care and Inclusion, Councillor Moira McLaughlin added: “Cherry Trees was planned and designed with the specific needs of people with dementia in mind.

“This type of service provides a real alternative to residential care, ensuring that people with dementia continue to have choice and control in their lives”

Each resident has an individual care and housing support plan to maximise their skills and level of independence.

An ongoing programme of activities is offered to residents, designed to stimulate and motivate to sustain their learning and social abilities, so they can stay actively engaged in day-to-day living and decision-making.

Tom Harrison, Managing Director, Rodney Housing said: "Cherry Tree represents a successful partnership between a number of organisations who have provided a home which meets the housing and support needs of the ten individuals who are now living at this scheme.

“Rodney Housing is very proud to be a part of the scheme's success.”

The project will be closely evaluated using various techniques to ensure that the scheme improves the quality of life of residents.

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Sufficient provision is an issue that we need to address, says David Manion
WHEN older people need to move from their own homes into a care home, it is important they have the reassurance that the quality of care meets recognised standards and regulations.

Thanks to the creation of the Care Commission in April 2002 and the subsequent creation of the Scottish Social Services Council, many of the staff who are employed in care homes are now registered and regulated.

These two changes alone have driven up the quality of care that older people receive in homes across Scotland.

There have, however, been unwelcome consequences – as demonstrated by recent care home closures such as Cockenzie House.

With the Care Commission seeking improvements to meet national standards, and the owners of care homes not in a position to make those improvements, the result has been a tremendously stressful and worrying time for the staff, residents and their families.

Hopefully, all who are involved with the impending closure and transfer of the residents in this case will work together to minimise the stress they will experience.

Care home closures highlight a potential problem for the future as Scotland's population ages and more homes for older people are needed.

In the Highland Council area there has been extensive debate, including petitions to the Scottish Parliament, about whether the local authority or the private/voluntary sector should provide homes.

This debate resulted in a commitment from the council to build and run five brand new homes to replace older ones that will no longer meet national standards.

That debate regarding care home provision will be one that is soon extended to the rest of Scotland.

There needs to be sufficient provision of quality care homes in communities across Scotland, and the p
lanning for these homes rests primarily with local authorities.

As demand for care home places increases, local councils need to make sure there are enough properties and beds to meet that demand.

For the quality of care homes to continue to rise, the Care Commission must ensure that the standards of care are well regulated. To increase the choice available to older people regarding their care, local authorities must be proactive in ensuring the provision of facilities in their areas meets demand.

It is also incumbent on councils to meet and discuss with care home proprietors their long-term plans and objectives, including what would happen if the Care Commission highlighted a need for improvement. Only then will the problems of care home closures will be minimised and stress to residents reduced.

• David Manion is chief executive of Age Concern

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The NHS has been forced to pay out more than £180 million in compensation to thousands of elderly people who were wrongly charged for care.

About two thirds of the pensioners had to sell the family home to meet costs which should have been paid for by the state. Some have already died.

Mervyn Kohler, the special adviser at Help the Aged, said: "There are still many inconsistencies in practices. There is a total lack of clarity about what the NHS should pay for, and as far as means-testing goes, the benchmark is set terribly low before you are expected to meet all your costs yourself.

"The Government must bring about radical change."

The compensation follows a decision to allow people charged for "continuing care" from 1996-2004 to have their cases reviewed.

While the NHS pays for medical care, it does not pay for personal care such as help with feeding, dressing or washing, which is means-tested.

Many people were wrongly assessed as not having a medical need, which denied them funding that should have been available, and eligibility criteria differed across the country, creating a postcode lottery.

For example, dementia sufferers living in their own homes but requiring three visits a day from a nurse to help them take their medication and get washed were not regarded as having a medical need. Many were then forced to sell their homes to meet care bills.

Five years ago, the health ombudsman Ann Abraham ordered a review in a report, which exposed the care funding scandal.

Applications for compensation had to be submitted to primary care trusts or local strategic health authorities by November for the pay-outs, which could take "distress" into account.

This led to more than 13,000 claims and 2,000 payments, costing £180million. The average pay-out is around £90,000 per person.

The final NHS bill could exceed £200million, because 1,300 cases are still being assessed.

But even where redress is paid, the amounts are not uniformly calculated across the country, creating yet another postcode lottery.

A Department of Health spokesman said: "The NHS has paid restitution to the affected individuals or their families."

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Councils in England are starting to pay by the minute for care that the elderly receive in their own homes.

Critics say it is not the best way to look after the frail and vulnerable, and will deter people from becoming paid carers when recruitment is a big problem and morale is low.

The disclosure, on BBC Radio 4's You and Yours, comes after the Local Government Association warned that council tax bills will rise by four per cent and basic services such as help with washing will be cut.

Harrow Council in north-west London has introduced a pay-per-minute system rather than paying for care in blocks of 10 minutes.

"It's not about cutting the service, it's about commissioning the time required," a spokesman said.

Another 35 councils will bring in electronic monitoring by March.

Dame Denise Platt, head of the Commission for Social Care Inspection, said: "If people receiving care and those giving it are watching the minute hand on their watch, that really is not a good supportive experience."

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Liberal Democrat leader Nick Clegg has outlined a £2bn "care guarantee" plan for the elderly, as part of his proposals to reform the NHS.
    
He said the extra cash should fund a minimum level of care for all who need it, ending the "scandalous injustice" of having to spend life savings.

Mr Clegg said people could also "top up" state contributions themselves.

Labour said the Lib Dems had "cynically ditched" an earlier commitment to free care for the elderly.

'Top up'

Under Mr Clegg's plans, elderly people could decide what type of care their government payments were used for.

They could make private contributions, which would be matched by the state, up to a maximum level.

People on low incomes would have the additional contributions made through the benefits system.

Mr Clegg said: "We are the first party with serious plans to end the punishing poverty which afflicts the many elderly people forced to pay for their personal care entirely out of their own pockets.

"We would introduce a personal care payment based on need, not on your ability to pay. It simply isn't possible to be committed to a free and fair NHS without ending this scandalous injustice."

Mr Clegg said he wanted to introduce directly elected local health boards, aimed at making NHS bosses more accountable.

He proposed giving patients more control over their own care, with the extension of direct payments and individual budgets to help people with chronic, long-term conditions, mental health problems and learning disabilities.

The Lib Dems say cancer patients should be advised by independent advocates on the best health and care options.

Mr Clegg said: "I am calling for a people's health service which puts individuals in the driving seat of their own healthcare.

"Sixty years after it was founded, the NHS is in desperate need of a new direction. The battle for extra investment has largely been won, but the service we are getting is simply not good enough.

"Cancer survival is below the European average and health inequalities have widened under Labour. Many older people are not getting the personal care they so desperately require. We are letting down those most in need.

"The question is not 'how much', but 'how we spend the money' so that everyone gets the healthcare they need."

Private plan

Mr Clegg, who became Lib Dem leader in December, has said NHS patients should have a guarantee of treatment within a specified time.

If that is not met, they should have private treatment, paid for by the NHS, he argues.

Two weeks ago Conservative leader David Cameron said he wanted his party to replace Labour as "the party of the NHS".

He has overturned his party's previous proposals to subside patients to go private and said he would set up an NHS constitution.

Prime Minister Gordon Brown has said he wants a more "personalised" NHS with a bigger focus on prevention. He has also signalled that he will also press ahead with an NHS Constitution.

Health Minister Ivan Lewis said Mr Clegg's care guarantee for the elderly was "not worth the paper it is written on".

He added: "He may be a new leader but he is up to the same old Lib Dem tricks making promises which are uncosted, misleading and will never have to be kept.

"Under the cover of a new policy he has cynically ditched the Lib Dem manifesto commitment to free personal care for all elderly people."

'Attractive'

However, Niall Dickson, chief executive of the King's Fund think tank, said: "We welcome the strong emphasis the Liberal Democrats have today placed on reforming a deeply unpopular system - one that has for so long not only damaged thousands of lives, but also wasted resources by failing to help people live independently without the need for more expensive support."

Paul Cann, of Help the Aged, said: "This Lib Dem policy package on social care is very attractive.

"Care is not cheap - and will become more expensive. Ensuring we have a fair and sustainable funding settlement is crucial to transforming our ailing social care system."

And Age Concern director general Gordon Lishman said: "We support the people-centred vision outlined by the Liberal Democrats today.

"This represents an important contribution to the debate about how to remedy the scandalous failure of the current social care system in England."

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A BBC campaign has highlighted the state of caring in the UK by introducing an online “care calculator”.

Designed in conjunction with Radio 4's You and Yours programme and the London School of Economics, the calculator gives information on social care provision for adults based on average figures for England.

Visitors to the site are led through a series of scenarios and asked what level of care they would expect in each case. When told what the actual situation would be, participants are then asked whether the reality meets their expectations. The results, which are being studied by the Personal Social Services Research Unit at the London School of Economics, will form part of the BBC’s Care in the UK season.

Social care consultant Ray Jones, former director of social services at Wiltshire Council and chair of the British Association of Social Workers, said: “It really does bring home how social care is being squeezed and how disabled and older people are then left stranded. It is shocking.”

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A SIMPLE yellow wrist band is at the forefront of providing the best care available to sufferers of Alzheimer's and dementia.

The James Paget University Hospital, Gorleston, has issued the bands to dementia patients so that nurses can quickly and easily assess their special needs.

The innovative scheme is the brain child of Gordon Steward, of Carlton Colville, who noticed that nurses were sometimes unaware of his wife's Alzheimer's until they read her medical notes.

Mr Steward wrote a letter to the hospital suggesting that patients should don a wrist band to make them instantly recognisable to nurses and doctors.

The hospital was so impressed by the idea that it immediately started to trial the yellow bands for patients in its orthopaedic ward.

Mr Steward, 87 and a member of the Lowestoft and Waveney branch of the Alzheimer's Society, said: “When my wife Joan came into hospital I realised that many nursing staff were unaware of her dementia until they were told or read it in her notes.

“The wards can be so busy that I felt it was important to have something that would help hospital staff to be aware of my wife's illness quickly.

“I am thrilled that letter I sent could have been taken so seriously and it is great that my idea is already helping other patients like my wife.”

At any one time up to 20 patients with dementia a day are treated at the hospital, which now plans to extend the successful band initiative across the whole site in the next few months.

Angela Wilson, practice development nurse said: “The pilot scheme has been a great success because nurses find it so much easier to identify patients quickly and to be more attentive to their needs.

“It has been really exciting to develop an idea from a patient's relative and I hope this will encourage more people to come forward with suggestions that can make a real difference to the hospital.”

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A debate in the House of Commons will today try to persuade the government to save the acclaimed Henderson hospital in Surrey, one of England's handful of "therapeutic communities".

The Henderson treats people diagnosed with personality disorder and residents run the service in partnership with staff.

But referrals to the unit dwindled when commissioning was switched from the NHS nationally to local mental health trusts. In December, the South West London and St George's Mental Health NHS trust said it could no longer afford to keep it open.

Kath Lovell, a former Henderson resident argues the hospital should be saved as it provides a desperately needed personality disorder centre of excellence.

.....

It is with immense sadness that there is a need to write this piece urging the government to consider the future of the Henderson, given that its closure is a very real prospect.

I feel extremely passionate that the Henderson must survive and I urge the government to consider the following points:

Firstly, the issue of financial outcomes. Although the cost of treatment per person seems very high, most people who go onto receive treatment at the Henderson have spent most of their lives in a revolving door pattern, frequently accessing and sometimes draining the resources of ill-equipped services such as A&E, primary and secondary care and acute mental health services. Indeed in the 18 months before I went to the Henderson I spent 11 months in a drug and alcohol programme that showed no efficacy in reducing my personality disorder (PD) symptoms and seven continuous months as an inpatient on an acute psychiatric ward interspersed with various trips to A&E after overdosing.

In the three years since leaving the Henderson I have neither attended A&E nor needed to be admitted to a psychiatric unit and I firmly believe that the cost of my treatment was recouped in the first 12 months since completing my year at the Henderson.

Secondly, there is the question of “worthwhile’ outcomes: How do you measure if a service is worthwhile? Is it all about how much money will be saved? What difference does a service like the Henderson make to people’s lives? In my case I believe the Henderson saved my life as I am sure that without this treatment, I would have continued with the destructive patterns that frequently resulted in serious self harm and suicide attempts. As a result I would likely be either dead or in hospital or prison.

Instead I am preparing to go back into full-time work, looking towards a bright future rather than at a bleak past. Not only was my treatment life saving, it helped me work towards a future, with optimism and a sense of recovery, something I could not have been able to sustain or even conceptualize five years ago. Many of my peers have gone on to educational opportunities, some completing degrees and professional training courses, others going back to work, and many putting something back into the mental health system through service user involvement. The most worthwhile outcomes for the majority of ex-residents include making significant improvements in social functioning, reductions in destructive behaviours and engagement in meaningful activity, these are not easily quantified by cost or financial saving but mean everything and more to those who achieve much after spending most of their lives socially excluded, disempowered, chronically distressed and labeled as ‘untreatable’.

Thirdly, the Henderson is a centre of excellence in terms of its knowledge base around personality disorder. Many of the newer pilot PD services are influenced in part by the Henderson and the model of treatment it delivers or by training and consultation from the outreach team. Many look to the Henderson as a source of inspiration and expertise and the loss of this centre of knowledge developed over the past 60 years could severely affect sustainability of new and existing services and dilute expertise.

I have worked as an expert by experience with the Henderson for the past two years and have been continually amazed by the innovative involvement and empowerment of service users which is unrivalled by any other initiatives I have been involved with on local, regional and national levels.

Why can’t everyone be treated in the community? Why have residential treatments? It is true that some would benefit from treatment offered in the community, but there will always be some whose behaviours and symptoms are so severe that they could not be contained in a community setting. I was deemed too unsafe to live in the community prior to my time at the Henderson, hence my extended period on an acute ward and this scenario was all too familiar with other residents’ histories. I now live independently in my own flat, an inconceivable thought five years ago. My argument is thus: there are pediatric departments in most hospital trusts, but there will always be need for a specialist hospital like Great Ormond Street, I believe the same to be true with Personality Disorder and the Henderson.

I implore for there to be solution that will secure a future for the Henderson that will ostensibly allow more lives to be changed for the better.

* Kath Lovell was a resident in the Henderson Hospital from September 2003 to September 2004. She is now project development manager for the charity, Borderline UK, and is a service user trainer.

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PROPOSALS to close a day care centre for the elderly will be fought to the end by its members and councillors.

Mildmay Day Care Centre, Albert Road, Ilford, runs daily activities for elderly people, but there are plans to close it and turn it into a learning centre.

Ethel Sinkins, who uses the centre regularly, said: "We have got nowhere else to go. They pick us up in the coach and it gives us a new lease of life.

"We hold bazaars and bands come. We look after the garden and recently paid for a new television."

Many of the people who use the centre are unable to walk and use it as a chance to socialise with their friends who they do not get to see very often.

A meeting was held on Saturday between the members of the day care centre and Cllr Filly Maravala who holds his weekly surgeries at Mildmay.

Cllr Maravala said: "There were about 10 people who had come and most of them were very upset. They asked me to draft a petition for them.

"This is their one and only pastime, and they're going to take it away from them."

The 30-signature petition was handed to Redbridge cabinet at a meeting on Monday night, and it is hoped that up to 80 people will sign it by the end of the week.

An 82-year-old user of Mildmay has written a poem about the day care centre, which was attached to the petition. It is printed below.

Cllr John Fairley-Churchill, cabinet member for adult social services, said: "We are considering the change because there is spare capacity in our day centres for older people, while we are in urgent need for a new centre for adults with learning disabilities, who don't have anywhere to go.

"The 69 people who use Mildmay as a day centre will be offered a place in our remaining centres, and the other 19 who use it as a drop-in centre will be offered an assessment to see whether they are eligible to be provided with a place at another centre."

The proposals will go through a five week consultation period for users to express any concerns about the centre's closure.

Cllr Muhammed Javed, who holds surgeries at Mildmay, said: "We should respect their wishes and they have gone through a lot in their lives.

"They have paid for what we have now in our roads and social agriculture, so we should be listening to them."

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THIS winter we'll again have to live with the fact that some of the most vulnerable members of society will have died purely because they did not have adequately-heated homes – and this despite all of the initiatives introduced in recent years to eliminate the scandal of elderly people living in fuel poverty.
The free central heating available for people aged 60 and over has brought relief to many around Scotland, but still thousands live in homes so poorly heated that their lives are at risk.

In 2005, the charity Age Concern estimated that 23 people would die every day from a cold-related illness. Recent figures suggest this situation has hardly improved and, as our elderly population increases, may be getting steadily worse.

Age Concern has also noted that Scotland has one of the highest rates of winter death in Europe. Scots senior citizens are reckoned to be at greater risk of such illnesses as pneumonia than people in colder countries such as Austria or Finland.

This year poses particular worries, meanwhile, because of a looming surge in power bills from major providers, which may see the average family bill rising above £1,000.

A particular criticism levied at power companies is that they have brought in swingeing rises in cost during winter instead of (as previously) the spring.

Age Concern has said many older people who are already cutting back on their heating could be at still greater risk.

Almost 40 per cent of single- pensioner households are said to be living in fuel poverty.

We should be analysing whether the winter-fuel heating allowance is adequate, given that the cost of heating homes that do not have modern heating installed can be particularly high.

There should be an urgent discussion, too, about whether allowances should be structured more effectively to give those at most risk the sort of protection that could save lives. In care homes, which are heated anyway, residents still receive a heating allowance; in households where a senior citizen fends for him or herself the modest dispensation towards winter costs is surely inadequate to make a major difference, and in many cases will be swallowed up by other (also
rising) costs.

For any senior citizen to have to worry about basic warmth is an affront to a civilised society. For the many elderly who do not need to live in care homes, we should take on board the demand for a VAT reduction on home improvements to facilitate proper heating as a matter of urgency – but we also want to take the argument a good deal further than that.

Government schemes to help those on low incomes improve energy efficiency and pay for fuel need to be promoted more vigorously – too often people who could benefit from them aren't aware that they exist.

We should also look at the winter-fuel payments to households with members over 60, which are currently worth £200 or £300 for households with members aged 80 or over. If energy charges rise, then so should the payments – as the social cost of the system at the moment is surely no longer acceptable.

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A BATTLING pensioner's fight to get his dementia-stricken wife back into a South Shields day centre has reached stalemate.
Joe Grant, 79, has been fighting for almost four months to reverse a decision to deny wife Blanche access to Garden Court Day Centre in Whiteleas.

The Alzheimer's Society, which operates the centre on behalf of the council, says the service no longer meets 75-year-old Mrs Grant's needs, because her condition has deteriorated.

And despite a recent case conference with representatives from the council's Adult Services section, a u-turn now appears unlikely.

Mr Grant, from Compton Avenue, South Shields, remains adamant his wife would still benefit from attending the complex a couple of times a week.

But now he has widened the issue to highlight the "deplorable way" elderly people with dementia are treated by society.

He said: "It's not just about
Blanche anymore, it's about all those with dementia. They are the forgotten people. Once you get dementia people just forget about you.

"I have no objection to money being spent on new schools and playgroups for the young, but what about the old people who are locked away and have the key thrown away?

"The same money that is spent on cancer and heart disease should be spent on dementia services."

Mr Grant remains determined to look after his wife at home, saying he would never dream of putting her into residential care.

He already has the support of carers who visit his home each morning and evening.

Now he has agreed to accept a 'sitting service' for his wife.

It means Mr Grant will have some "me time" for a few hours twice a week.

He added: "At first I rejected the offer of the sitting service, then I thought 'what am I doing?' I need all the help I can get."

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A care home worker told a patient he did not care if she died, a tribunal heard.

Frederick Pearson, 39, pushed an elderly man with dementia roughly and was abusive to two other residents at the Claremont Care Home in Ayr during November 2004, it is claimed.

Pearson, of Blackpool, is also accused of leaving drugs unattended where confused residents could find them, the Nursing and Midwifery Council was told.

Counsel for the NMC, David Mortimer, said one elderly dementia patient was suffering from low blood sugar on November 21 and Pearson was trying to give her a sachet of glucose gel.

It is alleged that he swore at her and told her "you just die, I don't care".

Care assistant Mary Brannan told the panel Pearson had been trying to physically force the resident to take the gel.

"She was very confused and disorientated because her blood sugar was so low. I felt very upset," Ms Brannan said.

Another resident, an alert elderly man, used to keep his window open at night which made his room cold.

The panel was told that Pearson said to him: "If you die you will still be fresh in the morning."

Pearson denies roughly handling a resident known as Resident C and speaking inappropriately to three others.

He admitted two further charges of failing to record a tablet of Senecot was missing, and failing to record the administration of a drug.

The hearing continues.

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COUNCIL chiefs have strenuously denied claims that plans to close four care homes in Coventry are a "done-deal."

Relatives of nearly 60 loved ones threatened by the proposed closures believe the decision to move to new facilities in Willenhall, Ernesford Grange and Stoke Heath has already been made, despite council claims of an ongoing consultation process.

The homes facing closure are Jack Ball House, George Rowley House and Eric Williams House - all specialist homes for dementia - and Hawthorne Lodge, a less specialised residential care home.

Anthony Tunnicliff moved his wife Christina, aged 78, to Hawthorne Lodge, two years ago after she suffered a major stroke.

And he believes that Coventry City Council's consultation process is "meaningless".

Mr Tunnicliff, aged 80, of Burnsall Road, in Canley, said: "The consultation meetings have been a laugh. They are virtually telling us what they are going to do.

"I thought this was meant to be a consultation process. It's a foregone conclusion."

However, Mark Godfrey, acting head of adult services at Coventry City Council, insists that no decisions have been made.

He said: "We are in a period of consultation. We held meetings all of last week with individuals and families.

"We want to hear peoples' views and we will be holding further meetings."

But people like Mr Tunnicliff, who visits his wife every day by taxi, have been left full of fear by the plans.

He said: "My wife has been at Hawthorne Lodge for 20 months and it's absolutely wonderful as far as I'm concerned. The staff could not be more helpful.

"She likes me to go everyday and I don't mind doing that. We have been married for 55 years and we have done everything together.


"I hate to think of her having to move to other side of the city. I could not afford the taxi all that way every day. It would be such a wrench."
 
 
      

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Hazel Davis meets the musicians making a difference for dementia patients in care homes


The Active Music, Active Minds project aims to involve care home residents in musical performance. Photograph: Live Music Now

"I remember one lady in Newcastle with severe dementia," recalls Debbie Bennett, "She was in her wheelchair, slumped over with her head on the table. I kneeled down to eye level and started singing the old song Daisy, Daisy. Suddenly, she raised her head and started to sing. It was just incredible."

Bennett is a trained opera singer. She and her colleague, pianist Elizabeth Keetley, have been working with Live Music Now (LMN), the UK's largest charity music outreach organisation, since 2003. They have just embarked on a new scheme to promote the benefits of music to the elderly.

The scheme, Active Music, Active Minds, a three-year project funded by Bank of America, was launched in December with the aim of bringing the benefits of live music to older people, specifically those with dementia. The project also plans to gather vital evidence on the impact of live music on the elderly.

LMN's director, Sarah Derbyshire, says: "You have to remember that this generation is not the TV generation. They had dances and glee clubs and now they're isolated and alone, many of them. This gives them a chance to get involved in a group activity and you'd be surprised at how readily they do it."

Keetley and Bennett – who both studied at Birmingham Conservatoire – are among 330 professional musicians who work freelance for LMN. Derbyshire says: "The musicians we use are usually at the outset of their professional career and they are keen to develop skills with non-traditional audiences. It gives them a wonderful direct feedback that they haven't had before, makes them realise how key their musicianship is after years of honing performance skills, and reminds them of why they wanted to become musicians."

The effects of music on people with dementia are well-documented. Professor Paul Robertson of the world-renowned Medici String Quartet has spent years researching the relationship between music and dementia. He believes that music can unlock memories when recollections appear locked away, temporarily helping to reconnect people suffering from dementia while the music is playing. And in 2006, residential care home provider Barchester Healthcare teamed up with music therapy centre Nordoff-Robbins to provide music therapy across its homes.

Active Music, Active Minds aims to take quality live, interactive music performances to more than 60,000 older people in care homes across the UK. Sessions can last from one to two hours ("depending on how long they keep you talking afterwards", says Derbyshire), and range from slightly more formal operatic recitals to sing-a-longs, music quizzes and percussion workshops.

The project will collect "more than just anecdotal evidence", says Derbyshire. "We want to try and capture data that will show in more quantifiable terms whether live music will contribute to lower dependence on drugs or fewer visits to the doctor, for example."

Feedback will take the form of standard report forms but LMN is involving the care home staff and talking to the service users. Plans are also afoot to expand the scheme to include localised training for care workers in music provision.

Karen Abrahams is care manager at Omega Oak Barn in the North Yorkshire town of Beadlam, where Keetley and Bennett played in December. She says the effects on her residents are astonishing: "It really helps them become focused and much less agitated. It's really amazing to see people who can't remember what happened yesterday remembering the words to songs from their childhood."

Abrahams adds, "I think people don't realise how depressing and isolating being in a care home can be, especially at Christmas. Having someone come in from outside, apart from anything else, can really cheer everyone up." But what's different from the usual "concert in a care home", says Abrahams, is that "the singer doesn't just sing, she gets dressed up for the part and she sings to the residents and holds their hands and actually interacts with them."

Omega Oak Barn's experiences with LMN mean a lot more music is happening. "We now have a lady who volunteers to come and play piano and we all join in, even if we don't know the words. And the more they get used to it, the more response we get," says Abrahams.

There is the danger, of course, that one-off visits such as these will only serve to show care home residents what they are missing out on or disrupt their routine detrimentally. But, as Derbyshire explains, the joy of the scheme is that revisits are obligatory: "If you can make this a regular feature in someone's life the cumulative effects can be overwhelming."

The benefits aren't just restricted to the residents either. Bennett says: "I have sung operas with large companies where I have never seen or heard the audience's reaction. Here, I get to see the impact my performance is having on someone, which sounds very egotistical but it's wonderful as an artist. I feel so privileged to be doing this."

• For more information on Active Music, Active Minds visit www.livemusicnow.org

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Doubts and fears about life in a residential or nursing care home are plentiful and clear: in the ways people talk of "ending up" in a care home or "putting people away", in the guilt that relatives describe when someone moves to a home, in the negative stereotypes portrayed so casually on television programmes, and in the policy directives that focus on the benefits of keeping people out of homes.

At any one time in the UK, around 450,000 older people live in care homes. This means that a large proportion of the population will live and die in homes. Yet, typically, residential homes are thought to be inadequate. So, considering the efforts to support people in their own homes, the development of alternative forms of specialist housing and the fact that so many people say they would not want to move into a home, many people are living and dying in these deeply unpopular places.

The topic of lifestyle in later years has been at the heart of much of my working life. In 1970, I was lecturing and training senior residential staff; since then I have researched, theorised, written, talked and agonised about lifestyles in homes. In a study in 1981, I set out to analyse the processes at work in care homes and the components of a good lifestyle. I argued then that homes could be good places to live, that they were necessary and that "constant denial of the value of their task will lead to a further lowering of the morale of staff". As is still the case today, the poverty of life in care homes was highlighted, but not that faced by many people living in their own homes.

I argued that a negative stereotype of homes contrasted unfairly with a favourable perception of people's own homes. I battled, with others, for residential care to be seen as a positive specialist resource to be used when appropriate. In the 90s, I reflected on the reasons why residential care remained unpopular: part of the answer perhaps being down to territory and ownership - would the perceptions of residents and staff change if people owned or rented their rooms?

Many improvements have taken place in residential care. In the 70s, some heads of homes were still called "master". It was argued that people liked to share bedrooms with strangers; they did not want private rooms. The last of the workhouse buildings with dormitories was closed in Avon in the mid 1980s. There have also been changes in the way care is given. Many of the regimented practices, such as lining up people to have baths, have gone. So why the continued negativity towards care homes?

Contrast society's attitudes to residential homes with those to hospices. The latter are seen as havens, and are highly valued by those who live in them and by their relatives. A statement on one hospice website sets out the way of working: "Rather than being 'in charge', staff and volunteers try to be alongside the person, as a friend for the journey. They aim to help people live life to the full, for whatever time they have left - no matter how long or how short."

Respect and dignity

If you are in the care of a hospice you can expect to be valued and given time, to be accorded respect, privacy and dignity; to be responded to with empathy, especially when in distress; to be listened to and have conversations that are sensitive and honest; to be shown understanding of your individual beliefs, lifestyle and culture. Why do we not feel the same about residential homes?

Care homes confront us with the harsher side of ageing, a side we do not want to see. In homes today, compared with those of the past, residents tend to be far older, less able to do things for themselves and more likely to suffer from dementia. Objectives such as independence and choice that are writ large in policy directives are proper for everybody. But they allow, indeed encourage, a refusal to recognise the reality of the lives of many older people in care homes. Ageing is not always easy: there are those who are weary, sad, depressed, confused, who want to be looked after and do not want to take decisions. The measure of the success of hospices is that they have transformed the experience of disease and dying for so many people. We have to ask whether a similar concern could transform residential homes.

The culture of a care home is the key component of whether a place works well or not. This can be seen as the beliefs and expectations of staff, residents and others, and the way these are translated into daily life. There is no doubt individual homes can (and do) develop life-enhancing cultures. But as long as society, and the government, holds care homes in such low esteem, the task of transforming them into life-enhancing establishments has little chance of success. What can it be like to live and work in places that are so ignored or dismissed?

At the heart of a remodelling of residential care is a revaluing of its task. Inspection, targets, guidance and NVQ training all play a part in improving practice. However, the core of the change will come from society's determination to recognise the value and complexity of the work of care homes. These are the places where some of us will live the last period of our lives, this self-interest as well as proper concern for members of our community means we should find a way to value the task.

A first step is to understand the reasons why homes are used. At conferences focused on later life I have been struck by the numbers of people who choose to recount experiences of relatives enjoying life in a residential home. We need to have a clearer picture of what people like and value in residential homes, and why residential homes may be the best resource for some people.

Via a website (at eskriggeresearch.co.uk/rescare), I want to find out from older people and relatives the positive reasons for living in a home and the strengths of residential care. On the site is a questionnaire and an opportunity for people to write about their experiences of care and housing. The site will feature reports of the feedback.

In pursuing this, I am not denying the fact that in too many care homes life is restrictive and demeaning. I am deliberately avoiding a review of the inadequacies of residential care and am steering away from an audit of quality. My search is to understand the attitudes taken to care homes for older people.

Let us start to think about residential care homes as our places, the homes where we may need and want to live. Might they one day be considered one of the great successes of social care?

· Roger Clough is professor emeritus of social care at Lancaster University and director of Eskrigge Social Research.

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THE transfer of Devon County Council-owned residential care homes for the elderly could take place on May 1 this year.

The transfer of 26 council-owned homes to Shaw Healthcare Group is part of DCC's Adult and Community Services Directorate modernisation scheme.

If formally agreed by the council's executive committee, the move would affect six homes in North Devon: Beech House in South Molton; Oakwell, Bickington; Fair Lea, Northam; Woodland Vale, Torrington; Burrow House, Ilfracombe; and Lydiate lodge, Lynton.

The council's executive committee awarded "preferred supplier status" for older people's residential and domiciliary care services to Shaw Healthcare Group in May 2007. Since then, negotiations have reached an "advanced stage", with current proposals to create a 30-year contract with Shaw.

A report to the Health and Adult Services Overview and Scrutiny Committee by David Johnstone, director of Adult and Community Services, said the main issues are likely to be agreed in principle to enable a transfer after May 1.

"The next steps will be a visit by Shaw to each of the homes to meet the managers, staff, residents, families and local people," said the report.

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A HOSPITAL ward has marked its first anniversary with a birthday cake and candles.

Staff at Elmwood ward at Parklands Hospital, Basingstoke - which provides care to older people with mental health problems - also celebrated their achievements over the last year.

The first year has seen a number of changes at the ward, geared towards improving the acute and continuing care for patients with Alzheimer's disease and other dementia.

Improvements have included more communication with service users and carers, developing therapeutic mealtime arrangements and introducing a multi-sensory area.

Other initiatives have helped brighten the ward environment and brought staff and service users together at social events.

Elmwood is also sharing good examples of care with other similar wards across the country, thanks to its involvement with the national Dementia Care Collaborative, a scheme that allows new ideas and good practice to be shared across dementia care services.
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Shelly Mason, the ward's modern matron, said: "Staff on the ward have created a very positive culture of caring.

"Their achievements are remarkable considering the short time that we have been running this service."

The service is run by Hampshire Partnership NHS Trust, which provides mental health and learning disability services across the county.

11:39am Wednesday 9th January 2008

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The Alzheimer's Society is planning to adopt an electronic tagging system to keep track of dementia sufferers, according to a report by The Press Association.

The tagging is done through satellite tracking technology and resembles the system used for tracing offenders. However, tracking of the patients will be done only with their consent and the plan is open for debate.

Tracking devices use global positioning system (GPS) to locate the wearer. A similar system that enables parents to keep track of their children's movements is increasing in popularity in the UK.

Alzheimer's Society hopes that the tagging plan will help relatives keep track of patients, enabling them to wander more freely. According to the society, dementia sufferers often have a strong urge to walk and this can result in them getting lost.

The plan, put forth by science minister Malcolm Wicks in April 2007, initially received a mixed response. Mr Wicks argued that people suffering from dementia and Alzheimer's needed more freedom to live their lives and mix with other people. A balance should be struck between giving the sufferers freedom to walk and keeping track of them, he said.

Neil Hunt, CEO, Alzheimer's Society, said the technology could offer benefits to people with dementia and their carers. "There is a careful balance to strike between empowering people and restricting their movement and this technology can certainly never be used as an alternative for high-quality dementia care," he said.

About 700,000 people in the UK are estimated to be suffering from dementia. A majority of them have Alzheimer's disease. Experts say that the figure might rise to more than one million in 20 years and to 1.7 million by 2050.

Last year, Torbay Care Trust, Devon and Cornwall Police, Torbay Council and the Alzheimer's Society jointly launched the Safely Home scheme in Devon to trace elderly people with dementia when they get lost. They are given a bracelet that contains a unique ID code and telephone number linked to a 24-hour support service.

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Charity calls on government to adopt radical new framework to meet ‘care funding gap’

Informal and private care is plugging a funding gap of £25k for every disabled person over the age of 65 in Britain today says a new report from national charity, Counsel and Care.  Millions of people are relying on loved ones or their life-savings, simply to make up the £66.4 billion shortfall.  

Drawing on new survey evidence from Counsel and Care’s Advice Service, the report also points to “widespread confusion” about the care system caused by the lack of funding, an information gap and a strong perception of unfairness. 

Coming ahead of a Green Paper on Social Care, Counsel and Care is calling for 2008 to be ‘the year of the care debate’.  In a unique framework for care and support published today – A Charter for Change – the charity states that:

• 1.9 million disabled people over the age of 65 receive no state-funded care and rely on informal care, a figure set to grow to 2.6 million by 2022
•  the combined value of informal unpaid and privately funded care for over 65s has escalated to £66.4 billion every year.  Most people are reliant on friends and family to make up the shortfall
• 3 in 4 local authorities only provide care to those whose needs are “critical” or “substantial”
• the cost of social care is expected to rise from the 2002 level of £10.1 billion to £24.0 billion by 2026 in response to our ageing population.

 

Counsel and Care is urging the Government to adopt its radical new framework for the future of social care. Only then, it says, can services effectively meet the needs of older people and their carers and help close the widening care gap. The Charter says that services must:

• be person-centred, showing dignity and respect for older people
• support the choices and needs of older people, their families and carers
• deliver independent living and active citizenship for older people
• set out clearly what the state will provide for individuals
• be sustainable in the longer-term
• provide value for money – to whoever is paying
• provide good quality, flexible care
• improve the skills and pay of the care workforce
• bring health and social care services together
• be inclusive and progressive.

 

Stephen Burke, Chief Executive of Counsel and Care said:

“On current rates of population growth alone, the costs of social care will double in twenty years. But this is not just a crisis of funding. It’s a crisis of fairness and a crisis of confidence.

“We know from our Advice Service that there is a real frustration amongst older people and their carers with the lack of fairness and lack of clarity over who is actually eligible for care. Widespread confusion is also rife on issues like self-funding and there is a huge gap in information about local services, particularly from local authorities.

“The Government has promised a radical rethink of the care system and said they want a world class service.  That’s an ambitious aim.  As a minimum the care system has to be simpler, fairer, transparent, consistent and flexible.”

New evidence from Counsel and Care’s Advice Service shows:

 

·        Older people and their carers are left baffled by the care system with 6 out of 10 (61.22%) people complaining about a lack of information - particularly in relation to council care services

 

·        Confusion about funding is widespread. Those with modest savings feel penalised by a system that expects them to self-fund their care

 

·        The way care eligibility criteria are applied is unclear and perceived as unfair.  4 out of 10 (43%) of those contacting the Advice Service about assessment raise concerns about eligibility

 

·        More than 6 out of 10 (62%) formal complaints are about local authorities

 

·        More than half of the calls (55%) about carers highlight conflicts of interest where the needs of the older person are being balanced against the needs of the carer. 1 in 4 carer enquiries (25%) are regarding a lack of access to local services

 

·        3 out of 10 mental health enquiries relate to dementia

 

·        Help with essential housing repairs is the single biggest charitable request for home owners living on a low income with limited savings.

The report draws on new evidence provided by Counsel and Care’s Advice Service (testimony provided by older people, their families and their carers) and current research from organisations including the Kings Fund Wanless Social Care Review, Carers UK, the Joseph Rowntree Foundation and government reports.  

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The government has opened up a huge and impassioned debate after it proposed a system of electronic tagging for dementia patients, but the Alzheimer's Society is backing the plans.

Science minister Malcolm Wicks told the BBC that fitting elderly people suffering dementia with Global Positioning System (GPS) devices would mean patients would be free to "roam around their communities" while their families had peace of mind.Some 60 per cent dementia patients have a tendency to go wandering and 40 per cent have got lost at some point.

Now the chief executive of the Alzheimer's Society, Neil Hunt, has spoken out in favour of the plans, as long as they are implemented with the consent of the patient and do not undermine the dignity of patients.Mr Hunt added: "There is a careful balance to strike between empowering people and restricting their movement and this technology can certainly never be used as an alternative for high quality dementia care." "This is about dignity and independence in old age," Mr Wicks reassured, confirming that the patient's family at least would have to agree to it. "By knowing where they are they could have the safety and security that they would wish for themselves and certainly their families would feel more reassured," he said. Currently 700,000 people living in the UK have some form of dementia, a number expected to rise to 1.7 million by 2051.

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Alzheimer's Society comment on Rights, risks and restraints, a study investigating restraint in the care of older people, published today by the Commission for Social Care Inspection (CSCI).

'Anyone reading this report will draw a sharp intake of breath at some of the appalling examples of restraint, in many cases involving people with dementia.

It is devastating to hear of vulnerable people not being treated with the dignity and respect they deserve.

'CSCI's report is right to acknowledge that often there isn't simply one place to lay blame for this abuse, as it is partly a result of an overstretched and under resourced system.

'It's all too easy to think that restraint is about belts and shackles. In fact restraint goes far wider: from the thousands of people with dementia being sedated by the inappropriate use of anti psychotic drugs to people being denied access to outdoor space because of a lack of staff in care homes.

'Many of the horrendous stories of abuse in the report occurred because of care staff's lack of understanding and training in dementia care.

Alzheimer's Society's recent Home from Home report echoed these experiences and we believe mandatory dementia training for staff in all care settings would begin to tackle the huge variation in dementia care.

'This report makes tough reading for any involved in or using older people's care services. It should provide a wake up call that we can no longer leave people in the front line of care to cope alone without adequate resources; proper inspection and regulation; and specialist dementia training.'


Nursing homes decry 'yet another unjustified character assassination' by the regulator

Britain's nursing home leaders have reacted with disappointment and frustration at what they call ‘yet another unjustified character assassination of the care home sector' by the national regulator, the Commission for Social Care Inspection (CSCI).

Responding to publication of CSCI's Rights, Risks and Restraints report, which reviews the use of restraint in care homes, the Registered Nursing Home Association (RNHA) claims that once again CSCI has ended up creating a negative impression and raising exaggerated concerns.

Said RNHA chief executive officer Frank Ursell:

"CSCI has failed to grasp this opportunity to work with the long-term care sector in finding practical answers to the extremely complex factors involved in looking after individuals who have multiple problems and who, in some instances, display erratic and challenging behaviour.

"On the one hand the regulator says that care home residents must be allowed to take risks. On the other hand, when risks are taken and something goes wrong, such as a very frail older person falling over and breaking a hip, or someone becoming very aggressive and assaulting other residents, the poor care home workers get the blame."

He added:  "Those on the front line of services, as opposed to the CSCI regulators in their London offices, sometimes feel that they're expected to possess the wisdom of Solomon, the patience of a saint, the eyes of an eagle and the speed of a formula one racing champion – and all for a wage around or just above the national minimum.

"As CSCI themselves admit, the issues around the use of restraint are very complex indeed.  Those of us who work in the sector were therefore somewhat disappointed to be invited by CSCI to a meeting where the document was presented to us as a fait accompli just a few days before its publication.

We had hoped to be able to comment on it and share our views.  That's not a productive way in which to work with outside organisations."

Stressing that the report was sending out very confused messages, Mr Ursell said: "On the one hand, the report claims that it is not providing any statistics about the use of restraint in care homes.

On the other, it quotes figures for the United States and Australia, which may have little or no bearing on what is happening here in the United Kingdom.

"Such contradictions permeate many of the report's pages.  I suspect that most nursing home managers and care workers who read it will find themselves even more perplexed as to what CSCI expects them to do."

Mr Ursell also queried CSCI's commitment to ensuring greater resources for the care of older people.  He said: "Whilst CSCI appear grudgingly to acknowledge the link between quality of care and the money available to pay for it, they don't suggest how many more staff are needed in care homes and how much more that would cost."

Speaking on the general issue of restraint, Mr Ursell said no one would disagree with the principle that it should be used only when absolutely necessary.

But in day to day practice, nurses and care assistants had to deal with hundreds of situations that crop up unexpectedly.

"They have to use their professionalism and common sense to decide what is best for the individual concerned and the other patients around them," he said.

"There is often no time to make detailed risk assessments or to consider a dozen or more different options."

Mr Ursell also challenged CSCI's view that a care home having a locked front door, possibly controlled with a keypad, constituted unreasonable restraint.

"Don't most people in their own homes lock their front door all or nearly all of the time?", he asked.

"And didn't CSCI themselves find care home residents who preferred the security of knowing that the front door was locked and that strangers couldn't just walk in?   CSCI's approach is a further example of mixed messages and mixed up thinking."

The RNHA said it would be consulting its own members about the CSCI report with a view to developing further, practical guidance and training for nursing home staff.

Concluded Mr Ursell: "Whilst the vast majority of nursing homes are already perfectly capable of drawing a sensible line between reasonable, justified restraint and unreasonable, unjustified restraint, we are always willing to look afresh at our policies and procedures to see what improvements and adjustments are needed.

Unlike CSCI, however, we will come at this from a practical perspective rooted in experience and common sense."


Tied up, strapped to chairs, drugged, and locked up.

The Commission for Social Care Inspection (CSCI) have today published a report (Rights, Risks and restraints'), stating that 'evidence from inspectors' reports reveal that levels of restraint are much higher than those recorded by staff in care homes.  

Inspection reports identified a tacit reluctance to acknowledge that restraint occurs'.  The report describes older people being held in bed; strapped into wheelchairs; blocked by chairs, tables or stools; dragged by their hair and tied into chairs; left in soiled pads for up to three hours; sedated; locked into rooms; and threatened or intimidated.

Gary FitzGerald, Chief Executive of Action on Elder Abuse (AEA), stated, ‘This is an appalling situation that warrants immediate and urgent action and collaboration between regulators and care providers to stamp out such behaviour.

These abuses are intolerable and go way beyond debates about lack of dignity.  Restraint turns care into imprisonment and we should not accept it.'

Noting that it is three years since the Health Select Committee recommended the production of this report, FitzGerald continued,

‘It is difficult to quantify how many older people have been restrained in that period of time, but it is more difficult to understand why the report does not recommend more immediate and concrete action to prevent further such abuse.

While we applaud CSCI in updating their guidance for inspectors on restraint, we feel that this matter requires a far more robust approach.

Last year CSCI produced a similar report on medication abuse, but there is no evidence that it resulted in a reduction in such abuse within the care home sector.  This is just not acceptable'.

Expressing concern that elder abuse is becoming an accepted fact, but not receiving the level of urgency that it merits, FitzGerald concluded.

‘If we were talking about the doping of children we would demand immediate action.  If we were talking about tying up children, or forcing them to stay for hours in soiled nappies, we would demand immediate action.

So why is it unacceptable for a 7 year old, but acceptable for a 70 year old?  This is not an academic debate.  It is about pain and humiliation and suffering, and we need it recognised as such.

Discussion documents are of course useful contributions to a greater understanding of the issue, but abuse demands immediate action and that appears missing.'   

AEA have consequently written to CSCI on this matter.

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CONTROVERSIAL proposals to make more of Suffolk's elderly and vulnerable people pay for care have been pushed through despite a last-ditch attempt to halt the idea, it was revealed today.

Currently, up to 90per cent of people in the county requiring care at home get it for free - but bosses at Suffolk County Council estimate more charging for services could generate upwards of £1.5million a year for council coffers.

They claim it is vital to trim the cost of the service because of budget pressures.

Under the council's home care programme, people deemed suitable are given help with things like getting up and dressed, getting washed, eating and taking medication.

Opponents argue council funds have just been boosted by a government grant that was £7m more than expected, rendering the changes no longer a necessity.

The shake-up, coming in from April next year, will mean only around 45pc of the current 4,000 people requiring care at home will continue getting it for free.

Labour councillors at Suffolk County Council attempted to get the new policy reviewed but the Tory administration was able to push the changes through following a vote.

Graham Newman, Suffolk County councillor responsible for adult and community services said: "It is very frustrating that the Labour group is playing politics once again with this issue.

"The simple fact is that virtually every council in the country operates a charging scheme similar to the one we are proposing, including all others in the east of England.

“Not only this, the government openly expects us to charge for these services and has moderated our funding accordingly.”

Cllr Kevan Lim, deputy leader of the Labour group, said: “This policy will take a slice from the incomes of thousands of Suffolk's most old and vulnerable, including those on income support and disability allowance, and force over 2,500 people to pay charges for the first time.

“The Labour group would use some of Suffolk's higher than expected government grant to avoid this unnecessary and unfair policy."

Cllr Kathy Pollard Lib Dem group leader said: “Even if this extra money isn't enough to do everything they would like to, it must surely make them question a policy as controversial and targeted at the vulnerable as this?”

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Proposals to make it easier for Britons to choose to have medical treatment abroad, paid for by the NHS, are due to be discussed by the European Commission.

Health Commissioner Markos Kyprianou will present the proposals to help European citizens choose where they are treated to the Public Health Committee of the European Parliament.

Labour MEP Linda McAvan, who is a member of the Public Health Committee, said: "For many years, individual people have been going to the European Court of Justice to establish their rights to treatment in another country."

"Legislation in this area will be helpful if it provides clarity to the public about the rules which apply when seeking treatment abroad and if it helps health systems to manage requests for treatment in other EU countries."

Mrs McAvan, who is MEP for Yorkshire and the Humber, added: "While cross border healthcare might be useful, it is the NHS that must decide what treatment it pays for if UK patients choose to travel abroad for care."

"Case law already exists from the European Court of Justice which allows patients who wish to receive care abroad to do so, and this has not resulted in a large number of people wanting to go abroad for treatment or a large number of other EU nationals seeking treatment in the UK."

"The priority for the vast majority of NHS patients is high quality healthcare received close to their homes."

Arlene McCarthy MEP, Labour's chairman of the Internal Market and Consumer Protection Committee which this year produced a report on health services in the EU, warned the European Commission not to raise false expectations that patients can access healthcare in Europe "anywhere at any cost".

"The right to access healthcare in other EU countries must not undermine the integrity and financing of the NHS and it mustn't disadvantage those who don't have the cash to pay up front for treatment," she said.

The draft proposals will be subject to amendments and change by MEPs and ministers from member states, and may take several years to become law in Britain.

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Terry Pratchett's announcement that he has early onset Alzheimers could be the start of a brave new world

"I am not dead yet," says best-selling author Terry Pratchett, in a statement of great style, five words managing to say so much more than one plain fact. He was revealing that he has a rare form of early onset Alzheimer's disease (AD), following a stroke two or three years ago . An "embuggerance", he calls it.

Sadly, however, death is not the most savage of the many cruelties that AD imposes. Before that, you lose yourself without even remembering how or when it happened as each receding tide takes a fraction more of what makes up your personality, history, behaviour, humour.

It's a process I've now watched take place in my father and my aunt - a process surreal enough at times to make a strand in one of Pratchett's marvellous plots. My dad, 86 on Saturday, has shed several skins of his identity but his passion for a joke refuses to disintegrate. Once able to speak several languages, he is reduced to gibberish, semaphoring his frustration with his eyebrows and hands.

He still knows he loves us, but why he does became a mystery many months ago.

My aunt, 92, has reached the terrible stage that makes euthanasia appear the most humane, dignified and caring act that her family could possibly perform. Ill with AD for eight years, she is a woman returned to babyhood. She has forgotten how to swallow. She has morphine patches because she appears to be in acute pain. She lies in a foetal position, not seeing, not hearing. She reached what has to be one of the loneliest places of all several years ago: a place where you have forgotten whom you love.

One or other of her three daughters, spends hours with her every day, in vigil for what has long since gone.

Some bloggers appear to loath two words in particular in the Cif lexicon, namely "baby boomers", but here goes. Pratchett, aged 59, was born in 1948. His generation is the one that is supposed to change the face of growing older. His diagnosis - unlike say cancer that has no age limits - is more usually the diagnosis of the elderly. For his group in society, it may act like the starter's gun, a reminder that they are now on a stroll (or a rapid and erratic bolt) to the end - and perhaps this is the time to begin to sort out a better kind of exit.

Assisted death in the UK has yet to get onto the statute books. According to the charity Dignity in Dying, 57% want to die at home but only 20% do so. One in two of all complaints about the NHS are about end of life care. This week, the Royal College of Physicians, published a report that said palliative care is "poor". And then there are the care homes.

Some are superb; the tiny minority. Too many are shameful. Even some of those given reasonable reports by the monitoring body, the Commission for Social Care Inspection, in years to come will be regarded as equivalent to the 19th century workhouse. Fortunately - and luck does seem to play a large part - my aunt is in an outstanding home in North Wales. My dad is in a psychiatric hospital with committed (if poorly) paid nurses and helpers.

Pratchett is also an atheist and a supporter of the British Humanist Association. It seems crass, in the immediate aftermath of diagnosis, to expect him to lead the campaign for legislation that allows us, if we so choose, to order up the end, at a time that suits. But he seems perfectly cast for the role.

Pratchett, of course, has the wealth to pay for the very best of care but when the time comes that will be more of a comfort to his family than to him. He is the second most read author in the UK, the seventh most read in the USA; he has sold more than 55m books world-wide; he has an OBE and, according to interviews, he seems a really nice bloke.

"I would prefer it if people kept things cheerful, because there's time for at least a few more books yet," he writes. Life may be even more surprising. In 1995, Christine Boden, then 46, was also diagnosed with early onset AD. She was divorced, the mother of three daughters, the youngest only nine. A biochemist, she was one of Australia's leading civil servants. In the years that followed, life became a series of post-it notes to remind her what objects were; how to reach the shops; not to repeat herself endlessly. Not to mind when people laughed at descriptions such as "a jug thing that pours" (a kettle).

Helped by her Christian faith, she had to give up her career but retrained as a counsellor; she forged better relationships with her daughters and she wrote one of the few books describing dementia from the inside out called, "Who will I be when I die?" She was diagnosed afresh with a different form of dementia. She married and for years has travelled the world, with help, to try and improve understanding, support and early diagnosis. I don't know if she's still alive - perhaps someone else knows? - but she lived a life as full, if not fuller after diagnosis.

In the front of her book she published verses by an unknown author that include the lines:

I asked for help that I may do greater things
I was given infirmity that I might do better things
I asked for all things that I might enjoy life
I was given life that I might enjoy things

Boden has God on her side and many of us, like Pratchett, don't - but for a man who lists one of his recreations as "life'"- it's not over until the fat lady finally forgets how to sing.

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Coroner voices concern about staff and politician calls for unannounced spot checks

WHEN John Jackson collapsed in his bed at Cheverton Lodge care home, there was, in the words of one of the nurses on duty, “panic” over how best to help him.
No mouth-to-mouth resuscitation was given and there was a delay in phoning for an ambulance. By the time paramedics arrived 30 minutes later, all they could do was pronounce the pensioner dead.
This chaotic account of Mr Jackson’s desperate fight for life – given in evidence to a coroner’s inquest last week – hardly fits the chi-chi care home brand marketed by owners Barchester Healthcare, one of the industry’s most successful operators in recent years.
It certainly concerned St Pancras coroner Dr Andrew Reid enough for him to warn at the end of the inquest: “This case raises concerns about the skills of staff nursing patients at Cheverton Lodge.”
Barchester last night (Thursday) said it had conducted its own internal investigation. A spokeswoman said: “Cheverton Lodge Care Home has conducted an internal inquiry based on CSCI [the regulator] standards and has found that practice in the home is of an excellent standard.
“Our residents’ health and wellbeing are always our utmost priority and we work closely with our regulators and the authorities to ensure the best standards of care.”
Islington’s social services, which placed Mr Jackson at the home in Upper Holloway, have rejected demands for a full-scale investigation into the death, despite growing pressure from opposition councillors.
Liberal Democrat department chief Councillor John Gilbert said: “We are very concerned about this incident and have been in touch with them [Cheverton Lodge], and with the local primary care trust and London Ambulance Service.”
Cllr Gilbert is bound to face further demands from Labour group leader Councillor Cath­erine West, who pressed this week for wider inspections of care homes, especially the ones the council has contracts with.
She said: “I believe that councillors ought to be carrying out unannounced spot checks on care homes to see for themselves the conditions for older people and people with disabilities living in care homes.”
Cllr West’s campaign has turned into something of a personal crusade on behalf of 71-year-old Mr Jackson, whose inquest was attended only by a niece.
The councillor’s unanswered questions centre on the nurses’ level of expertise in recovery techniques for use in emergencies and on whether care homes have enough staff.
On the grounds of “commercial sensitivity”, the Town Hall would not say how much money Islington hands over to Barchester each month, leading to speculation that the sum is likely to run into thousands of pounds. Cllr Gilbert would only add that an arrangement with the company expires in April.
Private clients spend from £900 a week on accommodation and care at Cheverton Lodge. The waiting list for places is over a year long.
It is clear that care homes have proved a lucrative operation for Barchester, whose investors include the billionaire Irish horse racing magnates John Magnier, JP McManus and Dermot Desmond, shrewd businessmen who rarely back a loser.
They first invested in 1994 and profits have increased nearly every year. Last summer, a refinancing deal saw the three investors collect a £125 million dividend while turnover for the year is estimated to be more than £350 million.
The company has built an enviable reputation for surpassing its industry rivals by offering fine touches to its care homes, taking care of appearance and focusing on cleanliness to the extent that one reviewer for a national newspaper said that Cheverton Lodge resembled an upmarket hotel.
No expense is spared, TV gardener Charlie Dimmock has promoted landscaping work at some of Barchester’s homes, while TV chef Paul Rankin was brought in to inspire chefs when planning menus.
Mike Parsons, Barchester’s managing director, has said in the past he got involved after seeing the poor state of care homes elsewhere in the country.
Cheverton Lodge had a glowing inspection report from the Commission for Social Care Inspection earlier this year. One recent visitor said: “If you step into the foyer there is no obvious sign it is a nursing home. It could be an airport hotel from the outside. Inside, it is a bit like Jeremy Bentham’s fam­ous panopticon prison, with the nurses having views of the corridors on each floor.
“There is a hair salon where patients are pampered and coq au vin is on the menu.”
Mr Jackson’s friends and his niece, Christine Goodwin, are less impressed. Ms Goodwin took the opportunity to grill Cheverton Lodge’s staff at the inquest.
Her uncle was not there long enough to enjoy the home’s celebrated facilities but those who know Cheverton Lodge are surprised that criticism has been levelled at a place considered a market leader.
Mr Jackson died in August, only a week after being admitted following treatment for kidney disease. His discharge from hospital had been described as “poorly planned” by his GP.
Ms Goodwin was in court as the inquest heard how he suddenly collapsed, taking staff by surprise.
Dr Reid, who has outlined his concerns in a letter to Islington’s primary care trust, said: “The issue of training and education should be reconsidered for all the nursing homes in the jurisdiction.”
Mr Jackson’s friend and neighbour, Linda Ralph, said on Monday: “He was a lovely bloke. A true London gent. I was so shocked when I found out. It won’t be the same without him. My husband and him were as thick as thieves. He always gave me a wave from his window.
“To think people go to a nursing home to get looked after and then this happens. It is an absolute tragedy.”
Cllr Gilbert said: “Islington Council has a contract for 20 beds and 10 intermediate care beds, for patients who are referred by social services.
“Individuals have a choice over which care home they choose.
“The primary care trust is responsible for procedures surrounding resuscitation in nursing homes, and we’ll be working closely with them. The amount of funding the care home receives from the council is commercially sensitive information. However, we can confirm that the contract expires in 2008. Care homes are inspected by the Commission for Social Care Inspection.”
A Barchester spokeswoman said: “Staff at Cheverton Lodge care about each and every one of the residents they look after.
“They were saddened by the loss of Mr Jackson and extend their condolences to his family.
“Following the coroner’s inquest, which found that Mr Jackson died of natural causes, Cheverton Lodge has taken on board the recommendation to update their PCT training on CPR [cardiopulmonary resuscitation].
“This had already been planned for January as part of ongoing training. Cheverton Lodge res­pects the privacy of its residents and staff in all matters and is therefore unable to give any further comment.”

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A charity that supports thousands of elderly people across the country announced today it has acquired four care homes and a sheltered housing scheme in north London.

MHA, which comprises the Methodist Homes charity and a housing association, has secured a tender to provide specialist care to 150 residents in Brent and Harrow.

The homes and sheltered housing scheme were run by Wembley-based Willow Housing and Care until they were taken over by MHA.

MHA's group director Jane Barker said: "We are delighted to have been chosen by Willow to operate their care homes and housing.

"MHA has experience of acquiring and managing services for smaller charities and housing associations who may find the legislation and responsibilities of running care homes challenging.

"We are committed to continuing to provide the highest standards of services to residents."

Established 65 years ago, MHA now provides services and care to more than 12,500 elderly people across the UK.

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A war veteran died after being treated "like a parcel" by nursing home staff, a coroner has said.

Charles Hounslow, a former RAF pilot, was left to die in agony after carers failed to notice that he had a broken hip for two days.

Veronica Hamilton-Deeley, the Brighton coroner, used his inquest to demand better care for the elderly

She summed up Mr Hounslow's treatment at Miles Court Nursing Home in Brighton, East Sussex, as "lamentable" and said she feared thousands of pensioners nationwide were suffering the same fate.

Mr Hounslow, 85, had suffered from vascular dementia since 2005 and needed round-the-clock care. He was admitted to Miles Court on April 7 and died on May 16.

Mrs Hamilton-Deeley said he "was treated like a parcel in the last few weeks of his life with insufficient emphasis placed on his wellbeing and care".

"There was a catalogue of incidents leading up to Mr Hounslow's death, all of which are examples of gross mismanagement at this nursing home," she said.

"I can only hope that Mr Hounslow was so withdrawn in his last few days at the home that he was not aware of the appalling care he was receiving."

She recorded a narrative verdict, saying: "Mr Hounslow died in hospital from pneumonia after fracturing his hip, in circumstances where the fracture remained undiagnosed for at least 37 hours by nursing home staff and his resulting pain and discomfort were allowed to continue unrelieved."

She said it was not legally possible to bring a verdict of neglect because his injury was not directly linked to his death, but added: "This is no way means his care at that home was anything more than utterly lamentable."

Other residents were removed from Miles Court for their own safety last month after a damning inspection by social services. Joginder Vig, the owner, did not comment.

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    * Concern over 'failing standards'

VICTORIA Hospital has come under fire for the conditions allegedly endured by elderly patients receiving treatment in its wards.
A Press reader, who did not want to be named, has accused the Kirkcaldy hospital of failing to maintain hygiene standards.

He also branded some nursing staff 'uncaring and inconsiderate', after his elderly mother caught the superbug Clostridium Difficile (C. diff) while being treated for a broken shoulder last October.

He was compelled to get in touch after reading last week about pensioner Katy Walkup (86), who died almost two weeks ago after contracting the infection at Victoria Hospital.

Her death was the latest in a number of cases of C. diff in Fife to be brought to the Press's attention in recent weeks.

"The story about Katy Walkup is a very sad tale but is becoming familiar in our hospitals," he said. "After
falling and breaking her shoulder my mother also caught the C. diff bug in hospital and was put into ward six of Victoria Hospital in October 2006.

"She was shocked at the treatment she received and has vowed she will die before entering another hospital ward.

"Most of the nurses in these wards do a wonderful job but there is a very small element that should not be in nursing as they are totally uncaring and inconsiderate."

The reader said elderly patients suffering from severe diarrhoea - a symptom of C. diff - were kept waiting for up to half an hour by nursing staff when they needed to use the toilet, causing embarrassing accidents.

"Like Katy's son, John, I found the smell of urine and excrement overpowering," he added.

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WREXHAM Council is planning to improve mental health care services for the elderly.

Councillors were asked to support a proposed new model for the service which includes the introduction of six full time primary mental health care workers.

Services in Wrexham are currently overstretched and cannot meet increased demand without development.

A report presented to the social affairs health and housing committee said the lack of support for primary health care in relation to older people's mental health was the strongest theme from a stakeholder event held this year.

It said: "It is proposed that six posts are developed for primary mental health care workers, who will support the delivery of mental health care by working with GPs across Wrexham.

"Each worker will
cover a maximum of five surgeries allowing sufficient time for a weekly clinic and other liaison work within the surgery."

Other services will be changed and developed and new services would be introduced as part of the model.

Improvements in older people's mental health services is said to contribute to the council's corporate priority "number of older people receiving support and range of services".

A home treatment team also forms part of the plans to provide crisis response, rehabilitation and re-enablement services. The team will also facilitate earlier discharge from the acute trust services by liaising with psychiatric wards.

It is also proposed that the three community mental health teams for older people across the North East Wales Trust (NEWT) area be restructured as two teams.

This, the report said, is so that Wrexham has a dedicated CMHT team for older people.

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The government is being urged to learn one of the key lessons to have emerged from last week's BBC Panorama programme on the treatment of dementia patients – that the right kind of care requires higher levels of staffing, more training and, inevitably, costs more money to provide than is generally available now.

Commenting on the content of the programme, which explored problems attributed to the inappropriate use of anti-psychotic drugs, Registered Nursing Home Association (RNHA) chief executive officer Frank Ursell said: "The message that the experts on Panorama were telling us – a lesson apparently confirmed by the case study featured on the programme – is that high quality care costs money."

He added: "To ensure that all their needs are met, dementia patients require a higher staffing ratio than is normally found in care homes.  Consequently, the government and local authorities should be ready to provide the requisite level of funding that will support the necessary staffing levels.

"As health ministers are currently urging everyone to treat older people with dignity and respect, they should be the first to set an example by putting their money where their mouths are.  You cannot preach the gospel of high standards if you don't provide the resources to enable those standards to be reached by care providers."

Reflecting on the Panorama experts' warnings about the lack of clinical benefits from anti-psychotic drugs used to treat dementia, Mr Ursell said this underlined the importance of careful, multi-disciplinary assessments of individuals' needs and the need to adopt behavioural approaches to behavioural issues, rather than relying on drugs.

"There is an increasing consensus about best practice in dementia care," he said.  "But we keep coming back to the unavoidable truth that behavioural approaches are necessarily labour-intensive.  Good training and the right staff to patient ratios are indispensable.

"I believe Panorama also confirmed what the care home sector has been saying for years – that it is doctors who make the decisions about the drugs to prescribe, not the care homes themselves.  Yet in the past it has often been care home managers and staff who have wrongly been the object of criticism about the types of medication being administered to residents ."

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Two care workers have been arrested on suspicion of murdering five elderly people at a Somerset residential home.

It follows the deaths of four women and a man at the former Parkfields Care Residential Care Home in Butleigh.

Registered nurse Rachel Baker, 45, and her chef husband Leigh, 48, are being held in Yeovil.

The pair were initially questioned following the death of 97-year-old Lucy Cox on New Year's Day.

Detectives also decided to exhume the remains of several other former residents to establish whether they had been poisoned.


The remains of Nellie "Mary" Pickford, 89, were removed from Glastonbury Cemetery on June 5 while grandmother-of-four Marion Alder, 79, was exhumed from the graveyard of St Leonard's Church, Butleigh, a week later.

And the remains of Fred Green, 81, a grandfather of 10, were taken from a graveyard in the village of Kingweston, near Somerton, in rural Somerset, on July 11.

Three other residents, whose deaths were being treated as suspicious by officers, had already been cremated.

Answering bail, the Bakers were arrested on suspicion of the murder of four women and one man, theft and unlawful possession of controlled prescribed drugs and attempting to pervert the course of justice.

Police spokesman Dan Mountain said: "Both arrests relate to ongoing inquiries into deaths at the former Parkfields Residential Care Home in Butleigh."

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Elderly people are to be given control over the home help they get from the state.

A new programme will strip social workers of their power to decide which services frail old people and their families can receive.

Instead, the elderly will be allowed to choose for themselves.

It could mean that a pensioner offered meals on wheels would use the money to pay someone to come in and cook.

The system, unveiled by Gordon Brown yesterday, will mean that poorly performing care homes and care providers will be dropped from NHS and local council contracts.

The "Putting People First" scheme is described as a "concordat" between Government, local councils and the NHS.

The programme, which begins in April, will be funded by £520million diverted from the NHS budget over the next three years.

It comes amid deepening concern over the way old people are left isolated when they become frail or ill.

Around 900,000 over-65s are currently unable to live independently without help, a figure that is expected to pass 1.3million by 2025 as the "baby boomer" generation ages.

Cutbacks in home help services have forced many to move into care homes - and pay the bills by selling their homes.

Last year a report by Sir Derek Wanless said help at home was far better than allowing people to drift into residential care.

At present, social workers assess an individual to decide what services they need. Under the new scheme, individuals or their families will be able to choose how the money is spent.

Councils will pay a person's cash entitlement into a special bank account which they can use to buy services from the state or private companies.

Younger disabled people will also be given personal budgets.

The Prime Minister says it will "put real control into the hands of those in care and their carers".

The Local Government Association called the scheme a landmark.

Chairman Sir Simon Milton said: "We are pleased the government has recognised that change comes at a price.

"The new grant will go some way to enable councils to move towards a more personalised and preventative system of care."

Charities welcomed the new system, but Help the Aged warned: "The devil will be in the detail."

It said state help should not be restricted only to the most vulnerable and sick.

Tory spokesman Stephen O'Brien said cuts in home help had been "the inevitable consequence of the policy to squeeze local authority budgets".

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Since its launch last year, the Nintendo Wii has opened the video game market up to everyone, not just young men.

A year later, the Wii began popping up in the most unlikely of places. It can be found in gyms, in retirement homes — and most recently, in hospitals as a tool to assist in physical therapy.

According to Reuters, a hospital in Alberta has been using the Wii to assist those recovering from strokes, and spinal cord or traumatic brain injuries, for the past four months.

Occupational Therapist Robbie Winget told Reuters the console helps patients build balance, coordination, endurance and upper and lower body strength.

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A lack of physical activity can lead to mental health problems, according to experts.

A lack of physical activity can lead to mental health problems, according to experts.

Evidence presented at the British Nutrition Foundation conference shows showed that not getting enough physical exertion can cause dementia and depression, reports the BBC.

Professor Nannette Mutrie, an expert in exercise and sport psychology at the University of Strathclyde, told the conference that it is only recently people have begun to see the link between mental health and exercise.

Dr Mutrie added that a person's risk of becoming depressed is doubled if they are inactive.

"It is estimated that over 700,000 people in the UK currently suffer from dementia and more research is needed to determine how this condition can be prevented," she continued.

Meanwhile, researchers at Yale University have suggested that a natural high gained from exercise could be formulated and used in medication to help people suffering from depression.

In a report in Nature Medicine, the research team stated that a drug based upon the gene VGF could be more effective than current depression treatments.

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A row over funding for Alzheimer's drugs on the NHS is to go to the Court of Appeal.

The manufacturer of one drug - Aricept - has been fighting a decision to restrict access to patients in the later stages of the disease.

The National Institute for Health and Clinical Excellence concluded the drugs are not cost effective for patients in the early stages of Alzheimer's.

The decision was upheld by the High Court earlier this year.

Drugs company Eisai brought the case to the High Court with support from fellow drugs firms Pfizer and Shire and the Alzheimer's Society.

The legal debate is about whether NICE followed a fair and transparent process in reaching it's decision.

The court upheld NICE's decision that the drugs are only cost-effective in later-stage disease.

However, NICE was told to rewrite guidance on how the disease is assessed to take into account people with learning difficulties or those who speak English as a second language.

It was the first time a judicial review had been sought on NICE guidance.

Recommendations

NICE guidance in 2001 recommended the drugs - which can make it easier to carry out everyday tasks - should be used as standard.

But guidance published in November 2006, after months of appeals, stated that the drugs should only be prescribed to people with moderate-stage disease.

NICE said the drugs, which cost about £2.50 a day, did not make enough of a difference to recommend them for all patients and were not good value for money.

Dr Paul Hooper, executive vice president of Eisai Europe, said: "We are delighted that the court has granted us permission to appeal the decision of the High Court which supported NICE's lack of transparency over the way that cost effectiveness has been calculated.

"It is disgraceful that NICE can restrict medicines used to treat a most vulnerable group of patients based upon secret calculations."

A spokesperson for the Alzheimer's Society said: "We are pleased to hear the appeal against the NICE juducial review verdict has been given the go ahead.

"While the Alzheimer's Society is not pursuing its legal arguments further in court, we support any challenge that could mean people with Alzheimer's get fairer access to the only drug treatment for the disease."

NICE chief executive Andrew Dillon said: "We are disappointed.

"Going back to court will require us to divert energy and tax payer's money from the work we do."

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he government today promised a comprehensive review of the controversial eligibility criteria which determine services for older people. Ivan Lewis, the minister for social care, said the government would address the "inflexibility and rigidity" of the criteria and promised a "complete and fundamental review" of the system.

Speaking at a Guardian conference in London on commissioning care for  older people, Lewis said the government would also crack down on poor quality care homes and told local authorities to use their buying power to drive them out of business.

"We want a world class service where older people are treated with dignity and respect and if necessary we have to drive out those providers who are not giving that quality of care."

Making sure older people had an active 'intergenerational' role in society was key to changing society's attitudes, said Lewis. "Older people do not need to be patronised but have a massive amount to offer that would keep them healthy and well," he said.

"I want to see in every community inter-generational programmes that bring older and younger people together. Why can't we see older people helping children with their reading or kids teaching older people about computers?"

He added that the government would tackle holes in the current system which result in people who fund their own care doing so without guidance and support.

"That was never our intention and we must do something about it," he said. "Self-funders should not be left alone to make difficult choices about where they get their care from." The government also plan to end an 'anomaly' whereby people who are publicly funded to live in private sector care homes are not covered by the Human Rights Act.

An ICM poll for the Guardian this week revealed that 66% of adults are frightened by the prospect of going into a care home.

Lewis today announced "a major expansion of the dignity in care campaign" for hospitals, care homes and homecare services. He said: "The test that should apply to politicians, managers and front line staff is this: if you wouldn't want your mum and dad to be treated like that, you shouldn't accept it for anybody else's mother or father."

The government will publish a green paper on the funding of social care next year and Gordon Brown has promised a new deal for millions of carers looking after family and friends.

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More than 100,000 people in Britain suffering from dementia are being prescribed drugs by doctors and care homes that at best offer few benefits and at worst are lethal, according to shocking new research.

The controversial drugs, which are often used to sedate patients, have been described as a "liquid cosh" by one expert and the study has provoked a call for stricter limitations on their use.

Professor Clive Ballard from King's College, London, investigated the effects of anti-psychotic medication, which is given to nearly half of dementia patients in care homes at an annual cost of £80million.

He found that those who had been given it were nearly twice as likely, over a four-year period, to die than those who were not prescribed it.

Professor Ballard said: "People who weren't taking the anti-psychotic drugs had a 62 per cent chance of being alive by the end of the study while the people who were taking the drugs had only a 36 per cent chance of being alive.

"For the vast majority of people there are no benefits, and considerable harm, from using these drugs. There were clearly deteriorations in some of the core symptoms, particularly their ability to communicate effectively."

Many elderly people only mildly affected by dementia but prescribed anti-psychotic drugs are reduced to a "zombified" state by them, says the Alzheimer's Society, which has demanded an end to their blanket use.

The study is featured in a Panorama investigation to be shown on BBC1 tomorrow.

It tells the story of Cheryl Byrne, who spent the past three years battling to have her father, Eric Hollingworth, taken off anti-psychotics.

Mr Hollingworth, who died recently aged 81, was diagnosed with dementia in 2003 and from the outset was prescribed anti-psychotics.

Upset by the rapid deterioration in his health, Cheryl resorted to secretly filming his condition.

The footage shows her father slumped in a chair looking, as she describes, "like a zombie".

He doesn't utter a word and gets up and down from his chair 17 times in ten minutes.

Mrs Byrne, a retired bank worker, said: "I never thought he was the same again after he'd been prescribed those drugs. Something was lost. They robbed him, physically and mentally, of what capacity he did have."

Mr Hollingworth was given a cocktail of drugs after barricading himself in a ward.

Last night Tim Kendall, deputy director of research at the Royal College of Psychiatrists, said: "I can't see the justification for this wide range of drugs. It is a liquid cosh."

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· Nearly 75% of authorities restrict social services
· Tens of thousands of the most vulnerable excluded
 
John Carvel, social affairs editor The Guardian Thursday November 22 2007 

The following correction was printed in the Guardian's Corrections and clarifications column, Friday November 30 2007

We said below that the Commission for Social Care Inspection had found that four local authorities, including Surrey, were intending to provide care only to people whose needs were classed as critical. Surrey county council will in fact continue to provide care for people with substantial needs as well. The information was wrongly supplied to the CSCI.

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Nearly three-quarters of local authorities in England are rationing social services to exclude tens of thousands of vulnerable people from help with the basic tasks of daily living, official figures revealed last night.

The charity Mencap obtained information showing the worsening plight of people who cannot wash, dress, prepare a meal or go to the shops unaided.

It said the problem affected older people and adults with learning disabilities in areas where cash-strapped councils have decided they can no longer afford to provide services to everyone in need.

The information, from the Commission for Social Care Inspection (CSCI), found 73% of local authorities were planning to refuse care to everyone whose needs were not considered to be "substantial".

The government's definition of substantial covers people who "cannot carry out the majority of their personal care or domestic routines" and do not have anyone available to provide voluntary help.

It excludes people with "moderate" needs who may not be able to carry out several daily routines such as getting up in the morning, bathing and doing the washing up.

The CSCI found four local authorities intending to ration services even more tightly to provide care only to people whose needs are "critical". Under this definition, people would not get support unless their life was in danger or they were at risk of serious abuse or neglect.

The four were Northumberland, Surrey, West Berkshire and Wokingham councils. They are about to be joined by the London borough of Harrow, which yesterday defended plans to tighten its eligibility criteria at a judicial review in the high court.

Dame Jo Williams, chief executive of Mencap, said: "These figures show the true extent of the crisis in social care. It is unacceptable in the UK in the 21st century that local authorities are refusing support to very vulnerable people with a learning disability who have no one else to turn to.

"Last month the government gave an increase of less than 1% for social services. Given rises in demand, we will just see more and more cash-strapped councils cutting back."

The tightening up of council funding means the number of households across England receiving local authority care fell from 528,500 in 1991 to 345,000 this year, despite growing numbers of older people.

The CSCI data showed rationing has become much tighter over the past two years. In 2005-06, 54% of authorities restricted services to people whose needs were deemed "substantial". This increased to 62% in 2006-07 and - according to councils' official plans - would reach 73% by the end of March.

Gordon Lishman, director general of Age Concern, said: "Chronic under-funding of home care services means people are being deprived of the help they need until they reach crisis point ... We need a better system for paying for care to end the postcode lottery and the unfair way people on low and modest incomes are charged."

The Local Government Association said: "Councils want to provide the services vulnerable people need but are increasingly unable to do so because central government funding has not kept pace with the demands of an ageing population."

David Rogers, chairman of the association's community wellbeing board, added: "Ministers need to turn with urgency to the long-term overhaul of the future funding of adult care services ... It is unjust that people have to wait until their life is threatened, or suffer from a serious mental and physical illness, before they receive care.

"If society is to meet people's needs and aspirations, the social care system needs root and branch reform, giving individuals choice, independence, dignity and control over their lives."

Harrow council last night defended its decision to save £2m by withholding services from people in substantial need. Chris Mote, the leader, said it received less from the government than other London boroughs and had to concentrate support on the most vulnerable. "We were forced to take action ... to balance the budget."

A Department of Health spokesman said: "Local authorities in England saw record investment of more than £65bn in 2007-08. This is set to increase by £2.6bn by 2010-11. In addition, direct funding from the department for social care for older people and support services for carers will increase by £190m to £1.5bn by 2010. It is for local authorities to manage their resources to meet the needs of their populations, and we expect their increased resources to be used in more innovative and flexible ways

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Last week, Joshua Cullip said "Mummy" for the first time. It was a breathtaking moment - and his mother's face lights up at the memory.

She says: "He was sitting in the high chair and clearly wanted more food. I was taking my time, and he started banging his plate - then he suddenly shouted 'Mummy' really loudly.

"It was as if someone had reached in and grabbed hold of my heart. It just physically lurched, and I still haven't got over the thrill of hearing him say my name."

Bitter blow: Joshua with his mother Jodie who is facing up to a difficult future

With that, as if on cue, Joshua says "Mama" again, and explodes into peals of laughter.

Like every first-time mother, Jodie greets each milestone with undisguised joy.

But each new achievement, each cause of celebration, is as agonising as it is gleeful. Because this sweet blonde 13-month-old baby with beseeching blue eyes and a ready smile is suffering from Alzheimer's.

Yes you did hear correctly - Alzheimer's. At some point before his fifth birthday dementia caused by the genetic disease Niemann-Pick C will set in, and this small boy will gradually forget every word he has learned.

It is perhaps one of the cruellest tricks of nature that within a couple of years, the child who now calls so happily for his Mummy will be too senile even to know who she is.

Jodie says: "It's as if everything Joshua says and does will slowly be taken away from us.

"He looks at me with such love, I can't imagine what it will be like for him not even to know me. To look at me in real confusion, with a stranger's eyes.

"He makes me so proud every day. He's just learned to do the rhyme Round And Round The Garden with his chubby little finger going around his palm, and he's so pleased with himself.

"But even then, I think: 'He won't remember this rhyme one day.' It's just another fresh pain."

At the age of 21, Jodie is an extraordinary young woman who remains incredibly calm and composed. When Joshua gleefully puts his plastic toys down the loo and empties out the shampoo, she remonstrates with him, but secretly delights in his mischief.

She says: "He's a little monster. I love to say that because it is just a little boy who gets into mischief. I just want him to stay a normal little boy for as long as possible."

Jodie is currently living apart from Joshua's father Callum, also 21. The stress, she admits, has been hard for the childhood sweethearts who have been together for five years.

She never planned to become a mother so young, but now, despite her own ambitions, she is devoting herself to caring for Joshua.

The news that she was pregnant came as a complete shock. Jodie says: "I planned to wait for a few years before settling down and having a baby.

"I was working in a children's shop and helping to run children's parties when I went to the local family planning clinic for my regular contraceptive injections.

"They do a pregnancy test as a matter of course, but this time the lady's face changed. She said: 'I wasn't expecting this - you are pregnant.' I was utterly stunned.

"I went straight to my niece's birthday party, and sat watching all the little children playing. I couldn't believe I was pregnant. Callum was shocked when I told him but we both decided we had always wanted a family.

"We were just starting earlier than we had planned."

The devoted young couple started to prepare for their baby - decorating their immaculate two-bedroom home in Milton Keynes, Buckinghamshire. But the pregnancy was difficult.

At six months, Jodie went into premature labour, which doctors were able to stop with drugs. During a scan at 33 weeks, Jodie discovered she was expecting a boy.

She says: "I had felt so sure the baby was going to be a boy, and I was thrilled. I knew immediately that I wanted to call him Joshua, and Callum chose his middle name, John.

"I had such wonderful plans for him before he was even born. I used to daydream, and wonder what he would be when he grew up."

At 35 weeks, Jodie's waters broke suddenly and she was rushed into theatre for an emergency Caesarean while her agonised partner waited outside.

"Joshua weighed 5lb 7oz," she says, "but I only saw him for a few seconds, because he was freezing cold and had problems breathing and they needed to get him to the special care unit.

"I could hardly see him under the blankets, and when they took him away it was awful, as if a piece of me had been amputated."

Within hours, Jodie's own condition had deteriorated. Kidney complications during her pregnancy returned, and she was treated in a separate unit, unable to see her child.

The following morning, a paediatrician arrived with the news that Joshua was jaundiced and unable to take milk. He had to be transferred to a specialist baby unit in Oxford, 40 miles away.

"The next two weeks were a total misery," says Jodie. "I was put in my own room, but I could hear all the other babies and their mothers on the ward.

"Callum would go and visit Joshua at the baby unit, then come back and tell me about him, and I felt so jealous. I started to wonder if I would ever bond with this baby I had never seen.

"Finally, after two weeks I discharged myself, I had to see him so badly. I could hardly walk, but I insisted Callum drove me to be with our son.

"I staggered into the special care unit and there he was, the smallest but most perfect baby I had ever seen.

"I just needed to hold him in my arms. Incredibly, almost as soon as I did, Joshua started to thrive. Within hours, he started to feed. His bowel movements became normal and his temperature settled.

"It was as if he knew Mummy had come for him, as if I had somehow willed him to get better."

After two weeks, Joshua was declared well enough to go home. Jodie says: "The doctors said they had to keep an eye on his jaundice levels, but I honestly didn't think jaundice was dangerous.

"I was just thrilled he was coming home and we were going to start our new life as a little family at last."

But after a few weeks, fresh blood tests revealed that Joshua's levels of bilirubin - the pigment which causes jaundice - were high, and he had to be referred to a liver specialist in London.

"As soon as I heard the words 'liver specialist', I started to panic," says Jodie, "but I told myself that the doctors probably just wanted to be safe.

"Joshua had slightly yellow eyes, but he seemed so healthy. He smiled at exactly the right time, and started gurgling and trying to talk to me with his own baby language.

"I couldn't believe that a baby who seemed so bright and so perfect could have something seriously wrong with him."

Baby book: Like other first-time mothers, Jodie meticulously records Joshua's progress

The family were sent to London's famous King's College Hospital, but further tests showed no liver disease. Clearly baffled, doctors asked Jodie and Callum if there was any family history of serious illness or infant death.

Jodie says: "My mother reminded me that my cousin's daughter Maddie had died at three months' old the previous year. We weren't close, I had never met the poor baby, but Mum decided to check the details.

"When she rang back, she said the baby had suffered from a very rare genetic condition called Niemann-Pick C - a form of dementia known as children's Alzheimer's.

"I told the specialist, and she said: 'It's very unlikely, because it isn't hereditary and I've never known two babies from one family suffer from this condition. But it is worth testing Joshua so that we can rule it out.'

"The tests themselves were horrific. Joshua had to have a bone marrow biopsy, a liver biopsy and a skin biopsy at the same time. I wasn't allowed to be with him, I just stood outside in the hallway, listening to his screams and crying my eyes out."

A week later, Jodie received a call from the specialist. She says: "The doctor just said that the tests had come back, and unfortunately they did show that Joshua probably had Neimann-Pick C. The final result, from the skin biopsy, would confirm if this was the case.

"I put the phone down and went straight onto the internet because I didn't have a clue what this condition was. I was absolutely devastated with what I saw.

"I learned that Niemann-Pick C is caused when both parents carry a faulty gene. It affects just one in 150,000 babies and causes harmful build-ups of fatty substances known as lipids in the liver, spleen, bone marrow and brain.

"Callum, myself and our parents all read up about this awful condition but somehow I managed to convince myself that the final skin biopsy would show that Joshua was clear.

"He was a healthy, happy, five-month-old baby who played and gurgled at my feet. I couldn't believe such a beautiful boy had such an evil disease."

Jodie and Callum are sheltered by their close-knit families, and when the young couple travelled to London for the final verdict in March this year, Callum's parents came with them for support.

"We arrived at Evelina Children's Hospital and we all walked in to meet the specialist," says Jodie. "I put Joshua onto the floor and I watched him roll around, playing. Then the specialist confirmed that Joshua had Neimann-Pick C.

"I remember him saying that children like Joshua, who had an enlarged liver and spleen usually pass away by the age of five from liver failure.

"There are some children who survive into early adulthood, but we should prepare ourselves for the worst."

The news was greeted with utter silence. Jodie says: "Nobody could talk. To be honest, I was devoid of any emotion. I didn't even cry, it just didn't feel real.

"I picked Joshua up and we left the hospital and went on a boat trip. It was totally surreal, because Joshua was laughing at the other boats and pointing, and none of us even mentioned the doctor or this awful prognosis.

"I couldn't even think about it. I just wanted to give Joshua a nice day out. It didn't seem fair to be talking about his death when he was having such a lovely time watching the boats.

"Even when I got home that night, I didn't cry. Reality didn't actually sink in for another few weeks. Then one day, I was reading an article in a local newspaper, and it talked about another little child who has Niemann-Pick C.

"It said the condition was known as children's Alzheimer's, because it causes progressive senile dementia, like the type seen in elderly people.

"It was as if my whole world came crashing down, because with the word Alzheimer's, the full implication of Joshua's condition, and his future, became clear.

"I had never known anyone with Alzheimer's but before my pregnancy I had happened to watch a storyline on Coronation Street which showed one of the main characters, Mike Baldwin, suffering from the condition.

"The irony was that I never usually watch soaps, but the sight of this character who kept forgetting things had been so disturbing that I had followed the whole story, watching the gradual disintegration of his mind.

"Now, the image of that shambling and confused man haunted me. Because I realised this is what would happen to Joshua.

"Everything that he learned would be forgotten. Everything he discovered about the world around him would be lost. Every toy that he loved would one day be discarded.

"The thought that eventually he wouldn't even recognise his beloved Grandad was unbearable."

With this, Jodie pauses and takes a painful gulp. "And then I remember that one day he won't even know me."

Joshua's condition is untreatable. A liver transplant is not an option because fatty deposits would attack any new organ. Jodie's beloved baby son is effectively a ticking time bomb.

At some point he will become clumsy, and start to tumble and fall. He will begin to forget where he has put his toys. Words will start to fail him, and he will have difficulty remembering the faces of those who love him.

Finally, he will lose the power of speech and the power to swallow. Jodie fights back tears as she says: "He loves his food so much. Whatever I cook for him, he really enjoys and that is what hurts me the most. The thought that he won't actually be able to swallow or taste the food he loves."

At the age of 21, where the only choices many girls make are where to go out on a Saturday night, Jodie is facing some of the most painful decisions any mother can make, and she does so with a maturity which belies her years.

"I don't want Joshua's life to be prolonged by painful treatment," she says. "I want him to remain happy and comfortable for as long as possible.

"It is hard to think about his death when he is so happy and doing so well. But I force myself to think about the future, for his sake. I want to plan it, so I don't fall apart when it happens.

"I've decided that when he has gone, I want to find a new career, a new chance to make the best of my life.

"I want Joshua to be proud of me, and I want to be the best mum he could ever hope for - even if he is in Heaven.

"I left school at 17 with just five GCSEs. Perhaps I'll go to college and study, maybe find a career which helps sick children. I just know I can't afford to go downhill and waste this precious chance.

"In the meantime, I just delight in everything Joshua does. If he's naughty, I pretend I'm cross but in truth I'm just thrilled that he has this incredible cheeky spirit.

"I video him all the time and then I watch the tapes back so I can savour every moment and enjoy every new little thing he does, time and time again."

Jodie has a baby book, where like many other first-time mothers, she meticulously records Joshua's progress.

There, her neat handwriting recalls, how he first crawled at ten months, pulled himself up to stand at nearly a year.

And last week, she recalls shakily, he said "Mummy" for the very first time. Up until then, he called her Jojo.

She smiles with pride and says: "His little voice is the sweetest sound I have ever heard."

And when it is gone, when Joshua can no longer say Mummy or plant wet kisses on her cheek, it is a memory she will hang on to for ever.

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