First adult social care budget rise since 2010 spent on higher costs

The first real-terms rise in spending on adult social care since 2009-10 has been swallowed by the rising cost of service provision and pay, according to data gathered by NHS Digital.

NHS Digital’s Adult Social Care Activity and Finance Report said that the total spent on adult social care by local authorities plus client contributions totalled £17.5 billion in 2016-17. The amount is a £556 million increase on 2015-16 and represents a 1% rise in real terms.

When the Better Care Fund and capital charges are also counted the total spent on adult social care in England during 2016-17 rises to £20.6 billion.

National minimum wage

However, the report found that the extra spending, which was mainly funded by the £382 million raised from the adult social care precept on council tax, did not lead to more service activity.

“While expenditure has risen there has been minimal change in activity, which may be linked to the increasing costs in the provision of care,” the report said.

The increase in the national minimum wage and the rising cost of residential and nursing care were cited as main drivers of extra costs in adult social care during 2016-17.

Compared to 2015-16 the average cost of residential care for someone over 65 increased from £549 to £565 per week while the average weekly bill for nursing care went up from £563 to £606. Similar rises were also reported for residential and nursing care for working-age adults.

Fewer carers supported

The number of requests for adult social care support remained static, rising just 0.2% on the previous year. In total there were 1.8 million requests for adult social care support, equivalent to 5,000 requests a day across England.

The number of people receiving long-term support fell slightly – down 4,080 on the previous year to 868,440. The number of carers who received support declined 5% and the amount spent on supporting them dropped 6%.

While spending on adult social care rose in every region of England, NHS Digital found significant variation at local authority level. In 42 councils expenditure on adult social care declined and in four authorities budgets increased by more than 20% in cash terms.

The report also revealed that 59% of people with long-term care plans had their support reviewed during the year, up from 55% in 2015-16.

Story is reproduced courtesy of Community Care – http://www.communitycare.co.uk/2017/10/27/first-adult-social-care-budget-rise-since-2010-spent-higher-costs/

How a Peanut Butter Test May Detect Alzheimer’s

But it has potential, according to researchers at the University of Florida. They conducted a peanut butter smell test hoping to find an inexpensive, noninvasive way to detect early-stage Alzheimer’s and track its progress.

The test was conducted on cognitively normal individuals as well as:

• 18 patients diagnosed with probable Alzheimer’s disease
• 24 patients with mild cognitive impairment
• 26 patients with other causes of dementia

The researchers found that the peanut butter test singled out those with probable Alzheimer’s.

Peanut butter smell test

Here’s how they conducted the test. The researchers asked each person to close their eyes, their mouth and one nostril. They opened a small container of peanut butter and moved progressively closer until the person could smell it. After measuring that distance, they waited 90 seconds and repeated the process with the other nostril.

In those with probable Alzheimer’s disease, the researchers had to move the peanut butter container an average of 10 centimeters closer to the left nostril than to the right nostril.

“This is a significant part of this study,” notes Dylan Wint, MD, a specialist in degenerative brain diseases who commented on the research. “There is a lot of research showing Alzheimer-related brain shrinkage starting on the left side of the brain, which is where the temporal lobe degenerates first.”

Ongoing research needed

The investigators, who published their study in 2013, said follow-up research would be needed.

However, a follow-up study in 2014 at the University of Pennsylvania could not replicate their results. The second research team found no difference in the ability of 15 patients with Alzheimer’s to smell peanut butter in their left versus their right nostrils.

“This highlights the scientific importance of studies being repeated and refined by other researchers in different patient populations,” Dr. Wint says.

Research continues on Alzheimer’s disease as well as on mild cognitive impairment.

A need for cheap, accurate tests

“The accessibility of current Alzheimer’s tests is one of the issues that is making diagnosis and research difficult,” notes Dr. Wint.

Currently, the most accurate early-stage diagnostic tests for Alzheimer’s are a spinal tap or an amyloid PET scan. However, these tests are expensive, uncomfortable and not available everywhere.

“The amyloid PET scan can cost $5,000, and that is just to figure out who should be studied in any Alzheimer’s study for early-stage diagnosis,” he says.

Accurate, accessible and inexpensive testing could inform more patients about their Alzheimer’s disease status. And diagnosing Alzheimer’s in its early stages is critical to finding treatments that can delay or prevent future memory loss, says Dr. Wint.

How To Spot The Symptoms Of Stroke, Plus Tips On Prevention

The charity blames high blood pressure, linked to inactivity and poor diet, as well as the fact people are living longer for fuelling the rise.

Dominic Brand, director of external affairs at the Stroke Association, said we must act now “to prevent the UK from sleepwalking towards a stroke crisis”.

The charity said investing £10 million in research could save 114,000 people from having a stroke by 2035.

What is a stroke?

A stroke typically occurs when the blood supply to part of the brain is cut off. It is a serious, life-threatening medical condition which can result in death.

 Who is at risk?

Roughly 110,000 people have a stroke in the UK each year. It was the second biggest killer globally in 2015, after ischaemic heart disease, according to the World Health Organisation.

Older people are most at risk of having a stroke. However they can occur at any age – including in children.

Symptoms

One of the main symptoms of stroke, according to the NHS, is when the muscles on one side of the face droop, which results in the person not being able to smile. In some cases, the mouth or eye area might have dropped too.

People experiencing a stroke may not be able to lift both of their arms and keep them there – usually because of arm weakness or numbness.

Additionally their speech may become slurred or “garbled”. In some cases, the person may not be able to talk at all despite appearing to be awake.

If you experience any of these symptoms, it is important to act fast and call 999 immediately. Speed is key with treating stroke, and the quicker a person is able to be treated, the less chance there is of permanent damage.

NHS England workforce planning ‘not fit for purpose’, says report

NHS England’s workforce planning is “not fit for purpose”, according to a report that found a high turnover of staff was hurting the health service financially and reducing continuity of care.

The Health Foundation found the number of nurses and GPs had fallen at a time when the NHS was struggling to cope with growing demand, although a rise in managers and consultants contributed to an overall increase in the NHS workforce by 2% in the year to April.

In Rising Pressure: the NHS workforce challenge, the charity says that almost a third of staff are leaving some trust each year. This left management fighting and spending huge amounts of money “just to stand still”, it adds.

Anita Charlesworth, the foundation’s director of research and economics, said: “There is a growing gap between rhetoric about the government’s ambitions to grow the NHS workforce and the reality of falling numbers of nurses and GPs.

“This year has been characterised by a series of one-off announcements and initiatives, beset by unrealistic timescales and no overall strategy.

“The challenges and risks ahead for the NHS are well known, and must be met by collective action led by the government to put in place a coherent strategy to provide a sustainable workforce for the NHS.”

The charity found that the number of nurses declined by 0.2% in the year to April, while the number of GPs fell by 0.7% from December to the end of June.

The report casts doubt on the government’s ability to meet a number of targets, including increasing the number of GPs by 5,000 and creating 21,000 new mental health posts by 2020.

The fall in the number of nurses was found to be most notable in community nursing and mental health. The Health Foundation also found 1,220 fewer students from England had started undergraduate nursing degrees this year, which it blamed partly on the switch from bursaries to loans for training.

Just 38 GPs were recruited from overseas in the first six months of this year, despite the government aiming to recruit 2,000 to 3,000 foreign family doctors over the next three years, the foundation found.

Danny Mortimer, the chief executive of NHS Employers, said more needed to be done to improve staff retention and that uncertainty over the future of EU staff post-Brexit had made the uncertainty worse.

A Department of Health spokeswoman said: “Patients can be assured that the NHS has the staff it needs to provide the best possible care — over 12,700 more doctors, 10,600 more nurses on our wards and over 5,600 fewer managers and senior managers since May 2010.

“We have a clear plan to ensure the NHS remains a rewarding and attractive place to work, including more flexible working for nurses and greater safeguards for junior doctors, alongside an historic 25% increase in undergraduate medical school and nurse training places.”

The NHS pay cap has been highlighed as contributing factor in staff leaving the health service. In a separate report, also published on Monday, the Institute of Public Policy says lifting the cap would be about half the headline cost of £1.8bn a year by 2019-20.

The thinktank’s analysis identified the real cost as £950m, after taking into account money immediately returned to the Treasury through higher tax receipts and lower welfare payments plus the impact of additional GDP generated.

It found that a “catch-up” scenario of increasing NHS pay in line with private sector earnings plus 1% would have a headline cost of £3.9bn by 2019-20, but a net cost to the Treasury of £2.1bn. The analysis was welcomed by NHS Providers and the Royal College of Nursing, which both urged the chancellor to act on it in his budget next month.

A Treasury spokesman said: “We have already confirmed that the across-the-board 1% public sector pay policy will no longer apply. The independent pay review process is now underway for NHS staff and will report in spring 2018.”

Southwark’s home library service

They offer this service to:

• people with disabilities – children and adults
• older people
• carers
• people who cannot visit the library due to an accident / illness

The service allows you to borrow:

• fiction and non fiction books
• books in large print
• talking books
• children’s books and DVDs
• books in other languages
• CDs and DVDs
• local history publications
• information specific to older people and people with disabilities

NHS may rent spare rooms to ease bed crisis

The scheme, which is being piloted in Essex, aims to tackle bed shortages and save money but has been criticised by medical professionals and social workers who warn it would give too much responsibility to untrained members of the public.

A startup, CareRooms, is working with the NHS and councils in Southend and elsewhere in Essex to pilot the model and finalise how it will work. It says patients would benefit from “a safe, comfortable place to recuperate from hospital” as well as helping the NHS.

Hosts would be asked to welcome patients recovering minor procedures, cook three microwave meals a day and offer conversation, according to CareRooms, in a scheme targeting people who do not have a family able to care for them.

The Save Southend A&E campaign group, whose members include doctors and other clinicians, warned it “opens a huge can of worms for safeguarding, governance and possible financial and emotional abuse of people at their most vulnerable time”.

CareRooms, which is part of NHS England’s clinical entrepreneur programme, said its governance and quality would address such concerns. Hosts would be interviewed and be subject to disclosure checks and food hygiene tests. There will also be barring service checks of police criminal records – used by employers, often to avoid problems of employees working with children and vulnerable adults. They would also need to understand some care law, including the Mental Capacity Act, which aims to protect those who lack the ability to make their own decisions about treatment.

So-called “bedblocking” in the NHS has risen by 40% in the past year and is estimated to result in as many as 8,000 deaths annually. On some days 6,000 patients are taking up beds when they no longer require hospital treatment.

Harry Thirkettle, a part-time emergency registrar in Essex who is the medical director of CareRooms, told Health Service Journal: “Everyone’s immediate concern is, understandably, safeguarding. We are working hard to be better than standard practice.

“We are not going off half-cocked … We are not going to start taking on patients until we have satisfied all these different organisations’ governance procedures and committees [NHS providers, commissioners and councils]. We are really carefully considering this and making sure it is as safe as possible.”

The financial model is still to be finalised. Thirkettle said rooms would be rented out to funders at about £100 a night, with half going to the host. The rest would be used to pay for the care services required and a margin kept by the company as profit. He said the assumption was that it would be jointly funded by the NHS and councils. “We may also look to take self-funding patients who pay us directly.” For patients who are prepared to pay the option would be presented by a hospital’s discharge team alongside existing options such as nursing homes, he said.

The Association of Directors of Adult Social Services said it wanted more details before making a full assessment but that the “model of care, as described, raises questions about whether the safety and wellbeing of the individual have been fully considered”.

A spokesman for Southend council said: “We want to make it clear that, at this early stage, the council has only agreed to continue exploring the viability of the project with other partners. We are awaiting further information on how the project will run and the preparation of a detailed business case before we can make any formal commitment or give support to the project.”

CareRooms has set up a stall in the restaurant at Southend hospital to find potential hosts.

Save Southend A&E said that in addition to its safeguarding questions, it was concerned about the way the company was pitching itself as a money-making venture for hosts, rather than emphasising care quality.

It said the company was handing out flyers in the public canteen at Southend hospital this month, which “headline with a financial opener offering people the chance to earn up to £1,000 a month renting out a spare room to accommodate someone needing to recuperate from hospital.

“We are shocked that an NHS trust is endorsing such a company … It is almost weekly that there are reports of abuse and poor care in registered residential and care homes, therefore the monitoring of such ‘placements’ in private homes would be a huge and risky task.”

The pilot involves Southend University hospital foundation trust; Southend and Castlepoint, and Rayleigh and Rochford clinical commissioning groups; Essex county council and Southend council.

The chair of the Mid and South Essex sustainability and transformation partnership, Mike Bewick, a former deputy medical director of NHS England, is an unpaid adviser to the company.

The Care Quality Commission (CQC) said that its registration team did not have a record of CareRooms and could not say whether such a registration would be required. “The CQC will contact CareRooms to better understand their business model in case they are providing something that would fall within the scope of our regulation,” a spokesman said.

The Department of Health said: “As NHS England have made very clear- this is a locally organised pilot scheme for patients following minor operations, not national policy, and to suggest it is a cheap substitute for social care is simply untrue. Any schemes such as these are subject to the strictest quality controls and regulations.”

Carers Rights Day Charity Collection

Please let us know if you can come along and help with the collection. We will provide buckets and support. We are looking for people to help out through the day (from 08:00 – 20:00. Please call the office on 020 7708 4497 to volunteer.

Have your say on Southwark’s new Suicide Prevention Strategy and Action Plan

Learning disabled fathers feel ‘let down’ by adults’ services, research finds

Fathers with learning disabilities feel let down by adults’ services, according to research.

A study carried out by the University of Bristol found that statutory services were failing to provide parenting support for fathers, and interventions were often focused only on mothers.

The lack of support was exacerbating the stresses fathers’ already felt about parenthood, and in some cases was contributing to serious mental illness, the study found.

The research was based on interviews with eight fathers with learning disabilities, aged between 26 and 60, and nine adult social care practitioners.

The fathers, many of whom had already experienced difficult lives, said the support from adults’ services tended to focus on housing, finance, and independent living.

They also viewed children’s services as being motivated mainly by safeguarding concerns, and said any interventions on offer tended to focus support towards mothers.

‘Not routinely engaged’

Social care practitioners interviewed for the study acknowledged that services viewed mothers as the ‘primary carer’ and fathers were not routinely engaged with support.

Most said they saw their role as supporting the adult, but felt that parenting support fell under the responsibility of children’s services. However, they felt that children’s services were only able to deliver short-term interventions, which were not sufficient for learning disabled parents.

Only one practitioner interviewed was aware of the outcome in the Care Act 2014 eligibility criteria that relates to an adult’s caring responsibilities for a child. This means that a person is eligible for care and support, where they are unable to carry out their caring responsibilities, and to achieve least one other specified outcome, as a result of their care and support needs, resulting in a significant impact on their well-being.

The research concluded that learning disabled fathers needed to be much better included in “family-focused social care practice”, in order for their needs to be met.

It recommended that adults’ services identify fathers at the point of referral and discuss how they could best be supported with the practicalities of parenthood.

‘Fulfil parenting role’

Jon Symonds, who jointly led the research, said: “The fathers we spoke to really wanted to be included in support to help them fulfil their role as loving parents to their children.

“Practitioners can support fathers with learning disabilities in the same way they do mothers – by including them in conversations about being a parent, and offering emotional, as well as practical support with parenting tasks.”

The study was carried out by the School for Policy Studies at the University of Bristol, and funded by the National Institute for Health Research’s School for Social Care Research.

Story is reproduced courtesy of Community Care – http://www.communitycare.co.uk/2017/10/24/learning-disabled-fathers-feel-let-adults-services-research-finds/

Safe as Houses: Stark report findings reveal worrying picture for Universal Credit recipients

Southwark Council has already, last month, given evidence to the Work and Pensions Select Committee to stress its concerns on the matter.

Now, Southwark Council, in partnership with Croydon Council and Peabody, will launch the new report by the Smith Institute at an event at the House of Lords today. The event will be chaired by Lord Kerslake, Chair of Peabody, who will lead a panel discussion on the findings of the report and the wider impact of Universal Credit.

Warning bells have already been ringing loud and clear for Southwark Council, one of the first boroughs nationally to see the full roll out of the new system.  The Safe as Houses report looks at tenants’ experiences, not just statistics, and the actual rent accounts show real evidence of the cycle of borrowing and debt.

The two London boroughs manage almost 50,000 council homes and both councils have raised concerns about the number of tenants claiming Universal Credit (UC) falling into significant rent arrears.

The evidence Southwark has already submitted to Parliament shows that the average council rent account in Southwark sits at £8 in credit, but for UC recipients, it’s at £1,178 in arrears meaning that rent arrears for those claiming Universal Credit are worse than under the previous housing benefit system. Southwark has already seen a £5.8m debt from arrears for those on UC and this only represents 12 per cent of residents – full rollout could be much more impactful.

More worrying still, Pecan Foodbank, which operates in Southwark, reports an increase in numbers of referrals of 94 per cent – mainly due to welfare reform and Universal Credit between Q1 2016 and Q1 this year and an even bigger increase among families with children (179 per cent).

The council’s own local welfare fund (Southwark Emergency Support Scheme – SESS) reports a big increase (34 per cent) in the numbers of food parcels issued in Q1 2017 compared with same quarter in 2016.  Among those applying online for support during Q1 this year, more than one in ten cited delays in receiving UC payment as the reason for doing so.

Councillor Fiona Colley, cabinet member for finance, modernisation and performance at Southwark Council, said: “This report’s stark evidence is why we need to lead this debate; I implore the Government to listen to how this is affecting the poorest and most vulnerable people in our borough, and the potential effects reverberating nationally. Universal Credit, in its current form, has the potential to be catastrophic, not just for residents at an individual level, but for councils’ HRA budgets for housing.

“The arbitrary delay in receipt of money – particularly for those already in difficult situations such as temporary accommodation, could mean a spiral of debt, poverty and people not being able to afford to eat.  I cannot think of a more compelling reason to push for change on this.”

Councillor Alison Butler, Croydon Council’s deputy leader and cabinet member for homes, regeneration and planning, said: “This report underlines the major flaws in Universal Credit, which is placing more and more Croydon and Southwark families in rent arrears and at risk of losing their home.   The Government needs to fix this policy now or risk devastating thousands more people not only in Croydon but nationwide.”

With Universal Credit full service due to be rolled out to around 50 new areas across the country per month, this event has been an opportunity to discuss the wide-reaching impact of the new benefit system and the wider welfare reform debate.

Background information

Key findings:

• Rent arrears for those claiming Universal Credit are worse than under the previous housing benefit system. Arrears were greater for those on UC than HB: by week 20, UC tenants were on average £156 in arrears while HB tenants had actually overpaid by 4 per cent of rent due
• Big underpayments and under-payers contributed most to arrears: 69 per cent of the value of underpayments was from those failing to pay more than 75 per cent of rent owed. The top fifth of those in arrears collectively owed over half of the level of arrears
• Arrears accrued early are paid down, but stabilise with time: There is a pattern of arrears accumulating each week for 11weeks. After around week 11 arrears do start to be paid down, but not enough to pay back all arrears accumulated
• Participants in this research almost universally experienced financial hardship as a result of transitioning onto UC, particularly as a result of the significant delays to payment
• The qualitative evidence demonstrates the significant impact UC is having on individuals – delayed UC payments have put many into debt and rent arrears, causing considerable stress. Many people are struggling to manage money on UC – for some it’s adapting to a single monthly payment, but for others it’s simply not having enough money

Safe as Houses: The impact of universal credit on tenants and rent payment behaviour in the London boroughs of Southwark and Croydon, and Family Mosaic and Peabody.

Speakers at the event include:

• Lord Kerslake – Chair, Peabody Housing Association
• Paul Hackett – Director, The Smith Institute
• Cllr Fiona Colley – Cabinet Member for Finance, Modernisation and Performance, Southwark Council
• Cllr Alison Butler – Deputy Leader and Cabinet Member for Homes, Regeneration and Planning, Croydon Council
• Kayley Hignell – Head of Families, Welfare and Work, Citizens Advice
• James Bolton, Head of Universal Credit Policy, Department for Work and Pensions

The report will be shared with and generate further recommendations to the Government and be used to inform council support and policy for council tenants and residents.