Working in Home Care in Hampshire we get to meet patients that have been discharged from the local NHS Hospital with mixed views on how they have been cared for.

Hospitals have been found by the CQC to be failing in delivering basic care in the areas of nutrition and dignity. It may only be 20 out of 100 that were not meeting standards, but 20% is a big failing when you are talking about basic needs. Worse still, is that 50% of hospitals gave cause for concern. On the plus side, 78% of hospitals accept the findings and this, we hope, will lead to improved care.

The report tells us that the inspections were just carried out on one day of the year and were only in two wards of a hospital. In addition the observations were made between 9am and 4pm Monday to Friday. This concerns us because there was no observation of what happens in the night when supervision is likely to be less nor at weekends when staff shortages can be more acute. The report states that this is a cost issue, yet people working in care are expected to work unsocial hours for no extra pay, what exempts higher paid inspection staff from working the unsocial hours for the same pay? This is a poor excuse for not doing these unsocial hour checks.

Why is it that inspection routines still seem only able to work 9am to 4pm? Care happens 24 hours a day 365 days of the year any inspections should take this into account. It would have been helpful to ask some preliminary questions with patients on when the most problems were being encountered. Just concentrating on the day and just Lunch delivery has probably meant that some even bigger issues have been missed.

Another potential flaw in the inspections is that the question of dignity being observed was based mainly on asking patients, the elderly do not always complain especially when they think that by complaining they may be treated in a different way. We would have liked to have seen questions asked of the family and other visitors to see if they felt that dignity was being observed.

Subsequently the government have announced further visits to hospitals and care homes; we do hope that the times of visits are more varied this time.

While hospitals and care homes strive to give a good service they should be seen as the back stop. We believe that you are still better off remaining at home receiving home care and being more in control of your own privacy and dignity.

Everycare (Central Hants) Ltd are pleased to announce that we have been selected on to the new Hampshire County Council  provider list.

Everycare started in Home Care in June 2010 in the Winchester area and have been a supplier to Hampshire County Council  (HCC) since then.  It was decided by HCC in 2011 to refresh their provider list.

HCC placed an advert on 5^th May 2011 inviting interested parties to express their interest in being placed on HCC’s Adult Services Panel of Preferred Providers. We registered an interest on 9^th June 2011 by completing an application form.

We were accepted onto the Panel as of 18^th July 2011 and look forward to a long relationship with HCC and their Service Users.

This is positive for Everycare because we believe that it endorses us as a quality supplier to the Home Care market in Winchester, Alresford, Twyford, Colden Common and surrounding areas.

Working in Home Care, delivering services in Winchester and surrounding areas in Hampshire, we can see that the need for more gadgets is needed, particularly in the UK where there is an increase in the number of elderly people without there being on-going funding available. Relatives of the elderly can be time constrained but still need to be reassured that their loved ones are safe, turning to technology may be one way of keeping relatives informed about what is going on or being assured that the elderly are living comfortably.

There are now products from amplified telephones and listening systems for televisions to devices for fall detection and remote monitoring. The technology industry is said to be responding to a growing demand for products specifically designed for today’s aging population.

Innovative gadgets and modern technology are helping people to deal with daily living. There are, also, some low tech devices around to help make daily tasks easier, including soft-handled or large-grip cooking and eating utensils, swivel cushions that make getting in and out of a car easier, and various assistive devices that eliminate the need to bend over when putting on socks, stockings or any other garment that you need to pull up over your feet.

We are hearing from America that high-tech assistive technology for aging adults is “nearing science fiction territory”. Examples being reported include shoes that help you keep your balance, a scanner that “reads” text aloud, and a voice-activated wheelchair knows its way around your home.

Other products are wearable devices that can automatically detect falls and send alerts to loved ones over the internet, there are devices that monitor heart-rate and body-temperature changes with the information being sent real time to centres where clinicians are based to monitor the data. To detect falls there are motion and floor-vibration sensors, devices that detect abnormal walking and pressure pads to put in beds to detect whether someone has got out of bed.

In reality, as we know with technology, it is expensive to be an early adopter so we expect that the more “science fiction” the products are the harder they are to find and the more expensive they are.

The more down to earth products that can be found today, bearing in mind that we are not recommending or endorsing any of these products because there are others on the market, are:

• Amplicom ring flash 100 phone call amplifier, can be switched to ‘T’ mode for hearing aid wearers around £20.
• Glow flow temperature controlled basin light, fits most taps with an adapter, illuminates the water with blue for cool and red for hot (over 32 degrees C) around £15.
• Light switch illuminator for standard single gang light switches to enable to be found easier in the dark around £7.
• Doro big button cordless phone around £40.
• Powertel 49 plus home desk phone with large buttons around £40.
• Powertel V 100 vibration pillow to put under a pillow or cushion to alert you to calls around £20.
• Lutall big button mobile phone with SOS button, works on all networks except 3, around £35.
• Sen Cit fall monitor that detects when a person has stopped moving and sends a message to someone remote to take action £198.
• Geemarc wireless TV listening device, basically a wireless headset and a base station that plugs into the TV around £150.

Just some of the products available.

The Dillnot Commission reports on Monday 4th July 2011 with, hopefully, recommendations on the future funding of care including Home Care (Care in the Community). The previous Labour government did nothing because the ageing population problem was not imminent and, unfortunately, governments tend not to want to deal with difficult issues when it could affect their votes!

The population of people 75 and over was 4.8 million in 2008, this is forecast to increase to 7.0 million by 2023 and 8.7 million by 2033 an 81% increase over 25 years. For people over 85 the population was 1.3 million in 2008 and is forecast to increase to 2.2 million by 2023 and 3.3 million by 2033 an 154% increase over 25 years. It is the people over 85 that are most likely to require care so the increases in numbers is alarming in terms of the cost of care to the nation.

The other way of looking at the population is the number of people available to support the elderly, the ratio of people of working age to those of pensionable age was 3.23 in 2008 dropping to 2.78 by 2033. More pensioners less people able to support them and this includes the effects of increasing the pension age to make people work longer.

As can be seen from the population information, there is a big Social Care funding issue going to hit the country. Action needs to be taken now to put a Social Care funding system in that will deal with this issue.

It is unfortunate that dealing with Social Care funding comes at a time when the government is trying to cut spending. Any increase in Social Care funding is going to be tricky to fund we are either going to have to pay ourselves for care directly or indirectly through increased taxation for the government to be able to pay the extra cost.

Social Care funding has the same problem as many government pensions where we are trying to pay out of current government spending rather than building funds that can be used to pay for the costs in the future.

I fear that the government will back away from taking the bull by the horns and putting a proper funding system in, because,  what is needed to be done is likely to hit the pocket of the individual at a time when we are all feeling the pinch. What makes matters worse is that the government, being in coalition, is even less likely to do something bold.

As a Care provider we believe that substantially more needs to be put into care funding because the number of care staff needed in the future will be much higher and to attract good people in to the sector would need pay rates to go up. We believe that care staff are undervalued and their role in society needs to get greater recognition.

We implore the government to be bold and not just kick all the recommendations of the Dillnot commission into the long grass.

We aim to run an excellent Home Care service in Winchester and the surrounding areas in Hampshire and want to support the Local Authority and the NHS in delivering first rate care to the people of Hampshire.

With an ageing population, Long Term Care provision is becoming a more prevalent issue.  One in four people are likely to need Long Term Care in the future, and provision for this eventuality is very often dismissed until there is an immediate need.  Indeed, for those receiving care or wishing to increase that care, there is the constant worry of how they can continue to afford it. Government provision is limited and more and more people will be faced with ‘self-funding’ their nursing/homecare fees, potentially depleting their assets.

We have compiled a panel of experts to present in clear English all the options currently available. The topics to be covered will include:

• what is homecare and how will it be paid for?
• how can you protect your assets, what are the options and what of future provision?
• look at the use of wills and powers of attorney
• how Domiciliary Care Providers deliver their services
• how a relationship with a team of trusted advisers can protect the recipients of homecare

The seminar will be hosted by Everycare and with guest speakers Brian Fisher of Life, Simon Whipple of The Cares’ Legal Centre Solicitors and Sarah Quirk (SOLLA Accredited) from SarahQuirk Associates. The venue for this FREE 90 minute presentation is at British Red Cross Centre, Red Cross House, Winnall Close, Winnall Manor Road, Winchester, Hampshire, SO23 0LB on Tuesday 5^th July 2011.

Timing of meeting:

• Lunch: 11:45 am for 12:00 noon commencing with buffet lunch

To book a space on the seminar call Mike on 01962 842548 or email  info@everycarehants.co.uk .

Often people who have strokes, after initial hospitalisation, are sent home with home care to rehabilitate but rather than ending up in this position it is best to be aware about how to prevent strokes.

There have been adverts on the television showing people what to look out for when a person is having a stroke. This campaign is about getting people who are suffering a stroke quicker medical treatment and letting the public know how important fast action is to reduce the impact of a stroke.

The latest thing to be aware of is the link between Atrial Fibrillation (AF) and strokes, if you suffer from AF then you need to consult your GP on how that affects your risk of getting a stroke and the preventative steps that can be taken.

AF affects about 750,000 people in the UK and accounts for about one in six strokes, but AF related strokes can be prevented because once your GP is aware of your situation he can give you the right medication.

AF’s most common symptom is a fast and irregular heartbeat. An irregular heartbeat is also known as an abnormal heart rhythm or arrhythmia.

The symptoms of AF are:

• Palpitations – this means you become aware of your heart. You may feel it beating in a fast and irregular way.
• Dizziness.
• Angina (chest pains) may develop. In particular, the pains tend to occur when you exert yourself, but may even occur when resting.
• Breathlessness is often the first symptom that develops. It may occur all the time, but you may become breathless when you exert yourself, doing a bit of gardening or walking up the stairs.

To raise awareness the Stroke Association is running a campaign on AF, its link to strokes and the signs to watch out for. People are sometimes reluctant to talk to a GP about stroke risks but the message is that if you are concerned you must ask first, before it’s too late.

If you want more information on AF The Stroke Association have a free factsheet F26 Atrial fibrillation and stroke. The Stroke helpline is 0303 3033 100 and the factsheet is available for download from www.stroke.org.uk.

Home Care workers all must have CRB checks done before working with vulnerable people but the system is not watertight.

A Care Worker in Leicestershire called Maxine Singh was allowed to work with the elderly despite having 33 previous convictions.

Maxine Singh pleaded guilty to stealing from a 71-year-old father, her conviction was a suspended sentence which makes you wonder what her convictions have been to spare her a jail sentence for what some would see as a serious offence.

It was the diligence of the son, who had to put a hidden camera in the house to prove the theft, that cause Maxine Singh to be caught.

People need to be aware that the fact that a person has been CRB checked by their employer does not mean that they have no criminal convictions.

The agency, Home Call, were working on behalf of the council and claimed to have checked Maxine Singh using the CRB process. Any employer has discretion, if the person is not barred on the Vetting and Barring list to work with Adults, to still employ someone no matter what the person’s history is.

In this case, common sense seems to indicate that the employer should not have used this carer to work with vulnerable people given the sheer number of convictions, though we do not know what they were for or how long in the past they were.

Leicestershire County Council are no longer using the services of Home Call which is good news for residents in Leicestershire.

Everycare do take every precaution to ensure that people we employ do not put any of our clients at risk. We do CRB all our staff and do references before employment.

Anyone using the services of any outside agency should immediately inform the agency if they are suspicious in anyway of someone who comes into their home.

As we approach the end of the financial year for Government organisations we are concerned over the future of funding for Social Care or Home Care.

The biggest cuts in Goverment spending are front loaded into fiscal year 2011/12 which means that the full impact of cuts is yet to hit. The local Government budget for 2011/12 have not been finalised yet so we have not heard what further pressure there will be on prices.

What concerns us as a service provider that in the rush to reduce costs the quality of care given is being forgotten. Decisions on what to spend and on what are now being taken by back office staff who are purely looking at the costs, front line staff are not being given control.

Central Government talked about wanting decisions on health spending beeing made by front line staff, those that are closest to the patient, but that is not what we are seeing on the ground when it comes to home care.

If service providers are continued to be squeezed on price then there will only be two choices, withdraw the service or cut wages to our staff. Cutting staff wages is not a sustainable business proposition because they are not highly paid in the first place and are suffering high rates of inflation at the moment, especially with regard to fuel which is essential for delivering care in people’s own homes.

It is hard to recruit good quality care staff because of the pay rates in the industry. Those staff that we have do a fantastic job for our clients and we do not want them to leave the industry because of problems brought on by circumstances beyond our control.

We understand that times are tough and that some sacrifices have to be made but just keeping prices the same with the inflation we are suffering at the moment is like a 5% price decrease. The increase in VAT hits home care providers because the services provided are exempt from VAT so no VAT paid on purchases can be reclaimed.

There is a disconnect between central goverment and local government, centrally there is a wish to protect health spending but locally managers are being given tough cost reduction targets so they target some of the big spending areas, which of course includes healthcare costs.

Francis Maude on Question Time said that Local Councils should cut out waste but then much to our dismay said that suppliers should be squeezed. Many Local Government suppliers are small busineses that cannot afford to be squeezed, these small businesses are those same ones that the Government want to be the engine room of the economy. Politicians should think through properly the consequences of what they are saying.

We hope as a business to do all we can to be agile and to help Local Government in the delivery of savings but it is not all about cost.

It is often said that exercise brings health benefits to people of all ages, I can personally attest to feeling good after taking exercise not only does it improve your health but it is a chance for your brain to concentrate on something else, a relief away from the normal routine or pressures of life.

Anyone that has been immobilised, for example, having a leg put in plaster knows what happens to your muscles when you are not using them. The recovery time to get your muscles fully functioning after coming out of plaster can be quite long. Why do we not take exercise and run the risk of our muscles becoming weak? It is a vicious circle as the muscles get weaker we seem less inclined to take exercise.

Our Home Care Agency will always encourage people to stay active and do as much as possible for themselves. Keeping fit, also, helps to avoid trips and falls which are a real problem for people as they get older.

Researchers at Duke University found that exercise serves as a natural antidepressant and other studies suggest it may improve brain function and even protect against dementia. During exercise, the body releases endorphins which are natural opiates and relieve pain. Activity in the brain’s frontal lobes and the hippocampus is also boosted. Levels of serotonin, dopamine and norepinephrine are increased and these neurotransmitters help to improve mood. Exercise also increases levels of brain-delivered neurotrophic factor or BDNF, which not only improves mood but also helps brain cells to last longer.

In fact, a recent study of people suffering from dementia showed daily exercise over a 12-month period improved mental ability by 30 percent. The subjects of the study also showed an improvement in their ability to feed, dress and bathe themselves. This is because activity keeps the body flexible and strong, and also improves balance and spatial control which has been proven to reduce the likelihood of falls. It’s also good for the heart and for blood pressure, both of which have been linked to dementia.

In another study, anxiety symptoms were reduced by 20 percent by adding daily exercise to subjects’ lifestyles. Even light exercise tires the body, which helps with achieving a full night’s sleep and maybe even developing a better sleep routine. One of the most important benefits of exercise is that it’s enjoyable and helps to pass time.

If you are in the position of being a carer yourself do not neglect your own health. Being a carer can be quite stressful and exercise can act as a natural stress reliever. It is even better if can exercise with the person you are caring for because you both improve your moods at the same time. It is important that you do not treat it as competition when you are getting someone to exercise who has not done it for a long time.

When beginning on an exercise regimen, start easy. Don’t push. The point isn’t to train for a marathon, it’s to gradually get the body moving more and increase mental health. What might seem like nothing to you, could be physically taxing for someone else.

There are many ways to include easy and fun exercise in your daily routine:

• Take walks around the garden, your neighbourhood or a shopping centre
• Perform light household chores.
• Participate in water exercises at your local leisure centre for resistance on every part of the body.
• Exercise using light weights, these can be purchased for a small amount or alternatively use objects from around the house.
• Choose a relaxing Tai Chi routine on DVD.
• Go cycling on a nice, easy path.
• Integrate Wii Fit’s several light exercise options into your routine, it is fun way of keeping fit and can be done with others as well.

Doing exercise should not be seen as a chore that has to be done every day. It should be fun and socially interactive.

Precautions Prior to Exercise when Older

If you have not exercised for sometime it is worth taking some precautions before doing any exercise that will exert you more than you are used to.

• Get a check up from the family doctor. Start training gradually and slowly increase physical exercise each day to build stamina and conditioning.
• Warm up. It is important to do plenty of stretching and to warm up properly. Failing to warm up could lead to injuries and be counter-productive.
• Consume liquids. Taking a bottle of water to the gym is important in terms of keeping the body hydrated and flushing toxins. Take regular sips of water during training.
• Focus on form and not the amount of weight lifted. Trying to lift too much can only serve to cause serious injury.

Mike Frizzell www.everycarehants.co.uk

Breast cancer is now the most common cancer in the UK. Just because you are older and maybe having Home Care or are in a Care Home it is never too late to be checking for the signs of breast cancer.

Here are facts from Cancer Research UK:

• In 2007 in the UK almost 45,700 women were diagnosed with breast cancer, that is around 125 women a day.
• 277 men in the UK were diagnosed with breast cancer in 2007.
• Female breast cancer incidence rates have increased by around 50% over the last twenty-five years.
• In the last ten years, female breast cancer incidence rates in the UK have increased by 5%.
• Important to note for older people is that 8 in 10 breast cancers are diagnosed in women aged 50 and over.
• In the UK in 2007/2008 the NHS breast screening programme detected more than 16,000 cases of breast cancer.
• It is estimated that the NHS  breast screening programme saves over 1,000 lives each year.

As with all cancers early detection is paramount in ensuring the best chance of survival from breast cancer. More women are surviving breast cancer than ever before; in the 1970s around 5 out of 10 women survived the disease beyond five years this is now increased to 8 out of 10 and in fact now more than three-quarters of women survive at least 10 years or more.

Modern medicine has brought cancer treatment forward in leaps and bounds with better detection, therapy, research, drugs and symptom management. As an individual you are in the best place to manage the monitoring of your breast because early detection is the best way to be cured.

How do you I check my breasts?

There’s no right or wrong way to check your breasts and you should never feel embarrassed in anyway about looking after your own health. Try to get used to looking at and feeling your breasts regularly. You can do this in the bath or shower, when you use body lotion, or when you get dressed. There’s really no need to change your everyday routine. Just decide what you are comfortable with and what suits you best.

Remember to check all parts of your breast, your armpits and up to your collarbone.

The breast awareness 5-point code

1.      Know what is normal for you, you know your own body best.

2.      Know what changes to look and feel for (see list below).

3.      Look and feel on a regular basis.

4.      Report any changes to your GP without delay, better to be safe than sorry.

5.      Attend routine breast screening if you are aged 50 or over, obtain advice from your GP on the regularity of this. You should insist on more screening if you are at higher risk, see later on what causes breast cancer.

What changes to look and feel for

• A change in size or shape of the breast.
• A change in skin texture such as puckering or dimpling (like the skin of an orange).
• A lump or thickening that feels different to the rest of the tissue in your breast.
• Redness or a rash on the skin and/or around the nipple.
• If your nipple becomes inverted (pulled in) or changes its shape or position.
• A swelling in your armpit or around your collarbone.
• Discharge (liquid) from one or both of your nipples.
• Constant pain in your breast or armpit.

Sometimes your GP may ask you to come for a check outside of your menstrual cycle to rule out any hormonal changes.

Causes of Breast Cancer

• Women with a mother, sister or daughter diagnosed with breast cancer have almost double the risk of being diagnosed with breast cancer themselves.
• Risk increases with the number of first-degree relatives diagnosed with breast cancer, but even so, eight of nine breast cancers occur in women without a family history of breast cancer.
• Obesity increases risk of postmenopausal breast cancer by up to 30%.
• Women currently using hormone replacement therapy (HRT) have a 66% increased risk of breast cancer.
• The risk of breast cancer in current users of oral contraceptives is increased by around a quarter.
• Drinking moderate amounts of alcohol increases the risk of breast cancer – as little as one alcoholic drink per day increases breast cancer risk by around 12%.
• A more active lifestyle reduces breast cancer risk.

In conclusion

As with all things to do with cancer living a healthy lifestyle will always reduce your risks and being aware of changes in your own body will give a greater chance of an early life saving diagnosis.