CARE HOMES OF THE FUTURE IN BRITAIN

ELDERLY NHS CARE HOMES OF THE FUTURE
A more seemless NEW integrated role for the National Health Service in the United Kigdom

The Revolution in Social Care during the next Decade of the 21st century
" From the Cradle to the Grave " ( NHS 1946 )

" Care Home Workers are the salt of the Earth. Hospice Workers are too. It is a National Disgrace that they have to relie on Charitable Donations to survive. The British Government should contribute more to these sectors before they estimate how much money they can put into the Overeas Aid Budget."  Raymond Williams MA MPhil MBA DIPM

PATHWAY TO THE FUTURE OF SOCIAL CARE IN BRITAIN

Thia article embrasses Private and Public Care Homes, Nursing Homes, Hospices, Mental Health Care Facilities.

The Pathway Objectives are to escape from a ' Swamp of Indifference and Inadequate Funding'  and to Create a new innovative role for the NHS in Britain, with adequat Funding from the Goverment for the benefit of the Elderly. How this can be funded is suggested later in this Article.

FACTS

Total of 1.2 Million people work in the Social Care sector in England

610,000 Care Workers visit Patients in their homes

150,000 Care Workers operate in care Homes, Nursing Homes and Hospices 

( 2018 official statistics )

It is well overdue that the Government should take steps to create a network of NHS CARE HOMES.

How can this be done ?

Select the best existing Care Homes throughout the United Kingdom.
Nationalise them. Turn them into Registered NHS Care Homes.
Employ current owners on a one year contract to be reviewed annually.
An NHS qualified Nurse should be assigned to each NHS Care Home where necessary.
All Carers must study part time for a new CERTIFICATE OF CARE. 
This will be a simple curriculum of How to care for the Elderly.
Yes, they will get a Certificate and an NHS badge off honour. They will be known as..
Registered NHS Carers.

Every NHS Care home will be inspected nore thougherly according to new guidelines every 6 months. If all is well, a Certificate of Compliance will be issued. No Care Home can operate without this Certificate of Compliance. These care Homes Reviews will be more indepth than at present.
The funding for this Plan will be an extra injection of funds from the Government - see later for Sources of Funds.
A new extra tax will be applied called NHS SECURITY TAX will be introduced to help cover future funding of the NHS Care Homes. The NHS will be funded as at present.

SUMMARY Of 10 POINT NATIONAL ACTION PLAN

1 - Existing good Care Homes to be Nationalised

2 - Create a network of NHS Care Homes.

3 - Each Care home to have at least one NHS Registered Nurse if justified

4 - Each new Care Home will be vetted every 6 months by a Government appointed oficial Inspector

5 - Care Patients should give feedback to Inpector every 6 months as part of Review.

6 - Funding from a new NHS Security Tax and Government grants and Inheritance Tax.

7 - Each New Care Home to be Registered and vetted every 6 months.

8 - Carers must be qualified by new CERTIFICATE OF CARE. Part time course. Paid by Department of Education. Spread over 3 months online wherever possible or by correspondance.

9 - Salaries of Registered Carers to be increased in Year 1 by 50% with Annual Reviews

10 - A NEW NATIONAL QUANGO- " NHS CARE HOME COUNCIL" to be established with is Minister of Elderly Health appointed by the Government.


NOTE

No Elderly person should pay around £50,000 per annum towards care.
No Elderly person should have to sell their home to pay for care.
In future Inheritance Tax should be reduced to 20% and this should be used to pay for Care in old age. Currently, the Government takes ( more than £5.2bn 2018 an increase of 8% from the previous year  ) from the Estates of the Elderly. The average bill is more than £179,000 ( 2016 ). It is substanitally more by 2020. So, the Elderly are eventually paying for their Care so they many should not be paying ££50,000 per annum as well.
Due to their Compamy Pension schemes, many Pensioners are still paying tax in their 80s.
Many have paid and are still paying tax after 60 years.

SOME DUTIES OF CARERS

Help patients dress and undress
Help them in and out of bed
Wash them
Bath them
Wash hair
Help them down stairs
Help to feed them
Clear up mess
Monitor medication
Complete paperwork
Clean up vormit
Deal with Family grief
Check patients are breathing
Work unsociable hours
Attend staff briefings
Travel at own expense
Little or no protective clothing

PRESENT INCOME LEVELS OF CARE WORKERS

The average hourly pay for a Care Worker in United Kingdom is £8.19.
10%
£7.20
MEDIAN
£8.19
90%
£9.83

What is the the range of Annual Range of Care Home Workers ?
Total Pay
£14,894 - £21,000

Recently, The Mayor of New York suggested that Frontline Workers should be paid
 "  Hazard Pay. " in recognition of the dangerous work they do which is essential for the Community.
He said that they should also get a 50% bonus once the Covid 19 crisis is over.
I agree with him. They deserve it !

OFFICIAL DEFINITION  OF A CARE WORKER

" What Do Care Workers Do?
A career as a care worker offers countless opportunities to work with children, disabled adults, and elderly people. Care workers care for people in a variety of settings, including residential homes, clinics, hospitals, and nursing homes. They often work on a team with other health care professionals, such as registered nurses and social workers, to care for patients and support their individual needs. Some patients may require around-the-clock care, so care workers may work first or Second shift."

ROOM FOR IMPROVEMENT

Not all our Care Homes are bad. Many are exemplary in their high standards of care and the hard work of Carers who show patients kindness, encouragement and carry out hygene tasks that most of us would not like to do. They are wonderful, dedicated people and very under paid.
However, at present there are criticisms about some care homes.

THE CQC - CARE QUALITY COMMISION

The CQC regularly check care Homes. The fundamental ingredients of each visit check includes the following....

" The fundamental standards are the standards below which your care must never fall.

Everybody has the right to expect the following standards.....

Patient Needs
You must have care or treatment that is tailored to you and meets your needs and preferences.

Dignity and respect
You must be treated with dignity and respect at all times while you're receiving care and treatment.

This includes making sure:

You have privacy when you need and want it.
Everybody is treated as equals.
You're given any support you need to help you remain independent and involved in your local community.
Consent

Consent
You (or anybody legally acting on your behalf) must give your consent before any care or treatment is given to you

Safety
You must not be given unsafe care or treatment or be put at risk of harm that could be avoided.

Providers must assess the risks to your health and safety during any care or treatment and make sure their staff have the qualifications, competence, skills and experience to keep you safe.

Safeguarding from abuse

Safeguarding from abuse
You must not suffer any form of abuse or improper treatment while receiving care.

This includes:

Neglect
Degrading treatment
Unnecessary or disproportionate restraint
Inappropriate limits on your freedom.
Food and drink

Food and drink
You must have enough to eat and drink to keep you in good health while you receive care and treatment.

Premises and equipment

Premises and equipment
The places where you receive care and treatment and the equipment used in it must be clean, suitable and looked after properly.

The equipment used in your care and treatment must also be secure and used properly.

Complaints "

The CQC do a good job. Here is my List that should be observed in each visit of a CQC Inspection visit -

EUEKYS CHECK LIST

1 - Managemnt Leadership

2 - Attitudes of Management

4 - Communications with Patients

5 - House Keeping cleanliness

6 - Acitivities for Patients

7 - Entertainment for Patients

8 - Exercise for Patients

9 - Food Hygene kitchen

10 - Patient rooms hygene

11 - Delivery and Supply of medicines

12 - Open spce facilities / garden

13 - Outings for Patients

14 - Review of Complaints and Suggestions

15 - Financial Monthly accounts

16 - Insurance Covers

17 - Personal Protective Clothing - PCC

18 - Staff feedback

19 - Furniture fit for purpose

20 - Heating Programme

21 - Lighting Ambience

22 - Emergency exits

23 - Patient emergency bedroom buttons / cord pulls

24 - Regularily of visits to the Care Home by Doctors or medical staff

25 - Annual Accounts Review

26 - Information display Boards

Of course any Check List such as above must contain Definition Guidlines of each of these areas of investigation.

Frequentcy of visit by the Inpectors should be every 3 months for visits 1 2 3 and a Final visit 4 at the end of the Financial Year when a full Review should be taken.


This Check List needs to be compared with the CQC Check List to see if the CQC Inspectors evaluation of the Care Home are as in depth as it should be.
In the past Abuse, Crualty, Poor Standards have gone unnoticed. How can this be if the Checks are thoughly made by the Inspectorate ?

THE NATIONAL CARE ASSOCIATION

The NCA represent the Independant Care sector in the UK. They play a very importanat role with Information and Reccomendations to carers and Care Homes about subjects like Best Care Practice and many other support areas via their National network of Voluneers.
Nadia Ahmed OBE is the Chair and she is backed by a dedicated team of people. Nadia Ahmed has been the Chair since 2011and she has some 35 years experience in the Social Care sector. A brilliant and caring woman facing a very difficult task In Britain Today.

The primary aims of National Care Association are to:
Lobby Government to benefit both members and the people they support, whether in their own homes or in residential or nursing care settings
Promote and develop the highest standards of care
Support individual members and local associations with the challenges they face with information, advice and guidance
Represent all care providers at local and national level in response to government consultations and on appointed local and national government bodies

One of the key areas that they have stressed from their research activity is the absolute imprtance of good Leadership and Management withiin Care Homes. I agree with their reserch findings 100%.
In spite of their excellent work, there is still a lot of improvement needed in many of our Care Homes In Britain Today. I hope that many more Care Homes will implement the good advice provided by the NCA.  In a recent research study the NCA asked inter alia, 3 key questions of Care Home providers.....

Are you worried about your Financial stabiity ?
65% said YES

Are you going to increase your Fees ?
YES most replied

By what % ?
2%-4% per annum

Are you listening to the NCA Government ? 

CRITICISMS OF SOME CARE HOMES

Regulation needs to be improved
Present professional development needs improvement
No regular feedback from patients
No regular check on food hygene
Squalid sized bedrooms
Lack of privacy
Negelect of some patients
Abuse
Staff treated like dirt
Staff poorly paid
Staff turnover high
Unsocial working hours
Basic food and poor variety
Poor staff management
Lack of open spaces
Poor dismal lighting
Inadaquate heating in winter
Communal bathrooms
Minimum entertainment
Lack of protective clothing for staff

The Care Home Professional Association said :  " One in Four of English Care Homes have been rated Inadequatee or needing improvement. "
This is quite an appauling statistic !

The Care Providers Alliance is another organisation thatis in the vanguard of ensuring that the needs of Elderly care is promoted at the highest level. The problem is......There is a lack of Government Department actions to remedy some of the growing problems in the Elderly Care sector. Lack of funding since the Financial Crash of 2008 and the Austerity recovery programme has put Elderly care at the bottom of the priority list of Government. It is time to reverse this and put Elderly Care at the top of the List.

What I find most disturbing is that we have some wonerful Organisations in Britain supported by thousands of wonderful Voluneers dedicated to Elderly care but still, as this Article shows, there is a massive hill to climb to provide decent suitable, well funded care in Britain today for the Elderly.

This above List is a general check list which should be used for the future scrutiny of Care Homes.
It does not apply to many of todays Care Homes.
I suggest a new rating structure in the future similar to the star ratings for hotels and guest houses.

 Foe example, a C Ratings. Effectives of care.

CCCCC - Excellent
CCCC - Very Good
CC -  Good
C - Need to improve

Now, many readers will say - " We are alreday doing this ? "
I say " You need to do better."

Does anyone remember QE ? QuantatativeEasing !
The Government created £400 Billions to support the Banks during the 2008 Financial crisis.
They can do it again to support the new NHS Care Homes structure.

IT CAN BE DONE IF THE WILL AND CREATIVITY IS THERE
After WW2 many people said.....
" It is impossible to create an NHS."
Welsman BEVAN proved that it CAN BE DONE.

Remember the clarion call from the newly formed NHS ?
It was " Free Healthcare for all from the cradle to the grave."  What went wrong ?


WHAT ABOUT IT BORIS IN 2023 ?

You can create this Revolution in Social Care for millions of the Elerly in Britain which is long overdue. As the Covid 19 episode has shown - Money can be created for vital projects if the Will of Government is there.
This third Decade of the 21st Century can be a great reforming period for Britain.
So, please make it happen in spite of the inevitable critics and doomongers !