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Elderly failed by broken care system

Reports reveal multiple failings

Jo Carlowe

Thursday, 17 November 2016

Older people and those with dementia are suffering due to a broken care system.

Two reports published this week, one from Alzheimer’s Society and one from Age UK find failings with the system. 

The Age UK analysis shows the number of people in England who do not get the social care they need has soared to a new high of 1.2 million — up by 48% since 2010.

According to the charity nearly one in eight old people are struggling without help to carry our essential everyday tasks, such as getting out of bed, going to the toilet, washing and getting dressed. Among those affected, 696,500 older people do not receive any help at all, while a further 487,400 receive some but not enough help.

Caroline Abrahams, Charity Director at Age UK said: “It is shameful that more than one in every eight older people in this country are now living with some level of unmet need for care, and we are extremely worried about the quarter of a million older people with multiple unmet care needs, struggling alone: how many of them are constantly in and out of hospital because they are unable to cope at home?

“The sad irony is that it would be far more cost effective, as well as infinitely more humane, to give these older people the care and support they need. All this adds up to a compelling case for giving social care the priority it deserves in the Government’s forthcoming Autumn Statement. It is high time the Government acts.”

Meanwhile, in a separate investigation the Alzheimer’s Society reports that only 2% of people affected by dementia say their homecare workers have enough training.  

As a result, poor quality care has seen many people with dementia left in soiled clothing, going without food or water, or ending up in costly hospital or care home admissions when they could have stayed at home, where they want to be, for longer.

The Alzheimer’s Society has launched a petition asking the government to “fix a broken homecare system” as part of its Fix Dementia Care campaign. The petition calls for funding for training to counteract years of cuts to social care budgets and to ensure the workforce have the skills to provide dementia care that’s needed.

Jeremy Hughes, Chief Executive of Alzheimer’s Society said: “Care scandals in hospitals and care homes have been well-publicised, yet unacceptable homecare practices are widespread and happen behind closed doors, hidden from public scrutiny.

“There is simply not enough money invested in the social care system. Homecare workers are crying out for more dementia training - without it their hands are tied behind their backs. From the scandals we have exposed, it is clear they are not fairly or adequately equipped with the skills they need to support vulnerable people with complex needs. We need the Government to support empowered and well-trained homecare workers who can transform dementia care in this country, allowing people to live independently and in their own homes for longer.”

Commenting, Dawne Garrett, Royal College of Nursing Professional Lead for Care of Older People and Dementia, said: “It’s unacceptable that so many care workers have not had any training in this area. People living with dementia require sophisticated care and this lack of training could mean they do not receive the high level of care they need and deserve.”

She added: “Building a fully-trained home care workforce would free up space in hospital for those who really need to be there. The Alzheimer’s Society’s Fix Dementia Care campaign illustrates how vital it is that the Government tackles this situation.”

The investigation involved a survey of homecare workers with Unison, research into the sector with Skills for Care, Freedom of Information (FOI) requests to all local authorities in England, and a survey of over 1,220 people affected by dementia, to gather first-hand testimonies about homecare.

According to the Alzheimer’s Society, while over 400,000 people with dementia are believed to receive homecare, more than one in three (38%) homecare workers have no dementia training and the majority (71%) do not receive dementia training that is accredited.

Some 43% of homecare workers have asked for further dementia training, yet more than half (54%) of those cases were turned down. 86% of homecare workers agreed that further dementia training would help them to provide better care for people with dementia.  

Key findings from the survey revealed:

  • Only 2% of people affected by dementia say homecare workers “have enough dementia training”.
  • Half (49%) of people affected by dementia do not think that “homecare workers understand the specific needs of people with dementia”.
  • More than a third (38%) of people affected by dementia do not think that homecare workers know how to treat people with dementia with understanding and dignity.

The Alzheimer’s Society learned of a multitude of failures that could have been avoided with sufficient training. These included instances where people with dementia were not provided with food or water, not properly supported to eat and not assisted in choosing meals, not given a bath or shower for weeks and left in dirty clothes for days, left to sleep in wet or soiled bed sheets, spoken down to, asked confusing questions, or not spoken to at all. In addition, there were cases of people reported missing with police, after the homecare worker had left the home not properly secured. Cases of dementia patients not given their medication, or had their medication mixed up or thrown away. Other cases involved patients left with an infection which was not identified causing avoidable emergency hospital admissions. 

Some patients were forced to move to care homes because the homecare workers could not cope with their needs. 

The FOI requests revealed that 71% of local authorities that responded, do not include an allocation for training within their contracts for homecare, and 38% do not fund dementia specific training sessions for homecare providers.

Alzheimer’s Society is calling on the Government to fund a dementia training pathway for homecare workers, for stricter minimum standards of dementia training and for closer inspection of care providers.

The Department of Health has said steps are being taken to improve care, with a £5 billion pot of money set aside to encourage joint work between the NHS and care sector, an additional £1.5 billion being added by 2019, and permission for councils to raise council tax by 2% to invest in care services. 

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