TrewCare - Live In Care and Home Care agency

Last week we attended a meeting addressed by one of the PCT Commissioners. Whilst the major part of the information was connected with the provision and funding of Continuing Care within Care Homes, we can only hope that the method will role out into the community. It was the very first time, in over thirty years of attending meetings in respect of care funding, that there was a genuine objective on behalf of the PCT to actually pay a price for providing care,  based on the patient’s need assessment and level of care required.

Usually, we are told there is only going to be so much percentage increase, no matter what it costs to actually provide the care.

Really, it felt as if the sun had come out, as the commissioner spoke. For once there was acceptance that there was a cost element to providing good care and that driving down costs ultimately drove down standards.  This was instrumental in providers deciding to give up providing care.

Unlike social care, Continuing Care is funded by the PCT, through the NHS and has been up until now purchased in Cornwall through Adult Social Care. Since October 2007 there has been a new national system put in place, to enable a decision to be made concerning eligibility for NHS funding for long term care outside of the hospital setting. This is not means tested, unlike social care.

Until then each area had its own eligibility criteria, which led to a post code lottery. Having a National Framework should do away with this and allow equity in access to NHS Continuing Care.

The Department of Health has developed a Decision Support Tool which will be used by practitioners when they apply the National Framework for Continuing Care and NHS funded Nursing Care. It is the aim that the Decision Support Tool will be used following an assessment by the multidisciplinary team, of an individual’s care needs.

As practitioners we welcome the implimentation of the Continuing Care criterea and look forward to working with the PCT in the provision of continuing care in the home.

Did you know that from April 2008, any individual or group can have a voice in how our Health and Social care services are provided?

LINK – a local network replaces the Patient and public Involvement Forums (PPIFs) from April. The aim is to give local people more influence on how our services are developed and run.

Members of the public, service users, providers, voluntary organisations and community groups may join.

If you require more information about how to get involved there is a form on the Cornwall PCT web site, go to www.cornwall.nhs.uk to access this.

LINK’s aim is to is to give everyone a voice about their local care services, to check how care services are run and to give feedback concerning their findings.

LINK will have the power to make reports and recommendations about local services and have a say in how these can be improved. They can request information which must be provided within an agreed timescale, also visit services to see exactly what they do.     They also have the power to communicate with the politicians on the Overview and Scrutiny Committee about their findings and expect a reply.

More information can be gleaned via the web site www.dh.uk/patientpublicinvolvement  and access the document ‘Local Involvement Networks explained.

It appears to be chaos within the banking community and stock markets, the dollar and pound falling to the lowest point for years. Prudence, the wonderful word used by our former Chancellor and now Prime Minister, obviously hasn’t been waving her magic wand, leaving all and sundry to pick up the pieces. The price of gold, always a safe haven in times of turbulence, has rocketed. Pity then our gold reserves were depleted by Gordon Brown as Chancellor, he preferred to buy Yen, very Prudent…..

Will it affect us - of course it will. We are seeing a relentless rise in the cost of living, mainly blamed on oil and wheat prices. The rise in the cost of motoring particularly hits us in Cornwall and other rural areas. If you are interested in the debate around fuel prices we recommend you look at Consol Oil’s blog www.consoloils.co.uk/blog which is very interesting and informed.

The delivery of care in the community is reliant on carers driving to the vast majority of their clients. Therefore the rising cost of fuel increases the cost  of delivering care. This impinges not only onto the organisations but to the individual carers and ultimately the clients.

Cornwall County Council has given an increase of only 2.5% this year. The amount they are able to pay out is very dependent on the funding the County Council receive from central government……..which is obviously inadequate to meet the needs of an increasingly older population. The County Council adopted a medium term financial strategy for adult social care giving an overall increase in funding between 2007/8 and 2009/10 of 5.5%. Last April the council decided to raise its eligibility criteria for those in need of care to the two highest levels, which are those of substantial and critical need. This led to less people receiving a service.

Of course people can access their own care and fund it themselves as many people do. However there really needs to be a national debate about accessing care, whether for older people, or those with a disability including children whose parents often struggle to care for them in extremely difficult circumstances, who may be unaware that there are services out there which can help them.

In her excellent article in last November’s Cornwall To-day, the Director of Adult Social Care for Cornwall County Council suggested we should be debating six questions:-

• Whether there should be an entitlement to social care, minimum and maximum, provided by government for those with disabilities, are older or their carers?
• How much should people in receipt of care be expected to pay themselves towards the social care they receive?
• Whether there should be local charge rates or a national level?
• How can people receive all of the welfare benefits they are entitled to?

Carole Tozer considered that without resolving these questions, the rights of vulnerable adults, older people and carers to a fulfilling life would be jeopardised. She also advocated that there is also a need for both improvement and reform of social care to enable people to have maximum choice and control over their own lives

Hello everyone,

This is the very first attempt at writing a ‘blog,’ so  hope you’ll be patient whilst we develop the style.

Last week saw the publishing of the ‘John Lewis list,’  whereby MPs can use taxpayer’s money to furnish their homes. £22,100.00 a year may be claimed for a second home, this can pay for mortgage and living costs. The list contains such things as a recordable DVD at £270, Lamp table £200, Wardrobe £700, Suite of furniture £2000, Install new kitchen £10,000, Install new bathroom £6,335.

This additional costs allowance is available to MPs who live outside central London, in order to cover the costs of either renting a flat or maintaining a second home.

Imagine how angry we feel at the above injustice. Whilst living and working in Cornwall we also had a Care home in another area, travelling backwards and forwards on a regular basis. A tiny cottage was rented near the care home to enable us to leave clothes etc. there and have cooking facilities at less cost than the local B&B.  Even though the administration for the second business took place in Cornwall, we were taxed on both the travel and cottage rental….there must be many others in our position, but obvously not MPs.

Whereas there always appears to be finances available for those involved in the government process, when it comes to services for older people money is always pitifully restricted.

It was sad to see the spectacle of Jack Tagg, a war veteran of 88, being denied treatment for age-related macular degeneration. This remarkable gentleman together with his supportive G.P. bravely took a petition to the Prime Minister to highlight the failure of the NHS to provide medical care for older people. What advantage is there to let older people loose their sight? Surely it is more cost effective to provide the treatment than to commit to providing social care for the longer term.

You really have to ask why are older people discriminated against when it comes to accessing treatment in the NHS. Jack Tagg’s story is the tip of the iceburg, there are thousands more ready to be told. Thankfully Jack had a positive outcome, with the provision of his treatment being finally funded by the NHS…….why was that only available after the visit to 10 Downing Street? Is that the only way older people can access the care they need?

Can you imagine buses full of Alzheimer’s sufferers all lined up outside No 10 to highlight the fact that they cannot access the drugs they need to slow down the onset of the disease?