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Social care funding can’t take any more setbacks. It needs reform now : The Guardian


The UK is approaching a perfect storm with an ageing population and many people unprepared for the future

Former Liberal Democrat cabinet minister Ed Davey (centre) and campaigners protest against Theresa May’s social care policy during the 2017 general election campaign. Photograph: Justin Tallis/AFP/Getty Images

For a short while, it seemed like the issue of social care funding would finally be addressed after years of government procrastination. The Conservatives promised a consultation on social care reformU-turned on the so-called dementia tax and, instead, confirmed their intention to cap the amount people pay towards care.

But now that plans to introduce such a cap have been scrapped and the social care consultation is rumoured to have been delayed until next summer, it seems that the government has followed previous administrations and kicked social care funding into the long grass.

Such a decision is worrying and flies in the face of public opinion. A cap on care costs will increase the fairness of social care, so it’s risky to turn our backs on this idea without an alternative plan in place. There are too many vulnerable older people at risk.

Following an election campaign full of confusing messages about social care, Anchor, England’s largest not-for-profit provider of care and housing for older people, conducted a public poll to gather insight into people’s understanding. Our research found that 70% of British adults believe there should be a cap on social care costs, while almost half believe that social care – including dementia care – should always be paid for by the state.

Sir Andrew Dilnot, who first proposed a cap on social care, has cautioned that plans to abandon it could cause a “catastrophic risk” of poverty in older age. And councils have warned that they cannot afford to pay for all those in need of state-funded care if the dementia tax is introduced, putting many providers at risk of going out of business.

The question of how we fund social care remains unanswered, and the most recent suggestions fail to get to the crux of the issue.

Jackie Doyle-Price, the social care minister, suggested that older people should sell their homes to fund their care. But this doesn’t take the full picture into account. There is a perception that all or most older people are well-off and own their own home – this isn’t the case. For those older people who are home owners and are, to quote the minister, “sitting in homes too big for their needs”, we know that two thirds would like to downsize but can’t due to a lack of suitable options.

Again, this comes down to a lack of funding and supportive policies, despite the fact that more retirement housing could save £14.5bn to the public purse over 50 years.

Whichever direction the future of social care funding is heading, and whether a cap is introduced or not, the government must be open and honest about how social care will be paid for so that everyone can plan for the best possible life in older age. At present, this is far from the case.

More than a fifth of people wrongly believe the state pays entirely for care needs in later life, and more than half underestimate social care costs by up to 20%. Considering these misconceptions, it’s no wonder that just 14% of us are currently saving for our care in later life.

We’re approaching a perfect storm where the future of social care funding is unclear, the population is getting older, and most of us are unprepared for the future. We need a transparent and sustainable long-term strategy that integrates social care, health and housing. Recognising, and acting on this, is our only option.

  • Jane Ashcroft is chief executive of Anchor

Source: Social care funding can’t take any more setbacks. It needs reform now : The Guardian

Sanctioned for not being able to sign on on bank holiday Monday. Tears, frustration and rain.


The poor side of life

Today’s demo started rather hurriedly and to be honest I didn’t know if I was coming or going. This feeling was amplified because it was cold, rainy and my daughter was a bit fed up. understandable of course. But she soon settled down into our usual routine and all was well.

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We are seeing a lot of new faces due to Stalybridge Jobcentre shutting. They don’t know us and what we are doing, and we don’t know them or their situations either. So we have to start from scratch, which at times isn’t easy.  But it’s a whole lot harder for them.

I started a conversation with a man who had been previously attending Stalybridge Jobcentre for his appointments. The first thing that he said to me was that he couldn’t believe how rude the front desk staff are at  Ashton Jobcentre, and how rude some of the advisors are also…

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Social? Care? Those are words the Tories hate – of course they have abdicated responsibility for it | Vox Political


In a Conservative Britain, the catchphrase is “Everyone for themselves” – so we should all understand perfectly well why they couldn’t give a flying fig for social care. The…

Source: Social? Care? Those are words the Tories hate – of course they have abdicated responsibility for it | Vox Political

Top Ten Tips for Newly Diagnosed Families


Original  post from Autism Speaks

‘…………..This is a post by Autism Response Team Senior Coordinator Jodi Miller.

Your child has autism.  Now what? You’re part of a new family, a group of people you never planned to be a part of, a life you never planned for yourself, your family or your child.  Your mind is swarming with questions. Who? What? When? Where? How? Why?

Though you never dreamed of or planned for this, things do get easier. Life will be good – it will just be different. You will celebrate this different life and revel in all of your child’s achievements.

It won’t be easy. It takes hard work and patience. Luckily, you aren’t alone on this journey.  There are people, resources and organizations to help, but you will need a roadmap.

1. Get organized

Receiving an autism diagnosis can be overwhelming. Not knowing where to begin or how to move forward is difficult. Get organized. Focus and simplify. Buy a 3-ring binder, dividers and paper. Create sections organizing information (i.e. contacts, schedules, diagnosis, etc.). Tips and forms are available in the Autism Speaks 100 Day Kit.

2. Become a research guru

Learning about autism and treatment options will empower you to make decisions. Read, go online and see what others are doing. Contact hospitals, universities and organizations learning about research studies. Your involvement helps you and professionals understand autism. Resource providers like doctors and therapists are in the Autism Speaks Resource Guide. Tool Kits cover a variety of topics ranging from pre-diagnosis through adulthood. Our Family Services Community Connections newsletter covers many topics. Find information and other resources in Autism Speaks’ Resource Library. Research opportunities and information are also available at the Autism Speaks website.

3. Evaluate your child’s strengths and needs

You know your child best. Your input helps determine therapies and treatments. Evaluate your child’s strengths and deficits. Just like any individual, children with autism are unique. It is sometimes said that if you know one person with autism, you know one person with autism. People with autism have a variety of difficulties; they also have unique abilities and areas of strength. Identify strengths and hone in on them helping your child feel proud of their achievements. This provides motivation and support to learn and excel in other areas. Check out a list of autism characteristics and unique abilities in the Autism Speaks 100 Day Kit.

4. Understand insurance/insurance reform laws/waivers

Insurance plans, laws and state waivers are confusing. Treatment options for autism aren’t consistently covered by health insurance. Currently, 38 states have passed autism insurance reform laws requiring certain policies cover autism treatments although some aren’t subject to these laws. The Autism Speaks Advocacy link has information about state and federal laws. Use the insurance interactive tool to learn more about what your plan covers and check out tips and strategies to improve your company’s insurance coverage. The Autism Response Team has information and resources helping you contact your state’s waiver program to learn more about the services in your area.

5. Assemble your team

A team of people including yourself can help you make decisions about your child’s medical care, therapies, treatments and education. Your team will consist of medical professionals, behavioral, speech, occupational and physical therapists depending on your child’s needs. Tips for interviewing and screening your team are in the Autism Speaks 100 Day Kit. The Autism Speaks Resource Guide lists service providers and can be searched at a local level to find providers that are nearest to you.

6. Know your child’s rights

You are your child’s best advocate. Learn the laws regarding your child’s educational rights and types of school environments. Learn about federal and state laws and how to write appropriate educational goals for your child. Know how to seek legal help if necessary. Tool kits focusing on the IEP process, working with the school community and learning how to advocate are available through Autism Speaks.

7. Communicate and connect with your child through therapies and play

Find activities that your child enjoys. Adapted activities make your child successful. Many communities have adapted recreational activities like “buddy baseball”, “hippo therapy”, and sensory friendly theatre events. Planning activities your family enjoys helps you bond. TheAutism Speaks Resource Guide has information about community and recreational opportunities. There are several issues of Community Connections focusing on this topic.

8. Care for the caregiver

This is an important one! Parents must learn to take a break. Everyone needs refreshing and recharging. You deserve it and shouldn’t feel guilty doing so. You will be stronger and healthier and benefit your entire family. Spend quality alone time with other members of your family. Find respite care providers in the Autism Speaks Resource Guide and read ourRespite Care and Autism issue of Community Connections.

9. Network with other parents/professionals

Connect with parents and professionals that have walked this journey. They know what works and doesn’t and can make recommendations about service providers and therapies. Join a support group and share with others. Support groups are available in the Autism Speaks Resource Guide.

10. Know how to ask for help

Know how to ask friends and family for help and don’t be afraid to do so. Your friends and family want to help but may be hesitant for lack of knowledge. The family and friends support tool kits helps get them on board. Teaching others about your child and autism helps you feel comfortable and accepted and allows your loved ones to help.

Largest ever privatisation deal for the NHS agreed – more Tory corruption. (#UK #Politics #Health #NHS)


Order Of Truth

privnhsWe have exposed the government and their greedy self-serving tactics time and time again, and now one of the biggest and most obvious abuses of their power has taken place through the largest privatisation deal for the NHS yet.

After making the NHS impossible to operate through their meddling the government have initiated the privatisation of surgery, x-rays, and other diagnostic tests through the back door.

Using a little known about body called ‘NHS Supply Chain’, a highly lucrative £780 million deal has been struck with eleven companies, three of them having previously been heavily criticised, including two by the NHS regulator, for providing poor quality of care in hospitals and care homes.

The total value of the privatisation is made up of five national contracts with a maximum value of £240m, £160m, £240m, £80m and £60m – adding up to a total of £780m.

The companies include several that…

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What’s behind the A&E ‘crisis’?


Press release from Nuffield Trust                                              The Report  What’s behind the A&E ‘crisis’?

‘…‘Disproportionate’ emphasis on A&E target not in patients’ interest, say Nuffield Trust

06 March 2015

A briefing examining the real reasons behind England’s A&E ‘crisis’ has warned that the emphasis on the totemic target of deciding on whether to admit patients within four hours has become disproportionate. It argues that new approaches to performance management, with other measures given equal status to the four-hour target, should be adopted.

England’s A&E system is near crisis. With the financial squeeze set to continue, there is no relief in sight if we keep up the current approach. We need to rethink our assumptions as many of the ‘magic bullet’ solutions suggested miss the point. It’s not about more people turning up, but about a system with a squeeze on hospital space and staff, which needs to get better at discharging people safely and on time.

Nigel Edwards, Nuffield Trust Chief Executive and report author

In the briefing aimed at political leaders as the General Election approaches, the Nuffield Trust think tank says that measuring the performance of A&E departments is essential. But how we react to changes against the four-hour target can distort behaviours inside hospitals in ways that are not in the interests of patients or staff. This, the think tank says, can mean that significant amount of staff time is spent reporting upwards to commissioners and regulators, with potentially detrimental impacts on the quality of care.

The briefing argues that policymakers should instead take a longer-term and broader view of performance in A&E, which may involve relegating the four-hour target to sit alongside a richer set of indicators. These could include the number of people leaving A&E without being seen or how long people wait on trolleys after the decision to admit them to hospital. Such an approach was announced by the then urgent care tsar Matthew Cooke in 2010 but has not been realised.

‘What’s behind the A&E “crisis”?’ describes how emergency departments are near “breaking point”. It presents data showing that major A&Es have not met the four-hour target (that 95 percent of patients should be admitted to hospital or sent home within four hours of arrival) since 2013; the number of patients waiting on trolleys for over four hours has almost trebled since 2010/11; and the numbers of delayed ambulance handovers have risen by 70 per cent over the same period. Yet other measures, such as waiting times to treatment and re-attendances within seven days have changed little.

The authors argue that the cause of the pressures has been misunderstood, with too much focus on the 2004 GP contract, NHS 111 and the gradual increase in numbers of people attending emergency departments. They show that long-term trends and immediate causes are often confused, suggesting that the recent problems are driven by an inability to discharge hospital in-patients quickly and safely enough to keep A&E patients flowing through hospitals.

Nigel Edwards, Chief Executive at the Nuffield Trust, said:

“England’s A&E system is near crisis. With the financial squeeze set to continue, there is no relief in sight if we keep up the current approach. We need to rethink our assumptions as many of the ‘magic bullet’ solutions suggested miss the point. It’s not about more people turning up, but about a system with a squeeze on hospital space and staff, which needs to get better at discharging people safely and on time. That doesn’t negate the need to for bold strategic re-design to ensure the urgent care system is fit for the long-term.

“The four hour target has come to loom over every other measure of how well patients with urgent needs are being cared for. Nobody denies that it really matters to people. But there are a lot of other things that matter in emergency healthcare. Politicians and regulators need to stop micro-managing this target and should instead examine how to put the four-hour target on an equal footing with other critical indicators like trolley waits or time to treatment. This could be achieved by introducing clustered randomised controlled trials of such indicators in some areas.” 

Commenting on the briefing, Professor Matthew Cooke, former urgent care tsar said:
“I wholeheartedly agree with the Nuffield Trust that overfocus on the four-hour target does not improve emergency care and may lead to perverse actions to hit the target whilst missing the point. The wider set of indicators I introduced when I was National Clinical Director were aimed to prevent this over focus and create a balanced set of quality measures. But the intense performance management of the four hour target has negated the impact of the balanced set of measures. Concentrating on the whole system and measuring quality across that whole system is, in my opinion, the way forward.” ….’

‘Social workers’ caseloads should be managed to provide more time for assessments under Care Act’


Original post from Community Care

‘…..Practitioners need to understand more about the person and their community to implement the strengths-based approach to assessment envisaged by legislation, says guide

Picture credit: Burger/Phanie/Rex Features

Picture credit: Burger/Phanie/Rex Features

Social workers’ caseloads should be managed to give them the time to adopt a “strengths-based approach” to assessing people’s needs under the Care Act 2014.

Practitioners should be given more time to prepare for assessments and to research community resources to enable them to put a strengths-based approach into practice from 1 April, when the act comes into force.

What is a strengths-based approach?

That was one of the key messages from a guide to strengths-based approaches to assessment published by the Social Care Institute for Excellence this week as part of its government-funded programme of work to support Care Act implementation.

The guide defines a strengths-based approach as one that takes into account how the person’s capabilities, knowledge, social network and community resources can help them meet their care and support needs and desired outcomes.

This is enshrined into the act’s provisions on assessing adults and carers, under sections 9 and 10, which require assessors to consider how community resources and matters other than care and support can help the person achieve their desired outcomes. The statutory guidance under the act stresses that this involves taking into account the person’s strengths.

What makes a good assessment?

The Scie guide says that a good strengths-based assessment involves thorough preparation, building trust with people, a recognition that it will take more than one session to conclude the assessment and a knowledge and awareness of community resources with which to connect people.

It says this requires social workers to get to know the resources in the communities in which they work, meaning that managers should

Managers will need to make changes to working practices, including workloads, to accommodate a strengths-based approach, to allow for the fact that assessments may take longer.

“Practitioners must prepare assessments thoroughly,” it says. “Time for preparation of assessment should be taken into account for performance purposes and definition of workloads.”

Social workers will need to get to know the resources in the communities in which they work, meaning that managers should also give practitioners more time to build up knowledge and awareness of community resources.

Freeing up time

This means management will have to look at ways of freeing up time for practitioners to invest in strengths-based approaches. The guide suggests the following:-

  • encouraging people to undertake supported self-assessments of their own needs, as allowed by the Care Act 2014, though in such cases the local authority must assure itself of the accuracy of the assessment;
  • using third party organisations to provide “trusted assessors” to carry out assessments instead of in-house social workers;
  • streamlining processes, for instance by removing the need for assessments to be always signed off by panels or managers.

Increase in volume of assessments

However, local authorities also face a significant increase in the volume of assessments they will be required to carry out in 2015-16 and 2016-17.

Councils are expected to have to undertake an additional 250,000 carers’ assessments in 2015-16 because of the reduced threshold for an assessment introduced by the act. In 2016-17, they are expected to have to undertake an additional 330,000 assessments of self-funders looking to qualify for council-funded support under either the  cap on care costs or the more generous means-test for residential care that will be introduced from April 2016. The government is allowing councils to start assessing this group from October 2015 to manage pressures.

While central government has provided funding to meet these additional costs, there are concerns over whether the funding will be sufficient. Any shortfall could undermine local authorities’ ability to invest in allowing social workers to conduct more strengths-based assessments.

SU4SW_LOGO-180px

This article is part of Community Care’s campaign to Stand up for Social Work. We’re standing up for social work by beinghonest, offering support and providing inspiration. You can stand up for social work by:

State of Sheffield


State of Sheffield 2014 –Executive Summary

An extract

‘ …………….This report summarises a study of the views and experiences of parents of children and young people (aged 0-25 years) with disabilities and/or additional needs in Sheffield. It makes recommendations to commissioners and providers of education, health and social care services.  ………….’

State of Sheffield 2013 – Consulation Report

An extract

‘ …………1. Background

This report summarises work carried out by the Sheffield Parent Carer Forum in April/May 2013 as commissioned by Sheffield City Council. It forms part of a needs analysis in relation to the support requirements of families with disabled children in Sheffield. Sheffield City Council will use the information gathered to decide whether current information, advice and support services for parent carers are meeting local need, or whether different or additional services are required. ………….’

Let’s start promoting wellbeing, not just treating illness


Original post from The Health Foundation

An extract

‘………The NHS Five Year Forward View promises unprecedented opportunities for the ways in which people with long-term health needs are enabled to live well, in the ways which matter to them. It calls for a ‘more engaged relationship with patients, carers and citizens so that we can promote wellbeing and prevent ill-health’.

This is a fundamental shift from treating illness to promoting wellbeing. To be successful, we must make use of collaborative approaches.

For most of us, contact with formal health services is only a tiny fraction of our lives. Indeed, the bulk of our care comes from informal sources such as our spouses, children and other unpaid carers.

But wellbeing is so much more than health. Wellbeing starts with us, our communities and the daily opportunities, challenges and habits which shape the bigger picture of our lives.

How then can the Forward View’s dual ambitions of more engaged relationships and promoting wellbeing be achieved? Three broad approaches may offer a good start…  …………’

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