Tag Archives: budgets

More work needed to raise social care standards

While the Care Quality Commission has tried its best to get a positive spin on the findings in its review of adult social care services  published today, as ever, most people and the media have focused on the negative aspects of it. And they’re right to.

Despite the overall quality of services improving in the past year in all areas, there is still a significant minority of ‘poor’ and ‘adequate’ services being provided to adults and especially older people.

Poor services are always unacceptable and need to be rooted out or given help to improve. Reports like these highlight them, but it means nothing if it doesn’t help to bring about change.

To this end, the CQC’s chief executive, Dame Cynthia Bower, said the CQC is determined to raise standards, hence why 8 councils have been designated as ‘priority for improvement’ councils and another 16 are to have an in-depth inspection of their services.

Elsewhere, the new registration system for adult social care providers, NHS providers and independent healthcare will have a single set of safety and quality standards. Also, the CQC is to get tougher powers and will be able to respond to concerns more quickly.

But local councils also have a role to play in improving services, especially commissioners; they need to look at the services they are purchasing and, if they are failing, move elsewhere. Obvious perhaps, but still needs to be said because it seems some commissioners don’t do this.

Unfortunately, this may be easier said than done. While eligibility criteria for receiving social care remained largely constant in the past year, after the previous 2 years when the number of councils providing care for ‘moderate’ or ‘low’ needs fell markedly, the spectre of eligibility levels being raised again in the coming years because of dwindling budgets looms large.

With budgets being squeezed, commissioners may feel under pressure to look at the cost of services rather than the quality. By the same token, service providers may also be under financial pressure and be looking to make cutbacks, which could affect the quality of their services.

So, in essence, the CQC’s reports are positive – let’s not forget standards are improving – but they show how much work still needs to be done. But by acknowledging this, and laying out strategies to help, the next report should be more positive still. As long as budget considerations don’t impact too much, that is.

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Filed under adult social care, Social care funding

Dementia care still falling short

Dementia makes the headlines again today, with news that half of all patients with dementia leave hospital in a worse state than they arrive in.

The Alzheimer’s Society says patients with dementia stay longer in hospital than those without the condition and a third have to move into a care home afterwards because they can no longer care for themselves, such has been their deterioration.

It is easy to see why people with dementia decline in hospitals – they can be noisy, disorientating and distressing places and someone with dementia is less able to cope with this than someone without.

And with 80% of nurses admitting in the Alzheimer’s Society’s survey to receiving no or not enough training in dementia, it is easy for the quality of care to vary and, in some cases, patients to not receive appropriate care for their condition – help eating and drinking, for example.

But there are already measures in place to address this; the Dementia Strategy, published in February, had an objective to ensure all health and social care staff who may be involved in caring for people with dementia have training in caring for people with the condition. This would be through basic training and continuous professional and vocational development.

This research highlights how urgently this training needs to be rolled out. With the numbers of people with dementia growing as the population ages, it shouldn’t be delayed.

But (as ever in social and health care, there is a but) it will come down to finances. Training is usually one of the first things to be shelved when cuts need to be made and with budgets already being tightened – and bigger cuts to come in 2010 and 2011 – this could well get quietly put to one side.

If it does, then little will change for people with dementia, and they will continue to cost the NHS millions by staying in hospital for longer and continue to deteriorate more rapidly than they could do. The training needs to happen.

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Filed under adult social care