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Content Article
The resources below have been categorised into the three audits within FFFAP: National Hip Fracture Database (NHFD) National Audit of Inpatient Falls (NAIF) Fracture Liaison Service Database (FLS-DB) Hip fracture: a guide for families and carers All about your hip fracture and what to expect on the road to recovery Recovering after a hip fracture: helping people understand physiotherapy in the NHS How should your hospital prevent and respond falls during your stay Inpatient falls Falls prevention in hospital: a guide for parents, their families and carers What should happen if you or someone you know experiences a fragility fracture Six golden rules for stronger bones Strong bones after 50 - after staying on treatment- Posted
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Content Article
The King's Fund: Social care 360 (2 March 2023)
Patient Safety Learning posted an article in Social care
The key trends in adult social care in England outlined in this report are: Requests: More people, particularly working-age adults, are requesting support. Receipt of care: The number of people receiving long-term care has fallen again. Eligibility: Financial eligibility is tighter and reform has been put back. Spending: Total expenditure has increased due to the Covid-19 pandemic and is now higher than in 2010/11. Costs: Local authorities are paying more for care home places and home care. Capacity: The total number of care home places has declined slightly. Vacancies: The staff vacancy rate is the highest since records began. Pay: Care-worker pay continues to rise but struggles to compete with other sectors. Carers: Fewer unpaid carers now receive paid support and respite care has also fallen. Quality: Quality is largely stable but fewer ratings were published during Covid-19. Personalisation: Fewer people receive direct payments. Satisfaction: Satisfaction of people using services is edging downward.- Posted
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News Article
England’s worsening care shortages leave older people struggling
Patient Safety Learning posted a news article in News
Hundreds of thousands of older people in England are having to endure chronic pain, anxiety and unmet support needs owing to the worsening shortage of social care staff and care home beds. Age UK has said older people with chronic conditions such as diabetes, high blood pressure and heart failure are increasingly struggling with living in their own homes because of a lack of help with everyday tasks such as getting out of bed, dressing and eating. The decline in the amount of support and care provided to older people is piling pressure on families and carers and leaving the NHS in constant crisis mode, contributing heavily to ambulance queues outside A&E departments, the charity said in a new report It warned that there would be a repeat of the NHS crisis this winter – in which rising numbers of elderly people have been unnecessarily stuck in hospital because of an acute lack of social care – without a shift to preventing unnecessary admissions. Read full story Source: The Guardian, 17 February 2023- Posted
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Age UK: Fixing the Foundations (17 February 2023)
Patient Safety Learning posted an article in Older people
Key findings Half (49%) of all the people arriving in A&E by ambulance are over 65. A third (36%) of all the people arriving in A&E by ambulance are over 75. Unplanned hospital admissions have been rising and have become more frequent, particularly for the oldest old. The proportion of older people feeling supported to manage their condition has been falling consistently, almost 20% in relative terms since 2016/17. 2.6 million people over 50 have unmet social care needs increasing to 15% of people in their 70s, and 21% of people in their 80s. In 2022, there were 165,000 vacant posts in social care- an increase of 50% and the highest rate on record. Call for action Integrated Care Systems (ICS) to develop comprehensive strategies for meeting the health and social care needs of older people at home, and in care homes, living in their areas. This must include major efforts to embed prevention in their work so older people can avoid the need for crisis care and maintain their independence. Social care reform and a major and sustained increase in funding. The NHS cannot deliver these improvements alone. The lack of adequate social care for basic daily needs simply stores up problems, leaving older people less able to care for themselves and arriving in hospital with serious health problems that could have been avoided. Multidisciplinary working to become the default method of delivering health and care services to older people. Older people are too often left to fall between the cracks of disjointed services and professionals who don’t communicate well with each other. For ICSs, this means making sure that social care services – and by extension the local authorities that are responsible for them - are central to their leadership and decision-making. A better paid health and social care workforce, with the skills and competencies to properly support older people would make a huge difference to the quality and availability of care. A step change in the recognition of and financial and practical support on offer to unpaid carers, who are holding up many parts of the health and care system.- Posted
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Community Post
Call 4 Concern
Claire Cox posted a topic in Keeping patients safe
Call 4 Concern is an initiative started by Critical Care Outreach Nurse Consultant, Mandy Odell. Relatives/carers know our patients best - they notice the subtle signs of deterioration in their loved one. Families and carers are now able to refer straight to the Critical care outreach team directly if they feel that care has not been escalated. Want to set up a call for concern initiative in your Trust? Need some support? Are you a relative that would like it in your Trust? Leave comments below -- Posted
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News Article
Care providers ask for doubled fees to care for people discharged from hospitals
Patient Safety Learning posted a news article in News
Care providers are demanding double the usual fees to look after thousands of people who need to be discharged from hospitals to ease the crisis in the NHS. Care England, which represents the largest private care home providers, said on Sunday it wanted the government to pay them £1,500 a week per person, citing the need to pay care workers more and hire rehabilitation specialists so people languishing in hospital can eventually be sent home. The rate is about double what most local authorities currently pay for care home beds, an amount Martin Green, the chief executive of Care England, described as “inadequate”. The demand comes as the health secretary, Steve Barclay promised “urgent action” with up to £250m in new funding for the NHS to buy care beds to clear wards of medically fit patients. The money will be used to buy beds in care homes, hospices and hotels where people are looked after by homecare providers, as well as pay for hospital upgrades. Stays will be no longer than four weeks until the end of March. The use of hotels as care homes began during the pandemic and has been controversial, with reports of problems with hygiene and supplies of specialist equipment. The charity Age UK last week criticised their renewed use as “not an appropriate place to provide high-quality care for older people in need of support to recuperate after a spell in hospital”. Read full story Source: The Guardian, 9 January 2023 -
News Article
Council providing three-minute care visits to vulnerable, finds ombudsman
Patient Safety Learning posted a news article in News
Care workers are taking as little as three minutes to help vulnerable people in their own homes, the social care ombudsman has found, after discovering a council was allocating extremely short visits to hundreds of people. Amid chronic staff shortages and rising unmet care needs nationwide, a homecare worker commissioned by Warrington borough council sometimes stayed for just three minutes, despite the family paying for the full visit. The council was found to have allocated 15-minute care calls to more than 300 people in the region, despite national guidance stressing these were “not usually appropriate”. The Homecare Association, which represents care providers, said the number of short calls being commissioned was increasing more widely and said “15-minute visits are inappropriately short”, result in inadequate care and are stressful for workers placed under “unfair pressure”. The case that triggered the investigation involved a woman with dementia who was paying the full costs of her care under a plan devised by the council. In 15 minutes two agency care workers were expected to wake her, prepare a meal and a drink, ensure she ate and drank, administer her medication, change her incontinence pad, administer any personal care and tidy the kitchen. Electronic monitoring showed they regularly stayed less than 15 minutes and the ombudsman said it was probable her care needs were not met and her care was not dignified. Read full story Source: The Guardian, 5 January 2023- Posted
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Recommendations Out-of-hours palliative and end of life care is currently inadequate and fragmented, and must be better valued, prioritised and strengthened. Services must be developed and provided equitably, irrespective of diagnosis, socio -demographic characteristics (e.g. age, ethnicity) and geographical area. Service development and planning must be actively informed by the voices of patients and informal carers; collaboration with patients and informal carers should be used to drive improvements in out-of-hours care, shape service development and help identify potential solutions for gaps in care. Integrated Care Systems, Health Boards and NHS Trusts, Integration Joint Boards and NHS Health Boards, and Health and Social Care (HSC) Trusts across the UK need to strategically develop, enable and support greater integration and coordination of out-of-hours services. District nurses and community nursing teams play an extensive role in providing hands-on out-of-hours care, but huge pressures on this workforce limit the care they can provide; improved workforce planning, provision, and support for community providers of out-of-hours palliative and end of life care is essential. A designated telephone line for people with palliative and end of life care needs and their informal carers should be available 24/7, in every part of the UK. Availability and use of shared care records should be audited regularly to overcome the challenges identified in using, sharing and implementing these records across the UK. Such records should be based on timely conversations about needs, wishes and preferences for care at the end of life, and include the availability of anticipatory medicines (if appropriate). The questionnaire provided in this report can be used by those with commissioning responsibilities to understand and address gaps in out-of-hours service provision and identify priorities for improvement. Research into out-of-hours care is essential for future service development and needs continued funding.- Posted
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News Article
Devon carer who murdered woman had violent crime history
Patient Safety Learning posted a news article in News
A carer who murdered the elderly woman he was employed to look after had a history of violent crime including actual bodily harm, a report found. A safeguarding adults review over the death of a 77-year-old Devon woman in 2021 criticised working practices among organisations involved in her care. Devon and Cornwall Police did not disclose information about domestic abuse callouts involving the killer in a DBS check by the care provider. He was jailed for life in July 2022. The woman had seen her killer as "a grandson" figure, it said. The 35-year-old killer attacked his victim after she discovered he had stolen several thousand pounds from her. The had no previous employment experience of care before being taken on as her sole carer by Complete Quality Care Ltd, an independent care provider. Read full story Source: BBC News, 24 November 2022- Posted
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NHSE - Commitment to carers
Patient-Safety-Learning posted an article in NHS England
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News Article
Northern Ireland carers 'suffer shocking levels of poor health'
Patient Safety Learning posted a news article in News
Unpaid carers in Northern Ireland are suffering from "shocking levels of poor health", according to the charity Carers NI. In a survey of more than 1,600 unpaid carers across Northern Ireland, more than a quarter of respondents described their mental health as bad or very bad. One in five carers said the same about their physical health. The survey also found some 40% had not had a break from caring during the previous year and 23% said support services in their area did not meet their needs. Tracey Gililand, from Portadown, cares for her two disabled sons and said families like hers have been all but forgotten since the beginning of the pandemic. "Carers are still having to ask for the full return of much-needed day care and respite services and it feels like we've been left to paddle our own canoes with no help," she said. "No one knows our struggles, the many sleepless nights and exhaustion during the day. The impact on carers' mental health. The isolation that families like us experience that no one else sees," Ms Gililand explained. Carers NI said it has called for a legal right to social care support for all unpaid carers, the appointment of an independent carers' champion to advocate for carers to government, and wider transformation of the health system. Craig Harrison from the charity said carers had been "driving themselves into the ground", and were physically exhausted and in a state of constant anxiety. Read full story Source: BBC News, 8 November 2022- Posted
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State of social care in England ‘never been so bad’, social services boss warns
Patient Safety Learning posted a news article in News
The state of social care in England has “never been so bad”, the country’s leading social services chief has said, with half a million people now waiting for help. Sarah McClinton, president of the Association of Directors of Adult Social Services (ADASS), told a conference of council care bosses in Manchester: “The shocking situation is that we have more people requesting help from councils, more older and disabled with complex needs, yet social care capacity has reduced and we have 50,000 fewer paid carers.” Over 400,000 people rely on care homes in England and more than 800,000 receive care at home. But care services are struggling with 160,000 staff vacancies, rising demand and already tight funding for social care that is being squeezed by soaring food and energy inflation. About a third of care providers report that inability to recruit staff has negatively affected their service and many have stopped admitting new residents as a result. Last month the Care Quality Commission warned of a “tsunami of unmet care” and said England’s health and social care system was “gridlocked”. Problems in social care make it harder to free up beds in hospitals, slowing down the delivery of elective care. “The scale of how many people are either not getting the care and support they need, or are getting the wrong kind of help, at the wrong time and in the wrong place is staggering,” said McClinton, who is also director for health and adult services in Greenwich. “It is also adding to the endless pressures we see with ambulances and hospitals, and adding to the pressures we see in our communities, more people requesting help with mental health and domestic abuse.” Read full story Source: The Guardian, 2 November 2022- Posted
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News Article
Social care ‘on its knees’ as vacancies hit record high
Patient Safety Learning posted a news article in News
Social care services face an “absolute crisis” over record vacancies as unfilled jobs have risen by more than 50% in a year, a new analysis reveals. New data on social care workers shows at least 165,000 vacancies across adult social care providers at the end of 2021-22. This is the highest on record according to the charity Skills for Care, which has collected the data since 2012. Leading think tanks have warned the figures to point to the “absolute crisis” facing social care with the “system on its knees”. At the same time the demand for care has risen, highlighting that social care is facing a complex challenge with recruitment and retention which will be impacting on the lives of people who need social care. The annual report by Skills for Care predicts social care services will need an extra 480,000 workers by 2035 to meet the demand but could be set to lose 430,000 staff to retirement over the next decade. Simon Bottery, senior fellow at The King’s Fund, said the report was evidence “of the absolute crisis social care faces when trying to recruit staff, a crisis that has profound consequences for people needing care”. He added: “A key reason for that is pay, which continues to lag behind other sectors including retail and hospitality, as well as similar roles in the NHS. Our recent analysis found that nearly 400,000 care workers would be better paid to work in most supermarkets." Read full story Source: The Independent, 11 October 2022- Posted
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Key findings Workforce and sector size An estimated 17,900 organisations were involved in providing or organising adult social care in England as at 2021/22. Those services were delivered in an estimated 39,000 establishments. There were also 65,000 individuals employing their own staff. The total number of adult social care posts in 2021/22 was 1.79m. 1.62m of these posts were filled by a person (filled posts) and 165,000 were posts that employers were actively seeking to recruit somebody to (vacancies). The adult social care sector was estimated to contribute £51.5 billion gross value added (GVA) per annum to the economy in England (up 2% from 2020/21). Recent trends – workforce supply and demand The total number of posts in adult social care in England as at 2021/22 was 1.79 million (up 0.3% from 2020/21). Of these posts, 1.62m were currently filled by a person (filled posts) and 165,000 were posts that employers were actively seeking to recruit somebody to (vacancies). Skills for Care workforce estimates show a decrease in the number of filled posts in 2021/22. Overall, the decrease was around 3% (50,000 posts). The vacancy rate has risen over the same period to the highest rate since records began in 2012/13. The number of vacancies increased by 52% in 2021/22 by 55,000 to 165,000 vacant posts. The vacancy rate in 2021/22 was 10.7%. This shows that the decrease in filled posts is due to recruitment and retention difficulties in the sector rather than a decrease in demand. Employers have not been able to recruit and keep all the staff they need. As a result, an increasing number of posts remain vacant. The starter rate has fallen from 37.3% in 2018/19 to 30.8% in 2021/22. The turnover rate these periods remained at a similar level (29% in 2021/22). Therefore, around the same proportion of people are leaving their roles, but there are fewer people replacing them. The UK vacancy rate has increased rapidly in the past year. This increase has created competition for staff and contributed to the increase in the adult social care vacancy rate over the same period. During 2022, following the relaxation of rules regarding testing and isolation, sickness rates have begun to decrease towards pre-pandemic levels (6.2 days as at August 2022 compared to 4.6 days in 2019/20). Workforce characteristics The adult social care workforce continued to be made up of around 82% female workers, the average age was 45 (with 28% aged 55 and over), 23% of the workforce had black, Asian and minority ethnicity and 16% had a non-British nationality. Data collected in the ASC-WDS since care workers were added to the shortage occupation list showed more people were arriving in the UK to take up adult social care jobs. In 2022, between February and August, 11% of workers new to their role within the year had also arrived in the UK within the year. This was greater than the equivalent period in 2021 (4%) and 2020 (2%). Almost a quarter of the adult social care workforce (24%, or 358,000 filled posts) were employed on zero-hours contracts. In April 2021, the NLW rose from £8.72 to £8.91 (2.2% in nominal terms). This increase contributed to a 5.4% increase in the median nominal care worker hourly rate from March 2021 to March 2022. This was the second highest increase over the recorded period. The median hourly rate for care workers decreased, in real terms, by 1.5% between March 2021 and March 2022. This compares to an average increase of 1.8% per year since September 2012. This decrease was driven by the high cost of living in 2021/22 with inflation rising to 7.0%. Analysis of workforce data from the ASC-WDS shows that there were differences in diversity between job roles. Notably, there were proportionally more males and more white people in senior roles than front line roles. The root cause of this difference can’t be ascertained from ASC-WDS data alone. Our forecasts show that if the number of adult social care posts grows proportionally to the projected number of people aged 65 and over in the population between 2021 and 2035, an increase of 27% (480,000 extra posts) would be required by 2035. Employers with favourable workforce metrics (such as high levels of learning and development), on average, had better outcomes (lower staff turnover and/or high CQC ratings).- Posted
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News Article
Social care: 'Jo's care will cost £1.5k a week - the system is broken'
Patient Safety Learning posted a news article in News
It was only a year ago that Boris Johnson stood up in Parliament and said he was going to fix the long-term problems in social care. He announced a new tax - to raise about £12bn a year - would be spent on health and social care costs only. But the UK's new prime minister, Liz Truss, has already scrapped the plan. Families, carers and care providers have been left asking where the funding will now come from to fix a system, which they say is broken. Dr Jo Wilson was a high-flying international executive before she was diagnosed with dementia two years ago, aged 66. Her husband, Bill, insists he's her husband, not her carer. But he now sees to Jo's every need. Bill has had to find fight and persistence to navigate the world of dementia care. "It took me two years to get a care package in place for Jo," he explains. "And I only got that because Jo had a collapse at home and was taken into hospital." Even after it was confirmed Jo could have carers come to their home to help, Bill found the variety of staff, unreliable time keeping, and a lack of understanding of dementia, left him questioning whether it was worth it. He's now permanently exhausted, and frustrated. Professor Martin Green, chief executive of Care England, says without a complete restructure of the social care system "thousands, if not millions, will be left without support, and the NHS will be on its knees". It is a warning heeded by others. A new poll by Ipsos Mori for BBC News, suggests more than 70% of those over 55 are not confident that social care services will provide care to those in need. More than half of responses cited staff shortages and limited public funding as their main concerns. Care providers say it's these issues that are putting them under extreme pressure. "We know currently that three in five people with dementia do not get the support that they need once they have that diagnosis. And that leads to crisis in care", says Fiona Carragher, director of policy at the Alzheimer's Society." Read full story Source: BBC News, 7 October 2022- Posted
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‘Perilous’ shortage of homecare workers leaves patients trapped in hospitals
Patient Safety Learning posted a news article in News
A “perilous” shortage of homecare workers is the biggest reason thousands of people are languishing longer in hospital than needed, driving up waiting lists and making people sicker, figures reveal. Almost one in four people unable to be discharged – sometimes for weeks – were trapped in hospital because they were waiting for home care, as agencies hand back contracts because staff are quitting owing to low pay, leaving 15% of jobs vacant. A fifth of people unable to be discharged were also waiting for short-term rehabilitation and 15% were waiting for a bed in a care home, according to analysis of data obtained using freedom of information requests and public records by Nuffield Trust and the Health Foundation. It estimated that in April this year, one in six patients were in hospital because of delayed discharge, and the discharge of patients with a hospital stay of more than three weeks was delayed by 14 days on average. “People are ending up in hospital for malnutrition and dehydration, problems which, even if you supported people a little bit at home, would stop,” said Jane Townson, the director of the Homecare Association. “More providers are having to turn down work than usual and some are having to hand back people because they can’t do it.” Read full story Source: The Guardian, 3 October 2022- Posted
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Content Article
Key issues Some of the key issues covered in the report include: understanding the significance of staging dementia, the challenges and decisions occurring at each stage, and the specificities of different types of dementias. delving into the impact of diagnosis on people living with dementia, their carers, relatives, and communities. addressing the symptoms and changes commonly associated with dementia, and the pharmacological and non-pharmacological interventions that can help people living with dementia and their carers. showcasing international and national perspectives on models of care. laying the groundwork for forward-thinking, principled approaches to dementia, necessary in order to move the needle forward. Recommendations The report makes the following recommendations: National dementia plans need to become a policy priority Person-centred care must become the norm Care should be culturally appropriate and gender inclusive Support for carers must be prioritised Care needs to be coordinated and accessible We must continue to challenge stigma and raise awareness – it remains a severe barrier Education must be improved and expanded Further trials of cost-effective and evidenced-based psychosocial interventions are needed Risk reduction must be bolstered