08 December, 2016

We are very happy today :)

We have heard today that Cambridgeshire and Peterborough CCG have agreed to repay 1 years care fees to my client, £36,000 to be exact!  We started our claim in 2012 and it has taken this long to get to this stage. The gentleman concerned sadly died in 2013 but his daughter wanted to see justice for her father.  This proves that persistence pays off and it can also help your case if you have some professional help from a company who understands the process.

31 October, 2016

Who are we and how can we help you?

The Care Advice Centre was set up by Independent Social Worker, Aleisha White in 2011. Aleisha has many years of experience in social care for older people and through this role, she spotted a gap in the provision of support, primarily for self-funders.  Self-funders are people who have over £23,250 in savings or a property that could be sold. 

At the Care Advice Centre, referrals come mainly from solicitors, financial advisors and generally anyone involved in the care of the elderly.

14 August, 2016

Who is looking after your loved one?

Older people often prefer not to bother their family, even when they are struggling to manage.

Are you worried about a client or a family member? The Care Advice Centre offers a regular monitoring visit to check on the welfare of the person you look after.

Having a weekly or monthly visit by a trusted person offers busy people reassurance and a friendly face to keep an eye on things.

This could also be particularly useful for Professional Deputies looking after the affairs of vulnerable adults.

25 July, 2016

Hospital discharge and getting the right services in place

There are regularly stories in the news about older people being discharged from hospital without the care that they deserve and to which they are entitled. Aleisha White, an independent social worker and founder of The Care Advice Service, offers advice on what services should be available and how to make sure they are put in place.

Why patients are discharged quickly

Hospitals are usually very keen to discharge patients at the earliest available opportunity to release beds and often work on “black alert”.

An NHS black alert is a warning to the healthcare community that a hospital is facing greater demand for services than it can handle. It’s at these times that the shocking situation arises where some very ill people are expected to wait on beds in A&E corridors while a bed is located in the hospital.

That’s why it’s vital that patients are discharged from hospital as soon as they have received all of the necessary assessments and are classed as medically fit.

Understanding the process

As an expert in care management I am often involved with families who are struggling to understand the discharge process and all of the assessments that should take place prior to discharge.

Hospital wards are busy places and it can appear intimidating to insist on information. It is vital that patients are actually medically fit for discharge and that they have received all of the assessments they need to be able to return home safely. Otherwise, it can turn into a cycle of re-admission if discharges are not handled in the proper manner.

It is extremely important to ensure that the following assessments have been carried out prior to discharge from hospital.

Medical assessments

All patients should have been reviewed by the ward consultant and pronounced medically fit for discharge.

It is possible that some further assessments can be carried out as outpatients, but they are usually best done whilst still in hospital. All too often patients are discharged when they are not actually medically fit and this often results in a re-admission – this is called a failed discharge.

Physiotherapy assessment

Physiotherapy helps restore movement and function when people are affected by injury, illness or disability.

It uses movement and exercise, manual therapy, education and advice that are tailored to an individual’s needs to promote, maintain and restore their physical health.

Patients should be assessed by a physiotherapist whilst in hospital and be given the time to return to their base line before they are discharged from hospital. It is important that physiotherapy involvement is instigated at the appropriate time in order to increase the chances of regaining independence.

Occupational therapy assessment

An occupational therapist can identify strengths and difficulties that the discharged patient may have in everyday life, such as dressing, cooking or getting to the shops, and will help them work out practical solutions.

They can work with the patient to identify goals that can help them maintain, regain, or improve their independence by using different techniques, changing their environment, and using new equipment.

NHS Continuing Healthcare Checklist

When it has been determined that a patient will have care needs on discharge from hospital, a NHS Continuing Healthcare Checklist should be completed on the ward, when the patient is deemed medically fit.

If the Checklist is positive, a meeting should be arranged with the discharge coordinator, a social worker and the patient (or a member of their family/representative) and a decision about eligibility should be made before the patient leaves hospital.

If eligible, NHS Continuing Healthcare can fund the cost of care at home or in a care home. The patient or representative should be fully involved in these assessments and copies of the assessments should be requested as you may need to refer to these at a later stage.

Referral to Social Services

In some cases a patient may be assessed as ineligible for NHS Continuing Healthcare.

In these cases, the ward staff should then make a referral to Social Services for an eligibility assessment and a financial assessment. Social Services can set up a care package or a care home placement in which the patient or family representative should be fully involved.

If the financial assessment reveals the patient has over £23,250 in capital, then they will be expected to pay for the cost of their care.

Support following hospital discharge

Help at home can include an initial intensive support package to ensure that the patient is able to continue to recover at home, i.e. support with personal care, meals, shopping and cooking.

Ongoing daily visits of up to four calls per day can be organised for those who need it. It is also possible to arrange a live-in carer if the person is deemed unsafe to be at home alone or indeed would like to have some companionship to support them to stay at home.

How do I find out if these assessments have been carried and what they’ve said?

Ask to speak to the ward sister and determine whether these assessments have been carried out and what has been said. If necessary ask to speak to the consultant responsible for your relative.

The Care Advice Centre, offers a flexible, tailor-made approach to care planning without the time, eligibility and budgetary constraints associated with local authorities. By working closely with individuals, their family and carers the Care Advice Centre can provide during an often difficult and stressful transition. Aleisha is also an affiliate of the Society of Later Life Advisors and a member of the British School of Social Workers and the Health Care Professions Council.

For more information, visit the Care Advice Centre web site, or contact Aleisha by email.

07 July, 2016

How the Care Bill must change to put social work at the heart of reformed care system

As the Care Bill returns to Parliament, Bernard Walker explains how The College of Social Work intends to press for changes to the legislation that will ensure social workers play a leading role in its implementation.

The government’s decision to put individual well-being at the heart of the Care Bill  has the potential to be its most radical innovation. We believe that the well-being principle, if it is fully implemented as part of the legislation, can bring about a deep-seated change in community-based health and social care services and improve the lives of the people who use those services.

The bill also emphasises the importance of prevention, which must be at the heart of any health and social care system which promotes well being.   It will take strong social work leadership to reshape health and social care so that it is less reliant on crisis-driven services and more focused on preventing and postponing the need for care and support in the first place.

If the aims of the Care Bill are to be realised, social workers must be fully recognised and valued by fellow professionals as making a specific contribution to the well-being of individuals and communities.  They will have to be confident and assertive with their health colleagues,  to overcome the exclusive “medical model” of the NHS and combine it more effectively with the social model of disability and need, public health planning and models of community development.

In order to exploit this leadership role to its full potential, the Care Bill must equip social workers to take it on.  A service geared to prevention would invest in information and advice for service users; it would make sure that assessments of need were conducted by the experts best placed to help people remain active members of their communities for as long as possible; and it would ensure that service users  were prevented from drifting unnecessarily into institutional and hospital care. Finally, it would give adult safeguarding the status and professionalism it requires if public expectations are to be met.

So we have a four-pronged strategy for amending the Care Bill:

Information and advice: named social workers should always be available to local information and advice services because they have the knowledge and skills to identify present and foreseeable need, and ensure that early and appropriate arrangements are made to prevent an unnecessary deterioration in an individual’s condition.

Assessment of need: registered social workers should be responsible for assessing people with complex needs to ensure that socially inclusive, community-oriented forms of care and support are put in place, focused on well-being.

Safeguarding: social workers should always be appointed to supervise safeguarding enquiries on the basis that they are trained to prioritise community solutions rather than default to institutional care and have the professional relationships with service users most likely to bring about a person-centred response.  We have also argued that the local authority representative on safeguarding adult boards should be social work-qualified and that safeguarding adult review teams should include a social worker with substantial experience of safeguarding work.

Powers of access: our survey of College members last year showed strong support for a qualified power of access by a social worker to interview a vulnerable adult where this was being blocked by a third party.  Such a power could only be granted by the courts, as is already the case in Scotland.  The government decided against including this power in the Bill, but along with our partners in the voluntary sector we are urging the government to reverse this decision.

So far the government has been receptive to our lobbying on the Care Bill in the House of Lords, in large part thanks to the efforts of Baroness Greengross and Baroness Browning in tabling several of our amendments.

Health minister Earl Howe conceded that qualified staff had a role to play in relation to information and advice services, adding that statutory guidance should lay out expectations.  He also agreed to review the assessment clauses of the Bill to ensure that people with complex needs are assessed by ‘appropriately qualified staff’.  Baroness Northover, speaking for the government, acknowledged that local authority representatives on safeguarding boards must have the required skills and experience.
Clearly, though, there is more to do to ensure that the government gives social work specifically the place it deserves in this Care Bill. When the Bill returns to the Lords on Wednesday (October 9) for its final stages before going to the House of Commons, we will continue to press for an explicit commitment to social work and the essential role of social workers in taking forward reform that is genuinely underpinned by the well-being principle.

Bernard Walker is chair of the Adults’ Faculty at The College of Social Work.

Community Care Website: http://www.communitycare.co.uk/blogs/adult-care-blog/2013/10/how-the-care-bill-must-change-to-put-social-work-at-the-heart-of-reformed-care-system/