Me, Food & Social Care

Apparently I am an overly fussy pernickety eater although I would prefer to say I have a truly sensitive palate which means that there are many foods that are not palatable to me! Many have tried to test and trick me but always have failed.

It is not something that has any significant impact on my life and I doubt I am the only person like this.

Yet what if someone with a similar palate found themselves suffering with dementia and placed in a care home. Without knowing the persons likes (because the dislikes will be far too many to mention!) it would be easy to try and give the individual just what is on the menu. Personally if that happened to me I would simply not eat what was in front of me, but how does that act get viewed by the care provider? Am I being awkward? Am I refusing to eat? The more I insist that I will not eat what’s in front of is my behaviour becoming ‘challenging’?

If I have no relative’s to speak up for me to explain my eating foibles what happens next?

If I am refusing to eat what is in front of me yet I don’t have the capacity to express that how can I be sure that my behaviour is interpreted correctly? And how will my non-eating be reacted to?

If I lack capacity then someone will make a decision in my ‘best interest’ under the guidance of the Mental Capacity Act. Obviously it would be in my best interest to eat yet if I were forced to eat something that tasted extremely bad to me the more likely my behaviour would become more challenging and I would probably be labelled as such and because of my limited likes it attempts to try different foods would also probably fail and lead to more ‘challenging behaviour’.

This is, of course, hypothetical yet there are, undoubtedly, many people in similar situations, it may not be with food but with other aspects of daily life.

This is why carers and families are so important in the social care system. Social care professionals need to understand the person who needs care services and, where individuals are unable to articulate their needs, listening to carers and families is vital in providing quality personalised care.

The quality of social care is not just about now, it is about the future and the quality of care we want to receive in the future if we find ourselves needing care services. Quality services can only be achieved by understanding the individual and, equally important, their individuality. By the time care ‘professionals’ become involved in a person’s needs it is likely those needs have already progressed to a point where understanding individuality becomes more difficult making it ever more important for those professionals to engage with carers and families to truly get to understand what makes the person needing care service tick.

Carers and families have a responsibility too. As someone they love begins to deteriorate through age-related conditions they should prepare that information to ensure they are able to pass it on. Obviously, as individuals, we also have a responsibility to make sure those things are known in case we need social care services in the future.

In reality the real onus is on those paid to provide social care services to ensure they are providing personalised care based on the information given to them by the individual, their carer’s and their families.

If I ever need social care services I want those people providing those services to understand all of my needs and provide care based on those needs. Undoubtedly you do to. So let’s focus on moving toward that for the benefit of those who need care services now.

Focus on Elderly Care

Over the last four years the number of people receiving council funded adult social care services has fallen by 17.5% and, given that in certain areas such as people with learning disabilities the numbers have increased, the majority of the decline in funded services has hit older people who are targeted under ever tightening eligibility criteria for Local Authority service.

This, of course, flies in the face of what we know about the population in general, the population is increasing and people are living longer so, in fact, we should be seeing an increase in the numbers of people accessing funded social care services, therefore we are seeing a bigger decline in services than the figures initially suggest, even if the numbers were to remain static it would, in real terms, still be a decrease.

Unfortunately much of the policy obsession (obsession used in a limited sense!) is focused on implementing the Dilnot proposals and focused on how much individuals should pay for their care. What this misses is the numbers of people who have no way of paying for their care and are entitled to local authority funded services, the numbers of which are decreasing at an alarming rate despite the fact they should be increasing.

In cases where older people do not meet ‘eligibility’ criteria the role of providing care and support goes to family and friends who, in essence, provide a free service for the state or, if they receive carers allowance, for the princely sum of £58.45 a week (subject to providing a minimum of 35 hours care - so £1.67 per hour!) and many do not receive the allowance because they have an ‘overlapping’ benefit. Research by Carers UK and the University of Leeds shows that, over the past ten years the number of those providing care has increased by 9% with the biggest increase in those aged over 65.

There are costs to looking after someone on a full time basis, particularly when it means giving up full time employment, not only are there the financial implications but also there is evidence of impact on health, well-being and social exclusion. There is help available for carers and many receive local authority assessments but, in terms of the wider social care picture, very little has been done to redress the increasing numbers needed to meet the shortfall in local authority provided services.

Despite these facts the plight of the most needy older people is still being overshadowed by the focus on who pays for care, and while this is important it is only a small part of the overall social care picture.

We need to widen the social care debate at national level which is why I have started an petition call for a Cabinet Minister for social care – I hope  you will take the time to sign  and pass on to others - http://epetitions.direct.gov.uk/petitions/39701

Calling for a Cabinet Minister for Social Care

I have set up an online petition calling for a Cabinet level Minister to be appointed for Social Care (click here) which I hope  you will sign  and which I hope  you will pass on  to friends and colleagues.

Why?

Around one in five of the population is affected by the decisions made by Government on Social Care and given that such a large portion of the country is involved it seems only right that they should have the appropriate representation at the highest level.

I say around 1 in 5 because the figure is hard to estimate and it could well be higher. Carers UK estimate that there are 6.4 million people in the UK providing unpaid care for loved ones (details here) and, naturally, there are a similar amount being cared for. The latest figures from the NHS Information Centre state that there are 1.4 million people in England receiving local authority funded care services, although this figure does not include those receiving continuing care funding from the NHS, additionally these figures are for England only, so the number is increased when the other countries are taken into account. They are then increased further by the unrecorded numbers who fund their own care services.

In addition, the latest figures from Skills for Care tell us that there are 1.6 million paid workers in adult social care. So, in a Nation that has a population of 62 million, one in five may well be a conservative estimate.

At present Social Care is presided over by a junior minister within the Department of Health and, whilst there is no doubt a strong link between health and social care, this fails to encompass the greater range of social care requirements of the people that need social care services.

Social Care is not a homogenous service. It includes services for the elderly, for those with learning disabilities, those with mental health issues or those with physical disabilities, yet, at present all these services are the responsibility of a junior minister.

Social care also encompasses much more than just health services, it includes housing issues, benefit payments, community issues, for those under the age of 65 employment services come into the equation.

As the population ages social care will be a greater part of life with even more people either using or providing services. It is time now for Government to fully recognise social care as a major part of social policy in this country and appoint a Minister to the Cabinet to take responsibility for it.

The e-petition link again - http://epetitions.direct.gov.uk/petitions/39701 I hope  you will  take the time to sign it and that  you will spread the word  to your colleagues and friends

Thank You

Shiny New House on Rotting Foundations

If someone spent time and money putting up a shiny new conservatory at the expense of sorting out the subsidence and rotting foundations in their house, what would you think of them?

If a business tried to launch a shiny new product with expensive advertising and a fancy, high profile launch at the expense of repairing the decrepit machinery in their crumbling factory that limits their ability to make the product, what would you think of them?

In both cases you would think they are fools.

So why should we think any less of the Government today.

Electoral reform and democratising the House of Lords will be the shiny product launch today, the new conservatory under in which the coalition can bask while ignoring the crumbling social care system which is subsiding fast under the Governments lack of action on supporting the most vulnerable in society.

The plight of millions is being ignored, the millions of unpaid carers who look after the millions of individuals who need care, the millions who receive funded services or who have to pay for those services themselves and the million or so low paid workers who are expected to deliver high quality care yet are in danger of being in a poverty trap themselves.

And while the coalition basks in the vain glory of their shiny House of Lords they forget another important point. Those millions affected by social care are also voters and why should those ignored by the coalition, left sinking in the financial quagmire of social care, even consider voting for the two parties that have flagrantly displayed contempt for the most vulnerable in pursing political expediency over the more pressing needs?

Of course the previous Government was no better but now at least the Labour leopard has the chance to change its spots and pursue the goal of achieving the best possible outcome for those who need and deliver care services.

The Government have exposed themselves as fools by, yet again, prevaricating over social care. Social justice is what underpins modern democracy and the shiny new house will be sitting on the rotting foundations of social justice presided over by the current Government