You can watch the debate online at the BBC website.

The social care charging measure will have to receive royal approval before it can be passed as law.

The public services ombudsman has ruled that the Welsh NHS ‘failed in its duty’ to fund and provide care for a patient, known only as ‘Mr B’, who sustained serious head injuries after being attacked. Mr B’s parents had to pay a substantial amount of money from their retirement savings for private treatments after he was discharged from hospital in May 2007. The ombudsman’s report criticises the NHS for not providing a ‘large part’ of the care package that Mr B needed. As well as paying for health care, the NHS should have funded other treatments such as speech and occupational therapy, but Mr B’s family ended up having to pay for these privately. The ombudsman has recommended that all these costs should be refunded by Carmarthenshire Local Health Board (LHB) along with ‘other financial redress’, and has ordered Mr B’s needs to be re-assessed so that a new care package can be drawn up. The LHB has accepted the ombudsman’s report and has apologized for the distress and inconvenience caused to Mr B and his family. It has promised to accept and implement the ombudsman’s recommendations for Mr B’s ongoing care as well as for financial restitution.

posted by Cheselden Continuing Care at
23:19

Care provider Pendine Park has announced that it hopes to create a world-leading dementia care centre on the site of a former hospital in Gwynedd, Wales. The company is about to submit a planning permission application for the £4 million project, which would provide a mixture of home and community-based services for dementia patients and their families. Pendine Park is a leading player in the independent dementia care market in Wales and already employs 500 staff. Company owner Mario Kreft comments on the new project: ‘Our vision is to provide a world class community based resource for older people with a range of needs…There will also be specialised “extra care” accommodation that provides independence and choice to those with varying care needs and enables them to remain in their own home, enabling the spouse or partner to remain as the main carer.’

posted by Cheselden Continuing Care at
23:08

Wales has launched a consultation process on the future of its social services. The consultation will be managed by a new body, set up in December 2009, called the Independent Commission on Social Services. The Commission’s role is to investigate and report back on how the Welsh Assembly Government should reshape social care and social services in Wales over the next 10 years. Its work will take place within the context of the recent Welsh Green Paper on the future of social care funding, ‘Paying for care’.

At present, social care costs Wales £1.2 billion per year, with services provided to 150,000 people by 70,000 staff. The Commission will look at improving the current system in four key areas:

• Best practice, training and development for staff
• Consolidating the existing services by bringing together all the individuals and organisations that contribute
• Joint working with other services, e.g. the NHS
• How to meet the social care needs of the Welsh population in the best and most effective way.

The Commission is urging carers, service users and the public to submit feedback on how the above areas of social care can be improved through a ‘Call for Evidence’ process. You can find out more about this at the Welsh government website. Submissions should be returned by 26 February 2010. The Commission will report back its findings and recommendations to the Assembly in November.

posted by Cheselden Continuing Care at
08:21

An ambitious project announced by the Welsh Assembly Government to provide a range of services for elderly people – including not-for-profit care homes designed to reduce financial pressure on the nation’s pensioners – has been postponed until at least 2011. Other services that had been planned under the One Wales agreement include nursing home beds, day care facilities and extra care housing. Now, the funding will be diverted and used to build affordable housing, because the Government feels that there is not enough time to complete the One Wales project. Charities and campaigners for the elderly have reacted to the news with dismay, with the Older People’s Commissioner for Wales, Ruth Marks, commenting: ‘We cannot accept the idea that funding allocated for ‘Not for profit’ homes should be reallocated to address housing affordability. This would mean that scarce resources would be redirected away from the older people in need of nursing care for whom they were originally designated.’ The Government’s commitment to completing the project is now on hold until after the 2011 elections.

posted by Cheselden Continuing Care at
12:59

Assembly Member for Wrexham Lesley Griffiths has urged Wales’ army of unpaid carers to make the most of the benefits and support that are available to supplement their income and protect their pensions. Over 375,000 unpaid carers provide around £4.7 billion of free care every year in Wales, yet many of them do not realise that they are entitled to benefits such as Carer’s Allowance, council tax discount, pension credit and housing benefit. Speaking in support of Carers UK’s national carers’ rights campaign, Ms Griffiths commented: ‘It’s a real concern that carers may not be getting all the help they are entitled to. Carers are fulfilling a vital role in society and without them the NHS and social care system would not be able to cope. It is essential that they are given information about their rights so that they get the support they need in order to plan for their futures.’ Roz Williamson of Carers Wales added that in particular, carers should seek advice to protect their pensions if they have been unable to make regular National Insurance contributions through paid work. Information and a free booklet are available from Carers UK’s free telephone line 0808 808 7777.

posted by Cheselden Continuing Care at
01:06

The Care and Social Services Inspectorate for Wales (CSSIW) has published its annual report on the Welsh social care service. Although it acknowledges that service levels are improving, the report criticises the variations between Welsh regions in both quality of care and access to services. The CSSIW reports that service users are becoming increasingly involved in decisions about their care and, on the whole, are being treated with dignity. However, it urges local authorities to move more quickly to modernise services despite shrinking budgets. CSSIW chief inspector Imelda Richardson described on BBC Radio Wales how councils will benefit from ‘…better partnership arrangements with other authorities who are doing well, learning from those who are doing well so that you’re able to refocus, redesign your own services and also listening to what people themselves want because often they want quite simple services and not complex ones.’ The Care Forum for Wales has welcomed the report’s recommendations, calling them ‘…a challenge that all parties responsible for social services and social care must sign up to and face together.’ The report can be read in full at the Welsh Assembly Government website.

posted by Cheselden Continuing Care at
01:04

Charities and Welsh Assembly Members are calling for an investigation into Welsh care home standards after a BBC TV programme was aired showing care rules being breached. The programme, entitled ‘Who cares in Wales?’ and broadcaast on 25 November, used undercover filming to expose substandard care practices in a home, including incorrect lifting procedures and elderly people being treated without dignity. The programme questioned whether care homes in Wales are being adequately governed by the Care and Social Services Inspectorate Wales (CSSIW). Conservative AM Darren Millar comments: ‘We’ve got to make sure that CSSIW has the teeth to deal with these problems when it finds them on a recurring basis. We’ve got to make sure that our elderly people in care are treated with dignity… we’ve got to make sure that our regulatory system works.’ The charity Action on Elder Abuse added its voice to the call for an independent enquiry, with chief executive Gary Fitzgerald urging ‘…everyone to work together on this issue.’ The Welsh Assembly Government has stated its confidence in the CSSIW, but has agreed to ‘look at the issues raised in the programme.’

Find out more about the ‘Who cares in Wales’ programme at the BBC website.

posted by Cheselden Continuing Care at
00:58

The Welsh Assembly has granted funding to enable more terminally-ill patients to die at home if they want to. A new rapid response service, jointly staffed by Marie Curie Cancer Care and Betsi Cadwaladr University Health Board, will be made available in the counties of Wrexham, Denbighshire, Flintshire and Conwy. Previously tested in England, the rapid response service enables more people to stay at home in the final stages of a terminal illness without additional cost to the health service. The service includes expert palliative care and support at home as well as overnight access to a specialist telephone helpline. Marie Curie spokesperson Emma Groves comments on the new scheme: ‘We will be able to provide a fantastic level of end of life care and support to many more patients and their families. The service will help the charity achieve its aim of doubling the number of people able to choose to be cared for and die at home.’

posted by Cheselden Continuing Care at
00:57

The deadline of 4 December 2009 for reviewing Welsh continuing care cases that pre-date 2003 has now passed. However, if your or a relative’s case pre-dates April 2003 and you have not asked for a retrospective funding review, you can still contact Cheselden and ask us to review the case. Although we cannot guarantee that we will be able to proceed, it is still worth contacting us as we could be able to help. Please complete our online enquiry form or call the Cheselden office on 0845 659 1588 for more information.

Any Welsh funding claims relating to cases dating from April 2003 onwards are unaffected by the deadline.

posted by Cheselden Continuing Care at
00:56

Wales has launched a consultation period on the reform of its social care structure and funding system. Entitled ‘Paying for Care’, the consultation Green Paper can be downloaded or read from a new, dedicated website www.payingforcareinwales.net. The website will be kept updated with the latest developments in and responses to the consultation process as well as information about how to get involved and have your say. The consultation will run until 28 February 2010.

A selection of initial responses to the Green Paper:

‘This cloned version of the UK government’s Green Paper offers no specifically Welsh solutions. The only thing that is clear is that the Assembly Government has no clue on how to deal with the looming funding crisis in social care.’

Peter Black, Welsh Liberal Democrat health spokesman

‘The care and support system in Wales is in need of a radical overhaul and it is under-funded and overstretched. The system is also overly complicated and unfair and it penalises savers, even those with modest assets. We need to identify what people should expect from care and support services, in terms of when they should be eligible, how much support they should receive and the quality of that service. We believe the fairest way to achieve this is by sharing the costs across society as whole. We conducted research this year which showed that 80% of people of all ages across Wales feel that care and support for older people should be free at the point of use and paid for through taxation. If taxation is being ruled out as an option then we must explore alternatives that will balance the responsibility of paying for care between individuals and the state so that everyone receives care when they need it.’

Victoria Lloyd, Age Concern Cymru and Help the Aged in Wales

‘It is clear that the current system for the provision of care and support is widely accepted as being outdated and in many cases grossly unfair. However, Saga’s research shows that there is no one size fits all solution with all of the proposals receiving a decidedly cool reception amongst over 50s. While many support the abolition of the postcode lottery in care provision and funding, many are still concerned that these proposals do not protect the family home as accommodation and food costs are still going to have to be met by the family.’

Emma Soames, Saga

‘Older people need a system that is fairer, more consistent and which addresses the longer-term financial issues as well. We need to listen to what people say as part of this consultation and look at what consensus comes through and take steps forward as this result. We have some concerns as a commission about proposals around future claims, claimants for Attendance Allowance which we think needs to stay as a benefit which benefits a lot of older people directly so we need to get involved in Wales in the UK consultation as well.’

Sarah Stone, Deputy Older People’s Commissioner for Wales

posted by Cheselden Continuing Care at
10:02

The Healthcare Inspectorate Wales (HIW) and the Care and Social Services Inspectorate Wales (CSSIW) have published a review of the impact of the National Service Framework (NSF) for older people in Wales, launched in 2006. The review is taking part in two phases over a two year period so that sufficient coverage is given to the complex and diverse range of services that the NSF offers. The first phase, published in autumn 2009, focuses on three core themes of dignity in care, nutrition and integrated services. The HIW and CSSIW gathered information from the review through talking to service users and their carers at regional conferences, inviting responses via their websites, setting up an advisory board and holding meetings with regional forums. Key findings within the review include:

• 93% of care homes have shown that they are meeting the requirements for providing dignity in care
• 46% of care homes reported staff training issues when dealing with dementia patients
• Most care homes and hospitals are not yet giving enough priority to patients’ nutritional requirements, although some positive initiatives have been identified
• Some health and social care services are found to be working well together, but community partnership agreements are not always specific to older people
• Older people with dementia were identified as the most vulnerable group amongst the older population and increased focus will be given to their needs in Phase 2 of the review.

Click here to read or download the Phase 1 review document from the HIW website.

posted by Cheselden Continuing Care at
09:56

As the consultation period for the English social care Green Paper ends, Wales is launching its own consultation process into the future of the country’s social care services and funding structure. The Welsh Green Paper, entitled ‘Paying for care in Wales: creating a fair and sustainable system’, is divided into two parts: the shape of the new social care system and the way in which it will be funded. As the Welsh healthcare system is devolved, they are free to develop their own social care system and, to an extent, decide how it will be funded. However, the country’s welfare and benefits system is still controlled by the UK Government. This means that any changes that are made to English benefits as part of England’s new ‘National Care Service’, such as the proposed abolition of Attendance Allowance, must be implemented in Wales also. It is therefore crucial that the new Welsh social care system is structured in such a way as to remain fair and viable in the light of any enforced changes to the benefits system. Wales also needs to decide if far-reaching English decisions and recommendations, such as Gordon Brown’s pledge to make personal care free to everyone aged over 65 who needs it, are suitable for introduction in Wales, or whether things should be done differently.

The Welsh Green Paper puts forward the same three proposals to fund social care services in future:

• Partnership – the state and the individual both contribute a proportion towards the cost of care, with the Government ‘topping up’ contributions for the less well-off.
• Insurance – people make voluntary payments into private or state-run insurance schemes to guarantee that future care costs will be met.
• Comprehensive – compulsory, lump sum payments into state-run insurance schemes for those who can afford it, to be made on retirement.

Deputy Minister Gwenda Thomas commented on the Green Paper’s publication and the launch of the consultation period: ‘This is a vitally important issue for all of us in Wales and it is essential that we get as wide a debate as possible going on in our homes and communities. I would encourage everybody to read and respond to this Green Paper, so that our discussions with the UK Government are as informed as possible.’ She added that it is ‘…widely acknowledged’ that the current funding system is ‘complicated, unfair and unsustainable in the long term.’

For more information about the consultation process, find out how to respond and to download the Green Paper and supporting documents, please visit the new, dedicated website www.payingforcareinwales.net. The consultation period runs until 28 February 2010.

posted by Cheselden Continuing Care at
10:10

Welsh Assembly Minister Peter Black has called on the Welsh First Minister to push back the 4 December deadline for patients and families to put in claims for continuing care funding that pre-date April 2003. Mr Black maintains that more time is needed to publicise the deadline and make sure that anyone who is entitled to claim is made aware of their rights before it is too late. His own investigations have revealed that local health boards are not doing enough to publicise the deadline and where they are doing so, the materials used are too technical and not sufficiently clear. He comments: ‘While I understand the need for a deadline for claims, such a deadline must be communicated to everyone in a way in which they can understand. Many people are not aware of the fact that they may be eligible to claim…(and) there is still confusion on how this deadline should be advertised… things need to be clear. I do not want to see anyone miss out on the compensation that they may be entitled to…This can only be achieved through a sustained advertising campaign and information in accessible language, not civil service speak.’ In response, Rhodri Morgan, First Minister, stated that he did not feel that the deadline was being inadequately communicated. At the time of writing, the existing deadline remains in force.

If you or a relative feel that you may be entitled to retrospective funding from the Welsh NHS for care fees pre-dating April 2003, please contact Cheselden immediately so that we can review your case. Please complete our initial questionnaire with the basic facts of your case or call us on 0845 659 1558.

For more information about Peter Black and to read about his stance on continuing care funding and the forthcoming reform of the Welsh social care system, please visit his website.

posted by Cheselden Continuing Care at
10:02

The Welsh Assembly has held a debate on the introduction of the social care charging measure, which aims to introduce maximum weekly charges for domiciliary care across the country and eradicate inconsistencies and unfairness. During the debate, Members called on the Assembly to approve the new measures in principle and it was agreed that a legislation committee will examine the proposals in more detail. Deputy Minister Gwenda Thomas spoke in favour of the new measures which she believes will make home care charges easier to people to understand and for local authorities to administer as well as fairer for everyone. A maximum weekly charge of £50 is proposed, with local authorities having the discretion to set their own fees provided they do not exceed that amount. Although this will lead to an element of consistency, the scheme has been opposed by some on the basis that weekly fees could potentially increase significantly for people that currently pay less than £50 per week, particularly if councils choose to interpret the £50 fee as a ‘standard’ rather than a maximum charge.

posted by Cheselden Continuing Care at
09:59

Plaid Cymru Assembly Member Leanne Wood has voiced her concern over the effect on the Welsh disabled population of the UK Government choosing to scrap Attendance Allowance (AA). The abolition of AA is proposed in the English Green Paper, published in July 2009, as part of the shake-up of the social care system. And because the Welsh benefits system is under UK control, Wales would be unable to retain AA, currently paid out to 115,000 people, if the benefit is scrapped. Wales has a higher proportion of disabled people than England and receives around 8% of total AA funding, but under the new system, funding would be cut to 6% – a loss of £130 million per year. Ms Wood comments: ‘This would be a significant cut to the incomes of disabled pensioners. Our research shows that the impact (of abolishing AA) in Wales could be even worse, with tens of millions lost to the Welsh economy because of the way Wales is funded by the Government in London.’ Ms Wood’s concerns were seconded in the Welsh Oral Question session on 11 November by MP for Brecon Roger Williams, who then called on the Welsh Office to abandon the entire social care consultation process. Deputy Minister Gwenda Thomas has responded to Ms Wood in writing, stating that her belief that the abolition of AA will be strongly opposed in Wales and urging the importance of ensuring that Wales’ own social care Green Paper gives the opportunity for affected parties to represent their interests to the UK Government.

In October, health secretary Andy Burnham confirmed that AA’s sister benefit, Disability Living Allowance which is paid out to disabled people aged under 65, will definitely not be abolished to help fund the new ‘National Care Service’.

posted by Cheselden Continuing Care at
09:54

Deputy Welsh Assembly Minister Gwenda Thomas has announced that a Green Paper will shortly be published proposing new ways of funding social care in Wales. Writing in Wales Online, Ms Thomas explains how the Green Paper will bring together ideas and opinions put forward in a national debate on paying for social care that she launched in 2008, as well as the findings of an Advisory Group that she set up to examine the issues in greater detail. The next stage of the consultation process will be launched on Monday 16th November with the publication of the Green Paper and the launch of a new website, www.payingforcareinwales.net, which will give further information and explain how to respond to the proposals put forward in the Paper. The Paper itself will have similar content to the English version published in July and will propose the same three options for funding social care in future: partnership, insurance and comprehensive. However, it is up to the Welsh Assembly to decide how social care is actually provided and funded in Wales. As with the English Green Paper, the Welsh version will not just focus on the needs of elderly people but will also consider how younger disabled people will be supported. A review of the benefits system and how it will fit within the redesigned social care system will also be included. The consultation period on the Green Paper’s proposals will run until 28th February 2010 and Ms Thomas is encouraging as many people as possible to get involved in the debate about how Wales’ social care system will be reshaped and funded.

posted by Cheselden Continuing Care at
17:44

Carwyn Jones, the candidate for Welsh Labour leadership, has described his plans to overhaul the country’s health service if he is elected to power. His policies centre on ‘common sense solutions’ to healthcare, providing people with better access to the right services and reducing red tape. Caring for the elderly is a focal point of Mr Jones’ policy and he pledges to improve standards across three areas:

• Tackling delayed discharge, where patients are kept in hospital unnecessarily because their care plans are not in place or they are simply fit enough to leave
• Reviewing residential care home provision in Wales to address people’s concerns around funding long-term care for themselves and their relatives
• Developing Labour’s commitment to introduce more not-for-profit nursing homes in Wales.

You can find out more about Mr Jones and his proposed policies at his website.

posted by Cheselden Continuing Care at
17:13

The Archbishop of Westminster Vincent Nichols, the head of the Catholic Church in England and Wales, has spoken of the nation’s elderly as ‘not a burden, but a gift’. His comments were made further to a survey undertaken on behalf of the Catholic organisation Caritas Social Action Network which revealed that 150% more care home beds will be needed to cope with rising demand over the next 10 years. Recent demographics also indicate that, by 2020, there will be over 11 million people in the UK aged over 65 and, by 2033, around 3.2 million people aged over 85. Referring to the results of the Caritas survey, the Archbishop called on people to remember the contribution that elderly people have made to their families and the wider community: ‘…without them our lives and our society would be impoverished and diminished. They have a right to our resources and our care.’

posted by Cheselden Continuing Care at
17:12

Liberal Democrat health spokesman for Wales Peter Black has warned that people who may be able to reclaim care home fees for continuing care before April 2003 need to act now before the cut-off date of 4 December 2009. After that date, only cases from after April 2003 will be reviewed for retrospective compensation. Mr Black expresses his concern that this deadline has not been widely publicised and that people who may be entitled to retrospective funding will not be made aware in time of their right to a review. At the present time, there are 900 cases awaiting review for continuing care funding in Wales.

Could you or a relative be entitled to retrospective funding for care home fees paid before April 2003? If so, please contact Cheselden as soon as possible so that we can review your case. Our initial review is free and there is no obligation to proceed.

posted by Cheselden Continuing Care at
18:05

Rhian Davies, chairperson of the Coalition for Charging Cymru has spoken out in Wales Online about the Coalition’s campaign to introduce free home care in Wales for everyone who needs it. Despite plans for free care being scrapped by the Welsh Assembly Government in 2006, the organisation continues to work towards its future introduction, although Ms Davies acknowledges that ‘…we are under no illusion that this will happen overnight.’ Her immediate concerns centre on the current social care charging legislation, which aims to eradicate the postcode lottery of different home care charges in different areas of Wales by introducing a maximum weekly charge for home care. The Coalition is concerned that any new maximum charge will be interpreted by local authorities as a ‘standard’ charge and that weekly care fees will therefore increase for many people, rather than go down. For the 14,000 people in Wales that currently pay for home care, which includes help with basic tasks such as washing and dressing, the weekly charges vary dramatically – people in one South Wales council pay £16.20 per week whilst others pay £200. The Coalition’s other concern is that there is no national standard for deciding who is eligible for social care funding – local councils are free to apply their own eligibility criteria, with some areas only allocating funding to those with ‘critical’ needs. The Coalition believes that the only way for the social care system to guarantee equality and fairness is to introduce free home care for all. Ms Davies concludes: ‘...every attempt to address this matter exposes that charging is unjustifiable and brings us closer to the day when no-one has to pay additionally for state support simply to get out of bed.’

posted by Cheselden Continuing Care at
18:04

Speaking at the national children and adult services conference, Andy Burnham has pledged that age discrimination in the NHS and social care services will become illegal by 2012. The health secretary’s announcement was made after research commissioned by the Government revealed that older people are receiving a lower standard of treatment from the NHS and social services than younger people. In particular, the care given to elderly stroke patients and older people suffering from mental health problems was singled out as markedly worse than the care received by younger patients. A survey undertaken as part of the research revealed that 50% of doctors that care for older people consider the NHS to be ‘institutionally ageist.’ Mr Burnham commented on the research and on the 2012 deadline to bring in the new legislation: ‘The age discrimination ban in the Equality Bill should apply for health and social care across England, Wales and Scotland at the same time as other sectors – in 2012. Meeting that deadline is ambitious, but achievable – and it’s vital if a central tenet of the national care service, the pursuit of fairness and equity, is to be upheld.’ A spokesperson for the NHS recognised that attitudes towards older people need to change, but that this change has to be echoed in the wider community as ‘…the NHS does not exist in isolation.’

Mr Burnham also told the conference how the forthcoming National Care Service, that will integrate the funding and running of health and social care services, will eradicate the current problems faced by the elderly where ‘…people play a random game of chance – with their financial wellbeing as the stake.’

posted by Cheselden Continuing Care at
18:02

Tina Donnelly, director of the Royal College of Nursing in Wales, has written an article for Wales Online explaining the vital contribution that is made by voluntary care nurses and calling on the Welsh Assembly Government to confirm that they will continue to support the service. Around 25% of nursing care in Wales is provided by the voluntary and independent sector and most of their work is in continuing care and specialist roles such as cancer care. Patient feedback has proved that voluntary care nurses, who work alongside NHS staff, make a real difference to the experiences of patients (particularly those with long-term conditions) their families and carers. Although a great deal of their work is done in hospitals, specialist nurses also make a valuable contribution within the community by working with GPs to promote public health and the appropriate use of community health services. Unfortunately, funding for voluntary care nurses has been badly hit by the recession, with downturns both in donations and public funding, and the service’s future is under threat unless the Welsh Assembly agrees to secure alternative funding.

posted by Cheselden Continuing Care at
13:54

The Care Council for Wales has launched a brand new website which provides comprehensive information for social care service uses, social workers and students. Available in both English and Welsh, the site has been designed to be clear, concise and easy to navigate so that visitors can quickly find the information that they are looking for. As well as providing information and up to date news on social care developments and events, the site’s ‘Your voice’ section invites service users, carers and the public to get involved with the Care Council and provide feedback on its services. Visit the new website at www.ccwales.org.uk

posted by Cheselden Continuing Care at
13:52

As of 1 October 2009, the organisational structure of NHS Wales has changed. The previous system of eight NHS trusts and 22 local health boards (LHBs) has been replaced by three new LHBs. The new LHBs will be responsible for secondary care services including hospitals and community services as well as primary care services such as GPs, pharmacies and dental surgeries. A key aim for the new boards will be to reduce unnecessary hospital admissions, by providing as many services as possible within the community or at the patient’s home, and to reduce waiting times for operations. In an article on the Wales Online website, Welsh NHS Confederation policy and communications manager Jonathan Davies expresses the organisation’s commitment to balancing the growing need for continuing care funding against budgetary pressures. He comments: ‘Increased pressure and demand on NHS services from an ageing population whose needs are often complex will mean that the new NHS faces a steady growth of demand for its services. The impact of the growing number of elderly patients will also lead to increased numbers of people being eligible for continuing healthcare. It is important that these patients receive the appropriate care in the right clinical setting. But, as a result of the Grogan legal judgement, the cost impact on the health budget will be substantial.’ For more information on the new LHBs and the areas of Wales they will cover, please visit the NHS Direct Wales website.

posted by Cheselden Continuing Care at
12:37

The Social Care Charging Measure, soon to be introduced in Wales, has led to concerns that home care costs will rise rather than fall for some residents. 14,000 people in Wales currently pay for home care charges. The Measure aims to combat the existing postcode lottery whereby people in different areas of Wales pay ‘wildly differing’ weekly rates for home care – ranging from just £16.20 to as much as £200. The new legislation will introduce a maximum weekly rate which is yet to be confirmed. The Coalition for Charging Cymru, which opposes any charge for home care services, is concerned that the new maximum rate will be seen by service providers as a ‘basic or standard charge’ and that the weekly charge for many people will increase. Rhian Davies, who leads the Coalition, comments: ‘The Social Care Charging Measure is definitely needed and long overdue, but getting the detail right is crucial. The effectiveness of the measure, and any potential benefits to people who use home care services will all depend on how this measure is applied…There must not be a situation where people are worse off because of the…maximum charge and having to pay more for their care.’

posted by Cheselden Continuing Care at
20:36

The Welsh Assembly Government is to impose a deadline after which it recommends that continuing care cases pre-dating April 2003 are no longer reviewed for retrospective funding. The deadline has been set for 4 December 2009. The Assembly has pledged to widely publicise the deadline so that all patients and their families who might be affected are made aware of the cut-off date for funding reviews. Although the deadline does not represent statutory law, it will be much more difficult for patients and families to obtain a review after the date has passed. Therefore, anyone who feels they have wrongly paid for care home fees in Wales before April 2003 should contact Cheselden straightaway so that their case can be reviewed as soon as possible. A spokesperson for the Assembly comments: ‘The WAG now intends to wind up these (review) arrangements. Individuals who believe that they may have been entitled to continuing NHS healthcare during this period have until 4 December 2009 to submit a claim. Claims relating to later periods are not affected by this cut off.’

posted by Cheselden Continuing Care at
15:39

The BBC’s Politics Show Wales has tackled the issue of ageism in the provision of services by the Welsh NHS and by the country’s care and housing providers. The Welsh branch of the newly-merged charity Age Concern and Help the Aged has described all these services as ‘institutionally ageist’ and has stated that ageism in Wales is rife across both the public and private sectors. The charity’s equalities manager Martyn Jones described to the BBC how some health service treatments were perceived to have an ‘imposed cut off that was based entirely on the chronological age…where perhaps certain services are not delivered to older people.’ Mr Jones went on to comment that the provision of treatments to older people appears to be analysed during diagnosis to see if it is cost-effective to provide the treatment and therefore extend the patient’s life. Both the Royal College of Nursing and the Welsh NHS have vehemently denied the accusations of ageism and reject the implication that clinical decisions are made on the cost-effectiveness of treating elderly people. However, a spokesperson for the Royal College did acknowledge that if people actively think that there is an ageism issue, then that is itself a problem.

You can find out more and watch a video clip from the Politics Show Wales at the BBC website.

posted by Cheselden Continuing Care at
16:33

A leading independent provider of social care services in Wales has described how the rapidly-expanding care sector could help the country’s economy to recover and move out of recession. Mario Kreft of the Wrexham-based Pendine Park care provider pointed to the fact that 80% of social care in Wales is now provided by independent firms like Pendine, whilst being mainly publicly funded. He has launched an initiative in Wrexham to encourage more providers to start working with Care Forum Wales, which regulates Welsh care providers, commenting: ‘We believe that even more independent providers want to be engaged in the process of moving standards and securing a fair deal (by signing up with Care Forum Wales). It is in everybody’s interests that we all work together for the greater good – by engaging the majority of providers in the process.’ The huge growth in the Welsh care sector has been made possible by a Memorandum of Understanding agreement that was put together by Care Forum Wales, the Welsh Local Government Association and the Association of Directors of Welsh Social Services. The Memorandum enables all parties involved in care provision to work together to improve standards and to develop services so that future needs can be anticipated and met.

posted by Cheselden Continuing Care at
16:31

Plaid Cymru councillor and prospective parliamentary candidate for Wrexham Arfon Jones has spoken out about the devastating impact that scrapping the Attendance Allowance (AA) benefit would have on the region’s pensioners. Plans to abolish the benefit and redirect the funds into other forms of social care are included in the English government’s Green Paper on the reform of social care funding in England. Wales will also be affected if the plans are implemented because the country’s benefits system is not devolved and is still controlled by Westminster. Councillor Jones fears the potential impact of losing AA on the 4,000 Wrexham residents that currently receive the benefit, as many of them would not be eligible for the social care funding that would replace AA. He comments: ‘There is a danger that those older people who are eligible for Attendance Allowance but not Social Care are likely to lose out. We already know that our older people receive less pension and other benefits than others in Europe, this will only make their situation worse.’ Across Wales as a whole 100,000 people claim AA which is worth up to £70.35 per week, depending on the claimant’s level of disability. AA is not means-tested and can be spent at the claimant’s discretion to help them cope with their disability, for example, by buying a wheelchair or by adapting their house or car. As well as opposing the abolition of AA, Councillor Jones also stated that Wales needs to be given devolved control over their benefits system in order to put an end to the current ‘blurred and confused’ system whereby Wales controls its social care funding, but not its benefits system.

posted by Cheselden Continuing Care at
16:29

The Vale of Glamorgan in Wales has welcomed the introduction of a national action plan to help the country cope with an anticipated rise in the number of dementia sufferers. The Welsh Assembly Government’s National Dementia Action Plan for Wales has now been put out for public consultation. It aims to provide support to individuals to enable them to remain independent, support communities to help their own residents with dementia and to improve access to services for everyone. Overall in Wales, there will an estimated 31% increase in the number of dementia sufferers by 2021 and the Vale of Glamorgan will be particularly affected because it has a large proportion of elderly people. Vale social services have welcomed the Action Plan as it will help them to cope with the increasing strain on their budget and services. However, they have commented that some areas of the Plan need further work, such as projects to enable more people to receive care in the community rather than in residential homes.

In other Welsh dementia news, scientists at Cardiff University have made a major breakthrough in the study of genes in Alzheimer’s disease. The University team have identified certain genes that are linked to the development of the disease and are now hoping to secure £5 million of funding that will enable them to carry out a study of 60,000 people to look for other genes linked to dementia. More details of the findings and proposed research can be found at the Wales Online website.

posted by Cheselden Continuing Care at
16:27

Wales Online reports that the Welsh NHS is to be overhauled with the core aim of treating more patients in the community and keeping them out of hospital wherever possible. The current system of running primary and secondary healthcare services separately is to be abolished from October 2009. The existing NHS trusts and local health boards will be replaced by new, integrated local health boards (LHBs) which will provide all healthcare services under a single umbrella. In making this move, Wales is following the example of Scotland and Northern Ireland who have already implemented single organisations to run all their healthcare services. The main aim of the LHBs to provide community health services so that people can be treated outside hospitals was a major recommendation in Derek Wanless’ 2003 review of the Welsh health service. Dr Richard Lewis, Welsh secretary of the British Medical Association comments: ‘This is an opportunity to deliver some of the recommendations that Wanless made – that the NHS needs to focus on high standards of primary and community care services to give patients better healthcare in the right place and not necessarily in expensive secondary care facilities.’ As well as improving standards of care and cutting costs where possible, the new system aims to be more responsive to patients’ needs, to enable earlier intervention and treatment and to provide faster access to better co-ordinated health services.

posted by Cheselden Continuing Care at
16:21

Welsh Assembly Member Lesley Griffiths is urging the public to get involved in the consultation process for the National Dementia Action Plan for Wales before the deadline of 11 September 2009. The Action Plan was announced in June and introduces new measures to meet the needs of dementia sufferers and their carers as well as raising awareness of dementia and reducing the stigma that surrounds the illness. Other areas covered include end of life care, housing issues and how patients can be cared for more effectively in their own homes, for example, by using new technologies such as telecare. The implementation of the Action Plan is a priority for the Welsh Assembly Government, which recognises that it must be suitably equipped to deal with an estimated 35% rise in dementia sufferers over the next 20 years. Ms Griffiths comments: ‘There will be a rapidly growing need for dementia care right across Wales in future years. In Wrexham, for example, it is anticipated that the number of sufferers aged over 75 years old, will increase by a staggering 60% by the year 2021. This tells us why we need this Plan in place now.’ To find out more about the National Dementia Action Plan for Wales and how you can get involved in the consultation process, visit the Welsh Assembly Government website.

posted by Cheselden Continuing Care at
16:02

A healthcare support worker (HCSW) based in South Wales has pledged to raise the profile of her profession as she believes that her work and that of her colleagues is being undervalued. Natalie Rowles who works at County Hospital in Griffithstown is responsible for helping to provide continuing healthcare packages for people with serious health needs who are being cared for at home. Her work involves carrying out medical procedures such as feeding through stomach tubes, catheter maintenance and giving oxygen therapy. However, she often meets with disapproval from nurses, who do not believe that she is qualified to do this work. Although Natalie has not followed the same training path as a nurse, she has been awarded a Level 3 NVQ in Health & Social Care and is on the same salary banding as nurses. She comments: ‘People don’t know the clinical side of our work and many of them are nurses. They assume when I say I’m an HCSW that I have no qualifications. I’ve seen and heard that happen so many times to my colleagues and myself. I think we are undervalued, but a lot of it is down to misunderstanding.’ Natalie has recently won the Nursing Standards magazine’s healthcare assistant of the year award and has written about her experiences as a HCSW in the British Journal of Healthcare Assistants. She hopes that her award and article will help to change attitudes towards HCSWs from the rest of the medical world and gain them the recognition that she feels they deserve.

posted by Cheselden Continuing Care at
09:41

A new scheme has been introduced in North East Wales that aims to improve the diets of elderly people in the area and help to stamp out malnutrition. The project is being jointly funded by the Welsh Assembly, Flintshire Local Health Board and the Wrexham Health, Social Care and Wellbeing Partnership. The Prevention of Malnutrition Project will be led by Tony Burgos, a specialist dietician based at Wrexham Maelor Hospital. In Wales, more than 1 in 10 people over the age of 65 is malnourished, amounting to around 5,800 people in the North East region. There are serious health implications for sufferers, as Tony Burgos explains: ‘If it’s not spotted early on it can lead to debilitating problems such as muscle wasting, increased risk of falling, more infections, longer healing and recovery from illness, and longer stays in hospital.’ The cost of treating people that are suffering from malnutrition across the UK is around £13 billion and with the elderly population steadily increasing, this cost is set to rise unless the diets of elderly people can be significantly improved. The Prevention of Malnutrition Project aims to achieve this by working with elderly people and their carers in hospitals, care home and in the community to establish best practice in North East Wales which can then be rolled out across the country and beyond.

posted by Cheselden Continuing Care at
09:33

Hospitals in Wales are trialling a new communication system which will help reduce the risk of gaps in a patient’s care and allow staff to respond more quickly to changes in their condition. The ‘1,000 lives’ campaign aims to improve the way that patient care is handed over from one member of staff to another by encouraging staff to use the SBAR system. Originally used by the armed forces, SBAR involves staff members completing a form to provide essential information about a patient’s condition that is then shared with other healthcare professionals that are involved in the patient’s care. For example, a nurse might complete the form at the end of a shift and pass it on to the nurse working the next shift. The form will prevent the patient having to be repeatedly reassessed or asked the same questions by different people. The information it provides will also enable a patient that urgently needs help to be treated more quickly as staff will immediately be made aware of their condition and situation. It is hoped that the implementation of SBAR will result in increased speed and efficiency of patient care as well as reducing the likelihood of harm caused by delayed treated or poor communication. For more information on the ‘1,000 lives’ campaign, please visit the NHS Wales website.

posted by Cheselden Continuing Care at
13:20

Welsh deputy minister for social services Gwenda Thomas has spoken to Wales Online about the Dignity in Care programme launched by the Welsh Assembly Government in 2007. The programme aims to improve the dignity and respect with which people are treated, whether they are being care for in hospital, a care home or in their own home. Dignity in Care has initially focussed on the treatment of older people but it may now be extended to also cover the care of younger adults and children in Wales. A number of initiatives within the programme have proved to be successful in improving the standards of care for older people, including:

• Events and training to raise awareness amongst care staff about treating people with dignity
• Compulsory submission of plans to the Healthcare Inspectorate Wales by local healthcare providers, describing how they will promote and implement Dignity in Care
• The sharing of good practice between organisations and across sectors

A national group has now been established to coordinate the programme and its activities, with representatives from charities, health and social services, independent care providers and academics. The first conference on Dignity in Care, entitled the Big Care Conversation, has taken place in Monmouthshire and enabled older people and their carers to give their views on how care practices can be changed to ensure that people get treated with the right level of dignity and respect.

Ms Thomas and the Assembly are so satisfied with the progress that the 10 year programme has made so far that a further £100,000 of funding has now been released to enable further development and new initiatives to take place. She comments: ‘Wales is recognised as a leader in its field for the way it cares for older people…This can be demonstrated by our work to improve the quality of life of older people through our Strategy for Older People and our appointment of the first Commissioner for Older People. I am pleased that dignity in care is one of the themes that will be looked at during the review of the national service framework for older people.’

posted by Cheselden Continuing Care at
13:17

In an article in Wales Online, the Welsh Royal College of Nursing (RCN) has urged the Welsh Assembly to reform the country’s current system of providing continuing care. In Wales, most continuing care is provided by the independent sector rather than the NHS. The RCN wants to see a fairer system where everyone who is entitled to continuing care is told about it and that equal access is available to funding throughout Wales. At present, many people with serious health conditions are unaware that they could be eligible for funding. And nursing staff are struggling to apply the complex assessment system consistently and fairly to all patients. The RCN calls on the Welsh Assembly to make sure that local health boards provide adequate facilities and resources to enable everyone in the community that requires nursing at home or in a care home to receive it. The way that nursing care beds are funded in the independent sector needs to change as its limitations could cause care homes to close, resulting in a lack of places for people leaving hospital. The RCN also wants to see investment in training nurses and healthcare workers that deliver care in the independent sector as well as more funding for e-health solutions such as telecare, which can help ease the burden on resources whilst promoting patients’ independence. It supports the Assembly’s proposed Social Care Charges (Wales) Measure, which it recognises will lead to important developments in how social care is funded.

posted by Cheselden Continuing Care at
14:16

Care Forum Wales has described how social care standards in Wales have improved since devolution took place ten years ago. The Care Forum was established in 1993 in anticipation of devolution and by 1999 had already laid the groundwork for the successful partnership now enjoyed by the independent care sector and the Welsh Assembly government. Mario Kreft, honorary chief executive of Care Fourm Wales believes that this partnership along with the increased focus on the precise needs of Welsh people has resulted in higher standards of social care across the country. He explains: ‘…we have a different slant to rest of the UK – and social care is all the better for our uniquely Welsh approach. We were the first in the world to have an Older Person’s Commissioner.’ The Assembly is currently working on a 10 year strategy to map out the future of social care services in Wales and independent care providers are expected to play a central part in the new agenda.

posted by Cheselden Continuing Care at
13:52

An article in Wales Online [link to http://www.walesonline.co.uk/news/health-news/2009/07/10/trapped-by-caring-for-a-relative-with-dementia-91466-24117584/] has highlighted the lack of support that is available for people in Wales that care for a relative suffering from dementia. Through the example of Keith Dewhurst who cares for his mother Odette, the article describes the problems faced by family members whose lives are completely changed when they become carers. As well as providing 24 hour care for his mother and rarely being able to leave his home, Keith has also had to give up his job and all his hobbies to look after Odette. On top of providing care himself, Keith pays £300 per week to a domiciliary care company to provide vital help such as getting Odette in and out of bed. He feels isolated and unsupported by social services, blaming politicians for their attitude of praising unpaid carers for their work whilst doing little to ease their burden. He comments: ‘Until dementia…is seen in the same light as a serious illness then carers will have to cope, often by themselves, with little or no help on the ground…It’s difficult to say how much longer I can care for her at home, but at the moment I feel trapped.’ Keith also draws attention to the ‘postcode lottery’ of care costs in Wales, with care home fees starting from around £350 in some areas and going up to £1,500 per week in other regions.

It is hoped that the support system for unpaid carers in Wales will improve when measures from the forthcoming Welsh Green Paper on social care (which will be based largely on the English Green Paper published on 14 July 2009) are introduced.

posted by Cheselden Continuing Care at
12:38

The All Party Parliamentary Group (APPG) for Parkinson’s Disease has reported that there are wide variations across Wales in the support available to Parkinson’s patients – and that the same problems are to be found throughout the UK. Problems include a lack of information, respite care and expert nursing, caused by an overall failure to deliver co-ordinated care. The APPG’s report also revealed that Government guidelines on caring for Parkinson’s patients – which could save the NHS £3million – are not being followed. It urged the Welsh Assembly to address the problems by monitoring local Parkinson’s services to ensure good practice, train more nurses so that all patients in Wales can receive specialist treatment and make more funds available for research into treatment. The APPG’s report: ‘Please mind the gap: Parkinson’s disease services today’ can be read or downloaded at the Parkinson’s Disease Society website.

posted by Cheselden Continuing Care at
16:31

Deputy Minister of Welsh social services Gwenda Thomas has released further details of Wales’ plans to reform the way that local authorities charge for non-residential care. The proposals aim to make the charging system clearer, fairer and more consistent across the country. Amongst other measures, local authorities will be required to provide much more free information to service users about their charges, how they are calculated and how the user can obtain a review. Ms Thomas also announced the launch of the First Steps Improvement Package which has been developed further to stakeholder consultation and independent research. The Package will be introduced to local authorities in April 2011 and will implement measures such as maximum weekly care charges to safeguard those on low incomes; mandatory adherence to the Fairer Charging Guidance; and the compulsory disregard of Constant Attendance Allowance and Severe Disablement Allowance when assessing for care costs. Ms Thomas commented on the package: ‘I am delighted to announce this intended package of reform…This will provide a further financial safeguard to ensure that the burden of charges is reduced to some of our most vulnerable people.’

In other Welsh care news, Gwenda Thomas announced her plans to extend the compulsory registration of social care workers in Wales to managers of adult care homes and domiciliary care services. Social workers and students and most people working in the child care sector already have to be registered with the Care Council for Wales. Adult care home managers will need to register by 1 July 2010 and domiciliary care managers by 1 July 2012. Ms Thomas also stated that registration will eventually be extended to all staff working in the social care sector, commenting: ‘This is an important step in our policy to promote the development of a high quality and well qualified workforce for social care in Wales.’

posted by Cheselden Continuing Care at
16:03

In more home care news, the Welsh Assembly has announced the introduction of a new bill that will end the country’s ‘postcode lottery’ of domiciliary care costs. The existing system has been described as confusing and complicated and has led to residents in the Neath Port Talbot area paying up to £183.80 more per week for home care than people living in Rhondda Cynon Taf. In total, 66,000 people in Wales receive some form of community care, of which half can legally be charged a fee. The new proposals, made possible by extended powers recently granted to the Welsh Government, will allow local authorities the discretion to offer services at a low cost or for free as well as introducing maximum charges. The Assembly’s overall aim is to ‘create a more level playing field in relation to charges for domiciliary care services’ and to build on its existing commitment to enable more elderly and vulnerable people to receive care in their own homes for longer. A £9m project launched two years ago has so far reduced or removed the cost of domiciliary care for 14,000 of Wales’ most vulnerable residents. The Welsh Assembly is currently working on its own Green Paper for the reform of the country’s social care funding, which is expected to reflect many of the options put forward in the forthcoming English Green Paper.

posted by Cheselden Continuing Care at
15:52

The Carers’ Legislative Competence Order (LCO), which aims to support some of the most vulnerable people and families in Wales, has been presented to the Welsh Assembly. It represents the next step in the Assembly’s gain of powers to create new legislation to support the provision of carer and carers themselves in Wales. Over 70% of community care in Wales is provided by unpaid carers and despite high standards in some areas, research has shown that this is not the case throughout the country. The quality of carers’ assessments and the information and support that is provided to them has shown to be patchy. Deputy Minister for Social Services Gwenda Thomas comments on the Assembly’s commitment to supporting Wales’ carers: ‘We must all acknowledge the vital role that carers have in our society; it’s a matter that goes to the heart of sustainable health and social services. Seeking new legislative powers will ensure that their selfless work will be supported by appropriate services’. A report entitled ‘Paying for Care in Wales’ was also welcomed by the Assembly and recommends how the current system should be reformed. This will be used to create a Green Paper which is expected to be available for consultation later in 2009.

posted by Cheselden Continuing Care at
14:16

The charity Age Concern Cymru and Help the Aged in Wales has announced the launch of ‘My Home Life Wales’, a new programme designed to improve the quality of life of residents of Welsh care homes. Recent research has shown that care home residents are amongst the most socially disadvantaged groups in the UK, with mental health problems affecting around two thirds of the population. Staff and management working in the care home sector, whilst doing their best to provide high standards of care for residents, are frequently hampered by bureaucracy and a lack of resources and support. Age Concern and Help the Aged (now merged) has responded to these problems by setting up the ‘My Home Life’ programme which will operate across the UK, with implementation in Wales being handled by the Welsh arm of the charity, supported by the Welsh Assembly. The programme will focus on eight wide-ranging areas that research has identified as necessary to improving the quality of life for care home staff and residents. The concepts of relationship-centred care and the Six Senses Framework will underpin the programme’s work in all eight areas. These concepts consider a care home to be a community where the staff, residents and their friends and families all have six basic ‘senses’ that must be fulfilled: security, continuity, belonging, purpose, achievement and significance. Crucially, ‘My Home Life’ will be run by the care home sector rather than a regulatory body, allowing care homes to take ownership of and manager their own programmes, using existing expertise and positive examples from within the sector to reinforce best practice. For more information on the programme, please visit www.myhomelife.org.uk.

posted by Cheselden Continuing Care at
13:54