The Duchess of Windsor is reported to have said that you can never be too rich or too thin. I don’t know about the first but you can be too thin.
Malnutrition refers to low body weight and/or recent weight loss and it is still with us. It is far more common than most people think. It affects all ages, but older people are particularly at risk and more than a million people over the age of 65 are affected.
This blog was contributed by Baroness Sally Greengross, a crossbench member of the House of Lords. Baroness Greengross is seeking to amend the Care Bill, which is currently being debated in the House of Lords, on the issue of delayed discharge.
The Care Billthat is currently being debated in the House of Lords is a vital part of the changes that are necessary to reform social care in England, by clarifying and bringing up-to-date the legal framework of the care system. A key area that the Bill must address is the delay that those needing social care experience, while waiting for a package of support to be put in place to enable them to leave hospital.
Facing a stay on a hospital ward can be difficult for anyone but for an older person being admitted following a crisis, such as broken hip from a fall at home, it can be particularly upsetting and disruptive.
Recent statistics show that people who experience a delay in accessing social care, go on to wait much longer for a package of support to be put in place compared to when the Government came to power. Someone will now wait an average of 27 days in hospital before a social care package is put together to allow them to go home – 12.8 per cent longer. For those accessing residential care the average wait is 30.3 days. Continue reading “Guest blog – Strengthening the Care Bill”
This blog was contributed by Dr Nick Goodwin a speaker at Age UK’s annual For Later Life conference. Nick is CEO of the International Foundation for Integrated Care and a Senior Fellow at The King’s Fund, London where he leads their programme of research and analysis for improving and integrating care for older people and those with long-term conditions.
When my elderly father was in hospital recently his experience of an uncoordinated, chaotic and impersonal service was both dispiriting and disturbing to both him and his family. Whilst clinical decision-making was good, and as a result his physical health returned through the miracles of blood transfusions and intravenous antibiotics, the experience undoubtedly took a large piece out of his mental wellbeing and future self-confidence.
The underlying problem was a lack of care co-ordination. The lack of information sharing on diagnosis, procedures, results and next steps led to worried waits about the seriousness of his condition and what, as a family, we needed to put in place for home care support. Different and conflicting advice and feedback from doctors and nurses was unhelpful. The lack of communication between wards, and between nurses on the wards, meant that his medication regime for Parkinson’s was often ignored despite constant reminders. No help was given to support discharge, and no plan put in place. Continue reading “Guest blog – Mad as hell: Older people must demand a better care experience”
The first inquiry into Mid Staffordshire NHS Foundation Trust catalogued extensive examples of neglectful care and appalling patient experiences. Stories of people being ignored, dehydrated, abused were visible signs of an organisation that had forgotten basic principles of care and at worst, wilfully put organisational considerations ahead of patients. Many, if not most, of the patients involved were older people.
The second inquiry reported in February and included 290 recommendations
that could help to avoid the same situation arising again, not just in Staffordshire, but throughout the NHS. You can see what we said about it in our blog.
The government yesterday gave its response to the report in a paper titled Patients first and foremost, and there’s much to be positive about in what it says.
What happened in the Mid-Staffordshire Foundation Trust was a truly sickening and extreme example of when training, professionalism, management, and structures all individually and collectively failed very vulnerable frail patients.
Few in the health sector could claim that Mid-Staffordshire Foundation Trust was an isolated case. Most of us have heard accounts of similar failures in care in our local hospitals or care homes, some relating to individual wards, others more widespread.
Today is a watershed moment for the NHS: 31 months after the Francis report was commissioned the final report was published on the 6th February. The report makes 290 recommendations on how to improve the system and we must once and for all take this opportunity to make the deep and lasting changes that are required. A ‘sticking plaster solution’ is not going to be acceptable and will certainly not be enough to reassure millions of older people and their families. Continue reading “Mid Staffordshire Inquiry Announcement”
This blog was contributed by Dianne Jeffrey CBE DL, Chairman of Age UK and Joint Chair of the Commission on Dignity in Care.
After many years’ service in health and social care I have seen much in both to be proud of. I have witnessed excellent examples of compassionate care, met many dedicated staff and seen how high-quality services have transformed lives.
Yet I have also been deeply saddened by the knowledge that in too many cases care has fallen short of these standards, letting people down when they are vulnerable and most in need of help.
That is why I have been delighted to co-chair the Commission on Dignity in Care; an independent commission established by Age UK, the NHS Confederation and Local Government Association to bring together expertise from right across the care system, including nursing, social care, medicine and commissioning with the voices of older people and their families.
Our aim was to help health and social care sectors to find long-term solutions to tackling poor care that work on the ground. We recognise that this is a difficult task, there are no silver bullets. Instead we wanted to understand the roots of poor care and find ways to support people to take action in their own organisations.
Today, just a little under a year since we began, we publish the Commission’s final report Delivering Dignity. The report’s main message is clear. Leaders in the health and social care sector must drive a “major cultural shift” to tackle the underlying causes of poor and undignified care of older people throughout care homes and hospitals.
The NHS already has ‘never events’, things that are considered so serious they should never happen, like operating on the wrong part of the body. The Commission has recommended ‘always events’, things which should never be forgotten and should be considered as basic rules for the delivery of dignified care in every hospital and care home.
This may all sound a bit theoretical at first glance. However our report has made 37 clear recommendations for steps that could practically be taken by people at every level from front line staff to board members. Ultimately it is the individual actions of people in the system doing the right thing which adds up to major change.
Delivering dignity will mean changing the way we design, pay for, deliver and monitor care services as the numbers of older people in care continues to grow. Alongside the consistent application of good practice and the rooting out of poor care, we need a major shift in the system to ensure care is person-centred and not task-focused.
This will require empowered leadership on the ward and in the care home, as well as a lead from boards and senior managers. It will also mean changing the way we recruit and develop staff working with older people.
We have to work with older people to shape services around their needs, and listen to patients and residents and their families, carers and advocates so we learn from their feedback and continually improve dignity in care.
We are also clear that it is the leaders of health and social care who are responsible for driving better quality care. Regulation and government action has a critical role to play, but it cannot alone deliver the cultural and organisational change that may be necessary.
In February we published an interim report to consult on our proposed recommendations. We were overwhelmed by the hugely positive response it received, with over 230 responses from across the health and social care sector, patient groups, members of the public and professionals. This clearly demonstrated to me just how passionately people feel about getting care right for older people.
Our next challenge is harnessing this passion and commitment to drive forward implementation of our recommendations.
I don’t underestimate the scale of this task and know we won’t see changes overnight. But from the very beginning we were determined that this wouldn’t be just another report that sat on shelf gathering dust.
In the autumn we will be launching an action plan. We will be seeking to work with people from across the health and care system, professionals and older people to make sure change happens.