Free Pressure Ulcer Prevention Course/Training

GNCS will be providing Full Day Pressure Ulcer Prevention Courses, taught by the leading specialists at our Head Office Training Room in Kettering, over the next 21 months, FREE OF CHARGE to all Care Providers in Northamptonshire. The first of these courses is to be held on the 22nd November 2010 If you would like to book a place on this course please email, phone or fax us with your nominations for the course and we will confirm the places in writing. Places will be limited and to start, we are accepting a maximum of 2 nominations per provider, this may increase due to demand. If you have any further questions or queries, please do not hesitate to contact Chris Aitken on 01536 527176 or email chris.aitken@gncs.co.uk or fax 08702 887 160.

Free Dementia Awareness Open Day

Free Dementia Awareness Open Day

For Families and Friends of Dementia sufferers

GNCS are the Largest National Healthcare Training Company in the UK. We provide specialist Training to Care Home staff across the country to help improve their knowledge, expertise and most importantly to improve the level of care they provide. In recent times GNCS have recognised that the level of support for families and friends of people who live in Care Homes is not readily avaliable and quite often impossible to access.

With is in mind GNCS's are holding a Free Dementia Awareness Open Day for families and friends of Dementia sufferes to talk and discuss the issue surrounding Dementia, with a qualified Dementia Expert. The aim of the day is to raise a greater understanding of what Dementia is and its effect on the sufferer and families. Each person will have a greater understanding of the different forms of Dementia, and be able to cope with Dementia in a more effective way and also an opportunity to meet other people who live with and care for people with Dementia on a day to day basis and share their experiences.

Dementia is the result od damage nerve cells in the brain. Dementia may present itself in different ways and this depends on which part of the brain has been affected. Dementai can be defined as progressive loss of mental faculties including, short and long-term memory. This condition is characterised by mental disorientation and impaired judgement and has adverse effects on emotions, learning capabilities and may cause functional disabilities. A gradual losss of daily activities and skills for life can affect and Dementia sufferer.

To register your interest for the Free Open Day, please email shane.hills@gncs.co.uk or call 01536 527170. We will then confirm the date, time and location with you and send you some further information.

Warmest Regards

Chris Aitken

Managing Director

GNCS Ltd

NVQ, BTEC and Mandatory Training Package for Care Staff FREE

NVQ and BTEC

NVQ, BTEC and Mandatory Training Package for Care Staff

            

GNCS have teamed up with Forward Thinking Training Solutions and are now offering an all round Training Package for Care Staff.

Whether you have existing staff who are looking to gain Nationally Recognised Qualifications in Care or would like to enroll new members of staff on a NVQ Course, GNCS can now offer this and more, all fully funded at no cost to your organisation.

What do your Staff Recieve? 

 > NVQ Level 2 or 3 in Care (dependent upon candidates ability) 
 > Level 2 or 3 BTEC Certificate in Health and Social Care (again dependent upon candidates ability)
 > Communication Le vel 2 (Equivalent to GCSE Grade D)
 > Application of Number Level 2 (Equivalent to GCSE Grade D)
 > All Mandatory Subjects delivered in-house or externally to all staff who enroll on the programme, with
    the opportunity for other staff to access this training free of charge*
 > Access to Specialist Training, again free of charge*
 > Programme leader, available at all times to guide and support your staff through the qualifications
 > Accredited training by Edexcel
 > A Bespoke Training Package, tailored to the needs of your organisation

*Dependent upon the number of staff enrolling on the NVQ programme, the more staff you enroll the more free training will be available

How much does all this cost?

 > Nothing, GNCS have funding available for this Training NOW! Please note, places are limited
 > Continue to pay your staff at their normal hourly rate, nothing changes
 > Up to £100 rebate per person to cover your costs for your staff to attend the English and Maths Courses/
    Exam, which is relevant to the workplace

Benefits of Training with GNCS in this way

 > Fully trained staff 

> Meeting Mandatory Training requirements for all staff

 > Cost effective, reduces training costs and time throughout the year, saving of over £3000 per member of staff

 > Reduces staff turnover

 > Meets all employment legislation in the Healthcare Sector

 > GNCS do all the hard work

 > You will recieve constant support from GNCS and will be able to access further educational programmes from    the Largest National Healthcare Training Company in the UK

How to enrol your Staff?

A quick response is advisable as places are limited and going fast.

Contact us on the details below with a rough idea of how many staff you would like to take part and we will put together a bespoke package which suits your needs.

---

 

To book your places, please call 01536 527176, or download the application form below and send back to chris.aitken@gncs.co.uk stating the number of staff you would like to enrol and we can develop your bespoke training package for your organisation.

 

Click here to download the NVQ & BTEC application form

(To save application form, right click 'here' and click 'save link as')

GNCS Ltd Booking Team

Tel: 01536 527178

Email: bookings@gncs.co.uk

Fax: 08702887160

MyLOt

myLot User Profile

GNCS Healthcare Training Courses

GNCS Limited is an independent training and consultancy company dedicated to raising the standards of care in nursing homes and healthcare settings across the UK. GNCS training courses are specifically designed to help meet the clinical triggers of the Care Quality Commission (CQC) and the Scottish Commission for the Regulation of Care (SCRC).

Our courses teach practical skills and deliver a working understanding of their subject for nursing home staff and healthcare professionals. We have a network of highly qualified Associate Tutors who teach evidence based learning and promote industry best practice. We teach Tissue Viability Courses, Venipuncture Courses, Dementia Care Courses, Pressure Ulcer Prevention Courses, Medical Law for Nursing Home Courses and a wide range of associated clinical skills at both practical and theoretical levels. To find out how GNCS could help your organisation get in touch:

Telephone: 01536 527 170 Fax: 08702 887 160 E-Mail: hello@gncs.co.uk

Apology after death of dementia patient

Published Date: 25 March 2010

By SUE GYFORD

HEALTH chiefs have been ordered to apologise to the family of a frail dementia patient after a "damning" report ruled she failed to get proper treatment before her death.

The Public Services Ombudsman has upheld a series of complaints against NHS Lothian after the death of the elderly woman at the city's Liberton Hospital.

In the wake of the findings, critics have called for independent advocates to be appointed for patients with dementia.

Ombudsman Jim Martin upheld three complaints against NHS Lothian which were lodged by the woman's husband after her death in August 2008.

He made eight separate recommendations, telling NHS Lothian to apologise to the woman's husband and ordering a review of nursing care on the ward.

The woman, identified only as Mrs C, was admitted to the ERI on 18 August after a fall and then moved to ward one at Liberton Hospital. She already had multiple health problems including dementia and asthma, and since falling four days earlier had become increasingly confused, lost her appetite and was becoming less mobile.

But even though her dementia meant she was deemed incapable of consenting to treatment, when she refused to take oral antibiotics for her pneumonia, this was not written into her records and her husband was not told.

When her condition worsened and she became distressed, her husband raised his concerns with medical staff, but instead of having her treatment reviewed, she was given the sedative haloperidol.

It was not until two days after she first refused medication that she became so agitated that a doctor recommended intravenous antibiotics to combat her worsening pneumonia. Despite the change in her treatment, she died a few hours later.

The ombudsman said: "I . . . consider that the board failed to provide appropriate treatment to Mrs C during the time that she spent in (Liberton Hospital] in the form of regular medical review, reassessment following a failure to respond to treatment and in the face of a deteriorating clinical state. Mrs C also received sedative medication without appropriate assessment."

He also criticised the hospital probe into Mrs C's death, which was led by the consultant responsible for her care, who he said would not have been sufficiently objective. He did acknowledge that ensuring that Mrs C had taken the prescribed antibiotics was unlikely to have improved her chances of survival.

The city council's Labour health spokeswoman, Councillor Lesley Hinds, said:

"It worries me that we continue to have cases like this and while the health board say 'we're going to take up the recommendations', who follows it up?"

NHS Lothian nurse director, Melanie Hornett, said: "We will formally write to Mr C, but I would like to take this opportunity to offer my sincere apologies for the distress caused and the shortcomings in the care provided.

Is the UK ignoring Dementia?

Is there enough support for you if you're caring for someone who has dementia? Millions are ploughed into cancer research but 12 times less goes into looking for a cure for dementia.

Dementia costs the country £23 billion per year and more than cancer and heart disease combined.

According to the Alzheimer's Research Trust 822,000 suffer with dementia - and it's estimated that figure will pass the one million mark before 2025. Each patient costs the country almost £28,000 each year and yet just £61 per person is spent on research.

How will we cope with dementia?

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Published Date:
15 March 2010

Action to help dementia sufferers and their carers have been announced as it was revealed the numbers living living with the condition in Northamptonshire will double over the next 15 years.

A third of people over 80 are expected to develop dementia and with people living longer, the increase in dementia patients will put pressure on health services and the husbands and wives left to care for them.

A series of workshops are currently being held in Northamptonshire to create a plan on how to cope with dementia in the future.

Annette Lumb, programme manager for dementia for the Department of Health East Midlands, said: "Health and social care teams need to get these services right otherwise there are going to be problems with service provision in the future.

"Ideally we want to allow people to live at home rather than be admitted to a care home or a hospital bed."

The announcement also comes as new figures show there are more than 27,000 unpaid carers looking after loved ones in north Northamptonshire, 2,800 of whom are in poor health themselves.

Doreen Cartin's husband Billy, 72, was diagnosed with dementia two years ago. He now needs help with everything from getting dressed and going to the toilet to drinking a cup of tea.

Mrs Cartin, of Higham Ferrers, said: "I think he knows something is wrong but he doesn't know what. I still love him deeply but he is not the same man."

There are currently 7,258 people diagnosed with dementia in Northamptonshire, including 560 in Corby, 1,024 in east Northants, 1,017 in Kettering and 847 in Wellingborough. The total number is expected to rise to 11,899 by 2025.

Poor medical care put elderly residents of Cumbrian private care home at risk

Staff at a Cumbrian nursing home over-sedated vulnerable residents, gave out wrong doses of drugs and allowed some medications to run out.

Riverside Court has in Maryport been given a zero-star poor rating by the Care Quality Commission (CQC).

Inspectors said the elderly had been put at risk by poor medical care, nutritional standards and safety procedures.

In one case a doctor ordered the use of sedatives to be reduced but the dosage was in fact tripled.

In another, a sedative should have been increased at night. Instead it was cut and the higher dose was doled out during the day.

The resident’s records contained entries such as ‘sleepy this morning’ and ‘very lethargic today’.

There was no evidence to suggest the dosages had been altered intentionally.

A stock take led to the discovery that some medicines were missing and there was an excess of others.

Inspectors said this meant they had not been administered properly.

Drugs were also allowed to run out – including angina medication and painkillers.

On occasions swabs should have been taken from wounds to check for infection but weren’t because staff said they didn’t have the right paperwork.

And a catheter bag fitted to someone with a kidney infection was left lying on the floor. Inspectors had to make a member of staff put it on a stand.

Among the other failures in duty of care were incomplete care plans and delayed tests for people on blood thinning drugs.

The CQC noted that residents had been losing weight, a significant amount for some, but the situation was not being monitored.

Elsewhere in the report it was revealed that staff had not received nutrition and dementia training.

Inspectors found the quality of the Salmoor Way premises off Irish Street was lacking too.

Stained bathroom tiles were falling off the walls and one of the baths had been out of use since 2008.Toilet seats and handrails were not screwed in properly, gaps in bedroom windows had been stuffed with paper and call bells were missing.

The home has been given until the end of March to meet all of the 17 statutory requirements it breached.

Or the CQC will take further enforcement action.

Riverside charges up to £585 a week and is owned by Four Seasons Healthcare.The firm has 350 homes across the UK and has recently wiped out £800m of its £1.6bn debt by giving creditors a stake in the business.

A Riverside spokesman said: “We recognise that the home has not reached the high standards demanded in a number of areas.

"We do note that the home was praised by residents and relatives during the inspection for its caring staff.

"A comprehensive plan is in place and under the leadership of a new manager and with support from the senior management team we expect these issues to be addressed.”

“We are working closely with the Care Quality Commission and social services and are confident that the improvements being made will be acknowledged.”

Dementia 'losing out' to cancer in funding stakes

Dementia now costs the UK economy twice as much as cancer but gets a fraction of the funding to find causes and cures, a report seen by the BBC shows.

For every one pound spent on dementia research, 12 times that sum goes on investigating cancer, figures from the Alzheimer's Research Trust indicate.

Bridging this gap is urgent, it says, particularly given the numbers with dementia are much higher than thought.

With 821,884 sufferers, dementia costs the UK £23bn annually, the report says.

The number of sufferers is 15% higher than had been estimated, according to the Dementia 2010 Report , and the trust says it will now pass the one million mark before 2025.

The annual burden on the economy meanwhile is 35% higher than the previous calculations of £17bn.

Researchers from the University of Oxford compared the cost of caring for a person with dementia to the cost of dealing with cancer, heart disease or stroke - the three main causes of death in the UK.

Shouldering the burden

As well as immediate health care expenses, they looked at the costs of social care, unpaid carers and productivity losses.

Every dementia patient, they found, costs the economy £27,647 each year - nearly five times more than a cancer patient, and eight times more than those with heart disease.

It was the costs met by unpaid carers and incurred by long-term institutional care - rather than expenses shouldered by the NHS - that pushed up the burden of dementia.

But they also found that the costs of these conditions appeared to bear little relation to the respective amounts invested by government and charities in research into causes, treatment and prevention.

With nearly £600m a year, cancer research funding was 12 times that of the £50m devoted to dementia, while heart disease received three times as much. Only stroke research received less.

They calculated that for every person with cancer, £295 is spent on research, compared with just £61 for each person with dementia.

Donation dilemma

The researchers believe the fact that a larger proportion of the cost of caring for cancer and heart disease falls on the NHS, rather than the individual and their family, goes some way to explaining the discrepancy in government funding for research.

Cancer and heart charities have also tended to be larger than those devoted to dementia.

But our own perceptions of this disease - one which primarily strikes in old age - may influence what we are prepared to donate, the researchers suggest.

"Many of us know people who have had cancer or heart disease but have been successfully treated and survived, so there is a perception that something can be done, and that more research will allow even more to be done," says Alastair Gray, professor of health economics at the University of Oxford and author of the report.

"In contrast there are no cures for dementia at present; there are not even many ways of delaying it or slowing it down, so there may well be a feeling of inevitability surrounding it. However the lack of effective treatments is surely an argument for devoting more effort to research, not less."

Rebecca Wood, head of the Alzheimer's Research Trust, said the true economic impact of dementia "had been ignored for too long. This report shows that dementia is the greatest medical challenge of the 21st Century".

"If research leads to a cure for Alzheimer's and other dementias, annual saving to the UK economy would be equivalent to hosting the London Olympics twice, or funding every British university for three years."

Michelle Mitchell, charity director for Age Concern and Help the Aged, said the disease was not going to go away and it was of "paramount importance" that the research was funded now.

Andrew Ketteringham, of the Alzheimer's Society, said: "We've got a lot of catching up to do and a lot of investment to do. And if people say, 'Well, how can we afford that?', I say, 'Well, we can't afford not to do that.'

"If we could just delay the onset of dementia by five years, we'd be able to save huge amounts."

But Care Services Minister Phil Hope said that by next year the government would be investing nearly £1bn in health research. "This money is awarded to the best quality research for any health condition, including dementia.

"I have set up a new ministerial group which will drive forward research into the causes, cure and care of dementia and help dementia researchers get more access to funding. This group will hold its first meeting later this month.

"I have also just appointed a new National Clinical Director for Dementia, Professor Alistair Burns, to provide leadership across the whole dementia strategy and help bring up standards of dementia care across the country.

Doctors 'need more dementia training' - 18 Mar 2010

People in doctors' jobs need more training about dementia, a charity group has stated.

According to the Alzheimer's Research Trust (ART), many people across the UK have dementia but have not yet been diagnosed with the condition.

The organisation believes giving doctors more training on the symptoms of dementia could help to tackle this problem.

However, the ART also noted that more research into how to spot dementia in its early stages must be carried out as well.

"We simply don't know enough about Alzheimer's and other dementias to be able to reliably diagnose it in every case," a spokesman said.

According to figures from the ART, about 820,000 people in the UK currently live with dementia in the UK.

However, the organisation believes factors such as the rising life expectancy of British people will lead to this statistic going up in the near future.

ART figures also show that while a quarter of the government's medical research budget goes towards fighting cancer, less than three per cent is used for tackling dementia.

By Claire Johnson

Nurses 'need more training to care for dementia patients' - 16 Mar 2010

People in nurses' jobs need greater training in order to adequately look after patients with dementia, a professional body has said.

According to the Royal College of Nursing (RCN), training and education for healthcare staff is "absolutely vital" if care for dementia patients is to get better.

The body also said that more money needs to be allocated towards specialist dementia nurses, as they provide "invaluable" support to people with the degenerative condition.

Janet Davies, executive director of nursing and service delivery at the RCN, has therefore urged politicians to commit to offering a minimum standard of dementia care ahead of the general election.

"We urge all political parties to ensure that every patient with dementia has guaranteed access to specialist nursing care," she commented.

According to figures from the NHS, about 570,000 people in England currently live with dementia.

However, estimates suggest this statistic could double over the next three decades.

By Neil Hill

Dementia 'costing UK £23bn a year'

Dementia costs the country £23 billion per year and more than cancer and heart disease combined but receives a fraction of the funding, according to a "wake up call" report.

The number of sufferers at 822,000 is also 17% higher than has previously been estimated and will pass the one million mark before 2025, the Alzheimer's Research Trust said.

For every pound spent on dementia studies, £12 is spent on investigating cancer.

Revealing stark differences in research funding, it calculated that for every pound spent on dementia studies, £12 is spent on investigating cancer and £3 on heart disease.

According to the report, which was prepared with experts from Oxford University, dementia's overall annual cost dwarfs the £12 billion cost for cancer care and the £8 billion for heart disease.

The £23 billion is made up of £9 billion in social care costs, £12 billion in unpaid care and £1.2 billion in health care costs.

Each dementia patient costs the economy £27,647 each year, researchers found, nearly five times more than a cancer patient and eight times more than someone suffering from heart disease. The expense is driven mainly by the extent of unpaid carers and long-term institutional care - in contrast to cancer and heart disease whose costs are mainly taken care of by the NHS.

Big differences in research funding were also revealed in the study, called the Dementia 2010 report. The report calculated that £295 is spent on research for every person with cancer, compared with just £61 for each person with dementia, and it documents a "diagnosis gap" between the expected number of people with dementia and the number of patients with dementia on GP registers.

In England, it is estimated only 31% of people with dementia are registered on GP lists.

Health minister Phil Hope said: "I would fully agree that dementia is one of the most important issues we face as a population, particularly as more and more people are living longer. I want to see a step-change increase in the volume, the quality and the impact of dementia research going forward.

"We have identified the importance of research in the dementia strategy I published last year. We convened a dementia summit bringing together the top researchers from across the country and abroad. We have identified the key areas we need to take forward around the causes for dementia and the possible cures for it and how we can better care for people, to help them live well with dementia."

Concerns over care home ‘not recorded in safety report’

Investigator tells Rosepark inquiry ‘serious shortcomings’ were omitted

By Cordelia O’Neill

Published: 18/02/2010

A fire-risk assessment at a nursing home where 14 residents died in a blaze uncovered “serious shortcomings” that were not recorded, an inspector has admitted.

Giving evidence to an inquiry into the fire at the Rosepark Nursing Home in Lanarkshire six years ago, John Reid said his report a year before the tragedy had not included key findings that had caused him “concern”.

As well as the 14 deaths, four residents were injured when the blaze broke out in a cupboard at the home on January 31, 2004.

A fatal accident inquiry is trying to establish the full circumstances of the tragedy, to prevent a similar fire from happening again and establish if any precautions could have been taken to avoid the deaths.

Mr Reid was employed on a retainer basis by the home’s owners, Thomas, Alan and Anne Balmer, to carry out health and safety inspections and offer recommendations for improvements in January 2003.

But while the report given to the Balmers warned the controls in place were not adequate to reduce the risk of a fire, he omitted information that could have helped prevent, or lessen, the impact of the fire.

These included failing to include the residents of the home in a list of people who might be at risk.

They also included failing to check and record documents relating to staff fire training and fire procedures, and failing to record that fire doors to residents’ bedrooms had been propped open and the safety catches disabled.

He said he had noted and raised the issue with the Balmers but was told the residents became distressed when the doors were left shut, adding he had been “concerned but understood why they had done it”.

Mr Reid told the inquiry he had not been aware of the home’s policy of investigating a fire alarm sounding before calling emergency services.

He said, had he known, he would have told the Balmers it was “not a suitable procedure” and that staff should have been told to dial 999 immediately.

The problems came to light during an inspection of the home in which fire exits and extinguishers, staff training and other fire risks were checked.

Mr Reid told the inquiry that, while he had not documented his concerns, all of the issues had been discussed with the Balmers.

Under questioning from Crown counsel James Wolffe QC, he admitted failing to inspect documents detailing what training and information staff had been given in the event of a fire meant he could not have “a sufficient base for answering in the affirmative questions about sufficient and adequate safety training, undermining the basis of his later advice”.

He also agreed that “any risk assessment which did not address risks to the residents could not be a sufficient and suitable risk assessment”.

Mr Reid also told the inquiry he was unaware of two key documents produced by the Home Office and the Scottish Health Service that specifically addressed fire risks in care homes.

Questioned by Paul McBride QC, who is representing the Balmers, Mr Reid accepted he had lacked the “competence and qualifications” to carry out the work he was employed to do.

Northern Ireland nursing homes being investigated

An investigation into nursing homes in Northern Ireland has been launched by the Human Rights Commission.

The commission has opened its phone lines for the next two weeks to allow relatives and staff to confidentially report any problems.

It said the rights of elderly people was at the heart of the investigation.

The commission has randomly selected some nursing homes to look into, but it also wants to hear from members of the public.

Human Rights Commissioner Monica McWilliams said nursing home residents can be vulnerable, especially those with dementia.

"Individuals who are in a closed environment for 24 hours can be potentially more vulnerable than what they might be in their own homes," she said.

Lack of resources

"Of course that's what we want to investigate."

Linda Maguire, who spent 20 years as a care worker, said a lack of resources and training meant standards were not always as they should be.

"You could be the only person that they see during the day - they may have no family," she said.

"You become their friend their counsellor, you become everything to them because they have nobody else in the world.

"But you are not given the training to sustain and support that individual in those areas."

Hugh Mills, chief executive of Independent Health and Care Providers, the body which represents many private care home owners, said two-thirds of abuse of the elderly "took place in the community, outside institutional care".

"Whilst it's important to eradicate all forms of abuse, and indeed we will support any aspect that emerges from the study and its call for evidence, we will be interested to see what might emerge," he said.

"If there are issues to put right and to be more thoroughly investigated, and improvements to be introduced, we will be right behind those."

When it comes to Alzheimer's, knowledge is all

Living with dementia is hard enough – but it's made all the worse by the inadequate care and advice sufferers often receive.

Living with Alzheimer's disease is tough. I don't have dementia, but spend most of my time with people suffering from the condition and those who care for them. I usually see the positive side.

Dementia care can be so much better now than it was. You can get diagnosed earlier, while there is time to sort out your affairs, and make changes in your lifestyle to keep you at home for longer. There is medication that can delay the troublesome symptoms.

Research shows how to design buildings that support you when you start to have serious cognitive impairments, rather than hindering you. Accessible and affordable training for qualified and unqualified staff is available, so that when you need care you can get it from the right people at the right time in the right place. And if your carer is a family member or a friend, they can be supported by one of the many third sector Alzheimer's organisations.

Knowledge about how diet and exercise and daylight can help is easily available. Practical strategies for troublesome symptoms such as wandering, sleeplessness, agitation, anxiety, excessive crushing fatigue, and aggression are all well known.

But I'm angry that half the people with dementia never even get a diagnosis. I get very angry when I meet GPs who don't know what to do if they think a person has dementia, or who avoid mentioning it because they think that there's nothing that can be done. They don't even know that the local Alzheimer's organisation is waiting to help.

And I'm incandescent with rage about architects and designers winning contracts for care homes and hospitals when they don't even have basic training in dementia-friendly design. For just £800 in three days, they could learn things that would it so much easier for sufferers – simple things like increasing the light level, or making it easy to get out into daylight once a day. Or they could read a book.

Care is provided often by people who know nothing about Alzheimer's disease, because their bosses say it is too costly to train them as they only leave anyway. Service providers faced with restlessness will sedate and flatten people with dementia, with the effect that they die quicker, rather than using the practical non-pharmacological strategies for which there is research evidence.

In general we'd be inclined to sue if cancer, heart disease or a stroke was treated in this casually neglectful way; but dementia at the current level of spend already costs more than these three conditions put together.

It is pathetic that we spend a fortune in our society doing things that do not work, or are actively damaging for the person with dementia. We need to challenge the health and social care workers, builders and politicians and the entire dementia industry to get on and do the job they are paid for.

• June Andrews is the director of the Dementia Services Development Centre (www.dementia.stir.ac.uk) at the University of Stirling. She is speaking at the Living with Dementia seminar at the Wellcome Collection on 14 January 2010

Michael Parkinson says care of elderly 'downright unacceptable'

Former talk show host condemns standards in hospitals and care homes in his role as government's dignity ambassador

Michael Parkinson described the places he had visited as 'hopeless and depressing'.

Older people in hospitals and care homes are being left without enough food and drink in incidents that are "absolutely barmy and cruel beyond belief", Sir Michael Parkinson says today in a report on his work as the government's "dignity ambassador".

The former talk show host, who also speaks out about his mother's care in her final years suffering from dementia, described some homes he had seen as "little more than waiting rooms for death" and said he had been appalled by letters members of the public had sent him.

Detailing incidents he called "inexcusable and downright unacceptable", he told how one woman had written to him saying her mother had been left naked, covered in urine and in full view in a side room at a hospital, while others had complained of patients' use of alarm bells being ignored for so long that they soiled themselves.

"I've been sent letters about older people being left without enough to eat and drink, food being taken away before they have had a chance to eat it, food being left at the end of the bed on a tray where they cannot reach it, food they cannot swallow or the reverse, a sloppy, unappetising blob on a plate," wrote Parkinson, who was appointed by the government in 2008 to promote dignity in care.

"It defies all logic to spend vast sums of money to keep people in hospital or a care home, to give them expensive drugs and then to forget to ensure they get the most basic of human needs." people's human rights, he added.

Parkinson, who described some of the places he has visited in the last year as "hopeless and depressing", said he had been concerned by the care his mother had received in her nineties, which, while not deliberately cruel or neglectful, showed a lack of respect and robbed her of her dignity.

Sometimes he and his wife visited to find her dressed in another woman's clothes, and on one occasion garishly made up "like Bette Davis in Whatever Happened to Baby Jane?".

"She looked like a clown, a figure of fun," he wrote. His mother was addressed in a loud voice when her hearing was perfect, and frequently patted on the head and called "ducky", "dear" and "love" when normally, he observed, she would have broken the arm of anyone who talked to her in that way.

"Most of her care was fine, but these incidents showed a lack of respect and denied her the dignity that she, and others, deserve," he said. "In other words, she was being treated as if she was decrepit. I think that is the thing we really need to address, the fact that we treat old people as unworthy of our time and consideration.

"If we treated young people the way we treat older people there would be an outcry."

He called for an end to stereotypes of older people, and for health and care staff to take small, cost-free steps to make sure patients and residents were treated with dignity, such as not calling them by inappropriate and unwelcome pet names, maintaining their appearance and ensuring they had their own clothes. The mountains of letters he received told him such lapses were not uncommon, he said.

He also criticised the "sometimes casual, vague and unfeeling responses" the organisations concerned gave to those who made a complaint. "It's the language of delay, the sense of a complaint sinking without trace in a bureaucratic quagmire, the suspicion of a cover-up that really upsets people," he said.

Parkinson said staff and managers blamed bureaucracy for stopping them delivering more dignified care, saying common sense seemed to be missing in the way targets were implemented.

The health secretary, Andy Burnham, said: "Sir Michael's report is an invaluable insight into the experiences of people who rely on support and those who dedicate their lives to helping others.

"Dignity must be at the heart of care. To achieve this we are transforming the care and support system to make it fairer, simpler and more affordable for everyone."

The culture change that created an appetite for excellence at care home

Calderdale's care homes are under the microscope more than ever to improve and maintain high standards. Brian Coates reports on how one is being transformed

A NURSING home has battled back from heavy criticism and will soon be accepting new residents.

Woodfield Grange, Greetland, was rated as poor last July by a watchdog and new arrivals were suspended.

Its owners, Aermid Health Care (UK) Ltd, immediately brought in troubleshooter Jeni Oetgen to turn the home around and since then rapid strides have been made.

It currently caters for 17 people but is registered for 36 and the latest inspection last month, by the Care Quality Commission, found 20 assessments to be good and another six were adequate.

Its report said: "There seems to be significant improvements which seem to be having a positive effect on staff and on the quality of life for the people living there."

Mrs Oetgen said the residents who remained in the home had been well cared for but it was right the home focused on improvements before accepting more.

"It has been five months of hard slog," said Mrs Oetgen.

"If you are rated as poor you should not be admitting someone's mother."

Mrs Oetgen said she found staff were in desperate need of training and most important of all personal centred care plans had been put in place.

"Standards had dropped and there was a culture of the tail wagging the dog," she said.

"Our culture has remarkedly changed with room for more improvement towards excellence and that is where we are going."

A refurbishment programme is well underway alongside the support of dignity and privacy for residents, said Mrs Oetgen.

Her appointment was initially going to be temporary but she has decided to stay and see the job through and will be officially the registered manager next week and she now has approval from social services to take more residents.

Oldest resident Dorothy Mears, aged 101, said standards had improved and it had been upsetting that the home was given a bad name.

She has lived at Woodfield for 11 years.

"I would not be here all that time if was a poor home," she said.

Browne starts major tour of residential care homes across Taunton Deane

Taunton constituency MP Jeremy Browne is conducting a tour of residential care homes in the area to check on the facilities currently being provided for vulnerable elderly people. He started by visiting Abbeyfield in Bishops Hull and Calway House in Taunton.

Jeremy Browne said:

"There are increasing numbers of very elderly people in Britain and many require residential care or nursing provision. Somerset's population is older than the national average so we have a particular need for high-quality care provision.

"Many elderly people want to stay in their own homes, and this can be the right option, especially if additional assistance is provided. Other elderly people are very happy in residential care and benefit from being guaranteed warm rooms, hot meals and social activities.

"There is a very diverse range of provision for elderly people in Taunton Deane. There are care homes run by charities and not-for-profit companies as well as residences which are privately-owned or part of large national companies. Different people have varied preferences and requirements and it is worth examining a number of the many options available before deciding which home is most suitable.

"I have visited dozens of Taunton Deane care homes over the years and it is noticeable how the provision for dementia sufferers has improved. Many homes have a range of different services so residents with increasing dementia needs can be cared for without them being moved into distressingly unfamiliar surroundings.

"The residential care sector is also a major employer in Taunton Deane. It forms an important part of our economy and it will get bigger still as the population continues to age. I have been impressed by many of the training opportunities provided for people wanting to work in the care sector.

"We are fortunate to have many really excellent residential care homes in Taunton Deane. Both Abbeyfield and Calway House have benefited from dramatic financial investment in recent years. I want standards to continue to rise and I am looking forward to visiting many more local residential care homes in the weeks ahead."

Care home campaign

Sir Michael Parkinson is campaigning for dignified care for the elderly after finding NHS conditions unacceptable during the last months of his mother's life.

Sir Michael Parkinson has just finished his year as the Government's National Dignity Ambassador. He agreed to take up the role after his mother experienced poor NHS care at the end of her life. Now he's published a report about his findings and is calling for an open public debate about the way we treat older people in this country.

Sir Michael visited various places that provide care, including hospitals, care homes and hospices and describes stories of good and bad care and describes some care homes as "little more than waiting rooms for death, hopeless and depressing".

Delivering dignified care

When he asked staff and managers what stands between them and delivering more dignified care while doing their job, most said bureaucracy. Almost universally, they said it wasn't the idea of targets they found difficult to accept but the way those targets were implemented; common sense seemed to be missing. The savvy managers and the good leaders are those who involve their staff in deciding how to achieve the targets while making those targets work for them and their patients, and not the other way round.

Funding issues

Undoubtedly, more money, staff and time would help with care standards, but what struck him is that most hospitals and care homes run on pretty much the same amount of funding and all face similar issues around staffing and time, so why is it that some provide wonderful care and others quite the opposite?

Sir Michael believes strong leadership is the key - not just from the top of the organisation but also from individuals lower down. He found on his visits, particularly to the smaller,care providers, much of what is good about the place stems from a good manager or one or two committed individuals.

He also says staff need to be trained but providing care with dignity and respect is more about values and culture. He suggests training should involve getting staff to ask themselves every now and again 'How would I feel if that person in care were me or one of my parents or grandparents?'

Maintaining independence

Sir Michael says: "maintaining independence is a fundamental aspect of one's sense of dignity and self-worth' and describes 'Extra Care Housing Schemes' as a good way of providing this: The scheme provides staff on site 24 hours a day but people live in self-contained bungalows and apartments as opposed to just having bedrooms. There are options for communal eating and activities but people have a choice.

Another important aspect of the campaign is recognising people who go the extra mile so they are encouraged to do it more often and so others are inspired to do the same.

Wales beats bed sores (Pressure Sores)

Welsh hospitals have been shortlisted for a top national award for qualliy improvement for their work in preventing bed sores.

Early last year, staff on Morriston Hospital's Anglesey ward introduced a new SKIN bundle in the hope of cutting rates of around 4% of their patients developing a pressure sore. But not one patient has developed a pressure sore since the start of the project in April 2008.

And the success hasn’t been limited to just one ward. The good practice has been rapidly spread with other wards reporting figures that have impressed health professionals across Britain.

As of 23rd December, figures included:

Morriston Hospital

Angelsey Ward- 604 days without a pressure ulcer incident
Ward B – 284 days without a pressure ulcer incident
Cyril Evans Ward – 205 days without a pressure ulcer incident
Dan Dannino Ward – 205 days without a pressure ulcer incident
Ward V – 138 days without a pressure ulcer incident
Ward E – 121 days without a pressure ulcer incident

Princess of Wales Hospital

Ward 11 – 117 days without a pressure ulcer incident
Ward 18 - 205 days without a pressure ulcer incident
Ward 19 - 205 days without a pressure ulcer incident
Ward 2 - 205 days without a pressure ulcer incident
Ward 20 - 236 days without a pressure ulcer incident
Ward 8 - 100 days without a pressure ulcer incident

Training and awareness sessions are being held throughout January and February across all four acute hospital sites – including community hospital staff - and ABM is on target to reach every general ward by the end of March 2010.

Treating pressure ulcers is estimated to cost 4p in every £ of the NHS budget, and can be potentially life-threatening to patients.

Mr Hamish Laing, Consultant Plastic Surgeon, commented:

“We have done fantastically well to even get shortlisted against a strong UK field.

“It is a fitting tribute to all the hard work of the project team in making this such a success, and of our colleagues on the wards in implementing the SKIN bundle with such enthusiasm and commitment.

“On average, before this project started, around one in nine of all our inpatients had a pressure ulcer and most of those had developed one whilst they were in hospital. These figures were typical of acute NHS hospitals. Treating pressure ulcers has been estimated to cost the NHS in the UK £2.1bn every year.

“These latest results are fantastic and show that it is realistic to have a zero tolerance approach to pressure ulcers in hospital.”

Pressure ulcers are a common problem for patients who have limited mobility, who sit or lie in one position for long times. Because blood flow is restricted by the pressure of their weight on parts of their body, the result can be severe tissue damage. Unfortunately pressure ulcers can lead to patients needing surgery and long stays in hospital.

The SKIN bundle means that patients are assessed on specific criteria within hours of coming onto the ward. The staff measure the skin integrity of the patient (S), make sure the patient keeps moving (K), and look at issues around incontinence (I) and nutrition (N).

The SKIN bundle measurements sit at the end of the bed and indicate any risks for the patient. It is also a useful communications tool for family and friends who are keen to keep up-to-date on the patient’s progress.

The work has already been recognised with an NHS Wales Award 2009 for Anglesey Ward.

Care homes forcing elderly to have feeding tubes fitted

Thousands of dementia sufferers told they must have surgery to gain entry

Thousands of elderly people are being forced to have tubes fitted so they can be artificially fed if they want to be admitted to a care home, a major report warns today.

There is no evidence that tube feeding prolongs life, and it deprives patients of the pleasure and social contact involved in normal eating and drinking, says a Royal College of Physicians working group which recommends that artificial nutrition should only be used as a last resort.

The report found that many care homes across the country are making it a condition of residence that people, often in the advanced stages of dementia, have a tube fitted into their abdomen.

"This is an invasive procedure with a risk, so it should not be undertaken lightly," said Dr Rodney Burnham, chair of the working group. "One of the concerns we had was that we felt in many places there were cases where this was done without proper thought.

"This is a widespread problem. Many care homes say they will not take a patient until they have had a gastrostomy. There is no reason for them to do that. They should have nursing support."

With time and care, elderly people with swallowing difficulties can be helped to eat and drink normally, says the report.

Produced with the help of the British Society of Gastroenterology, the report aims to guide healthcare professionals, who are sometimes at odds over the merits and ethics of the situation. There is a misguided belief, it says, that tube feeding keeps patients alive longer. But the evidence does not support this.

A recent national confidential inquiry into patient outcomes and death (NCEPOD) investigation found 19% of those undergoing the procedure had it fitted inappropriately. "They described it as futile," said Burnham. Almost half of those who died (43%) did so within a week.

While a nasal tube is safer than a device fitted in the abdomen, a so-called PEG, the best option for patients is normal feeding wherever possible. "'Nil by mouth' should be a last resort," says the report.

It calls for agreement between the patient, relatives and healthcare professionals about the aims of artificial feeding. "Such decisions should never be based on the convenience of staff or carers. Nor should artificial feeding ever be required as a criterion for admission to any institution providing care," says the college.

All trusts and care homes should ensure there are enough staff to help those with difficulties take longer to eat, especially at meal times. "People in the later stages of dementia have complex end-of-life needs and it is vital that the use of artificial nutrition or hydration not be used in place of good quality care tailored to their specific needs," said Neil Hunt, chief executive of the Alzheimer's Society, which believes that "the quality of life should be considered a priority over length of life in the later stages of dementia".

The numbers of people in the community fitted with tubes for artificial feeding has risen steeply. One survey showed a growth of 11.6% between 2006 and 2007.

A Department of Health spokesperson said: "The use of intrusive interventions, such as tube feeding, is a clinical decision and should only be used when necessary, based on the circumstances of the person concerned, and with their or their representative's agreement. We would expect services to allow maximum choice and control wherever possible and to respect people's dignity and human rights right up to the end of life."

New multi-million pound Bristol care home rated as... 'adequate'

A new care home in Keynsham was given a one-star rating after its first official inspection.

This means the Care Quality Commission judged the care at Charlton House, part of a complex in Hawthorns Lane, as adequate.

The lowest rating is zero, meaning poor, and the highest is three, meaning excellent.

The complex, which opened in January, is one of three such centres to be built by Bath and North East Somerset Council as part of a £28.8 million redevelopment of care facilities.

Fifteen people with care needs and 15 with dementia live in Charlton House.

While residents and their relatives spoke highly of the new home and caring staff, the inspection in May revealed shortcomings in training, care plans and the management of medication.

Three care plans were checked and "none contained full clear and accurate information about the care needs of the individual and how they were to be met," said the inspectors' report.

"One contained contradictory information regarding how the individual's medical condition should be treated.

"Another did not contain information relating to personal care needs that was documented in the social services care plan. In the same care plan information recorded on the assessment documentation relating to a pressure sore had not been transferred to the care plan, and no actions recorded to advise staff as to how to manage this need to promote healing for benefit of the individual".

"A further care plan did not contain any information to staff relating to the care needs of an individual taking warfarin."

A number of mistakes with medication were reported to the inspectors.

Since the inspection, a series of improvements have been introduced. These include:

* All residents' files have been checked and are audited regularly. Letters are sent to all residents, confirming their placement and that the home can meet their needs.

* Clear systems are now in place to ensure regular reviews of all care plans.

* Medication management policies have been updated and new procedures even more clearly written.

* More in-depth training has been provided for staff who work with people with dementia.

* The management of the home has been strengthened to support the team.

A statement from B&NES communications officer Katy Atkins said: "We have high aspirations for the three centres and are committed to providing the best possible service to the people who use them.

"This is supported by the fact that two out of the three centres have been rated as 'performing well' by the CQC.

"There is still room for improvement and we have clear plans in place to further boost these ratings in all of our centres by 2011.

"The inspection of Charlton House took place on May 1 when the centre had only been open for a few months.We were pleased that the feedback from residents at the centre was very good .

"However, improvements were needed and the council has already taken action to address all points outlined in the report to help improve the initial adequate rating so the overall standards are consistent with those established at CRC's in Bath and Midsomer Norton."

Can Gerry Robinson fix Dementia care homes?

Businessman Sir Gerry Robinson returns in a new series in which he tries to turn around three struggling care homes.

In the next twenty years over a million Britons will have dementia, and sufferers are likely to end up in one of the country's privately run care homes. It's a huge business worth six billion pounds, largely paid for by taxation, yet a great deal of the care is woefully inadequate. Can Gerry, whose father had the disease when he died, change a culture of stagnant lounges, a lack of specialist training among staff, and a focus on keeping people alive rather than helping them to live a happy life?

Following last week's shocking BBC programme 'Can Gerry Robinson Fix Dementia Care Homes?', Cathy Baldwin, Dementia Training Manager, Alzheimer's Society gives her response.

Many of you watching last week's programme will come away shocked at just what goes on behind the closed door of too many care homes. The real shock is that good dementia care is not only possible but also easy to achieve with a little knowledge and know how.

The sad truth is that our expectation of care is unacceptably low. I only had a few hours with Gerry, after which he asked me why no one insisted that everyone working in care attended a dementia training course. Perhaps this is a question we should all be asking?

Dementia is caused by physical diseases that slowly destroy memories, skills and abilities yet leaves the feelings and emotions we all experience exposed. As unique individuals everyone will experience their journey through dementia in their own unique way, this is why good dementia care must focus on the person and not the disease.

The two greatest barriers people with dementia will face is the ignorance of those around them and the experience of living in an environment that enhances the disability.

Good care can make all the difference, the willingness to see the world through the experience of a person with dementia is the key. Good care is not simply about performing tasks that allow people to function; it is about recognising the person behind the condition, caring for people’s emotional needs as well as their physical. We can’t know what it is like to live with dementia, but I’m sure we would all agree that our quality of life is not only dependent on simply being washed, fed and kept warm: we all need social interaction at some level, stimulation to make life a little more interesting.

Watching the programme it is clear to see that many staff didn’t have a clue how to help residents. I wanted to be in that home to show them how easy it can be not only to improve the lives of the residents but also to gain a true sense of job satisfaction. Engaging with the people in their care at every opportunity, supporting them to continue to live their lives rather than simply existing in misery and confusion would bring everyone immense happiness.

I know that I need a purpose in my life, I need to feel valued and respected, I need to feel dignity and pride in myself, what right do we have to deny anyone these feelings and opportunities just because they have dementia?

We must see beyond the body, beyond the disease and see the unique person inside who has a lifetime of experiences, no sense does not mean no feeling, there is always ‘sense’ if we are willing to truly listen.

My lifelong passion for dementia care began as a nurse at the age of 17. Even at that young age I knew the way people with dementia were treated wasn’t right but it wasn’t until I joined Alzheimer’s Society that I understood what was missing and saw another way forward. My passion now is to share the knowledge I have gained, by providing high quality dementia care training to anyone who is willing to listen. But we all have a responsibility in changing the way we care for older people. We must challenge ignorance and misperception and speak out when we see bad practice, our complacency will only encourage the status quo!

I am thrilled that Gerry shares this passion but one man alone cannot change the system. I hope having seen the programme you too will join our mission.

To join Alzheimer’s Society campaigners’ network to help campaign for a better quality of life for everyone with dementia visit the website below or email campaignersnetwork@alzheimers.org.uk.

Click here to book Dementia Training course.