The telegraph has reported the stories of three families who reclaimed their relatives’ care home fees after successfully challenging the National Health Service decision not to award them NHS continuing health care funding. The families of Judith Roe (74) and Marjorie Eyton Jones (88), who both suffered from Alzheimer’s, won back £130,000 and £165,000 respectively. The family of Rod Johnson (54) who was left partially paralysed following a brain haemorrhage were awarded £51,500.

http://www.telegraph.co.uk/health/healthnews/6053909/NHS-care-home-refunds-are-the-tip-of-the-iceberg-leading-lawyer-warns.html

Most state funding for care home residents is provided via local authorities. If the social service department assess an individual as needing a care home, unless they have been sectioned under specific sections of the Mental Health Act, they have to financially assess  the care home resident to determine if they will pay towards his or her fees and if so how much. However if a individual’s need to move into a care home is primarily of a nursing or medical nature they may qualify for NHS continuing health care funding which is not means tested.

Age Concern’s factsheets 10 and 20 give more comprehensive information about the state system of funding for care home residents, including the criteria used to determine what a primary health care need is. http://www.ageconcern.org.uk/AgeConcern/factsheets.asp

The Relatives and Residents Association has publised research on The Commission for Social Care Inspection's (CSCI) inspection of care homes for older people: Inspection in Action: making inspection work.

The Comission for Social Care Inspection(CSCI) was responsible for:

• the registration and inspection of all care homes in England;
• enforcing the regulations and national minimum standards relating to care homes;
• publishing their inspection reports and
• awarding a star rating to for each home for how well it performs againsnt the national minumum standards. 3 stars signifies an excellant home, 0 star a poor home.

These functions have now been taken over by The Care Quality Commission.

The Association concluded that there were wide variations in the way CSCI awarded star ratings. It also criticized examples of reported poor practice being tolerated and called for the new system of regulation being introduced to remedy these failings.

The Relatives and Residents Association is a national charity which exists to promote the well being and to represent the interests of older people in care homes. You can find out more about their work, including how to purchase this publication, through their website>

The publication of the national dementia stategy is good news.  In time, it should lead to more people being diagnosed earlier and to improved services, both for people with dementia and carers of people who have dementia.

With funding provided by the Freemasons' Grand Charity, EAC has been working to improve our knowledge of different accommodation and care options for elderly people who have dementia, particularly when they are diagnosed early.  Traditionally people with dementia have usually stayed in their own home, with many being admitted to care homes in later stages.  Late diagnosis has led to there being few alternatives.  This is still what happens for many people.  Housing providers have been working hard to improve services however and now an increasing number of sheltered and retirement housing schemes offer on-site care services.  A small number of these schemes provide specialist services for people who have dementia, enabling them to live in their own flat in a supportive and enabling environment.  EAC is able to advise callers to their Advice Line whether there are any schemes like this in their area.  EAC also has information about care homes for people who have dementia.

The strategy promises a personal dementia advisor for everyone with a diagnosis.  This proposal is particularly welcome.  With the help of an advisor, a person diagnosed at an early stage can be meaningfully involved in planning for their own future needs.

EAC looks forward to assisting in the provision of high quality information for people who have dementia, as well as for their family and carers.

Dame Joan Bakewell who has been appointed a champion of elderly people by the government, is encouraging people to sign the manifesto for change in Times Online.Dame Joan's role is to act as an ''independent and informed advocate'' on issues affecting elderly people.The manifesto for change is how to improve conditions and make good quality care more accessible and more affordable.

• Read more about the manifesto for change in Times Online
• Fill out the Times care homes petition here

Up to now only residents in care homes provided by public bodies were covered by the Human Rights Act. Recently introduced government legislation has ensured that care home residents in privately run care homes (both private and not for profit) whose fees are funded by the State, or where the contract is arranged by the State, now have the protection of the Human Rights Act.

Prior to this state intervention a number of high profile court cases had found these circumstances to be exempt from the Act as the providers of accommodation were not''exercising a function of a public nature''.

The government introduced measures in the Health and Social Care Act 2008 to overturn the precedent set by these cases. The relevant provision (s.145) came into force on 1/12/08 

EVIDEM is a major new initiative on identifying what works in the care and provision of services for people with dementia or memory problems, which is looking for volunteers to help in reaching their goal.

Ther are five projects that will consider diagnosis; challenging behaviour; incontinence at home; enhancing end of life care; and practical guidance on the use of the law about making decisions for people who might be unable to do so themselves (the Mental Capacity Act 2005).  EVIDEM is seeking volunteers who live in North London, Essex, Hertfordshire and Bedfordshire.  They may live in any setting.  If you, a person you are looking after, or a friend or family member are currently experiencing memory problems or have been diagnosed with dementia and want to consider volunteering to take part, please contact one of the Programme Managers by E-mail or telephone:
David Lowery: d.lowery@nhs.net / 020 3214 5889 or
Jane Wilcock: j.wilcock@pcps.ucl.ac.uk / 020 7830 2239

They will be pleased to answer any questions you may have that will help you to decide if you want to be involved in this important research.

The Commission for Social Care Inspection (CSCI) has recently published a study “Safeguarding adults” on the effectiveness of local authorities’ arrangements to safeguard adults, including elderly people, from abuse and on the support they offer to those who experience abuse. CSCI’s report found: 

• The effectiveness of arrangements to help prevent abuse and provide support for people who have been abused varies within and between local authorities’ areas.  It also varies within individual care services. There are councils showing active leadership and building strong strategic partnerships. However, there is a gap between the best and worst performers.
• More needs to be done to ensure people who direct their own support are safeguarded.  
• The evidence suggests that if a council is performing well safeguarding its adults a greater number of care services in its area are also performing well. There is an also a positive relationship between a care service’s overall CSCI quality rating and its ability to safeguard adults.

CSCI is the government body responsible for regulating and inspecting all social care providers - whether public, commercial or not for profit. They are also responsible for assessing the performance of local councils’ social services departments. Their press release can be viewed at http://www.csci.org.uk/about_us/press_releases/people_experience.aspx. The full report can be downloaded free from http://www.csci.org.uk/PDF/safeguard%5b1%5d.pdf

 A recent Ombudsman report which can be found in their News section has found maladministration by a local authority  in relation to a number of issues in their provision of care services to an elderly man after his wife died. 

http://www.lgo.org.uk/news/info.php?refnum=262&startnum=5  

The report  states that initially the Council provided a package of  care at home but there were serious concerns about the quality of care and the Council failed to ensure that the agency was complying with the care plan. It goes on to explain that the client was subsequently admitted to hospital and on his discharge the Council failed to undertake a proper assessment of his needs and he was placed in a care home against both his and his family's wishes.

Finally, it states that while the person was in the home the Council assessed him as a permanent rather than a temporary resident and consequently made excessive charges.The Ombudsman found maladministration causing injustice on a number of counts and the Council agreed to:

• improve its monitoring of home care packages
• improve its assessments of residents on discharge from the hospital
• refund the excessive residential care charges of £11,800.64 levied on the basis that the person was a permanent rather than a temporary resident
• pay compensation of £600 to the person and £200 to the family for the avoidable distress and inconvenience caused, and £200 for time and trouble to the family member pursuing the complaint.

EAC's Advice Line provides advice and information on care at home and care in care homes, rights to assessment and care home funding, and can be contacted on 020 7820 1343.