Category: CT blog


It’s a hard, hard world

Posted on November 13th, by geoff in Caring Times, CT blog. No Comments

By Caring Times editor GEOFF HODGSON

A recent survey has found that 63% of the general public believe the NHS provides social care and 42% think it’s free.

It might be difficult for we who are involved with social care to appreciate this ignorance of the reality, but most people have little engagement with social care, which is why government has hitherto felt that, as long as the system doesn’t actually collapse, it can get by with a very minimum drip-feed of extra resources.

But the increasing unmet need is making itself felt in the NHS, with frail elderly people being increasingly yo-yo’d between hospital and home – at huge cost and with huge stress to the elderly people concerned.

It is the latter which makes the situation so morally repugnant. We have come quite a long way towards social justice but it has yet … Read More »


Sign-up and pay, or perhaps pay more

Posted on November 6th, by geoff in Caring Times, CT blog. 5 comments

By Caring Times editor GEOFF HODGSON

There are powerful arguments why carers working at night in small specialist care facilities should be paid their full hourly rate, even if they spend much of the shift asleep. But there is a strong economic argument why ‘sleep-in’ shifts should be paid at a flat rate of £35-£45, with only that time spent delivering care being paid for at an hourly rate.

Until recently the latter argument has prevailed, but now the employment tribunals and the unions have insisted that the workers must be paid the hourly rate and this should be back-dated.

Care providers howled that they couldn’t afford it at the current rates of funding and that back-dated payments could cost the sector as much as £400m.

Government has responded in some measure to providers’ concerns, suspending enforcement action against them and waiving at least some … Read More »


The parallel universes of social care

Posted on October 30th, by geoff in Caring Times, CT blog. 2 comments

By guest blogger JOHN BURTON

The Care Quality Commission’s adult social care ‘productivity’ dipped in August and for the umpteenth time the 90% target of annual inspections was missed by quite a margin. Why? Well, the teams were ‘under considerable pressure’ according to the chief inspector because of holidays, sickness, vacancies, retirement and ‘enforcement actions’.

In addition, of those care homes that were inspected and received a ‘good’ or ‘outstanding’ rating, 23% – or nearly one in four – were discovered to have deteriorated. On re-inspection, 20% ‘required improvement’ and 3% (that’s still a lot of homes) were ‘inadequate’. So, more special measures and enforcement action to do. Next year, ‘good’ and ‘outstanding’ homes will be inspected even less often. The ‘timeliness’ of report writing continues to lag behind the generous ten-week target, but as usual, this is interpreted as ‘improving’.

As Andrea … Read More »


A job in care – what’s it worth?

Posted on October 23rd, by geoff in Caring Times, CT blog. 1 Comment

By Caring Times editor GEOFF HODGSON

While the Cavendish Coalition, with formidable representation of both the NHS and private social care sector, lobbies to protect the position of EU workers in a post-Brexit Britain, the biggest worry must be that these workers will vote with their feet.

When I last looked, 89 pence buys one Euro and many financial wallahs are predicting that the two currencies will continue to edge closer to parity. The incentive then, for EU citizens to come to the UK, or even remain here, and work is likely to dwindle; why work in an isolationist UK when similar wages can be earned in other western european countries?

But recruitment difficulties in health and social care go much deeper than Brexit and the question of overseas workers. The perception persists that care work is unskilled (it’s not); that it is a … Read More »


End of life care – care homes can do it well

Posted on October 16th, by geoff in Caring Times, CT blog. Comments Off on End of life care – care homes can do it well

By guest blogger Professor Keri Thomas,

Clinical director, National GSF Centre for End of Life Care

News that care homes could, based on current trends, overtake hospitals as the most common place for people to die, has many implications for the sector. Aside from the questions of funding and staffing, consider for a moment the preparedness of the existing care homes’ workforce.

As the number of deaths in care homes annually has risen over the last decade from 85,000 to 106,000, so the sector has, at least in pockets, upped its game in the way it cares for people in their final years of life.

Whereas ten years ago many residents would have endured numerous inappropriate hospital admissions and died in hospital, increasing numbers are benefiting from a better trained, more confident workforce equipped to better anticipate and fulfil their wishes. But these pockets … Read More »


The DTOCs dashboard dilemma

Posted on October 9th, by geoff in Caring Times, CT blog. 2 comments

By guest blogger JEF SMITH

The Department of Health refers to delayed transfers of care – the issue of people not being able to move quickly from acute hospitals to less intensively medical care in the wider community – as DTOCs. My problem is – how do you pronounce it? Is it DeeTeeOhCees or detox? Until someone puts me out of my misery, I’m having to avoid the abbreviation in conversation, instead spelling out the whole inelegant phrase. It almost makes me want to bring back ‘bed-blocking’.

There are, of course, bigger issues at stake. In the absence of a timely discharge, hospital managers are left holding the baby – or, more often of course, the older person – and a hospital system which depends on steady throughput suffers increasing pressure. Fresh patients wait on trolleys or in ambulances because there are … Read More »


From where I stand . . .

Posted on October 2nd, by geoff in Caring Times, CT blog. 2 comments

By Caring Times editor GEOFF HODGSON

A group of residents’ families have criticised the Care Quality Commission’s refusal to review the ‘good’ rating it awarded to the care home where the residents live. The families, who believe the care home deserves an ‘outstanding’ rating, say they made their criticism public without any prompting from the provider concerned. The story will be told in detail in the November issue of Caring Times.

Neither the families nor the regulator are necessarily wrong in their differing assessments; they are each using different methodologies and assessing different things. We may assume the families concerned visit their loved ones at the home very regularly and witness the care delivered over a long period. Their loved ones will tell them how well they are looked after and the relatives can directly observe the positive and supportive relationships between residents … Read More »


Equality & Human Rights – got them sorted?

Posted on September 25th, by geoff in Caring Times, CT blog. 1 Comment

By Caring Times editor GEOFF HODGSON

Safe, Responsive, Caring, Effective and Well-led – the regulator’s ‘Key Lines Of Enquiry’ (KLOEs) cover it all, wouldn’t you think?

Apparently they don’t. Apparently, anyone who aspires to the provision of social care must now give heed to Equality and Human Rights (their capitals, not mine).

Into this acronym-plagued milieu, I’ll throw in another; the time-honoured KISS (Keep It Simple Stupid). Social care regulation has evolved layers of such Byzantine complexity that we have come to where one piece of regulation may easily find itself in conflict with another. Providers have given me many examples of this but I must try to keep this blog short. However, take risk; on one hand there is plenty of regulatory guidance which encourages risk-taking (it’s in the human rights guidance), and an equally plentiful supply of sanctions for those who … Read More »


Flu jabs – a vexed question

Posted on September 18th, by geoff in Caring Times, CT blog. 3 comments

By Caring Times editor GEOFF HODGSON

As the days grow shorter and temperatures fall, the annual anxiety about ‘flu and whether or not to be vaccinated against it returns to plague us.

For care home operators this is a vexed question. Without doubt, flu carries-off elderly people every year, and the contagious nature of influenza makes it a big headache for care homes and hospitals.

But there is very real doubt about the effectiveness of the flu vaccine, with some scientists putting its effectiveness as no more than 50%. No one claims it to be 100% effective, and it is demonstrably not the case; many of us will know of someone who has had the jab, only to subsequently develop flu.

And there is some doubt about the safety of the vaccine, and while most health authorities do their best to assuage people’s fears, one … Read More »


Health & social care integration – an epic quest of the 21st Century

Posted on September 4th, by geoff in Caring Times, CT blog. Comments Off on Health & social care integration – an epic quest of the 21st Century

By Caring Times editor GEOFF HODGSON

For centuries, marine explorers sought to find a ‘North West Passage’ whereby ships could travel from the North Atlantic, across the top of Canada and so into Asian waters. Their endeavours were hampered by the vagaries of wind, extreme low temperatures, drifting pack ice and the very real risk of becoming ice-bound.

It was not until 2009 that a reduction in ice brought about by climate change enabled a permanently navigable North West Passage to be established.

To my mind, those who would bring about health and social care integration find themselves just as challenged as those early explorers and that, until a circumstance as potent as climate change supervenes, the best they can hope for is only limited success.

Take ‘Devo-Manc’, the health and social care integration programme for Greater Manchester which left the slipway in April … Read More »



Latest blog posts

It’s a hard, hard world

By Caring Times editor GEOFF HODGSON

A recent survey has found that 63% of the general public believe the NHS provides social care and 42% think...

Sign-up and pay, or perhaps pay more

By Caring Times editor GEOFF HODGSON

There are powerful arguments why carers working at night in small specialist care facilities should be paid their full hourly...

The parallel universes of social care

By guest blogger JOHN BURTON

The Care Quality Commission’s adult social care ‘productivity’ dipped in August and for the umpteenth time the 90% target of...