highland officials give assurances despite estimated costs soaring by £6million

Council chiefs gave an assurance yesterday five planned care homes will be built in the Highlands, despite estimated costs soaring by £6m.

In June council chiefs estimated that the cost of building the care homes in Inverness, Muir of Ord, Tain, Grantown and Fort William would be £21.5million.

But yesterday Highland Council’s housing and social work committee heard that the likely costs are now estimated at £27.26million.

Director of housing and property Steve Barron said the increase was the result of factors including inflation in building costs – which are estimated to rise by £3million by 2011 – demolition costs and external works. However, he stressed to councillors that these were only estimates.

And he added that the current costs did not include a number of extras such as decanting, IT equipment and cabling, land acquisition and legal fees. Designs are being produced for the developments at Burnside, Inverness; at Caol; and at Urray House, Muir of Ord – which are hoped to be complete by spring 2011. Negotiations with NHS Highland and the adjoining landowner are continuing over the development at Craighill Terrace, Tain.

Outline planning permission has also been lodged for the development which, it is hoped, will be completed about six months after the first three. However, discussions with NHS Highland are continuing over the funding of the care home at Grantown. In six months the health authority will confirm whether funding will be available in 2012 for a joint facility. If funding is denied, then councillors will be asked to look at developing the town’s Grant House as a care home.

Despite the costs increases, councillors remained confident in the programme.

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ELDERLY people could be facing an uncertain future after a residential home went into administration.

The financial situation at Amber House in Brunswick Village, Newcastle, has got so dire owners Helpcare Ltd and Carestream Ltd can no longer continue looking after the premises.

More than 20 residents, many of whom suffer dementia and Alzheimer’s disease, could be affected as new owners are sought.

Chris Stevens, from the business recovery service Vantis plc, which took over the property yesterday, said: “It is business as usual as the home continues caring for its residents at the highest level. Together with the management team, we are committed to identifying buyers to secure the future of the home and safeguarding jobs.

“We do understand residents’ families will be concerned, but the home will remain open and we do not foresee any problems with finding new owners soon.”

It was breakfast time as usual at Amber House this morning as staff tried to put on brave faces despite the news.

The peaceful and homely building, covered inside by photos of happier times, seemed to be carrying on in the face of adversity.

And staff said they are hopeful that no residents will be forced to move out and no-one will lose their jobs.

One staff member, who did not wish to be named, said: “We have been told everyone will be staying here. Families will be informed later today.”

A care home crisis has condemned elderly and vulnerable people throughout the region to a worrying future.

As the Chronicle reported earlier this year, Vantis plc came to the rescue when Lismore Care Home, in Kirton Park Terrace, North Shields, also went into administration.

In March the last residents left Essendene care home in Ashington.

A month before, 30 residents of Pembroke Court sheltered housing complex in Newbiggin-by-the-Sea learnt the Anchor Housing Group planned to close their centre.

And more than 100 workers and 21 residents in Meadway House, Forest Hall, and Annitsford House, Annitsford, were shocked as North Tyneside Council closed their homes.

Charity Age Concern said closures could have serious health consequences.

Karen Evans, regional development officer for Age Concern North East, said: “There is a loophole in the law that means people in privately-run homes do not have the same rights as those in council-run homes.”

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Motion sensors, video-monitoring

"This is a biggy," says Mark Barnett of Aged Care Direct, an Australian not-for-profit that provides technology information to aged care providers and suppliers. "We want to know that mum is taking the tablets she's meant to be taking and having the food she's meant to be having, and that she's not lying on the floor in the bathroom for three hours and we didn't know about it. These sorts of communication technologies are becoming an important part of aged care."

Barnett says people are receptive to this technology. "Those over 65 are number two on the list of high users of technology. We all think of our kids of being No. 1 - and they are - but retirees are big users."

The technology is commercially available but, as Seamus Small from the TRIL Centre in Dublin, says: "There's no basic retail product that you could pick up on the high street, you would need to invest some time and know-how to implement it."

Remote monitoring

Certain vital signs can easily be remotely monitored with the readings transmitted wirelessly back to health care staff. For example, the e-Health Research Centre in Brisbane is conducting a clinical trial of heart rate devices and gait-measuring monitors (accelerometers) embedded in mobile phones to assist patients recovering from strokes and heart attacks, and cut down the time they have to spend returning to the hospital for rehabilitation. "Most people are very keen to try anything that will improve their health, especially after a major event like a stroke or a heart attack," says Dr David Hansen, a principal research scientist at the Centre.

Robot carers

Meet the uBot-5, a wheeled contraption with bendable arms and a computer monitor on its shoulders, which looks a bit like Johnny-5, the robot in the soon-to-be-remade Short Circuit movie. It can dial emergency services, pick up objects, remind people to take their medication and facilitate "virtual visits" from family and health care professionals via the built-in web cam. The device is in the research and development phase at the University of Massachusetts, and its creators plan to commercialise the technology over the next few years. They aim to bring the cost of your very own domestic robot carer down to a few thousand dollars. There are similar robots in development with child-care applications.

Within residential aged care

Professor Bruce Barraclough, the medical director of the e-Health Research Centre in Brisbane, says there is a lot of potential for use of information technology in aged care facilities. Monitoring people's movements may help dementia patients who tend to wander, he says, while medication management is another field with potential. As is incontinence management: "It's possible to get monitors to identify when beds are wet - if the bed is wet for any amount of time they get pressure ulcers," he says.

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Elderly people in care homes will suffer as a result of changes to new immigration rules, bosses have warned.

Homes are likely to close and fees rise because of employment restrictions on workers from outside Europe, they said.

Martin Green, chief executive of the English Community Care Association, said his "worst fears" about the list of jobs available to non-European Economic Area workers had been confirmed.

Only the most highly skilled care workers earning more than £8.80 an hour are included on the shortage occupation list.

He warned the industry needed workers from places like India and the Philippines because similar skills were not available in Europe.

"We're going to get closures because local authorities won't pay more," he said.

"At the end of the day vulnerable people will suffer."

Heather Wakefield, national officer at Unison, warned social care would "collapse" without migrant workers and said the ageing population meant the situation was likely to get worse.

Ministers touted the new list as a toughening of the rules. Immigration minister Phil Woolas said there were 200,000 fewer posts available via the shortage occupation route.

But the Migration Advisory Committee (MAC), which drafted the list after examining labour market shortages, has said only 7% of the jobs were actually taken by non-European Economic Area workers last year.

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A Bristol care home manager has been jailed for assaulting a vulnerable resident in his care.

Danny Purgaus, who owned Overnhill House residential home in Downend, was sent to prison for three months for attacking 80-year-old Ronald Thomas.

A court heard how he grabbed Mr Thomas by the collar, pulled him from his seat and dragged him across the home’s lounge floor to an electric fire after he complained of being cold and asked for a heater to be turned up.

Magistrates said the attack was “an abuse of trust and power”, describing it as a “vindictive and cowardly” attack on a frail gentleman in his care.

The home was closed down by an emergency court order in January after deputy manager Margaret Byrne blew the whistle on Purgaus’ treatment of residents.
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Mrs Byrne claimed patients suffered at the hands of Purgaus, 59, incident reports were not filed and the home did not conform to regulations set out by the Commission for Social Care Inspection (CSCI).

Mrs Byrne, 49, who worked at Overnhill House for five and a half years, said: “It was a really good place to live and work when I first started, the residents were happy, and I had a good working relationship with Mr and Mrs Purgaus.

“But 12 months prior to closure things started to turn bad. Paperwork wasn’t up to scratch, and incidents of falls weren’t logged.

“Mr Purgaus had an anger management problem and would shout at staff about small things, like washing not being put away or dishes tidied up.

“He didn’t have the social skills to realise that elderly people and their needs have to come first all the time. He had no patience.”

Mrs Byrne claimed that Purgaus, who ran the home with his wife, Pat, for 13 years, would bully residents.

Mrs Byrne called the CSCI in October 2007 to raise her concerns and inspectors visited the home.

She said: “You could see the anxiety and anger in the residents’ faces when he was around – I think they lived in fear of him. On a bad day everyone knew about it.”

But Mrs Byrne contacted the CSCI again in January after allegations that Purgaus has assaulted two patients in December and January, and the home was closed down within 48 hours of her call.

Purgaus was cleared of attacking Henry Ham at North Avon Magistrates’ Court last month, but was convicted of  assaulting Mr Thomas. In a  statement read out in court, Mr Thomas said Purgaus had a “split personality”, and that dragging him across the floor  had made him feel like “a second-class citizen”.

In mitigation, Purgaus’s lawyer Garry Crowther said that his client had a “lifelong history of caring”, and that he had continued to do voluntary work since the home’s closure.

But magistrates took a dim view of his actions, saying that it had been a “degrading, cowardly and vindictive” attack on a vulnerable and frail man, and that Purgaus had abused the trust of Mr Thomas, the other residents, their families and his staff.

Purgaus, who was in tears during the hearing, called out to his former members of staff as he was led away, saying: “I hope you are very happy with what you have done.”

Speaking after the sentence, Mrs Byrne dismissed Purgaus’ emotion as “crocodile tears”, and said that she and her colleagues shed a few tears of their own when the sentence was read out.

She said: “It is a hollow victory as, once again, care homes are making the news for all the wrong reasons.

“But Mr Purgaus gave us no choice. We weren’t happy with his behaviour, and we had to make a stand. The majority of care homes are good and staff do a good job, so we have to stamp out the bad apples.

“We want people – staff and residents – not to be afraid, but to speak up if they know of any abuse taking place.”

“It has been very important for us to be here and see it through and have some closure.”

Imelda Richardson, South West regional director for the CSCI, said: “We are glad there has been a clear outcome to this case and hope it gives Mr Thomas and his family, as well as other former residents of Overnhill House, a sense that justice has been done.

“It shows how important it is for people to come forward with information about any forms of abuse or neglect, whether they are care workers or relatives of those who rely on care services.

“In this case the information we received enabled the commission to work with the council to protect the safety and welfare of the residents at Overnhill House.”

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THE death of a severely-disabled man who fell from a hoist has resulted in the company running his care home being prosecuted in court.

The Health and Safety Executive (HSE) took MacIntyre Care to St Albans Magistrates Court following the death of Mark Westbrook, aged 56, of Crosby Close Care Home in the city in March 2007.

The company, which has its head office in Milton Keyes, was fined £10,000 and ordered to pay full costs of £2,476 after pleading guilty to breaching Section 3(1) of the Health and Safety at Work Act 1974.

Mr Westbrook fell from his hoist after being lifted by an inexperienced carer at the care home in February last year. A cerebral palsy sufferer who was both blind and deaf, he had been living at Crosby Close for eight years.

He broke his right femur and elbow in the fall and after a short stay in hospital he returned to the care home. But he was taken back to Hemel Hempstead Hospital a short time later.

He was diagnosed as suffering from severe pneumonia which later developed into a blood infection which killed him.

At the inquest in January, Herts coroner Edward Thomas said that on the balance of probabilities, the fall at the care home was a secondary cause of death.

Recording a verdict of a narrative death, he said he would be writing to the Commission for Social Care Inspection to recommend that they made sure all care homes used two carers to operate a hoist.

HSE Inspector Rubeena Surnam said after last week's court hearing: "This was a needless death. I hope it demonstrates to care home employers that they need to take positive steps to identify the risks in their workplaces and manage them.

"Employers must be sure they adopt safe systems of work and care staff are trained in the use of equipment such as hoists and aware of the potential risks involved.

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Local councils which perform well on safeguarding against abuse and neglect tend to have a greater number of home care agencies and care homes in their area which are performing well too, says a new study by the Commission for Social Care Inspection (CSCI).

'Safeguarding: A study of the effectiveness of arrangements to safeguard adults from abuse' looked at arrangements in place in England to help prevent the abuse of adults and to support those who experience abuse.

The study found:

·    Prevention of abuse is variable within and across council areas and within care services
·    Disabled and older people who are abused get a varied quality of support due to uneven progress by councils and care services in developing effective safeguarding arrangements
·    More needs to be done to ensure people who direct their own support are able to benefit from safeguards
 
Councils rated as good by CSCI were also those that had more care services in their area with effective safeguarding arrangements in place. Care services that receive a good or excellent quality rating from CSCI were also more likely to have effective safeguarding arrangements in place.

Paul Snell, CSCI's chief inspector, said: 'The study shows that in the best councils and services there is a commitment to good safeguarding practice that starts at the top.

'Although it confirms the rising profile of work to safeguard adults from abuse across the country, there is significant variation in the degree of priority shown to safeguarding adults, and more work is required to bring all services up to the standard of the best.'

Neil Hunt, Alzheimer's Society chief executive said: 'The abuse of vulnerable adults is an unacceptable violation of their human rights and can be prevented. Care staff need specialist dementia training, guidance on safeguarding people and strong leadership. There must also be a robust regulation system in place.'

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However, the unnamed invention from technology giant Honda could transform the lives of the growing numbers of elderly people around the world.

Robotics experts say the powered leg frame takes all the strain out of walking, with a design created to support body weight, reduce stress on the knees and help with climbing steps.

The system, unveiled by Honda in Japan yesterday, has a computer, motor, gears, battery and sensors that allow it to respond to body movements.

Although the price and launch date are yet to be decided, Honda will start testing a prototype with its assembly line workers this month before deciding on its commercial future.

To wear the device, the user straddles the seat, puts on the shoes, pushes the "on" button and starts walking.

Lindsay Scott, spokesman for Help the Aged in Scotland, said: "This does look to be a hugely exciting development, particularly because it seems to support the body weight and relieve pressure on the knee joints.

"The Japanese are at the forefront of this kind of technology as Japan has one of the most rapidly ageing societies in the world and it'll be fascinating to see how this develops.

"Whether it is successful or not will probably come down to how much it costs, but if the Japanese can mass-produce it, it may be commercially viable."

A major study published this year revealed Scotland's elderly population could rise by as much as 81 per cent over the next 25 years. The Scottish Government has been warned the cost of providing free personal care for the elderly could treble to £813 million by 2031.

Japan has about 27 million elderly people and the largest proportion of over-65s – 21 per cent – of any country.

Engineer Jun Ashihara, who unveiled the device at Honda's Tokyo headquarters, said the machine would also be useful for people standing in long queues and those who run around to make deliveries.

"It should be as easy to use as a bicycle," he said. "It reduces stress and you should feel less tired."

Honda has been carrying out research into mobility devices for more than a decade, introducing the Asimo humanoid in 2000. It recently unveiled a belted device boasting motors hooked to frames strapped to the thighs, that help the walker maintain a proper stride.

That device is already being used in rehabilitation programmes for disabled people in Japan. The country is also a world leader in robotics technology for industrial use, entertainment and companionship.

Massive market for sons of the Sinclair C5

EVER since the unveiling of the Segway human transporter in 2001, there has been fierce rivalry between inventors and technology companies competing to tap into the potentially lucrative "personal transport" maket.

The Segway, a scooter-like vehicle which was in development for more than a decade, is powered by batteries but controlled by body movements.

Best known for flummoxing US president George Bush when he fell off one during a test drive in 2003, the Segway has sold some 250,000 units.

Its success inspired British inventor Sir Clive Sinclair, whose electric car proved a disaster in 1980s, to create the A-bike in 2006.

Last year saw the unveiling of a robotic suit to help people who had been partially paralysed.

Earlier this year, the Toyota Motor Corporation unveiled a Segway-like ride designed for elderly people.

Japanese robot firm Cyberdyne has recently begun renting out the Hal – a device with mechanical braces that strap to the legs and which reads brain signals to aid movement.

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Staff will discuss the proposals at public meetings in affected areas

Highland Council is giving care home residents and their families a chance to learn more about plans for new care homes which will replace existing council-run homes at Fort William, Inverness and Muir of Ord.

Outline planning consent has been granted for the proposed care-home developments at the BMX-site, Caol – to replace Invernevis House, Fort William – at Burnside, Inverness – to replace Ach an Eas and Burnside, and at Urray House, Muir of Ord – to replace the existing care home there.

Council staff will be available to discuss the proposals, firstly at meetings in the existing homes with residents, their families and staff, and later at drop-in sessions in the communities.

Representatives of the social work and housing and property services will be on hand to explain the proposals to people on an individual or small group basis.

The council also proposes to replace care homes at Grantown (Grant House) and Tain (Duthac House) and similar sessions will be held there as and when the sites and planning permissions have been agreed.

Councillor Margaret Davidson, chairwoman of the housing and social work committee, said: “These new care homes will greatly improve the facilities for everyone and ensure that all modern standards are met.

“We want to meet with residents, their families and staff as well as the wider community to share the progress we are making and to hear people’s views.”

The public meetings are as follows: Muir of Ord: Wednesday, November 12, Muir of Ord Village Hall, 2pm-4.30pm; Muir of Ord Pavilion, 5pm-7.30 pm.

Inverness: Thursday November 13 , Inverness Town House 3pm-7.30pm.

Fort William: Tuesday November 18, Caol Community Centre 2pm-7.30pm.

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A care home rated one of the worst in the country has managed to turn around its fortunes in just six months.

The Roseland Care Home, in Draycott Avenue, Kenton, was rated 'good' in a recent report and fulfilled 12 out of the 13 recommendations required in a previous inspection.

In a recently released report by the Commission for Social Care Inspection (CSCI), an independent group set up by the Government to inspect adult care homes, the home was awarded two stars out of three.

Tony Lawrence, the lead inspector, said: "Prospective residents and their representatives should be confident the home will meet their identified care needs."

As reported in the Observer in May, the home had been deemed a fire hazard and awarded no stars. In the previous report the inspector saw fire doors were wedged open and bedroom doors did not have door closers, meaning in a fire smoke would spread easily through the building. The bathrooms were also described as 'bare and institutional'. Even the owner, Jerome Manuel, stated he was reviewing his involvement in the business and considering selling the home.

Fast forward six months and the home has been transformed by the staff. The home has refurbished one of its bathrooms and is set to have another one redone by January 2009. The bedrooms were also described as having a good standard, and being clean and hygienic. An action plan was developed to improve fire safety standards.

Manager Coral Lake said: "We are over the moon. We did a fire risk assessment on the whole building and property and put in all the things we needed to make it up to fire standards.

"All the relatives have been really pleased, but they were happy before. They were really shocked at the story, as they saw all the work the staff and I do."

Mrs Lake said the care home had completed the recommendations in the previous report, which had included performing risk assessments for residents who smoked and providing automatic door closers to improve fire safety.

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The number of people suffering with dementia will double over the next 30 years with costs to the economy expected to triple to reach £50bn by 2050, Government scientific advisors have warned.
 

Prevention, early detection and timely treatment will be vital in the battle against cognitive decline, the 400-page Foresight report said.

It means the way new treatments are evaluated for use on the NHS must be changed to take into account the wider benefits to families, carers and society of keeping older people healthier and independent for longer, it said.

Currently the National Institute for health and Clinical Excellence has a remit, set by Government, to analyse the costs and benefits of a new treatment to the health service. This has led them to determine that certain drugs such as Aricept for Alzheimer's disease is only cost effective in the moderate and late stages of the disease.

The Foresight report said: "A priority should be to develop and use treatments to slow or arrest decline in the early stages before quality of life suffers substantially and before sufferers become dependent on families and the state."

Chris Riley, an independent economic consultant, said care costs need to be taken into account and the wider economic benefits including the fact that people whose health improves are more likely to be employed, have higher earnings and less days off work. He said there is 'scope' for a fuller analysis than Nice is currently doing.

The increase in dementia is forecast primarily because of the ageing population.

The means the number of people with dementia could double to reach 1.4m over the next 30 years, consistuting an 'expenditure time bomb' with costs to the UK economy expected to triple from £17bn today to £50bn a year by 2050.

The report also recommends extending treatments that are already recommended by Nice to all dementia sufferers to deliver economic benefits in excess of £1bn a year. It says: "The extra treatment costs would be vastly outweighed by higher Government revenues and reduced benefit payments."

The report, Mental Capital and Wellbeing, covers all areas of life from pre-birth, through childhood, adolescence, working life, and old age, and documents what impacts on mental health and what can be done to improve wellbeing.

As well as diagnosing and treating dementia earlier, people in middle age should be encouraged to be active and continue learning as this has been shown to delay symptoms of cognitive decline.

Prof Barbara Sahakian, professor of clinical neurology at Cambridge University, said 40 new treatments for dementia were in the pipeline including drugs that will improve memory and thinking abilities in Alzheimer's patients and also protective agents that will stop damage done to the brain by the disease.

It was also suggested that internet access could be installed in older people's homes in the same way as stairlifts and bathrooms aids are now, so the elderly can remain socially and eoncomically active, get involved in social networking online and encourage continued learning.

Care Services Minister Phil Hope said: "This report confirms that much of our work on improving mental health services, increasing access to psychological therapies and creating the first dementia strategy is on the right track.

"It comes at a very important time, as we start to develop a new mental health policy framework that will help shape services for the next 10 years.

"We will use this report to see how we can go further and faster towards creating a healthier, more contented society."

Neil Hunt, Chief Executive of the Alzheimer's Society, said: "Thousands of people with dementia and their carers will welcome this report. They are the experts who know that early access to treatments can have huge benefits not just to the individual but to carers and families. This report adds to evidence that NICE need to change the way it decides who should have access to drug treatments.

"As the number of people with dementia rises to more than a million people in less than twenty years, the healthcare system in future can only work if it works for people with dementia."

 

   
  

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Social care lead bodies line up to urge more cash for dementia strategy

ADASS, LGA, NHS Confederation among bodies responding to dementia consultation with cash appeal

More funding needed to kick start dementia strategy

The government must find significant extra funding if its national dementia strategy is to succeed, health and social care leaders have said.

The Association of Directors of Adult Social Services, Local Government Association, Alzheimer's Society, English Community Care Association and NHS Confederation used their responses to the strategy consultation, which closed last week, to call for more investment.

Most respondents backed the objectives laid out in the consultation paper, published in June.

These included:

● The creation of early diagnosis and intervention services in all areas.

● Core training in dementia for all care staff working with older people.

● Comprehensive home support services.

● Improved access to mental health services for care home residents.

● A regulatory requirement for all care homes to be able to provide dementia care.

In a joint response, Adass and the LGA said each of these would require additional resources over the course of the strategy, from 2009 to 2014.

On the workforce front, it said there was currently "little incentive for staff to remain in this difficult and challenging area when better paid alternative employment is readily available".

The associations also pointed to the fact that many people with mild dementia were excluded from council-funded social care because they fell below eligibility thresholds.

When care services minister Ivan Lewis launched the consultation, he said additional resources would be available but did not specify a figure.

The only costed plan in the consultation paper was for early diagnosis and intervention services, which would require £220m a year.

Adass vice-president Jenny Owen, who co-chairs the working group on developing the strategy, said that with government spending limits for 2008-11 already set, significant extra investment may have to wait until 2011-14 with the first two years of the strategy being more preparatory.

Alzheimer's Society head of policy Andrew Chidgey warned efficiency savings should not be relied upon in the first years of the strategy as "we are starting from such a low base in dementia".

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 INSPECTORS are swooping on care homes across Somerset from next week as part of a major health and safety blitz.

And they are warning they will come down hard on any rogue home owners found to be flouting the rules.

The unannounced, targeted visits by a team of six inspectors from the Health and Safety Executive are being carried out in the fortnight starting on Monday.

They will be checking on issues relating to hot water, hot surfaces, unguarded windows, legionella, manual handling, latex, bed rails and migrant workers.

Inspectors from local authorities and the Commission for Social Care are also carrying out visits during the same period.

HSE inspector Trudi Smyth, who is co-ordinating the initiative, said: “This inspector blitz should give both us and the local authorities a good overview of the standards of the health and safety in care homes across the county.

“Our findings will help to inform our pro-active work with the homes and we will be holding a series of health and safety awareness days, together with the local authorities, across the South-West in the New Year, prior to our next inspection campaign.”

She warned owners though that the exercise was not just about collecting data.

She added: “Over the next two weeks, inspectors will robustly challenge any owners or managers of homes where employees, residents and visitors are being put at risk because of health and safety failures and we will not hesitate to take enforcement action to secure improvements.”

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Elderly people and their families face paying billions more for personal care services like cooking and cleaning, MPs say today.

Because Government spending on personal care for the elderly is growing more slowly than the number of people needing help, a £6 billion "funding gap" will emerge, the MPs say.

More than 1 million people use council care services in order go on living independent lives, paying fees that can vary widely between council areas. Ministers are reviewing the care system and have promised a green paper next year.

In a report published today, the Work and Pensions Select Committee say that without major reform of the current unpopular system of means-tested care services, the old and their families will end up shouldering even more of the burden.

Private care spending is around 57 per cent of total care expenditure, but on current trends this share will grow to 66.5 per cent by 2022, the MPs say.

"Those who need care will be expected to pay more of the cost," the report says.

It adds: "Currently state funding for social care is growing at a much slower rate than the demographic changes require. This means the Government is heading for a funding gap of an estimated £6 billion, unless the system is changed."

The number of people over 65 using council care services is forecast to more than double over the next 40 years.

Last year, the Commission for Social Care Inspection, the Government's watchdog, showed that responsibility for paying for care was shifting from local councils to the families of society's most vulnerable citizens.

Anyone with assets over £21,000, including property, has to pay for their own social care whether they live in a nursing home, their own home or warden-controlled sheltered housing. For those under that level the state pays for care.

The means-testing of care services has meant many more elderly people having to pay for their own care. The number of households receiving social care help from local authorities fell from 479,000 to 358,000 between 1997 and 2006 even as the number of pensioners rose.

"State support is means-tested, which is especially disliked by older people who have saved hard for their retirement," the committee says.

An ageing population means that over the next generation, almost everyone in the UK will either need care or become a carer, according to the King's Fund, a health think-tank.

In their report, the MPs also call for a fundamental change in the benefits system for carers.

People who provide unpaid care for relatives and friends save the taxpayer an estimated £87 billion each year and have only limited access to benefits through a complicated system of entitlements, the committee says.

At £50.55 a week, Carer's Allowance is the lowest-paid benefit of its kind.

Ministers have promised to review the benefit, but the committee calls for a wider change, recommending the introduction of two distinctive types of support for carers: an income replacement support for carers unable to work full-time; and compensation for the additional costs of caring for all carers.

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This article is related to the percentage of care homes receiving excellent or good ratings in their Commission  for Social Care Inspection Reports.

More than 80% of care homes are providing good or excellent quality care according to the latest CSCI star ratings statistics.

 

A search of the regulator's website shows that out of just over 15,000 rated care homes, there were 2,384 three-star and 9,733 two-star rated homes.

 

Only 384 care homes, or 2.56%, were failing to provide services to the required standards.

 

Currently 3,408 care homes are yet to receive a CSCI rating, while 33 have had their rating suspended as CSCI acts to remove their licences.

    
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A CARE home that left the bodies of pensioners dead in their beds must be shut down, a leading politician has said.

Catherine West, leader of Islington Council's opposition Labour group, wants independent inspectors to take action over Lennox House - which only opened in August last year.

Her calls come as the home's suspended manager has now handed in her resignation.

As first revealed in the Gazette, 97-year-old Winifred Staines and 68-year-old Elsie Walford were left in their beds for around two days after dying at the care home in Durham Road, Holloway.

Bosses at private company Care UK, which runs the home under contract from Islington Council, has since summoned relatives for urgent meetings.

But Councillor West, who met with council chief executive John Foster on Monday, said: "He admitted the council has serious concerns - about care plans for each individual resident and about end-of-life care.

"I am looking into the immediate closure of this home right now - and I am asking the Commission for Social Care Inspection to investigate a possible closure."

Meanwhile, more complaints about Lennox House have surfaced.

Irene Clarke believes her 83-year-old diabetic aunt Winifred Bone was failed.

The dementia sufferer, a retired dressmaker from Newington Green, was rushed to hospital on December 8 after Lennox House staff found her in spasm. She died later that month.

An independent investigation criticised the home for an "absence" of the clinical expertise and communication required.

It found that the diabetic woman's blood glucose level had not been tested on December 7. And even when Miss Bone's urine was tested later that night - for only the second time since her admission - doctors were not called despite the abnormal result.

Ms Clarke, 62, a television production manager, said: "I think Win Bone was absolutely, desperately failed. I would like to send Lennox House into outer space."

And Maria Hogan wants to move her 68-year-old father - who has dementia - from the home.

The 31-year-old single mum said: "Their medication ends up not being taken or on the floor. No member of staff helps them eat their food. And my father's room really, really smells of urine - but he has a catheter on 24 hours day."

Care UK said the 87-bed home was rated "adequate" when CSCI inspectors visited in June - and that the company was not aware of any calls for its closure.

A spokesman said: "Care UK can confirm that a letter of resignation has been received from the suspended manager.

"Care UK is grateful for and has been heartened by the support of many relatives of residents. They have praised the standards of care provided by our hardworking, diligent staff.

"We recognise from time to time we need to initiate improvements when mistakes occur."

Councillor Terry Stacy, deputy leader of Islington Council, said: "Lennox House is under new management and is still working to make specific improvements we have demanded as part of a remedial action plan

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The "Bank of Mum and Dad" becomes the "Bank of Sons and Daughters" later in life, a new study  claims to show.

According to the study, 47 per cent of adults do not realise how much long-term care for their elderly parents will cost.

When informed that expenditure generally ranges from £25,000-£30,000 a year to fund the care, a total of 36 per cent said that they would have to make significant sacrifices to meet these costs.

Ironically, it will have been this group which is currently taking advantage of their baby boomer parents' comparative wealth, by raiding the "Bank of Mum and Dad" for help with mortgage deposits and current living costs.

A spokesman said: "The cost of care is not always something people think to talk to their parents about, but it is vital to start planning as early as possible. As this research reveals, there are a huge number of people who are relying on an inheritance from their parents, though underestimate the cost of long-term care.

"By not discussing the issue and making provisions, they are neglecting the fact that their parents may be facing a situation where they will be forced to turn to their children for financial help. With careful planning this can be avoided."

for further information, please see our 'funding information' section

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Southern Cross, the troubled care home group, today reported a 18 per cent rise in revenue after raising the weekly fees it charges to its elderly patients.

The company said revenue for the 14 weeks to July 6 rose from £207.6 million to £245.6 million, while earnings before interest, tax, depreciation and amortisation (Ebitda) rose by 6.9 per cent to £24.4 million.

Over the period, Southern Cross's average weekly fee rose from £506 to £530.

In June, the healthcare group issued a profit warning and announced that it was seeking an extension to its loan facilities from its banks, which it has now secured until October 30.
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Southern Cross also announced that its finance director, Jason Lock, had resigned and was replaced by Richard Midmer.

Mr Midmer worked with Bill Colvin, chief executive at Southern Cross, at NHP, another care home group.

Southern Cross's problems arose after a deal to sell the property assets of some care homes acquired with borrowed money fell through.

As the value of commercial property decreased due to the downturn, it became more difficult to sell the assets.

The company said this morning that it is in discussions with several potential purchasers of the assets, adding that "the board is encouraged by the progress made to date".

Shares in the company rose 3 per cent to 127.75p today, but are trading well below their peak of 599.5p of nine months ago.

Despite an ageing population, the care homes industry has suffered as a result of local authorities finding it cheaper to keep elderly people at home.

Average occupancy of Southern Cross homes was down to 89.2 per cent for the 14 weeks to July 6, compared with 89.6 per cent during the first half of the year.

Despite its problems in selling property, the company bought an additional 145 beds during the 14-week period and hopes to add another 304 by the end of the year.

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The Alton Centre, in Irchester Road, Knuston, was suddenly shut when an inspection found there to be "serious and urgent" concerns.

After a weekend of uncertainty about their future, residents are expecting to be told today where they will live from now on.

But still no reason has been given why the home was closed and what was found to be wrong.

Leslie Weatherley, whose sister Christine has lived at the Alton Centre for four years, said: "To know why this has happened would put a lot of people's minds at rest. A lot of people are very disgruntled. It was really traumatic for the staff and residents."

The Alton Centre, which looks after 40 people with learning or physical disabilities, was closed on Thursday after an inspection by the Commission for Social Care Inspection.

Residents were taken away in ambulances so their needs could be assessed and decisions made about future care.

In a joint statement, Northamptonshire County Council and Northamptonshire Primary Care Trust confirmed an order had been made by magistrates following an application by the inspectors.

The statement read: "We know our colleagues at CSCI only take such urgent action when new concerns emerge that seriously affect the health and welfare of vulnerable people.

"As soon as we were informed of CSCI's intension to seek closure we began working to ensure the safety and welfare of residents."

But residents and their relatives, said there was bewilderment at the closure.

It is understood inspectors found something wrong but residents and care home staff say they do not know what.

Mr Weatherley said: "We do worry. There weren't any guarantees that residents would end up in Northamptonshire and they said they were looking at neighbouring counties.

"It's such a shock to see it close so quickly. We wouldn't be happy with Christine moving to another county."

He said his sister, who has Down's Syndrome and had a stroke before being admitted to the home, had been well treated.

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Care for elderly, infirm and disabled people could be stripped from local authority control under radical new government plans in an effort to end the so-called "postcode lottery" that sees wildly different standards of care across the country.

Social services chiefs have been warned they will lose their responsibility for care unless they step up improvements in their performance over the next three years.

More than 370 nursing and care homes have been given "no star" ratings after the independent Commission for Social Care Inspection (CSCI) assessed their services as "poor". A further 31 have been sent legal notices stating the CSCI plans to cancel their registration and move their residents elsewhere.

Last week it obtained a court order to cancel the registration of a residential nursing home in Brackley, Northamptonshire, after a random check found the safety and welfare of its elderly residents were "at serious risk". Several residents of the home were taken to hospital for treatment. Two subsequently died after inspectors shut the home.

The reputation of the sector has also been damaged by repeated revelations of abuse and neglect of residents in some of the 10,000-plus private homes across the country. Some 150 local authorities across England spent £14.2bn on social care for all adults last year including elderly people, residents with dementia and young people with learning difficulties. Their role is already under threat, however, from reforms designed to give individuals "personalised" control over their own care, including control of a personal budget under the Government's Putting People First programme.

The health minister Ivan Lewis has warned that the Government is prepared to go further, and remove local councils from the system if their performance does not improve. He said: "If at the end of three years, local government has not delivered on those building blocks, I think there will be some really big questions to be asked about its capacity to commission these services in the future."

Department of Health insiders said the warning could mean the worst-performing councils being stripped of their powers – or, in extreme circumstances, the power over commissioning care being handed to a new body altogether. In an interview with Community Care magazine, Mr Lewis said the postcode lottery was one of the "big, big concerns".

Age Concern gave a cautious welcome to the Government's proposals. A spokesman said: "We have been concerned about councils being in charge of assessing people's needs and then deciding how much should be spent on them. There have been concerns about the quality of care offered to older people, in particular. At least threatening local authorities with sanctions if they do not improve can be of benefit."

But the Local Government Association (LGA), a cross-party organisation representing councils in England, insisted that local authorities still had a vital contribution to make. "Councils are best placed to make decisions on providing care and support to local people, thanks to their knowledge of what's available in each area and how best it can be managed," a spokeswoman said.

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Care home practitioners and old age psychiatrists have been warned that they could face long jail sentences if they allow a patient with dementia to have sex even with a long-term partner.

The warning, delivered by Professor Peter Bartlett, Professor of Mental Health Law at Nottingham University to the Annual Conference of the Royal College of Psychiatrists, follows widespread concern within care homes that staff might be at risk of prosecution under the Mental Capacity Act which came into force at the end of 2007.

"Take the case of a husband who comes visiting on a Saturday afternoon and closes the door of his wife's room, leading to staff making the assumption that they are having sex. It may seem perfectly acceptable at one level. But because someone with dementia does not understand what sex means, the encounter is sexual assault and therefore extremely illegal."

Professor Bartlett, who has investigated the problem after numerous requests for clarification from health care practitioners, said that hundreds of care homes face this dilemma every single day: whether they should prevent a married couple from having sex while also attempting to provide patient-centred care.

He said: "The Mental Capacity Act provides the opportunity for people to document their wishes in an 'Advanced Directive' in advance of suffering from dementia. But sex is rightly considered too personal a decision to be included in such a directive. The husband may assume a continuing consent to sex based on the long-term relations he has had with his wife. But I find it difficult to find a reason to make this assumption. One major problem is: how do we know whether the person is liking it?"

Professor Bartlett said that people with dementia living at home with a partner presented an even more complicated scenario. "Technically they should be on the vulnerable adults at risk register. It is somehow easy to understand how this law can be applied to children who lack the capacity to understand the meaning of the sexual act. We should not behave differently when it is an older person who lacks capacity."

Speaking after the meeting, Dr Peter Jeffreys, consultant old age psychiatrist at Northwick Park Hospital in North London, said there was an 'iceberg situation' with an urgent need to clarify how clinicians can manage sexual activity among dementia patients while protecting against abuse. "If a person lacks capacity, a clinician or care home staff member could be seen as colluding in a criminal act. Opportunities for intimacy are clearly an important aspect of quality of life but sex may be a step too far in residential care," Dr Jeffreys said.

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This article is related to the delayed closure of a care home in Derbyshire.

SOLICITORS taking legal action against Derby City Council's decision to close a care home said they would not pursue the case if the home was kept open for at least 18 months.

The decision to close Bramblebrook House in Mickleover was taken when the previous Labour administration was in place.

The closure was being fought by residents in the home through Smith Partnership solicitors. A judicial review was due to be heard this year, which would mean a High Court judge would rule whether the council had made the right decision to close the home.

But last month, the new cabinet member for adult services and health, Liberal Democrat Ruth Skelton, announced she would propose to the council's cabinet that the home should be kept open for at least 18 months.

She said that would allow the council to carry out a review of all care provision in the city before it made a final on decision on which home, if any, should be closed.

Simon Richardson, of Smith Partnership, said if the cabinet agreed to her proposal when it meets on Tuesday he would not continue the legal action.

“However, there are side issues I want looking at, such as exploring the use of Bramblebrook for other specialist care,” he said.

“Also, if the decision is taken at the end of this review to close Bramblebrook, then it will be up to the residents if they want to challenge that decision with a separate action.”

The number of permanent residents at Bramblebrook when its closure was announced was 38. That has now gone down to 20 due to deaths and some residents accepting places at other homes.

The former cabinet member for adult services, Labour councillor Fareed Hussain, said the cabinet should take into consideration whether keeping the home open made financial sense with the number of residents declining.

He said: “I know when I was the cabinet member the cost of running the home each year was more than £700,000.

“With just 20 residents, that means the cost per person there is high and if that number reduces further, then that cost will be even higher.”

Michael Foote, corporate director of adult services, said that if the number of residents at Bramblebrook went down considerably during the next six months then the council may have to look at the situation again.

“We will look at the situation at the end of the review but it is unlikely there will be so few residents there,” he said.

Under the proposals, residents who have moved to other homes because they believed Bramblebrook was going to close this year will be able to move back, as long as they accept that their return may not be permanent as the review could still conclude the home should close.

The money from the sale of Bramblebrook, in Rough Heanor Road, would have gone to make the Arthur Neal site in Mackworth an extra care complex.

If the Mackworth site becomes an extra care home, residents would be able to live in individual flats while also having 24-hour specialist care staff on hand.

The cabinet will have to consider on Tuesday whether to carry on with work to develop the Arthur Neal site while the review is carried out.

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This article is related to the development of a new care home in Sutton Coldfield despite protests from local residents.

A controversial back-garden development, which will involve demolishing four detached houses in order to build a 61-bed private care home for elderly people, has been given the go-ahead in Sutton Coldfield despite a protest campaign by people living nearby and the local MP.

Birmingham planning committee has given permission for the scheme in Penns Lane, Wylde Green, after being told that refusal would be contrary to Government policy requiring local authorities to provide more high-quality accommodation for people in their 80s and 90s.

The committee’s legal adviser warned the city council would probably lose an appeal, and face substantial costs, if the application was turned down.

Members also approved the construction of 11 four and five-bedroom houses next to the care home on the same site.

The appl