Local authorities need to look at the bigger picture when it comes to care - Kirsty Page

People already paying for their own care are cutting back and reducing visits that previously covered basic needs like administering medication and help with washing and dressing. Others are using savings and pensions to keep them going.

The report also highlighted that one in eight people are now paying for private healthcare to try and skip the NHS waiting lists, and eight out of ten saying they would still prefer to use the NHS.

We are noticing this more and more at West Park Care and many of our clients are now having to challenge the provision they receive, but it does vary so much from one authority to another. The whole point of the Care Act was to prevent this happening, but so much is left to individual interpretation, and it simply doesn’t work.

Whilst my current role as Operations Director is important, my background as a social worker has proved invaluable to supporting our clients, as it enables me to advocate for their rights and fully support them in challenging their service provision. The purpose of the Care Act was to provide a wellbeing principle, and promote strength and independence, but we are finding that we are challenging basic human rights.

A recent example involved challenging the provision of one hot meal a day, which was being withdrawn by reducing a visit from 45 minutes to just 30, on the basis that a ready meal would suffice. Our carer was providing home made meals of much higher nutritional value and greater enjoyment for the person involved. The reduction in time also impacted companionship, which we place such a high importance around. Not eating or enjoying food, health deterioration and then potential falls. Short term changes that have long term impact, resulting in more care, not less, being needed in the end.

We are not unreasonable in our support for our clients either, we do fully appreciate that there are budget constraints, and that we need to work within these, but in some cases, authorities are just not looking at the bigger picture.

What is needed is more of a balance. Everyone should be working within a wellbeing principle, that is person centred, and based on the individual needs of each person. A decent home-made meal may be more relevant for one individual, but for another a daily shower may be more important. It is about consistency and people’s interpretation of the Care Act.

There also needs to be consideration when someone’s health deteriorates. Increasing the number of visits temporarily, will mean that longer term they can then be reduced again, once that individual is back on their feet. Not increasing the number of visits could result in a fall, or their condition worsening, resulting in hospitalisation and temporary placement in a care home.

We advocate so much for our clients and help to ensure they overcome these obstacles, as we know what they are entitled to, but not all care companies can do this. We also highlight to our clients about means-testing and financial assessments by their local authority and needs assessments to see if they qualify for support under their provision. So much of our work relates to ensuring our clients have the right advice and support, especially for self-funding care. We can signpost people to the level of care they both need but are also entitled to.

Care doesn’t just relate to a person’s physical health, but completely encompasses their mental health too, and cannot be looked at in isolation. We supported a new client, who we first met following a hospital admission, and whilst there her husband very sadly died. Understandably she had a lot of anxiety around this and didn’t want to be at home alone. As a self-funder and applying the principles of the Care Act, we were able to agree a suitable support package that involved four visits a day with a member of the team sleeping overnight also, which we put in place promptly. This was a temporary measure, and as she regained her confidence and independence, we adapted her support, so she was able to do more for herself and reduced from four visits a day to two visits a day.

By taking this approach, we avoided a delayed stay in hospital, which would have been a cost to the NHS, increasing risk of further infection to the client, and emotional impact to the client. It also avoided an unnecessary stay in a care home.

This should be happening for everyone everywhere, but sadly is not. We are grateful for the local authorities who do look at the bigger picture for each individual, as this is what is needed and what each person is entitled to and deserves.

Kirsty Page is head of service at West Park Care.