Some patients in the North (Ireland) not seen by their GP in over a year

The Commissioner for Older People for Northern Ireland, Eddie Lynch, said that while the figures are alarming, care for people with dementia is often assessed and provided by memory clinics and multidisciplinary teams, not solely the GP. 

One in six dementia patients in the North were not reviewed by their GP for over a year.

Belfast-based news and analysis website The Detail has found that more than 2,000 patients diagnosed with dementia did not have a face-to-face medical review by their family doctor for at least 15 months.

The Stormont Department of Health data is recorded by doctors under a Quality of Outcomes Framework (QOF), which is used to plan for the care and support of the 13,600 people diagnosed with dementia in Northern Ireland. An examination of the data for 2015/2016 showed 2,139 dementia patients were not reviewed by their GP for over a year.

It is estimated that a further 7,000 people in Northern Ireland remain undiagnosed and untreated for dementia.

The Department of Health said it was not mandatory for doctors to review dementia patients within 15 months but confirmed that GPs receive a government payment under the QOF for reviewing between 55 per cent and 70 per cent of dementia patients within this timeframe. GPs were paid £30 million in 2015/2016 under the QOF. The majority of the 347 GPs in Northern Ireland met the maximum threshold, with just seven GPs falling below 70 per cent.

Many reasons

The Royal College of General Practitioners said there are many reasons why a patient may not have been reviewed.

“It could relate to the degree of dementia, whether a patient has early onset or mild dementia and is not on any treatment and they might slip through the net. It could be a misdiagnosis or a change of diagnosis; or it could be a case of a patient with dementia having a stroke, for example,” said Dr John O’Kelly, chair of the organisation.

“It would be interesting to know why these patients haven’t had a review recorded. It would certainly be worth drilling down into the data to establish why.”

The Commissioner for Older People for Northern Ireland, Eddie Lynch, said that while the figures are alarming, care for people with dementia is often assessed and provided by memory clinics and multidisciplinary teams, not solely the GP.

“However, it is important that Health and Social Care Trusts look at the reasons why 2,000 patients did not have a face-to-face medical review by their GP for at least 15 months and consider if they are receiving the appropriate treatment.”

SOURCE: Irish Times, Maresa Fagan

Staff shortage sees ‘quarter of home care visits cut short’

One in four home care visits in Wales is cut short, research suggests.

An analysis of 2,884 home care call records by the Care and Social Services Inspectorate found 24% of visits were “clipped”, including 7% of cases where the calls lasted less than half of the planned time. A further 3% of calls had been missed entirely.

The watchdog, which published the findings as part of its review into home care services, said staffing shortages meant calls were being “crammed in”, especially at peak times of the day. Care providers were also scheduling back-to-back visits for staff but failing to factor in travel time, it added.

The staffing problems were exacerbated by the low fees councils paid providers for care, as this had a knock-on effect on the pay and conditions on offer to staff. Several providers had pulled out of contracts as a result  of the fees squeeze, the inspectorate warned.

‘Market fragility’

Other findings included:

·         Care workers employed by councils were on more favourable terms than those in other services.

·         Commissioners were struggling to get providers to agree deliver care to people with more complex needs or who lived in more remote, rural communities.

·         An “overzealous application” of procurement rules had resulted in a tendency to drive down prices in the short-term and punitive contract terms.

 

The report recommended that the Welsh Government undertake a review of the cap on charges to make funding available to pay for care at reasonable rates.

Ministers should also support the development of a standardised approach to contract monitoring, which includes ethical commissioning principles for the workforce, it said.

Providers should ensure adequate travel time is included in care schedules and that when visits are delayed they must ensure there is good communication with service users, especially those who are likely to feel anxious, the report recommended.

“There is a real danger that if we don’t invest time and resources in bringing order to the system now, costs across the health and social care system will rise significantly in the future,” the inspectorate said.

“More money needs to be made available in the system so that in years to come there is a resilient, competent workforce.”

SOURCE: communitycare.co.uk, Rachel Carter

Woman with dementia stuns fellow care home residents with beautiful rendition of ‘Danny Boy’

Daphne Egan was so moved by a youth choir who had come all the way from Switzerland to perform at the Bryn Seiont Newydd Dementia Care Centre in Caernarfon that she decided to sing herself.

After they had finished performing, Daphne, originally from Ennis in County Clare in the Republic of Ireland, stood and performed to the elderly audience.

Daphne, who previously lived on Anglesey , said: “I’ve sung all my life, with choirs and with other groups, and still enjoy singing today, so it was lovely to follow this lovely choir with my own little song.

“I had voice coaching when I was young and that taught me to sing without straining my voice.”

Daphne said she also found love through singing.

Her daughter Cath Rees-Jones, 41, said: “Mum grew up in the west of Ireland. She has always sung and has been choirs all her life. She actually met her husband doing a musical.”

The Caernarfon-based centre puts a lot of attention on music and the benefits it can have for dementia sufferers.

Nia Davies Williams is the resident musician at the care centre.

She completed a master’s degree in dementia, plays the harp and accompanied Daphne on the piano.

“Music is a great way of communicating with people with dementia,” said Nia.

“People with dementia can often still remember verses to songs. Daphne always likes to sing and we often finish our sessions together with a performance of Danny Boy.”

Despite the song Danny Boy being closely associated with Irish communities it was actually written by English song writer Frederic Weatherly after it was added to the Irish tune Londonderry Air.

The choir inspired Daphne to sing was the 25-strong Vokalnsembles Incantanti from the canton of Grisons in the south east of Switzerland.

They were making a special appearance at Bryn Seiont Newydd where they presented a selection of traditional Swiss folk songs.

SOURCE: Wales Online, Will Hayward

Shocking secret tapes reveal care home staff's callous treatment of 80-year-old woman - joking about her incontinence and 'plotting to cover up their mistreatment'

Police are investigating a care home after a son exposed the shocking treatment of his 80-year-old mother by secretly recording staff.

Pete Rozanski, 56, decided to take action after seeing the health of Grace Rozanska deteriorate at the £1,000-a-week Wyndley Grange Nursing Home near Birmingham.

He planted a tablet in her room at the home in Sutton Coldfield, and was left heartbroken when he listened back to the recordings and heard his mother crying.

One carer can be heard exclaiming: 'S**t! Dear God how smelly is it. Yak. Yak. Yak' while changing her incontinence pad. 

In another conversation, one carer says to another: 'How am I supposed to hold her up and wipe her a**e?' 

Pete says harrowing audio clips captured carers using degrading and abusive language as well as threatening Grace.

He said: 'They have stripped her of her dignity and I had to expose what was happening because I do not want another family to go through what we have gone through.' 

He claims staff made jokes about her incontinence, removed her TV, and then after not repositioning her to prevent bed sores, falsified records to say they had.

West Midlands Police confirmed an investigation into an alleged assault is underway and Birmingham City Council is reviewing safeguarding procedures.

The watchdog Care Quality Commission (CQC) says it is aware of the allegations and is liaising with the police, council and NHS.

Today Mr Roaznski, from Lichfield, Staffordshire, said: 'This is every son's nightmare, I knew she was being mistreated but to hear it happening was heart-breaking.

'My mother has severe vascular dementia and was officially diagnosed in 2014, but has been suffering with the illness for a lot longer.

'She used to live with me until March last year when she first went into the care home.

'She had always taken a dislike to two of the carers, but they hadn't done anything wrong to her.

'She would roll her eyes when they walked past and they knew she didn't like them.

'In June last year, she was moved to a new unit and was the first resident in there.

'The whole thing started when a manager told me they were putting mum on a behavioural chart as she was resisting personal care and was lashing out.

'At first I didn't think much of it as dementia can affect your personality and make you volatile.

'But over the next few weeks, I spoke to some of the excellent carers - and there are some who are wonderful to the residents - and they said they hadn't had any problems with mum.

'I was going in every day to give her some lunch because I wanted to make sure she was eating one proper meal a day.

'Something bad must have been going on because she was refusing to go back to her room because she was associating it with bad events.

 'That's when I decided to make the audio recordings, because something needed to be done for the sake of my mum's health.

'They have stripped her of her dignity and I had to expose what was happening because I do not want another family to go through what we have gone through.'

In one recording a carer can be heard saying: 'Let me change your pad. Oh dear, how smelly is it. Yak.

The carer continues: 'Let me check your pad Grace, dirty isn't it?'

Grace replies: 'Don't call it dirty', and the carer says: 'Why, you did something there, we didn't do anything on the pad, it was you.' 

Despite handing his evidence to Birmingham City Council, the NHS and the Care Quality Commission (CQC), an investigation was dropped when Pete moved Grace out of the care home in a desperate bid to save her health.

He added: 'I have had so many emails, conversations and meetings with different agencies and been disgusted by the inaction over the evidence I have presented them.

'What more could they possibly want, there was 30 instances of abuse and mistreatment which I counted.

'Eventually, I took mum out of the care home on August 17 this year and she is thriving at her new care home.

'She is happy, chatty, smiley and feeds herself most of the time now. She is a completely different person.

'At first, the two owners were very apologetic and I was hoping we could work together to improve the situation, but then things turned nasty.

'I deeply believe they wanted mum out of the care home so they made her more aggressive to push the process along.

'Just because my mother has left Wyndley Grange should not mean they get away it, I do not want this happening to other vulnerable pensioners.'

The 23-room Wyndley Grange Nursing Home is run by Homecroft Care Group, owned by brothers Guy and Nic Murch.

Guy Murch said: 'A complaint has been made by a relative of a former resident in relation to the behaviour of an agency carer who was contracted to us for a short period of time.

'This complaint is being investigated by us and external agencies and until the investigation is complete it would be inappropriate for legal and other reasons to comment further.'

A spokesman for West Midlands Police said: 'We can confirm that we have received an allegation of assault on a resident at Wyndley Grange Nursing Home, Sutton Coldfield. The investigation is on-going.'

Jenny Belza, Chief Nurse and Quality Officer for NHS Birmingham Cross City Clinical Commissioning Group (CCG) said: 'At Birmingham CrossCity CCG, the safety and quality of the care received by our patients is of the utmost importance.

'As this matter is subject to an ongoing police investigation, as well as our own internal procedures, it would be inappropriate to provide any further comment at this stage.'

David Gray, head of adult safeguarding at Birmingham City Council, said: 'We are working with our partners to establish whether there are any on-going safeguarding issues at this nursing home that need to be addressed and we are continuing to liaise with the home's owners on this matter.

'The safety and dignity of our citizens remains an absolute priority for all of us as a city.' 

SOURCE: Martin Robinson, Mail Online

Woman defied judge to take dementia patient to live in his native Portugal

A GRANDMOTHER from Sussex has been jailed for six months after taking an elderly man with dementia to a care home in his native Portugal and refusing to bring him back to Britain.

Teresa Kirk, 71, was found guilty of contempt of court after disobeying orders for the 80-year-old man - identified only as MM - to be returned to the UK.

The man, born in Madeira, had lived in Devon for some 50 years and had a "large circle of friends" but did not have the "capacity to make decisions about his residence and care", according to court transcripts.

The legal issues began in 2014 after Kirk removed MM from his home to hers in the county.

Then, last year they went to Portugal and she admitted him to a care home, where he remains and Kirk reportedly believed he was happy.

However, this was in defiance of court orders and social worker recommendations it was in the man's best interests to live in a care home in south-west England.

Passing sentence at the Court of Protection, Mr Justice Newton, said: "I am left with no alternative but to pass a sentence of imprisonment, however much I have made it perfectly clear that I do not wish to do so."

The judge said Kirk has "deeply held, sincere beliefs" and is "genuinely concerned" about the welfare of MM but there had been a "long period" where she had "successfully frustrated" court orders.

The hearing was held at the Court of Protection on August 18 but the transcripts were only released on the court judgment website last week.

The relationship between MM and Kirk cannot be published for legal reasons.

A spokesman for the Courts and Tribunals Judiciary reportedly said the online judgment had been held back from publication ‘so an error could be amended’.

Open justice campaigner and former Liberal Democrat MP John Hemming said: "What's very important about this case is the public have no idea as to the validity of the reasoning for the court order.

"I have a better understanding - and in my view it stinks.

"I have been worried about secret imprisonments for some time. In this case the judgment was held back from publication until some weeks after she was sent to jail."

The sentence was originally suspended for seven days to "give Mrs Kirk one last chance to comply", according to the transcripts.

It is understood she is being held in Bronzefield prison in Surrey.

Wanda Maddocks, 50, from Stoke-on-Trent was the first person known to be imprisoned by the Court of Protection in 2012 after a judge ruled that she should go to prison for five months for contempt of court after trying to remove her father from a care home where his family thought he was in danger of dying.

SOURCE: The Argus, Siobhan Ryan

Keeping audio diaries can boost confidence of people with dementia

Recording regular audio diaries can boost the confidence of people with dementia and help to reduce stigma, according to a new study.

Researchers at Leeds Beckett University evaluated ‘Dementia Diaries’, a project launched in 2015, which documents the day-to-day lives of people living with dementia as a series of audio diaries.

The diaries reveal the feelings of disbelief and terror people can have when they get their diagnosis of dementia, with diarist Jo Bennett saying: “It didn’t matter how many people or times they said ‘you’ll get used to it’, I thought ‘no ¬ I won’t.’ It was frightening. But gradually, I began to realise that I wasn’t thinking about it all the time, and there had become space in my head for other things again.”

For others, diagnosis can come as a relief after months of not knowing what was wrong. “I can imagine that such a diagnosis would be quite traumatic for most, but because I knew that there was something not right, and this diagnosis was confirmed, I felt a huge relief.

“At last it had been recognised, and now I feel that I can move on with my life,” said diarist Kathy Dunning.

Researchers found it gave the people who take part a voice and something constructive to focus on. It also strengthened family relationships.

Dr James Woodall, Reader in Health Promotion at Leeds Beckett, said: “This evaluation has affirmed that the Dementia Diaries project has been successful. Dementia Diaries has made a difference to the lives of the people involved increasing their confidence and strengthening their relationships with family members. We also found that the project has influenced how the media report about dementia and has positively informed a wide public audience about dementia and issues that affect people with the condition.”

Dementia Diaries is delivered by On Our Radar, comprised of a group of journalists, technologists and charity workers, and is funded by Comic Relief.

Claire Surr, Professor of Dementia Studies at Leeds Beckett, added: “Challenging inaccurate and negative reporting of dementia in the press has been identified as an important step to reducing societal stigma of the condition. Our study shows Dementia Diaries is one way of helping to challenge that stigma in a positive way.”

Professor Claire Surr is currently leading a study at Leeds Beckett, funded by the Department of Health Policy Research Programme (DH PRP), which will shape the future of education and training around dementia within the NHS through investigating the most effective approaches to training health and social care staff.

She is also leading a £2.4m study evaluating an approach to improving the quality of dementia care in care homes funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme.

SOURCE: homecare.co.uk, Sue Learner

Home care services should give people more responsibility to manage their medicines, says NICE

NICE is urging home care staff to make sure they give people direct responsibility for their own medicines wherever possible, with help from family or carers if needed.

In a new draft guideline which is being published for public consultation NICE has set out how staff can help adults who are receiving social care support at home to manage their medicines safely and correctly.

The latest report from the Care Quality Commission (CQC) into the state of the care system in England said home care services that were rated as outstanding achieved this mainly because staff took enough time to have meaningful discussions with people.

NICE says staff should discuss with each individual their needs and preferences and record decisions about what support they need in their personal home care plan.

If a home care worker needs to offer support, the draft guideline outlines how to approach this. It covers areas such as ordering prescriptions, administering medicines and what records to take.

Anne Bentley, lead pharmacist for East Lancashire CCG and chair of the group that developed the NICE guideline, said: “More and more people are using home care services and this will often include help with managing their medicines. If people do not take their medicines properly they may end up in hospital or become overly reliant on NHS services.

“People receiving social care support so they can stay living in their own home may already have much to worry about. We want to support people to be as independent as possible so they can take their medicines safely and get the most from their treatment."

To ensure staff are able to effectively carry out their roles, NICE is saying that home care providers should give their staff adequate training in medicines’ support. They should also be told when and how to seek help and advice.

NICE also sets out how services should share information to ensure people get the same high-quality care if they have to move into a care home or hospital or change who provides their home care. For instance it says prescribers should avoid only passing on information about changes to a person’s medicines verbally.

If things go wrong NICE wants home care providers to foster an environment where staff and the people using their services can easily report their issues.

NICE calls for a “fair blame” culture, where people, family members, carers and home care workers are able to freely talk about things that go wrong. It says allowing people to raise concerns can minimise harm and help improve their care in the future.

Anyone working in health and social care, as well as the public can send NICE their views on the draft guideline.

We want to support people to be as independent as possible so they can take their medicines safely and get the most from their treatment.

SOURCE: Anne Bentley, NICE

Cash booster for mental health anti-discrimination campaign

A campaign to tackle the stigma around mental health has been given a £20 million boost.

The Time To Change initiative, run by charities Mind and Rethink Mental Illness, works with schools, employers and local communities to reduce discrimination against people with mental health problems and raise awareness of conditions.

The campaign has been supported by £30 million so far but now the Department of Health, Comic Relief and Big Lottery Fund have pledged a further £20 million.

The charities say that as a result of the campaign, the proportion of people reporting discrimination as a result of mental health issues has dropped from 42% to 28%.

More than 800 schools have discussed mental health in lessons and assemblies, and almost 400 employers are implementing plans for improving mental health in the workplace, they said.

Health Secretary Jeremy Hunt said: "Tackling the stigma associated with mental health problems is essential if we are to break down barriers and encourage people to seek help before they reach crisis point.

"Time To Change is already making a difference, but with recent studies showing that just 50% of people seek help following a suicide attempt, it's clear that we still have major work to do.

"This funding will help create a social movement of people of all ages who will tackle mental health stigma in their areas. It's time for us all to talk and time to change attitudes to mental ill health."

Over the next five years, local Time To Change hubs will be created to lead anti-stigma campaigns in local communities, and hundreds more organisations will be urged to take part in projects.

The news comes after figures from NHS Digital on Thursday showed a jump in the number of women aged 16-24 experiencing mental health problems.

More than a quarter (26%) of young women aged 16-24 are suffering worrying symptoms - more than three times the rate for men the same age (9%).

Around a quarter of young women have also self-harmed - most commonly cutting themselves - compared to just 10% of men the same age.

In 1993, young women were twice as likely as young men to exhibit common mental health disorder symptoms (CMD), but they are now three times more likely to experience them.

CMD symptoms include irritability, worrying, depression, anxiety, feelings of panic, compulsion and trouble sleeping.

Overall, across all age groups in England, one adult in six has a CMD - about one woman in five and one man in eight.

A fifth of adults (20.6%) reported that they had thought of taking their own life at some point, and this was more common in women (22.4%) than men (18.7%).

Jo Loughran, interim director of Time To Change, said: "We know that the attitudes of others stop the one in four of us who experience a mental health problem from seeking the help and support we need.

"Since Time To Change began, we've made real progress in transforming public attitudes and empowering thousands of people to tackle discrimination, but we've always said that this is the work of a generation and there's still more work to be done.

"Too many people are left feeling worthless and ashamed because of their mental health problem and with this continued investment our growing movement of individuals, communities, schools and organisations can put an end to this."

SOURCE: BT

IPC Advice Bulletin for Care Homes

To support Care Home staff, here is some information on good infection prevention and control (IPC) practice.

Preventing dehydration

Dehydration occurs when the body loses more fluid than it takes in. It is particularly common in older people due to:

• Medications - some medications have a diuretic effect while others can cause increased sweating

• Decreased thirst - a person's thirst can lessen with age

• Mobility problems - or reliance on others to provide drinks can result in insufficient fluid intake

• Memory problems - without prompting some people forget to drink enough fluids

• Reluctance to drink - many older people are reluctant to drink to avoid the need to go to the toilet

• Decreased kidney function - as our bodies age they lose kidney function and we are less able to conserve fluid.

Recognising the signs can help prevent serious illness and admission to hospital!

• Feeling thirsty and lightheaded

• Dry mouth

• Tiredness

• Dark coloured, strong smelling urine

• Passing urine less often than usual

• Dry skin

• Headache

• Constipation

• Irritability/confusion

• Little or no urine

• Weak rapid pulse

• Low blood pressure

• Fast breathing

• Dry mouth and tongue

• No sweat or tears

Diarrhoea and vomiting (D&V) can quickly cause dehydration in the elderly!

Mild to moderate symptoms
Severe symptoms
To prevent dehydration, particularly if you have an outbreak of D&V, ensure all service users have regular drinks as they often do not feel thirsty and may not ask!

SOURCE: Harrogate and District NHS

Care home provider gives £100,000 to loneliness helpline

A CARE home provider has provided a welcome cash boost to a loneliness helpline.

HC-One, who run the Larchwood Care Home in Braintree, has announced it will donate £100,000 to The Silver Line.

The Silver Line is the only free, national and confidential helpline open every day and night offering friendship to older people.

The HC-One Foundation is a founding partner of the helpline, which has just received its one millionth call.

Dame Esther Ranzen, founder of the helpline, said: “We’re really grateful for this amazing donation from HC-One which will go towards helping us to keep the vital night-time service going.

“We urgently need more donations from wonderful friends and supporters, like HC-One - who are doing so much to ensure we are always there for the people who need us most.”

Dr Chait Patel, chairman of HC-One, said: “HC-One are delighted to be part of such an important project, and playing an active role in our local community.”

SOURCE: Robbie Bryson, Braintree and Witham Times

Top restaurant, cinema, spa and salon - inside Britain's first 'boutique' care home for people with dementia

The super-posh Chelsea Court Place home also has a 24-hour cafe, sensory room, indoor garden, zumba classes and memory club.

 The Chelsea Court Place home is for people with Alzheimer's disease and dementia

Britain’s first purpose-built home for people who have dementia has opened - complete with a 48-seater restaurant presided over by top chefs, cinema, spa and beauty salon.

The Chelsea Court Place home in posh Chelsea, southwest London, boasts 15 ‘boutique’ rooms for people with Alzheimer’s disease and dementia.

The home bills itself as the UK’s ‘first luxury, purpose built residential and day care home ’ and comes complete with a 24-hour cafe, sensory room, indoor garden, zumba classes and ‘memory club and day care’ where members can enjoy the care and services on a daily, weekly or short term basis.

All staff are fully trained to deal with dementia sufferers and there is a 24-hours concierge service to attend to residents, with no set bed times and flexible meal times.

A private dining room allows residents to have meals with their loved ones, with menus created by head chef Matt Dodge, the runner-up in the National Association of Care Catering’s Chef of the Year in 2015.

He is assisted by sous chef Alex Morte, who this year won the National Association of Care Catering’s Chef of the Year gong.

The care home also offers pet therapy, craft sessions, gardening, music and Zumba classes and yoga - with ‘memory quizzes’ and happy hours - and trips to see opera and ballet shows also on the cards.

The blurb for the home - which costs £2,000-a-week, states: “The premium residence emulates the modern, elegant design of a private members club and caters to the unique needs of memory care residents.

“The club fuses cutting edge dementia-friendly interior design with state of the art technology, delivering an innovative sanctuary designed to support and elongate the quality of life for its members.

“Most importantly Chelsea Court Place prides itself on the exceptional, bespoke curated 24 hour nursing care, practiced by a team of leading dementia-trained professionals.”

Chairman Laurence Geller CBE said this week: “My vision for Chelsea Court Place is to deliver excellence in personalised service and curated dementia care in a happy, supportive environment, and to enrich the lives of our residents and day club members.

“Through my foundation, I will continue to work tirelessly to fund research that will ultimately eradicate dementia, a pandemic that is afflicting the lives of hundreds of millions of people worldwide.”

James Cook, Managing Director of Chelsea Court Place, said: “We are delighted to open Chelsea Court Place and to offer a world class, luxurious home to residents and memory club members.

 “Every level of attention to detail has been taken to deliver a safe, tranquil and nurturing environment that is supportive to the unique needs of our residents.

“We are passionate about pioneering the latest research, techniques and technology in our approach to care.”

 SOURCE: The Mirror, Martin Bigot and Stian Alexander