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What exactly is 'social care'?

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I read in Yesterdays Daily Mail that all Failed Asylum seekers are to qualify for free NHS care. 
Also it says a lot of elderly vulnerable patients are dying from malnutrition.

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Reading the link from Stephen Johnson's post which is a transcript from the house of Lords discussion on Personal Care at home bill. It's clear that some of our Nobility have spotted the difficulty in obtaining CHC. a notable remark from Baroness barker who observed a discussion between some charitable care workers : 
3.15 pm 1/3/2010 in the House:

Baroness Barker: My Lords, my Amendment 23, which is grouped with Amendment 21, was tabled for exactly the same purpose as that of the noble Earl.

After I tabled it last week, some individuals in my other working life, who did not know who I was and did not know that I had anything to do with your Lordships' House, happened to have a conversation which I simply sat in on and observed. They were all workers for a voluntary organisation who have had experience of assisting older people with the process of assessment for continuing care. They were trying to establish between themselves-they came from three different areas-whether there was any consistency at all in the decision-making processes to which they had been party.

What set my mind particularly to this matter was the description of an elderly man who has multi-infarct dementia, is blind, cannot walk, is doubly incontinent, has lost the ability to swallow and therefore has to have all his food made for him and pureéd. He is not eligible for NHS continuing care. That sparked a discussion about what NHS continuing care is. I do not know whether this is right, but I am interested in the point made by the noble Earl and in these care workers' distinct impression that only when someone has to be peg-fed do they have a remote chance of being considered for NHS continuing care and that that must be but one of their conditions; there must be others, too. I, too, want to know how the criteria for this care, which will be the new revised version of FACS, will work alongside NHS continuing care. Will the Minister tell me for how long on average the 45,000 people who receive NHS continuing care have received it? I am trying to gauge how ill someone has to be to be eligible under the criteria.

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http://www.theyworkforyou.com/lords/?id=2010-03-01a.1194.9&s=speaker%3A13524#g1209.0
The full commentary of this debate 1/3/2010 above is worrying to say the least, some questions are being asked about eligibility, but lip service only.

 

Quote

PirateBarnabus wrote:Reading the link from Stephen Johnson's post which is a transcript from the house of Lords discussion on Personal Care at home bill. It's clear that some of our Nobility have spotted the difficulty in obtaining CHC. a notable remark from Baroness barker who observed a discussion between some charitable care workers : 
3.15 pm 1/3/2010 in the House:

Baroness Barker: My Lords, my Amendment 23, which is grouped with Amendment 21, was tabled for exactly the same purpose as that of the noble Earl.

After I tabled it last week, some individuals in my other working life, who did not know who I was and did not know that I had anything to do with your Lordships' House, happened to have a conversation which I simply sat in on and observed. They were all workers for a voluntary organisation who have had experience of assisting older people with the process of assessment for continuing care. They were trying to establish between themselves-they came from three different areas-whether there was any consistency at all in the decision-making processes to which they had been party.

What set my mind particularly to this matter was the description of an elderly man who has multi-infarct dementia, is blind, cannot walk, is doubly incontinent, has lost the ability to swallow and therefore has to have all his food made for him and pureéd. He is not eligible for NHS continuing care. That sparked a discussion about what NHS continuing care is. I do not know whether this is right, but I am interested in the point made by the noble Earl and in these care workers' distinct impression that only when someone has to be peg-fed do they have a remote chance of being considered for NHS continuing care and that that must be but one of their conditions; there must be others, too. I, too, want to know how the criteria for this care, which will be the new revised version of FACS, will work alongside NHS continuing care. Will the Minister tell me for how long on average the 45,000 people who receive NHS continuing care have received it? I am trying to gauge how ill someone has to be to be eligible under the criteria.

 

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From the commentary of the speech and discussion, it would seem that once the bill becomes law, the main assessing tool will be the FAC, fair access to care, even for NHS FFCHC, with the main problem being when people are receiving ffchc at home.
FFCHC has always contained the personal care element, it seems they now want to split that from FFCHC when at hjome, and then before long in institutions no doubt, so that the social services pay for that element.
That is probably why the current 'thrust' is to keep people in their own homes!, rather than institutions/care homes.

Quote:-

21: Clause 1, page 1, line 22, at end insert-

"( ) make provision for those persons eligible for, or in receipt of, the free provision who are also deemed eligible for NHS continuing care"


Earl Howe (- Shadow Minister, Health; Conservative) 

I have tabled this amendment to ask the Minister questions about the potential for dispute in the way that the provisions of the Bill are implemented. My main questions centre on the interface between personal care at home and NHS continuing care.

The number of people currently in receipt of continuing care from the NHS is roughly 45,000. It is likely, although I confess that I have no figures to support this, that a high proportion of those people will be assessed as being in critical need of personal care under the FACS-fair access to care services-definition. The FACS guidelines, which are currently the subject of revision, set out the criteria for determining a person's level of need, the four categories being "low", "moderate", "substantial" and "critical". As we know, the Bill is designed to cover only those in critical need, and then only those who require substantial help with four or more activities of daily living.

The Minister will know that NHS continuing care has provided a field day for lawyers over the past 10 years. A senior lawyer described it to me the other day as a sub-specialisation in the field of litigation, such are the quantity of challenges brought by patients, and also very often the families of patients, against decisions taken by the NHS about eligibility. With this Bill, we have in prospect another dimension of this type of challenge, one in which the NHS itself is likely to argue that at least some of the burden of looking after people in their own homes should be borne by local authorities. The assessment process is set to become even more fraught than it has been up to now. We can envisage local authorities resisting the idea of providing someone with free personal care at home and directing them instead towards residential accommodation with additional nursing, while at the same time the PCT will resist that idea and argue in favour of personal care in the home with little or no nursing element. Somehow, there will have to be protocols to deal with this type of situation. continued...............

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This is what the guidance for nurses says in the published local PCT instructions to nurses who are completing checklists for CHC: I thought the DOH directive gave PCT's instructions to consider the patients total needs and the interaction of those needs to formulate a picture of the "Primary Health Need" 

"Be specific and explicit about why the patient requires the care of a registered nurse.
An accumulation of social care needs does not indicate the need for nursing home care. The language used by nurses filling in assessment documentation is important. “Requires 2 nurses to mobilise” is a phrase often seen in assessments. More accurately, it might read “requires 2 people trained in moving and handling to mobilise”. A clear indication needs to be made if any “social care” activities need to be overseen by a nurse for any reason."

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What they don't seem to realise [ perhaps by ignoring the obvious ] is that people are not in a nursing/care home just because they need dressing etc. They are in the care home because their fundemental illness is that they have physical illness / dementia. Dementia is a disease of the brain , even the Nursing staff must agree with this. So if we put it in " Jack + Jill" terms - they are in a care/nursing home because they have some PRIMARY disease of the physical/brain and ANY needs arising from this are certainly NOT only social. The illness come BEFORE any other social need. If the person could dress / bath / shop / etc etc for themselves they would be IN THEIR OWN HOME. 

BTW my daughter saw the NHS Dementia advert on TV and was very angry about the way a person with dementia is portrayed as a competent speaker with a highly groomed appearance. Well she saw her Grandmother when she started with dementia and sadly she was none of those. The NHS have whitewashed it , yet again , and have failed to show the true face of dementia probably to play down any Primary health needs a person with dementia has. I said to my daughter - yes they are paving the way to make it appear that all these people need is social care. I am disgusted at the level the NHS has sunk to.

Edited by Guest Author

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This is an interesting article from a QC. I am particularly drawn to the case shown at Para C3
This seems to bolster the case of say a Dementia patient who is bundled into a residential home with few facilities where more specialised care would otherwise be appropriate. Any views on this?

www.byromstreet.com/pdf/winstonhunter2004.pdf

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Social care covers a wide range of services, both private and public, and can include anything from help getting out of bed and washing, through to care homes and drop-in centres. Social care is provided by the Local Authority and is means-tested to a £23,250 cap. This means that it is only free for those with assets that amount to less than £23,250. Everyone else, who has assets above £23,250 must fund their care themselves until a time where the value of their assets drops below the £23,250 means-tested cap. Individuals who pay for their own social care are referred to as ‘self-funders’.

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