 The independent care sector in the UK
has been transformed over the past few years culminating in
the adoption of the latest set of standards in April 2002. The
new standards are regulated by the National Care Standards Commission,
and this should ensure that the quality of provision of care
in this country either matches or exceeds that of other Western
Countries. This must be good news for those people that are
on the verge of needing care or receiving care packages at home
now.
1) Client Independence
2) Standards of Care and Quality of Life
3) Financial Implications
If any word in the field of care is misused and abused, it
is the word 'independent'. Once a client is assessed as being
in need of care, support, and assistance, then the true meaning
of independence is diluted. For example, a clients mobility,
or mental process, can be restricted through age or illness,
and ordinary activities, such as shopping, then become curtailed.
Remaining at home does not in itself mean that the client
can 'hop on a bus and nip down the supermarket'. The phrase
'remaining at home to preserve their independence' just does
not add up. If the overall list of choices and freedoms of
clients in their own homes, and clients in care homes, are
compared , there is little difference. In fact it could be
argued that being relieved of day to day chores, worries,
and financial pressures, actually enhances the care home client's
independence. They are free to live their life any way they
wish.
Myth 1 - Only clients at home retain their independence.
Wrong - Clients in care homes also retain their independence
to at least the same level.
Domiciliary care (care in the clients own home - either from
agencies or relatives etc). This type of care is based on
the principle of minimum input. Because the service is costed,
carers limit their time with each client. For example, 1 hour
in the morning, 1 hour in the evening, meals are sporadic
and mass produced. If 2 hours of care are provided each day
(if they turn up?) then what about the other 22 hours of loneliness
and risk?
A care home delivers care/supervision 24 hours a day and
a range of varied menus for all tastes and diets. Carers are
'there for the client' to provide comfort, support, companionship,
conversation and stimulus. Why is solitary confinement in
a clients own home with sporadic care and occational meals
championed as the way forward? The body called AEA has also
recently published results showing 70% of cases of all types
of abuse occur in the patients own home, with only 10% reported
in all care homes ie clients are 7 times more at risk in their
own homes.
Myth 2 - Care is delivered to the same standard whether
at home (domiciliary) or in a care home.
Wrong - The delivery of care and overall general quality
of life is always far superior in a friendly care home setting
where standards are monitored and statutory inspections regularly
completed to ensure quality of service.
The most cost effective care delivery system is provided
by care homes. A 30 minute visit by a care worker equated
to approximately £24 per hour (with travelling time
added). A district nurse visiting for 20 minutes equates to
over £40 per hour (with travelling time added and administrative
time at the G.P. Surgery). Care in a residential setting equates
to £2.50 per hour and care with nursing £3 per
hour.
Care home fees also attract various subsidies. For example,
nursing care payments for low, medium and high dependency
are £40, £75 and £120 per week (Oct 02 levels).
Full attendance allowance is not taxed or means tested and
is worth £50 plus. A one-off premium under the new single
premium schemes can provide for the remaining lifetime fees
at NO EXTRA COST.
Clients in care homes do not suffer the whole range of property
costs. No home insurance, no maintenance, no council tax,
no repairs, no labour costs for odd jobs (gardening). Money
released from a house sale can be invested efficiently to
provide care home fees, without affecting the value of the
fund. In fact, clever timing of the sale can take advantage
of peaks of property values and avoid future losses in down
turns. This, in itself, can provide substantial inheritance
benefits.
Myth 3 - Care home fees are expensive and deplete
capital.
Wrong - Care homes deliver the best value for money care
and with a range of subsidies, and careful investment packages,
funds can be protected, or in some cases, improved, when compared
with continuous home ownership.
The emergence of a new deal in care created by recent legislation,
and improved standards, now means that care homes are offering
good quality of life, and maintenance of independence, and
(with financial packages offering excellent value for money)
affordable fee structures. The modern care home should be
viewed as a positive choice to ensure clients receive a happy,
secure, comfortable, well cared for existence in the twilight
years of life. |
