Laundry
All clothing is asked to be labelled when admitted. However if a relative or friends wishes to help with a residents laundry this is acceptable.
Meals
Breakfast is served at 8.30.
Lunch is served at 12.30
Tea is served at 4.30
These times stated above are flexible and the homes will accommodate to any dietary requirements. If meals want to be taken in the evening this can be arranged. There are choice of two main meals and deserts daily. There are also additional snacks such as salads fresh fruit. There is a range of beverages, which are offered throughout the day too.
Medical attention
Each of the residents will be able to have their doctor continue to visit them if it is necessary. A chiropodist visits every six weeks, and dentists and opticians services can be arranged too.
Citizen’s rights
All residents will be able to retain all the rights you enjoyed as a citizen in your own home. Residents are also free to come and go as they please, with a key to their own room. There is a residents committee and a social group, and resident’s comments and views will be very much appreciated.
Electrical equipment
Any electrical appliances must be checked before used within the home. This too requires a small fee.
Valuables
Limited facilities are available within the home for safe keeping of all the residents cash and valuables, it is advised to the residents that they take out an insurance policy for personal belongings.
Finances
The social worker who negotiates the residents admission will also be responsible for completing their financial assessment to determine the level of charges they will be required to pay, there are several options available for them to pay charges and they are welcomed to continue to be responsible for drawing their pension still.
Smoking
The smoking policy is determined by the policy of NCC. Residents may smoke in a specific area. For safety reason smoking is not allowed in the bedrooms.
THE WAYS IN WHICH SOCIAL SERVICES IS FUNDED AT A NATIONAL LEVEL, IN NORFOLK AND HOW FOULGER’S HOUSE IS FINANCED
Health and social care may be funded in many different ways. As you can see below:
The government allocates funding to the social services. It receives money through grants and contracts, allowing a constant flow of money. This allows improvements and funding for current projects, the type of grants received by the council doesn’t always have to be through the government. Lottery grants received, fund raising charities, and mass advertised and publicised groups such as children in need can also contribute to raising money for county council.
The National Health Service is funded by the central government. The way in which this money is collected is through National taxation. This is where income tax, value added tax (VAT) and National insurance contributions are put into work. The Central governments department of health and the Treasury has to then consider how much money will be given and spent on the National Health Service each year. When this amount has been decided, it is the department of health’s responsibility to then allocate the money to certain Health Authorities. The amount of money in which will be allocated to these health authorities will depend on the size, age and health of their resident population.
The amount of money in which needs to be given to the National Health Services has been increasing each year, and one of the reasons for this is the increasing age population. For example it has been suggested that the NHS expenditure had increased from £28.9 billion to £39.5 billion in 1998-9, and that will have probably rose to £46 billion in 2001-2.
Local authorities are given money too from the Local Authorities which is also determined by the treasury and the department of health. ‘Standard spending assessment’, refers to how much each authority will be given.
The social services funding has too risen to £9.3 billion. (Figures from 1999). The three main departments in which this money is spread between is:
- services for children
- residential care for older people
- domiciliary care for older people
Foulger’s house receives its money for minor personal expenses via a petty cash fund. The account has a basic £400, which can be accessed by a chequebook for any day to day emergencies. Just like the county council, Foulgers house also holds fundraising events. Raffles and fetes to raise the necessary capital to keep the place running efficiently. Below is the structure in which Foulgers house is funded:
NCC
Expenditure (treasury)
Social services budget
Director of social services
Residential home allocation available for Foulgers house.
As you can see above, this is the process in which Foulger’s house is funded. Norfolk County Council receives their money, which will then be decided by the treasury how much will be given to each of the departments and homes etc. Social services will then be given their budget allowance and Paul Adams the director of Social Services within Norfolk will be responsible for the finance of such homes like Foulger’s house. He is in charge of all the funding of the Social Services. The staff who work at Foulger’s house will be paid directly from Norfolk county Council. When they first are employed by the home they will have a contract from NCC so they will pay them. Each week they will fill in their time sheets and send it off to the NCC in which they will get paid the following month. Money for necessities such as food supplies, cleaning materials, decorating, building work etc will all be paid directly from social services and Paul Adams will be in charge of sorting out that it get paid. This is because home like Foulger’s house cannot afford to pay out for such things like food, building work etc. The petty cash money that Foulger’s house receive is a very small amount compared to the actually money in which is spent on the weekly running.
THE PROCESS IN WHICH AN ELDERLY PERSON CAN BECOME A RESIDENT AT FOULGER’S HOUSE
If someone wanted to become a member of Foulgers house, the first step would be to get into contact with his or her local social services to receive an assessment of their needs. They can do this by getting into contact with their nearest social services office that will put them into contact with the reception and referral team. This reception and referral team will be able to do the following points:
- give you information and advice
- They might pass on your details to a social worker, who will then arrange a visit to discuss your needs and asses you.
The Norfolk social services department have a team of workers, who specialise with dealing with the elderly. They are the to help assist the old whether it be in becoming a resident at a home, or that of a old patient within a hospital who might be concerned about how they will cope when they get discharged.
The assessment that an elderly person will be given will include defining whether you are a priority to the department by comparing your needs to a chart. If they were to fall within the ‘major concern’ category then they will be helped as soon as possible by social services.
When a person is assessed they will have this done by Occupational therapists. They will not only look at what your needs are, they will discuss the best way in which you can meet them. When deciding how these needs can be met, relatives, and partners of those who may be able to offer help will too be considered to establish what the best step is to be taken.
After this assessment contact will be made with either an Occupational Therapists or a Social Worker will write an individual care plan. This will include all the services that will be on offer to you. The plan that will be given will list the help that the social services will be able to offer you along with help which may be required from other services. For example, contact may be made with housing associations about residential care to make sure that needs are met. For example, in the case of any improvements needed to a persons home, the Norfolk County District will be contacted. The social workers are there not only to assess your needs but also to help you meet them by either offering the services they provide to help you, or give you information in which you can contact other services. Once someone is put into contact with the other relevant services arrangements will be made for the needs to be met.
The financial issue of going into a residential home
The Social Services Department makes charges for care provided in all residential homes. The cost depends on the ability of the resident to pay and also on the cost of their service. All potential residents of a home will need to fill in a Service User Details Form’, and a Financial Assessment Form.
On the Financial Assessment form all potential residents should put down all their income
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Include income such as wages, benefits or their pension.
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Don’t include the mobility part of the Disability Allowance, housing benefit, and payments from the Independent Living Fund or their Child Benefit.
Social services will work out how much each person will have to pay and they work it out how it is stated below:
- If they have more than £16,000 of capital (savings or shares, not property or possessions) they will have to pay the full cost of their service
- If their capital is more than £3,000 but less than £16,000 we assume they get a weekly income based on a fixed yearly interest rate of 4%
- If their capital is less than £3,000 we do not count it in their assessment
As you can see it is very expensive to cover the costs of moving into such a residential home as Foulger’s house. All the services, accommodation, food, equipment have to be paid for by the residents but only if they have sufficient funds. In the event that a resident at Foulger’s house cannot afford to pay for such services then, social services will pay for it instead.
Within Norfolk the head of social services is Lisa Christensen, and she has three assistants, which are in charge of different departments. Glen Garrod is responsible for community care, which involves all services for adults who are clients including; assessment and care management, homecare, residential or short-term accommodation, day services, rehabilitation and equipment
The other two assistants, , being the senior assistant is responsible for services including planning, finance, administration, research and information contracting, training, buildings and supplies and communications, and Rosemary Claridge who is an assistant director is responsible all services for children and families who are clients, including child protection, residential accommodation or fostering, family support and services for children with disabilities and adoption.
HOW FOULGER’S HOUSE AND SOCIAL SERVICES WORK TOGETHER WITH OTHER AGENCIES TO PROVIDE THE BEST SERVICE FOR THEIR CLIENTS.
Foulger’s house work very closely with the Social Services in order to provide the best possible service and care they can for their clients. In order to achieve this they have to offer a wide range of additional services to their clients along with their own. In the diagram below you can see the services in which are on offer to the clients of Foulger’s house:
All the things stated above are thing in which the residents are going to need to make sure that they are living the best possible life they can. These are all things in which the clients need to be able to access within Foulger’s house.
Doctors
In the event of one of the residents needing a doctor, they may need to call out that particular resident’s own doctor. This means that the residents doctor has to be made aware of when that resident has moved into a home, and where that home is. All the relevant data will be given to the doctor before the resident moves into the home. The patient can continue visiting their doctor and transport may be arranged for them to do so, or if that is not available then it might be the case that the doctor makes regular visits to the home to visit the resident.
Dentists
Dentists like the doctors are very important with regards to being accessible to the residents of Fouger’s house. Most of the residents will be using dentures, because they have lost all their own teeth. This will mean that if anything was to happen with their dentures then a dentist’s appointment will need to be arranged, because it could mean that the residents might not be able to eat, obviously this is s serious problem. Regular dentist appointments will need to be arranged for the residents of Foulger’s house.
Hair dressers
There will usually be a hairdresser who comes once a week in to residential homes. Foulger’s house follows this same policy and he residents can make appointments each week to have their hair done. A small fee will be asked of each of the residents for the haircut, and this is additional to their other payments. This is not so much of a necessity for the residents, but it is a service, which will make them feel more at home and emotionally promoting.
Catering
The catering system at Foulger’s house requires money being paid directly by the head of social services within Norfolk – Paul Adams. A catering service will be arranged by the manager of Foulger’s house to in keep with his or her own budget and then this will be paid by social services. The residents receive three meals a day, breakfast, lunch and dinner. And other things such as tea, coffee or biscuits will be available to them during the day. Small costs may have to be given for such snacks etc. Foulger’s house will have to work closely with their catering system and staff because they will need to make allowances for those residents who have a different dietary requirement to others, or they might be a vegetarian.
Such other services like opticians, buying clothes and shoes, chiropodists, leisure activities will be on offer to the residents of Foulger’s house. It may be the case that these types of services are going to have to be paid for by the residents as extra activities. However they are all services which are needed by the residents therefore this is why Foulger’s house is working very closely with the other services in order for them to be able to provide a better service for the residents.
RECCOMMENDATIONS FOR IMPROVEMENTS
There are many barriers, which prevent potential residents of Foulgers house, along with current residents from accessing the available services. These barriers can be categorised under four different headings, information, physical, financial and psychological barriers.
Information:
- The elderly can be extremely oblivious of how to access the services, which are available to them mainly due to not being able to access the information. The Internet is probably a resource, which the elderly are not capable to use. This is because elderly people do not have computers at home, or will go into a library etc to access the Internet. On the other hand elderly people may have someone like a relative or friend who has access to the Internet so this could actually be another way in which they can be made aware of the services if these families and friends for them access them. This could limit the amount of information, which they could access about the services. A way, in which this barrier could be overcome, would be to advertise on a broader level, for example: radio, television or at bus stations. Another potentially dependable place which leaflets could be placed is within a post office, as most elderly people will collect their pensions from there. This way elderly people could become more aware of the services that are actually obtainable to them.
- Some elderly people are home bound and find it arduous to access information. Perhaps introducing a leaflet drop from those who receive services from meals on wheels. This would be a direct way for information to be brought to those who cannot access it.
- Obviously the health of elderly decline with age, so factors like poor eyesight could become an issue when trying to read a leaflet or information. In these cases, larger and bolder information is an exigency to give those with poor sight a chance to be able to read up about residential homes and services, which they may have not usually read, due to their disability. Along with leaflets with larger print there also so be ones which include Braille for those who are not able to even read the large print.
- Because moving into a residential home is such an ordeal for the elderly along with a life changing moment, they need to feel that it is the right decision for them. By creating enticing leaflets, which include activities, and services, which they will be entitled to reason, may change the perspective that they had on moving. If the home was too look respectable and welcoming then the elderly may feel that it’s not actually as fearful as they had once presumed. By including pictures, it can also be made more appealing and they would really be able to envision what it would be like too live there.
- It is all very well to increase the amount of elderly people who can access information about services, however it is a prerequisite to include a contact number, so if there is any queries about the information and elderly person can easily be reassured or informed by calling a contact number.
- A good way of finding out any improvements, or issues in accessing information can be found out by conducting questionnaires or surveys. These can provide reliable results to any improvements, which could and need to be made. Service users such as the residents themselves, family and staff should also be consulted regarding improvements to accessing information.
Physical barriers:
- Perceptibly there can be a lot of physical barriers, which can prevent people from using services. A major barrier is disabilities such as wheelchairs. Excursions or trips to specific places may not be obtainable to people in a wheelchair or people who have difficulties in walking because the transport does not cater for those who need special access to the mini bus or van. By making sure that all buses are other forms of transport have wheelchair access like ramps and lifts which facilitate for the disabled to take part in these activities.
- There are many barriers physical barriers which may occur within the home which may prevent elderly people from entering a home and using these services. Residential homes often have doors which can not be wide enough for a wheelchair to fit through, so it is indispensable for these to be changed to ones that a wheelchair can easily fit through. This would also include in washing areas, and the doors will need to be fitted so that the doors open outwards. Any residential home will need to make sure that they either have all their bedrooms and any other rooms which residents go in, to be on the first floor. Elderly people will find it incredibly hard to go up and down stairs, so there should be lifts for them to access any second floor rooms, however it would be simpler to have all the rooms on the first floor. The furniture within the residential rooms needs to be lower than usual beds, so it is easier for the residents to get in and out of them. Hand bars will need to be put next to beds so residents can use these to assist them getting in and out of bed. Because a fair few of the residents in a residential home will be in a wheelchair, it is essential that the flooring can accommodate wheelchair, so it needs to be vinyl flooring throughout the home, so disabled people will be able to access everything without much complexity. Because residents may be open to falling over within the home, it is essential that there is no radiators in places where this could happen. If a resident is known to fall over or collapse at times they will need to go into a home where they would not have to worry about falling over and hitting the radiator and potentially injuring themselves fatally. If the home was to have no radiators, then under floor heating will need to be installed, so the home would still be heated. Also, in the case of a elderly resident falling over, and not able to get help, the under floor heating will keep them warm in this incident. As you can see there are an incredible lot of physical barriers which might prevent a person from being able to go into a residential home if they can not accommodate for their needs.
Psychological barriers
Along with physical and information barriers, there are some psychological barriers which might not enable a resident to move into a home.
- Moving into a residential home, for any elderly person is a major change in their life, one which may be very fearful for them. Some old people feel like they will be loosing all of their independence if they move into a home, and it could result in them staying at home which would not be the most suitable option. In barrier, it would be a good idea if potential residents had a counsellor that they could speak to. If they were able to express their personal concerns to someone, then they would be able to explain to an elderly person, that they would not lose their independence and could make them feel much more secure and positive about moving into a home.
- Residential homes often are the subject of bad press. They can be slaughtered by the media for incidents which may or may not have occurred within the home. This can totally put off an elderly person from moving in to that particular home, but also any other residential home due to lack of faith. Bad press can focus in on the residential homes treatment and services, and this can be very off putting for anyone. Therefore it would be a good idea if PR conferences were set up, so any worries about residential care homes can be brought up and discussed in a way in which potential residents become at ease with the system and regain their faith in the service.
- Most of the residents which move into homes are extremely worried that they will feel alone when they move into the home. They could fear lack of visitors or might be getting split up from a loved one. Moving into care is a very frightening thing on its own, without the fear of being alone. This is a barrier for elderly people, especially if they are shy and unsociable. They might need to encourage them into moving to the home by someone who works there. They could possibly show them around the home, introduce them to other residents so they would not feel completely alone when they got there. A worker in the home could pare new residents up with current residents, which could show them about and make friends. Perhaps inviting potential residents to social events might help them to feel like they will be so alone. Importance will also need to be stressed on the fact that visitors can pretty much come whenever they like, so that resident will feel content that their family can visit.
- Another, and probably the most fearful psychological barrier would be embarrassment to that particular resident. Most residents have physical problems, like for example incompetence, which is obviously extremely embarrassing for that resident. This is a major barrier; however it can be overcome offer support from the carers in home to help them.
The last type of barriers is that of financial matters. Moving into a residential home can be extremely expensive, and often elderly people do not have a lot of money to their name. So moving into a home can see a very hard option due to money matters. Some might have to sell their own property and give any money they have saved for relatives away to pay for their care. This is sometimes not the option that elderly people would opt for because they want to give their relatives something back.
- Services which residential homes have to offer, like for example hairdressers, can be very expensive, and an elderly person might not be able to afford it so they are not able to access these services.
- Residential homes have to meet certain regulations, because these change all the time, they have to constantly keep updating the building. If they fail to do this because of the lack of money, then the home will be closed until it can meet the regulations. This in the long run would cause the home to become more expensive, and again preventing elderly people from using the services because of financial matters.
- Government could overcome most of the financial problems; they should set up some plan in order to have all the care in residential homes free for the elderly because at the end of the day some of them simply cannot afford, otherwise they are not able to access the service. If a resident is not willing to give up their savings so they can go into a home, might stay in their own homes and suffer, this is extremely sad.
PROVIDING A SEAMLESS SERVICES
Foulgers house needs to provide a seamless service to its residents and to make sure that it interacts and co-ordinates themselves in this manner too. One of the main problems in being able to provide a seamless service is the fact that the Social Services and the Health department are separate. If these two departments do not work along side each other it is impossible to provide a seamless service. There have been many problems and issues which have occurred because of the two departments being separate. For instance: Gordon Lishman from the Age concern department in England stated that ‘Many older people continue to be stuck in hospital when they are well enough to leave because care is simply not available to them’. This is a typical example of how the Health service and Social Services are not providing a seamless service. With patients stated above, the Health service focus in on their medical health, and then pass them off to the Social Services to find them a residential home etc, which causes there to be delays in beds being available within hospitals because it is not always an easy job for the Social Services to find beds easily for the patients. This has a knock on affect with the elderly and other members of society because they too will be affected by the non existence seamless service when needing to go into hospital and having to wait because the Health Service can not provide a bed for them. ‘There is poor co-ordination between the health and social services organisation’, this was stated in the NAO report indicating the fact that it is not a seamless service.
It is important that the elderly remain independent, and it is the job of both the social services and health services to consult patients of their plans in order for them to take part in decision making, allowing them to remain independent. However this is not the case, a Charity for the elderly said that ‘the NAO report showed how older people were suffering, and were not being consulted about plans for their hospital discharge’. This is not providing a seamless service, because the patient is not consulted. This patient may not feel well enough to be discharged and by making the decision for the patient is providing a poor service.
My personal thoughts on how to provide a seamless service is that are absolutely imperative for the health department and social services to work together to provide the kind of service that is expected. It is extremely hard to make recommendations about how else a seamless service can be provided. However I do feel that there needs to be something done about the way in which patients are dealt with in hospital and after when waiting for a place within a residential home. For example: perhaps by setting up a separate home, or department to the hospital which would enable the elderly who are well enough to move into a residential home, but cant because there is no bed space, or elderly who cannot go into hospital due to the waiting list, to go into an be cared for until a bed is allocated for them in either the residential home or hospital, it could cut down on some of the poor treatment and long waiting. However the problem with this is that there would need to be a lot of funding provided to enable some sort of intervene to be provided, although I do feel that it would be a method which could be successful.
The social services are looking at the patient as a whole however the health department is only looking at the illness. Consequently it is not providing a seamless service. For example the health department would be looking to treat any illness that a patient comes into the hospital with, but not looking at their will being or anything to do with them after the treatment. The social services are looking at the patient as a whole, and working to make any decisions based on the well being of the client, therefore there is a divide in the way in which the two services approach the elderly. This is why it is imperative for them to work closer together, for more consultations to take place in order for them to close the divide to provide a seamless service which would be better for all patients as a whole.
Something which could be done to help create a seamless service for the elderly would be that of perhaps assigning a ‘key worker’ to each of the residents. If a key worker is assigned to each of the residents it would be possible for them to look after the resident’s dietary requirements, dental appointments, optician appointments, doctor’s visits and even birthdays! Not only will this make sure that the resident will be able to carry on their usual appointments, etc they will also be not only looking after the health of the health of the patient but they too will be looking after them as a whole. This subsequently will mean that they are providing a better service which is more seamless than before.
Another issues which is important to consider when providing a seamless service is the fact the Fouger’s house is shutting down and the residents are moving to the new housing with care – Lakenfield. Social services and the health services will need to make sure that there is a smooth interaction between the moving of the residents from Foulger’s house to the homing with care. Something in which they could do to allow this smooth interaction to occur would be if there were schemes of ‘befriending’. If the residents were either assigned to a member of staff and a current resident before they move in, then when they actually move in to the housing with care then they will have a familiar face or two. This might mean that the whole experience is slightly less intimidating than before. This will be providing a good seamless service if this type of practice is introduced into the system.
THE IMPACT OF GOVERNMENT POLICIES AND LEGISLATIONS
The development of residential care over the last 30 years has changed considerably. Because of the vast increase of medical advances people are now beginning to live longer than once before, subsequently this means that the new longer aging population increases the demand on residential care.
As you can see below in the table showing the increased life expectancy, it has increased by a huge amount:
Above is a diagram of the life expectancy over the past 30 years. As you can see it has increased by a considerable amount. By the year 2013 it has been estimated that 1 in 5 people will be over the age of 65 and 1 in 20 people will be that of 80 or over.
When people get older, most of them will find that they will not be able to remain as autonomous. They may have to depend more on relatives, friends or that of help from voluntary services. Often someone will be able to remain more independent if they have support from these types of people, however if they do not then they may have to consider such things as going into a residential home. There are a lot of problems, which are now occurring because of the increase amount of elderly people.
One of the main problems is that there is now a greater need for the health and social care services. Not only are people now living to a longer age, it also means that services are going to be needed to be provided to those for a longer period in time. An example of one of the effects it could have on the health and social services is stated below:
It has been suggested that the amount of people with dementia is high already, however it has been estimated that by the year 2040 the amount of people who will suffer from dementia will have risen from 700,000 to about 1.2 million. This is a massive amount to have increased by and what is more worrying is that a yearly cost of caring for someone with dementia each year will be that of £21,000-£30,000. This would have a huge effect on the heath and social care services, and this is something which is very worrying.
It is also going to have a large effect on the budget which is given to care for such people. There will be a lot more pressure to providing these services. One of the main things which has been suggested to overcome such a problem is that people should now start to arrange private provisions for their pensions instead of simply relying on a state pension for their retirement, because by the looks of this it is going to increase by a lot within the next few years with the increasing age population.
These demographic changes on the provisions services have forced these recent changes to take place; fundamentally it means that more residential homes have had to be built. However this is not the only massive change to have occurred the standard of the homes too has had to be monitored and in cases improved tremendously.
The social services have had to respond to many new laws and changes in already founded ones. The list below outlines some of the law in which they have had to deal with:
- Health and Safety Act
- NHS community Care Act
- Registered homes Act
- Care standards Act
The NHS and Community Care Act
This specific act was brought about in 1990 by Parliament. It was intended support the principle that people are best cared for in their own homes, or in other familiar surroundings, rather than being admitted into residential care as a matter of policy. Obviously Foulger’s house is a residential home, and therefore if this Act were actually enforced, Foulger’s house would have had to close down. It has brought about many changes within the welfare state, one of the biggest changes since the World War. The Government's aims are to:
- Make the best use of public money
- Encourage local authorities to set priorities
- Ensure that local authorities check on the quality of care which is being provided
- Encourage local authorities to use other organisations to provide services
The Health and Safety Act
This act has been put into place to make sure that residential homes are built, and maintained in a way which puts no risk to that of any resident or staff worker. This might include many different things for example door ways now have to be a specific width to allow easy access of wheelchairs. Homes such a Foulger’s house has been inspected to make sure that the relevant new Acts apply to they are up to standards. Other things which will be looked at are that there are no safety risks like beds being too high, or no hand rail bars. Foulgers house has been affected by these new laws in a major way. Many homes have not the funding to improve their homes to fit for the new legislations. The way in which Foulgers house has been affected by the Health and Safety Act is:
- Moving and handling
- COSHH – hazardous substances ( control of Substances hazardous to health)
They now have to make sure that there are extra careful whilst handling substances, they have to now wear cloves and protective clothing. This in itself is not too much of a problem, but staff have to follow the new standards exactly, and have all the right clothing etc. if they do not then it could end in those staff having to be retrained, or in the worst possible cause of the staff continuing not to follow the new laws they may lose their own jobs. It is also the job of the manager of Foulger’s house to make sure that they are in keeping with the new legislation.
The COSHH law, is also there to make sure the health and safety of the residents within the home. Residents are now protected from burning themselves on dangerous substances or being poisoned by them. So not only is it in the interest of the staff who work in such residential homes, but it is also been enforced for the welfare of the residents.
Moving and handling is something which has too affected Foulger’s house they now cannot move a resident without the aid of special equipment or those who are able to. This is so that the staffs at Foulger’s house are not leaving themselves open to get injured.
Registered Homes Act
The Registered Homes Act 1984 covers independent residential care homes, nursing homes and mental nursing homes and private hospitals. Residential care homes, which provide residential accommodation with both board and personal care (but not nursing or mental nursing care) are registered under Part I. Homes which provide nursing or mental nursing care are registered under Part II
This Act makes sure that all owners of homes are registered and homes are reaching the standard which is set. One of the major problems is that, in fact anybody could set up their own residential home, or become part of the Health and Social business. This has caused there to be in massive increase in the business within the health and social care. Within these new homes standards have had to be established which is where the Registered Homes Act has come into place. This Act was enforced in order to stop people from setting up inadequate homes. Therefore there has been more regulation, and private homes have now been shut down because they could not afford to make such changes as to increase the amount of fire exist, or allow bigger rooms for residents.
The Care Standards act
The main purpose of the Act is to reform the regulatory system for care services in England and Wales. Care services range from residential care homes and nursing homes, children's homes, domiciliary care agencies, fostering agencies and voluntary adoption agencies through to private and voluntary healthcare services (including private hospitals and clinics and private primary care premises). For the first time, local authorities will be required to meet the same standards as independent sector providers. In England the Act provides for an independent National Care Standards Commission to undertake this regulatory function. These Councils will regulate the training of social workers and raise standards in social care through codes of conduct and practice and through other means. For the first time a register of social care staff will be set up and maintained by each of the Councils.
Obviously in a residential home, there has to be certain levels of care, and all homes now have to meet these standards. If they fail to meet them staff ill have to be retrained or subsequently the home will either close down or new more efficient staff will be placed in the home.
The way in which the government has introduced new legislations and policies on the residential care has been a successful one, in the way that it is looking to improve the standard of care which can be offered to patients. They now will be receiving a higher standard of care, which is much safer for both the residents and staff; however the problem with this is that some residential homes cannot make the changes. The main reason for residential homes not being able to make the changes is that they can simply not afford it. It is very expensive to make these changes, and because the standards are constantly changing, it is increasingly getting more expensive too. These homes are then forced to attempt to fund raise to afford to make the changes but this is not actually a successful method.
These new legislations and policies in which the government have introduced will affect certain categories of people, these may be the following:
- Rate and taxpayer
- Residents and family
- Managers of social services
- Managers within the homes
- Staff within the homes
- Health care professionals
These legislations and policies are going to have either a positive or negative affected on the categories.
Rate and taxpayer
Rate and taxpayers will be looking at these new legislations and policies and establishing what the value of them is. They will want to have value for money, therefore if these new legislations and policies will mean that they will be given better care in the future this will be ideal for them because they will be getting the value for money in which they will have expected when paying their tax, and rates etc. They would not be contented with new legislations and policies which will mean that their tax rates will go up etc. So in the interest of the rate and taxpayers the new legislations will only be that of an effective one if they are looking to have value for money in the long term.
Residents and family
These new legislations and policies will have a massive impact on the residents of such homes like Foulger’s house, and also their families. For example, if the new legislations means that I residential home was to be shut down then an option may have to be for a particular resident to move into another home. This could not only cause a lot of upset to that resident from the stress of moving, but also it could possibly mean that they are further away from their families. In some cases it might be a necessity of the resident’s family having to move nearer to the residential home. This obviously would be an upheaval for the whole family, and the new legislations might actually have this affect.
Another affect, in which these legislation’s may have on the residents of Foulger’s house is that because the residents are anxious about losing their home, they may be even harder to care for. They may have taken the new extremely badly, as it can be terrifying to them, the fact that they have to move out of their home, they may worry about what is going to happen to them and subsequently they may become rather distressed and upset.
The managers of social services and the managers of residential homes
The new legislations are going to have a greater impact on the managers than probably expected. They are going to have to adapt to all the new laws and policies whilst, making sure that their residential home is meeting the standards which is now expected. Unfortunately it has meant for Foulger’s house that they have had to shut down. This was because they could not afford to make the necessary changes to improve the home. They were unable to make the changes to the sizing of the bedrooms available to the residents. Therefore the manager of Foulger’s house has now had to take drastic action to re house the residents etc.
Under the Registered Homes Act, managers who are running an inadequate home will have met certain standard in order to stay open. This will mean that if they cannot afford to make the changes they will shut down. This will mean that the managers of these types of homes will no longer have a home to run, and obviously will have no job.
Like the staff of the homes, like Foulger’s house, managers and assistant managers will lose their job if the legislation’s are not met. So the effected of the new laws and policies can not only be drastic to the residents of the home, but also that of the managers.
The staff within the homes
The staff might find the adaptation to the new legislations and policies that of a hard task. They will need to be retrained in some incidents to make sure they are able to cope with the new standards. Under the new Care Standards Act staff will now have to make sure that they are providing care which is efficient in order for the home not to be closed down. A higher level is now expected. Under the Health and Safety Act, staff is now not allowed to move or handle residents in case they injure themselves. They now have to be even more careful when handling substances and have to make sure they are wearing the correct uniform to do so. All of these new changes are going to have to be adapted in order for the care to be that of what is now expected.
Like I have explained before, the residents may have a lot of serious affects occur after they have been made aware that they will have to leave their home. Because they can become more distressed, upset it will mean that it is harder for the staff to make them feel content. They are all going to have to make more of a conscious effort to make the residents feel comforted. This may prove to be difficult but it is something in which the staff is going to have to work at in order to make sure the residents are achieving the highest level of care, which they should be receiving.
Obviously the biggest effect in which the legislation’s will have on the Foulger’s house and other care homes is that if the home has to close because they can not make the changes in order to be in keeping with the new legislation’s, the home will close down. This will subsequently mean that all the staff has actually lost their jobs and may find it difficult to find another one. The staff of homes such as Foulger’s house will want the home to pass all the new legislation’s otherwise they will be out of a job.
Some residents could in fact become part of the housing with care scheme. This would mean that they would become tenants, but receive some source of caring. This can only happen to those residents, which are dependent. This would mean that they would have to be able to dress, wash, cook etc for themselves. If they were not able to do this then it would not be suitable for them to go into a home. All the members of Foulger’s house have lost their independence because they have been looked after for many years. Because of this effect it would be necessary for Foulger’s house to retrain these skills in which they have lost through being put into the residential home. If Foulger’s house were able to retrain the residents how to look after themselves and regain as much independence as possible then it means that they would be able to move into the new ‘housing with care’.
I feel that on one hand the government are making residential homes such as Foulgers house improve the standard of care, and the home etc, but they are not providing any financial help to allow them to be able to do this. In the long run it means that if a residential home cannot afford to make changes they will get shut down. Then you will have twenty odd or more residents with no home, therefore they will either have to go into hospital to wait for a residential bed, or will have to move into another home. This will not only be very expensive but it will also block up the access to the residential homes etc. therefore I believe that I would be more appropriate if the government could allow more money to be put into the improvement in residential care. Foulgers house has been affected in this way too, they are unable to provide the changes and are now shutting down, luckily they are now going into a partnership with another residential home and setting up a new place under the housing with care scheme. Foulger’s house has been forced to enter the new ‘Lakenfield housing with care’. This is because of them not being able to meet the demands of bigger rooms within Foulger’s house. The director of social services had not choice but to let Foulger’s house close down because they could not make the improvements as there was simply not the budget for this. Because there are many homes like Foulger’s house having to be closed down, the idea of the new care scheme had to be set up and developed. The affect it has had on the health care, as a whole is that it is very much going back to how it was 60 years ago, with the idea of ‘housing with care’. This would have cost a lot more than simply making the changes by the government.