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How to sort out the crisis engulfing dementia care | Dementia

by Ozva Admin
How to sort out the crisis engulfing dementia care | Dementia

Directors of adult social services share concerns about the poor quality of some care and support for people living with dementia (Dementia patients in England facing a ‘national crisis’ in security of care, December 28). But as his report makes clear, the underlying cause is the inadequate funding of our social care system. We must disagree with the claim by a spokesman for the Department of Health and Social Care quoted in the report that the government is giving social care “the biggest funding increase ever” of “up to £7.5bn available in the next two years.”

Some of this funding is extensions of existing short-term grants, some is winter funding extensions focused on hospital discharges, and some is contingent on council tax increases, which not all local authorities will impose. While there is an additional general social care grant from the government, it must be shared with children’s services. In the past, the split has been 50:50. Given the growing needs of people and the rising costs of care providers, the financing package is helpful, but it doesn’t come close to what is needed. It is certainly well below the extra £7bn a year for social care that Chancellor Jeremy Hunt identified as needed when he was chairman of the Commons’ health and social care select committee.
Sarah McClinton
President, Association of Directors of Adult Social Services

The negligent treatment of older people with dementia is not new. And, as Helen Wildbore of the Residents and Family Association tells us (Complained of nursing home neglect and faced a visitation ban? This is the new normal, December 29), this is one more expression of the broader crisis facing social assistance. We don’t have to look far for some of the reasons for this egregious behavior: too few staff employed to provide adequate service; little access to training to prepare staff for difficult and demanding work; and inadequate leadership and supervision to counter bad practice.

But the Care Quality Commission, whose inspection reports detail failures in homes it once considered “good,” must also take responsibility. When it’s known that securing a “good” rating gives your home “inspection vacation,” as is the current practice, managers are likely to be relieved. However, relief can easily turn to complacency, then indifference, and then rot sets in and it becomes the new normal. Annual inspection (at a minimum) must be reinstated, along with at least one additional unannounced visit each year. Poor performance should lead to more frequent inspection, with stiff penalties when homes are found to be substandard.
they bright
Exeter, Devon

A generation ago, children’s homes were closed largely because they did not keep children safe and the risk was managed in the community. This approach is now necessary for older people in nursing homes: early diagnosis of dementia, caregiver support and utilization of advanced directives may allow people with dementia to stay in their own homes for longer. Dementia care costs England at least £20bn a year, and if a proportion of this were diverted to supporting people at home, by closing 50% of beds in care homes and redistributing the community support staff, many dementia patients could avoid a miserable end to their lives.
jeremy seymour
Retired consultant in old age psychiatry, Sheffield

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