When it comes to choosing residential care or sheltered housing, would-be residents and their relatives can be faced with a bewildering task in finding out what is available locally. Often it is more a matter of luck than judgement if they come up with a place which really suits their needs.
In Tameside, Greater Manchester, an innovative service provided by the local Citizens Advice Bureau (CAB) is taking the element of chance out of choosing care services. The CAB has established a one-stop-shop known as "ChoicE" where older people and vulnerable adults and their relatives can come to find out about the range of providers in the area and which ones have vacancies.
Annette Goodfellow, bureau manager says: "Marketing literature never tells you everything you need to know, like whether you can smoke, or take your pet with you or if you can bring some of your own furniture. We ask the questions that people should ask, but often don't because they don't know what to ask."
Local care providers complete a detailed questionnaire about their services, the results of which are collated by the CAB and presented in a user-friendly format. Providers fax in details of bed spaces every Friday and Tameside social care and health department also provides a list of vacancies based on their own research.
"People can sit down, have a cup of coffee and compare one care home or sheltered housing unit with another," says Goodfellow. "When they've narrowed down the range they can look at available inspection reports and read about them, warts and all."
ChoicE was set up eight years ago as a joint project between the CAB, local authority and one of the larger independent care providers in the area. At first, the service was partly funded by providers but now the full cost of £43,000 a year is met through a local authority contract.
Service supervisor Nigel Morgan explains that social workers refer people to ChoicE at care planning meetings. "The service is available for anyone to come in and use," he says. "There's a member of staff available who speaks Gujarati and Urdu. Staff can guide people through our system and select homes to look at from the map of the area, but we are clear that our role is to offer impartial information not advice."
Tameside CAB also provides an advocacy service for older people placed in residential or nursing care by the local authority. The idea is to provide an independent voice for the client so their views are properly represented at six-week and annual reviews.
An advocate visits the resident before a review and goes through a checklist covering everything from dentistry and podiatry to whether they are taken out on visits and are able to practice their religion. Vicky Lowe, CAB advocate, says that people suffering from dementia often respond better to a conversation about issues rather than to direct questions. "I might ask someone if they are put into their wheelchair gently and whether they are consulted about where they would like to go on trips."
Lowe adds: "You have to be clear with residents about why you are there and that you are independent. It's confidential so if there is anything they are not happy with it's their decision whether action is taken on their behalf. But if everyone complains about the food we would take it up as a group issue."
Goodfellow believes the service provides a crucial independent voice for vulnerable adults. "There is someone they can turn to if they are not happy. Everyone can express a view and we put that to the professionals at the review."
The advocacy has been instrumental in improving services for all residential and nursing care home residents in the area despite being under contract to represent only Tameside-funded clients. Morgan says: "We highlight issues affecting a number of residents, such as people being discharged from hospital with MRSA or pressure sores or problems with getting a dentist."
He describes how he lobbied successfully to improve dentistry services. "I wrote to local MPs and to health minister Rosie Winterton who then contacted the primary care trust. We can raise an issue and get through to the right people."
Lessons Learned
