Adult Care Blog: March 2011 Archives

A job for the Audit Commission?

By Vern Pitt, journalist, on March 31, 2011 4:07 PM | No Comments

The Care Quality Commission (CQC) announced today that it wants multiple organisations to run its excellence rating schemes for adult social care providers.

Among the list of qualities it's looking for in a candidate it says: "Successful applicants will need a track record of delivering audit or inspection programmes as well as knowledge of the social care sector."

I can think of few better qualified applicants than those good people at the Audit Commission who have years of experience in scrutinising councils over adult social care issues. Since it became a victim of Osborne's bonfire of the quangos last year I image there will be a raft of people looking for just this kind of opportunity.

Plus, the CQC says it is actively encouraging applications from voluntary organisations. Well, if the audit Commission was as hopelessly bloated and over paid as the government claims i'm sure their inspectors will be happy to sit on their fat savings accounts and do pretty much the same job for free.

Funny how things work out in the end isn't it?

Image by futureshape on Flickr

Law Commission rescues care duties from Pickles?

By Vern Pitt, journalist, on March 31, 2011 10:15 AM | No Comments

White knight by hans s.jpg The Law Commission appears set to back the retention of the majority of council's adult care duties but it would be complacent to see it as the white knight rescuing them from Pickles' threat.

Normally I would be satisfied that the government will listen to the Law Commission, indeed it has previously announced its intention to put forward legislation in the light of the Commission's recommendations. But because this new consultation is being driven by Pickles' department and, as I've already mentioned, the two processes seem less than joined-up, it seems legitimate to fear common sense may not win the day.

In addition, some key duties need to be defended to the last as they do not form part of the Law Commission's review.

Here are a just a few duties on council which are still under consideration:

To provider mental capacity advocates where people lack capacity
To conduct domestic violence homicide reviews
Pay disabled facilities grants
To inform social services when a child may be at risk of becoming homeless
Provide advise on homelessness
To get an approved mental health professional (AMHP) to assess mental health patients if they may need to be detained in hospital
To ensure they have enough qualified staff to exercise powers under the Mental Health Act.

There also remains a raft of duties within children's services, many of which are under consideration be a range of other reviews.

While the consultation continues to run until 25 April, it's imperative that people make their voices heard and ensure the continuation of these services which are so vital to service users.

Image by Hans S on Flickr

Big Society: Community groups urged to tackle root causes of social problems, not symptoms

By Mithran Samuel, adults' editor, on March 31, 2011 8:31 AM | No Comments

A timely report out today from charity analysts New Philanthropy Capital looks at how community groups can deal with the climate of funding cuts - and maximise their opportunities under the Big Society - by more rigorously demonstrating the value of their work.
This is of course difficult for small organisations with limited capacity, but the report stresses that it is vital.
A key message is that groups should focus on tackling the root causes of social problems, in areas such as poverty and violence against women.
An example of good practice in this area, it says, is Toynbee Hall, which works to tackle poverty in London's East End.

Social workers may gain new powers to tackle adult abuse and users' rights to care look safer

By Mithran Samuel, adults' editor, on March 31, 2011 7:37 AM | No Comments

Big news today is the Law Commission's analysis of responses to its consultation on reviewing adult social care law. Ok, sounds a bit dry, doesn't it? Here's why it isn't:

As we report today, a top judge has called for social workers to have the power to enter homes where adult abuse is suspected. Baroness Hale's comments could bring this controversial power closer to becoming a reality and may, she argues, give adult protection similar status in councils' priorities to child protection.
We've been entertaining you and scaring you in equal measure about the potential threat to social care from communities secretary Eric Pickles' review of all council duties. Well, be a little more reassured today, as the Law Commission has found strong support for the retention of existing entitlements to care for service users, despite the need to make statutory provisions simpler and less bureaucratic. This will inform its final report, due in early May.
Why is this important? Because the Law Commission's final report - along with the report of the Dilnot commission into social care funding - will inform legislation on overhauling the system next year.

Care providers' fees to CQC set to rise

By Vern Pitt, journalist, on March 29, 2011 1:52 PM | No Comments

Sources in the industry tell me the Care Quality Commission (CQC) is set to raise its fees for care providers later today.

One provider said they received just a few days notice of the higher fees, wrecking their financial plans.

The CQC conducted a consultation on this earlier in the year. It's not clear at this point how far fees will rise, or how many providers it will effect but in the consultation it estimated a rise of £5.7m overall.

Providers had calculated this could equate to an increase of over 80% for some providers.

Needless to say, care service providers were pretty irritated in January. Some said that the regulator did not provide a good value service.

I can't imagine they'll be overly happy about it now and it's difficult to imagine the bill not being picked-up by councils or the public.

Dilnot expected to recommend cap on care bills for elderly

By Jeremy Dunning, senior adult beat journalist on March 29, 2011 12:11 PM | No Comments

The Dilnot Commission - the independent review of social care funding chaired by Andrew Dilnot - is examining how the state could cap the costs of care bills, according to the Financial Times.

The thinking seems to be that the state should guarantee the risk of high end users - those that rack up bills amounting to tens or even hundreds of pounds.

Guaranteeing this risk should allow people to better plan how to pay for their care while also encouraging the financial services industry to offer more effective products.

The financial services sector says this is an idea that's been doing the rounds for a while and could well be picked up by government because the sorts of users Dilnot is referring to are those facing costs of more than £150,000, while most face lifetime care costs of £20,000.

The question is what amount should individuals pay and what amount should the state pick up.

Another council faces prospect of judicial review over cuts

By Vern Pitt, journalist, on March 29, 2011 9:21 AM | No Comments

Scales Justice by James Cridland.jpg West Sussex council will today become the latest local authority to be embroiled in a legal challenge to its cuts programme.

A local group is seeking a judicial review of its consultation process on a decision to cut care for those with moderate. The group claim the consultation was not meaningful because it lacked enough information to make informed decisions.

West Sussex is far from the first. Birmingham Council is facing a judicial review of its savings programme, Wirral Council is in the same boat, London Councils has already lost such a case as has Pembrokeshire council.

Details on the nature of their claims are avaialble after the jump.

Image by James Cridland on Flickr

Continue reading Another council faces prospect of judicial review over cuts.

Lib Dems stage revolt at benefit cap

By Jeremy Dunning, senior adult beat journalist on March 28, 2011 12:06 PM | No Comments

The Observer has an interesting political story surrounding growing Lib Dem unease at the £500 a week benefit cap per family.

In what the paper reports as a more assertive approach sanctioned by Lib Dem leader Nick Clegg, Jenny Willott, the party's backbench spokeswoman on welfare has warned that the policy risks increasing child poverty and homelessness.

She wants ministers to build more flexibility into the system - and to consider removing child benefit from the cap altogether.

The paper suggests this shows a more assertive approach by Clegg's party. If so that will ease party jitters that it is losing its identity, but whether this approach will help it recover from dismal polls is another matter.

£5 million scheme to be launched to divert mentally ill offenders from prison

By Jeremy Dunning, senior adult beat journalist on March 28, 2011 11:31 AM | No Comments

Tonight the first stages of a national service to divert mentally ill people from prison is set to be unveiled by health secretary Andrew Lansley and justice secretary Ken Clarke.

According to the Guardian the pair will say that they've found £5m to put into 100 "diversion sites" across England and Wales as part of their plan to create a national liaison and diversion service by 2014.

This service was first revealed in Clarke's green paper, Breaking the Cycle, which said that the justice system is not always the best place to manage the problems of less serious offenders where their criminal behaviour is related to their mental health problems.

Of course this is something that mental health bodies and the Women's Institute have been calling for, for some time now.

For the WI this represents something of a victory as it's been campaigning on this subject since 2008 through its Care Not Custody campaign and will be marking this with a reception at Westminster this evening with the Prison Reform Trust.

The question now is how will the diversion plans work in practice?

Should people be screened for dementia at 75?

By Vern Pitt, journalist, on March 28, 2011 11:03 AM | No Comments

Today the Alzheimer's Society has backed calls to introduce universal screening for dementia at the age of 75.

It's a difficult idea to argue against in principle. Screening for cervical cancer, for instance, is acknowledge to have had a positive impact on brining down instances of the disease.

Plus, it may go a long way to tackling the often reported problem of under diagnosis of dementia.

The only problem I see is that any screening process will not be straight forward, as there is no simple clinical test for the disease.

However, fears that it would lead to an influx of service users miss the point. That would only serve to force the government ot give dementia care the priority it deserves as the population ages and the numbers of cases inevitably grows.

Southern Cross says industry in long-term trouble over falling local authority placement levels

By Jeremy Dunning, senior adult beat journalist on March 28, 2011 10:42 AM | No Comments

Southern Cross chief executive Jamie Buchan continues to blame falling local authority placements and fee levels along with rising rental agreements with its landlords for the source of its troubles.

And along with this Buchan continues to insist that until the government resolves long-term care funding and care commissioning issues the whole of the industry will continue to experience problems as local authorities cut back on placements and fee levels.

Buchan, who was interviewed on Radio 4's Today programme, refuses to consider the company's funding structure doesn't help, though at one point he admitted the rental levels were set in different times and different market conditions.

This, of course begs the question why the model wasn't flexible enough to cope. And why the other big ones aren't experiencing the same problems?

What is clear is that Buchan believes there will be "an equitable solution" in Southern Cross's talks with its landlords. For the full interview click here. It was on at about 7.18am.

For our coverage on Southern Cross click here.

Inquiry into deaths at care home launched

By Mithran Samuel, adults' editor, on March 28, 2011 10:02 AM | No Comments

An inquiry has been launched into the deaths of residents of a care home in Scotland, the BBC reports.
NHS Grampion is investigating whether the deaths are connected to a suspected virus though all of the people who died had underlying medical conditions.

Dilnot urged to back care insurance as report finds industry can expand sevenfold

By Mithran Samuel, adults' editor, on March 25, 2011 5:09 PM | No Comments

Care funding commission chief Andrew Dilnot (pictured, left) has been urged to give strong backing to insurance products for people with immediate care needs, after a report predicted this industry had the potential to benefit thousands of more people.
While just 7,000 people have so-called immediate care annuities at the moment, the report predicted that 45,000 self-funding care users in England could benefit from them - or one-third of self-funding care home residents.

It also concludes that this can save the state a modest amount of money by diverting away some people who may eventually fall back on council-funded care.

Couple of points about this report:-

It was commissioned by Partnership, one of the leading providers of care insurance, which obviously has quite a stake in what the Dilnot commission says about these products. However, it was written by Julien Forder of the LSE, one of the country's foremost social care economists.
Another report on the same subject - by think-tank the Strategic Society Centre - put the potential market at 36,000, but put a more negative spin on this conclusion, pointing out that this represents a small proportion of the 400,000 self-funding users of care.

Ensuring that the annuities market grows to something like its full potential seems a sound idea, so long as people are receiving good financial advice before they take decisions.

The question is how: Partnership wants councils to help people access better financial advice (from trained advisers); but this may not be sufficient to see the rise in demand that the report envisages.

MPs line up against Social Fund overhaul

By Mithran Samuel, adults' editor, on March 25, 2011 3:51 PM | No Comments

We've reported before on the strong opposition of welfare rights specialists and anti-poverty charities to the government's plan to scrap the national system of grants and loans to families in crisis under the Social Fund and give councils the power - though not a duty - to set up similar systems locally.
Now an early day motion has been tabled against the plans in the House of Commons, which has the backing of 37 MPs so far, led by Labour's Kate Green, former head of the Child Poverty Action Group.
The EDM has been drawn up by a coalition of charities headed by family support body Family Action, and also including Child Poverty Action Group, Citizens Advice, Community Links, Disability Alliance, Gingerbread, Homeless Link, RNIB, Shelter, Save the Children and Buttle UK.

Southern Cross share price begins recovery as negotiations continue

By Jeremy Dunning, senior adult beat journalist on March 25, 2011 1:41 PM | No Comments

Ailing care home provider Southern Cross appears to be convincing the market that it has got the right strategy in place to avoid going into administration.

From a share price low last week of 5.6p, it has now climbed back to 15.75p.

It's not clear what has sparked this mini-revival and there is a long way to climb to its position of 12 months ago - £1.36.

What do we know at the moment? Well Southern Cross and its bolstered management team are renegotiating terms with their landlords to try to achieve more favourable rental terms.

So this mini-rise could be that the market thinks it over-reacted to Southern Cross's announcement last week that it might break its banking covenants because of declining trade.

Combined with this it thinks the landlords are highly likely to do a deal with Southern Cross because who else will rent the homes.

Or it could be that the market has trust in the bolstered management team - and there is some credence in this view because its spokesman says the share price started going back up around the time the new members of the management team were unveiled.

What does this say about Southern Cross long-term position? Doubts still remain about its leaseback model, whereby it leases care homes from landlords, which is a factor behind its current problems along with declining income from local authority placements.

Meanwhile the Association of Directors of Adult Social Services is developing some work on ensuring provision should the worst happen to large numbers of care beds at the same time.

A spokesperson said: "ADASS is working with a number of partner organisations in order to ensure that if threats to large numbers of care-beds occur at the same time, plans are in place to carry out our priority role and protect all the older and/or vulnerable people who might be affected."

Cuts: The process begins

By Jeremy Dunning, senior adult beat journalist on March 25, 2011 1:07 PM | No Comments

As we know the cuts are real and are a week away, unless tomorrow's march can bring about an unlikely and sudden change of heart. The Guardian is running a 50 cuts project to give a snapshot of what the loss of some publicly-funded services will mean to people and communities

Stigma and mental ill-health in sport

By Jeremy Dunning, senior adult beat journalist on March 25, 2011 12:33 PM | No Comments

Following from yesterday's sad news, on which I blogged, that England and Sussex cricketer Michael Yardy has been forced to return home from the cricket world cup suffering from depression come some ill-judged and frankly crass comments from commentator Geoffrey Boycott.

As the Guardian story points out it reveals the difficulty of people in acknowledging mental illness in sport.

Thankfully Boycott has been heavily criticised, but it underlines the difficulties mental health charities have in ending the stigma that people with mental health problems experience.

Dr Andrew McCulloch, chief executive of the Mental Health Foundation, made this same point in his blog.

In a nice retort to Boycott he adds: "Mr Boycott admitted in his interview that he 'doesn't understand depression and can't comment on it'. With the greatest respect to someone who, in his day, was a very fine cricketer, we wish that he'd acted on his belief that he wasn't qualified to comment on Yardy's illness."

Mike Selvey's blog on the story sheds some good insights on Yardy and the life of the modern cricketer that is well worth reading. Selvey points out that Yardy's underlying condition was exacerbated by a life on the road, which is the life of a touring cricketer.

England cricketer Michael Yardy withdraws from squad through depression

By Jeremy Dunning, senior adult beat journalist on March 24, 2011 9:39 AM | No Comments

Sad news reaches me from the world of cricket where England and Sussex player Michael Yardy has been forced to withdraw from England's World Cup squad suffering from depression.

This is to allow him to get home and "receive the best possible advice and support as he seeks to overcome an illness he has been managing for a prolonged period of time," according to a statement from the England and Wales Cricket Board.

This isn't the first time an England cricketer has been forced to withdraw from international matches as a result of depression.

Somerset skipper Marcus Trescothick retired from international cricket because of clinical depression. However he continues to successfully play county cricket and speaks openly about his illness.

It is to be hoped Yardy manages to recover and he is to be supported and praised for his decision to go public about his battle with depression.

England's leading mental health anti-discrimination programme Time to Change believes mental health problems are the last taboo and wants people both with and without mental illnesses to start conversations about mental health.

It has recently launched a four-minute film on YouTube called Time to Change.

This features Frank Bruno, Alastair Campbell, comedienne Rebecca Front and EastEnders actor Derek Martin alongside everyday people with mental health problems.

Picture from Flickr.com courtesy of СНΛЯАKΛ

Budget: Osborne scraps extra winter fuel payments

By Mithran Samuel, adults' editor, on March 24, 2011 9:30 AM | No Comments

Chancellor George Osborne has scrapped extra winter fuel payments worth up to an extra £100 for pensioners, as part of yesterday's Budget.
This will reduce annual payments for people over 80 from £400 to £300 per household, and cut the benefit from £250 to £200 for those aged 65-79, reports The Daily Telegraph.
The extra payments were brought in by Labour in 2008 and were renewed in subsequent years.
Michelle Mitchell, the charity director of Age UK, said: "We appreciate that the winter fuel payment has been retained in the face of huge financial pressures, but with energy prices continuing to escalate, many older people will find it strange that they will receive less this winter than last."

Here's our other Budget coverage from yesterday:-

Budget pledge to cut red tape facing social care enterprises
Budget: Osborne scraps councils' final salary pensions
Budget boosts Big Society but no let up in cuts
Mileage rate boost for domiciliary care workers

Mental health services need to improve cultural approaches to recovery, says report

By Jeremy Dunning, senior adult beat journalist on March 23, 2011 11:00 AM | No Comments

Transcultural approaches to recovery to be developed further, particularly for women from ethnic communities, according to a report out today.

Published by the Mental Health Foundation, in partnership with Survivor Research, "Recovery and Resilience: African, African-Caribbean and South Asian women's narratives of recovering from mental distress", calls for improved transcultural approaches to recovery from mental and emotional distress.

I reported on this need not that long ago when I pointed out there was a need for some people in some ethnic communities to use faith in combating mental health problems.

This report interviewed 27 women from African, African-Caribbean and South Asian backgrounds in order to explore their individual experiences of distress and recovery within mental health services from personal, social-cultural, familial and bio-medical perspectives.

Key findings:

The way in which women perceive recovery is linked to the way in which they understand their mental distress - notably through their perception of personal, socio-cultural, familial and bio-medical settings.
Racial, cultural, gender, sexual and spiritual identities gave the women interviewed a sense a worth in themselves and in their role in the community.
For many women recovery involved being free from medication.
Recovery approaches and models need to begin from a point where a person was supported in addressing the causes and contexts of distress, and not from a point after the distress was identified as an 'illness' with psychiatric diagnoses.

The report calls for:

Acknowledgment that a person needs to recover not only from the mental distress itself but from the underlying causes of it.
Transcultural approaches to recovery to be developed in order to understand distress as a legitimate response to life events, spiritual crises, trauma and stress.
An exploration into the actual effect of the continued use of medication and its role within recovery.
A need for increased access to talking therapies, counselling and forms of therapeutic alliances in order to explore the causes of distress and the contexts for recovery.
A need for more investment to create further opportunities for black and minority ethnic women to tell their stories of emotional distress and recovery, which have important personal and political functions.

Clegg takes charge on reforming health bill

By Jeremy Dunning, senior adult beat journalist on March 23, 2011 10:38 AM | No Comments

Interesting story in The Guardian today that the Lib Dem leader Nick Clegg is to take responsibility within government for reining in the health reform programme.

The Guardian believes he will negotiate personally with health secretary Andrew Lansley to beef up the governance and accountability - which we have known for a while - while minimising the financial risk of the new GP consortiums, and having some limits on the types of new private providers that can come into the system.

It is also thought this will delay the bill.

What does this say about Lansley's position? The fact that both prime minister David Cameron and now Clegg have had to become involved doesn't sit in his favour. It probably helps Clegg's poor poll ratings that he's being seen reforming an unpopular piece of legislation.

Meanwhile guidance released by the National Institute of Clinical Excellence (NICE) recommends increased testing of HIV in key risk groups.

The guidance aims to increase the uptake of HIV testing to reduce undiagnosed infection and prevent transmission among African communities and gay men.

Picture from Flickr.com courtesy of World Economic Forum

After Southern Cross, what is the future of residential care?

By Vern Pitt, journalist, on March 22, 2011 2:54 PM | No Comments

Sometimes things just come together. The other week I asked what the future was for residential care. This week Southern Cross, the country's biggest care home provider, has hit the rocks of financial disaster.

For years residential care has been pushed to one side by policy in favour of care in the community. Now providers (well one, for now) are suffering heavily due to a fall in council referrals.

So it all adds up to a pretty bleak picture. Does residential care have a future at all and if so what is it? That's what I'd like to know, so I'm asking you to tell me what you think of the current state of residential care in the survey below.

Create your free online surveys with SurveyMonkey, the world's leading questionnaire tool.

Scots take action to protect victims of forced marriage

By Mithran Samuel, adults' editor, on March 22, 2011 2:30 PM | No Comments

A new law in Scotland aims to protect victims of forced marriage and prevent them from occurring.
The Forced Marriage (Protection and Jurisdiction) (Scotland) Act 2011 introduces forced marriage protection orders to allow the courts to take actions necessary to prevent marriages and protect victims, such as taking them to a place of safety or preventing them from being taken abroad.
Breaching an order will see perpetrators face a sentence of two years in jail, a £10,000 fine, or both.
The law mirrors the Forced Marriage (Civil Protection) Act 2007, which covers England and Wales and also introduced forced marriage protection orders.

One group at particular risk are people with learning disabilities, as we discussed recently in a piece that identified the dilemmas and barriers facing social workers in this area of practice.

Social workers can help tackle digital exclusion

By Mithran Samuel, adults' editor, on March 22, 2011 12:52 PM | No Comments

By Ian Agnew, chief executive of Digital Outreach

Television plays a critical connecting role in the lives of many people, especially the most isolated individuals in our society. Up to 300,000 older people in the UK can go a month without speaking to a family member or neighbour. Television can be a lifeline to those people and an important source of comfort and pleasure.

For many disabled or older people who have limited mobility or live alone, TV can also offer a sense of independence. It connects them to the outside world and makes them less reliant on others for information and entertainment.

But it's often these more socially isolated individuals who need the most help in switching to digital. By 2012 almost everyone in the UK will be able to receive digital TV through an aerial. For people to keep their service, they must convert their televisions to digital before their area's switchover date.

Social workers can play an important role in helping people with this process and the Switchover Help Scheme, run by the BBC to offer practical help at switchover, is already working with many local authority social care teams. But we need more help. Older or disabled adults who are supported by social care staff often turn to them when they're unsure of a new situation. Being able to refer people to the Help Scheme and supporting them to complete application forms or phone the help line can take the worry of switching to digital away and it ensures no one is left behind.

Digital Outreach delivers a strand of the Help Scheme's outreach work called the Communities Programme. We train local community groups to identify 'community supporters' - trusted individuals who come into contact with the most isolated people on a regular basis - who can pass on information about the Help Scheme. They range from local shopkeepers, hairdressers and carers and to postmen, GPs and psychiatric nurses.

Take Mr M, who is partially sighted and visits his local cafe every week. Zoe, a waitress there, noticed that Mr M never talks to anybody. A community supporter explained about the Switchover Help Scheme and asked if Zoe knew anyone who might be eligible. Zoe thought of Mr M, as she didn't think he had any friends and his wife died six years ago. He didn't know anything about switchover and found he was eligible for a free digital box. Since their conversation, Mr M has begun talking to some of the other older people in the café and become less isolated.

The people least likely to get through switchover on their own are often individuals like Mr M who might not respond to 'mainstream' communications. Social workers often come in to contact with such people - individuals who are unable to leave their home or who receive care. Our aim is to make sure no eligible person is left behind at switchover and social care staff can play an important role in achieving this.

Visit the Switchover Help Scheme or Digital Outreach websites for more information, or call the Help Scheme on 0800 40 85 900.

Homelessness charities smell victory in the battle over super-strength lagers

By Jeremy Dunning, senior adult beat journalist on March 22, 2011 9:49 AM | No Comments

Plans to introduce a hike in the tax on super-strength lagers are expected to be confirmed in this week's Budget, according to the BBC.

This would represent a victory for the many homelessness organisations that have been calling for the measure for years. Indeed I wrote last year that there was a similar expectation during last year's Emergency Budget.

The BBC also says that calls for a minimum price for alcohol are intensifying.

There's also a blog from St Mungo's on the recovery approach towards helping homelessness people, many of whom have experienced histories of complex trauma, rough sleeping, mental health problems, drug or alcohol dependency, or offending behaviours.

The aim is to help them live to their full potential using the personalised model. It's an interesting approach that St Mungo's recovery manager Christin Marshall is going to audit to track progress across several projects, but it's promising.

Finally there's an intimate collection of views from the streets by service users of the homelessness charity Connection at St Martin's-in-the-Fields, which runs a photography workshop for users.

Picture from Flickr.com courtesy of Eoin Murphy

Miller: 'Disability benefit reform won't shunt cost onto councils'

By Vern Pitt, journalist, on March 21, 2011 2:04 PM | No Comments

There's been a lot of speculation about how reforms of disability living allowance may push the costs of supporting disabled peoples onto councils and the NHS. But last week Maria Miller, minister for disabled people denied this was the case.

"We do not envisage these changes generating additional costs for the NHS, Department of Health, Department for Communities and Local Government or local authorities," she said in response to a Parliamentary question.

It was obvious that the government believed this, after all they can't be seen to knowingly push this cost onto another service and defeat the object of reform, but it's interesting to see her being so strident in promising this result.

Especially when you take into account the earlier part of her answer, which concedes there is no data on the number of disability living allowance recipients usage of the NHS and her answer to a separate question on the same topic: "We are considering the most appropriate delivery model for the personal independence payment [the replacement for disability living allowance] assessment. No decisions have been taken, including how it will apply to existing DLA recipients."

I hope her prediction turns out to be correct.

Image by cliff1066 on Flickr

Lib Dems aim to bring greater scrutiny to health and social care reforms

By Jeremy Dunning, senior adult beat journalist on March 21, 2011 9:46 AM | No Comments

There's an interesting story in today's Guardian outlining changes that are likely to be made to the health reforms.

The reforms, being made by senior Lib Dems and in line with what we have heard, are likely to focus on areas such as ensuring that GP commissioning boards have a duty to prevent cherry-picking by the private sector, and that the boards contain locally-elected councillors or are scrutinised by councils.

However a blog from Saturday from former government health adviser Paul Corrigan shows why the reforms are in trouble - it's the speed of the reforms.

Have a go at our guide to self-neglect cases

By Mithran Samuel, adults' editor, on March 18, 2011 1:43 PM | No Comments

You may have spotted this already but we have produced an interactive guide for social workers to handling cases of self-neglect.
It's a pretty complex area so this is designed to provide some guidance to navigating your way through the legal and moral minefield. Hope it helps!

Ministers in talks to save stricken Southern Cross

By Mithran Samuel, adults' editor, on March 17, 2011 8:49 PM | No Comments

Ministers are in talks to save stricken care home provider Southern Cross Healthcare. The issue was raised with David Cameron at Prime Minister's Questions yesterday and today Leader of the House of Commons George Young said ministers were in talks with the firm to address its financial difficulties, reports the Press Association.

The firm's difficulties seemingly relate to two things - the general squeeze on care home fees by local authorities and the fact that Southern Cross's leases the majority of its care homes and is facing mounting rental costs.

In a statement this week, chief executive Jaime Buchan said its rental obligations had become unsustainable and it was seeking to renegotiate its leases by July - but with no guarantee of success.

The question is what will happen to the 31,000 residents of its homes?

(Image on Flickr from the World Economic Forum)

Scotland's bid to transform older people's care

By Mithran Samuel, adults' editor, on March 17, 2011 2:44 PM | No Comments

Interesting post on Scotland's plans to transform older people's care from the public sector consultancy iMPOWER.

This relates to a £70m "change fund" for the NHS and local authorities to reshape care in order to manage mounting demand - the emphasis being on earlier intervention, more care at home etc.

iMPOWER points out this is a substantial sum of money - with £300m expected to be provided up to 2014-15, this is much more, proportionately, than the £520m allocated to English councils through the Putting People First programme.

But, it says, the Scottish government is currently committed to letting local partnerships come up with their own solutions. This may result in a postcode lottery of progress across the country, iMPOWER warns. Its other warning is that the relative lack of progress of personalisation in Scotland (a draft Self-Directed Support Bill has been published but this is not likely to come into law for some time) could hold up any plans to transform care for older people.

Have a read if you get a moment.

Death on the curriculum

By Mithran Samuel, adults' editor, on March 17, 2011 12:12 PM | No Comments

Should death be on the national curriculum? Yes, according to the National Council for Palliative Care and the Dying Matters coalition, who say that all secondary school pupils should be taught about death and dying.

Their argument is that this will help children and young people who lose a parent or loved-one as well as fostering a wider - and beneficial - culture of openness of dying in wider society.

They have produced a lesson plan and resources, which is worth a look if you have time.

(Image from Axle on Flickr)

£1bn funding gap for adult social care - have we forgotten the £4bn funding gap?

By Mithran Samuel, adults' editor, on March 17, 2011 10:55 AM | No Comments

There's lots of coverage in the nationals today about social care facing a £1bn funding gap by 2015, based on this report from the King's Fund.

Some of you may be wondering why this story is not on Community Care. Well, it is; it's here, with a different news angle - that the report says there needs to be much closer integration between health and social care funding to avoid conflicts over resources as the cuts start to bite.

The reason we haven't gone with the £1bn angle is that not so long ago we were all talking about a £4bn funding gap for adult social care.

This is what the Local Government Association claimed would be adult social care's fate following last October's spending review. (It's worth noting that the figure was rubbished by care services minister Paul Burstow).

Why the difference?

It's all about the assumptions that you make about how far councils will protect adult social care from the worst of the cuts and how far demand and cost pressures (such as staff pay) will push up the bill for services.

The King's Fund's figure (which is really £1.2bn) assumes that councils will cut adult care less deeply than other services (by 7% in real terms from 2011-15). The funding gap rises to over £2bn if the cut is 14% in real terms (which is in line with the government's calculations for the total reduction in council budgets over the 2011-15 spending review period).

I don't have the LGA's assumptions to hand, but as I understand it, they include a calculation that pressures on social care will push up costs by 4% a year in real terms. The King's Fund report sticks with the 4% figure for 2013-15 but reduces the annual cost pressure to 2.5% in real terms in 2011-12 and 2012-13 because there will be a public sector pay freeze during these years.

I'm not saying any of these figures are right or wrong (I'm entirely unqualified to do so) - just that it's all about the assumptions.

However, it is odd that the press is getting very excited today over a £1bn funding gap, when this figure is far lower than a previous estimate, and many in the social care sector would be very happy indeed to get away with this level of cut over the next four years.

Cuts, the fear of cuts and the limits of localism - the depressing picture for domestic violence services

By Mithran Samuel, adults' editor, on March 16, 2011 4:17 PM | No Comments

Domestic violence services are among the biggest casualties of the age of austerity.
As we reported earlier this month, 60% of refuges face closure as they have no funding arranged from April; the situation is worse for outreach services where 72% of services are at risk. Women's Aid, who carried out the survey, has calculated that 70,000 women - and their children - will go without a service as a result, putting lives at risk. That is on top of the many women who already do not receive a service.

A round table discussion I went to this week shed light on the story behind these figures, particularly the role of the government's localist philosophy and of unhelpful attitudes to domestic violence in some statutory services.

Attended by some of the biggest figures in domestic violence, equalities minister Lynne Featherstone and Local Government Association lead on the issue Ann Lucas, the round table explored the issue of whose responsibility domestic violence was.

Featherstone asserted strongly that the government had taken its share of responsibility: it was allocating £28m in ring-fenced funding for specialist services from 2011-15 and sending out a "strong message" to local authorities that this was a priority area, through its strategy to end violence against women and girls.

But she was clear that, under the coalition's localism agenda, it was up to local authorities, and their statutory partners, to take decisions on funding; and it was up to local voluntary agencies to strongly put the case for protecting domestic violence resources.

"It's for local people to be shouting and screaming about [cuts to DV] and not allowing it to happen," she said.

However, as domestic violence leaders pointed out, the voice of the sector is not being heard by many councils and councillors for a number of reasons.

(Image from Rex Features)

Continue reading Cuts, the fear of cuts and the limits of localism - the depressing picture for domestic violence services.

Vulnerable children and adults will be protected as Travellers are cleared, says council

By Mithran Samuel, adults' editor, on March 16, 2011 4:02 PM | No Comments

News that Basildon Council will be spending £8m - or a quarter of its budget - clearing a Travellers' site - Dale Farm - has hit the headlines.
The Travellers own the green belt land and have occupied it since 2001, but do not have planning permission. Basildon voted to evict them after winning a Court of Appeal case in November allowing them to move the families on without finding them new pitches.
With 500 people affected, there are significant implications for any vulnerable adults and children from being evicted.
To complicate matters, the housing authority - Basildon - differs from the social services authority - Essex Council.
We have just heard from Essex who says they are doing all in their power to ensure the safety and well-being of vulnerable children and adults. Here is their statement:

"Essex County Council recognises its duty under the Children and Community Care Acts and the Essex Safeguarding Children and Safeguarding Adults Boards procedures and standards to ensure that any enforcement action will be carried out with due regard for the wellbeing of children and vulnerable adults. Essex County Council has fulfilled all of its statutory obligations to the community on the site whenever our services have been requested. Gypsy & Traveller Services and the Ethnic Minority & Traveller Achievement Service (EMTAS) have maintained regular discussions with all parties (including the Travellers) for some time now to ensure that the safety, welfare, education and well-being of the children will be secured. The county council is committed to providing the appropriate care for those that need it throughout the county."

Government feels the heat over health reforms

By Jeremy Dunning, senior adult beat journalist on March 16, 2011 3:38 PM | No Comments

Excellent blog from the Guardian on the health reforms, which showed a prime minister left floundering with Labour leader Ed Miliband challenging him over the introduction of EU competition law to the NHS.

Moreover David Cameron failed to answer clearly whether or not the government will feel compelled to table further amendments to the bill.

I think it's fair to say this is a government under pressure.

The changing role of the social work assistant

By Jeremy Dunning, senior adult beat journalist on March 16, 2011 12:51 PM | No Comments

As we know there's a growing concern over the numbers of non-social workers carrying out assessments.

Unison is now carrying out a survey to find out how the role of the social work assistant or support worker is changing in the current climate.

Technically there's nothing wrong with it but it arguably undermines the role of the social worker and raises concerns over the assessment of users.

Of course non-social workers are fully trained up to carry out assessments.

But as pointed out by Ruth Cartwright, joint manager for England at BASW, they have not had the benefit of two or three years' professional training and yet would need to be fully aware of the impact of complex needs and family dynamics, and of the possibility of adult abuse.

Councils back health and wellbeing boards, says DH

By Jeremy Dunning, senior adult beat journalist on March 16, 2011 12:16 PM | No Comments

Yet more spin from a Department of Health trying to argue it has widespread support for its controversial health reforms that will hand commissioning power to GPs.

This time it's saying that councils back the health and wellbeing boards and that 134 local authorities had signed up to join a network of early implementers.

This is one part of the proposals that have found support - but the claims have to be treated with a fair degree of scepticism.

Councils have been itching for more powers in health for a long time, particularly in public health and in helping set commissioning priorities.

But there is some doubt over the powers of the health and wellbeing boards - witness the Lib Dem demand for more scrutiny and accountability in the bill - and its powers vis-a-vis the NHS commissioning board.

Clearly also councils, scenting the way the wind is blowing, will want to get in early.

Care services minister Paul Burstow is right when he says: "Local authorities have an in-depth understanding of the public health needs of their populations, but too often they haven't had the right systems in place to work with the local NHS to get the best health and wellbeing for their people.

"There are some good examples of local partnership working, but there is scope for far greater joining up of health and social care services.

"That's why we're making health and wellbeing boards a statutory requirement."

However there are too many parts of the bill that don't make sense.

It's arguable that doctors have a vested interest in preserving the status quo, but when experts (non doctors) are also lining up against the bill it suggests there's a problem, as outlined by The Guardian. There is also now evidence that dissent is growing among Tory ranks.

I'd suggest that councils and groups like ADASS beware hitching themselves too tightly to its fortunes.

Continue reading Councils back health and wellbeing boards, says DH.

Social services must identify malnutrition in the community

By Mithran Samuel, adults' editor, on March 16, 2011 11:00 AM | No Comments

Figures out today show that a third of people admitted to hospitals or care homes from their own homes last winter were at risk of malnutrition. The finding comes from a report by the British Association for Parenteral and Enteral Nutrition, based on a week of screening patients admitted to hospital or people entering care homes.
BAPEN says this means that not only is it vital for hospitals and care homes to screen people for malnutrition and take appropriate action, but for social care services in the community to be alert to the issue.

Doctors call for halt to health reforms

By Jeremy Dunning, senior adult beat journalist on March 16, 2011 10:41 AM | No Comments

Today's big news is reaction to yesterday's call on the government by doctors to put a halt to its overhaul of the NHS in England.

The vote, which stopped short of opposing the plans outright, is unlikely to sway the government, which said it was disappointed at the vote, but demonstrates the growing levels of opposition to the plans encompassed in the health and social care reform bill.

Health secretary Andrew Lansley wants to give 80% of the NHS budget to GPs and increase competition, but opponents argue the plans will reduce patient care.

Lansley has his supporters with the plans and has managed to find GPs and doctors who approve, but surely it's reached a point for the prime minister to step in and take charge of what is increasingly looking like a complete mess, particularly with the Lib Dems having rejected large portions of the plan at the weekend.

As former health adviser Paul Corrigan points out the government does not have a strong mandate for the changes. It is known that the Lib Dems are looking for greater scrutiny and accountability within the plans.

What is almost certainly likely to happen is for the House of Lords to bring in several amendments to remedy some of the reforms. Apparently he'll be on Radio 2 at 1pm discussing the health reforms.

Continue reading Doctors call for halt to health reforms.

Former Lib Dem MP tells doctors that many of the reforms are unacceptable to the party

By Jeremy Dunning, senior adult beat journalist on March 15, 2011 2:49 PM | No Comments

Former Lib Dem MP and doctor Evan Harris clearly can't be on message as he apologised to doctors that the Lib Dems had only just made its opposition to the health and social care reform bill clear.

Harris told the British Medical Association's emergency meeting today that: "Much of this bill is unacceptable to us and Downing Street is wrong if it really believes that this is simply about reassurance."

And he went on to say that the NHS should be based on cooperation and that it was vital for the government to listen and to introduce amendments based on transparency and accountability.

Labour aims to harness public anger against NHS reforms

By Vern Pitt, journalist, on March 15, 2011 2:06 PM | No Comments

Labour have launched a petition against Lansley's much criticised health and social care reforms.

In a statement shadow health minister John Healey said: "His plans for heath will open all parts of the NHS to free market competition and rip the 'N' out of the NHS."

The petition call for the government to:

Protect frontline NHS services
Stop precious NHS money being wasted on a big top-down reorganisation, which is putting the NHS at risk
Provide the real increase he promised in NHS funding

Increases in CRB fees will hit care services hard

By Vern Pitt, journalist, on March 15, 2011 1:37 PM | No Comments

Having just received substantial cuts in their payments from local authorities and increases in their fees to the regulator, care services are now having to pay more for CRB checks.

An enhanced CRB check is set to increase from £36 to £44 in April, the Criminal Records Bureau announced yesterday.

As a industry where the primary cost is in staffing it will hit the care sector more than most.

Martin Green, chief executive of the English Community Care Association, was not best pleased about it.

"At a time when the social care sector is recoiling from the level of cuts being levied by local authorities, regulators and quangos seem to live in a parallel universe where they believe they have the right to unilaterally increase fees at levels substantially beyond the inflation rate," he said.

The upshot of all this is, at the end of the day, worse care or less choice in the market as providers close.

Protests planned against Westminster council's plans to ban soup runs

By Jeremy Dunning, senior adult beat journalist on March 15, 2011 12:48 PM | No Comments

Protesters are to stage a demonstration on Sunday against Westminster council's plans to ban soup runs and rough sleeping, reports Inside Housing.

Westminster Council is consulting on plans to ask the Communities and Local Government department to approve a bylaw preventing people from lying down or sleeping in a public place, or distributing bedding, and giving out free food or drink.

Beware the Ides of March, Mr Lansley

By Jeremy Dunning, senior adult beat journalist on March 15, 2011 11:17 AM | No Comments

Beware the Ides of March, doctors are warning the health secretary Andrew Lansley today in their emergency meeting today on the health and social care reform bill.

The Ides of March is March 15 and is historically the day that Julius Caesar was assassinated..

Listening to the British Medical Association emergency meeting today there was a nice analogy to Lansley as Caesar.

What's clear is that doctors are utterly opposed to the health and social care bill as a danger to cooperation and patient care and many want it removed. Others point out that it has positive aspects and that it needs changing not removing.

One speaker said: "This isn't evolutionary, this isn't a tweak. This is enormous. This isn't evolutionary. This is revolutionary."

Doctors attack health reforms amid anger over increased competition

By Jeremy Dunning, senior adult beat journalist on March 15, 2011 9:38 AM | No Comments

It's fair to say that in UK health terms the focus of attention is one man - the health secretary Andrew Lansley. How much longer can he survive?

He faced further embarrassment today as two more health organisations have refused to sign up to the government's "responsibility deal" on public health.

Diabetes UK and the British Heart Forum, members of the panel looking at food and obesity, said they would not sign up to the deal which is being launched by the government.

Their decision follows a walk-out yesterday by six leading health organisations who had been sitting on the alcohol panel.

Meanwhile today he faces a vote of no confidence during a special meeting of doctors to debate the health reforms.

The emergency meeting of the British Medical Association (BMA) comes amid grassroots anger about the plans which could see increased competition. We'll update readers as and when. Alternatively watch the live webcast.

As Paul Corrigan, former health adviser to the government of Tony Blair, pointed out this is the first time such a meeting has taken place since 1992 when then Conservative Prime Minister John Major, was identifying the possibility of a purchaser-provider split in the NHS.

He has an interesting point that it reflects partly a desire among doctors to humble their own leadership, which had previously adopted a position of critical engagement, but also a failure of government to engage with the membership.

Finally care home operator Southern Cross is in further financial troubles as a result of failed takeover talks and poor trading as hard-up councils cut back on residential placements.

This follows on from my colleague Vern's blog and questionnaire of yesterday where he asks about the future of residential care.

Picture from Flickr.com courtesy of NHS Confederation

Impact of a bad job on mental health as harmful as no job at all

By Jeremy Dunning, senior adult beat journalist on March 14, 2011 11:30 PM | No Comments

The impact on mental health of a badly paid, poorly supported, or short term job can be as harmful as no job at all, indicates research published online in Occupational and Environmental Medicine.

Because being in work is associated with better mental health than unemployment, government policies have tended to focus on the risks posed by joblessness, without necessarily considering the impact the quality of a job may have, say the authors.

They base their findings on seven waves of data from more than 7,000 people of working age, drawn from a representative national household survey conducted every year in Australia.

The authors found that those who were unemployed had poorer mental health, overall, than those in work.

But the authors also found that the mental health of those who were jobless was comparable to, or often better than, that of people in work, but in poor quality jobs.

The health benefits of finding a job after a period of worklessness depended on the quality of the post, the findings showed.

Getting a high quality job after being unemployed improved mental health by an average of three points, but getting a poor quality job was more detrimental to mental health than remaining unemployed, showing up as a loss of 5.6 points.

What's the future of residential care?

By Vern Pitt, journalist, on March 14, 2011 2:33 PM | No Comments

The trend of successive government, including the current one, has been to emphasise the need to increase the amount of care delivered to people in their own homes, instead of residential care.

Alongside this there are frequent stories gracing the wider press about the dire state of care homes.

Where does this leave the future of residential care?

If you could spare a few minutes to fill out the survey below we'd like to hear what to think.

Create your free online surveys with SurveyMonkey, the world's leading questionnaire tool.

Burstow to resign if NHS reforms are not amended?

By Mithran Samuel, adults' editor, on March 14, 2011 11:35 AM | No Comments

My colleague Jeremy blogged earlier about the Lib Dem conference vote criticising aspects of the government's health reforms.
An interesting sub-plot is the position of care services minister Paul Burstow. Following the conference vote, Burstow promised to take those concerns back to government.

Amid concerns among Lib Dem activists over privatisation, he said there will be "no US-style privatisation of health on our watch".

Burstow used similar wording in an interview with The Guardian last week - except he said that he would leave the government if he "thought he was part of a project to bring in a US-style health service".

Elsewhere in the Guardian interview he said he was open to amending the bill along the lines suggested by Lib Dem activists.
This means one of two things:-

That Burstow will resign if the bill isn't amended in this way.
That Burstow is already satisfied that the bill doesn't allow for US style privatisation but he is keen to improve it along the lines suggested by Lib Dem activists.

For those who like Burstow - of which there are many in the social care sector - I think the second explanation is more plausible, meaning he should be with us for the time being. But the use of language is fascinating.

Coalition under pressure as Lib Dem activists attack health reforms

By Jeremy Dunning, senior adult beat journalist on March 14, 2011 9:41 AM | No Comments

As predicted in every newspaper and mentioned here the Lib Dems voted for major changes in the Health and Social Care Reform Bill during its spring conference.

The leadership accepted two amendments, supported by Baroness Shirley Williams and the former MP Evan Harris, and promised to take the critical messages back to government.

The messages were essentially criticisms that the bill effectively represents privatisation of the NHS, which Lib Dem leader Nick Clegg and health secretary Andrew Lansley deny, and shows undue adherence to competition.

This, of course, represents an embarrassment in some respects to its leadership, but it also represents opportunities in that it frees up Lib Dems in the House of Commons and the House of Lords to bring about changes to a bill that many in the party are known to be unhappy about.

Melissa Kite, from the Daily Telegraph wrote: "Baroness Williams branded the changes "lousy", while the Lib Dem MP Andrew George said the party should not be "the architects of the NHS's demise".

Paul Corrigan writes that we should not expect to see the bill brought down by this vote because the Lib Dems are unlikely to vote down any piece of major legislation that would leave them at the mercy of the electorate. However it is likely that the House of Lords will seek to bring about changes.

Is Lansley damaged by this? It is generally understood that the prime minister isn't happy with the way the reforms have been sold by the government and this will surely add fuel to the flames.

Probably because of this vote the department of health has put out a press release talking up the reasons for the reform. This quote caught my attention.

"The NHS will not be able to meet this increase in demand unless it changes. Add to that the fragmented and inefficient way the NHS currently looks after people with long term conditions and the health service just won't be able to cope a few years from now."

Like many people I feel the reforms, through GP commissioning, will see it becoming more fragmented.

Finally today six health organisations have walked away from the government's "responsibility deal" on alcohol, saying that Lansley has allowed the industry to drive through a series of insignificant pledges that will do nothing to reduce drink-related illness and deaths.

The deal, due to be announced tomorrow, will see supermarkets, pubs and drinks manufacturers pledge to do their bit to reduce harmful drinking.

Picture from Flickr.com courtesy of David Spender

Poor attitudes towards mental illness in South Asian communities

By Jeremy Dunning, senior adult beat journalist on March 11, 2011 5:05 PM | No Comments

A report from anti-discrimination programme Time to Change has uncovered a culture of stigma, secrecy and shame surrounding mental illness in South Asian communities.

The report, called Family Matters: Attitudes towards mental health in the South Asian community of Harrow, North West London, backs up an article I wrote on mental health in the Muslim community in England.

The report finds that mental illness is a taboo subject for people in South Asian communities and that misconceptions and misunderstanding about the causes of mental health problems are barriers to reducing negative attitudes.

Other obstacles include pressure to adhere to social norms, fear of socialising with someone with a mental illness and the view that those with mental health problems are 'stupid'.

Family Matters also highlights the role immediate family inadvertently plays in perpetuating negative attitudes towards mental illness.

Government threat to councils to act reasonably lacks clarity, says top MP

By Jeremy Dunning, senior adult beat journalist on March 11, 2011 4:32 PM | No Comments

Eric Pickles threat to force councils to act reasonably when cutting the voluntary sector may not be all it's stacked up to be, according to Public Finance.

Clive Betts, the chair of the commons local government select committee, wrote to Pickles asking him to clarify his comments after he had declared that Westminster was prepared to legislate immediately to stop councils inflicting 'disproportionate' cuts on charities.

However it's unclear how the government intends to do this, as Betts makes clear.

I wrote recently about the financial secretary to the treasury's categorical assurance to voluntary groups that government had been clear that charities, voluntary groups and not-for-profit organisations shouldn't bear a disproportionate share of the pain.

Petition to save the health service launched

By Jeremy Dunning, senior adult beat journalist on March 11, 2011 12:46 PM | No Comments

Just spotted that Campaign group 38 degrees, which was a key player in opposing government plans to sell off forests, has just announced its latest battlefront: the NHS and the proposed health and social care reforms.

It is now collecting signatures for a petition to save the health service.

Considering the government buckled badly over the forest sell-off, thanks in part to 38 degrees, it will be fascinating to see how the government reacts to this.

Of course if it does buckle under the pressure it's arguable that it would have to call an election.

Welsh denied own language benefit assessments

By Vern Pitt, journalist, on March 11, 2011 12:46 PM | No Comments

People in Wales are encountering great difficulty in getting assessments for disabled unemployment benefits in Welsh.

Under the Welsh Language Act all government documents have to be produced in both languages, many businesses do this as well. It basically guarantees your right to conduct your business in Welsh if you so desire.

But according to Guto Bebb, MP for Abberconwy, this isn't happening for those applying for employment and support allowance in his constituency. They should be able to get to see a Welsh speaking medical professional to conduct the work capability assessment, which is a key part of the application process for ESA, but they can't.

Speaking in a debate in the House of Commons earlier this week, Bebb said: "I am MP for a constituency where about 42% of the population are first-language Welsh speakers. Time and again, people who come to my surgeries are expected to attend a work capability assessment in which they must explain their position and say whether they are capable of working. Often, they have to do that in English, even though the Welsh Language Act 1993 requires them to be able to do it in Welsh.

"When someone is in a stressful situation such as that, it is unacceptable that the Department is unable to provide a bilingual service. I have received assurances that the Department is working within the demands of the Welsh Language Act, but time and again the situation on the ground in north Wales does not correspond with those assurances," he added.

Maria Miller, minister for disabled people, responded: "I will make sure that I get back to him about our communications with the Welsh Assembly and about the importance of making the work capability assessment available in a way that is consistent with legislation on the Welsh language."

Image by Bryn S on Flickr

Social work stress at chronic levels, warns Unison

By Mithran Samuel, adults' editor, on March 11, 2011 11:16 AM | No Comments

Stress levels among social workers are at chronic levels, Unison warns today as part of its campaign with Community Care to improve working conditions for practitioners.

More and more members are getting in touch warning that they are struggling to cope with mounting workloads, as well as the traumatic cases they have to deal with, day in, day out.

As part of our Social Work Contract campaign, we are calling for all social workers to have the right to support to deal with stress and traumatic cases.

"Counselling should be made available to any social worker who needs it, for as long as they need it," says Unison national officer for social work Helga Pile. "Proper support plans need to be there to ease the way back when people return to the front-line. Councils and trusts need to develop pro-active strategies to tackle the burn-out that is driving social workers out of the profession."

Sign the petition to support our campaign.

Inspections and the CQC

By Jeremy Dunning, senior adult beat journalist on March 11, 2011 11:05 AM | No Comments

Yet more on the inadequacies of the Care Quality Commission as highlighted by blogger Fighting Monsters and BBC reporter Mark Easton.

It's nothing new but it shows how appalling the situation is now getting.

As an example my colleague Vern recently wrote on long delays in the CQC's processing of registration applications from providers.

Pickles puts social care at risk and more on the cuts - Community Care's latest podcast

By Mithran Samuel, adults' editor, on March 11, 2011 11:03 AM | No Comments

Community Care's latest podcast is ready with some really exciting topics under discussion, namely how social workers should respond to the cuts and the government mooting the removal of all social care duties from councils - an issue that is stirring up anger across social care.
Have a listen.

Health reforms set to be scrutinised by Lib Dems

By Jeremy Dunning, senior adult beat journalist on March 11, 2011 9:57 AM | No Comments

These are fascinating times for political observers.

The Lib Dem conference is about to start with Nick Clegg, its embattled leader, and fellow Lib Dem ministers facing a massive rebellion over the health reforms.

In the Guardian today care services minister Paul Burstow offered concessions by promising that foundation hospitals can be made more accountable to elected health bodies and was open to the possibility of seeing as many as half of GP commissioning boards made up of elected councillors.

He also insisted the health bill would not allow the new health service regulator, Monitor, to promote competition regardless of the needs of patients or the health service.

As Nicholas Cecil pointed out in yesterday's Evening Standard this rebellion is being backed by people from the top to the very bottom of the party, including ministers.

However it's clear Lib Dem ministers favour large parts of the plan - including establishing health and wellbeing boards being established by local councils as a way of ensuring that the NHS is accountable - so whether the concessions will win over the opposition is dubious.

However Lansley has his own woes. The British Medical Association is considering passing a vote of no confidence in him amid mounting anger over his plans to radically restructure the NHS.

Picture from Flickr.com courtesy of Liberal Democrats

Law Commission not informed of Pickles' social care review

By Vern Pitt, journalist, on March 11, 2011 9:48 AM | No Comments

When I first blogged about the review of statutory duties on councils, being conducted by Eric Pickles, I described its non-announcement as 'quiet as a mouse'.

Well, it seems I had little idea just how quiet.

The Law Commission, which is currently in the midst of a major review of all adult social care law (and therefore many of the same duties) had no idea about the review. The commission hadn't been told about it.

Indeed the first they knew about it was when I called them to ask for comment.

It's one thing to run a public consultation without soliciting public opinion (it's not good practice but it's not unusual), it's a step further to not even inform your partner agencies.

The situation was described to me by other commentators as "chaos" and an example of the "left hand not knowing what the right had was doing".

On the plus side, the Department of Health were aware that this was going on and indeed supplied Pickles' department with the list of duties which are now under consultation. You can make your own mind up as to whether they should have edited it down a bit beforehand or not.

I have also had it confirmed that this review will not trump the Law Commissions and the two will be considered together.

While we wait for a bit of explanation on how this has been allowed to occur please enjoy this musical masterpiece.

Helpline launched to support combat veterans with their mental health needs

By Jeremy Dunning, senior adult beat journalist on March 11, 2011 12:01 AM | No Comments

Veterans with mental health problems will get targeted support from today with the launch of the new Combat Stress Support Helpline.

A new 24-hour freephone helpline number, 0800 138 1619, will help veterans and their families access expert advice from people trained and experienced in dealing with ex-service men and women and their often complex mental health needs.

The government is giving £200,000 to fund the running of a one year pilot of the helpline.

It will be run by the charities Combat Stress and Rethink Mental Illness.

The helpline will provide:

Round the clock support for veterans;

Diverse ways to access mental health support including advice via telephone, and later this year text and email;

Support to veterans' families, whose lives can be affected as a result of mental health problems, with improved support to help them to access mental health services in their local area; and

Provide assistance in accessing further advice on other social problems affecting veterans including housing and employment advice.

Homelessness up by 15%

By Mithran Samuel, adults' editor, on March 10, 2011 2:42 PM | No Comments

Worrying figures out today from government showing a 15% rise in the number of households accepted as homeless by councils in the last quarter of 2010, compared with the same quarter last year.
Many fear this situation is only going to get worse as housing benefit and other welfare cuts start to bite over the coming years, and homelessness charities struggle to deal with the fallout as their funding from councils and other sources goes into reverse. Not a good situation.

Spending cuts and Nick Clegg

By Jeremy Dunning, senior adult beat journalist on March 10, 2011 9:50 AM | No Comments

We start off today with a link to Patrick Butler's CutsBlog in The Guardian, where he has reprinted part of a prayer written by church leaders in West Yorkshire for the victims of spending cuts.

As he says: "The prayer is in part an appeal to people with responsibility for making cuts to reflect on the consequences of their decisions with humility and wisdom."

The church says it is its duty to speak up for those who will suffer most from the cuts.

Nick Clegg, everybody's favourite Lib Dem, has to run the gauntlet of his party's spring conference in Sheffield this weekend.

The Guardian reports how strong support has emerged for an amendment to a motion at this weekend's conference, demanding that the NHS, rather than the private sector, should be the preferred provider in the health service. The amendment also calls for commissioning to remain a public function.

The Guardian story goes on to report that Clegg (above) is concerned by the revolt with care services minister Paul Burstow holding a series of telephone conferences with party members to explain the thinking behind the changes.

Similarly the BBC report that doctors' leaders have likened the shake-up of the NHS in England to the privatisation of the gas, electricity and water industries.

Finally the Daily Telegraph reports how a husband filmed his wife's death in an assisted suicide to prove it was not murder after she asked him to "end it" following 40 years of constant pain.

Nick Clegg courtesy of Flickr.com by World Economic Forum

Council scraps low threshold for care

By Mithran Samuel, adults' editor, on March 10, 2011 7:31 AM | No Comments

Calderdale Council - one of just two councils in England that sets a low threshold for adult care - has decided to raise it to moderate, reports the Yorkshire Post.
The Post reports that 700 people will be affected but there is also something symbolic in it too in terms of what it says for the provision of low-level help for disabled and frail older people in the country.
Sunderland, I think, is the only council left with a low threshold.
For more on this issue, see our special report on eligibility thresholds last year.

Welfare Reform Bill backed by House of Commons

By Mithran Samuel, adults' editor, on March 10, 2011 7:12 AM | No Comments

Just to let you know the Welfare Reform Bill easily passed its first stage in the House of Commons (the second reading) by 308 votes to 20 (looked like the Labour lot abstained).

As I blogged yesterday, this has massive implications for social work, so it is worth keeping your eye on it. Next up is the committee stage, when a group of MPs will study the bill in more detail; this is where amendments get proposed and (hopefully) passed, so it's pretty important.

The quiet removal of the duty of care?

By Vern Pitt, journalist, on March 9, 2011 3:57 PM | 1 Comment

Quiet as a mouse the Department of Communities and Local Government announced a review of all statutory duties on local authorities today.

That sounds like a dull exercise in tidying-up the statute book that I bet you'd rather not be involved with, right?

But if you work as a social worker you might lose your job if you're not involved.

A quick look through all those duties bestowed upon Adult Social Care reveals that they are all pretty essential if people are to obtain services. They are also virtually all duties discharged, in part at least, by social workers. Yet, the government is clearly intent on whittling this list down.

For some areas there may well be anachronistic duties which can be consigned to the scrap heap, but it's difficult to imagine that being the case with any such social care fundamentals as the right to a carers assessment or the duty on councils to prepare community care plans.

If even one of these were removed it could seriously erode the role of the social worker. Councils are stretched enough at the moment and I think it unlikely they would continue with any work they currently do if they were told it is no longer a legal requirement.

At this stage the future of the list is out to consultation. Now is the time to make your voice heard.

Image by e3 on Flickr

Tracking the cuts with Homeless Link

By Jeremy Dunning, senior adult beat journalist on March 9, 2011 12:39 PM | No Comments

The charity, Homeless Link has launched a crowdsourcing project to track cuts.

Click here for more about the project here.

So far its results show:

    * 41% (31 councils) are cutting supporting people budgets by less than the amount of total formula grant they have lost from government.
    * 15% (11 councils) are cutting SP budgets in proportion with the amount of total formula grant they have lost.
    * However, 44% (33 councils) are cutting SP budgets disproportionately - and many of these areas are ones where rough sleeping figures have increased since last year.

'You lack mental capacity, but you can't see the evidence for that'

By Vern Pitt, journalist, on March 9, 2011 11:23 AM | No Comments

There's a really good piece in the Telegraph today about a man, who seemingly has mental capacity, being refused sight of a GP report which declares he does not.

Broadmoor patient set to have detention case heard in public

By Jeremy Dunning, senior adult beat journalist on March 9, 2011 11:20 AM | No Comments

This story from The Independent will make interesting reading for mental health experts.

Broadmoor patient makes history with court appeal: Man locked up for 23 years to have detention case heard in public

Council tax freeze adds to pressures on social care

By Mithran Samuel, adults' editor, on March 9, 2011 9:57 AM | No Comments

News today that the vast majority of councils have frozen council tax for 2011-12 shows that massive cuts in central government funding for authorities are not being compensated for locally.

In reality, it is not really a freeze. English councils that do not raise bills for their residents will receive a sweetener from communities secretary Eric Pickles (pictured) equivalent to a 2.5% rise in the tax.

Technically, councils in England can increase their council tax levels by 3.5% - the level at which the government has promised to cap rates.

But it is understandable that few have bothered. There is not a great deal of difference between 3.5% and 2.5%; and making a 3.5% would no doubt attract the clunking fist of Pickles, who has spent the last several months lambasting councils for their budgetary decisions.

The result is not enough funding for adult care and other services, and the lack of an honest dialogue between councils and their citizens about how to pay for the things that they value.

(Image from Department for Communities and Local Government on Flickr)

Charities debunk government disability cut reasoning

By Vern Pitt, journalist, on March 9, 2011 9:53 AM | No Comments

The government's reasons for removing disability living allowance (DLA) from those in residential care have been debunked in a report signed by 39 disabled people's charities.

The whole thing sets out very clearly why the government, according to these charities, is wrong.

It takes eight of the government's justifications in turn and puts a fairly comprehensive argument against them. I would try to summarise it but it's pretty technical and I wouldn't do it justice.

The issues it addresses are:

1. The responsibility for mobility / transport costs should be met by the care
home provider.
2. DLA mobility is being misused and needs reforming.
3. DLA mobility is being used to purchase wheelchairs when this cost should be
met by the NHS Wheelchair Service.
4. The change will align the rules for people living in residential care with people
in hospital.
5. There is an overlap in transport provision for disabled people. Schemes such
as dial-a-ride provide for the transport needs of individuals with a disability.
6. Local authorities should be assessing and meeting personal mobility needs.
7. Local authorities' contracts with care homes should cover personal mobility
needs.
8. People in NHS funded residential care do not receive DLA mobility.

Protests begin against NHS reforms

By Jeremy Dunning, senior adult beat journalist on March 9, 2011 9:49 AM | No Comments

We start this morning with what is fast becoming the Andrew Lansley show and demonstrates his difficulties in winning over a sceptical public and health profession to his reforms.

In this case NHS Direct Action - a group campaigning against the proposed NHS reforms - staged its first protest with action outside private health firm Care UK's offices.

About 50 people took part, says The Guardian - a mixture of student doctors, workers and former NHS staff.

Care UK is set to be one of the biggest beneficiaries of the health and social care bill and has links with Lansley from his days as shadow health secretary.

At the same time a survey of 800 family doctors by the Nuffield Trust health thinktank reveals that patients in England face increasing rationing of healthcare in the next few years as a result of the government's NHS shake-up.

The Nuffield study also found that fewer than a quarter (23%) of all the GPs agreed that the Government's reforms would improve the quality of patient care.

Meanwhile The Guardian's David Brindle has an interesting feature on how innovative thinking and goodwill can help stop preventive healthcare services being sidelined as the cuts start to bite.

Picture on Flickr.com from NHS Confederation

Why the Welfare Reform Bill matters to social work

By Mithran Samuel, adults' editor, on March 9, 2011 8:37 AM | No Comments

Work and pensions secretary Iain Duncan Smith will present his Welfare Reform Bill before the House of Commons today for its first major debate. Here's why it matters to social workers:

Disabled people will be hardest hit by the bill's cuts. Of £3.9bn in annual cuts earmarked for 2014-15 from the bill's measures, at least £2.5bn will come from the pockets of disabled people, through the replacement of disability living allowance (DLA) by personal independence payment (PIP) and by limiting employment and support allowance (ESA) for a year for some claimants. Disabled people are already twice as likely to be poor as non-disabled people - this means more misery for families and more pressures on the social care system.
The cuts will take money directly out of social care. Councils' recoup charges from social care users on the basis of their eligibility for DLA. As fewer will be eligible for PIP, this means less charging income for councils.
Your clients are angry about it as the campaign launched this week by online disability group Broken of Britain makes clear (see image above). You will feel this anger.
Social Fund reform looks set to both deepen poverty and put social workers in the firing line of clients' anger. The government intends to scrap the national payment of Social Fund community care grants and crisis loans for vulnerable families in need and give councils the power - though not the responsibility - to provide this service locally. There is a real fear from experts that this will result in more hardship for families and put social workers in the invidious position of having to grant - or refuse - cash requests from clients.
The creation of the Universal Credit is a massive reform of the benefits system that all in social work need to know about. The credit will replace most income-based benefits payments for working-age adults and is designed to simplify the welfare system, increase take-up of benefits and improve work incentives (by enabling people to keep a bit more of their benefits when they move into work). This is the centrepiece of the bill

Girls behind bars: female experiences of justice

By Jeremy Dunning, senior adult beat journalist on March 9, 2011 12:01 AM | No Comments

Eve McDougall was 15 when she was sent to an adult prison for breaking a window.

The experience led to a chaotic lifestyle before she was able to turn her life around.

Now she is one of several artists appearing in a powerful exhibition demonstrating female offenders' experiences of the criminal justice system, which has been organised by mental health charity Together.

The exhibition marks four years since the ground-breaking Corston Report, which led to the provision of a national network of women's centres, and the development of bail support, including hostel places, to help keep vulnerable young women out of prison.

However, sustainable funding remains an issue, with many of the centres facing possible closure or reduction in services.

Over 70% of women prisoners have two or more mental health disorders and they account for 52% of self-harm incidents in prison, despite constituting only 5% of the prison population.

Together is calling for the continued funding of the women's centres, and for a roll-out of diversion schemes nationally that can identify and divert such women away from custody and into community-based alternatives that address mental health needs.

eve work.JPG

This work, by McDougall, now 52, helped inspire the exhibition and demonstrates how she saw herself in prison at that time with other children ranging in age from 13 to 15.

The exhibition aims to explore their lives, and what justice has been like, from their points of view.

As she says: "People working in mental health, the criminal justice sector, social workers, the public, and politicians need to come and see this exhibition."

The show also includes a collaborative project between female prisoners and arts organisation Pharmacopoeia.

The work on display spans a variety of mediums, including video, photography, paintings, drawings, sculpture, poetry, audio and installations.

It has been sourced from current prisoners at HMP Holloway, women and young offender groups supporting ex-offenders in the community, as well as individual artists, and women supported by Together.

Girls Behind Bars: Female Experiences of Justice is on show to the public at the Together Our Space Gallery, in Old Street, London, from 9 March to 10 June.

Both pictures courtesy of Flickr.com from Girlsbehindbarsexhibition

Is the regulation of hospices stifling the Big Society?

By Vern Pitt, journalist, on March 9, 2011 12:01 AM | No Comments

Jonathan Ellis, director of policy, Help the Hospices2.jpg

As the government closes its consultation on volunteering and the Big Society Jonathan Ellis, director of policy at Help the Hospices, argues that some of the best examples of the Big Society, hospices, are being stifled by other government initiatives.

Eight months ago David Cameron described hospices as one of the "great successes of the Big Society that we have in this country". He was right. But this could be undermined by the Health and Social Care Bill.

There are more than 200 independent charitable hospices across the UK, providing specialist health and social care to about 360,000 people a year. Rooted in the communities they serve, hospices' value is reflected in their strong public support. Well over £1 million is raised for hospices each day by local people and businesses. And more than 100,000 people donate their time to hospices, with the contribution of volunteering to hospices estimated to be in excess of £112 million each year.

Yet instead of feeling empowered by the Big Society, local hospices are constantly challenged by an ever-more demanding regulatory burden. With more red tape likely to come out of the health and social care bill, hospices will have less time and resource to do what they do best - provide high quality care and support to those in need in their local community.

Often perceived as just a health provider, hospices are major providers of social care for people with life-limiting illnesses. So, as well as their own strong internal governance procedures, hospices must meet the regulatory requirements of the Care Quality Commission (CQC), and care professional regulators. Many also have to negotiate their way through the unnecessarily complex NHS standard contract. This is in addition to regulatory requirements set out by the Charity Commission.

Hospices are understandably concerned about the government's plans to introduce more controls to help manage the new healthcare market under the Health and Social Care Bill's reforms. As well as being regulated by the CQC, providers will also have to be licensed by Monitor, the financial regulator for foundation trusts. Introducing yet another layer of bureaucracy seems to be counter to the government's promises to reduce the burden of red tape on charities, particularly those providing public services.

As the Bill calls for providers to work more closely together, why can't regulators develop better partnerships to reduce the burden on hospices and minimise regulatory duplication This must be the central recommendation of the Big Society Deregulation Taskforce, which, ironically, is delayed after being inundated with examples of excessive regulation.

In this time of austerity, it is important that the future regulatory system for hospices aims to thin out red tape to enable hospices to continue their valuable work.

Care home residents failed by GP cash incentives

By Vern Pitt, journalist, on March 8, 2011 11:00 PM | No Comments

Residents of care homes suffer poorer care than those in the community under GP performance related pay schemes, a study has found.

The study published today in the British Medical Journal found care home residents with chronic disease had worse outcomes in care homes than in the community.

Plus, GPs often excluded these patients from being measured against quality targets. The study found 34% of stroke patients were excluded from being included in the targets compared with 17% in the community.

It's worrying news given the government's health white paper which places more power in the hands of GPs and gives them financial incentives to performance well. This study shows those incentives don't always result in all the community getting better care.

Care home organisations often say they have difficulty even getting patients to see a GP in the first place, a problem which has persisted for years. Now it seems that even if they can get that they are not getting the same care.

Disability benefit reform elicits massive public response

By Vern Pitt, journalist, on March 8, 2011 3:05 PM | No Comments

The Department for Work and Pension's has described its consultation on the abolition of disability living allowance (DLA) as one of the department's 'biggest ever' consultations.

It has received 5,500 responses to the consultation which ended on 18 February. That's plenty of reading for the civil servants to do.

Approximately 5,000 were from members of the public and 500 were from disabled people's organisations.

Maria Miller, minister for disabled people, said: "I know from the visits I made during the consultation, that DLA gives essential support to many people.

"But I've also found through talks with disabled people and their organisations that the claim form is too long, too complex and unclear, leading to widespread inconsistencies in the way DLA supports disabled people with similar needs in different parts of the country."

Miller said she was not able to give any detail of how the responses might change the government's plans for DLA at this stage.

Image by quinn.anya on Flickr

Government set to shake up communications in bid to win PR battle over health reforms

By Jeremy Dunning, senior adult beat journalist on March 8, 2011 1:49 PM | No Comments

There's a fascinating little piece in The Times [paywall] today about how Downing Street's new director of communications has been told to "shake up" the health team.

This comes amid fears the government is steadily losing the public argument on its reorganisation that will see GPs in charge of the NHS budget.

Whether a shake-up in the communications area will help the government win the public relations battle is debatable.

I've already blogged that in a choice between doctors and politicians, the public will trust doctors every time and many are currently critical of the reforms.

Care home closure stopped by injunction

By Vern Pitt, journalist, on March 8, 2011 1:44 PM | No Comments

Another day another way to stop cuts.

Today the Wirral News reports that the closure of a care home in the county has been stopped by an injunction.

There is expected to be a judicial review of the councils decision to close the service later this month.

London Councils launches new consultation on cuts to voluntary groups

By Jeremy Dunning, senior adult beat journalist on March 8, 2011 12:44 PM | No Comments

London Councils has now launched its five-week 'supplementary consultation' on cuts to its grants programme to the voluntary sector.

I blogged last week that it was planning how to carry out this process, which came after a High Court judge found the original consultation had failed to meet statutory equality duties.

Will this lead to changes? Somehow I doubt it, but it's worth taking part.

Disabled people tell MPs: Sickness benefit test must go

By Mithran Samuel, adults' editor, on March 8, 2011 9:55 AM | No Comments

Disabled people told MPs some harsh truths about the much-hated assessment system for sickness benefits in an emotional public meeting in Burnley yesterday, reports The Guardian.

Burnley is one of two areas trialling the reassessment of people on incapacity benefit on their fitness to work, using the work capability assessment.

MPs on the work and pensions select committee, who scrutinise these matters, were told by about 50 disabled people of their negative experiences of the test.

One said of their assessment: "I felt it was assumed that I was lying. It was more like a police officer cross-questioning a suspected offender than someone looking at my health and welfare and mental condition."

Drug addicts paid to have long-term contraceptive implants

By Jeremy Dunning, senior adult beat journalist on March 8, 2011 9:36 AM | No Comments

US anti-drug charity Project Prevention says it has paid 26 female drug addicts in Britain to have contraceptive implants or coils fitted.

Last year the charity tried to sterilise drug misusers, also with a £200 bribe, but had to back down under enormous pressure and instead plumped for long-term contraception.

At the time drugs workers said the concept of paying addicts to be sterilised was unethical.

The charity says its plans will cut the number of babies born in the UK hooked on drugs, though there is doubt that giving cash to drug addicts would cut the numbers of addicts.

A recent report for the charity Kaleidoscope by Bernadette Hard, a GP specialising in substance misuse, estimated that more than 250,000 children are affected by parental drug abuse in the UK.

The study also found that around a third of all social work cases involve substance abuse by parents, costing the taxpayer around £117m a year.

60% public say service cuts leave us less prepared for aging population

By Vern Pitt, journalist, on March 8, 2011 5:30 AM | No Comments

Sixty percent of the public say government spending cuts have left the county ill prepared to deal with an aging population, a poll finds.

The poll of 2,000 people by Age UK also showed over a third thought that services for older people should be protected from cuts.

Michelle Mitchell, director of Age UK, said: "If responding to demographic change is filed away as 'too difficult' then our current leaders will fail future generations of both young and old as the demographic changes begin to take effect."

"We want to see the government now start to address these issues in an intelligent, holistic way that encourages departments to work together to come up with different and better ways of working that will prepare us better for an ageing society," she added.

The survey also found that 84% of people feel the government is not prepared to meet the needs of an aging population. Plus, 79% said their local council was in the same position.

The poll was commissioned to inform the development of Age UK's Agenda for Later Life report, which calls on the government to meet 12 challenges to deal with the ageing population.

Read Age UK's twelve challenges after the jump...

Continue reading 60% public say service cuts leave us less prepared for aging population .

Learning disability tsars may be spared axe

By Vern Pitt, journalist, on March 7, 2011 4:43 PM | No Comments

I reported last week the government has decided to axe the central delivery team for its core learning disability strategy, even though it still has nearly a year to run.

At the time it wasn't clear what would happen to the directors of the programme.

Co-directors Anne Williams and Scott Watkin, who has a learning disability himself, were both appointed at the programmes inception in 2009. Unlike many government appointments, which are frequently falling foul of political whims, they've managed to stick around.

When the government said delivery of Valuing People Now would "no longer be led through the centrally funded programme team" it seemed likely they'd be included within this.

However, after a bit of pressing the government has today told me: "We are still finalising future arrangements for the co-national directors."

So Valuing People Now may not lose all momentum after all. That will surely give some comfort to those that warned axing the team would hit reverse on the progress made so far.

It won't however give much comfort to those in the team still losing their jobs.

Image by mangpages on Flickr

Hostel closure raises questions of support for homeless people

By Jeremy Dunning, senior adult beat journalist on March 7, 2011 2:06 PM | No Comments

I'm still in the dark over how Lambeth Borough Council's decision to decommission its 120-bed hostel in Clapham won't lead to more homeless people on the streets when it closes for good in March 2012.

In November Lambeth took the decision to decommission its Cedars Road Hostel saying that "given the stark financial realities we must look again to ensure that we are buying the best possible, modern, care and support that we can afford.

"We are crystal clear that this will not lead to more homeless people on the streets."

However it insisted it remained committed to tackling rough sleeping with the emphasis on a pathways approach. However quite how it can be clear this won't lead to more homeless people on the streets is a bit beyond me considering the economic climate we are in.

Surely more help and support is necessary.

At the time St Mungo's, which runs the service, urged the council to commission a full study into homeless provision in Lambeth and said it should remain open to continue to provide a valuable service. No such luck.

As St Mungo's says: "We are very concerned that, at a time of rising rough sleeping, an important and progressive project - with its history and expertise in housing and helping homeless people - is to be lost.

"We are worried that the growing impact of recession, funding cuts and proposed housing benefits changes are all likely to contribute to further rises in homelessness and mean this project and staff team will be very much missed by the people they could have helped."

This isn't the only hostel to be faced with closure across London or the UK. Where will people go when the support is no longer there?

Self-funding care users need to be advised to plan for their care early

By Jeremy Dunning, senior adult beat journalist on March 7, 2011 12:43 PM | No Comments

Reports into self-funding care users have urged councils to up their game on advice and information for those not eligible for state-funded care.

This came out most recently with the Local Government Information Unit's report, which called on councils to provide better information to ensure self-funders get better value for money, preventing them spending their resources so quickly.

However there's a missing element here, which also needs to be considered. Self-funders may not necessarily go to councils to be signposted to information on financial advice for their future care needs.

And yet neither are they likely to have started saving for their future possible care needs in say their 40s because financial experts are not generally providing advice about these needs, but instead on traditional areas, such as investments and pensions.

This point has been made by Hammersmith and Fulham's cabinet member for Community Care, Cllr Joe Carlebach.

Carlebach said: "If you talk to most self-funders about coming to a council for financial advice they would probably think you are barking mad.

"The key is financial advisers. I was speaking to accountants, tax advisers who didn't have a clue about self-funders."

Similarly Richard Jones, president of the Association of Directors of Adult Social Services, suggested uptake by users of council websites signposting them to specialist advisers may not be that high.

There is, he said, such a problem with awareness that until government and other stakeholders partners reach some clarity on a care funding solution the market for insurance products in this country will remain low.

Opposition to disability benefit reform growing

By Vern Pitt, journalist, on March 7, 2011 11:09 AM | No Comments

Today sees the launch of the launch of Broken of Britain's Left Out in the Cold campaign to highlight the position disabled people will be left in by benefit reforms.

It's a strong image and one I can see being repeated across the media in the coming days. Though I'm not sure it's necessarily one you should be looking at at work.

Kaliya Franklin, the disabled woman in the image, said: "It's vital we all remember we are just an accident or illness away from becoming disabled. Many people think if they do become disabled that the state will look after them.

"But the fact is that even under current provisions, disability benefits are not enough for disabled people to live on. If the Welfare Reform Bill is passed, the situation will become unimaginably worse."

Also kicking off the campaign Broken of Britain has published an open letter to Maria Miller, minister for disabled people, arguing for major disability benefit froms to be dropped from the government's Welfare Reform Bill.

Notable is the number of academics who have signed the letter, 58. These people are both experts and often with less political agenda than campaign groups, unions or professional organisations.

It would seem that the opposition to the changes is not only mounting it's widening.

Social care pay heed: the NHS is worried about finance

By Mithran Samuel, adults' editor, on March 7, 2011 12:00 AM | No Comments

Social care leaders may look on in envy on their NHS siblings' financial settlement but things are not all rosy in the health garden, a survey by the NHS Confederation out today makes clear.
.
Sixty three per cent of NHS leaders say balancing their finances is one of their top three concerns, far ahead of any other issue.

While people in Westminster have been concentrating on the government's controversial head reforms, it is finance that is the real issue, the confederation argues, and that has implications for social care.

Less investment in primary care means people's social care needs are likely to escalate, while constraints in the hospitals sector will mean that councils will need to find more care placements more quickly for those leaving hospital.

This is the warning from confederation chief Nigel Edwards: "We are already picking up worrying signals from a number of hospitals and primary care trusts about significant money pressures emerging, and this is before the very challenging rigours of next year's tight financial settlement. Policy makers have got to be alive to this if they are serious about protecting frontline services."

Social care leaders should pay heed.

Watchdog challenges ministers over scrapping of national poverty fund

By Mithran Samuel, adults' editor, on March 7, 2011 12:00 AM | No Comments

As we have reported, welfare rights experts and charities have slammed plans in the Welfare Reform Bill to scrap the national payment of grants and loans to families in crisis under the Social Fund and transfer the power - though not the responsibility - to do this to councils. Critics fear that this will deepen poverty and exacerbate relationships between social workers and their clients, if practitioners are left with the job of considering applications for cash.

While this may be dismissed by some in government as the usual suspects having a moan, even the most hardline of ministers will need to take account of the views of the man on our left - Karamjit Singh, the Social Fund Commissioner. Singh's role is to scrutinise and review Social Fund decisions taken by Jobcentre Plus. And while he has not joined the rejectionists, he has raised some very serious questions about the government's proposals - which would also see his office abolished.
He has said that any reformed system must:

Ensure funding for councils is sufficient to meet local need.
Provide consistency of assessment and funding between areas.
Include a central overview that provides assurance that standards are being maintained.
Include access to an independent grievance procedure to ensure decisions are fair and seen to be fair.
Provide high-quality responses to applications that are timely and reasonable decisions.
Provide openness about the type of support that is available for people.

He also says that the current system targets help at those in most need.

It is pretty clear that the proposed system will not provide consistency of assessment and funding between areas as local authorities will not be under a duty to even provide these payments; nor will there be a central overview. While it is possible that the local government ombudsman may provide some independent review of complaints, this would be far weaker than the commissioner's current role, which involves the ability to overturn decisions.

For its part, the Department for Work and Pensions' view is that the current system is poorly targeted and the quality of decision-making is poor; and that a locally-provided service will be better targeted and more responsive to local needs, locally professionals will have a better understanding of local issues and individuals' needs.

While this may answer one or two of the commissioner's points, it leaves most of them unanswered. It will be interesting to see how much noise he makes as the reform proceeds.

Listen to the latest social care news through Community Care's new podcast

By Mithran Samuel, adults' editor, on March 4, 2011 9:51 AM | No Comments

Community Care launches a weekly podcast, bringing you the most significant social care news stories of the week, as told by our team of journalists. Have a listen and see what you think. You can also link to the podcast.

TV ad bids to raise awareness of early signs of dementia

By Mithran Samuel, adults' editor, on March 4, 2011 9:36 AM | No Comments

This is a TV ad launched today to raise awareness among families about the early signs of dementia, as part of a £1.2m government campaign.
It tells the tale of a daughter who starts to see her father struggling with certain situations, such as forgetting where he has parked his car, and aims to bring home the message that getting help early will enable her to have the dad that she knows for longer.

The campaign - which is being launched in the North West and Yorkshire and the Humber regions - is designed to improve early diagnosis of dementia, so that people can get support sooner.

The problems with diagnosis were highlighted this week by Alzheimer's Society's diagnostic map of the UK, which showed large disparities between areas.

"People are afraid of dementia and rather than face the possibility someone they love has the condition, they can wrongly put memory problems down to 'senior moments', said care services minister Paul Burstow.

"But if you are worried, the sooner you discuss it and help the person seek support the better. Don't wait until a crisis forces your hand. Being diagnosed with dementia won't make the condition worse but leaving it untreated will.

"We can't cure dementia, but we can help you keep the person you love for longer."

More information on the early signs of dementia is available here.

(The ad is available on YouTube).

Police "undervalued", social workers silent

By Vern Pitt, journalist, on March 4, 2011 9:32 AM | No Comments

The Mirror reports today that police groups have slammed the cuts being made to their budgets saying they are undervalued by the government.

In comparison with those working in social care the police are quite highly valued among both the public and its elected representatives, in my opinion.

Yet we rarely seem to see social work leaders using this kind of language to defend themselves from cuts.

Personalisation is failing the elderly and those with mental health issues

By Jeremy Dunning, senior adult beat journalist on March 4, 2011 9:10 AM | No Comments

Is personalisation failing the needs of older people and those with mental health needs?

This is the question being asked by Fighting Monsters today in an excellent blog well worth a read.

Along with many social workers Fighting Monsters wonders how a stretched social care system along with personalisation is helping less engaging client groups at a time of cuts, particularly those without anyone to advocate for them leaving them with "the same 'old style' service delivery model of the cheapest agencies providing poor quality care by rushed carers on minimum wage; questions we've also pondered.

This powerful quote says it all I think.

"It's unfortunate that the agenda has sprung into life at a time when cuts are at the front of our communal minds. It has become too easy to see personal budgets and cuts in the same sentence when they were never meant to be.

"The truth is that the whole system is failing those who need the support, advocacy and choice the most."

Fighting Monsters makes the point that she was a great fan of personal budgets as they did produce great results, but now she thinks it is "even more exclusive and inequitable than the previous system," with no-one seemingly listening to concerns and criticisms, she says.

She cites research published by the Social Care Institute for Excellence, which she says that that key to the successful implementation of a personal budget - for older people and those with mental health problems - is information and the involvement of a professional.

I've opened up a thread on CareSpace to hear your views.

CPS chief says prosecutors failing disabled hate crime victims

By Mithran Samuel, adults' editor, on March 3, 2011 1:51 PM | No Comments

Prosecutors are "still in the foothills" when it comes to tackling disability hate crime, the Director for Public Prosecutions has admitted in a major speech on the issue.
Keir Starmer QC said thousands of cases go unreported each year and name calling, bullying and harassment of disabled people is so widespread as to be considered routine.
He warned that the Crown Prosecution Service, which he heads, was getting it wrong in this area by assuming that disabled witnesses or victims would be unreliable or unconvincing witnesses.

Mencap has welcomed the speech as recognition of the problems learning disabled people face in the criminal justice system.

"Of course, recognising the problem is only the first step," said Mencap chief executive Mark Goldring. "We look forward to working with the CPS to improve how they interact with and support people with a learning disability."

Mencap is due to launch a campaign - Stand by Me - against disability hate crime later in the year.

Princess Royal Trust revamps website to target isolated carers

By Mithran Samuel, adults' editor, on March 3, 2011 1:44 PM | No Comments

The Princess Royal Trust for Carers has redesigned its website in an attempt to reach more isolated carers.
An online survey by the charities found that over half felt alone and isolated.
The revamped website is designed to make it easier for carers to link up with each other, and to share experiences through discussion forums and blogs.

Guidance on end-of-life care issued

By Mithran Samuel, adults' editor, on March 3, 2011 1:21 PM | No Comments

The National End of Life Care Programme has launched guidance for learning disability practitioners and those involved in domiciliary care.

The guides raise some important questions for practitioners in these areas and are worth having a read of when you get a moment.

Minister accused of hypocrisy over cuts

By Vern Pitt, journalist, on March 3, 2011 12:45 PM | No Comments

Paul Burstow, minister for care services has been branded a hypocrite followwing the news that a dementia care home in his constituency may close, the Evening Standard reports.

Lansley to scrap price competition idea for healthcare

By Mithran Samuel, adults' editor, on March 3, 2011 12:34 PM | No Comments

Today's blog is turning into the Andrew Lansley show but there does seem to be a lot being said by or about him today.
The latest is that he is going to amend the Health and Social Care Bill to prevent providers competing against each other for NHS funds on price (the FT has reported this).

Lansley has been accused of wanting to promote price competition, by introducing maximum - rather than fixed - prices for services. This implies that providers will be able to undercut each other in competing for business from GP commissioning consortia.

However, the bill will now be amended to ensure this doesn't happen (not sure how the amendments will work).
As we have reported in the past, there are big concerns among health professionals about the impact of price competition on the quality of care, particularly for vulnerable groups.

This U-turn - if that's what it is - may go somewhere to assuaging opinion (though judging by the British Medical Association's offerings today, Lansley may need to go a whole lot further).

Perhaps unsurprisingly, the health secretary denies any U-turn has been performed:

"Our modernisation plans have always been about competition on quality, not on price. We want the tariff to be a nationally-regulated price, not a starting-point for price competition. These amendments will put our intentions beyond doubt, sort out the confusion which we inherited from Labour, and put an end to the scaremongering we have seen."

Make of that what you will...

(Image on Flickr from NHS Confederation)

Patient services could suffer under health reforms, say critics

By Jeremy Dunning, senior adult beat journalist on March 3, 2011 11:10 AM | No Comments

Yet more problems for the health secretary in trying to "sell" his proposed reforms to a sceptical public.

Firstly there is today's British Medical Association poll, which found that two-thirds of the 1,645 respondents fear competition between providers, including the NHS and private companies, will reduce the quality of patient care.

Then the Health Service Journal found that GP practices could boost their income by diverting cash meant for patients to pay instead for their surgeries and equipment.

This came from a series of freedom of information requests that it used to examine trials of GP-led commissioning in the last two years.

The finding highlights a key concern about the government's health bill - which nine out of 10 doctors now openly fear will damage the NHS - because £80bn of NHS spending is to be handed to doctors in general practice to buy treatments for patients.

Finally the think-tank the King's Fund questioned whether the government's health reforms will deliver much-needed changes to the provision of hospital services.

The government of course says that private companies will not be able to profit by running NHS services. However surely that's the point of private companies?

All of this just shows the battle that is on the health secretary's hands. Surely it's time for him to listen because if he doesn't as I mentioned earlier he hasn't won over clinicians who are meant to be leading these reforms.

And if that leads to mess then social workers may well end up helping clean it up.

Doctors' poll shows most believe health reforms will bring more risks than benefits.

By Jeremy Dunning, senior adult beat journalist on March 3, 2011 12:01 AM | No Comments

Most doctors are not convinced that potential benefits of the government's plans for the NHS in England outweigh the risks. (Shock horror - is anyone?)

This is the finding of an online survey for the British Medical Association published today.

This matters for social workers because the reforms are meant to bring about closer cooperation between health and social care. If cooperation is lacking then questions have to be asked about how well they will work.

Carried out by Ipsos MORI, the survey of 1,645 BMA members reveals concerns to increase competition even among those supportive of the changes.

These show agreement that:

Increased competition in the NHS will lead to a fragmentation of services (89% agree)
Increased competition in the NHS will reduce the quality of patient care (65% agree)
The move for all NHS providers to become, or be part of, foundation trusts will damage NHS values (66% agree)
The proposed system of clinician-led commissioning will increase health inequalities (66% agree)

Overall, the survey suggests that doctors believe the changes that are most likely to be achieved are those which are least welcome.

Almost nine in ten (88%) think it is likely that the reforms will lead to increased competition between providers.
Only a fifth (21%) believe this will improve the overall quality of NHS care.

Doctors also believe the changes that would be most beneficial are least likely to be achieved.

Two thirds (67%) think closer working between general practice and hospitals would improve the overall quality of patient care.
Only a third (34%) believe it likely that the reforms will lead to this.

Among other findings:

A third (33%) are broadly opposed to the changes.
Around a fifth (18%) are broadly supportive.
Just over a third (36%) say they are waiting to see what happens.

There are mixed views about the impact of the proposed system of GP-led commissioning.

Two thirds (66%) agree it will increase health inequalities and half (49%) that it will reduce the quality of patient care.
The vast majority (84%) of GPs have taken, or their practices have taken, at least one step to prepare for the reforms, for example, attending a meeting about clinician-led commissioning.
But only half of GPs (49%) agree that GPs in their local area will be ready to take on new roles leading commissioning.

Should this give the government pause for thought?

Most people would have said yes. But it is very clear that ministers are convinced their reforms will create efficiencies and that it will improve the quality of care. Nor does it regard the changes as revolutionary but evolutionary.

The government also regards doctors as a lobbying group resistant to change.

However people tend to trust doctors and if the professionals who are meant to be leading the changes believe it will damage patient care you can bet your bottom dollar people will believe them over politicians.

The government, and particularly health secretary Andrew Lansley, has a major presentional problem if it intends to win over a largely sceptical public and a largely sceptical group of doctors.

As Dr Hamish Meldrum, chairman of council at the BMA, says: "This survey shows that the government can no longer claim widespread support among doctors as justification for these flawed policies."

The NHS Confederation typically is urging willing engagement as it points out that the reforms do present benefits to patients, but there are risks that need to be both fully understood and properly managed.

It's as if we've two opposing camps who are unwilling to cede ground.

If they (Lansley and the BMA) don't come together with a meeting of minds we'll have an almighty botch-up that could impact upon everyone.

Picture courtesy of NHS Confederation on Flickr.com

Tories spark fiery debate over palliative care funding in Wales

By Vern Pitt, journalist, on March 2, 2011 3:36 PM | No Comments

The Conservatives have attacked the Welsh Assembly government for not devoting enough funding to palliative care services in the country.

Speaking ahead of a debate in the assembly on the subject, Nick Ramsay, shadow minister for health and social services, said: "Hospices in England and Scotland receive as much as 40% of their funding from government, while hospices in Wales receive only 15% from the Labour-Plaid Assembly government, meaning they are increasingly reliant on donations, which is an unpredictable income.

"To be able to invest in more staff, improved facilities and greater accessibility of palliative care services in all parts of Wales we must increase funding.

"Ministers have admitted that services remain 'patchy', but have not taken measures to address a decade of underfunding," he added.

He said the Conservatives would invest an additional £8m in palliative care services.

Image by johanferreira15 on Flickr

Devolution could bring difficulties for social workers crossing borders for work

By Jeremy Dunning, senior adult beat journalist on March 2, 2011 3:01 PM | No Comments

Could the increasing policy divergence between the four UK nations make it difficult for social work professionals to move across the borders for jobs?

So far this isn't a widespread thought, though it is one that is beginning to be uttered.

As Jon Skone, director of social services in Pembrokeshire and county director of health with the Hywel Dda Health Board, said to me in relation to Wales, the systems social workers and directors work in within those two countries are physically and structurally different from each other.

Hence personalisation is different between the two as is the split between adults and children's departments in England, which remain combined in Wales.

So if someone has to move to another of the home nations to be with a partner, say from Wales to England, that person would be up against people who have worked in England before and know the systems well. Unfortunately one can imagine the outcome.

Skone admits: "I would be anxious about going in a job in England because I don't understand what a director of a social services department does anymore. I don't have a feel about that and what does personalisation mean in England?"

Does this matter? In itself no but in somewhere like Wales where there is a small and shrinking pool of directors there may be difficulties in finding replacements, though not insurmountable.

To a degree this links with stories of social work students from Wales who study in England or other parts of the UK struggling to make ends meet after no longer being eligible for bursaries from the Welsh regulator.

Five-week consultation planned in London Councils rerun over planned cuts to voluntary grants programme

By Jeremy Dunning, senior adult beat journalist on March 2, 2011 11:59 AM | No Comments

London Councils is planning a five-week 'supplementary consultation' on cuts to its grants programme to the voluntary sector after a High Court judge found the original consultation had failed to meet statutory equality duties.

Its leaders' committee is meeting next week to formally approve the process. It is unlikely that its plans to cut funding for the voluntary sector in London by a third next year will be significantly reduced, despite being ruled unlawful last month.

Its plans were to cut its £26m programme for commissioning services from the voluntary sector to £17.6m in 2010-11 and £9.9m in 2011-12.

This begs the question over the point of consultations. As my colleague Vern wrote a judicial review doesn't oblige a council to change its mind.

And in this case the judge was explicit in ruling there was nothing wrong over the decision. The issue was the consultation submission did not go into service details and it therefore breached its statutory equality duties. He also quashed the decisions on:

•   Categorisation of services for funding purposes
•   Timing of changes to the Scheme
•   Transitional arrangements

The report, which also recommends that contract terminations should take place three months from notification, makes it clear the timetable is tight and the cost of any changes will amount to £1.8m with the consultation costing £150,000.

The voluntary sector has its doubts over the seriousness of the consultation with some calling for a 12-week period. However this would see costs rise to £4.2m.

However London Councils says it has received advice that its position is "legally robust" and therefore it doesn't have to carry out a full consultation.

Officers candidly admit: "This will not be easy in public relations terms...a hostile reception must be anticipated."

Guidance on people with learning disabilities and the criminal justice system

By Vern Pitt, journalist, on March 2, 2011 11:32 AM | No Comments

Guidance on how to better help people with learning disabilities within the criminal justice system has been issued by the Department of Health.

It's all sensible stuff laid out in a very accessible format.

If you work in social care it may not be directly relevant to your day-to-day work but it's a good place to signpost colleagues in the police, courts and prisons if you need to.

Minister for irony Eric Pickles threatens to force councils to ease cuts to charities

By Mithran Samuel, adults' editor, on March 2, 2011 11:19 AM | No Comments

Communities secretary Eric Pickles is obviously a fan of irony: how else can you explain his announcement yesterday that he may legislate to force councils to act reasonably when making cuts to charitable funding?
The first irony is that this act of top-down government would be incorporated into the Localism Bill - the centrepiece of the coalition's devolution and Big Society agendas.
The second is that the announcement comes exactly one month before the start of a financial year in which councils providing social services in England are having to make cash terms cuts of 4.7% on average due to Pickles' local government funding settlement for 2010-11.

Of course, the idea of protecting voluntary sector services is a good one; not just because it is in tune with the government's Big Society vision, but because vulnerable people will suffer as a result of the gravity of the cuts, as our recent survey of social care charities amply illustrated.

The problem is that Pickles' intervention is far too little, too late; it provides councils with no new money, thus failing to tackle the root cause of the problem; and it comes with most councils having agreed, or virtually agreed, their budgets.

The government's argument is that the issue is not one of funding for councils but one of council strategy; Pickles cites four councils who are succeeding in protecting the voluntary sector (cleverly, two of these, Thurrock and Wolverhampton, are Labour-run), but this simply begs a whole host of questions, as Pickles' cuts are falling disproportionately on some councils at the expense of others.

This measure may well not go ahead and, if it does, is likely to have little impact on the magnitude of the cuts. But, it is likely to worsen the already fraught relationship between Pickles and councils without doing much to help the voluntary sector.

(Image on Flickr from Department for Communities and Local Government)

Deprivation of liberty: 'I fear more unnecessary detentions'

By Vern Pitt, journalist, on March 1, 2011 4:53 PM | 1 Comment

Lucy Series, blogger and researcher in law at the University of Exeter, argues today's court ruling to free an autistic man from social care control may not be the last if social care professionals don't expand their knowledge of the system that took his liberty.

The deprivation of liberty safeguards contain many rights for families of people lacking capacity, but they're not much help if they, or the professionals supporting them, don't know about them. That's why it took Steven Neary's father a year to get his son returned home, as reported today.

The safeguards were established following a similar detention of man at Bournwood hospital in 1997, but in that instance it only took five months for the young man to be returned home to his parents.

Steven Neary was detained under the new safeguards, but they are complex and difficult to understand. The Mental Health Alliance has reported that even the professionals who are meant to understand them have difficulty - so what chance do families have?

When people are formally deprived of their liberty, like Steven, they and their 'personal representatives' have a right to independent advocacy services to help support them. Professionals acting on behalf of supervisory bodies are meant to refer representatives or detainees to advocacy services where they think they are having trouble accessing their rights. But the Mental Health Alliance has found widespread failure to do this, and said 'the vast majority of family representatives are receiving no support in grappling with an opaque and impenetrable system'.

Neary's case also highlights widespread shortage of legal expertise in this area - Mark Neary, Steven's father, called over 50 law firms before he found one who could take his case. The Independent reported that one solicitor had told Mark Neary he wasn't entitled to legal aid. Personal representatives automatically qualify for legal aid under the safeguards, whatever their income, but families could be easily deterred by solicitors misinforming them.

Where there are serious disputes about where a person should live, it is good practice for local authorities to refer the case to the Court of Protection to decide. Steven's case was finally brought to court in December by Mark's solicitors, rather than the local authority. Highly unusually, the judge immediately ordered that Steven could return home, and a hearing in May will determine whether the council acted unlawfully when it deprived Steven of his liberty.

Situations like Mark and Steven's could be resolved more quickly if accessible information and advice was more widely available to families. But until the system is more widely understood by those charged with administering it I fear we may see yet more heartbreaking cases like Neary's.

Image by derekskey on Flickr

More anti-cuts musical hits from Captain Ska

By Vern Pitt, journalist, on March 1, 2011 1:51 PM | No Comments

Captain Ska's last musical contribution to the cuts debate proved quite popular in our office, and with readers of this blog.

So although his newest song has little to do with social care directly I thought I'd post it here for you to enjoy.

Man deprived of liberty returned home to father

By Mithran Samuel, adults' editor, on March 1, 2011 9:53 AM | No Comments

An autistic man, Steven Neary, is now back home with his father after a deprivation of liberty order that had allowed him to be placed in a care home was overturned by the Court of Protection.
The deprivation was authorised by Hillingdon Council. A three-day hearing will be held in May to decide Steven's future care arrangements.

One in five people with depression could have bipolar disorder

By Jeremy Dunning, senior adult beat journalist on March 1, 2011 12:01 AM | No Comments

As many as 1 in 5 people being treated for depression in primary care could have undiagnosed bipolar disorder, according to a new study published online by the British Journal of Psychiatry.

Psychiatrists from Cardiff University invited 3,117 people living in South Wales and being treated for depression by their GP to take part in the study.

Of these 576 people agreed to take part and completed a questionnaire to determine if they had bipolar and 370 were then invited for a face-to-face clinical assessment with 154 agreeing.

The researchers found that 29 of the 154 people assessed met the diagnostic criteria for bipolar disorder.

Based on this the researchers argue that 3.3% of patients being treated in primary care for depression may have undiagnosed bipolar disorder.

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