Home of choice

    When it comes to choosing residential care or sheltered housing,
    would-be residents and their relatives can be faced with a
    bewildering task in finding out what is available locally. Often it
    is more a matter of luck than judgement if they come up with a
    place which really suits their needs.

    In Tameside, Greater Manchester, an innovative service provided
    by the local Citizens Advice Bureau (CAB) is taking the element of
    chance out of choosing care services. The CAB has established a
    one-stop-shop known as “ChoicE” where older people and vulnerable
    adults and their relatives can come to find out about the range of
    providers in the area and which ones have vacancies.

    Annette Goodfellow, bureau manager says: “Marketing literature
    never tells you everything you need to know, like whether you can
    smoke, or take your pet with you or if you can bring some of your
    own furniture. We ask the questions that people should ask, but
    often don’t because they don’t know what to ask.”

    Local care providers complete a detailed questionnaire about
    their services, the results of which are collated by the CAB and
    presented in a user-friendly format. Providers fax in details of
    bed spaces every Friday and Tameside social care and health
    department also provides a list of vacancies based on their own

    “People can sit down, have a cup of coffee and compare one care
    home or sheltered housing unit with another,” says Goodfellow.
    “When they’ve narrowed down the range they can look at available
    inspection reports and read about them, warts and all.”

    ChoicE was set up eight years ago as a joint project between the
    CAB, local authority and one of the larger independent care
    providers in the area. At first, the service was partly funded by
    providers but now the full cost of £43,000 a year is met
    through a local authority contract.

    Service supervisor Nigel Morgan explains that social workers
    refer people to ChoicE at care planning meetings. “The service is
    available for anyone to come in and use,” he says. “There’s a
    member of staff available who speaks Gujarati and Urdu. Staff can
    guide people through our system and select homes to look at from
    the map of the area, but we are clear that our role is to offer
    impartial information not advice.”

    Tameside CAB also provides an advocacy service for older people
    placed in residential or nursing care by the local authority. The
    idea is to provide an independent voice for the client so their
    views are properly represented at six-week and annual reviews.

    An advocate visits the resident before a review and goes through
    a checklist covering everything from dentistry and podiatry to
    whether they are taken out on visits and are able to practice their
    religion. Vicky Lowe, CAB advocate, says that people suffering from
    dementia often respond better to a conversation about issues rather
    than to direct questions. “I might ask someone if they are put into
    their wheelchair gently and whether they are consulted about where
    they would like to go on trips.”

    Lowe adds: “You have to be clear with residents about why you
    are there and that you are independent. It’s confidential so if
    there is anything they are not happy with it’s their decision
    whether action is taken on their behalf. But if everyone complains
    about the food we would take it up as a group issue.”

    Goodfellow believes the service provides a crucial independent
    voice for vulnerable adults. “There is someone they can turn to if
    they are not happy. Everyone can express a view and we put that to
    the professionals at the review.”

    The advocacy has been instrumental in improving services for all
    residential and nursing care home residents in the area despite
    being under contract to represent only Tameside-funded clients.
    Morgan says: “We highlight issues affecting a number of residents,
    such as people being discharged from hospital with MRSA or pressure
    sores or problems with getting a dentist.”

    He describes how he lobbied successfully to improve dentistry
    services. “I wrote to local MPs and to health minister Rosie
    Winterton who then contacted the primary care trust. We can raise
    an issue and get through to the right people.”

    Lessons Learned

    • Without a one-stop outlet, people looking for residential care
      or other care services have to go round each provider individually.
      Says Goodfellow: “There is generally only a short window between a
      person getting funding from a local authority and being admitted.
      Our service enables people to make comparisons based  on
      independent information and  find out about current vacancies,  all
      under one roof.”
    • As well as representing the views of individual residents, the
      advocacy service provides feedback to the council about
      shortcomings in the care services they are paying for. “We report
      back to social care and health on the issues we uncover and that
      helps improve care for vulnerable adults,” says Morgan.


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