The series is described thus:

“Businessman Sir Gerry Robinson tries to improve three struggling care homes. Can Gerry change a culture of stagnant lounges, poor quality of life and a lack of specialist staff?”

That description alone sums up the deficiencies of the entire present regime.

The major flaw in the system is that most dementia sufferers end up in care homes in the first place (although actually nursing homes too in many cases), where in most instances, the logistics of providing a decent standard of care are fatally compromised by the sheer cost of doing so.

In other words, the overheads in such institutions are already so onerous that it can become a critical extra expense to significantly improve on the care delivered, the increasing cost of complying with ill-conceived and ever burgeoning Health and Safety regulations in particular (to which Sir Gerry refers) being a major element of those overheads.

Let us dwell for a moment on what the present standard of care actually is.

I quote from Sir Gerry’s commentary on the first program in the series:

“The average time a dementia resident is actually engaged in any form of contact with anyone is two minutes in every six hours”.

So for a total direct engagement time with their carers and other staff of just 56 minutes in every week, the average dementia sufferer in the average care home is being charged up to £750. As only a few pounds out of that figure is spent on the carers’ wages per se, then the rest is overhead, which as that is already now becoming unmanageable for many care homes (and is the reason why many are already now failing of course), means that any extra cost in improving the standard of care (such as the dementia mapping that Sir Gerry talks about) will simply send yet more of them over the edge into bankruptcy.

And that in a nutshell is why the average standard of care in UK care homes is so poor – the overheads are simply too prohibitive to enable all but a relative handful of them to provide decent care.

There is ultimately only one practicable solution to this problem and that is to abandon the whole concept of trying to care for dementia sufferers in care homes at all, and simply look after them in their own homes instead.

There they can receive more like sixty HOURS of direct contact with their carers per week as opposed to 60 minutes, and in that setting there is obviously no limit on the time their carers have available to give them all the help and support they need.

I would be interested to see other contributors’ views on the same issue.

Even the government has recognised this fact. In an interview with Sian Williams on BBC Breakfast Time on 30/9/09, the Prime Minister said: “institutional care” is where most people “least want to go”. He further confirmed that the government is planning legislative changes which will allow as many people as want and need to the opportunity to be cared for in their own home.

Gordon Brown has been speaking to BBC Breakfast’s Sian Williams, the day after his keynote speech to the Labour Party conference – click here to watch the full interview. To skip to the point about social care for the elderly fast forward to 4:20 section of the interview.

Indeed it is in the innocent absence of that knowledge that even in this day and age, some of the most well-meaning of relatives still sometimes feel constrained to persuade their parents or other elderly relatives to uproot from their own home and make the often irreversible move into a nursing or rest home.

There is absolutely no need to use even the UK’s best nursing homes

Not only does a good homecare agency provide a level of nursing which is at least a match for that in even the very best nursing homes, but the patient’s quality of life is invariably much better too, the cost of nursing homes is usually higher too.

From the patient’s point of view, they can get up and go to bed when they want, have meals of their choice and when they want (breakfast in bed being an obvious favourite), watch whatever they want on TV, bath or shower when they want, go out when and where they want and entertain their friends and relatives at will – anything they want to do in fact (and are able to do of course) – albeit with the assistance of those looking after them where they might need some help in any of those areas.

In short, then despite the fact that they may be dependent on a degree of nursing care in order to be sustained in their own home, they are nevertheless still ultimately in charge of their own life.

For obvious reasons, such a level of freedom and autonomy is simply not logistically possible in a nursing home or rest home.

Although it is a tragedy which mercifully strikes proportionally far fewer of us, more intense nursing care is equally available for the more critically ill such as those who have become incapable of communication or movement, the terminally ill or those who may be temporarily or permanently bed-ridden, because despite their illness, then if they are nevertheless of the certain knowledge that they will receive the same level of nursing care as they would in a hospital or hospice, many would still far rather spend their last months in their own home as would most of us.

In a workshop entitled “Who cares? Reforming Long-Term Care” Professor Jon Glasby said that the current system placed an unfair burden on individuals.

He said that alternative methods of funding long-term care needed to be considered, including:-

? Introducing compulsory long-term care insurance
? Abolishing long-term care fees
? Drawing on the value of homes through equity relief

Professor Glasby said that he hoped that the government’s Green Paper on care and support, due this year, would provide an opportunity to stimulate debate on the issue and lead to the overhaul of the system. He said: “There is the risk that we retain the status quo, with a few tweaks, but I believe the existing system needs a radical overhaul to fund long-term care for older people. It is a fundamental personal and political issue that is at stake and we really need to think and talk about where we may go next.”

“I personally think that it does not make sense that we distinguish between people who are “sick” and those who are “frail” or “disabled”. One service is free and the other is means-tested, which has significant implications for who pays and who provides. It does not make sense that someone who has cancer and is being treated in hospital pays nothing, while someone who is in a care home and is being treated in a similar way for Alzheimer’s is charged for their care. It is not meaningful to have a separate system of health and social care.”

1. There’s No Place Like Home

As people get older, their home tends to become even more precious to them. Any move away from this familiar environment, for example a holiday in a hotel, or even a short stay at the home of a son or daughter, can make them feel confused and disorientated. It is remarkable, however, how quickly they perk up when they return to the comfort of their own home!

Living in their own home, surrounded by familiar furniture, pictures, photographs and other objects, provides older people with a physical and emotional anchor and helps maintain their sense of identity.

In contrast, uprooting people and moving them into residential care can lead to a sense of confusion and hasten memory loss. Some older people can become depressed and apathetic and may even lose all sense of purpose when they are moved into a care home.

Furthermore, many older people still have a pet and the prospect of having to abandon their much loved cat or dog because they are moving into a care home can leave them feeling bereft and heart-broken.

2. Staying in Control of Your Life

Where older people remain in their own home, they maintain a sense of being in control of their own lives. They are able to determine their own daily routine and decide for themselves what time to get up and go to bed, what to eat and drink and what programmes to watch on television.

If they have had a long day on a Sunday, perhaps involving a trip out with members of their family, they can have a lie-in on the Monday without anyone expecting them to get up at a particular time, as would happen in a care home. This ability to continue to making decisions for themselves and stay in control of their life is important in helping older people to maintain their morale and remain in good psychological and spiritual health.

3. Support & Companionship

A good live-in carer will quickly gain an understanding of the person they are looking after and will be sensitive to their feelings and moods. They will learn what to say and do to cheer them up if they are feeling low, but just as important, they will develop a sense of when they want company and when they want to be on their own for a time.

A good carer will come to be valued as much for their companionship as for their care skills and many will find themselves treated almost like a member of the family. In a care home, on the other hand, there are just too many staff, each with too much to do, for individual patients to establish a close personal rapport with anyone.

4. Help with Personal Needs

Where an older person is suffering from painful arthritis or has other mobility problems, their carer will be able to help with their personal needs, such as dressing, washing and going to the toilet. A good carer will know how to offer their support in a sensitive and inobtrusive way, in order to preserve as far as possible the privacy and dignity of the person they are caring for. Furthermore, the help will be given as soon as it is needed, unlike in a care home, where patients will have their personal needs attended to at times which suit the busy routine of the care assistants.

5. House-Keeping

Eyesight and mobility problems will often prevent older people from maintaining the same standards of house-keeping as they did in their younger days. A live-in carer will keep the house clean and tidy, clear up any accidents or spillages and make sure that food stored in the fridge or larder is not kept longer than it should be. A clean and tidy house is more pleasant for the person being cared for and more welcoming for family and friends who visit or come to stay.

6. Shopping & Cooking

As part of the care needs assessment which takes place before the start of a live-in care service, a person receiving care at home will be asked in details about their likes and dislikes in terms of main meals, snacks and beverages and carers will always try to buy the food they like and cook it in the way they like it. Provided with meals they have chosen themselves and able to eat at a time which suits them, most older people will enjoy their food more and will tend to eat better than if they are offered the often unappetising food served up in care homes, which patients are often expected to eat much earlier in the day than they are used to at home in order to meet the home’s busy daily routine.

7. Social Contact

When an older person still lives in their own home, it is much easier for family, friends and neighbours to drop in, even for a few minutes, than if they have moved into a care home, where visiting times are restricted and quiet facilities limited. Moreover, visiting someone in their own home is a much more pleasant experience for family and friends than visiting them in a care home, where there is little privacy and where they are just one patient among many.

Wherever practicable carers will encourage the person they are caring for to invite round and entertain family, friends and neighbours on a regular basis. The carer will help them plan and prepare the refreshments and will then melt into the background, so that the client can enjoy their traditional role as host. By contrast, entertaining in care homes can be fraught with difficulties because of problems with visiting hours, catering and the lack of facilities for visitors.

8. Health & Medication

Once an elderly person who has previously lived on their own starts receiving live-in care, their health as well as their quality of life will generally start to improve. They tend to feel happier and more secure, they generally eat better and they may take more exercise; even more significantly, they start taking their medication more regularly, something which often falls by the wayside when they are struggling to cope with living on their own. Taking regular medication can often lead to significant improvements in their health and well-being, which in itself will give their family greater peace of mind. People cared for in their own home generally enjoy a better quality of life and may therefore live longer than people who move into residential care.

9. Protection from Accident or Harm

With the support of a carer at their side to help them if need be with the more demanding physical tasks in life (getting dressed, bathing and/or showering, moving about the house, night-time visits to the toilet etc), people receiving care at home are less likely to suffer falls or other accidents and are also less vulnerable to burglars or intruders. They will feel safer, more relaxed, more confident and, in all likelihood, happier in themselves. Furthermore, the knowledge that an ageing parent, who was previously struggling to cope with living on their own, is at less risk of accident or harm can be a huge relief to their children, who may live too far away to be regularly on hand.

10.Trips and Outings

Where appropriate carers can be provided who drive and this will enable the person receiving care to go on trips and outings. They may want to attend church or be driven to see family and friends or visit a local beauty spot. Such outings can be important in helping maintain contact with the outside world and keep their spirits up. By contrast, once people have moved into a nursing home, they often become so institutionalised that they rarely want to venture beyond the confines of the garden, even if given the opportunity to do so.

Chief Medical Officer, Sir Liam Donaldson, said today that most people affected by the virus would recover and the government had a “clear plan” to help prevent the virus spreading.

Given that the people whom we support with care will be one of the most vulnerable groups at risk from the imminent Swine Flu pandemic we want to ensure that the advice issued by the Department of Health is communicated to all clients and staff accordingly.

The Department of Health has issued some broad guidelines for anyone who may show flu-like symptoms:

• Those affected should stay at home and contact health services by phone.
• Good hygiene is particularly important. Washing your hands with soap and water is a good way to stop the spread of germs. It is important you cover your nose when sneezing, ideally using a disposable tissue which is immediately binned to avoid any transmission of the virus.
• Swine flu symptoms are similar to those produced by standard, seasonal flu.
• If you think you or a member of your family has the virus, you can check your symptoms and get official advice from the NHS Direct symptom checker.

The government has issued the following advice for those who think they are a family member might be infected:

1. Stay at home and rest; take medicines such as aspirin, ibuprofen or paracetamol to relieve symptoms (following the instructions with the medicines)
2. Children under 16 must not be given aspirin or ready made flu remedies containing aspirin
3. Drink plenty of fluids
4. Contact your surgery for further advice
5. For advice and information visit www.nhsdirect.nhs.uk, go to NHSDirect Interactive on digital satellite TV by pressing the interactive button on the remote control, or telephone NHS Direct on 0845 4647 47

There are Department of Health briefings at www.dh.gov.uk/en/Publichealth/Flu/index.htm, including the Chief Medical Officer’s guide to pandemic flu.

A stroke happens when the blood supply to the brain is disrupted. A blood clot restricting the flow of blood to the brain is the most common cause of strokes, but some are caused by bleeding in or around the brain from a burst blood vessel.

– In both cases the brain is starved of oxygen, damaging or killing cells
– Sufferers are often left with difficulty talking, walking and performing other basic tasks.

What are the symptoms of a stroke?

Not everyone will have the same symptoms and the symptoms may vary. The most common symptoms to look out for are:

– a sudden weakness or numbness of the face, arm or leg on one side of the body
– sudden loss or blurring of vision, in one or both eyes
– sudden difficulty speaking or understanding spoken language

In addition the following symptoms may also be apparent:

– sudden confusion
– sudden or severe headache with no apparent cause
– dizziness, unsteadiness or a sudden fall, especially with any of the other symptoms.

What are the clear signs that someone has suffered a stroke?

There’s three key things to look for.

– Facial weakness – Can the person smile? Has their mouth or eye drooped?
– Arm weakness – Can the person raise both arms?
– Speech problems – Can the person speak clearly and understand what you say?

What should I do if I think someone has had a stroke?

A stroke is a medical emergency. If you suspect a stroke call 999 immediately.

By calling 999, you can help someone reach hospital quickly and receive the early treatment they need. Prompt action can prevent further damage to the brain and help someone make a full recovery.
Delay can result in death or major long-term disabilities like paralysis, severe memory loss and communication problems.

What is a Transient Ischaemic Attack or TIA?

A TIA (sometimes called mini stroke) is similar to a full stroke but the symptoms may only last a few minutes and will have completely gone within 24 hours. Don’t ignore this because it could lead to a major stroke. See your GP as soon as possible and ask to be referred to a specialist stroke service. This should happen within seven days.

You can obtain further information from your local NHS direct or by calling the Stroke Association Helpline on 0845 3033100

There is no doubt that once you get in to your later years things become more difficult and help is needed for some of the tasks that might ordinarily have been a lot easier a when you were a bit younger. There is help at hand with care in your own home with the privacy that this brings with it. It might be that you only need help at certain times of the day, for example, you might need help with getting your breakfast, lunch or dinner, but to have someone there will make all the difference.

If you only require part-time care then you need to employ the services of a “Visiting Care Agency” who will be geared up for this type of service. However, if you need more regular care throughout the day, for whatever reason, or you would like companionship, then a live-in carer is what is recommended.

A live-in carer from say Care at Home UK Limited will have the experience to deal with all eventualities with an elderly person living at home and will have the necessary training to mach the skills.

Both visiting care and live-in care are very expensive, especially full time live in care, becuase it is labour intensive. However, your local council should be able to offer help where this is concerned and the goverment are pushing for more private home care by offering “Direct Payments” to the person requiring the care.

Care at Home – The Home Care Live-in specialists

Care at Home were established in 1990 and have their head office based just outside Saffron Walden in Essex.

Live-in Care works because more and more people are looking to retain their independence and want to maintain a quality of life as well as retain the freedom of their own home. Care at Home employ their carers who are all trained to the highest standard and who have been fully checked with the Criminal Records Bureau (CRB).

Live in care also works well because you are in your own home where things are familiar and you have complete say in what happens – there are no visiting times and if you want to keep your pet, then you can.

In summary Care at Home is key in providing the following:

One-on-One care

The key benefit of live in care in your own home is that you receive one-on-one care, which is unlike the service provided in a care home where one carer might serve several residents at the same time. The service can therefore be absolutely tailored to suit your needs. You are in complete control of your care and it will be your decision as to the time you get up in the morning to the time you go to bed.

Client specific care plan

We prepare a bespoke care plan for you which is tailored to your specific needs and is then used by the carers to carry out your care on a day to day basis. The care plan covers the following areas:

– Details of your family and who visits you regularly and what involvement they will have in your care.
– Details about your home and the access arrangements for visitors including both your family and friends. Also, whether you have any pets living with you.
– Your communication ability and whether or not you have problems with either of your speech or of your hearing. Do you wear a hearing aid and will you need help with fitting it, for example and whether you wear glasses to read.
– Information relating to your existing medical conditions and allergies that you may have and are you on any medication so that we can assist you in making sure that you take any tablets you have been prescribed. Included within in this we make sure we know about your continence so that the carer can cater to your specific needs.
– What personal care do you specifically require, for example how mobile are you and what assistance will you need in getting around your home. Will you need any help with washing and with the cleaning of your teeth and of course at what time do you like to get up in the morning and then go to bed at night.
– You can let us know what are your favourite foods and drinks and of the things you dislike together with any special health needs you might have. We ask things like where do you like to eat you meals and whether or not you require help in cutting your food up.
– We specifically like to know about your mobility so that we can help you, where necessary, to go out of the house on walks around your neighbourhood or if you have a wheel chair our carers can assist you in moving about. You can tells us what you have difficulty with, for example, stairs or uneven floors etc.
– We like to find out specifically what you like to do, for example do you like going for walks, or do you enjoy watching the TV, or perhaps seeing your family and friends.
– Your care plan will also include vital information about your local GP, your district nurse and any other important contacts in case of an emergency or changes to your situation.
Security and comfort

If you decide to use the services of Care at Home you will obviously continue to live in the comfort of your own home. You will continue to be in a familiar and safe environment with the added security of having a carer on hand 24 hours a day seven days a week. You will avoid any unnecessary stress involved with moving and you will continue to live in your known neighbourhood where all your friends that know you live too.

If you would like to chat with a friendly member of our team please either:

Call on 01799 541400
Email: To email click Care at Home
Or visit our website at Care at Home.

We look forward to hearing from you.

It might be you are viewing this web site and at the point of deciding whether or not you should stay in your own home or whether you should consider going into a nursing or care home. You might be looking for care on behalf of a loved one or for a friend and trying to help them decide which route is better, a care home or for them to remain in their own home and retain their independence.

We have put this page together to try and help you make that decision and you are quite welcome to contact us to ask any personal questions you might have on this extremely important decision.

Care in your own home – the benefits

- Familiar surroundings – there is no better place than home, both for the person receiving the care and for the visiting family. Most people would prefer to be in their own home, whether it be returning from a holiday spent in an hotel or in this case being care for at the winter of life. The surroundings are familiar and you are free to do what you want to do.

- Retain your independence – retaining independence is important for most people, which might mean something as simple as being able to see family and friends whenever you wish, as compared to having more strict visiting hours in a care home. It also extends to being able to keep the good old trusted friend – your pets! If you have a dog or a cat or perhaps a parrot, if you decide on the nursing home route you will not be able to keep your pet. Whereas if you stay in your own home, there is no problem with keeping your pets and we can help you in looking after these for you. There is no question about the important role a pet can play in someone’s overall health and well being – there is nothing like a friendly dog wagging his tail to bring a smile you your face!

- Cost of the care – The cost of care provided in your own home is not that much different from the care provided in a nursing home. Our charges start at around £650 per week for a full time live-in carer. A nursing home in Sudbury charges between £645 and £665 per week for a room in their care home.

- No disruption – Moving at any time of life is regarded as one of the most stressful events and this is no different at a stage in life where you require extra help and support, if anything it might be even more stressful. It is therefore, vital to reduce any stress and by staying in your own home there is no disruption to the way you live. If a special bed is required or a stair lift or whatever other adaptation to your home is necessary – these can all be done at a minimum of disruption to both the person receiving the care and to the family.

- One on one care – If you are in a nursing home you have to ’share’ your carers with many other residence, whereas if you use Care at Home you will retain the services of your own personal carer. You will have a carer living with you 24 hours a day seven days a week who is there to help you and to be your companion.

- Local friends and sites – Depending upon your level of mobility there is nothing better than to be able to go out and visit your local park or your local pub and to see your neighbours and friends – if you move to a nursing home you will have to make new friends and not have your familiar local amenities to hand.

- Your own menu – You are living in your own home so have a choice in what you have to eat and what is cooked for you by our carers – if your favorite dish is Shepard’s Pie, then tell your carer and they will happily oblige.