The regulations are essentially there to ensure standards of quality and safety and for each regulation, there is an associated outcome, and as the CQC put it “the experiences we expect people to have as a result of the care they receive“.

These regulations and the standards that apply are extremely high and require a large investment by those reputable businesses looking to adhere to these high standards, which in turn will likely push up the cost of home care for the elderly. However, as with all government legislation and departments, we are not sure whether the local councils or the government departments responsible for the funding of homecare are aware of the high costs associated with this line of work!

However, for those businesses chosing to supply carers on a ‘Self-Employed’ basis do not have to follow the rules and need not be registered with the CQC at all, which makes it a non-level playing field. So we would say ‘buyer beware’, if they take on a self employed carer from an agency, to make sure that they make sure they do all the necessary checks themselves, like referencing and Criminal Records Bureau (CRB) checks etc, as the agency in these cases is not duty bound to do so.

“With nearly a quarter of the UK’s population expected to be over 65 within 20 years, the dilemma of who should pay for the care of the elderly is a pressing issue for government. Dame Joan Bakewell has been exploring how we are facing up to old age.”

Click this link to go to the BBC to watch the video – Elderly Home Care Video from Panorama

With visiting care in many parts of England now costing £20 an hour during the week and £24 an hour at the weekend (and often up to £30 on Bank Holidays and at Christmas, New Year and Easter), then if a client is receiving an average of just 4.5 hours a day visiting care for 7 days a week, then the total weekly cost (£666 a week) is likely to be on a par with what they would typically be expected to pay for 24 hour live-in care.

If either you personally or a close relative is already receiving an average of 4 hours or more per day of visiting care, then you might like to consider the benefits of switching to 24 hour live-in care. The advantages of live-in care are many and varied and some of them are outlined below.

Support & Companionship

With a visiting care service, there is often a high turnover of care staff and a succession of regularly changing faces can be confusing for the person being looked after. By its very nature a live-in care service provides greater continuity of care and 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.

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 unobtrusive way, in order to preserve as far as possible the privacy and dignity of the person they are caring for.
Furthermore, in contrast to a visiting care service, where assistance is available at set times of the day, a live-in carer is 24 hours a day and can provide help and support as soon as it is needed.

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 detail about their likes and dislikes in terms of main meals, snacks and hot and cold drinks. Unless the family has made other arrangements, it will normally be the carer who does the shopping and buys in fresh food and then cooks it in the way the client likes it. If they are 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 presented with pre-prepared meals at set times by a visiting carer.

House-Keeping

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.

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 morning coffee or afternoon tea and will then melt into the background, so that the client can enjoy their traditional role as host. In contrast, offering help with entertaining is not a service that visiting care agencies can reasonably offer their clients.

Health & Medication

Once an elderly person who has previously lived on their own starts receiving 24 hour live-in care, their health as well as their quality of life will generally start to improve. They will tend to feel happier and more secure, they will generally eat better and, with their carer’s assistance, they may take more exercise; even more significantly, they will start to take their medication more regularly, something which may fall by the wayside if calls are missed by a visiting care provider.

Protection from Accident or Harm

With the support of a 24 hour 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.

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. In contrast, time does not normally permit a visiting care service to take their clients on trips and outings.

Switching from Visiting Care to Live-In Care

Very few visiting care agencies offer live-in care, so if you are thinking of switching to live-in care, make sure you talk to a specialist provider of live-in care.

Care At Home are specialist providers of 24 hour care and operate across London, the South East and the Midlands. If you would like to explore the possibility of switching to live-in care, then please give us a call and ask us to arrange a free Care Needs Assessment Visit. You will then receive a visit from Diane Bowyer, our Nurse Risk Assessor or Sarah Vincent, our Care Manager, who will be able to advise you on the level of care required and the likely cost.

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.

In addition to having a years experience as a live-in carer, you must also have your basic skills for care training and have started your NVQ level 2 training. However, if your training is not up-to-date on your basic skills we will help you get this back on track and up-to-date for you.

Our recruitment process is to ask you to complete an application form “Live in care jobs application form“. Please complete this form and send it to our head-office whereupon, if you are chosen for interview we then write to two of your chosen references. If you receive two good references and you pass the interview we then have to follow the usual Criminal Records Bureau (CRB) checking procedure and will then get you started as soon as possible.

To become a live in carer for Care at Home we require the following:

- At least 1 years live-in care experience. Additional experience at a care home, nursing home is an advantage in this job.

- A person who has empathy for others and has a calm and caring personality with an ability to provide physical and emotional support.

- Satisfactory references and an enhanced CRB check (We will carry out a CRB check before your employment commences).

- Qualifications in care, including Moving and Handling, SOVA, Health and Safety, Food Hygiene and Medication. However, we do provide training in these areas, if your qualifications for this are not completely up-to-date.

So if you are looking for live in care jobs, then you can download our Live-in care application form by clicking here.

Once we receive your Live-in carer application form – You application will be reviewed and successful applicants will be ask to attend an interview at our offices in Wendens Ambo (Essex), which are right next to the Audley End train station on the train line from London Liverpool Street to Cambridge. All trains leaving London stop at Audley End, which makes it easy for those of you that live in London.

If you prefer – you can telephone on 01799 541400 or email us for the application form and we will send one to you in the post.

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.

The upset displayed by John Suchet is a prima facie illustration – albeit a particularly harrowing one – of the feeling of desolation and isolationism that we as a company see only too often when people initially approach us for help in dealing with this condition.

Hugely helpful as the Admiral Nursing initiative is, as Mr Suchet points out, it remains unavailable to the vast majority of us and so the prospects for most sufferers of this awful disease continue to look ever more bleak – and even more so for their spouses or offspring who are almost invariably left to try and care for them.

The situation is not actually as bleak it might seem however.

By far the most significant factor in relieving the pressure and stress felt by relatives who would otherwise be left to deal with this condition on their own is having someone around who can basically shoulder a lot of the actual day-to-day burden of it on a hands-on basis rather than through counseling alone – or at all in fact. In other words, someone who can shoulder all the behavioural and physical demands of the person actually suffering from the disease and engage them emotionally also.

Time and again I have seen the lives of both sufferers and carers utterly transformed by this measure alone, and finally I have now experienced the benefits myself:

My own mother has for some while been afflicted with Alzheimer’s disease, a problem which was for a time exacerbated by her steadfast resistance to accepting any support at all outside of the family, which is often the case incidentally. But now we have a competent team of carers looking after her, it is hard to describe not only my own feeling of exaltation and well-being in seeing her being properly looked after by proper dementia-trained carers who take all this in their stride, but in witnessing also the distinct recovery in my mother’s own physical and emotional well-being.

And the moral of this story? Even the sufferers of Alzheimer’s disease don’t necessarily have to live a life of misery because of it.

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.

So if you are looking for companionship for the elderly and would like to have someone live with you then look for a companionship agency with a good reputation.

Care at home provides a 24-7 live in service for the elderly so to provide elderly companionship is a simple extension of our service and one that we have done for many years. Some of our clients simply require our carers to do a bit of cooking and cleaning around the house and to be there for a chat and a quick cup of tea!

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.”