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There are more than one million people in the traditional care system. They live full-time in care homes and nursing homes. Some pay for their care, others receive help from their local authority. But there are other options to these more traditional forms of care.

Moving in with a carer

In recent years, councils have become increasingly involved in shared-lives schemes – paying individuals to provide care, including personal care, in their own home. Providers are regulated and used to provide short breaks for family carers as well as full-time arrangements. More than 13,000 people benefit from shared lives, including those with learning disabilities and mental health problems as well as older people. Of the 150 schemes in the country, two-thirds are run by councils, with the rest provided by the voluntary sector.

Home share and befriending

The price of property has prompted growing interest in home-share arrangements – someone who can provide help moving in with an older person who has space free in their house. The carer provides only basic support such as shopping, cleaning or gardening, not personal care, in return for accommodation that is free or for a small rent. There are now about 20 home-share schemes in the UK, helping several hundred older people.

Another popular idea in a similar vein – older people are linked up, usually by a charity, with a volunteer who provides companionship and some low-level support, such as shopping and trips out.

Home Care or Care at Home

Living independently at home is something most of us would like to do for as long as possible. When that time comes to make the decision to ask for extra support to continue to live independently as much as possible, our home care services are tailored for exactly that. Home care  can be arranged on an hourly, daily, weekly basis or a much longer plan to suit your needs.

Home care supports activities of daily living . At home care services allow adults to receive day-to-day help with the personal care they need, preserving their dignity and maintaining a good quality of life. Assistance with activities of daily living can include bathing, grooming, and medication reminders

Costs aside, one-to-one home care offers a number of substantial benefits over residential nursing home care, both for the care recipient and for their family. One-to-one home care provides innumerable benefits, including: The maintenance of your independence and freedom to live life as you choose.

Retirement villages

Unlike in a care home, retirement-village residents usually buy an apartment on the site, although in some schemes they can part-buy or even rent the property. Residents bring their own furniture, decorate as they wish, and are free to have friends and family come to stay. Most villages allow pets to come too. They can also pay for care and support services, which are on-site, as and when they need them.

The properties have been designed to keep the individual living independently as long as possible and so can be kitted out with alarms, fall sensors and easily accessible showers. Such complexes are popular in Australia, New Zealand and South Africa, but have yet to completely take off in the UK. There are fewer than 30,000 units in the UK – Australia has six times more – with the highest concentration in the affluent South East.

Sheltered housing

There are many different types of sheltered-housing schemes. Some will have a warden, living on or off the premises, and all provide 24-hour emergency help through an alarm system. Rented accommodation is usually self-contained, but there are often communal areas, such as the lounge, laundry room and garden.

Many schemes run social events for residents. For those needing more support, extra-care sheltered housing may be available where residents can have personal care and meals provided. Most schemes are run by councils or housing associations, and there are often waiting lists for places.

Adapt your home

Equipment can be provided by councils or brought privately to make it easier for older people to live in their house for longer.Traditional aids such as stair lifts and grab rails are still popular, but technology has opened up a whole host of other options, from flood detectors to sensors that raise the alarm when the individual does not move around their property normally.

Councils and the NHS are also investing in ” telehealth ” and ” telecare ” technology, including devices to remind people to take medication and ways for carers and health staff to remotely monitor things such as blood pressure.

Relying on family and friends

By far the most popular option is family and friends. An estimated 1.5 million older people rely on them for their care needs.The care provided can be pretty substantial. A third of carers provide more than 100 hours a week of care, with many of the carers older people themselves. Sometimes this is supplemented by formal help from councils, but surveys suggest that is decreasing.

However, the pressure is having an impact on the health and wellbeing of those providing the care. Six in 10 older carers who provide 50 or more hours of care a week say their health is not good.

If you wish to learn more about how we can support you, please contact us and let one of our advisers come to see you and your family for a more detailed plan on how we can support you.

Sandwell and West Birmingham Hospitals NHS Trust, which also runs City Hospital in Birmingham and Rowley Regis Hospital, has been given a requires improvement rating from the Care Quality Commission.

England’s Chief Inspector of Hospitals has rated the services provided by Sandwell and West Birmingham Hospitals NHS Trust as Requires Improvement following an inspection by the Care Quality Commission.

This inspection included the following core services; emergency department, medical services, surgery services, end of life care services, outpatient and diagnostic imaging services and the Birmingham Midland Eye Centre. Further unannounced inspections were carried out on 6, 11, 12 and 13 April 2017.

CQC has rated the trust as Requires Improvement overall. It was rated as Outstanding for being caring, Good for being well-led and Requires Improvement for being safe, effective, responsive. The trust’s previous rating was Requires Improvement.

Inspectors found that many services had improved since our 2015 inspection with End of Life Care being rated as Outstanding at both hospitals and in the community service; however, community inpatients was rated as inadequate.

CQC’s Chief Inspector of Hospitals, Professor Ted Baker, said:

“Although some improvements had been noted since our previous from October 2014, the trust had not made all the necessary changes to alter their rating.”

“Staff in the outpatients department did not have their competencies assessed to ensure they were confident and competent to carry out their role. The trust did not always ensure there was enough staffing or appropriate skill mix.”

“CQC rated the community inpatient services as inadequate because of lack of mental health capacity assessments, poor care planning and inconsistent assessment of risk.”

“Paediatric Ophthalmology services were delivered in a service that was not focused on the needs of children.”

“Despite these concerns, we found a number of areas of outstanding and good practice across Sandwell and West Birmingham Hospitals NHS Trust. “Staff must be particularly commended for their caring approach and we rated this area as Outstanding overall. We also rated end of life services and community health services for children and young people as Outstanding.”

“Patients and family members said that the care was not only excellent but that staff always went that extra mile. We observed interactions across the trust and spoke to numerous patients and relatives whom said they were treated well and kept up to date and well informed about their treatment.”

“The trust leadership knows what it needs to do to bring about improvement in the areas identified and our inspectors will return at a later date to check on what progress has been made.”

The CQC has told the trust it must take action in several areas, including:

  • Patients in the emergency department must receive treatment within one hour of arriving in line with the Royal College of Emergency Medicine (RCEM) recommendation.
  • Medical care services must ensure temporary staff being used are competent to fulfil the role.
  • Records of care and treatment in surgery provided to patients are accurate and complete.
  • The trust must ensure doctors use the appropriate proforma in place for effective clinical pathways.
  • The trust must improve local governance and ensure risks to the service are escalated, recorded, actioned and reviewed in a timely manner.

Inspectors saw several areas of outstanding practice, including:

  • The palliative and end of life care service ensured that patients and their families were involved in their care and their choices and preferences were upheld, including where they would prefer to be for their care and when they died.
  • Staff showed great compassion, empathy and an understanding of patient’s needs and preferences.
  • Newton 4 ward at Sandwell displayed a high-level person centred care approach. A number of innovative practices were developed on this ward, which included the breakfast therapy club to aid with patient rehabilitation, rewarded by the Stroke Association.
  • The palliative and end of life care service integrated coordination hub acted as one single point of access for patients and health professionals to coordinate end of life services for patients.

Full reports for the trust are available on the cqc website.