“Care Closer to Home”: the Torquay experience (not good)

Concerns that care in the community is failing some Torbay and South Devon residents have been raised by a health campaign body.

Gordon Jennings, chairman of the Community Health and Welfare Alliance, set up at the time of the consultation on the closures of community hospitals in Torbay and South Devon, said they feared the consequences of the closure of at least 74 beds across Torbay alone. One of the main providers of care in the area Mears Care was recently taken out of special measures by Government inspectors but they still rated it as ‘requiring improvement.’

It comes after Torbay and South Devon NHS Foundation Trust marked the second anniversary of the launch of the pioneering integrated care organisation in the area.

Mr Jennings said: “We are concerned as we have a high proportion of over 80s in the population, we should be making sure there are suitable arrangements for those people. The integrated care organisation’s argument is that the alternative to community hospitals is care at home. But they haven’t got the staff for home care. How are you going to get quality of care? Changes usually mean improvement, but it’s arguable that under the Devon NHS Sustainability and Transformation Plan (STP) this is not always the case and is a series of cuts – including the loss of 100 hospital beds.

“Evidence is being gathered on experiences under ‘Care in the Home’, but we would implore Torbay communities to become involved and share your experiences with Healthwatch Torbay, Paignton Library, who are conducting ‘have your voice heard today’ consultation on this and other health subjects.

“We need to remind ourselves that South Devon and Torbay Clinical Commissioning Group admitted at the consultation meetings in regards the lack of staff in this area. With your help it is our intention, not only to seek a meeting with the CCG, with these findings, but also Torbay Council Health and Well Being Board, who have a responsibility in this area.

“We have been seeking evidence that it isn’t working and we have had some cases come forward but we are looking for more. If people can write to us with their concerns we can take it up with the right people.”

Dr Kevin Dixon, chairman of Torbay’s independent consumer champion for health and social care, Healthwatch Torbay, said: “Healthwatch Torbay regularly shares an extensive variety of local feedback from Torbay residents on hospital discharge and community care with both Torbay and South Devon NHS Foundation Trust and the Care Quality Commission, along with relevant providers and health commissioners, in order to contribute to their intelligence reports and prompt them into any relevant action.

“Although we have heard public concerns with both discharge and community care, we have also received praise for both.

“The findings of the CQC report into Mears Care Ltd. were reflected in the feedback we have gathered from those people who shared their experiences with us, which indicated that although there was some improvement in the quality of care Mears have provided since the original CQC report in 2016, a number of issues still exist.

“We remain committed to escalating any public complaints and concerns directly with Mears Care Ltd. and continue to monitor the quality of care they provide. Healthwatch Torbay will carry on gathering local public feedback and sharing it with key decision-makers to ensure the public voice is listened to at a commissioning level.”

Michael Rennolds of Coombe Road, Preston, has muscular dystrophy and Muscular Dystrophy UK say the condition is a progressive and life limiting muscular wasting condition for which there is no cure and no effective treatment. That means he has high needs.

Joel Rackham, care and information advocacy officer has written to Torbay and South Devon Healthcare Trust saying Michael required constant individualised care and intervention over each 24- hour period including regular physiotherapy, support with food and drink, toileting and bathing needs.

They say it is critical an up-to-date care plan is in place. But they say he has lost out on several respite days as well as his care hours were reduced from 84 hours a week to 41 which the charity say is ‘insufficient to meet his care needs’ .

At the same time £16,200 was taken out of his bank account which would have been used to pay for care. The charity has asked for the money to be reinstated and say it is ‘not fair’ to expect his mother, who works part time to be expected to care for him as her health is being affected and she cannot be expected to handle Mr Rennolds on her own.

The charity has asked for a minimum of 98 hours of care per week, more than double the amount budgeted for.

Nic Bungay, director of Campaigns, Care and Information at Muscular Dystrophy UK told Devon Live: “Without the right support in place, the difficult job of helping Michael to get out of bed, get dressed, eat his meals and live his life will fall on his mother Susan. The severe and progressive nature of Duchenne muscular dystrophy means that any reduction in care is wrong, but cutting the hours in half and leaving an entire day without any provision is unthinkable. His hours need to rise to the recommended 98 hours a week immediately.”

Mrs Rennolds said the money has still not been reinstated and she had been told the consideration of her complaint had again been adjourned.

“The NHS have taken the £16,200 out of Michael’s bank account, because he wouldn’t sign some papers that were in dispute. Only an idiot would sign some papers they disputed. The charity has written stating that money has to be put back. Michael is really down about this.”

A Torbay and South Devon NHS Foundation Trust spokesman, said: “We are currently in the process of responding directly to Mr Rennolds’ complaint. “We are fully committed to providing our clients with the best possible care. We work hard to ensure that people stay as healthy and independent as possible and that those who would be at risk of injury, illness or isolation are cared for as a priority. Each client will have their individual needs professionally assessed on a regular basis and our health and care professionals will work with them to identify the best way for their needs to be met. This means we can be sure we continue to meet individual’s changing needs.

“Whilst we cannot discuss individual client cases, when clients have their needs and care plans reassessed, we always do this working in partnership with the person and jointly agree the outcome.

Direct payments are made to meet an individual’s specific care needs. In addition, as part of the national guidelines, all recipients of Direct Payments sign an agreement that states that we reserve the right to reclaim money that is not being used. If people in receipt of direct payments accumulate a significant amount of money saved from their direct payments, in line with these national guidelines, we will recover a proportion of this money which will then go towards providing care for other vulnerable people. When monies are recovered, we will always ensure a significant proportion still remains in their Direct Payment account to cover their own care costs as well as a contingency for any unexpected expenditure.”

Marilyn and Ivor Martin, of Salisbury Avenue, Torquay say they are struggling with the level of care offered at home after Ivor, 68, had a serious stroke.

Marilyn said he had a stroke out of the blue one lunchtime which has left him affected all down the left side and incontinent. She said: “I cannot fault the hospital staff at all, the ambulance staff they were incredible. He was moved to Newton Abbot and his care there was wonderful, impeccable. Then I had a visit from occupational therapy from Newton Abbot who said he was coming home. I said my house isn’t suitable.

“I have steps in my garden, I was told there was no money to do that. I have a corner bath and they said there were no aids to get him in and out of the bath so he would have to strip wash and he would need to for the rest of his life if needs be. If I wanted adaptations I would have to pay for it myself. I was offered handrails which would take six to eight weeks to install after he got home. He couldn’t get upstairs and I said I was not having him home if it was not safe. They said I would have to put a bed in the dining room. I don’t have a single bed but was told I would have to buy or borrow one. They put a rail on my bed upstairs, a commode, a rail around the toilet so he could get himself up.

“I was told if I don’t have him home he would have to go in a care home. That would cost hundreds of pounds, money which should be put into caring for people in the community. We had him home and within three days he had a hospital appointment at 12noon. I was told there would be transport but it would come at anytime between 9.30am and 11.30am, and they would pick him up any time between 1pm and 4pm. He’s incontinent, he would be sat at the hospital all that time without food. I was told ‘that’s the way it is’. We had three appointments in one week for the heart and lung department, but they said they couldn’t arrange for them all on one day so we had to get him up there three times. I took him up with my son’s girlfriend who helped, but I am lifting him in and out the car and I had open heart surgery last year. There is no thought about the carers.

“They said that while I was at work, there could be someone coming in the morning to dress him and someone to give him a sandwich at lunchtime. They said they could come any time between 7.30pm to 10.30am. He wouldn’t stay in bed that late, he’d be getting himself up and falling. I can’t have that. Then they could be back at 11am and 2pm getting him lunch. It’s ludicrous.

“I had help filling out the forms for attendance allowance but you can’t have that until they have been ill for six months. I have spent nearly £4,000 on having a ramp put in the garden and shower unit changed and putting in a second hand stairlift. The physios have been fantastic but suddenly they were told they weren’t coming again until October. His arm isn’t working at all and his hand is swollen. It’s not right. Having the physio in really boosts his morale as well. If you are going to have care in the community you have to the people to do it. Ivor could go swimming at Plainmoor Pool but there’s no way to get help taking him there, I have got to do it. If someone doesn’t have someone at home to help how do they get there?

“There needs to be an organisation that sets up a package and says you will need this, this and this and get it organised for you. In hospital they were fantastic every single nurse and doctor, but if you are going to do care in the community you need to set up what people need before you throw them out there. Nobody is helping us. “

Torbay and South Devon NHS Foundation Trust, the integrated care organisation responsible for social care in Torbay, said they could not comment as they had not had a direct complaint from the Martins. On the question of a shortage of carers a trust spokesman said: “We recognise that, like other places in the country, having enough people with the right skills and training to provide domiciliary care for people to be able to continue to be supported at home is a challenge. And there are a number of things we are doing to ensure the right level of care can be provided including supporting the campaign ‘Loving to Care’ to encourage more people to enter this very rewarding career.

A key part of how we are addressing the challenge is our partnership with a national provider of domiciliary care, Mears, This partnership helps to ensure enough carers are recruited, trained and supported to develop their skills. We extend our training and support so that carers working for all care providers are able to benefit from our training provision. This is an incredibly worthwhile profession and by supporting providers to be able to offer increased opportunities for development of their staff they are not only gaining important skills they also benefit from greater job satisfaction and are more likely to want stay in the caring profession.

“In addition to this support we also offer alternatives for people , such as direct payments which enables people to employ their own support assistant directly.”

Torbay residents can share their experiences by calling Healthwatch free on 08000 520 029, visiting upstairs at Paignton library, or even by rating and reviewing a local health and social care service online via http://www.healthwatchtorbay.org.uk. If you have a case write to Mr G Jennings, c/o Acorn Centre, Lummaton Cross, Torquay, TQ2 8ET.”

http://www.devonlive.com/news/devon-news/south-devons-pioneering-care-community-708511

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