Continued economic concerns as well as ongoing demographic challenges mean that changes like the recent announcement by Suffolk County Council, where adult social care funding is being cut in actual terms, are likely to be increasingly more common. We believe that over the course of the next generation, it will become increasingly more common for the elderly to have to pay for at least part of their personal care needs. It is vital therefore that provision is made for these future needs.

At Penrose Care we have a straightforward approach to calculating the cost of homecare services provided, providing clear quotes allowing our clients to appropriately budget for their care needs. These fees are set to be sufficient to comply with all relevant laws and regulations such as the National Minimum Wage and Employers National Insurance contributions, fund top of the range training which includes an up to 12-days induction vs 1-3 days common in the sector, continuing professional development such as a QCF Level 2 Award in Dementia Awareness, Penrose Care’s unique London Living Wage committment, top-of-line infrastructure such as our staff’s smart phones and our NFC-enabled time management system, and so on.

We believe that the increasing percentage of care receivers paying directly for their own care will undoubtedly drive up standards in the sector, with care providers ‘upping their game’ by focusing on developing a highly professional and motivated workforce.

References

(1) “Suffolk County Council announces £38.6m of cuts”: 26 Jan 2014 (BBC News, 2014), available here.

Dr. Knight trained as a doctor at the Royal Free Hospital School of Medicine, Hampstead and University College London (UCL). He then undertook his postgraduate training in Internal Medicine, based in north west London, and is currently working full time as a Registrar in Respiratory Medicine, at the Barnet General Hospital. His main interests are Asthma and allergy and he is currently studying part time for a Masters degree in Allergy, at Imperial College London. Dr. Matthew Knight is the co-founder and non-executive director of Hampstead-based Penrose Care, a provider of home care services in London to the elderly – including to persons with dementia – and to non-elderly adults with physical and/or learning disabilities.

Penrose Care is proud to be only one of three Accredited Living Wage Employers in the London home care sector out of over 1,000 agencies. Penrose Care provides short care at home visits, day sitting, night services including sleepovers, and live-in care services.

Since the fourth quarter of 2013, Penrose Care has experienced a marked increase in press coverage for our pioneering efforts in ethics in social care. Such press coverage is in of itself a testament to a component of our ethos that it is not sufficient to just be ethical within our own remit, but also to promote ethics generally by speaking up. Our firm belief that ethics in social care promotes excellence is care is backed up by the facts of Penrose Care: to date, all our client feedback has been excellent and we’ve had no care worker leave voluntarily.

To assist our clients and prospective clients in keeping abreast of Penrose Care’s social impact initiatives, we have collated this press coverage in this article.

Press coverage since the fourth quarter of 2013

In our first news coverage of 2014, on 7 Jan 2014, the Guardian published an article “Care at Christmas” (by Claire Burke), which mentioned a Guardian Witness submission of a video of a Penrose Care-organised choir singing Christmas Carols at Marie Curie Hospice Hampstead on 15 Dec 2013, as part of a community giving initiative. Read More…

We at Penrose Care were particularly proud to be featured in the December 2013 homecare.co.uk, the UK’s #1 independent information site for home care, in a 4 Dec 2013 article “Profile: ‘To promote a caring workforce, the organisation itself must be caring’ says Penrose Care managing director” (by Nina Hathway). The article highlights the unique and pioneering ethical frameworks underlying Penrose Care’s home care services including our being the first independent sector home care provider to be compliant with Citizens UK’s landmark Social Care Charter. Read More…

One of the most high-profile ethical commitments of Penrose Care has been our London Living Wage commitment, which really stood out after the HMRC revealed that a number of providers were flouting the national minimum wage, let alone paying the living wage. A 4 Dec 2013 Guardian article titled “Pressure mounts for better pay for homecare workers” (by Sue Learner) noted Penrose Care’s unique commitment to the living wage. Read More… The article followed an article of the same topic on homecare.co.uk published 25 Nov 2013 titled “A third of home care providers pay less than national minimum wage” (also by Sue Learner). Read More…

Within a wider set of coverage on whether or not Westminster Council should be paying the London Living Wage, the Wood & Vale ran a special feature on 21 Nov 2013, “Care bosses take salary cut to ensure staff receive fair income” (by Alex Wellman) for Penrose Care’s management accepting to be paid below typical rates to ensure frontline care staff can be paid the London Living Wage. The article also highlighted our community giving initiatives with St John’s Hospice. The article can be read online on page 4 of this 21 Nov 2013 digital edition of theWood & Vale. Read More…

On 04 Nov 2013, at the start of the UK’s Living Wage Week 2014, ITV published the current list of Accredited Living Wage Employers. The list exemplified the continued uniqueness of Penrose Care’s Living Wage commitment with it being only one of nine such Living Wage employers in England’s home care sector out of over 7,000 providers. Feeling that its excellent workforce deserved the new London Living Wage rate of £8.80/hour (from £8.55/hour), Penrose Car’s management took the heroic decision of implementing the rate increase immediately. This move was picked up by homecare.co.uk in its article “London home care provider raises carer pay” (by Nina Hathway). Read More…

On 10 Oct 2013, the Great British Care Awards announced Penrose Care had been shortlisted as a finalist in the Great London Care Awards 2013 as “Best Employer”. This news was followed up on 11 Oct 2013, in the Jewish Chronicle’s article “With friends and outings, life is rosy” (by Billie Josephs) on page H12 of the Health & Wellbeing Supplement (digital copy not available).

Older articles

On 28 June 2013, the Jewish Chronicle’s article “What makes a perfect carer?” (by Elisa Cowen) on page CN6 of the Care & Nursing Supplement (digital copy not available), highlighted Penrose Care’s industry leading induction program for care workers that lasted up to 12 days. For comparison, in the same article, a competing provider described as “another agency with a highly developed training infrastructure”, only provided a two-day induction training for its care workers – highlighting the uniquely high standards of training Penrose Care workers are put through.

On 5 Nov 2012, we received our first mention in a media outlet with the Guardian publishing the first-ever list of the UK’s Accredited Living Wage Employers in the article “Boris Johnson and Ed Miliband” (by Andrew Sparrow) speak on the living wage: Politics live blog, for which Penrose Care is among the first four in England’s home care sector. Read More…

Robert Stephenson-Padron is the co-founder and managing director of Penrose Care.

We usually associate G8 conferences with rallies against globalization and rescue packages for the world economy. Yet today world leaders have committed to furthering international efforts to fight dementia- one of the greatest ticking time bombs threatening our society. The UK government alone will double expenditure from its current 60 million pounds to over 130 million pounds by 2025.

The G8 have stated that it would “develop a coordinated international research action plan to target the gaps in research and ways to address them” (1) The Alzheimer’s Society state that there are 800,000 people in the UK with dementia (2), the vast majority of whom are over the age of 65. There are an estimated 44 million people world wide that currently suffer from dementia and how society will meet the challenge of their ongoing medical and home care needs is not yet clear.

The term dementia describes a wide range of conditions- characterized by the progressive decline in the brain’s function. It often presents with difficulties with memory in the first instance, but may also present with general cognitive functions, language skills, mood and judgment (3).

There are many causes of dementia- but the most common ones include Alzheimer’s Disease (where protein structures called plaques and tangles deposit within the cells of the brain causing cellular dysfunction), Vascular Dementia (where brain cells are damaged due to blockage of the blood supply resulting in small strokes), Dementia with Lewy Bodies (a disease with some similarities to Parkinson’s Disease, which results from abnormal protein collections called Lewy bodies depositing in the frontal lobe of the brain- mainly affecting judgment and causing hallucinations) and Fronto-temporal dementia (where damage to brain cells in the front of the brain results in personality and character changes in the early stages). There are up to 100 different causes of dementia.

The accurate diagnosis of dementia is vital- to ensure that appropriate treatments and services are made available (both now and as new treatments become available in the future) and to ensure that reversible causes of confusion are addressed (for example recurrent urinary tract or chest infections, poor eye site, high blood pressure and cholesterol increasing the risk of progression of vascular dementia). The diagnosis of dementia often involves being seen by a specialist following consultation with a GP, and may involve referral to a memory clinic and will usually involve a number of blood tests and a scan of the brain.

The diagnosis of dementia can come as quite a shock and accessing appropriate support is vital. Your GP and specialist can advise on this. A large amount of support material can be found via the Alzheimer’s Society website http://www.alzheimers.org.uk which provides a wide variety of information booklets and links to local support agencies and services.

We are please to see that in patients where the diagnosis of Alzheimer’s versus another form of dementia is unclear, a new dementia brain scan that detects Amyloid protein in the brain (which is a characteristic sign of Alzheimer’s disease) is now available here in the UK.

Once dementia is diagnosed a specialist will decide on whether drug treatments which slow down the process of loss of brain cell function and neurotransmitter depletion are likely to be beneficial (at present these medicines do not slow the rate of cell death down) (4)

As the process of dementia advances, it is likely that more support services will be needed. Home care services can provide a vital support facilitating activities of daily living such as helping with washing and dressing, medication reminders, shopping through to providing companionship and company.

Increased funding into research in dementia will help us identify treatments to slow the process down or even reverse some of the damage already done and investigate further the risk factors associated with dementia. A recent 35 year longitudinal study from Cardiff University found that exercise was the single biggest influence of dementia levels (5)- hopefully future research will delineate the mechanisms underlying these associations and help us find a better cure for dementia. We believe that this combined and coordinated approach from the worlds leading countries will help us fight the battle against dementia, which has scarred the lives of so many families.

At Penrose Care we provide support to our clients with various forms of dementia, and are happy to liaise with family and the patients doctors and hospital nurses to ensure that each client is adequately cared for. We provide a range of services in our clients homes ranging from short term respite care (from regular respite 1 day per month through to a few weeks to cover a holiday for a spouse), through to intensive home care packages in the home. We aim to maximize quality of life and independence for our clients.

Dr. Knight trained as a doctor at the Royal Free Hospital School of Medicine, Hampstead and University College London (UCL). He then undertook his postgraduate training in Internal Medicine, based in north west London, and is currently working full time as a Registrar in Respiratory Medicine, at the Barnet General Hospital. His main interests are Asthma and allergy and he is currently studying part time for a Masters degree in Allergy, at Imperial College London. Dr. Matthew Knight is the co-founder and non-executive director of Hampstead-based Penrose Care, a provider of home care services in London to the elderly – including to persons with dementia – and to non-elderly adults with physical and/or learning disabilities.

Penrose Care is proud to be only one of four Accredited Living Wage Employers in the London home care sector out of over 1,000 agencies and the first independent sector home care organisation in England out of over 7,000 agencies to be compliant with Citizens UK’s landmark Social Care Charter, an ethical pathway for social care providers. Penrose Care provides short care at home visits, day sitting, night services including sleepovers, and live-in care services.

References

1) “G8 ‘will develop dementia cure or treatment by 2025′”: 10 Dec 2013 (BBC News, 2013), http://www.bbc.co.uk/news/health-25318194

2) What is dementia? Fact Sheet: March 2012 (Alzheimer’s Society, 2012) http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=106

3) About Dementia – Dementia Guide (NHS, accessed 11 Dec 2013) http://www.nhs.uk/Conditions/dementia-guide/Pages/about-dementia.aspx

4) “Dementia: Five Priorities”: 10 Dec 2013 (BBC News, 2013), http://www.bbc.co.uk/news/health-25263341

The Guardian Social Care Network and Department of Health’s recent homecare survey (1) found that one of the three key factors of offering good homecare was “friendly, respectful, capable care workers” – in summary, those special people who have a vocation to care.

When in 2012 Dr. Matthew Knight and I founded Penrose Care, a homecare provider based in Hampstead, London, our goal was to find these special people and put them to work looking after the elderly and disabled. Paying the London Living Wage in a sector that struggles to even comply with the National Minimum Wage (2), we felt, was essential to achieving this goal.

As Living Wage Week 2013 marks one year since Penrose Care became one of the UK’s first Accredited Living Wage Employers in the home care sector, we now have hard facts we can share. Since there are only four of us in London out of over 900 homecare agencies – we have unique insights.

It is difficult to teach friendliness and respect and so the best thing is to hire care workers who already possess those qualities. Being a Living Wage Employer has helped us attract excellent workers like Perrine, a degree educated young woman who discovered her vocation to care while caring for the infirm in Lourdes, France. She is a model of a care worker who is friendly, respectful, and capable and she can pursue her vocation at Penrose Care because we pay a Living Wage.

The results of hiring individuals like Perrine, along with adhering to other ethical practices outlined in Citizens UK’s landmark Social Care Charter (3), are stark.

Whereas Guardian’s survey found that less than half of respondents had a positive experience with care staff, all our client feedback to date has been excellent. This is exemplified by our being the only home care agency with a 5/5 Star Rating on NHS Choices (4) within a 3 mile radius of our branch.

The Equality and Human Rights Commission (5) has linked low-pay with the issue of high staff turnover and non-continuity of care staff. At Penrose Care, we have had no care worker leave voluntarily. We strongly associate this with being a Living Wage Employer (6) (7).

Moreover, the attributes of being friendly and respectful should extend to care organisations as well. A great benefit of the voluntary nature of the Living Wage is that it gives employers an ability to give a credible signal to the public that we are ethical.

This is hugely beneficial as just increasing funding of the care system will not necessarily imply care firms will be more ethical. Sweden, which has the highest proportional public funding for home care in Europe, has suffered its own care scandals (8) by independent sector enterprises.

Penrose Care looks forward to continuing to work with the Living Wage Foundation and Citizens UK in promoting ethics in social care.

Robert Stephenson-Padron is Penrose Care’s managing director. Prior to founding Penrose Care in 2012 with Dr. Matthew Knight, Mr. Stephenson-Padron was a healthcare equity research analyst at Merrill Lynch in London. Prior to joining Merrill Lynch in in 2010, Mr. Stephenson-Padron was a healthcare equity research analyst at Barclays Capital, also based in London. From 2003-2008, Mr. Stephenson-Padron was a research assistant to epidemiologist Prof. Alison Galvani of Yale University.

Penrose Care is proud to be only one of four Accredited Living Wage Employers in the London home care sector out of c 925 agencies and the first independent sector home care organisation in England out of nearly 7,000 agencies to be compliant with Citizens UK’s landmark Social Care Charter, an ethical pathway for social care providers. Penrose Care provides short care at home visits, day sitting, night services including sleepovers, and live-in care services.

References

(1) “Time, pay and lack of training are main challenges for homecare staff”: 30 Oct 2013 (Guardian, 2013), available here.

(2) “Care budget cuts by councils put older people’s rights at risk, says report”: 08 Oct 2013 (Guardian, 2013), available here.

(3) London-based Penrose Care backs Citizens UK’s landmark Social Care Charter: 22 Oct 2013 (Penrose Care, 2013), available here.

(4) Home care (NHS Choices, accessed 08 Nov 2013), available here.

(5) Home care commissioning practices by local authorities must protect older people’s human rights: 08 Oct 2013 (Equality and Human Rights Commission, 2013), available here.

(6) Paying the Living Wage benefits business as well as employees: 04 Nov 2013 (The New Economics Foundation, 2013), available here.

(7) An independent study of the business benefits of implementing a Living Wage policy in London: Feb 2009 (London Economics, 2009), available here.

(8) “Stockholm elderly care scandal widens”: 02 Nov 2011 (The Local, 2011), available here.

Penrose Care is please to see a move in government policy the recognises both the desire of the elderly to stay in their homes and the need for care to be adequately funded.

The deferred loan scheme (1) for social care loans proposed by the Local Government Association (LGA) offers a pragmatic solution to providing high quality care, by allowing care costs to be borrowed from a government backed scheme and repaid at the end of life from the user’s estate.

The challenging demographic situation across Europe and the developed world, with ageing populations and shrinking work forces, means that government funded care is likely to continue to face significant funding pressures.

By recognising the need to fund care properly and provide the elderly with a form of liquidity at their time of need, schemes like this will enhance the quality of life and care of many elderly people who will benefit from having dignified personal care in their twilight years.

References

(1) “Councils call for national old age social care loans scheme”: 07 Nov 2013 (BBC News, 2013), available here.
Dr. Knight trained as a doctor at the Royal Free Hospital School of Medicine, Hampstead and University College London (UCL). He then undertook his postgraduate training in Internal Medicine, based in north west London, and is currently working full time as a Registrar in Respiratory Medicine, at the Barnet General Hospital. His main interests are Asthma and allergy and he is currently studying part time for a Masters degree in Allergy, at Imperial College London. Dr. Matthew Knight is the co-founder and non-executive director of Hampstead-based Penrose Care, a provider of home care services in London to the elderly – including to persons with dementia – and to non-elderly adults with physical and/or learning disabilities.

Penrose Care is proud to be only one of four Accredited Living Wage Employers in the London home care sector out of c 925 agencies and the first independent sector home care organisation in England out of nearly 7,000 agencies to be compliant with Citizens UK’s landmark Social Care Charter, an ethical pathway for social care providers. Penrose Care provides short care at home visits, day sitting, night services including sleepovers, and live-in care services.

At Penrose Care we have long been concerned that poor conditions for home care support workers are in large part responsible for driving down standards of care for some of the most vulnerable members of our society. It is for this reason that we have actively worked with Citizens UK and the Living Wage Foundation in raising standards and were one of the first care companies in the UK to adopt the London Living Wage.
A recent article on the BBC News website(^1) aptly describes the current crisis. The Equality and Human Rights Commission in its detailed home care report ‘Close to Home’ concludes that the way in which care is commissioned by local authorities may increase the risk of older people suffering human rights abuses(^2).

We believe that the work of home care workers (Support Workers) is complex, requiring patience, compassion and technical skills. At Penrose Care we are committed to creating the best working environment to support our staff in caring for those in need- we constantly strive to deliver home care with a human touch.

The following quote from the Cavendish review describes the challenges faced by care workers in the community:

“The phrase “basic care” dramatically understates the work of this group. Helping an elderly person to eat and swallow, bathing someone with dignity and without hurting them, communicating with someone with early onset dementia; doing these things with intelligent kindness, dignity, care and respect requires skill. Doing so alone in the home of a stranger, when the district nurse has left no notes, and you are only being paid to be there for 30 minutes, requires considerable maturity and resilience.”(^3)

The Commissions report in particular criticises the practices of short visits and not paying staff for commuting time between client homes (which reduces the actual hourly rate of pay by some 19%(^4), and often takes it below the National Minimum Wage).

Penrose Care provides Home Care in London and surrounding areas, and is based in Hampstead, North London. We have what we believe is a simple strategy for delivering high quality care- a strategy we have been successfully executing since our foundation in 2012:

• Select staff both on their technical abilities and their human qualities. At Penrose Care we only take on staff that we are truly happy with, which means we are willing to temporarily fore-go growth for the sake of maintaining the excellence of our staff and services. We only take on clients when we have appropriate staffing levels
• We pay staff a fair wage- we set our minimum pay as the London Living Wage. At Penrose Care we believe that our staff deserve to be paid a living wage to help them feel more secure and confident so they in turn are better able to help our client feel secure
• We pay staff for things a decent company would pay but which is not common in the social care sector such as travel time between client homes, training time, and staff meetings. The majority of home care workers in the independent sector are only paid for direct care time(^5), as in not paid for their travel time. This unjust practice has come under heavy criticism from the Equality and Human Rights Commission, the UK Home Care Association and Citizens UK. We pay our staff from the beginning of the working day until the end of their shifts.
• We invest in training staff properly and maintaing their levels of knowledge. Penrose Care has one of the longest induction training programs in the sector – 12 days. We have regular educational updates for our staff and aim that all staff will fulfill sufficient continuing professional development education per year.
• At Penrose Care we do not do ‘short’ visits for purposes of personal care (washing, bathing, feeding). Our minimum visit length is 1 hour for visits involving personal care (we will do shorter drop in visits for security purposes during the day as part of a care package). We believe that both those we care for and our Support Workers (Home Care Workers) benefit from having a longer minimum visit time. Human interaction is a vital, yet unmeasurable, part of care. We structure our care plans to ensure that care does not need to be rushed or hurried through.

The results of our ethical practices speak for themselves: we have had only excellent client feedback, we’ve had no voluntary staff leavers since our inception, the Care Quality Commission found us to be compliant with all care standards, and our staff is made up of substantially high calibre personnel than is typical in England’s social care sector.

References

(1) “Concern over home care worker ‘poor’ conditions”: 08 Oct 2013 (BBC News, 2013), available here.

(2) Close to home recommendations review (Equality and Human Rights Commission, 2013), available here.

(3) The Cavendish Review (HM Government, July 2013), pg 7, available here.

(4) An overview of the UK domiciliary care sector (UK Home Care Association, Feb 2013), pg 8, available here.

(5) Time to care (Unison, 2012), pg 21, available here.

Dr. Knight trained as a doctor at the Royal Free Hospital School of Medicine, Hampstead and University College London (UCL). He then undertook his postgraduate training in Internal Medicine, based in north west London, and is currently working full time as a Registrar in Respiratory Medicine, at the Barnet General Hospital. His main interests are Asthma and allergy and he is currently studying part time for a Masters degree in Allergy, at Imperial College London. Dr. Matthew Knight is the co-founder and non-executive director of Hampstead-based Penrose Care, a provider of home care services in London to the elderly – including to persons with dementia – and to non-elderly adults with physical and/or learning disabilities.

Penrose Care is proud to be only one of three Accredited Living Wage Employers in the London home care sector out of c 925 agencies. Penrose Care provides short care at home visits, day sitting, night services including sleepovers, and live-in care services.

The UK is not alone in experiencing the challenges of providing for an increasingly aged population. In 2012 the Office for National Statistics report on Pension Trends and a changing population^1 sharply drew our attention to the demographic challenges of the next 50 years.

In 2010 17% of the UK population was aged over 65, by 2051 this is projected to be greater than 24% (and the percentage over 85 years of age will increase from 2% in 2010 to over 7% in 2051). In 2010 there were 3.2 15-64 year olds for every 65 year old and above. In 2051, if projections are correct, there will only be 2.0- in other words the number of working people supporting 1 pensioner will fall from 3.2 to 2.0. Furthermore life expectancy continues to rise and birthrates continue to fall. The UK has been in state of sub-replacement fertility since 1973- that is that the birthrate is not sufficient to maintain long term population stability^2 resulting in an increasingly elderly population and a reducing ‘economically productive’ population.

This realisation led to substantial reform of the pension system in the United Kingdom, and around other European countries^3. In particular in the UK an increase in the age of retirement and a significant reduction in the benefits received by people in public sector pension schemes.

Whilst projected spending on pensions, health and social care is increasing under the terms of the current spending review (spending on pensions will from 11.7% of total government spending in 2004 to 14% in 2017 and NHS spending from 17.9 to 19.4% of total government spending^4 it is unlikely that the rate will increase sufficiently to provide for all the ongoing needs of an ageing population. A recent report to the Scottish Assembly indicates that the cost of providing elderly care has escalated by over 150% in the last 7 years^5 and health minister, Norman Lamb MP is engaged with talks with care providers around the UK to ensure a ‘crisis’ in home care similar to crises in nursing homes and Mid Staffordshire hospitals, do not occur in the home care sector^6.

At Penrose Care we believe that to ensure good quality and high standards of care starts with recruiting and retaining high quality staff, based on their compassion and dedication to care. This can only be done if staff are trained, paid and treated properly. This however requires significant investment in Elderly care service. During a time of economic crisis, where this money comes from- the State, the individual or a mixture of both- is an ongoing and highly charged debate. Yet a solution needs to be rapidly found as the future of care for our elderly is at stake.

In this Quality in Elderly Care series we will be posting short articles discussing issues in elderly care, drawing on examples from around the world. We hope you find this series interesting- and we welcome feedback or contributions- enquiries@penrosecare.co.uk

References

^1 Pension Trends (ONS, 2012), available online here.

^2 Smallwood, Steve and Jessica Chamberlain, “Replacement fertility, what has it been and what does it mean” (Population Trends, 2005, v119), p. 16, available online here.

^3 The single-tier pension: a simple foundation for saving (DWP, 2013), available online here.

^4 Crawford, Rowena, “Spending through the decades”: 25 June 2013 (BBC News, 2013), available online here.

^5 “Personal care costs rise by 150% in seven years”: 28 Aug 2012 (BBC News, 2012), available online here.

^6 “Disabled and elderly home care: Crisis talks being held”: 13 Jun 2013 (BBC News, 2013), available online here.

Dr. Knight trained as a doctor at the Royal Free Hospital School of Medicine, Hampstead and University College London (UCL). He then undertook his postgraduate training in Internal Medicine, based in north west London, and is currently working full time as a Registrar in Respiratory Medicine, at the Royal Brompton Hospital. His main interests are Asthma and allergy and he is currently studying part time for a Masters degree in Allergy, at Imperial College London. Dr. Matthew Knight is the co-founder and non-executive director of Hampstead-based Penrose Care, a provider of home care services in London to the elderly – including to persons with dementia – and to non-elderly adults with physical and/or learning disabilities.

Penrose Care is proud to be only one of three Accredited Living Wage Employers in the London home care sector out of c 925 agencies. Penrose Care provides short care at home visits, day sitting, night services including sleepovers, and live-in care services.

Yesterday, 31 Jan 2013, the NHS Health and Social Care Information Centre (HSCIC) published the fiscal year 2011-12 (fiscal year ending March 31, 2012) data on England’s expenditure and unit costs in providing personal social care services and it reveals a social care sector in north west London which is in a far more severe funding crisis than we at Penrose Care initially anticipated.

When reading the below data keep in mind that according to data from ONS (2012), the 65+ population in Camden is projected to increase by 2,566 to 26,735 in mid-2021 from 24,169 in mid-2011. The 65+ population in Westminster is projected to increase by 6,178 to 30,801 in mid-2021 from 24,623 in mid-2011.

Camden Council’s expenditure on home care fell a whopping 20.7% year-on-year in FY2011-12

Within Camden, Penrose Care’s home council area, FY2011-12 gross council expenditure on adult residential and nursing care and home help/care declined 10.7% year-on-year (“yoy”) to £51.4mn from £57.6mn and the number of weeks of adult residential and nursing care and home care provided fell 3.7% yoy to 81,104 in FY2011-12 from 84,756 weeks in FY2010-11.

Camden’s expenditure on home care specifically fell a whopping 20.7% yoy in FY2011-12 to £10.7mn from £13.5mn in FY2010-11. The average unit price paid by Camden Council paid to independent home care providers fell 6.7% to £19.61/hour.

The pain has been felt in both residential and nursing care as well as home care. The total number of weeks of older people supported in council-funded residential and nursing care in Camden fell by 11.4% yoy and the number of council-funded home care “contact hours” fell by a staggering 15.0% to 545,426 hours in FY2011-12.

On a positive note, 95 more adults in Camden received direct payments at the end of FY2011-12 bringing the total to 535 from 440 at the end of FY2010-11. However, total funding for direct payments only increased £969,000 vs the decline of £6,153,000 in gross expenditure on residential and nursing care and home help/care for all adult client groups in FY2011-12 vs FY2010-11. The average gross weekly expenditure on direct payments per adult receiving direct payments at 31 March 2012 was £192.74/week, a slight increase from £192.00/week in FY2010-11.

Westminster Council’s expenditure on home care fell a horrendous 30.6% year-on-year in FY2011-12

In Westminster, the council area where St John’s Wood and Maida Vale are located, FY2011-12 gross council expenditure on adult residential and nursing care and home help/care declined 18.8% year-on-year (“yoy”) to £54.5mn from £67.1mn achieved by gutting payment rates as the number of weeks of adult residential and nursing care and home care provided actually increased quite dramatically by 10.2% to 97,522 in FY2011-12 from 88,457 in FY2010-11.

Westminster Council’s expenditure on home care fell a horrendous 30.6% yoy in FY2011-12 to £13.3mn from £19.1mn in FY2010-11. The average unit price paid by Westminster Council to independent home care providers fell 19.5% to £17.07/hour.

Despite the increase in the number of weeks adults received some sort of council-funded care in Westminster in FY2011-12, the provision of care to elderly in residential and nursing care and adults receiving home care both declined in FY2011-12 vs FY2010-11. The total number of weeks of older people supported in council-funded residential and nursing care in Westminster fell by 6.0% yoy and the number of council-funded home care “contact hours” fell 13.7% to 775,253 hours in FY2011-12.

The number of direct payments recipients in Westminster declined by 110 people to 395 in FY2011-12. As a result, spending on direct payments declined by 8.1% yoy to £5.6mn despite a 17.3% yoy increase in the average direct payment to £272.18/week from £231.95/week.

Conclusion

This newly released data demonstrates the necessity of what we are committed to doing at Penrose Care – providing excellent care with compassion – and highlights the need for the independent sector to improve the lives of numerous individuals who have or are going to be negatively adversely impacted by the ongoing public social care austerity measures in Camden and Westminster.

In our commitment to excellence in care, we are proud to remain north London’s only home care provider to be an Accredited Living Wage Employer (according to the Living Wage Foundation’s most recent accreditation list published 24 Dec 2012) – as we recognise that care professionals must themselves be well treated and feel secure to help ensure they treat our loved ones well and help provide them with a sense of security.

References

Accredited Living Wage Employers: 24 Dec 2012 (Living Wage Foundation, 2012), available online here.

Personal Social Services: Expenditure and Unit Costs, England 2010-11: 29 Mar 2012 (NHS Information Centre, 2012), available online here.

Personal Social Services: Expenditure and Unit Costs, England 2011-12: 31 Jan 2013 (NHS Information Centre, 2013), available online here.

Subnational population projections for England, Interim 2011-based: 28 Sep 2012 (ONS, 2012), available online here.

Robert Stephenson-Padron is Penrose Care’s managing director. Prior to founding Penrose Care in 2012 with Dr. Matthew Knight, Mr. Stephenson-Padron was a healthcare equity research analyst at Merrill Lynch in London. Prior to joining Merrill Lynch in in 2010, Mr. Stephenson-Padron was a healthcare equity research analyst at Barclays Capital, also based in London. From 2003-2008, Mr. Stephenson-Padron was a research assistant to epidemiologist Prof. Alison Galvani of Yale University.

Government proposals to limit the contribution of individuals to their care costs to £75,000 over a lifetime are promising. More interesting was MP Norman Lamb’s proposal to create a more ‘decent’ society. By this he meant one in which the local community is engaged and supports the elderly living in their own homes. This comes as part of the governments campaign to reduce the number of admissions to elderly care homes and nursing homes.

How can we in our local community help provide a safer place for the elderly? Being aware of your neighbours and being neighbourly is a good start. Yet the hectic nature of people lives in London today mean that often we do not get to see or meet our neighbours from one week to the next.

Recreating the village atmosphere is not something that can be legislated for. However, proposals such as neighbourhood watch extending to neighbours being aware of vulnerable people in their community are promising.

As we age we often become less able to participate in the local community and risk disappearing or becoming invisible, just at the time when perhaps the help and support of the local community is most needed.

Home care and home living support is designed to help support living in the community by making a thorough care assessment of a persons needs, and providing appropriate physical and personal support in their own homes and community, enabling them to live as full a life as possible.

By supporting not just physical needs such as washing and dressing but also by providing the opportunity to socialise and be as active as possible in the local community, quality of life is improved and neighbours are supported in supporting each other. When doing a full physical care assessment, the need to get out of the house and participate in community life must not be overlooked as this is vital to the spiritual and psychological welfare of those who might, without help, be housebound.

We look forward to the upcoming government review and hope to be able to support and implement suggestions for improving the lives of those we care for.

References

Dale, Samuel, “Govt pledges LTC funding reforms ‘before March Budget’”: 24 Jan 2013 (MoneyMarketing, 24 Jan 2013), available online here.

Kirkup, James, “Neglectful Britons blamed for forcing elderly into care homes”: 31 Dec 2012 (The Telegraph, 2012), available online here.

Ross, Tim, “Elderly care reforms will have to wait, warns Chancellor”: 21 Sep 2012 (The Telegraph, 2012), available online here.

Dr. Knight trained as a doctor at the Royal Free Hospital School of Medicine, Hampstead and University College London (UCL). He then undertook his postgraduate training in Internal Medicine, based in north west London, and is currently working full time as a Registrar in Respiratory Medicine, at the Royal Brompton Hospital. His main interests are Asthma and allergy and he is currently studying part time for a Masters degree in Allergy, at Imperial College London.

Note: As part of Penrose Care’s commitment to our local community, Penrose Care screens and trains volunteers to provide occasional companionship to vulnerable individuals residing in north west London. More information can be obtained by visiting our Volunteer Corp page: https://penrosecare.co.uk/volunteer_corp.html

Professor Karol Sikora of the University of Buckingham believes that part of the reason that the elderly receive less treatment is due to generational differences in deference towards professionals. In this short video he advocates one simple method to help improve the quality of care you receive. Ask the specialist seeing you “Why is a more invasive treatment not suitable for me?”.

We believe that attending a medical appointment with a friend, family member or another person who can help to support you as a patient and if necessary act as your advocate is a vital part of achieving better care.

The healthcare professionals looking after you will be working their hardest to provide good quality care, but assumptions about quality of life are often made in the cases of elderly patients, and in the busy and hectic environments of hospitals and clinics, it is vital to communicate your feelings about the type of healthcare that you would want.

References

20 Dec 2012, “Cancer expert admits ageism exists in NHS”: 20 Dec 2012 (The Telegraph, 2012), available online here.