HEATHER PET: AN EVERYDAY STORY OF INADEQUATE SOCIAL CARE?

Jo Moriarty

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AN UNNECESSARY BIOGRAPHY Heather was first heard on air in 1999 She stayed at Brookfield in 2003 following the death of her

husband, Solly, in 2002 He was a ‘reasonably successful toilet paper manufacturer’

She made another extended stay in 2008 while Ruth received treatment for breast cancer

A series of falls followed by a stroke resulted in aborted plans for: David and Ruth to buy a farm in Prudhoe (Northumberland) to be near her Heather to move to Brookfield (meaning that Jill and her writing desk had to go

to Lower Loxley to stay with Elizabeth) Heather died in a motorway service station on her way down to

Brookfield with Ruth on 28 September 2015

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CONTRASTING NETWORK TYPOLOGIES?

The Pritchards The Brookfield Archers

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Heather

?Solly

Ruth David Kenton Shula Elizabeth

PhilJill

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WHAT IS SOCIAL CARE?

Crucial difference between NHS and social care is that it is means testedRising demand for services with ageing of population and proportion of people with a disability BUTTotal spending on social care for all age groups is 10% less than in 2009 (Humphries & Appleby, 2015)Number of people receiving social care services has fallen (Fernandez et al, 2013)Care Act 2014 brought in major changes but cap on charges has been postponed until 2020

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Care and support services, also known as social care services, help people who are in need of practical support due to illness, disability, old age or a low income. Care and support services could include having a personal assistant to help you around the home, structural changes to help you move around or manage in your house, or even an alarm system so that you can call for help if you have a fall

NHS Choices

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PAYING FOR SOCIAL CARE

Means test If you have capital and savings above £23,250, then you will have

to pay for all your social care If you have between £14,250 and £23,250 in capital and savings

and you are eligible for care, your local council will contribute towards your care costs

If your capital and savings are below £14,250 and you are eligible for care, your council will pay for the costs of your care

Heather’s assets House worth £250k ?Income and savings (Life insurance policy to value of £250k)

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SELF FUNDERS

Very little known about people who fund their own social care About 40% per cent of those in care homes Perhaps as high as 57% with ‘top ups’ Highest proportions in south east and lowest in

north east (Baxter & Glendinning, 2014) Approximately 270k older people paying for help

with shopping, washing and so on (IPC, 2011)

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DUTY TO PROVIDE INFORMATION

Care Act 2014 made it clear that information needed to be provided to self funders tooWebsite survey and ‘mystery shopping’ undertaken for Independent AgeSelf funders have right to an assessment but not always made clear to people that they can ask for this

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INDEPENDENT AGE DATALocal authority Website review

scoreCare Act Compliant

Satisfactoryresponse to questions posed by ‘mystery shoppers’

Northumberland 27 Yes NoWarwickshire 27 Yes YesWorcestershire 26 Yes Yes

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Independent Age Mystery Shoppers, Range 0-40. Top scores were 27-30 (32%). Forty three per cent scored 21-26. About a third did not give satisfactory answer to 12 scenarios posed by mystery shoppers calling on behalf of a relative. Most councils are ‘doing the minimum’

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CHALLENGES OF PROVIDING SUPPORT IN RURAL AREASOlder population increasing

24% people aged 65 and over live in rural areas compared with 18% under 65

Projected increase in older population higher in rural than urban areas (Connors et al, 2013a)

Cost of providing home care more because of extra time travelling and costs of travel Providers may not see it as worth their while – rural

councils tend to pay less to companies to provide home care (UKHCA, 2015)

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A CARE HOME IN NORTHUMBERLAND IS CHEAPER THAN THE LAURELS IN AMBRIDGEWeighted average weekly fees

£ Care home £ Care home with nursing

England 569 774North East 522 631West Midlands 529 731London 628 899

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Laing and Buisson, 2014/15

By comparison, home care costs on average £15 per hour

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LINKS WITH HOUSING AND TELECARE

‘Ageing in place’ seen as preferable in policy terms and in terms of older people’s preferencesVery dependent on suitable housing optionsShortage of extra care housing in rural areas (Connors et al, 2013a)Rural residents may be unaware of housing adaptations and there is not enough suitable housing stock (Connors et al, 2013b)Slow broadband speeds and poor mobile signals may hinder widespread use of telecare

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RIGHTS AND CHOICES

Oh! I'm in such a mess.I don't know the new address - Don't even know the blessed neighbourhood. And I feel as if I mightHave to stay out here all night. And that ain't a goin' to do me any good. I don't make no complaintBut I'm coming over faint

From ‘Follow the Van’

Extra care housing x Homeshare/co-housing xHome care xMental Capacity Act and advance care plans x

End of life care xTelecare X (think no alarm)Care home √ Intermediate care √Carers assessment & support x

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DISCUSSION

Were there missed opportunities to present some of the decisions made by people needing social care support every day? Presented through reports of others – even Ruth was

often absent as a speaking characterReality is that ‘real life’ Heathers and Ruths would probably be in a similar position Changes needed to achieve ‘personalisation’ in rural

areas (Manthorpe & Stevens, 2010)17 February 2016

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SOURCES AND REFERENCES (1)

No. Link1 Silhouette of Heather in The Archers Who’s Who:

http://www.bbc.co.uk/programmes/profiles/3z3RSfvyLQxbRl4b5bDRQ5l/heather-pritchard and marmalade from The Journal: http://www.thejournal.co.uk/culture/food-drink-news/marmalade-awards-look-forward-10th-83201682 Details from The Archers website: http://www.bbc.co.uk/blogs/thearchers/entries/14fc6015-cec3-4333-8b3b-5d7583a46ac2 and http://www.bbc.co.uk/programmes/profiles/3z3RSfvyLQxbRl4b5bDRQ5l/heather-pritchard3 Various photos of the actors on The Archers website

4 NHS Choices: http://www.nhs.uk/conditions/social-care-and-support-guide/Pages/what-is-social-care.aspx Humphries & Appleby: http://www.kingsfund.org.uk/blog/2015/11/social-care-future Fernandez, Snell & Wistow: http://www.pssru.ac.uk/pdf/dp2867.pdf17 February 2016

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SOURCES AND REFERENCES (2)No. Link

6 Baxter & Glendinning: http://www.sscr.nihr.ac.uk/PDF/ScopingReviews/SR11.pdf6 IPC: http://ipc.brookes.ac.uk/publications/index.php?absid=6467 Bottery:

http://www.theguardian.com/social-care-network/2016/feb/01/care-act-social-care-councils8 Qa Research (for Independent Age):

http://www.independentage.org/media/1200922/care_act_information_and_advice_research_report.pdf9 UKHCA: http://www.ukhca.co.uk/pdfs/ukhca_the_homecare_deficit_201502_web_version_in_spreads.pdf

10 Costs of care: https://www.partnership.co.uk/paying-care-fees/paying-for-long-term-care/how-much-will-care-cost/11 Connors et al: http://www.ilcuk.org.uk/index.php/publications/publication_details/impact_of_an_ageing_population_on_service_design_and_delivery_in_rural_area12 Manthorpe & Stevens: http://dx.doi.org/10.1093/bjsw/bcp038

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DISCLAIMER & THANK YOU

The Social Care Workforce Research Unit receives funding from the Department of Health Policy Research Programme. The views expressed here are those of the authors and not the Department of Health

Thank you for listening

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