New 'continuing healthcare' framework document - system for funding older people's homecare

If you are getting care in your home, you might find it useful to get the new NHS guidance on 'continuing healthcare'. This is the funding system for paying for homecare if you don't need to be in hospital. It's more generous and flexible that community care funding from local authorities, but you can only get it if you need healthcare (so you get this free from the NHS), as opposed to help with the activities of daily living (which you have to contribute to and get from the local authority social services). It's a stupid division of responsibilities, which comes from the fact that healthcare is legally free from the NHS, but if you don't need the health element, they don't have to pay. The social services principle is that you should be responsible for your own everyday living needs, so you do have to pay for services to help you with that.

Anyway, there's a complicated assessment process, usually done by nurses from your local health services, which is described in the 'National Framework'. A new edition has just been published, so if you want the lowdown on what they're supposed to be doing, here it is. If you want to dispute what they're saying this is a useful guideline.

Link to the new National Framework.

If you're used to dealing with the old national framework document, you might find a newsletter from the lawyers Mills and Reeve useful. The new document has some changes in practice, and the order of the old document has been mucked around. This newsletter tells you about the changes and has a table setting out where you can find the main topics in the old and new documents.

Link to the Mills and Reeve legal newsletter.

Young and old drivers criticise each other

The maga Mature Times reports an AA survey which shows that both young and old drivers think that the other generation needs training to be better drivers. The article goes on to advertise the AA's courses for upskilling drivers. It quotes several older people who have reduced their driving at some stage of life and then have to start again, perhaps after being widowed.

This happened to me: I gave up driving for several years when public transport was more convenient, and when waiting for cataracts to be ready for operating on stopped me from being safe on the road. It certainly was a nervous time starting to drive again. And I must say increasingly I find public transport a much more congenial way of getting round, at least here in London. Threats to the freedom pass are a bit of a worry.

Link to the Mature Times article.

You can't know in advance how big your pension will be (New Report)

I’m back on to pensions again. There’s a new report out. Link to the full IFS report or click the pic. 

Apparently people in late middle age don’t understand their pensions, don’t have enough information to calculate what they’re going to get when they retire, and aren’t saving enough in the present economy. As I’ve been finding out while I negotiate my own pension arrangements (and OMG as younger people say on the internet, doesn’t it take a long time), you can’t really tell what you’re going to get until it flows into the bank account. But having been in various public sector jobs for half my working life, I was forced to save more than I would have done if I’d been left to my own devices, and this is the reason I’ve done better than others who didn’t have that requirement on them.

It’s unimaginable how much you have to save of your income (and you’ve got to be both lucky and not tricked out of money by our shoddy banks) to have a reasonable income during the long period that people are now going to be retired.

The ESRC are highlighting this report from the Institute of Fiscal Studies (that’s the organisation that always gets a big press commenting on how the Chancellor of the Exchequer’s got it wrong again when he presents a budget – I always like to look at the websites of people who are well-informed and critical).

Link to the ESRC short article. 

Rights for people getting home care

I’ve always been a bit doubtful about whether the human rights law can be used on behalf of older people (or anyone else) where there are problems with care services. But a new and rather trenchant pamphlet from the Equality and Human Rights Commission gives advice, probably based on some cases they have helped with.

Link to the Equality and Human Rights Commission pamphlet on human rigts and home care.

What’s particularly intriguing about this is that it’s about home care, where the services are delivered to your home. It’s a bit more obvious that when you are in care home, because it’s someone else’s property and you are probably more disabled or frail than if you are in your own home, you are more likely to have your rights curtailed. But of course people giving you more or less the same care in your own home have more chances to interfere with your private life and are less likely to be observed by someone else doing so.

The pamphlet deals with several of the human rights enshrined in the law, and here are some examples of what it says. Anyone who works in the care services knows that some of these things happen, because of financial pressures and sheer lack of consideration. It’s not that I think people using care services should be going to law all the time, but I do think we should be thinking much more clearly about what our rights are. We can be grateful, but we don’t have just to be grateful; we are entitled to get appropriate help too.

You can see from the dots that I've edited this - there's a whole lot of useful information in the pamphlet.

Article 2 “Right to life”

Public authorities must not place your life in danger. If someone dies as a result of consistently poor treatment by care workers, this may be a breach of their right to life under Article 2. It may also be a criminal offence.

Public authorities must also act to ensure your life is protected. For example, councils must ensure your care package gives you enough support for your assessed needs…If a care worker does not raise concerns about a serious deterioration in someone’s health and this contributes to that person’s death, this could also be a breach of the person’s right to life.

 

Article 3 “No one shall be subject to inhuman or degrading treatment”

Depending on the circumstances, examples of inhuman or degrading treatment by care workers could include: repeatedly failing to change your soiled clothes or bed sheets if you are incontinent not providing you with enough food or water failing to wash you over a prolonged period if you cannot wash yourself if you are bed bound, not moving you over a prolonged period so you get severe bed sores using excessive force to restrain you.

Only the most serious cases of poor treatment will be considered a breach of this right. However, other cases may still count as a breach of your right to a private and family life, home and correspondence.

 

Article 5 “Right to liberty and security”

You have the right not to have your liberty taken away from you. You should be free to leave and return to your home at will. You should not be prevented from leaving or returning to your home by other people.

Care workers should not lock you inside your home.

They should not stop you from going outside because you have a tendency to fall or if you might get confused. To do so could be a breach of your right to liberty and security.

 

Article 8 “Right to a private and family life, home and correspondence”

You should be able to live your life as you choose. It is your right to request care workers leave your post unopened or leave you to take a phone call in a different room if you wish...

...when care workers are helping you to wash, you can very reasonably ask them to close the curtains, close the bathroom door or place a towel over you to protect your modesty.

If you cannot live with your family you should be allowed to have regular contact with them. For example, if your spouse is moving to a care home because it is unsafe for him or her to live at home, the council should not place your spouse in a care home far away, where you would not be able to visit them. In offering your spouse a care home placement, the council must consider your rights to a family life and those of your partner.

Care workers turning up late, not carrying out all of the tasks listed in your care plan or simply not carrying out tasks properly could amount to a breach of your right to a private life.

Care workers must change what they do if you ask them to be more careful, use disability equipment correctly, and not cause you discomfort or pain. If they do not respond, they could be breaching your human rights.

You might prefer to have meals being delivered to you, a laundry service, or door to door transport instead of a care worker. If you do not want care workers to visit you at home, perhaps because you find it intrusive, you do not have to accept this help.

Your care worker cannot make you wear items of clothing you do not like or would not normally wear. Your care worker cannot make you wear slippers on a shopping trip just because it is easier for them to put them on instead of outdoor shoes. If you are stopped from wearing clothing or jewellery related to your religion, this could also count as a breach of your religious freedom…

If care workers are visiting at inappropriate times to help you, this undermines your right to control your day. For example, being put to bed or being helped to eat too early or too late could be a breach of your right to a private life. If care workers are visiting at irregular hours so you cannot go out to visit friends or family, this could also infringe your right to a family life.

 

Article 9 “Freedom of thought, conscience and religion”

…Care workers should be able to help you to practice your religion. For example, if you wear a turban, hijab or a cross and chain because of your religion, your care worker should help you to continue dressing in this way. Likewise, if you follow a particular diet because of your religion, for example, a halal, vegetarian or kosher diet, you should get meals that meet these requirements.

 

Article 14 “Right not to be discriminated against in the way your human rights are protected”

Your human rights cannot be breached or enforced differently because of your age, religion, gender, sexual orientation, ethnicity, political beliefs or your disabilities. This right can only be used in connection with another article set out in the Human Rights Act. For example, a Muslim does not get halal meals, but his Jewish neighbour gets kosher meals from the same home care agency. The Muslim man is being discriminated against in the enjoyment of his right to practice his religion.