Wednesday 3 March 2021

Direct Payments and the Right to Choose Your Care

To Be Human Is to Choose

A very big part of what it is to be human is that you are able to make choices. And as a very wise person once wrote: even not choosing is a choice. Given that making choices is central to your humanity, is it any wonder that you are angry when you denied your right to choose. Joel Feinberg was an American philosopher. He stated that when you are subjected to paternalistic interference - interference that restricts your freedom to choose -  you feel “…violated, invaded, belittled”.

Caremark carer helping customers

Your Right to Choose Your Care Provider

There are some decisions in life that you have to make that are just so important that your freedom to choose should not be interfered with. That is not to say that you should not seek advice; indeed, that would in many cases be a sensible thing to do. Choosing your care provider, for example, is one of those decisions. Quite rightly, you will feel violated, invaded and belittled if your right to choose is denied.

The good news is that you do have a right to choose who provides your care. This is a right that should not be interfered with. This right to choose exists whether you are funding your own care or you are wholly or partly funded by social services. 

Direct Payments

A direct payment is a payment of money from social services directly to you that you will use to meet your care needs. If you qualify for help with funding from social services you will be given a personal budget. The idea behind personal budgets is to give you greater control over how your care needs are met. 

Caremark carer assisting customer

If you qualify for support from social services and are allocated a personal budget and you do not fall into a small category of persons (people with certain court orders against them) who are not entitled to direct payments, then, under the Care Act 2014, social services have a duty to provide you with a direct payment where you have requested this. 

It Is your Responsibility to Request Direct Payments

Direct payments are all about choice and putting you in control. It is very important to realise that you must request a direct payment. Social services are required to have in place "clear and swift" processes to deal with such requests. Because it is all about choice, you do not have to have a direct payment. You are free to choose. Indeed, if you choose to have a direct payment and decide after a time that it is not for you, changing your mind is perfectly fine. You cannot be forced to have a direct payment. The idea behind direct payments is to enable and empower you. To force direct payments on you would do precisely the opposite.

Direct payments are good news. There is no-one who knows your needs better that you do. You go through life making your decisions, why should it be any different when it comes to choosing something so intimate and personal as care and support. 

To repeat the point, making choices is a big part of what it is to be a human being.

01843 235910 : 01304 892448 : :

01843 235910 : 01304 892448 : :

Friday 12 February 2021

You Have a Choice: How to Choose the Care Provider You Want


You have a choice with Caremark
Making Choices with Caremark

Are You Happy with The Care Provider That Was Chosen for You?

If you are receiving home care that is funded wholly or partially through social services you have a right to choose your home care provider. There is nothing wrong with allowing social services to set up everything for you. However, you may feel that you want the independence and autonomy that comes with choosing your own provider.

How to Choose Your Care Provider

It is very simple. If you want to choose your own provider the first thing to do is ask for a direct payment. If you have qualified for social services funding, you will have been allocated a personal budget. Having a direct payment means that your personal budget is paid directly to you. This allows you to deal directly with the home care provider of your choice. For more information about direct payments, go to this article.

With a small number of exceptions, you have a right to a direct payment. 

The law is very clear about this. With a small number of exceptions, you have a right to a direct payment. Section 31 of the Care Act 2014 says that if you request a direct payment, the Local Authority to which the request is made “must” make the payment to you. In an Act of Parliament, the word “must” used in this context means that a duty is imposed on a body or bodies, in this case Local Authorities. Where there is a duty imposed on a body there is usually a right granted to another allowing enforcement of that duty. In this case you have the right to a direct payment that is enforceable against the Local Authority.

Choosing Your Home Care Provider

Once you have a direct payment, you can go about choosing your home care provider. You cannot use you direct payment for just anything. It must be used to pay for goods and services that meet your care needs. You can, however, choose your home care provider. The people who carry out your care needs assessment and financial assessment  may wish to advise you about providers ans they may suggest that you go with one of the Local Authority providers: but the choice is yours. 

There is plenty of information available about home care providers in your area. A very useful website is This site has a search facility that allows you to type in your postcode and it will return home care providers within a chosen distance of that post code.

The people who carry out your care needs assessment and financial assessment  may wish to advise you about providers, they may suggest that you go with one of the Local Authority providers: but the choice is yours. 

I have written quite extensively about choosing home care providers. You will find this article very helpful.  If you are looking for live-in care, take a look at this article.

To Summarise...

...very simply: you have a choice.

01843 235910 : 01304 892448 : :

Our Homes Are Where Our Pets Are

A Caremark live in carer can help with looking after your pets
A Caremark live in carer and help you look after your pets

It’s interesting that a comparison of the strength of our attachment to our homes is made with the attachment that we have to our pets. The strong bond that we have with our pets is another powerful reason why people choose live in care. Research conducted by the charity Blue Cross suggests that

Two thirds of UK older pet owners said they would be ‘devastated’ if they had to give up their pet to go into care.

The social isolation of the elderly and vulnerable is one contemporary of Britain’s great challenges. Many pet owners would say you are never alone with a pet, and there is some pretty weighty research to back this up.  A recent report from Mars Petcare and the Human Animal Bond Research Institute (HABRI) says

There is increasing evidence pets can play an important role in helping people feel less lonely and more socially connected.

To make the point again, pet owners would not need to be told that.

There is a further point to make on the issue of social isolation. Pet owners tend to be more sociable. More accurately, our pets make us more sociable. If you are a pet owner, you will know exactly what this means. Pet owners in general have something in common with other pet owners. More specifically, dog owners have something in common with dog owners; cat owners with cat owners. Lifelong friendships have been known to have been forged because of pets. This is what a piece of American research had to say:

Pets make people more sociable. As noted above, loneliness can be dire; isolation raises the risk of heart disease by 29% and stroke by 32%. An analysis of 70 studies featuring 3.4 million people found that people suffering social isolation had a 30% greater risk of dying in the next seven years. But 65% of the aging pet owners in the new survey claimed that their animals connected them with other people.”

If you speak with almost any pet owner, she will tell you about how her non-human companion helps relieve stress. Pet owners will each have their personal stories to tell; however, you can bet that quite a few will tell you about how their pets make them laugh, keep their blood pressure low and keep their hearts healthy.

For various reasons when we get older, we may feel that our lives lack meaning.  A life without meaning can be devastating for our well-being. Our pets can give meaning to our lives. To quote again from the American research mentioned above:

Pets help seniors stick to a routine. More than half (62%) of the surveyed seniors said that caring for their critters helped them keep a routine, and 73% said their pets provided a sense of purpose.

These are just a few reasons why our pets – and our homes – are good for us. Our pets and our homes – two things to which our emotional attachments are so strong. Is it any wonder that we do not want to abandon either? 

01843 235910 : 01304 892448 : :

Wednesday 11 December 2019

Leadership and Privileged Duties

Jemma Clayton, Kerry Hill and Xana Welch have been appointed as directors  of Caremark Thanet

The Duties of Leadership
I have recently been in the proud and privileged position to appoint three directors to Costain Care Limited, a domiciliary care company founded by my wife, Jayne, and I in 2012, which trades as Caremark Thanet. I am proud because being able to do this is the achievement (the pinnacle of achievement) of one of the principal goals that we had when we founded the company: to create career opportunities for local people. I am privileged because we and only we were in a position to make this happen.

We talk a great deal about human rights these days. A world ordered by respect for human rights is, undoubtedly, a better world than one where a human rights discourse is absent. Where there is a right there is a correlative duty that allows that right to be enforced. I find it difficult to conceive of circumstances where there is a right without some correlative duty. However, the reverse situation – where there are duties without any connecting rights – is more than conceivable.

Leaders have innumerable duties imposed upon them. Many of these duties are imposed by law and are connected to rights. However, I should suggest there exist certain duties that leaders have that are not connected to rights in any way. This means that they are duties that are unenforceable. They are duties that, should leaders wish, can be ignored. They are duties that I call privileged duties.

One such duty is a duty to create opportunities for people – particularly for employees - to develop: to develop professionally and personally; socially and culturally; in their competencies and education. Opportunities, though, must be seized. The leader’s duty ends where the duty is offered. The challenge with opportunities, certainly the opportunities that I try to create, is that they involve something for something not something for nothing, a quid pro quo not a gratuity, an exchange not a gift. For this reason, opportunities are often turned down. There is a fabulous quote attributed to Douglas MacArthur which sums up perfectly what I am talking about: “There is no security on this earth: there is only opportunity.” Spot on!  Opportunities come with risks, not guarantees. Once seized, opportunities involve hard work. Indeed, there is a great deal of hard work required just to be in a position to be offered an opportunity.

What Are Privileged Duties?
I use the word privilege here to mean an advantage granted to someone (people in positions of leadership in the context of this article) that is not available to anybody else. I use the word duty to mean a moral obligation.

Thus, I believe I have a privileged duty to create opportunities for employees. It is a privilege because I am in a position to act on this duty and create opportunities and only I occupy this position, at this particular time, with regard to this particular group of people.

It is a position of advantage because I am the only person in the world who can do this act for this group of people. It is a duty, but one that is unenforceable. I can walk away from it. I can ignore it. The world will probably be no worse if I ignore it. However; the world generally, my community more particularly and the group of people to whom my duty is owed more especially still, may benefit from my acting on my duty. My acting for the benefit of others – and in the circumstances outlined I am the only person who can act in this way and bring about this benefit – benefits everyone, including me. It adds something to the store of individual and community well-being. And being able to do that, indeed, is a privilege.

Caremark Thanet appointed three new directors from the 1st of  December 2019.  The company has been providing domiciliary care services to the residents of Thanet for over 7 years. During this time, it has developed an enviable reputation for the quality of the care it provides, the way it engages with its community and the career opportunities it creates.

I wanted Caremark Thanet to be a harbour for ambition, where talent can flourish and hard work and loyalty are rewarded. I wanted to create opportunities. The three people appointed to directorships have made a significant impact on the performance of the company. They have worked their way up through the company and with each step in their progress they have met head on Douglas MacArthur’s dictum and dealt with it with competence and confidence.

Xana joined Caremark Thanet in November 2016.   Xana has quite a varied CV. She was a foster carer for six years - 2 years with Kent County Council and 4 years privately; before joining Caremark Thanet, she had worked in care for eleven years and has also worked as a bar manager. Xana initially joined Caremark Thanet as a supervisor. Xana is appointed to the post of Director of Education and Innovation. In addition to this, Xana has been appointed as the Registered Manager for Caremark Dover.

Kerry joined Caremark Thanet in March 2017. Kerry brings vast care experience with her. She worked in both residential and domiciliary care for over 15 years as a care and support worker, supervisor and care co-ordinator. Kerry also spent short periods working in retail and hospitality. Kerry initially joined Caremark Thanet as a Care Co-ordinator. Kerry is appointed as the Director of Safeguarding and Compliance. In addition to this, Kerry has been appointed as the Registered Manager for Caremark Thanet.

Jemma joined Caremark Thanet in October 2016. Jemma has an artistic background and gained a degree in Fine Art. She has run her own business, making and selling jewellery. Jemma also worked in education administration for a number of years. Jemma joined Caremark Thanet as the Business Development Manager. Jemma is appointed as the Director of Business Development and Marketing.

And so, the challenge continues. There are, of course, risks, but these risks are monumentally outweighed by the opportunities. For me, one of the most interesting opportunities is that there are now three people in leadership positions who will have their own chances to discharge their own privileged duties.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email You can also visit Caremark Thanet's website at

Friday 15 November 2019

Could It be Sepsis? A Simple Question That Could Save Lives

What Is Sepsis?

Sepsis is a life threatening condition. The Sepsis Trust explain:

"Sepsis (also known as blood poisoning) is the immune system’s overreaction to an infection or injury. Normally our immune system fights infection – but sometimes, for reasons we don’t yet understand, it attacks our body’s own organs and tissues. If not treated immediately, sepsis can result in organ failure and death. Yet with early diagnosis, it can be treated with antibiotics."

The facts and figures on sepsis make uncomfortable reading. It is estimated that there are 52,000 deaths from sepsis each year. Now here's a shocking fact: that death toll is greater than the number of deaths from bowel cancer, breast cancer and prostate cancer combined. Yes, you read that correctly: bowel cancer, breast cancer and prostate cancer: COMBINED. That's about one death every five minutes. during the time that you are watching the latest episode of your favourite soap opera, six people will have died from sepsis. 

Caremark Thanet's sepsis awareness conference 14 November 2019

Around 25,000 children are affected by sepsis each year. It is estimated that about 25% of sepsis survivors are left living with life changing conditions. Sepsis is also a concern in the workplace.

Sepsis is sometimes referred to as septicaemia, or blood poisoning. The Sepsis Trust list some of the fairly common conditions from which sepsis can result: "a chest infection causing pneumonia, a urine infection in the bladder, a problem in the abdomen, such as a burst ulcer or a hole in the bowel, an infected cut or bite, a wound from trauma or surgery,  a leg ulcer or cellulitis. Sepsis can be caused by a huge variety of different germs, like streptococcus, e-coli, MRSA or C diff. Most cases are caused by common bacteria, which normally don’t make us ill."

The Sepsis Alliance, an American organisation say that: "Mortality from sepsis increases by as much as 8% for every hour that treatment is delayed. As many as 80% of sepsis deaths could be prevented with rapid diagnosis and treatment." There is, however, some good news. Prompt treatment is essential. It is recognised that with early detection and treatment the outlook is good. International guidelines suggest that treatment should be started within one hour of sepsis being suspected. Although sepsis is a medical emergency, prompt treatment with antibiotics and fluids is very effective.

The Signs of Sepsis

With adults the following are the symptoms of sepsis. In the early stages, these signs can be confused with the symptoms of flu:

Slurred speech or confusion
Extreme shivering or muscle pain
Passing no urine (in 18 hours or a day)
Severe breathlessness
I know something is badly wrong with me
Skin that's mottled, bluish or very pale.

Note how the initial letters spell out the word sepsis.

With children, The Sepsis Trust advise that the following symptoms indicate sepsis. The child:

Is breathing very fast
Has a ‘fit’ or convulsion
Looks mottled, bluish, or pale
Has a rash that does not fade when you press it
Is very lethargic or difficult to wake
Feels abnormally cold to touch

Where a child is under five, you should also be alerted to sepsis if he or she:

Is not feeding
Is vomiting repeatedly
Has not passed urine for 12 hours

Caremark Thanet: Could it be Sepsis?

On Thursday 14 November, Caremark Thanet held a sepsis awareness conference. The conference was held in memory of Ellie Lunn, the daughter of Caremark Thanet's Registered Manager, who tragically lost her life to sepsis at the age of just 11 months in 2015.

The conference was very well attended. Ellie's heartbreaking story was told by Xana Welch, the Registered Manager of Caremark Dover. Gemma Rawling and Angela Hall from the NHS Outreach Team spoke about the signs, symptoms and treatment of sepsis. Barbara Hall told her own moving, but ultimately uplifting, story of how she survived sepsis -  three times. Rob Mercer from the South East Ambulance Service, explained how over the last 10 years the awareness, detection and treatment of sepsis as improved enormously: medical professionals are now trained to "THINK SEPSIS". 

Caremark Thanet's epsis awareness conference was held in memory of Ellie Lunn

If there was one clear message that came from the conference it was, as The Sepsis Trust Advise: "just ask, could it be sepsis?".  Asking that question of a medical professional if you suspect that someone might have sepsis could save his or her life. Caremark Thanet, Ellie's mother, Kerry, and her family want to raise awareness of this awful condition. Increased awareness will increase confidence to ask the question: could it be sepsis? Asking that question will save lives.

Caremark Thanet, Kerry and her family intend to continue the campaign to raise public awareness of sepsis in Ellie's memory. If you would like more information please contact Caremark Thanet on 01843 235910 and ask for Xana Welch.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email You can also visit Caremark Thanet's website at

Tuesday 11 June 2019

Do you Live in Margate?

Do you want to work in domiciliary Care?

We are looking to recruit a number of people to join our team of care and support workers in Thanet. We currently provide help to around 250 people and employ over 100 people. We are particularly keen to recruit car drivers in  Margate. However, we have work throughout Thanet.

Caremark Thanet's Fun Day

We are looking for people with talent and ambition; who are flexible and reliable; and who share our ambition to transform domiciliary care. When you work for us you are never just a carer; you are one of the most important people in our business.  
Our ethos: "We believe that our customers are the most important people for our business; that our care and support workers are the most important people in our business; that a socially responsible business is most important for everyone. We are part of the service sector."
We have some fantastic opportunities for the right people. These are not just jobs; they are careers. We can offer very competitive rates of pay; petrol payments;  promotion opportunities; pensions; free uniforms, and last, but by no means least, some of the most exciting training opportunities in Thanet. 

Do you want to work for a company that has an ambitious vision? Do you want to work for a company that is uncompromisingly and unrelentingly customer focused? Do you want to work for a company that recognises and rewards your reliability, hard work and commitment? Do you want to work for a company that is engaged with the local community?

Our Vision: "To be Thanet’s first choice private domiciliary care provider for customers and carers."
Don't miss these fabulous opportunities. If we sound like a company that you would like to work for, contact us today on: 01843 235910 or email:

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email You can also visit Caremark Thanet's website at