Funding Social Care in England: What the Main Political Parties Propose: UPDATE

At the time of writing this article, political parties have published their manifestos and are actively campaigning throughout the country for our votes. Predictably, there is little agreement amongst the parties on most things. There is one point, however, upon which all parties agree, and with which few people in the country would take issue: that point of agreement is that our social care system needs reforming. There is no agreement, though, about how this reform will be funded. This article very briefly looks at what the main parties propose for funding social care in England.

The week just gone, week beginning Monday 15 May 2017, saw the Conservatives publish their manifesto. The proposals contained in that manifesto for funding social care have received quite an amount of media attention. At the moment, financial help with social care fees is provided to people with savings less than £23,250. With regard to domiciliary care, the equity in your home is not taken into account (it is for residential care fees).

The Conservative's proposal is that help with social care fees will no be available for people with savings up to £100, 000. However, the equity in your home will be included in the calculation for qualifying for help with both residential and domiciliary care fees. You will not have to sell your property during your lifetime nor whilst a surviving partner is living in your home. You will, though, have to take some form of loan to pay for your care fees until your savings drop below £100,000.

The thing that occurs to me is that the long term consequence of this may be to discourage home ownership and saving and in a generation or two's time we will be back to a social care funding crisis. To prevent this occurring there may need to be penalties incurred by those who dispose of assets in their lifetime and/or some kind of social care tax or insurance. Which brings me to the Liberal Democrat's proposals.

The proposals from the Liberal Democrats include an immediate one penny rise in the basic, higher and additional rates of income tax. This will raise, it is claimed, £6 billion that will be used to fund the NHS and social care. At some future point, this one penny increase will be replaced by a health and care tax, which may involve a reform of our national insurance system. Eventually, the aim is for one health and social care budget.

Labour's proposals include developing a National Care Service for England. Social care will receive an extra £8 billion during the first Parliament of a Labour government, with an additional £1 billion in the first year. The National Health Service and the new National Care Service will require £3 billion extra in the "first years". A limit will be placed on an individual's lifetime contribution to care fees. To pay for these proposals the Labour manifesto suggests options including wealth taxes, employer contributions and/or a social care levy.

The inescapable fact is that the money to fund social care has to come from somewhere. To give more money to social care either some other area of Government spending receives less, or more money is raised. And the ways of raising more money are fairly limited.

Update

As you are undoubtedly aware, Teresa May announced last week (week beginning 22 May 2017) that, should the government be re-elected, there would be a cap on the amount that you are expected to pay for your social care; notwithstanding that this commitment was not present in the Conservatives' manifesto.

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 garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

Understanding Care Services: Reablement

What Is Reablement?

Reablement is a service offered to you to help you regain or maintain your independence and thus continue living safely in your home. Typically, it is offered to you after you have spent a period of time in hospital or where you are recovering from injury or illness.

The approach underpinning reablement is aimed at helping you to live your life independently. Reablement workers are not charged with the responsibility of doing things for you; they are responsible for helping you become confident and competent in doing things for yourself. Therefore, reablement workers should not be coming into your home to cook a meal for you; they should come in to help you learn or relearn the skills to do this for yourself.

What Is the Purpose of Reablement?

If things go well everyone benefits from reablement. You gain the skills and confidence to continue living in your home independently. You may still need home care from a home care provider; however, there is evidence to suggest that this is at a much lower level than it might otherwise have been.

Who Qualifies for Reablement?

This varies from area to area. The aim is to provide reablement services to people who will benefit from it. It is Local Authorities who oversee reablement and, as with all types of health and social care, there are limited resources available to provide the service. Some hard decisions will have to be made, therefore.

If you live in Kent, reablement is called enablement. You can find out more about what is available from Kent Social Services here and here.

How Do You Get Reablement?

The first step is to get yourself referred to the Local Authority. In Kent you can make a referral yourself; for more information go to this page. You will then need to have an assessment. The purpose of the assessment is to determine what help you need to be able to continue living your life in your home as safely and independently as possible for as long as possible.

What Is the Cost of Reablement?

Reablement is free for a period of up to six weeks. This is the case even if you normally have to pay wholly or partly for care that you are receiving. In certain circumstances, reablement may continue beyond the period of six weeks.

What Does Reablement Involve?

Everyone who has reablement is different; therefore, the detail of the service you receive will be tailored to your needs. There are, however, some common features of enablement.

The aim is always to help you regain your confidence by learning or relearning important skills to help you live independently for as long as possible. There should be a reablement plan in place that both you and your reablement workers are working to. This plan will include goals for you to aim for. These goals could include such things as walking up and down stairs and/or preparing a meal.

Who Provides Reablement Services?

It is local authorities that run the service. They may sometimes be run in conjunction with NHS Continuing Care. Local Authorities may have their own reablement workers. Alternatively, Local Authorities may use private suppliers to provide the services. It is probably that other health professionals, like occupational therapists and physiotherapists, may be involved with your reablement service. You are entitled to sort out your own enablement provider.

Whilst you are receiving reablement support, social services should be working with you to determine the care you will need when reablement finishes. Such other people as your carers and family should be involved in this planning also.

If you would like any further advice about reablement or any aspects of domiciliary care, please contact me on the telephone number or at the email address below.

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 garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

Eight Things You Should Know about Community Care Assessments from Kent County Council

Introduction

In order to get financial help from Kent social services for your home care needs there are two assessments that social services must undertake.  

To take these in reverse order; the second assessment that is carried out is a means test. This determines whether you are entitled to have your home care provision paid for in full by social services; partly paid for by social services or not paid for at all by social services –  in this last case, in other words you have to pay for it yourself. There is, though, an assessment that comes before this.

The first assessment is one of your care needs. This is known as a community care assessment. You may also hear it referred to as a care needs assessment. This article deals with the community care assessment only.  

The information that follows applies specifically to adults. It is also aimed at people looking for domiciliary care (home care) although much of what is said applies to people seeking residential care.

Here are eight things you should know about community care assessments from Kent social services. 

1. Kent County Council (KCC) has a statutory duty to carry out community care assessments. 

Local authorities, like Kent County Council, often have statutory duties placed upon them. What this means is that there exists a law that has been passed by Parliament – a law contained in an Act of Parliament, also known as a statute – that places the local authority under an obligation to do something. When such a duty exists, it is something that a local authority cannot fail to do. Such is the case with community care assessments. Local authorities, like KCC, therefore, are under a duty imposed by law to carry out community care assessments.  

2. The Duty to carry out community care assessments is interpreted in such a way that means that in practice it is highly improbable that KCC can refuse to carry out an assessment of your care needs.

The law imposing the duty says that if it appears that you may need community care services that your local authority may be able to provide then your local authority has a duty to carry out an assessment of your care needs.  

Even in circumstances where the KCC believes that you have little chance of qualifying for community care services: it must still conduct the assessment. Even in circumstances where KCC believes that you will not qualify financially for social services help: it must still conduct the assessment.

If you are disabled Kent County Council has an additional duty imposed upon it by law to carry out an assessment. 

3. If you are a carer who looks after someone (your wife, husband, relative or friend), you are also entitled to have a community care assessment. 

If you look after someone, you can request a community care assessment when the person you care for is being assessed. You are entitled to an assessment even if the person you care for decides not to have an assessment of his or her needs undertaken. 

4. To get a community care assessment your first step is to make a referral to Kent social services. 

You can do this yourself. Alternatively, a relative, friend or carer can do this on your behalf. You can also be referred by your GP or another health or social care worker. To contact Kent Social Services you can telephone: 03000 41 61 61 (text relay 18001 03000 41 61 61) or email social.services@kent.gov.uk.  You can also drop into a Gateway Plus Centre. There are several of these in Kent and you can find their locations by following this link. 

5. To get an assessment takes about 28 days from the day of referral.  

Although local authorities have a duty to conduct community care assessments, there is no duty placed on them that dictates how quickly they must deal with referrals. There are guidelines; however, and the guidelines state that referrals must be processed within 48 hours and the whole procedure completed within 28 days. Kent County Council says that in most cases it completes assessments within a month. In an emergency, a local authority can put in place temporary care services.

6. Assessments usually take place in your home.

If you are seeking home care this is the best location for an assessment to take place. It is possible for alternative locations, like a GPs’ surgery, to be used. If you are a little unsure about explaining your needs to someone, you might like to have someone with you at your assessment. This person will sometimes be referred to as your advocate, that is, someone who speaks on your behalf. 

It is also possible for assessments to be done by telephone. This may be fine for simple assessments but it is not advisable if you have more complex care needs. Telephone assessments are controversial because they can be used as a means of screening out people before the formal assessment is conducted.  

You may also be asked to carry out a self-assessment of your care needs. This may help you focus your mind on what your needs are but in no way should it be used as a substitute for a formal community care assessment.

7. Your care needs will be assessed as falling into one of four categories. 

The community care assessments measures the risk to your independence and well-being if nothing more is done – in other words what is the risk to your independence and well-being if no care is provided. 

The four categories are referred to as eligibility criteria and they are called: critical, substantial, moderate and low.These criteria are a measure of how serious your needs are. 

In the first, and most serious, category your needs are judged to be critical. If your needs fall into this category then your life may be at risk, and/or you have significant health problems, and/or you are at risk of serious abuse or neglect if nothing else is done. 

In the second category your needs are deemed to be substantial, which means that if nothing more is done you will havelimited choice and control over your living environment and/or you will be at risk of abuse or neglect. You will not be able to carry out most of your personal care or domestic tasks. 

The third, moderate category, without more being done you are not able to carry out several tasks relating to your personal care or domestic tasks. You are not able to maintain a lot of contact with society or take an active part in family life. 

In the final, low category, will not able to carry out one or two tasks relating to your personal care or domestic tasks without more being done. 

Many local authorities will provide funding for care only where your needs fall into one of the first two categories. Kent County Council provides funding for care falling into the first three categories. 

If you qualify for funding you are said to have an eligible need or eligible needs. However, even though you have an eligible need you will still need to qualify on a means test. 

8. If you are assessed as not having eligible needs, or you feel the assessment of your needs is inadequate, you can appeal. 

You must ask for the decision in writing. You need to know the reason why you have been assessed as you have. Make sure that you are aware of the local authority’s complaints procedure. Kent County council has a complaints team at: Brenchley House, 123-135 Week Street, Maidstone, Kent ME14 1RF.  Telephone:  03000 410 410 or:  Brook House, Reeves Way, John Wilson Business Park, Whitstable, Kent CT5 3SS.  Telephone : 03000 410 410. Alternatively you can email them at: complaintsteamadults@kent.gov.uk.

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 23591001843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

How to Get Financial Help for Home Care from Kent Social Services

What this Article Is About

The purpose of this article is to guide you through the procedure for gaining support from Kent Social Services for your home care needs. This applies to adults only. 

To qualify to have your home care paid for fully or in part by Kent Social Services you have to have two assessments. The first one assesses your care needs and is called a community care assessment.

The second assessment is a financial assessment that decides if you are entitled to have your home care paid for fully or in part by Social services.

Community Care Assessment

To receive funding from Social Services, the first step is to have your care needs assessed. This is called a community care assessment.  

The assessment can be done face to face or by telephone. You explain what your care needs are and Social Services use this information to decide if you are eligible for Social Services support. To arrange an assessment you need to contact Kent Social services on the following number:

03000 41 61 61 (text relay 18001 03000 41 61 61) or email social.services@kent.gov.uk.

Your needs are assessed as falling into one of four bands.

1. Critical

2. Substantial

3. Moderate

4. Low

You only qualify for Social Services support if your needs fall into one of the first three bands. If your needs are assessed as low you do not qualify for Social Services Support.

If your care needs fall into one of the first three bands, Social Services will then work out how much this will cost. This is called your actual personal budget. This is not necessarily how much you will get from Social Services. How much you get depends upon your financial circumstances.

Financial Assessment

This is a type of means test. First of all, you will be asked how much you have in savings. This does not include your home. If you have more than £23 250 you will be asked to pay for your care in full. 

If you have less than £23 250 in savings, Social Services then assess the amount of income that you receive each week. Income includes your pension and benefits. If your income is over a certain amount, you will be asked to contribute to the cost of your care. 

Everyone’s circumstances are different. However, for everyone there is a protected income level of £185.44 (in 2014-15) per week. There are various allowances that increase the amount that Social Services cannot make you use to pay for your care. Certainly if your income is below £185.44 you will not pay at all. For more information, you can take a look at this booklet. 

If you have savings between £14 250 and £23 250, Social Services assume that part of this makes up your income. For every £500 that you have above £14 250, Social Services will add £1 to you income.  

For example, if you have £16 250 in savings (that’s £2000 above £14 250), Social Services will add £4 per week to your income. So, if your income is £200 per week, the extra added on because of your savings makes your income £204 per week. 

The amount of money that you have left after Social Services have deducted all your allowances is called your available income. It is the money that Social Services assess you as having available to contribute to your care each week. Available income is your actual income less your protected income plus other allowances. 

An Example

Let’s say that you the following figures apply to you: 

Income: £250 per week

Protected income plus other allowances: £225

Therefore, your available income is £25 per week (£250 - £225) 

This means that Social Services will say that you can contribute £25 per week to your care costs. 

Now let’s assume that your actual personal budget is £150 per week. Remember that your actual personal budget is how much your care is going to cost based on how it has been assessed by social services. 

To meet this figure of £150 per week, you will have to pay £25 per week and Social Services will pay £125 per week. 

Direct Payments

Once you are receiving financial help from Social Services, make sure that you asked to receive you money by direct payments. Social Services should inform you of your right to direct payments.  

Social services can arrange everything for you. However, if you want to take control over who provides your home care you need to request to receive direct payments. If you receive direct payments it means that you are given a sum of money that allows you to purchase your care from whichever company you choose. And the importance of this cannot be overstated.  For more information about direct payments; go to this page. 

Direct payments work in a very straightforward way. KCC pay an amount of money into your bank account or onto a Kent Card. The Kent Card is a Visa debit card and you can find out more details here. You then use this money to buy your care from a provider of your choice. 

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 garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

The Important Factors When Choosing Home Care

The Care Quality Commission (CQC) recently conducted a survey in which 84% of the survey’s respondents said that choosing care (whether home care or residential care) for an older relative was stressful. I’m not sure that finding exactly breaks new ground. It is more an affirmation of what we know from our own experience or the experience of others who have sought care for loved ones. And even if you have no experience of finding care for a relative the CQC’s finding will hit you as being intuitively correct. Even the most pleasant of life’s events are stressful. Finding care for a relative does not fall into the category of pleasant events; therefore, it is of little surprise that we find it so stressful.

The CQC, incidentally, is the independent body that regulates health and social care in England. The survey was conducted during the period 7 July to 19 August 2014 and was prepared by Mumsnet for the CQC. All 259 of the respondents were users of Mumsnet or Gransnet. You can read the full report here. The survey’s publication coincides with the announcement from the CQC of the changes to its inspection regime for care homes and adult social care providers.

The survey also offers some useful information about what is important to people who are looking for care for a relative. There are a number of factors that the survey shows are of critical importance to most people looking for home care. I don’t think that this was intended to be an exhaustive list. There may well be other factors that you might add to the list. The factors discussed below just happened to be the ones that the survey chose to ask respondents about the importance that they would place on each of them. Let’s examine these factors.

Finding a homecare services that offers a choice of times for visits

It offers no surprise to me that 92% of respondents thought that this was a very or quite important factor when considering choosing a home care provider. Domiciliary care provides some very distinct advantages for its recipients. Not least of these advantages is that home care allows you to remain living independently in your home and to continue with your own routine. If, however, you are told that you cannot have the times you want for your calls the effect can be to disrupt severely the routine you are used to. 

It is necessary to be realistic and reasonable when considering the times that visits can be arranged. A good home care provider will always go the extra mile to give its customers calls at the times that its customers want. Why wouldn’t it? That is good business practice and good customer service. Sometimes, though, there will be operational and logistical challenges that make it next door to impossible to satisfy every customer with calls down to the minute. 

What is quite unreasonable, though, is for providers to dictate the times that customers can have calls. Worse than this, I should suggest, is for providers to dictate that calls will fall into a designated time slot that might span 2 or 3 hours.  

Every home care provider has times in the day that might be considered pinch points: mornings between about 7.30 and 10.30 would qualify as pinch points for most providers. If every customer wanted a call at, say 8.00, something would have to give. Of course, in reality, customers, thankfully, do not all want the same time.  Therefore, it would not be unreasonable for providers and customers to work out a schedule that allows most (if not all) customers to have a call within 10-15 minutes either way of their chosen times. 

Finding a homecare service that provides a choice around male and female carers

It is not unusual for customers to specify their preference for a carer of a particular gender. In my experience, it is more likely to be that case that a female carer is preferred – often, but not exclusively, by female customers. This is especially the case where personal care is involved. In the survey, 69% of respondents thought this was a very or quite important factor when choosing home care. 

I think it is understandable that customers will have a preference for the gender of their carer. It may be a request that some providers are uncomfortable about acceding to – and I can understand that. However, where possible I don’t think it is unreasonable to offer this choice to customers. It’s also important that carers are not placed in situations that may be acutely uncomfortable for them.  

Finding a home care provider that works well with other agencies and individuals

The precise wording of the question that the survey respondents were asked was: “How important or unimportant would you find the [following factor]: Finding a homecare service that works well with other services that are involved in the care of my parents, spouse or older relatives e.g. dentist, GP practice or social worker”, and 88% of those respondents thought that this was a factor that was very or quite important to them. 

When you think about it, carers have a role that is of central importance in the lives of their customers. Amongst a very large number of other people involved in the care of any particular individual, it is likely to be that person’s carers who have the most contact with him or her. In some cases, this contact can be several times a day 7 days a week. Little wonder, then, that the ability to work well with other agencies is regarded as so important.

And working well with these other agencies and individuals often comes down to communicating with people. The ability of human beings to use language is one of the things that separate us from the animals. I know that we are told that other animals can communicate, but none have produced the equivalent of the works of Shakespeare.

We human beings have this wonderful tool that we call language. With language: we talk to each other, we listen to others, we text each other, we use email and snail mail, we have social media presences and we read books, watch television and listen to the radio. None of those things would be possible without language. And yet so often we communicate so poorly with each other.

Finding a home care provider that communicates with key people in the customers life

As in the factor above the exact question was slightly longer. It read: “How important or unimportant would you find the [following factor]: Finding a homecare service that communicates with me effectively by keeping me updated on my parent/spouse/older relative's care and involving me in decisions.” This time 93% of respondents thought that this factor was very or quite important for them. 

The person who is being cared for has to be at the centre of everything that a home care provider does with regard to that persons care. However, it is very often the case that there are other people in the customer’s life who need to be consulted and involved in the care of that person.  

It goes without saying that providers must comply with the obligations of confidentiality that are placed on them. However, these obligations are manifestly not there to prevent significant people in the lives of customers being reasonably involved in the care being provided to those customers.  

Finding a home care provider that treats customers as individuals

This question asked: “How important or unimportant would you find the [following factor]: Finding a homecare service friendly, compassionate and well trained staff that treat my parent/spouse/ older relative as an individual, spend time with them and take into account their likes and dislikes when providing care.” I doubt that anyone will be surprised that 97% of respondents considered this factor to be very or quite important. 

There’s a lot in that question, but essentially it reduces down to that fact that everyone is different. There is no one size fits all with care. The very highest standard of care can be achieved only when it is recognised that each customer has his or her own requirements. And it’s not always possible to find these out immediately.

Home care providers will assess an individual’s needs and find out as much as possible about him or her prior to care starting. But it’s virtually impossible to discover everything immediately. And the truth is that providing care is as much about building relationships with customers as it is about the delivery of the technical side of care. Relationships evolve and as they do carers find out more and more about an individual’s preferences. Much of this is about carers building trust and confidence with their customers. 

The very best carers have outstanding interpersonal skills. In my experience, those with the very best interpersonal skills have something that just comes naturally to them. These are the people who, when their natural ability is combined with first class technical ability, make outstanding carers.

Finding a homecare service which provides specialist care for people with dementia (or similar conditions)

At first sight, it seems odd that just 71% of respondents thought that this was a very or quite important factor to be taken into account when considering home care. On reflection, however, it is understandable. In many cases, people may be looking for care that is fairly general. The relative for whom care will be provided may have no specific condition and the care sought may be quite generalised personal care, companionship or other type of care. 

However, where your loved one has a specific condition it follows that specialist care will assume far greater importance. In such circumstances, it is highly probable that you will want to find out a little more about the training and experience that potential carers have. 

In Summary

I think that what the survey tells us about the factors that are important to us when choosing home care can be summarised succinctly as providing choice, meeting needs and respecting individuality. We are all different. A generic care template is a thing of the past. Individualised care is not just what we all want; it’s what we should all be entitled to.

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 garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

Care in the Home and Charles Dickens’s Great Expectations

Home care is not a new phenomenon. People have always been cared for in the home, often, as now, by their families. The human body’s increasing fragility, frailty and tendency to infirmity with age are part of life. Great art often brings into sharp relief aspects of the human condition. Few great artists did this better than Charles Dickens, a writer who had a close connection with the Isle of Thanet, Broadstairs in particular. 

If you live in Thanet, you will probably be well aware that the annual Broadstairs Dickens’ Festival is held usually in June each year. This year it ran from the 14 – 20 June 2014. For more details about the festival, go to the website of the Broadstairs Dickens’ Festival. 

Dickens spent a great deal of time in Kent – he bought Gad’s Hill Place in Higham in 1856 and died there in 1870. The story goes that as a child Dickens would walk with his father past, and look admiringly at, the property he later bought. His father told him that he might one day live in the house should he work hard enough.  

Dickens first visited Broadstairs in 1837 and was a regular visitor to (as he called the town) “[o]ur English watering place” for the next twenty years or more. Our English Watering Place was the title of an affectionate article that Dickens wrote in 1851 in which we might detect a hint of snobbery in his description of Broadstairs’ visitors: 

“So far from being at a discount as to company, we are in fact what would be popularly called rather a nobby place. Some tip-top ‘Nobbs’ come down occasionally - even Dukes and Duchesses. We have known such carriages to blaze among the donkey-chaises, as made beholders wink.” 

To say that Dickens’s family life was not always happy is, perhaps, somewhat of an understatement. His father was imprisoned for debt when Dickens was just twelve; his marriage was anything but harmonious, and his own sons had financial difficulties of their own. And yet in Dickens’s writing we often find descriptions of home and hearth that make us long for roaring log fires, extended families and domestic happiness. One such description is found in a later novel, Great Expectations. Although the novel is one of Dickens’s most popular, the characters I’m about to describe are not, it is reasonable to say (with the exception of the main protagonist), from the premier league of the great man’s dramatis personae. 

Pip is first introduced to John Wemmick towards the end of chapter 20 of the novel. Wemmick is Mr Jaggers Clerk. Jaggers is a lawyer and Pip’s guardian. Wemmick lives with his father, whom he refers to as “aged P”, “aged parent” or sometimes just “aged”. Pip gets to meet Wemmick’s father in chapter 25. 

‘“Well aged parent,” said Wemmick, shaking hands with him in a cordial and jocose way, “how am you?” 

“All right, John; all right!” replied the old man. 

“Here's Mr Pip, aged parent,” said Wemmick, “and I wish you could hear his name. Nod away at him, Mr Pip; that’s what he likes. Nod away at him, if you please, like winking!”’ 

The aged P is one of Dickens’s comic delights and the favourite grandfather you might  (be lucky enough to) have or always wanted to have. When Pip is hurt by the evil Miss Haversham, Wemmick suggests as a remedy “a perfectly quiet day with the Aged”.  

John Wemmick lives a life that today we would describe as hitting a pretty good work life balance. By day Wemmick is Jaggers’s henchman. He is business-like, slightly feared by those owing money to Jaggers and somewhat clinical and stern. At home he is very different. He is caring, loves his home, loves his aged P and has an engagingly tender side. For Wemmick, work and home are different spheres that never connect.  

 

Wemmick looks after his aging father. Here is a touching scene of familial warmth and devotion:

“…Wemmick said, ‘Now, Aged Parent, tip us the paper.’

Wemmick explained to me while the Aged got his spectacles out, that this was according to custom, and that it gave the old gentleman infinite satisfaction to read the news aloud. ‘I won't offer an apology,’ said Wemmick, ‘for he isn't capable of many pleasures - are you, Aged P.?’

‘All right, John, all right,’ returned the old man, seeing himself spoken to.

‘Only tip him a nod every now and then when he looks off his paper,’ said Wemmick, ‘and he'll be as happy as a king. We are all attention, Aged One.’

‘All right, John, all right!’ returned the cheerful old man, so busy and so pleased, that it really was quite charming.”

Dickens didn’t just tug at the heart strings he stretched them with a winch.

There are many people today who live lives similar to that of John Wemmick. They may be unable to make such a clear cut demarcation between work and home as Wemmick, but their lives are similar in that they work and care for someone they love. For some, however, both working and caring is impossible. Many have to give up work to care for their loved ones. It is estimated that there are something like 6.5 million adult cares in the UK; that’s about 12.5% of the adult population.

Home care is not a new phenomenon. we didn't talk about domiciliary care in Dickens's day; we did, though talk about care and the home. There was little help for carers in Dickens's day. We may not yet be perfect, but today there are a few more options.

If you would like free, no obligation advice about the options for home care that might be open to you, contact Caremark Thanet today on 01843 235910, or email us at thanet@caremark.co.uk.

 

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 garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

 

 

 

 

 

 

Domiciliary Care Changes in Thanet and The Emperor’s New Clothes

The provision of domiciliary care provided by social services in Kent has recently been transformed beyond recognition. At Caremark Thanet we believe that you have an inviolable right to choose who comes into your home to care for you.   

How Your Choice of Home Care Provider Has Been Reduced

Prior to this year, 2014, Kent County Council (KCC) worked with over 120 private home care providers throughout Kent. This has been reduced to just 23. [In Thanet, there are just 3 providers. The providers from July 2017 are listed here.] However you look at it, however it is explained, however it is justified: the single, inescapable fact is that if you receive care wholly or partly funded by social services, your scope to choose your home care provider has been conspicuously reduced.  

We are acutely aware of the challenges faced by KCC. The position is very simple. Whilst there is only so much money available for domiciliary care, the demand for that care, for many reasons, continuously increases. It is estimated that the change implemented by KCC will save around £2.7 million per year. You can read more about KCC’s changes to your home care provision here.  

However much we may appreciate the fact that hard choices have to be made when it comes to using a finite resource, we cannot accept that it is correct to reduce the number of providers (a reduction that may include your existing provider) from which you may choose your home care service. Whatever benefits the changes may bring: restricting your choice is not one of them. It is well to remember the story of the Emperor’s new clothes, a fairy tale by Hans Christian Andersen. 

Hans Christian Andersen, Charles Dickens and the Isle of Thanet

Hans Christian Andersen was a visitor to the beautiful Isle of Thanet where, in 1847, in Ramsgate, he met the man he greatly admired, a man who had a long association with Kent, Thanet and, especially, Broadstairs: Charles Dickens. Andersen is said to have remarked (possibly in Danish because his English is thought to have been quite weak) that immediately upon meeting Dickens he felt that they had known each other well. Dickens was, at first, equally charmed by the Danish poet although, it seems, that Dickens’s liking for Andersen cooled somewhat.  

On Andersen’s first visit to Ramsgate, he stayed in a hotel then called The Royal Oak Hotel. The hotel still exists, known now as The Oak Hotel, located on the harbour in Ramsgate. Before Andersen returned home, he and Dickens dined in Broadstairs. The next morning, Andersen sailed from Ramsgate and Dickens was at the harbour to wave him off. 

Hans Christian Andersen was a prolific story writer. Many of his fairy tales are very well known to us. They include The Little Mermaid, The Princess and the Pea, The Ugly Duckling and, of course, a story that just seems so pertinent given the context of the changes occurring in Thanet’s home care provision, The Emperor’s New Clothes. 

The Emperor’s New Clothes
In The Emperor’s New Clothes  an Emperor is taken for a bit of a ride by a couple of tricksters who tell the him that the fine clothes that they will make him will be invisible to anyone not fit for office. No-one can see the clothes, not even the Emperor himself, because they do not exist. Everyone knows the reality but refuses to admit it, until a little boy watching the Emperor’s procession shouts out that the Emperor has no clothes.  

Fairy tales are often more than just good stories that we tell to children. They often have a moral or a message for us. The moral may be lost on us as kids, but may well resonate with us as adults. The Emperor’s New Clothes exhorts us not to be afraid to challenge what is not right. Merely conforming will not make something good which is clearly not capable of being good. To look at this form a slightly different angle, something is not necessarily good just because everyone seems to be saying how good it is. 

If your home care is wholly or partly funded by social services, the reduction in your scope to choose your home care provider is one of those things that are not good. Nothing can make this good. This Emperor may have no clothes but there is something you can do: ask social services to provide you with direct payments. 

Direct Payments

Under normal circumstance, if your home care is wholly or partly funded by social services, you have a right to receive a direct payment. Kent County Council has a helpful page about direct payments. The great thing about direct payments is that they put you back in control of choosing your care provider. 

Direct payments work very simply. Kent County Council pays a sum of money into your bank account or onto your Kent Card that allows you to buy your domiciliary care from a provider of your choice. The Kent Card is a Debit card available from KCC. For more details about the Kent Card go to this page.  

You have a right to choose who provides care in your home. You have a right to receive a direct payment if your care is wholly or partly funded by social services. Caremark Thanet are happy to advise you about direct payments. 

If you would a like free no obligation chat about direct payments contact us on 01843 235910, or email us at thanet@caremark.co.uk.

 

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 garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.