Thursday, February 28, 2013
WITH huge concerns about the budget for adult social care in the county, Councillor Martin Curtis is clear: doing nothing is not an option.
The number of older people in Cambridgeshire is growing fast – between now and 2020 there will be a 31 per cent rise in the number of over 65s.
In the same period, the number of over 90s, a group which traditionally has a high need for adult social care services, will increase by 73 per cent.
That demographic change, which is down to people living healthier for longer, means many more residents will potentially require the county council’s help.
For example, the number of Alzheimer’s Disease sufferers is expected to rise by 37 per cent by 2021, from 7,544 currently to 10,685.
Yet at the very time CCC is expecting increased demand, funding from central Government for local authorities is being cut.
That leaves Cllr Curtis, the council’s cabinet member for adult services, and Adrian Loades, executive director for adult social care, with a dilemma. How do you provide more care with less money?
Cllr Curtis is clear: “If someone needs a care package from us, they will get that package.”
People are classed according to four levels of care: low, moderate, substantial and critical.
At the moment, care workers become involved in substantial and critical cases – and that will not change, Cllr Curtis said.
Nor would it make sense to: “If we raise the threshold, a large number of people at substantial will come back to us at critical,” he said.
The council currently cares for approximately 9,000 people but if that were to rise to 12,000 or higher Cllr Curtis said their care would be met.
“It is a statutory obligation,” he said. “We have to provide care for those people.”
Yet as the council’s Adult Social Care Business Plan for 2013/14, written by Mr Loades, makes clear: “In the absence of any national resolution of the funding challenges facing adult social care, it is increasingly difficult to see how current levels of service can be maintained.”
The first focus is to stop people needing care altogether – by educating them about making healthy lifestyle choices and encouraging them to plan for old age.
The council has set up Your Life Your Choice, a website where people can complete self-assessments and get advice on where they can get help.
It is not saying that people should start budgeting for their care when they are older, but that families perhaps do need to think about how they will help a parent or grandparent in the future.
For those that do enter the adult social care system, the focus will be “reablement” – encouraging people to gain their independence.
Reablement is used at present but Cllr Curtis wants to “change thinking” so that reablement is the first option. That means patients will go through an 18-week programme where carers do not just provide care, but teach patients to care for themselves. That could mean not just dressing a patient, but helping them get to a point where they can dress themselves.
Reablement currently saves CCC between £2-3million per year, as 50 per cent of the patients who go through it do not need care afterwards.
Cllr Curtis also believed: “If you provide too much care, you’re deskilling them to the point where it has a negative impact in the future.”
He admitted that reablement does not work for everyone, but the council believes there is a possible “win-win” situation for it and patients’ families.
Most people want to live independently or be cared for at home by their loved ones, it said, pointing out that the majority of care is provided in that way.
The council’s role is therefore to give more support to families to provide that care, whether it be through low-level support, building supportive networks or creating short-break services.
One of the main goals, Cllr Curtis said was to use volunteers to reduce social isolation, which creates problems and leads to worse problems.
He added: “If someone is isolated at home and becomes depressed as a result, they might stop looking after themselves, which could lead to health problems.”
He also believed technology could be used to greater effect. For example, by having alarms that not only remind someone to take medication but monitor whether it has been done.
Cllr Curtis is calling on the Government to not only increase funding but lead the way in innovations that might provide technological advances in the provision of care.
“We are doing all of this at a time when we have got a difficult financial situation,” Cllr Curtis said. “We have to be ambitious, but what we are doing is not without risk.
“However, the real danger is that we are so scared of that risk that we actually do nothing.
“We cannot do nothing. We have to do things differently.”