We must improve the social care complaints system

Dear Vixl,
I have seen the developement of both the Private Sector and the Public sector over a period of 30 years and have been directly involved in the transition between the Care of the elderly from the 20 bed Geareatric Wards in Hospitals Run by so called experts into Nursing Homes with single ensuite bedrooms with spacious Lounges and dining rooms with in house entertainment etc. mostly managed and run by staff from the old wards unencombered by the so called experts and all done at a quarter of the cost of the NHS . I am proud of what we have acheived, all done at a pittance of what has been thrown at the NHS .Why has no one done a “value for money exercise” on this I am sure if one involves the client/ patient in this exercise they will soon get the message that the Public ,in general, really do appreciate the value for money that the Private Sector offers as in hotels one cannot expect a the Ritz at the price of a Travel Lodge. Bye the way I do not class the NHS provision as the Ritz in this equation

ABSOLUTELY John.

Your comment covers everything but the biggest problem of getting them implemented is that they will have to be put in place by the very people who appear to be, on past and existing experience, the least likely to understand why and how… and unwilling to involve others who do.

Still, when their example is set by our politicians, what else can one expect?

I agree with you and it perplexes me. In the UK we have top flight Universities and Schools in every appropriate discipline, Royal Colleges rich in eminent practitioners in every field of mental and physical illness or disability, a Civil Service stuffed with golden brains, a whole legion of Commissions and Champions, and a voluntary sector that is intelligent, observant, supportive, and compassionate – and not without resources. I cannot see why these powerful forces cannot be brought to bear on the problems; obviously it is not a national priority in the same way as other issues are [like plastic bags, wind farms and the TV licence fee]. Of course, we also have politicians, a taxation system that does little to assist those struggling to care for their elderly relatives [unlike the tax benefits for raising children], and a private care sector that has access to capital but cannot repay it from its nett income at commercial rates of interest and still provide the quality of care required; in that scenario something has to give and since the bankers won’t relent the standard of care has to suffer, and the residents and their families and the staff also have to suffer. Do we just put up with this depressing state of affairs or can we do something about it collectively, as a country, with a goal, and an ambition to achieve it against all odds? I have a feeling that once we crack the problem of looking after our elderly in a decent and dignified way a lot of other issues will pale into insignificance and so much competent energy will be released into more productive activities that the benefits would be out of all proportion to the costs [for those that must first have an economic justification for everything]. I also think we should not overlook the role of domicilary care in looking after those who do not need full-time residential care but nonetheless require help and support at certain times every day. At the moment this is also a fragmented, haphazard, inadequate, and grossly under-regarded part of our social care system subject to the whims and caprices of local and national politicians in the allocation of resources.

Dear John,
As you have offered an answer to the problems of the Private Sector (Bankers etc.) faults may I veture to give you a similar simplistic answer to your first oberservation regards to the Public and Voluntary Sector, may I suggest that if they practised a half of what they preached a considerable number of them would be redundant is it maybe all a matter of self preservation.
At least the Private Sector have to give value for money otherwise the Public would not support them, this is not the case for others mentioned.
I am sorry if you think this is to simplistic but space is limited and I have not enough time to go into years of pratical experience which leads me to this conclusion.
You are also correct in stating that the Politicians haven’t the guts for it, maybe Gerry Robinson someone else quoted might be the man ?
You seem to haved missed a very big player in this farce and that is Unison , this Union is very involved in the Publuc Sector and has members in all levels including even places like the BBC.
Over the years I have noticed many instances where they have been involved in policy making decisions, I realy think they could easily be as important as say the Bankers.
Just making room for thought as they say

Dear John,
I did say my comment was simplistic, but since you ask, UNISON actual have tried to enroll both Nursing and |Care staff from within the Private Sector with little success.
After the vote rigging scandal which was so well dealt with by the Labour Party are you honestly telling me that our Unions including Unison are lilly white and not prone to political pressuring.

If Unisons intentions wer as well meaning why do the only concetrate their efforts against the private sector, why do they not do more to support whistleblowers within the NHS etc why do they not encourage their members at the BBC to highlight the massive problems at say the midstaffs hospital, surely this one sided approach taints what good work they do with nepotism (I think this is the correct word).

I do not agree with your statement with regards to either Government trying to get something on the cheap ,over the years, all Governments have thrown billions at the NHS and other Public Services and they always ask for more. On discusion with friends, who are Public Servants,
most are prepared to admit this and when pressed most of them agree the problem lies in bad senior management and collosul wastage. It seems however that they would rather promote blatantly bad management to more senior positions (BBC & NHS)rather than grasp the nettle an sack them. The Public Sector needs to get its act together and give the British Publlic “Value for Money” ,just out of interest are you aware that the NHS hs millions of pounds outstanding for treat ment given to so called medical tourist and cannot be bothered to collect it.

Gerald . . . a few points in response:

I am not surprised Unison have little success in recruiting nursing and care staff in privately-run establishments. That is unfortunate because I see trade union involvement as a positive influence in not only improving workers’ conditions but in supporting management in resolving issues and raising standards. Having disgruntled staff with no trade union support and an unresponsive management is not a recipe for a happy and well-run care home. I appreciate managements’ difficulties but I have seen how responsible trade union consultation and participation can actually make things much easier. A lot of little niggles can get nipped in the bud and the organisational culture improves for everyone’s benefit.

I presume Unison always acts in support of its members in dealing with workplace issues. I know nothing about any political involvement and I don’t know enough about the “vote rigging scandal” to judge whether that is relevant.

I expect Unison believes adult social care services would be better run by the public sector [as indeed the domicilary side largely is – by local authorities]; that is probably the collective view of Unison’s membership and they naturally seek to represent that view to government and the media. This Conversation is about adult social care which is outside the responsibility of the NHS and the BBC.

I said that governments have been “trying to get adult social care on the cheap”. Of course they have spent billions on the NHS, as well as on education, defence, and many other state functions. But the NHS is not the chief provider of adult social care and no party has yet suggested that there be any cuts in the NHS to fund better adult social care. My point is that the under-funding cannot go on for ever and serious money will have to be found from somewhere, whether this is to directly invest in better domicilary care and provision, or in the residential sector, or through fiscal support to families and individuals to enable them to have the care they need in a suitable way at an affordable cost.

I don’t know how the BBC comes into the question again – it is not even run by the government. The NHS always has been lax in collecting payments for medical treatment where another party is liable [road accidents are a classic case and the insurance companies have got off lightly]. If the NHS were as bad as it is portrayed there would be no “medical tourists” to worry about; I’m not saying it’s a feather in our cap but I suspect it’s a consequence of the NHS being largely governed and managed by people with the health and welfare of others at heart rather than by accountants.

Getting back to the topic, the Ombudsman is telling us that “adult social care” is giving rise to an increasing number of complaints and that the majority of them are upheld. That is deeply worrying and needs addressing in a focussed way without casting aspersions over other areas of public provision.

Well John we are now fully aware on which side of the fence you are sitting ,yes let us get back to the ombudsman ,as far as I am aware a large number of the complaints you are referring to actually refer to complaints against the Public Sector and ,as you state the have increase significantlly ,particularly since the formation of the CQC in fact if you check the numbers you might find a corellation between the time when the NHS and the Council were self monitoring and the time when the CQC took over the inspection of the Public Sector, particularly when certain senior managers of the CQC got the sack for covering up the Mid staffs hospital mess and intimidating certain inspecting officers .I refer to the BBC and Unison because of their completely unfair and biased approach and I do not believe that this sort of smear campaigning is actual for the Public good.
I once again reiterate my point regards the Publics freedom of choice (promised by all governments) the figures speak for themselves, the Public want the Privalte Sector and are prepared to pay for it, I wonder what they know and you just do not seem to understand,
When you refer to “the NHS being governed and managed by people with the heaalth and welfare of others at heart ” I wonder how you can make this statement in the light of recent revelations, please explain how the promotion of the Chief exec. of the Mid Staffs to the top job in the NHS and other massive cover ups at Leeds, Bristol and currently Wales go any way towards supporting your statement..I would also like to know where Unison has been involved in protecting all their members who have been involved with whistleblowing, how have the management got away with massive intimidation and even bribery do Unison cndone these payoffs I wonder..
I believe that any discussion ralaiting to Adult Social Care has to encompass all providers, Public and Private and not just be a one sided smear campaign which some of thes discussions are turning into.

I hold no brief for either “side of the fence” and I think it would be better if we did not have this divisive approach. I have no problem with adult social care being largely provided by private organisations [and the charity sector] so long as it meets society’s requirements, and the needs of its clients. I also happen to think that private companies could make a better job of delivering daily home care sevices than local authorities, although I believe the big thing lacking in this area is consistent national standards and adequate ring-fenced funding commensurate with the needs of the local population and the realities of life in each area [e.g. delivering home care in a rural county cannot be as efficient as it might be in a city’s suburbs so it’s no good having the same targets or per capita funding]. So far as trade unions are concerned, I accept that they have many faults just as many managements are not perfect and some employees are recalcitrant; nevertheless, I firmly believe it is impossible to deliver personal social services in a residential setting or in the client’s own home without a lot more engagement with the staff employed, a proper process of participation and consultation, and an organisational culture free of blame, fear and victimisation.

Dear Papagray,
You are correct when you say that some Local Councils misdirected funding away from Care Home provision of Adlut Social care and various methods were uised to do this inclding changing criteriors , means testing etc.this was not done to save money it was mainly done to promote the”Care in your own home” dogma which these Councils supported and encouraged I am not getting involved with the merits of this scheme as I think that will resolve itself in time , I will only say that when you refer to value for money coming from the Private Sector and thick you might find that the General Public might agree with you that the Private Sector Care Homes are better value than the Public Sector.
The main reason for Councils closing down their homes to the lack of Public support because they had had not been kept up to the new standards required by CQC the” independant” regulators.
Your point regards fee setting is off the mark as all Council funded placements are set by the Councils and in general for a number of years now have been depressed by Social Services at times against their own officers recomendations .