So what do you think is wrong with the NHS and social care systems and why are they failing?

There is a distinct lack of available care staff across health and social care. This directly affecting the NHS, with delayed discharges, bed blocking and the patient flow throughout the system. It is estimated ￡900 million will be lost caring for people who are medically fit, that could be cared for in their own homes.

This, in part, is due to the lack of care staff available for what is classed as double handed care; two carers to operate the equipment and care for the patient. There is a myth that has been around for years that it is unsafe to care for highly dependent people with less than two people. Councils are spending huge sums of money on expensive packages of care. The shortage of care staff in the community also means that sustaining these packages is often difficult to achieve and co-ordinate.

Andrea Sutcliffe from the CQC raised concerns regarding the safety of the service users, A new report indicating that a quarter of all services are unsafe, they have classed this as an unacceptable level. This confirms the issues highlighted in the LGO report that cataloged the concerns about home care and care providers . Examples given were staff shortages, resulting in staff rushing around to carry out tasks in care homes and staff missing calls in home care.

The CQC highlighted poor care inspectors had found, including:

• A number of cases where residents had been put back to bed in the morning because there had not been enough staff to provide them with support in the evening. It did not consider the number of residents who were got up in the afternoon as there is no enough staff to get everyone up in the morning.
• The death of a 62-year-old man who had broken his neck in a fall from a shower chair at a care home. The company in charge was prosecuted and fined ￡190,000.
• Cases where incontinence pads had not been changed regularly and were even reused in some instances.
• A lady with serious burns after falling against an uncovered radiator at a Residential Home.
• Numerous medication errors a resident of a home who had died after errors
• Poorly managed rotas staff having to multitask between different areas kitchen and residential care
• Home care services missing calls, as well as arriving late, carried out rushed visits

Single handed care will make a difference with the correct equipment, training and education this can be achieved.

Therefore, what happens is often the vulnerable and frail elderly are medically fit to go home but cannot be discharged from hospital due to the lack of carers. Operations get cancelled, in December 2016 143 hospitals were closed for admissions, requiring the emergencies to be diverted to other hospitals. Over the three-month winter period that figure had risen to 478 closures.

One billion pounds has been invested into the system and so far, this has reported no actual benefits, the system is in crisis and is going to fail more dramatically than last winter. They have had over six months to start working towards this.

Deborah Harrison

Managing Director A1 Risk Solutions Ltd Honorary Lecturer at the University of Salford Specialists in Manual Handling online technology and Single-Handed Care [email protected] 0161 327 2195