The council’s community care boss has outlined a future where the elderly and those suffering from dementia will increasingly be looked after at home and “allowed” to do as much for themselves as possible.
Though the term was never used at today’s social services committee, the policy shift from institutionalised care is in essence a revisitation of the controversial care in the community programme wheeled out by the Thatcher government in the 1980s.
Director of community care Christine Ferguson told councillors the move was necessary given the cost and resources swallowed up by residential care and was part of a national programme dubbed Reshaping Care for Older People.
It also follows a collapse in demand for residential care for the elderly, in part created by an increased desire among the population to remain at home for as long as possible. There are currently only 12 people on the residential care waiting list and eight of these are already in care homes and awaiting placement at their first choice residence.
The new proposals tear up a previous agreement for 2011-14 as “unaffordable” and mean the council will scrap plans for 136 additional long term care places by 2020 which were to have included a mixture of care home places and extra care housing. Some 14 of these places were to have been at Edward Thomason and Taing House which were hailed as excellent facilities at the meeting, and are due for redevelopment in the coming year to provide residents with improved exterior social space.
The rethink will pare £35.6 million off the capital programme and save £1 million per year in running costs over the next decade. That spend would have been “neither sustainable or desirable”, according to the report.
Uncommitted capital projects such as a replacement for Viewforth, which provides a range of services for people with dementia, and Isleshaven in Yell were likely to be delayed, it added. The proposals are in line with budgetary slashes agreed by the council earlier this month.
Community care would be enabled by increasing reliance on “telehealth” and “telecare” – hi-tech remote monitoring of a patient’s health and conditions – backed up by an increased reliance on voluntary care and with an emphasis on the latest social work buzzword – re-ablement, in other words allowing people to do simple tasks for themselves.
Mrs Ferguson said: “It’s quite a stark statistic that if every single person of working age provided care that would still not be enough people to meet the needs of an ageing population in the way we do things now.”
She added: ”Institutional care settings particularly, despite economics of scale, eat up staff much more than any other model.”
Councillor Alistair Cooper raised concerns about the increasing age and frailty of people in care centres and questioned some of the basic design features of the centres, such as door widths being insufficient.
Councillor Gary Robinson wondered if it was possible to segregate patients with severe dementia within care facilities and Mrs Ferguson added that a care setting with multiple ranges of patient illness was not the best way of caring for those with dementia.
Care staff have been in the process of instituting new methods of dealing with patients over the past couple of years with a more hands-off approach to care.
Telehealth is described as the consistent and accurate remote monitoring of a patient’s vital signs, health and wellbeing through easy to use monitoring technology. The technology provides real time information and helps to identify changes to a patient’s condition, leading to earlier and better-informed interventions.
Telecare offers a way of monitoring risks to a person’s wellbeing 24 hours a day. Unobtrusive sensors are placed around the home, which automatically raise an alert if they detect a possible problem such as smoke, gas, flood or fall.
The Shetland NHS board approved the closure of 22 long stay hospital beds at the end of last year.