Car homes

[7daysinaweek]

11 hours ago, Mice! said:

I agree that the price increases on the PPE they want is wrong, but as others have said on other threads, they charge a lot of money for their services.  Their not NHS their mostly privately ran businesses. 

You are correct K, most residential care and nursing care homes are privately ran. The local Clinical Commissioning Group (CCG) is responsible for planning and buying health services in relation to care of the local population. The local authority is responsible for personal care whereas the NHS is responsible for nursing care. (It can be a very complex area of when an individual has needs of both social and nursing care)  The delivery of care to residents and patients of both residential and nursing homes are owed a duty of care irrespective of nursing needs or social and correctly so. This duty of care extends to the local authority in so much that the environment and services provided  by the provider business be safe, supportive and meet the physical, emotional and social needs of the person to a minimum expected quality.

The local CCG as uses part of the "Emergency Preparedness Resilience and Response Framework" (EPRR) in order to plan for factors which could impact upon its delivery of safe care directly and on behalf of the providers among many other scenarios. Care homes are responsible for purchasing standard ppe for basic infection control measures for the staff and clients/patients alike. The local authority commissioner for NHS and social care  has responsibility for ensuring ppe that homes have  access to adequate stocks of personal protective equipment.

Standard ppe in care homes consist of the following.

Waterproof plastic standard disposable single use aprons, these come on a roll 200/1000, roll of 200 approx £10

Non sterile single use gloves boxes of a hundred approx £7, some private supply chains are now reporting wholesale supply costs increased which are being passed to end user.

Continence and cleaning wipes single use pack 50 approx £ 5

yellow/orange clinical waste bags roll 50 approx £5

Buckets and mops for separation of cleaning  infectious areas

Tuffie disinfectant wipes/Virkon/Aticholr which the home should have stock of for standard infection control cleaning of body fluids spillages, blood/vomit faeces in the spillage infection which they would be required to have in place as standard.

Continence supplies such as continence pads, catheters, catheter bags and stoma bags are in most circumstances supplied through NHS supply continence chain for the client/patient and are costed for from NHS money.

I think the last time I looked at clinical waste costs it was running around £1700 per ton for incineration for the local authority.

 

The current guidance for care homes/nursing homes staff for close contact of under 2 metres for confirmed and suspected Covid 19  is as follows :

Disposable gloves single use

Disposable plastic apron single use

Fluid resistant SURGICAL MASK tyPe 11R facial masks (FRSM) sessional use (meaning can be used for whole of session shift until break time then disposed of)

Eye /face protection glasses/face visor risk assess /sessional use which I interpret as being if patient is high risk for body fluid contact then wear.

To sum up outside of the standard carried stock prior to the pandemic I would assume that the increased costs in a monitory capacity would be the increased use  of single disposable items for the increased symptoms across more clients. Purchasing of face masks and visors, increased clinical waste costs which the local authority provides at set tariff for the home. Increase in use of agency staff costs to make up shortfall of resources from staff who are off with Covid symptoms or isolating or shielding because of a family member.  

I was going to mentally crunch some numbers but I think most will be able to if you take say 5 staff in a home for 40 clients overnight 8-8am,  8 Staff 8-8pm 13 staff per day seeing to 40 clients, bear in mind that not all clients would usually require single use ppe. However, in the present climate  re the infection control risk management all areas appear to be adopting the present guidance to take all measures at minimum to reduce risks so that means all staff wearing single use for every client contact as above.

Just of the top of my head I think other costs would be.

Minimum requirements for staff competencies.

Staff training yearly , has to be completed in line with national and local Clinical governance SOPS

infection control/food handling preparation for healthcare workers

Cardiopulmonary resuscitation training  ( CPR) (would be delivered privately at local level in the home) in a group from the external trainer ( cannot be train the trainer cascade training)

Moving and handling delivered same as above in house.

staff uniforms

Insurance vicarious liability for staff and bricks and mortar

Moving and handling equipment for individuals with specific nursing needs and mattress/profiling beds come out of local authority budget

Food for clients

probably quite a few other costs.

Sorry K I have digressed a bit as usual.

 

2 hours ago, toontastic said:

My partner works in a care home they have recently been sent a number of patients from the NHS. these people are isolated and have a member of staff living in their room with them 24/7 to limit contamination. 

As for PPE my partner has to order it in, she often finds that when she tries to order stuff she gets told they are prioritising supplying the NHS.

Hi toontastic

If there are significant concerns regarding shortage of stock that may have an impact the home the manager should contact the local Health protection team (HPT) via email and phone, they should be able to assist in prioritising  supplies to the home, they have a duty of care to protect the staff and residents. They can access ppe through NHS supply chain and local national private chains. If further concerns in relation to stock not arriving they can raise this with the local authority safeguarding team who will liaise/assist with the local CCG and I would surmise would get escalated to high priority.

May I take the time t thank your partner for working at a very challenging time.

 

2 hours ago, discobob said:

In part from what I have heard, is that some hospitals are pushing back onto care homes for them to provide care to their residents that have Corvid but who are on death's door. This is introducing an increased level of risk to the staff and homes who are now having to provide services above and beyond.

Carers, by the very nature have to get into exceedingly close contact with the residents and can't social distant themselves from them.

I do believe that there is a case for the government to ensure a supply to the care homes. But there is also a cost of a fee that the home would have to pay, if it was private. The same as would come off any hospitals budget.

Hi DB

Many hospitals are discharging patients who have deteriorated and who may be sadly approaching the end of their life. This has been usual practice for may years, approximately 20% of population die in residential/nursing homes and around 6% in hospice . A significant proportion having had a hospital admission shortly before discharge back into a community  setting as it has been identified that they are approaching their end of life. 

Patients who have unfortunately  developed  a Covid  associated pneumonia and possibly other complications may well have their needs best served towards the last weeks or days of life in residential setting. Discharging into residential care settings , hospice and  home has been been a informed  patient choice  wherever possible or a best interests for individuals when the ability to make informed decision or mental capacity is impaired, inclusive of relatives and carers input towards end of life /terminal illness and this has been the case for many years. For some patients who are gravely ill this will not be in their best interest as moving the patient from the hospital setting would cause emotional and physical discomfort and risks of death en route to home or residential care are high. Each person needs to be assessed on a individual need which meets the best interest of the patient. It must be borne in mind that once discharged into residential care that there is support for the patient not only from the care home staff towards end of life.  In many  circumstances the community specialist palliative care team, palliative care district nurse team, gp, on call gp, community matrons, urgent care response team will also be visiting in a professional capacity for  symptom management and emotional support for the individual , relatives and carers.

Many patients that have been diagnosed with Covid  will have deteriorated despite medical and nursing intervention. Just because they have had Covid that does not mean that all are still shedding the virus in its infective form/virulent element.  However I do understand  and empathise will all concerned and that there are increased risks in relation to infection control and increased workload pressures. I have always said that our country would grind to a halt without the selfless care staff who go to work day in and day out in these rewarding but challenging environments.

atb

7diaw

[The Heron]

40 minutes ago, oowee said:

You mean it's a business? Would you rather they were run by the public sector? 

No in general everything in life seems to be about money 

[Mice!]

1 hour ago, 7daysinaweek said:

Sorry K I have digressed a bit as usual.

Not like you at all😉😉

1 hour ago, 7daysinaweek said:

have always said that our country would grind to a halt without the selfless care staff who go to work day in and day out in these rewarding but challenging environments.

It certainly takes special people to work in these environments now more than ever, not something I could do.

Did you see the old boy in Preston? One of his carers had had his late wifes picture put on a cushion for him, such a sweet moment and reaction.

[7daysinaweek]

43 minutes ago, Mice! said:

Not like you at all😉😉

It certainly takes special people to work in these environments now more than ever, not something I could do.

Did you see the old boy in Preston? One of his carers had had his late wifes picture put on a cushion for him, such a sweet moment and reaction.

I did, it was very touching. 

[Jaymo]

4 hours ago, Mice! said:

 

I think you've read it wrong Jaymo, let's say the home is charging a grand a week, very expensive but let's say they have 50 residents, £50k a week then!! 

That's 2.6 million a year! Obviously there are Bill's and overheads to come off that figure, but I'll bet their making a good profit.

 

From your 2.6 million you have a building of 50 beds with a mortgage on it of say £7 mill ( I honestly don’t know how much such a building costs).

Then as 7DIAW states, the cost of say twenty staff plus management, cleaning staff, business rates, catering, insurances, maintenance, equipment and their replacement , heat, electric- the list goes on and your 2.6 mill dwindles significantly.

 

[Mice!]

55 minutes ago, Jaymo said:

the list goes on and your 2.6 mill dwindles significantly.

Obviously the 2.6m comes down it has to, but there is still a lot of money being charged and made.

[button]

19 hours ago, Mice! said:

Obviously the 2.6m comes down it has to, but there is still a lot of money being charged and made.

 Turnover £2.6m, borrowings of £3m, assumed cost of £300k per year, wages and overheads, £1.5m, £800k per tax profit ain't bad! 100% right slot of money been made!

[12gauge82]

On 24/04/2020 at 08:49, Jaymo said:

All that profit? Do you even have a clue as to what margins they have? 
There are overheads you know, Buildings/ staff/catering/consumables/insurances/ maintenance- the list goes on.

Viewing charges against unknown expenditures is purely guesswork and rather naive!  

Do you really need to be so derogatory when you disagree with something posted on here?

I actually personally know a owner of some very large care homes and believe me, they have a very healthy profit margin, I also believe Duncan Bannatyne made the bulk of his fortune from care homes so I don't think hawkfanz is far off the mark at all, which is alot more than I can say for your ramblings!

[toontastic]

Care home staff are dying just like NHS staff the only real difference is no one really gives a toss about carers.

Carers have asked for help in making sure they are provided adequate protection and there's an outcry.

Someone even mentioned being prepared with contingencies. To give an example of how things are, my partners care home has 40 patients and on an average night they use several sets of PPE. Now they are using 40 sets an hour can anyone tell me their company plans for that kind of increase. Last night one patient who they've just had transferred in from the NHS rang his alarm over  50 times during the night, that's over 50 sets of PPE just on one patient. 

Several years ago a work colleague told me his wife was a nurse and she wouldn't degrade herself to look after old people. Many local shops who have a carers hour won't allow care home staff to attend as only NHS staff are regarded as proper carers. We as a nation are happy spending billions furloughing the wages of staff employed by big business but object to helping provide life saving gear to carers. You may spout rubbish about wealthy owners but the truth is the people who look after dementia sufferers and the terminally ill are looked down upon and always have been. 

Just to add I've read a few articles about care home's and hospice's asking for help with PPE and not one of them was asking for it to be bought for them they were all just asking for government help in locating supplies, but obviously that's just a bit too much of a waste of tax payers money for some.

Edited April 25, 2020 by toontastic

[Mice!]

11 minutes ago, toontastic said:

You may spout rubbish about wealthy owners but the truth is the people who look after dementia sufferers and the terminally ill are looked down upon and always have been. 

I know what your saying, but it's not what I'm thinking. 

The hospice staff who looked after my mum where fantastic, the carers are doing a job I couldn't do. 

But the owners aren't working on the front line, yes the staff need the PPE absolutely, which means it's got to be payed for.

The big price increases need looking at, that's for sure.

[toontastic]

3 minutes ago, Mice! said:

I know what your saying, but it's not what I'm thinking. 

The hospice staff who looked after my mum where fantastic, the carers are doing a job I couldn't do. 

But the owners aren't working on the front line, yes the staff need the PPE absolutely, which means it's got to be payed for.

The big price increases need looking at, that's for sure.

But as I have said the hospice's and care home's I have read about are not asking for help to pay for it, they are after government help in finding it. Which appears to be too much of a waste of tax payers money for some.

[Jaymo]

1 hour ago, 12gauge82 said:

Do you really need to be so derogatory when you disagree with something posted on here?

I actually personally know a owner of some very large care homes and believe me, they have a very healthy profit margin, I also believe Duncan Bannatyne made the bulk of his fortune from care homes so I don't think hawkfanz is far off the mark at all, which is alot more than I can say for your ramblings!

Ramblings, hmmm pot n kettle possibly springs to mind.

Once again I surprised, then again I’m not actually, at the conclusion and unawareness of how the world of major business and economics are intertwined.

There are too many ready to judge those who have used their initiative or business acumen to build wealth, to be abhorred by so many or expected to forego this wealth? 
Why on earth should they? If they took the chance and invested in themselves and others, should they give it all away? Would you? Where is the cut off? To you it may be a million, to some I know a thousand pounds would elevate them from their current situation- I’m sure you have a thousand pounds so maybe you should throw it all into this ‘large pot’ that the rich under your reasonings, should be contributing too?

If your friends/acquaintance, has made a healthy profit then hats of to him- maybe we should all invest, or start up Care Homes?

Why haven’t we? Because in this life there are some who do and some who don’t.

Yes this post is partly aimed at your reply to my post, but also to others and other posts, that constantly bash others more fortunate or those who are thought not to deserve their wages, such as the recent reference in one thread to footballers? 

Happy weekend to all 

[islandgun]

1 hour ago, toontastic said:

Care home staff are dying just like NHS staff the only real difference is no one really gives a toss about carers.

Carers have asked for help in making sure they are provided adequate protection and there's an outcry.

 

Thats it in a nutshell......... why care who pays ? just get the ppe to those that must have it

[12gauge82]

3 hours ago, Jaymo said:

Ramblings, hmmm pot n kettle possibly springs to mind.

Once again I surprised, then again I’m not actually, at the conclusion and unawareness of how the world of major business and economics are intertwined.

There are too many ready to judge those who have used their initiative or business acumen to build wealth, to be abhorred by so many or expected to forego this wealth? 
Why on earth should they? If they took the chance and invested in themselves and others, should they give it all away? Would you? Where is the cut off? To you it may be a million, to some I know a thousand pounds would elevate them from their current situation- I’m sure you have a thousand pounds so maybe you should throw it all into this ‘large pot’ that the rich under your reasonings, should be contributing too?

If your friends/acquaintance, has made a healthy profit then hats of to him- maybe we should all invest, or start up Care Homes?

Why haven’t we? Because in this life there are some who do and some who don’t.

Yes this post is partly aimed at your reply to my post, but also to others and other posts, that constantly bash others more fortunate or those who are thought not to deserve their wages, such as the recent reference in one thread to footballers? 

Happy weekend to all 

Once again, exactly like another poster on here you've judged me by your own morals. I practice what I preach and under my very loose example of a million threshold (if things got that bad), id actually  be in the bracket that would make a heavy loss, so you can keep your pot and your kettle!

Edited April 25, 2020 by 12gauge82

[blackbird]

On 24/04/2020 at 16:11, The Heron said:

My father was recently quoted £1200 per week basic care in a Buckinghamshire care home. 

And if he had been a lazy ##### instead of looking after himself financially the government would pick up the bill.

Edited April 30, 2020 by blackbird

[Vince Green]

On 24/04/2020 at 08:10, hawkfanz said:

these places charge up to £1000 per week per resident,its up to the owners to pay for it out of all that profit.

£1000 a week? and the rest, that's the starting price round here. The one my friend's mum was in was over £2000 a week and she took her mum out because she wasn't being cared for properly.

Its not a matter of opinion its a matter of law that they are responsible for all aspects of what we can call "duty of care" for both the staff and the residents, its inescapable.

Could a H&S inspector go on a building site and say to a contractor "Where are all the hard hats, boots, goggles, gloves, hi viz etc ?" and be told "too expensive mate, they have gone up you know" the site would be closed there and then.

Mind you, I do have sympathy for the staff, they are being treated abominally 

 

[oldypigeonpopper]

hello, i just see on news some care homes are charging residents the cost of PPE and care staff having to buy their own

[toontastic]

1 hour ago, oldypigeonpopper said:

hello, i just see on news some care homes are charging residents the cost of PPE and care staff having to buy their own

My partners care home is currently getting through 20 times the usual amount of PPE.

They like a lot of care homes and hospices have asked for help in finding stocks.

I find it hard to believe some on here object to government resources being used to help them locate the stock. 

 

 

 

 

[oldypigeonpopper]

6 minutes ago, toontastic said:

My partners care home is currently getting through 20 times the usual amount of PPE.

They like a lot of care homes and hospices have asked for help in finding stocks.

I find it hard to believe some on here object to government resources being used to help them locate the stock. 

 

 

 

 

hello, at this present time the government should give all the care homes and NHS  PPE  but like you say some areas are in short supply and some PPE companies are charging obscene prices, hope there are all safe in your partners care home, cheers

[toontastic]

Just now, oldypigeonpopper said:

hello, at this present time the government should give all the care homes and NHS  PPE  but like you say some areas are in short supply and some PPE companies are charging obscene prices, hope there are all safe in your partners care home, cheers

She's fine but 2 carers she knows at another home are in hospital in critical condition. 

[oldypigeonpopper]

Just now, toontastic said:

She's fine but 2 carers she knows at another home are in hospital in critical condition. 

hello, oh that is not good, lets hope they pull through, i hope after this epidemic we continue to give all care workers the credit they deserve

[bluesj]

The employer is responsible for supplying any ppe that is needed. if you work for the nhs its a government problem if you work for a care home its the owner of that business if you work for Bob the builder its him that has to supply it if your self employed its you. But don't blame the government for the lack of ppe that you or your boss is ment to supply as some of the care homes or news outlet are.

The technical hitch at the moment is you can't get the gloves masks etc because its mostly going to the nhs because they need it. The people doing some asbestos removal near use have had to stop work because the can't get some of the ppe they need, we have stop some of the higher risk work we do because we can't get the ppe and for other parts of the job its up to the person doing it to decide if they can or are willing to do the lower risk jobs. Is it Boris's fault? No, its the situation we are in.

 

[toontastic]

28 minutes ago, bluesj said:

its mostly going to the nhs because they need it. 

 

I get what you're saying. So the nurse from the hospice who was on the news talking about her struggles to find a supplier of PPE should just stop whinging as the dying cancer patients she was looking after aren't as important as NHS patients.

[Westley]

Having had experience of finding suitable care for 4 Family members over the past 20 years, all I can say is  Thank God for privately run homes. Of all the homes I visited, trying to find something suitable for my relations needs, it was ONLY the privately run homes that I would have considered. In fact some of the er,..........'lesser standard' homes, I would have been hard pushed to leave my dog with. Now some 20 years on and still dealing with a particular care home, I will not have a bad word said against any of the Staff or the Owners. I could not have given those relations the level of care that they,  and in 1 case are still,  receiving.

[bluesj]

42 minutes ago, toontastic said:

I get what you're saying. So the nurse from the hospice who was on the news talking about her struggles to find a supplier of PPE should just stop whinging as the dying cancer patients she was looking after aren't as important as NHS patients.

What I'm saying is if you try to get any ppe you get the answer its all going to the nhs because they need it so no one else gets a chance