Presentation from Academic Archers Conference 17 February 2016

1. HEATHER PET: AN EVERYDAY STORY OF
INADEQUATE SOCIAL CARE?
Jo Moriarty

2. AN UNNECESSARY BIOGRAPHY
 Heather was first heard on air in 1999
 She stayed at Brookfield in 2003 following the death of her husband,
Solly, in 2002
 He was a ‘reasonably successful toilet paper manufacturer’
 She made another extended stay in 2008 while Ruth received
treatment for breast cancer
 A series of falls followed by a stroke resulted in aborted plans for:
 David and Ruth to buy a farm in Prudhoe (Northumberland) to be near her
 Heather to move to Brookfield (meaning that Jill and her writing desk had to go to
Lower Loxley to stay with Elizabeth)
 Heather died in a motorway service station on her way down to
Brookfield with Ruth on 28 September 2015
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3. CONTRASTING NETWORKTYPOLOGIES?
The Pritchards The Brookfield Archers
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Heather
?
Solly
Ruth

4. WHAT IS SOCIAL CARE?
Crucial difference between NHS and social care is that
it is means tested
Rising demand for services with ageing of population
and proportion of people with a disability BUT
Total spending on social care for all age groups is 10%
less than in 2009 (Humphries & Appleby, 2015)
Number of people receiving social care services has
fallen (Fernandez et al, 2013)
Care Act 2014 brought in major changes but cap on
charges has been postponed until 2020
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Care and support services, also known as
social care services, help people who are in
need of practical support due to illness,
disability, old age or a low income. Care
and support services could include having a
personal assistant to help you around the
home, structural changes to help you
move around or manage in your house, or
even an alarm system so that you can call
for help if you have a fall
NHS Choices

5. PAYING FOR SOCIAL CARE
 Means test
 If you have capital and savings above £23,250, then you will have to
pay for all your social care
 If you have between £14,250 and £23,250 in capital and savings and
you are eligible for care, your local council will contribute towards your
care costs
 If your capital and savings are below £14,250 and you are eligible for
care, your council will pay for the costs of your care
 Heather’s assets
 House worth £250k
 ?Income and savings
 (Life insurance policy to value of £250k)
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6. SELF FUNDERS
 Very little known about people who fund their
own social care
 About 40% per cent of those in care homes
 Perhaps as high as 57% with ‘top ups’
 Highest proportions in south east and lowest in north east
(Baxter & Glendinning, 2014)
 Approximately 270k older people paying for help with
shopping, washing and so on (IPC, 2011)
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7. DUTYTO PROVIDE INFORMATION
Care Act 2014 made it clear that
information needed to be
provided to self funders too
Website survey and ‘mystery
shopping’ undertaken for
Independent Age
Self funders have right to an
assessment but not always
made clear to people that they
can ask for this
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8. INDEPENDENT AGE DATA
Local authority Website review score Care Act Compliant Satisfactory
response to questions
posed by ‘mystery
shoppers’
Northumberland 27 Yes No
Warwickshire 27 Yes Yes
Worcestershire 26 Yes Yes
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Independent Age Mystery Shoppers, Range 0-40. Top scores were 27-30 (32%). Forty
three per cent scored 21-26. About a third did not give satisfactory answer to 12
scenarios posed by mystery shoppers calling on behalf of a relative. Most councils are
‘doing the minimum’

9. CHALLENGES OF PROVIDING SUPPORT IN
RURAL AREAS
 Older population increasing
 24% people aged 65 and over live in rural areas compared
with 18% under 65
 Projected increase in older population higher in rural than
urban areas (Connors et al, 2013a)
 Cost of providing home care more because of
extra time travelling and costs of travel
 Providers may not see it as worth their while – rural councils
tend to pay less to companies to provide home care
(UKHCA, 2015)
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10. A CARE HOME IN NORTHUMBERLAND IS
CHEAPERTHANTHE LAURELS IN AMBRIDGE
Weighted average
weekly fees
£ Care home £ Care home with
nursing
England 569 774
North East 522 631
West Midlands 529 731
London 628 899
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Laing and Buisson, 2014/15
By comparison, home care costs on average £15 per hour

11. LINKS WITH HOUSING ANDTELECARE
‘Ageing in place’ seen as preferable in policy
terms and in terms of older people’s
preferences
Very dependent on suitable housing options
Shortage of extra care housing in rural areas
(Connors et al, 2013a)
Rural residents may be unaware of housing
adaptations and there is not enough suitable
housing stock (Connors et al, 2013b)
Slow broadband speeds and poor mobile
signals may hinder widespread use of telecare
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12. RIGHTS AND CHOICES
Oh! I'm in such a mess.
I don't know the new address - Don't
even know the blessed
neighbourhood.
And I feel as if I might
Have to stay out here all night. And
that ain't a goin' to do me any good.
I don't make no complaint
But I'm coming over faint
From ‘Follow theVan’
Extra care housing x
Homeshare/co-housing x
Home care x
Mental Capacity Act and advance
care plans x
End of life care x
Telecare X (think no alarm)
Care home √
 Intermediate care √
Carers assessment & support x
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13. DISCUSSION
 Were there missed opportunities to present some
of the decisions made by people needing social
care support every day?
 Presented through reports of others – even Ruth was often
absent as a speaking character
 Reality is that ‘real life’ Heathers and Ruths would
probably be in a similar position
 Changes needed to achieve ‘personalisation’ in rural areas
(Manthorpe & Stevens, 2010)
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14. SOURCES AND REFERENCES (1)
No. Link
1 Silhouette of Heather inThe ArchersWho’sWho:
http://www.bbc.co.uk/programmes/profiles/3z3RSfvyLQxbRl4b5bDRQ5l/heather-pritchard and marmalade
fromThe Journal: http://www.thejournal.co.uk/culture/food-drink-news/marmalade-awards-look-forward-
10th-8320168
2 Details fromThe Archers website: http://www.bbc.co.uk/blogs/thearchers/entries/14fc6015-cec3-4333-
8b3b-5d7583a46ac2 and http://www.bbc.co.uk/programmes/profiles/3z3RSfvyLQxbRl4b5bDRQ5l/heather-
pritchard
3 Various photos of the actors onThe Archers website
4 NHS Choices: http://www.nhs.uk/conditions/social-care-and-support-guide/Pages/what-is-social-care.aspx
Humphries & Appleby: http://www.kingsfund.org.uk/blog/2015/11/social-care-future Fernandez, Snell &
Wistow: http://www.pssru.ac.uk/pdf/dp2867.pdf
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15. SOURCES AND REFERENCES (2)
No. Link
6 Baxter & Glendinning: http://www.sscr.nihr.ac.uk/PDF/ScopingReviews/SR11.pdf
6 IPC: http://ipc.brookes.ac.uk/publications/index.php?absid=646
7 Bottery: http://www.theguardian.com/social-care-network/2016/feb/01/care-act-social-care-councils
8 Qa Research (for Independent Age):
http://www.independentage.org/media/1200922/care_act_information_and_advice_research_report.pdf
9 UKHCA: http://www.ukhca.co.uk/pdfs/ukhca_the_homecare_deficit_201502_web_version_in_spreads.pdf
10 Costs of care: https://www.partnership.co.uk/paying-care-fees/paying-for-long-term-care/how-much-will-care-cost/
11 Connors et al:
http://www.ilcuk.org.uk/index.php/publications/publication_details/impact_of_an_ageing_population_on_service_desi
gn_and_delivery_in_rural_area
12 Manthorpe & Stevens: http://dx.doi.org/10.1093/bjsw/bcp038
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16. DISCLAIMER &THANKYOU
The Social CareWorkforce Research Unit receives funding from the
Department of Health Policy Research Programme. The views expressed
here are those of the authors and not the Department of Health
Academic Archers 1617 February 2016