DERBYSHIRE (Evening Telegraph), November 2, 2007: The image of expressionless faces grouped together in a communal care home lounge, staring at the same television screen, could be a thing of the past in decades to come. Our elderly people deserve dignity and respect - something the Government has now acknowledged. That is why it wants council social services departments to channel resources and efforts into looking after elderly people in their own homes, rather than sending them into care homes straight away.In some cases, this can mean social services care staff visiting a person's home dozens of times a week to help them with the tasks that mean the difference between living in an institution and staying in their own home.
That might simply be help with getting out of bed, eating breakfast and having a wash.
Daphne Evans suffered a brain tumour relapse 20 months ago, leaving her mentally impaired, partially-sighted and with poor hearing.
The 83-year-old wanted to carry on living at the family home in Oakwood. Daughter Janet Grace felt the same but, as a busy teacher, she needed help to care for her mother.
That is where social services came in, making four visits a day to Mrs Grace while her daughter was at work. Over two-and-a-half hours a day, carers help her with breakfast, lunch and dinner and showering. Mrs Grace said that without such help her mother would be in a care home. "There is no way I could cope on my own without the home care service because I work full-time," she said. "It is also really important for my mum to stay at home. If she had had to go into a home, I don't think she would still be with us now."
Every week, Derbyshire County Council provides 30,000 hours of care to people in their own homes. In Derby, the figure is 19,700 hours a week.
Both councils provide the care for free for anyone whose needs are assessed as moderate or above.
Sheila Downey, assistant director of adult social services for the city council, said the hours involved showed what intensive packages councils were putting together for people. "We do do a lot of care now - sometimes it can be 15 to 20 hours a week so that people can carry on living at home." And for people who cannot be cared for in their own homes, councils are developing a new generation of housing.
In the past, the only option for those who became too poorly to live on their own with support from family and home care staff was to go into a care home. This meant giving up their independence and privacy - losing their separate bathroom, lounge and kitchen for communal ones and not having their own front door.
Now, councils are creating housing which falls between own home, sheltered accommodation and care home.
It is called extra care and can take various forms but the idea is the same - to give someone their own privacy. At its most basic form, it means providing care staff at a sheltered housing site 24 hours a day to keep an eye on tenants living in their own flats.
In some parts of the country, though, entire villages are created with shops, hairdressers, cafes and gardens for people who need more than just sheltered accommodation.
Councillor Fareed Hussain, cabinet member for adult services at Derby City Council, said that across the country there was a move towards providing extra-care accommodation to meet the changing needs of older people.
"We have a reasonable amount of sheltered housing in Derby but this is not always suitable for people who may need regular care and support," he said.
"The idea behind extra-care housing is that it offers people choice and enables them to have a higher level of support while continuing to enjoy as much independence as possible."
Derby has just created its first extra-care scheme at a sheltered housing complex site in the city. The flats are at the Retail Trust Leylands complex in Broadway and, from this week, social services staff are on site overnight but will eventually be there 24 hours a day to provide care for tenants who require it.
It has brought peace of mind to 77-year-old Gwendaline Eden, who moved to Leylands earlier this year.
She has suffered a stroke which left her with no feeling in her left side, although it is gradually returning.
She needs help in the morning to get washed and have breakfast and in the evening to eat.
Now that Leylands is an extra-care complex, that help is on site.
"It is good for me to know that I can be looked after here but I still have my own place," she said. "Knowing there are staff on site and that I will be able to stay here and get the care I need is a real reassurance."
Further development of the estate will start next spring to provide 76 one-bedroom living units to mobility and disability standard and provide a hairdressers, medical room, activity rooms, a restaurant/coffee shop and wheelchair accessible gardens.
The site's manager, Irene Thomas, said it was a significant step forward for elderly people.
"We are delighted to be working with the city council to develop the first extra-care scheme in Derby. We already have similar schemes in Liverpool and Glasgow and are currently building a scheme in Salford. Extra care enables older people, who may be quite frail, to continue living as independently as possible in their own homes."
Next in line for transformation is Rebecca House, in Uttoxeter Old Road, which is managed by Derby Homes. It currently has 25 bedsits, two communal lounges and two kitchens but could be converted into 57 flats, each with its own kitchen and bathroom. Work could start in April on transforming Tomlinson Court, in Alvaston, into a 38-flat extra-care complex, which is managed by Housing 21.
The city council wants to have four extra-care developments in Derby, providing a total of 240 units, by 2009. Where the service is provided, social services pay for staff to be on-site, whether the complex is council or privately-run.
Elsewhere in Derbyshire, the county council is developing three extra-care schemes in conjunction with housing associations. They are in Glossop, Wirksworth and Dronfield, and will provide 128 flats. By 2010, the county wants to have created 400 extra-care places.
Although extra-care and home care are currently another option to residential care, there are those who fear they will come at the price of care homes.
In Derby, the council is predicting that the demand for residential care will fall and has suggested closing Mickleover's Bramble-brook House residential care home to help pay for the added expenditure on services like home and extra-care.
It is a move which has made some groups anxious.
Katy Pugh, of Age Concern Derby and Derbyshire, said: "I have seen in places like Oxford that councils have gone on a campaign of closing down their own care homes, leaving only those in the private sector.
"Because of that it means the private sector can push up its prices and make it difficult to afford.
"We are in favour of extra care and home care but think it does need to be in addition to council care homes rather than instead of."
The dilemma facing councils is that the pressure is there to provide more care for elderly people so they can live independently but the funding is not being made available from Government.
This week, the Evening Telegraph revealed that the adult social services department was facing an overspend in its budget of £3.2m. More than two-thirds would be as a result of providing home care.
It is clear that as people continue to live longer, council budgets will face more strain and difficult choices on how they meet the higher expectations of the next generation of elderly people.
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