The value of a life in a care home

The Health & Safety Executive publishes a very sad story here and it is indeed a message to all those – including care providers –  who fail to understand the importance of systems, care plans, risk assessments, record-keeping, staff training and communication.  To mention but a few.

“The UK’s biggest care home provider has been ordered to pay £170,000 in fines and costs after a vulnerable resident choked to death on fish and chips during an entertainment evening at its Chorley premises.”

“The company, of Groves Road in Douglas, Isle of Man, was fined £125,000 and ordered to £45,000 towards the cost of the prosecution.”

“Our hope is that the seriousness and financial implications of this case for the company will ensure that nothing like this will ever happen again at a Four Seasons or any other care home. This would mean that Rita’s tragic death will not have been entirely in vain.”

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Dementia as a marketing ploy – abuse or not?

What would  you do if you became aware that someone who claims to have a diagnosis of dementia is being used and abused by a ‘company’ that claims to be involved in the care industry?

That someone may well have mental health and other issues to deal with, and without wishing to disrespect them at all, they are well aware that they are being used.

That someone knows exactly what is going on but they are unwilling to listen to any advice or comment that comes their way.  It’s not in their own best interests to do so.

However, it is in the best interests of  their own quest for fame and glory.  So they are unlikely to question the advances that have been made to them, all in the very best marketing interests of a ‘company’ that has absolutely no previous history (apart from a few failed attempts), no track record, that changes its website almost daily to reflect its latest ‘acceptable face’, but still a ‘company’ that has absolutely nothing to do with the care industry.  In spite of the way it allows itself to be described.  In fact, it describes almost every aspect of itself on its website incorrectly, misleadingly and with abominable cunning.

A ‘company’, that is, that has absolutely no right to use the word ‘care’ in its online description of itself, let alone to encourage vulnerable people to support their misleading claims and to perpetuate the misleading descriptions of itself.  Globally now!!!!  A ‘company’ that loves the word ‘global’ and encourages its prey to use the same word.

A ‘company’ that made the first and every subsequent approach to the vulnerable adult and managed to persuade him to go along with their plan.   All in the best marketing interests of the ‘company’ trying to devise a present and a future for itself, and also in the best interests of a vulnerable adult who cannot resist attention, flattery and support in his quest for fame.

A ‘company’ that fails, time and time again, to correct any of the information being circulated by their found prey.

A ‘company’ that encourages the vulnerable adult to continue to promote it, albeit via incorrect information sources.  All that information remains uncorrected by the vulture.

What would you do, in the face of such vicious abuse of a vulnerable adult who may – or may not – be living with a diagnosis of dementia?

All replies will be received with thanks, and will be considered in depth,

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A caring care home with a pub in the garden

A care home that listens to the residents and fulfils their desires.

“A “pub” has been set up in the grounds of a care home in Shrewsbury after residents were asked for suggestions for the garden.

Coton Hill House expected requests for flowers or benches but pensioners instead called for somewhere they could enjoy their favourite tipple.

The opening of Ye Ole Coton Arms summerhouse was celebrated with a barbecue and free bar.

It will stay open for the rest of the summer.”

Thanks to BBC News for this uplifting story.  I sincerely hope that summer lasts a very long time this year, extends to the Christmas period and well into the New Year.

“”It is free of charge to all residents, and, as expected, is proving to be very
popular with them.”

Congratulations to Coverage Care Services Limited.

May the residents go from strength to strength, and may their elbows enjoy the exercise.

I’ll be raising a glass to Alison Gough and all at Coton Hill House.

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Thoughts on diabetics’ access to blood glucose strips being restricted

A timely reminder appeared on the BBC website today in the form of this piece bearing the title Diabetics’ access to blood glucose test strips ‘restricted’, which led me to the Diabetes UK report Access to test strips – A postcode lottery? (Aug 2013) .  The Daily Record from your short time in Care UK’s Lennox House care home featured heavily at the NMC hearings that started in February 2012 and concluded in April 2013.

One entry in the Daily Records was a strange entry, written almost as a post-script afterthought once you’d been admitted to hospital in a diabetic coma.

That entry (unsigned, by the way) gives the results of a urine test, and alongside is bracketed the following: “There was no available glucose strip since the GP does not prescribe according to Deputy Manager & Home Manager”.

Does that not appear to be a peculiar entry in a record of care?  It almost looks like an attempt to validate the absence of care.  The full urine test results were indeed alarming.  I’m not a medic but it didn’t take me long to work out which parts of the results should have rung bells.  But the care home didn’t find them sufficiently alarming to call an ambulance, because they waited  another 15 hours before doing so, by which time you were in a desperate state, with spasms lasting nearly half an hour noted hours before an ambulance was called.

When I arrived in A&E, soon after your arrival there, I was asked to explain how your diabetes had come to be ‘so out of control’.  I didn’t know that it was out of control, of course, but the hospital for some reason thought that you lived with me and that I was responsible for your care.  Not so.

When I asked the manager to explain to me what that entry in the Daily Record meant, she said that the GP refused to prescribe test strips for the care home, and that Care UK also refused to supply them.  That’s the point at which I offered to pay for a full year’s supply for the care home so that no other person would suffer the way you did.

During the investigation into what happened with your care, the investigators were told that test strips had been bought from a well-known chain of chemists – but no evidence could be found to support that.  Not even a petty cash record.

However, at the hearings at the NMC, there were other and different rationales put forward.  One proposed by the manager was that your diabetes was ‘diet controlled’ and not medication-controlled.  Not so.  When she saw you, allegedly just before she left the building, you were “warm and pink” and you gave no indication of distress, pain or suffering.  What a shame she didn’t have the time to act on your urine test result, that she was surely informed of before leaving the building.

You were not in a position to monitor your own glucose levels.  Vascular dementia made that impossible for you, and in any case your previous GP (not the one providing services to Lennox House) had monitored you regularly, as had your clinic appointment regime.  You never missed an appointment.  It was the responsibility of the care home to monitor your diabetes – that’s what care homes are supposed to do.  Care.

Another memory has been brought forward by today’s reports.  The GMC (General Medical Council) was informed by the GP involved that she had no knowledge that you had diabetes, and that had she known she would have carried out the required test and had you admitted to hospital.  The NMC was told a very different story by the nurses involved, namely that the GP had indeed been informed of your diabetes when she visited you (and prescribed an antibiotic for a suspected UTI).  They can’t all be right, can they?

Again at the NMC hearings, mention was made by the manager and other nurses and their representatives  that there had been no training in diabetes at Lennox House, before your arrival there.  It was even said that there was no specific training in diabetes given for a couple of years after your death.  Not so.  Would nurses never have heard of  Hyperosmolar Hyperglycaemic State (HHS)  (previously called  Hyperglycaemic Hyperosmolar Non-ketotic Coma (HONK) or  Diabetic Ketoacidosis  (DKA) ?

Diabetes UK calls the restricting of access to test strips a lottery.  You definitely did not win the lottery in Care UK’s Lennox House care home where your diabetes was neither monitored nor tested, whether by strip or by other means.

Barbara Young, Diabetes UK Chief Executive,  said “Rationing test strips to save money does not make any sense, because  it is putting people at increased risk of complications that are hugely expensive to treat.”

You’d be a fool to argue with that.

I sincerely hope that Home Secretary Theresa May, recently diagnosed with diabetes, will not find her access restricted.  If she does have that experience, she will no doubt take steps to ensure the restrictions are lifted.

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Care UK regrets they weren’t able to care for you, madam

With apologies and thanks to Cole Porter and Ella Fitzgerald, two of your favourites.

Care UK regrets they weren’t able to care for you, madam.

Care UK regrets they weren’t able to care for you.

They can’t even apologise.

Best they can do is  just general regret, madam.

Care UK regrets they weren’t able to care for you.

Care UK strives to provide appropriate care for all their residents across the various services that they run.”  Allegedly.

It is always a matter of regret if a service is not provided as they would wish.”   Allegedly.

Apparently I “clearly consider that there were failings in the care provided” to you.  I most certainly do, and I’m not alone in that opinion.

Care UK’s solicitor has been asked “to pass on their regret in respect of this”.

Care UK has been made aware of the fact that Catherine Igbokwe and Sheila Ali have both been struck off the register by the NMC (Nursing and Midwifery Council) for misconduct and for failing you miserably, and that Maria Rholyn Secuya (nee Baquerfo) has received a 3 year caution order for misconduct and for failing you miserably, and that Dahlia Dela Cerna (nee Enriquez) has received a 2 year caution order for misconduct and for failing you miserably.

Care UK can only  come up with an expression of general regret, via a third party at that.  General regret is overworked these days.

Care UK promised to provide a substantial sum in your memory, acknowledging that it failed miserably to provide care to you, and so that we would be able to establish what Care UK’s then Managing Director of Residential Care called “a positive contribution to the world of dementia”. In your memory.   Care UK has now broken that promise.  How foolish we were to place our trust in Care UK.

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Care in the UK makes progress

Last week saw the final stage of the hearings, at one of numerous NMC locations that have hosted the fitness-to-practise procedures, into the lack of nursing care provided to you during the time you were in Lennox House care home, Holloway/Islington, in 2007, and just before your death.  Appropriately enough, we were directly opposite the Old Bailey for the finale.

Over the main entrance to the Old Bailey, which opened in 1907, figures were placed representing fortitude, the recording angel, and truth, along with the inscription

“DEFEND THE CHILDREN OF THE POOR & PUNISH THE WRONGDOER”

As I sat in the hearing room on the 5th floor of the building,  those words were directly in front of my eyes all week.

On 17th April 2013, Sheila Ali the former care home manager / nurse  was struck off; her name is removed from the register of nurses allowed to provide nursing care to people.   She wasn’t present to hear the decision because, overnight, she decided suddenly to withdraw from the proceedings, and to remove her instructions from the barrister who had represented her.  When he announced this to the hearing, he was invited to leave.  He left.  So neither of them was present to hear the decision.

On 19th April 2013, Dahlia Dela Cerna/Enriquez wept as she received a 2-year caution order, having been found guilty of misconduct and with current impairment.  That’s the first time she’s shown anything that resembled human emotion.  They have all shown callous disregard for you – and for me.

On 21st December 2012, Catherine Igbokwe was struck off,  having been found guilty of misconduct and with current impairment, so her name was removed from the register.

On 21st December 2012, Maria Rholyn Secuya/Baquerfo received a 3-year caution order, having been found guilty of misconduct and with current impairment.

The documents in the above links are very long but very detailed.  Words I’ve heard used to describe the hearings include ‘complex’, ‘extremely involved’, ‘complicated’ and ‘very difficult’.  The decision documents are just that too.  Presumably to deter people from reading them in full, and in detail.

After you died, over 5 years ago in December 2007, there were lots of investigations and reports written, some of which I have never been allowed to see.   No matter how hard I’ve tried, the words written have all been kept behind closed doors, far away from the eyes of those who cared about you.  We, your family, have never been granted access to the full reports of the investigations by Islington local authority.

It was on 1st October 2008 that I first referred these nurses to the NMC.  The hearings at the NMC began on 6th February 2012 and concluded almost 15 months later  on 19th April 2013.  Once I had been called as a witness and had given my evidence, I attended every single day as an Observer.  So I observed and heard every single word spoken in public.

Needless to say, I’ve heard things said that I have never known about.  I never knew before now, for example, that the care home manager Sheila Ali had been in Lennox House all day on 7 December 2007 without bothering to come to see you or to dial 999, even though she had apparently been alerted to the fact that you were in spasm for long periods, unable to speak, unable to swallow, unable to move.   She didn’t care.

She didn’t care much for those residents mentioned in this article in the Daily Mail in August 2008, bearing the gruesome title ‘Care home boss suspended after dead bodies of two pensioners ‘are left for days’.  That was 8 months after you’d died.

It goes without saying that there were many other revelations at the hearings too.  No wonder we have never been allowed the full knowledge of your last days.

It’s been extremely difficult for me to sit through those sessions, but I owed that to you and I had to represent you.  It was the only thing I could do on your behalf and in in your absence.  Your voice was taken from you by  Care UK and its so-called care home, Lennox House.

I’ve found it hard to be told, by the legal representatives of the nurses involved, “You have no need to be here” – “These proceedings are nothing to do with you” – “You are not involved in these proceedings”, and so on.  I had every need to be there; the proceedings had much to do with me and with you; I will always remain involved.  There’s more I have to tell, and tell it I will.  Honestly, openly and transparently.

They took away your voice.  Nobody took away my presence.

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Care Circus is back in town next week

Well, here we go again.

Next week the Care Circus is back in town.

The latest batch of NMC hearings is about to stir its loins again and get on with the work that it was charged with handling long ago on 1 October 2008.  That was only a few very short months after you died, thanks to the rubbish care that came your way, courtesy of Care UK and Lennox House so-called care home in Islington, London.

It was also a few very short months after I’d asked so many questions of Islington’s Mental Health Care of Older People team, and then Islington’s Social Services, and then the CQC (or CSCI as it was called back at the beginning of 2008), and the Coroner’s Office, and Islington’s Safeguarding of Vulnerable Adults Team, and  most of all of Care UK … well, you will know how many questions I asked of them all, each and every one of them.

They don’t like answering questions, do they?  Especially if those demanding but necessary questions are likely to cast a very dim and dark shadow over their (lack of) accomplishments.

Last December 2012, the NMC decided that one nurse involved in your demise should be struck off, from their register of nurses allowed to nurse in the UK.  Another nurse was delivered a 3 year caution order, requiring her to be on her best behaviour.

Next week, 15 to 19 April 2013,  the Circus is back in town.  Fifteen months after the NMC hearings first started, looking in depth at the circumstances surrounding your rapid decline, within 10 days of arrival in that so-called care home, Lennox House, and your admission to hospital in a diabetic coma.  You died 3 weeks later.

The  final 2 cases, still waiting in the wings, are to be dealt with by the NMC next week.

One case  is that of the care home manager, who is mid-way through an interim 9 months suspension order, placed to allow time for her to seek permission for a Judicial Review in the High Court, of the NMC decisions thus far.  The High Court refused permission to seek a Judicial Review.

The clowns will all be wearing their costumes.  Their faces will all be heavily disguised beneath the cake of their make-up.  They will all have their props to support them.  Their scripts will all have been written, re-written and then written again.  Edited, heavily edited, and then edited again.

You weren’t allowed to write a script of  your own, were you?  Let alone edit it.

The script of your final years, months and weeks of your life was snatched from you.  Grabbed by thugs.  The uncaring, unqualified, untrained, unmonitored, unsupervised, unsuitable thugs who were charged with the most basic and fairly simple duty of looking after you.

Next week, they will still be wearing their masks, their costumes  and their heavy make-up.

As they will continue to do year after year.  Uncaring as always.  Unkind in their presentation thus far.  Unwilling to admit that they failed miserably in their duty of care to you, for you and about you.  They didn’t care enough to care.

The chance to wear your dresses, your gentle make-up and to present your smiling face to the world was taken from you.  By the thugs of care.  The thieves of care.  The robbers of care.

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Alzheimer’s Society and the Horse fraternity

Over recent months or even years, many people have become irritated, bemused, frustrated, confused and perplexed by the Alzheimer’s Society’s online chat room also known as Talking Point.  Posts have been dumbed down and members dumbfounded by many of the decisions made by the appointed representatives of the Alzheimer’s Society, working and operating its online forum.

Many people were hoping that things had changed, once the Alzheimer’s Society had rid itself of what it perceived to be irritating members who were brave enough to challenge the Administrative nonsense going on.  Similar to the way that Julie  Bailey and ‘Cure the NHS’ have challenged the brick walls of care, resulting at long last in the Francis Report.

It is so easy for the Alz Soc to ban forum members who challenged the ignorant actions of its Administrators and Moderators.  The Alz Soc compromised many members by editing and/or deleting their posts, even if they only referred to Winterbourne View, or … wait for it …. the British Geriatric Society, or even Peter Carter of the RCN.  All mentions were obliterated without being able to be questioned by the members.   Members who posted about BSE or CJD and dementia-linked situations were also deleted and obliterated.

It was all too uncomfortable for the Alzheimer’s Society to contemplate such matters.

It is far too comfortable for the Alzheimer’s Society to silence those members who had the guts to challenge matters.

It makes  me wonder how the Alz Soc will react if/when the latest horse-meat scandal comes to evidence a connection between dementia and the introduction into the human food supply of a drug called Phenylbutazone - a drug that is now only used in the care of horses but which was  previously used in the care of human beings who also happened to have arthritic/rheumatic joint problems.  The experimental use of Phenylbutazone in humans was disastrous and resulted in death, and it also resulted in Phenylbutazone being banned for use in human beings suffering from arthritis/rheumatism.  That was circa 1975, so it’s possible that any use of Phenylbutazone now in human beings is heavily restricted, controlled and monitored.  I hope so.

The Alz Soc shed the skin of those that it felt irritated by, namely those who posted examples of sub-standard care.  All mention of Winterbourne View was eradicated from the forum, as were posts mentioning Southern Cross, to name but a few.

Almost overnight, it became acceptable for people to name Stafford Hospital, to call social services ‘social circuses’, to talk of ‘lies and more lies’ when referring to social care systems that the posters had come by.  Even mention of MPs was suddenly allowed, whereas previous posts mentioning similar had been edited and/or deleted.  So members were thinking that things may be changing and on the up.

The forum Administrators and Moderators prod and poke and provoke.  Until such time as the Alzheimers’s Society’s appointed Administrators and Moderators can ban thinking members.  It’s so much more comfortable for the Alz Soc to leave its own comfort zone untouched and unsullied by those Members of the Alz Soc who would like questions to be answered.

The latest example goes beyond the acceptable when it comes to caring about dementia.  [I choose not to use the word Alzheimer's because it denies recognition of all other forms of dementia.  It also sweeps away most of the important factor that people living in the UK care about at present.]

It is all swept away by someone who has no idea what it means to be trying to achieve quality care in the UK.

Here, the Alzheimer’s Society’s online Talking Point forum:

“While this may be your view, that’s all it is – your view. Some care homes may be like this, some are not. To state that all of anything is untrustworthy is inappropriate in my view.”

Is that the view of the Alzheimer’s Society?  Is it the view of an appointed Alzheimer’s Society person?  Is that the point of view of someone who has not one single clue about what it means to be living in the UK with dementia and caring about those who are living in the UK with dementia, let alone those who are living in the UK and still dealing with the care home system that is so sadly lacking in quality and standards of care.

It is the point of view of someone – an online forum Moderator,  appointed by the Alzheimer’s Society –  who has never had any direct experience of the care home system in the UK, who has never had any experience of social services in the UK, who has never had any dealings with that which most people are dealing with when it comes to care in the UK.

But someone who  is still given full reign to spout about that which affects every single person living in the UK.

A virtual Queen of the World.

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HOT Care in the UK

The Francis Report calls for a ‘legal duty of candour’.  He mentioned honesty, transparency and openness too.

He may well have stolen my term for exactly the same kind of care that he’s calling for.

HOT Care.

I’ve been calling for HOT care for more than 7  years now.  As have those affected directly by the Stafford Hospital.  Cure the NHS.  Cure the Care too.

HONEST +  OPEN + TRANSPARENT = HOT

I first used the acronym HOT in my correspondence with Islington Local Authority’s Mental Health Care of Older People team, circa 2005 and many times thereafter.  I’ve called for that same HOT Care in each of my communications with Care UK since 2007 when my relative suffered at the hands of such cold care courtesy of Care UK.

Could we now find a way to move towards HOT Care in the UK?

Is it so impossible for us to expect/demand/require HOT Care?

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More Alzheimer’s Society madness

There’s a lull in proceedings at present so I’ve been analysing my Blog stats and the search engine terms people use before finding me.  Fascinating reading it makes too.   The searches range from ‘fugitive nuns on the run in France’ via ‘do I have to declare that I’ve been removed from the NMC register if I apply for a job  as a nurse in a care home?’ to ‘what is a stalking horse?’ and  ‘what’s it like to work for the Alzheimer’s Society forum?’.  With a sprinkling of the obvious essay questions such as ‘describe how issues of public concern have altered public views of the care sector’ and ‘what does vicarious liability mean in nursing?’.

I’ve written  a few words about all of the above  - yes, even Nuns on the run- the alternative to residential care  - but I don’t seem to have mentioned what it must be like to work for the Alzheimer’s Society forum.  So here goes, and I confess here and now that I can only comment on the qualities you may need, Dear Searcher, rather than the reality of the life of a moderator or administrator on the Alzheimer’s Society’s Talking Point forum.

This selection of posts by moderators may give you an idea of the heartless, cruel person you need to become, if you are to succeed.

Moderator  1 starts a thread with: “Do not feed the troll. …. because they are cowards …. they never write over (sic!)  their own name and often reveal their trolliness (sic!) in the chosen ID.  ….. Trolls rarely answer a direct question - they cannot, if asked to justify their twaddle – so they develop a fine line of missing the point.” ( Mod 1 then cites Wikipedia as the source of her wisdom, so you had better change your thinking, Dear Searcher, and acknowledge Wiki as a source of wisdom.)

Moderator  2: “Thank you … we learn something every day …. :cool: …. and here was I thinking a troll lived under a bridge.”  (Sarcasm is a requirement for a successful application, Dear Searcher.)

Member interrupts this indelicate and immoderate session: “I’m just about to send you a PM (Private Message).”  (You will soon learn the power of the PM system, used and abused by Moderators galore, as they spread their message to their fan-club.)

Moderator 3: “It is my belief we currently have a troll posting to Talking Point.  This is a person who has mental health issues …. Our troll’s aim is destruction, pure and simple.  …. Make no mistake, they don’t even recognize they have a problem.  Sad but true.”  (So, Dear Searcher, you will also need to be as cruel as this moderator can be, even when she has declared openly that she has been taking medication for years for her depression.  Hardly surprising – she spends her whole life moderating the forum immoderately.  Perhaps that is another part of the job description.)

Moderator 1: “I agree with every single point you have made.  That’s why I started this thread.”  (Never disagree with Moderator 3 – that is not allowed.)

Moderator 4: “Thank you …. and thanks for starting this thread.  It’s reassuring to know the facts about trolls.”  (By now, Dear Searcher, you will realise that you need to demonstrate that you have the inner qualities of a dog, the kind of dog used for hunting foxes, now banned as a recreational pastime in the UK.)

Moderator 5: “It’s not me!”

Moderator 3 snaps rudely at a member who has a seriously ill husband and who is upset by this thread but who doesn’t know how to do quotes: “Can I ask something, B,  … because I’ve been wondering?  Do you not know how to do quotes or can’t you be bothered?”  (Rudeness is a requirement.)

Member replies to Moderator 3: “It might have escaped your notice but we, (husband) and I need help.  As do lots of others who are not so verbal as you are.  …. You do not listen!’

Moderator 3 replies to same distressed TP member: “Look, …. We have a person posting on the board who the moderators have good reason to believe is not trustworthy.  In the past, members have exchanged email addresses with this person only to be harassed by them.”

NB.  I have it on good authority that was a lie from Moderator 3, and that the person in question had never harassed anyone by PM or by email.  Moderator 3 then went on to tell more lies. but that’s what Moderator 3 has a nasty habit of doing, all in her own best interests, of course.

This unsavoury and tasteless exchange of posts, largely by moderators but with a few normal interjections by normal TP members, went on for some 70 posts or so, with mention being made by an administrator of the police almost having been called in to deal with this person’s allegedly threatening emails and PMs.  (Telling outrageous untruths is another requirement.  But of course, once you become an Alzheimer’s Society appointed moderator, you will be beyond challenge.  You will be allowed to get away with virtual murder, and there’s nothing the normal membership can do about that.  You will soon adapt to the slaughterhouse that is called Talking Point.)

These are just a few of the qualities you may need, Dear Searcher, if you are to want to apply to work on the Alzheimer’s Society’s online forum.  Surely the Alzheimer’s Society cannot be proud of allowing its moderators and administrators to post like that on what is supposed to be a forum providing support and care for its members.  The Alzheimer’s Society ignores totally the voice of the members.

But fear not, Dear Searcher, the Alzheimer’s Society received a big fat donation of more than £670,000 from Santander in 2011 to fund the online forum Talking Point for 3 years.  It pays for an annual gathering in London of the moderators, the one living  in the US, the one living in Canada, and all the others in the UK, all expenses paid, of course.

Compare and contrast that £670,000 being squandered on a sometimes sad and feeble chat-room, dominated by Moderator 3, with the fact that the Alzheimer’s Society is now planning to charge  dementia sufferers £10  to receive a befriending visit from a Volunteer Befriender.  That’s £10 per visit.   The Alzheimer’s Society says that dementia sufferers can apply for and use a Personal Budget from their local authority to pay for the visit.  That decision is not being received well be the Alzheimer’s Society’s online forum  supporters.  They are voicing their objections here. 

Funny way to run a charity.

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