Care Home Week 18: Engagement Blog from Swaran Rakhra

“Ring a ring a roses, a pocket full of poses, a tishoo a tishoo; we all fall down”

Looking back at our childhood days, we remember this wee rhyme as something we sang and played as children at playtime. The meaning of it as innocents we did not have a clue about as was all about the plague in the 16th Century where many died! The symbolism escaped me as we all held each other’s hands and went round and round supporting each other till we fell down!

It’s a wee bit (dare I say) like that in the social care sector, where we must hold onto each other and engage with the challenges facing each service.  Be focused, sometimes losing our orientation as we spin around the circle, spinning and balancing our regulatory responsibilities, trying to cope with the challenges of funding.  Good communication, understanding of issues, fighting for equality and remaining compassionate throughout as we wish reciprocity from partners such as commissioners. Yet we hold onto each other, encouraging each other, engaging with each other, so we don’t fall down.

Caring is not easy, it’s not a game, it’s serious, it’s something that must be valued by everyone who partners in the process. And there’s no reneging, as we together must stand united as we spin around with our focus on those we care for at the centre. So fellow providers of quality care within Scotland, let’s stand firm under the massive challenges we are facing, and start looking outwards turning challenges into opportunities facing us as we go forward together holding each other up, and when someone stumbles, be there with a hand of compassion and love. United we stand, divided we fall!

 

Swaran Rakhra

Membership Support Manager, Scottish Care 

@RakhraSwaran

 

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Care Home Week 18: Cycling Without Age

The Cycling Without Age movement was kickstarted in Denmark by Ole Kassow in 2012.  Ole wanted to help the elderly get back on their bicycles, but he had to find a solution to their limited mobility. The answer was a trishaw and he started offering free bike rides to the local nursing home residents.

In 2016, Cycling Without Age came to Scotland, where it was piloted in the Falkirk area to great success. In the last two years more and more communities have become involved with the concept, which is a fantastic way for care homes to engage with their community. Below we hear from Ballifeary House in Inverness on the impact Cycling Without Age has had for their residents.

 

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Care Home Week 18: Engagement with Recruitment

There are lots of modes and combinations of engagement that are beneficial in a care home setting. A group of residents in the Highlands wanted to become more actively involved in the recruitment process for carers in their home. So, working together, the Resident's Forum of Highview Care Home in Inverness produced an A to Z of what makes a good care worker to help with the recruitment process. A fantastic example of engagement with the people that will experience the end result.

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Care Home Week 18: Care Awards Launch!

Care Home Week 2018 is drawing to a close and all week we have been highlighting and celebrating the great things going on in care homes around Scotland. And as we focus on showcasing the fantastic work of care home staff, what better time to launch our National Care Home Awards nominations?

This year you can nominate in 13 categories as follows:

1. Ancillary & Support Staff Award

2. Nutrition & Eating Well Award

3. Meaningful Activity Award

4. Training & Staff Development Award

5. Innovative Practice Award

6. Emerging Talent Award

7. Manager/ Leader of the Year Award

8. Nurse of the Year Award

9. Carer of the Year Award

10.Specialist Service/ Unit of the Year Award

11. Care Home Service of the Year Award

12.Outstanding Achievement Award

13.Positive Impact Award

If you work with an individual or a team, or perhaps are a family member who wants to acknowledge excellent care then please take the time to complete the nomination forms ahead of the August 31 deadline. The Awards themselves will be held on November 16, 2018 at the Hilton Hotel in Glasgow. This is always an emotional night of celebration for those involved and is a true showcase of the high standards and dedication of those working in the sector. 

Scottish Care has a longstanding collaborative relationship with documentary maker Michael Rea. The film below highlights the finalists from the Nurse of the Year category of the National Care Awards 2016. Take a look and see if you know someone similar who might be worthy of a nomination!

Please read the guidelines below before beginning you nomination. You can nominate online or download a Word version of the nomination form and submit the completed version to [email protected]

If you opt to nominate online, you will be prompted to complete the nomination form in one sitting, so we advise you to download the PDF version beforehand to see the steps required. 

Good Luck!

 

Care Home Week 18: Project ECHO

It is indisputable that delivering care in a rural setting is vastly different to doing so in an urban environment. The saying goes that necessity is the mother of invention and those working in the social care sector in the Highlands would say that it is the geographical challenges that have shaped and driven the need for innovation, adaption and change in the region. 

Below we hear more about a telementoring project set up by the Highland Hospice.

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Project ECHO at Highland Hospice – Working With Care Homes

At Highland Hospice we have been facilitating ECHO communities of practice since 2016, supporting care homes, out of hours practitioners, community specialist nurses (Macmillan Nurses), community pharmacists and more recently, remote and rural GPs.

Project ECHO began in New Mexico (USA), successfully increasing the ability of rural primary care clinicians to deliver “complex speciality care in the area of Hepatitis C.” It is now used for a wide variety of diseases including diabetes, asthma, and rheumatological conditions, and is proven to improve care.

The heart of the ECHO model™ is its hub-and-spoke knowledge-sharing networks, facilitated by specialist teams who use multi-point videoconferencing to conduct virtual ‘clinics’ with community providers. In this way, care home staff, primary care doctors, nurses, and other clinicians learn to provide excellent specialty care to patients in their own communities.

Participants benefit by receiving evidence-based, best practice guidance through expert presentations and by sharing their experience through the presentation of case studies. Facilitated discussion ensures that the ECHO mantra ‘All teachers and all learners’ is upheld.

To date, through ECHO, we support 20 care homes across the Highlands who wish to learn and share their experience in topics, chosen by themselves, related to palliative and end of life care.

In a recent evaluation of Project ECHO carried out by the University of the Highlands & Islands Department of Rural Health & Wellbeing, six care home staff were interviewed and their comments evaluated.

Generally, interviewees felt they needed support and advice to deal with palliative care, which can be a large part of the care they provide.  As care home staff do not necessarily have medical backgrounds, they value being able to just “pick up the phone” for advice.

Care homes, particularly in the Highlands of Scotland, can be located in rural areas that are a long distance from any specialist services. Research showed that being rural can lead to the feeling of being a “lost cause at the end of the valley”.

As an attempt to try and meet some of this need, Project ECHO was positively evaluated by care home staff who described a range of specific ways that they had changed their daily practice as a result of participating.

One manager had ordered fans straight away for residents with breathing difficulties following a session on breathlessness. Another described devising and introducing palliative care plans following discussion with District Nurses, GPs and families. This manager felt that these plans have had positive impacts on daily life in the home because they allow staff to pinpoint a resident’s needs more easily, without having to look through a whole care plan.  There was also a feeling of confidence to approach end of life care at the ‘moving in’ meetings with new residents and families.

Falls prevention and communication (ie use of talking mats; language and phrases to use with patients) were also identified as areas of increased knowledge for care homes.

Highland Hospice has recently been granted a licence as one of 11 (to date) global training centres or ECHO ‘Superhubs’ sited in the USA, Canada, South America, India and the UK. Highland Hospice is the only Superhub in Scotland, and we hope to replicate the experience of other areas of the world where Project ECHO has been described as a “revolution in medical education and care delivery.”

If you wish to learn more about Project ECHO please visit the University of New Mexico’s website (https://echo.unm.edu/) and if you would like to discuss ways in which Highland Hospice might help you develop your own ECHO communities of practice (in any healthcare field, not just palliative and end of life care) please contact either Sharan Brown (Project Lead) at [email protected] or Jeremy Keen at [email protected].

Care Home Week 18: Guest Blog from Hospice UK

Cicely Saunders, the founder of the modern hospice movement said, ‘You matter because you are you. And you matter to the end of your life.’

We could add to the end of that quote, ‘no matter where you are’. Whether someone is in a care home or a hospice, they have an equal right to palliative care, and every person providing that care should be equally valued.

At Hospice UK, we recognise that care home and care at home staff are at the forefront of delivering palliative and end of life care, though many may not call it that. We also recognise the toll such care can take on staff who can feel unsupported and undervalued, as Scottish Care revealed in its major workforce report ‘The Trees that Bend in Wind.

Hospice UK is the national membership charity for hospice care in Scotland, and across the UK. Our mission is to enable hospice care to transform the way society cares for the dying and those around them. Part of that work is to highlight and promote the benefits of joint work across care settings and expertise.

For example, over 37,000 Scots live in care homes, many with complex palliative care needs. With need set to grow against a backdrop of shrinking budgets and workforce challenges, we conducted a survey of Scottish hospices and found that 85% are engaged in some form of joint work with care homes, with member hospices keen to do more.

Examples of joint work include:

  • Technological ‘hub and spoke’ knowledge exchange and support like Project Echo where a hospice team works with a number of care homes across a wide area.
  • Hospices have developed a wide range of formal and informal training such as foundation level palliative care, Quality End of Life Care for All, communication skills, dementia focused care, complementary therapy, anticipatory care planning, debriefing techniques for emotional staff support and early identification tools. Hospices also offer bespoke and ad hoc training to social care staff such as pain management for people with cognitive impairment.

But there is so much more happening. Hospice and social care teams are increasingly working together across a range of settings with a range of objectives in recognition of the strength in collaboration.

The learning and support is two way: hospice staff have much to learn from social care colleagues. This joint work is about professionals with a wide range of expertise coming together to share resource, experience and strength to ensure the very best care is given to every person in need, and the people who care for them.

We know that partnerships between hospices and social care providers improve people’s end of life experiences and reduce avoidable hospital admissions. However, our research suggests there are barriers that can stop these partnerships reaching more people such as low awareness of the benefits of such partnerships and short term funding models.

Increasing awareness of what hospices, care homes and care at home teams do, and could be doing together is key to widening access to palliative care. At the same time, we want to see Health and Social Care Partnerships supporting joint work in their areas, and ensuring there is enough money to sustain joint work over time.

Collaborative working across providers is not just a nice idea. It’s absolutely crucial to supporting staff to deliver and sustain the best care to ensure everyone has access to palliative care at the right time, no matter where they are.

Eilidh Macdonald 
Policy and Advocacy Manager Scotland, Hospice UK

For more information on what hospices in Scotland do and about their work with care homes, visit www.hospiceuk.org – Hospice UK’s 2017 report: ‘Hospices and Care Homes in Scotland’ can be found in the Briefing and Consultations section.

Care Home Week 18: Adapt to Physical Activity

The Care Inspectorate (commissioned by the Scottish Government) leads the ‘Care…about physical activity (CAPA) improvement programme’. Working with eight partnerships across Scotland, the programme will run until October 2018 and the CAPA team will build on the skills, knowledge and confidence of social care staff to enable those they care for to increase their levels of physical activity and move more often. Organiser hope that social care staff will also discover ways to be more active themselves. 

Developing and spreading work to improve physical activity participation in these care services through the CAPA improvement programme supports the Scottish Government’s 2020 vision of maintaining people in their own home or in a homely environment, prevention of ill health and admission to hospital and supporting self management.

Taking on the learning from CAPA can be hugely beneficial for care home residents but doing so is a process of adaptation for many. After seeing the tremendous advantages of moving more often, below we hear more about how to embed CAPA outcomes when the programme concludes this autumn.

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Maintaining and sustaining improvements key to CAPA legacy

In this film clip Louise Kelly, Improvement Manager talks about sustainability, how important it is for older people to feel fitter and healthier and to be able to move more every day and what we all need to do to make sure this happens. 

Care Home Week 18: Change & Adaptation Blog from Margaret McKeith

If you could change one thing what would it be?

How often have you been asked that? Probably as often as “If you won the lottery, what would you do?” or “If you had three wishes, what would they be?”

Even I, the eternal optimist, have realised that a lottery win is very unlikely and that the chances of a genie springing out of a magic lantern is zilch.

Resigning myself to these two facts, what I can do is acknowledge my ability to create change and hope that I use this ability to both my advantage and to the advantage of others.

Whether they have an impact on only me or on others, whether they are significant and transformational, whether they are so slight they are barely noticeable, whether they are made on impulse or the result of long and careful planning, whether they are the result of situations out with my control, each and every one will make a difference of varying degree. My hope is that whatever change I make, the consequences will be positive.

If I was given three wishes, perhaps always making a positive difference to others would be one of them.

I am in no way unique, each and every one of us has the ability to change and adapt and to make “that difference”.  

Those of us who have been involved in health and social care for some time (longer than I am prepared to admit!) are used to change. No matter what role we play, we are continually changing and adapting to the environment we work in and to those around us.

This week we are celebrating care homes and the people who live and work in them. On being asked to write a blog on “change and adaptation” I thought about these people and considered what to focus on. I could have written about changes in technology and equipment, changes in registration requirements, changes in dependency levels, changes in expectations, changes in legislation and employment law and so on, but I haven’t.

 Although these all undoubtedly necessitate adaptation and change, I want to take the opportunity to acknowledge the “change” moving to live in a care home has on a person and their families and on the skills and dedication of the care home staff involved in supporting them through that process. Having the ability to support a family well during this time of transition is absolutely crucial. Providing this support requires a chameleon like ability to change and adapt as well all know that no two people or their circumstances are alike.

Some family members may have an enormous feeling of guilt and think they have let their loved one down while others view their loved one going into a care home and an exciting and positive new adventure. Sadly, in my experience, the former is more likely.

Negative media coverage, often biased and ill-informed, do not help. Though incidents of poor care in unsatisfactory surroundings do exist they are fortunately very much in the minority. Sadly good news and celebrating good care does not always sell newspapers, so is not always what springs to the publics minds when they hear the words “care home”.

The dedication of those working in care homes must be highlighted. Their commitment to making changes which result in a positive outcomes of those they support, their ability to continually adapt their approach and use different skills to best meet the individual needs of those in their care, their ability to adapt and respond appropriately to highly sensitive and often emotionally charged situations, their quest to gain further knowledge and expertise and their relentless drive to make a positive difference must be acknowledged must be and celebrated.

If the words “care home” immediately conjured up the public’s visions of happy, stimulated, active, valued, involved older people living in bright, stimulating, safe environments then the prospect of a loved one going into care would be much less daunting.

I mentioned earlier us all having the ability to make change. One I, and my colleagues in the Partners for Integration and Improvement team within Scottish Care, can make and strive to make is to change the impressions the public has of our sector. By highlighting and sharing good practice and by supporting innovation, we hope we are making a difference. We feel we owe that to our colleagues working on the front line.

Going back to my three wishes, if I was granted these, one would be that the myths that Karen Hedge (National Director, Scottish Care) discussed in her blog earlier in the week, would be completely and utterly busted.

Let’s make that change.

Margaret McKeith

National Lead, Partners for Integration

@MargaretMcKeith

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Care Home Week: the role of care homes in supporting solace

In the fourth day of Care Home Week 2018, we're focusing on change and adaptation in the care home sector. 

One of the most significant changes in recent years has been the complexity of care required and lengths of stay of care home residents, with many care homes now delivering high levels of palliative and end of life care.  

Care Home Week is therefore a good time to highlight the critical role of care homes in the last days, weeks and months of someone's life and their ability to support someone to have a good death.

The care, compassion and skills of care home staff are highlighted in Scottish Care's 'Supporting Solace' project including the Trees that Bend in the Wind report.

We encourage you to use Care Home Week as an opportunity to explore the Supporting Solace resources, to celebrate care homes' role in high quality palliative and end of life care and to consider how care homes and their staff can be further involved in partnership working, knowledge exchange and resource sharing in this vital area of care and support.

 

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