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Scottish Care comment on Care Home Provision Research

Analysis on care home provision and planning recently published by professional services firm JLL has been widely covered in the Scottish media. To read the organisation’s news release please see the following:

http://www.jll.co.uk/united-kingdom/en-gb/news/3164/scotland-facing-future-shortfall-in-care-home-provision

Scottish Care has been asked to comment on this analysis and has provided the below statement to media.

 

Scottish Care CEO Dr Donald Macaskill said:

“Scottish Care appreciates that as more and more individuals are living longer, we need to ensure that there are a sufficient range of services which will enable people to have real choice in their care.

“Even though more people are living in their own homes later into life, we recognise that there will always be a need for high quality residential and nursing home provision. This research shows that we not only require the existing volume of care beds but a substantial increase in beds over the next ten years. The investment to achieve this will not come about unless there is an equal substantial increase in what we are prepared at a national and local level to pay for care with dignity.

“At present, we do not have a significant shortage of care home places in Scotland but with a staffing crisis matched by insufficient funding, the risk of not having places for people to go when they leave hospital is a real one.

“Scottish Care is seeing an increase in the number of care homes having to close because they are no longer financially viable with rising staff and operational costs. Whether charitable or private, care homes cannot continue to deliver quality care on the rates currently offered by the public purse.”

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Care in Mind: 26 September

Scottish Care will hold a Care in Mind workshop event for members on 26 September 2017 at the Renfield Centre in Glasgow.

The physical and mental wellbeing of our workforce is critical if high quality health and social care services are to be delivered to the most vulnerable people in society. Recent research by Scottish Care indicates that the pressures and demands facing the front line social care workforce are creating significant recruitment and retention challenges for employers.

Care in Mind is a practical workshop designed to explore how we can manage and promote good mental health and wellbeing of those working in care homes and care at home organisations.

Please see the full programme details below. If you wish to register for this free event, please contact [email protected] by 11 September.

#careinmind

 

Care in Mind
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Care Service Providers Survey

The Scottish Government’s Self-Directed Support and Care Inspectorate sponsorship team is seeking help to shape their planning to fulfil the following aims:

  • Implementation of the SDS action plan 2016-2018
  • Promoting the new Health and Social Care Standards which are aligned to SDS practice
  • Exploring Care Inspectorate practices with a view to promoting a greater degree of innovation and creativity
  • Supporting the CI conduct Thematic Inspection of 6/7 Local Authorities in 2017-8 focusing on the implementation of SDS, choice and control

Scottish Care members are invited to please complete the attached Care Service Providers Survey by the 16th August.

 

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Guest Post from Local Integration Lead: Sue Newberry

Community, Culture and Co-production

When our family moved to the beautiful Isle of Whithorn our friends and neighbours said that ‘if incomers make it through three winters they probably stay!’ Well, 16 years later the Isle is still our safe haven – and to be honest, where else would you want to live?

We moved here from the Midlands and soon felt at home - not only because of the familiar stone dykes surrounding the fields, but more importantly because of the local sense of community and the local culture created by residents and our regular visitors.

I originally joined Scottish Care as a consultant to support Reshaping Care for Older People in Dumfries & Galloway in August 2013. Since then, a small team has been developed to support a range of different R&D activities and now Health and Social Care improvements. For this blog, I’m going to focus on one unique element of our work – and, after all,  we all need a bit of culture!

Research has demonstrated that organisational culture is now a major factor in the success of any organisation or partnership. In D&G, all four partners (the NHS, Social Services, Third and Independent Sectors), have started to work together to improve the culture of our partnership. We believe that this is will help to underpin how the partnership is able to co-design, co-produce and co-deliver sustainable care and support services in the future.

Measuring and changing Organisational Culture

Working with Human Synergistics UK, a representative sample of over 2500 individuals from across our partnership completed a questionnaire called the Organisational Culture Inventory ® or OCI. This phase of our work generated two important results:

  • our ‘current culture’ – where we are now, and
  • our ‘ideal culture’ – where our partnership wants to be in the future

The OCI measures what is expected of members of organisations and helps us understand how different team members feel in their work role. Results are plotted on an OCI Circumflex which shows the distribution of results across 12 different ‘styles’. For example, Style 12, (‘Self-Actualising’), is where ‘Members are expected to gain enjoyment from their work and produce high-quality products/services’.

 These 12 styles are grouped into three important clusters:

  1. constructive styles (shown in blue),
  2. aggressive/defensive styles (shown in red) and
  3. passive/defensive styles (shown in green).

The circumflex shown below illustrates the OCI Research Benchmark, the culture of the most successful organisations and partnerships – notice all the blue!

Our partnership results have highlighted differences between different sectors and between different groups of staff – all of which have helped inform our improvement plan. Team members, from all partners, have become accredited in the use of these tools and are working together with colleagues from all localities to create improvements.

Measuring and changing leadership styles

We believe that ‘Culture happens. Leaders and managers can let it happen or they can manage what happens. It is a choice.’ We want to harness and improve the leadership across all sectors, to move us closer to achieving the ideal overall culture for the partnership.

An important element of our improvement plan is already well underway, lead by our IJB members. Research has demonstrated that to be truly effective and efficient leaders we need:

  • a better understanding of ourselves
  • a better understanding of our own way of thinking and how resulting behaviour is perceived by others
  • an appropriate balance between ‘task’ and ‘people’ orientation.

The Life Styles Inventory (LSI) enables leaders to do just that, comparing self-reflections and feedback from our colleagues. Two cohorts of IJB members and senior leaders from across the partnership have already engaged in this process.

Working together

The LSI and OCI work together to help us identify improvements at an individual and at an organisational level. Creating the ideal culture begins with each one of us – we all need to ‘take a good, hard look in the mirror’ and see how we can improve. Is what we’re doing helping the partnership to achieve that long-term vision of our ideal culture? If not, we need to adjust our way of thinking and/or our own behaviours. Remember ‘Leaders and managers can let it happen or they can manage what happens. It is a choice.’ In fact … its our choice. Ignoring ineffective behaviours or ‘walking by’ won’t get the job done for HSCI.

As a partnership we have to be honest with each other to identify and change those things that are no longer fit for purpose. This could include a range of different things that need to be changed such as:

  • improving our understanding of each others’ roles and responsibilities
  • enhancing the way that our meetings are structured and who is invited to attend those meetings (and whose voice is not heard)
  • the way we treat, listen to and respect each other
  • sharing information across all appropriate partners to support the efficient delivery of care and support services

Focusing on the ‘tasks’ of creating new models of care, developing early intervention strategies, delivering sustainable intermediate care etc.  is, of course, vital. But this important work relies on all four sectors working together as equal partners to co-design, co-produce and co-deliver sustainable care and support services in the future. And to do this well we all need a bit of culture!

 

Dr. Sue  Newberry, Regional Integration and Improvement Manager, Dumfries & Galloway

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Mental Health Nursing Forum – 2017 Awards

The Mental Health Nursing Forum (MHNF) has opened the nominations to its 2017 Awards, which will be held on 2 November this year.

For further details on these and to access the associated submission forms, please see below.

 

[gview file=”https://www.scottishcare.org/wp-content/uploads/2017/07/MHNFS_Awards_2017_-_Covering_Information1.doc”]

 

[gview file=”https://www.scottishcare.org/wp-content/uploads/2017/07/Sumbission-form-2017.doc”]

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SSSC: Opportunity to join Council

The Scottish Social Services Council are looking for someone who is registrant to join their Council. This is a tremendous opportunity for someone with experience of working in the independent sector to join the Council and represent the views of the sector.

Scottish Care members are encouraged to give consideration to applying or passing this information on to someone who might be interested.

Please get further details on the Public Appointments website.

Applications have to be submitted by 16 August 2017

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Job: Lippen Care Project Worker

Lippen Care Project Worker

Development of Angus Wide Palliative Care Strategy

15 hours per week – 12 months with possible extension to 18 months

An exciting opportunity has arisen for the right person to develop a fully integrated Palliative Care Strategy across Angus Health and Social Care Partnership. Join us and help improve how Angus deals with the hard times which can come with death, dying and bereavement.

We are looking for someone who can demonstrate leadership skills and the ability to communicate and engage with a range of partners/stakeholders. The post-holder will be educated to degree level or able to demonstrate experience of producing work at this level. You will be able to prioritise workloads and work unsupervised to meet outcomes and deadlines.

This is a new post and its purpose is to support palliative care in an integrated way across Angus to promote more open and supportive behaviours around death, dying and loss. This will be achieved by developing a strategy that integrates training, organisations and support across a range of partners and location types

This is a unique position which should be attractive to someone who wants to achieve change in an integrated manner. The post itself is funded through Lippen Care with the post holder employed through Scottish Care with line management held in Angus Health and Social Care Partnership.

It is essential that you have a current driving licence and skills in use of new technology

Salary – £41,000 per annum pro rata

Closing Date for applications – 18/8/17

Interviews to take place 11/9/17

Please contact Ivan Cornford [email protected] for an application pack and job specification.

 

 

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Latest blog from our CEO: A human right to health and care?

A human right to health and care?

In my role as CEO I often get invitations to go to events and seminars furth of Scotland. As a rule I tend to turn down the vast majority of such invites feeling that they are not directly pertinent to the work of Scottish Care. Last week, however I accepted an invitation to join a small group of economists, senior Government officials from the four nations, and policy experts to explore and contribute to the latest research on how we should fund/finance health and social care in the United Kingdom. Organised in London by the Health Foundation and Rand Europe, during the seminar a group of twenty of us explored the various developing ‘options’ and their relative attributes.

How we finance health and social care in the years and decades ahead is an important issue faced as we are with the potential of a growing number of healthy older individuals and fewer and fewer people of working age to contribute through direct taxation. The technical debate on the relative merits of  individual insurance, direct taxation and mixed contribution modelling etc was all very challenging but what I was left with on the way home after the meeting was a whole range of thoughts on the inequality of our treatment of health and social care.

It is part of our practice and policy DNA to know that NHS services are free at the point of access. Indeed the NHS was created out of the ideal that good healthcare should be available to all, regardless of wealth. When it was launched by the then Minister of Health, Aneurin Bevan, on July 5 1948, it was based on three core principles:

  • that it meet the needs of everyone
  • that it be free at the point of delivery
  • that it be based on clinical need, not ability to pay

So today nearly 70 years later we would not expect to pay for a hospital bed or an A&E consultation or a GP visit. Indeed in Scotland even services we once paid for are now free, such as prescriptions. In that sense they are universal.

The First Minister has stated her particular desire to see that in terms of human rights in Scotland we will be able to do ‘even more, even better’ (See speech https://news.gov.scot/speeches-and-briefings/snap-human-rights-innovation-forum, December 2015). She at that moment and subsequently has encouraged the consideration that Scotland might become the first part of the United Kingdom to consider embedding the ‘right to health’ as part of our legislative framework. See a fuller description of this debate at http://www.healthscotland.scot/media/1276/human-rights-and-the-right-to-health_dec2016_english.pdf

Now what a ‘right to health’ might mean in practice and for those who access as well as deliver health services is open to much debate. But in this debate what has been noticeably absent is a consideration of how should that right to health relate to social care.

I have written elsewhere (https://www.scottishcare.org/scottish-care-news/blogs/lessons-from-a-boiler-breakdown/) about how integration has enabled us in Scotland to start to embed a whole system approach to the health and care impacts which an individual experiences, for good or ill, during their lifetime. Indeed I am increasingly of the opinion that one of the barriers to truly focusing upon the person is our continued encampment in health and social care camps. Whether it be the lack of fully pooled budgets, a split workforce strategy, an over-emphasis on one part than the whole, we are some way off from effective integrated working. But for individual citizens whether it’s from the NHS or a care home we receive our care is of less concern to than is the quality and essence of the care received.

In practice and policy we are a long distance from a Wellbeing Service incorporating health and social care. Indeed one of the issues that hit home to me in my meeting in London is the inequality of the two (however linked) systems we currently have. Because as much as we would never conceive paying for an NHS provision if we are living with cancer – why should we as an individual supported in the community be means-tested for our care and support if we live with dementia? Why is there an inequality in the way in which we expect people to pay for their social care be it in a care home or their own home, but do not expect the same if a person was in an NHS long-stay ward? Is the care we get from the NHS better or more important than the care we receive from social care staff? Does the presence of a stethoscope or uniform enhance the professionalism on offer? Are we emphasising clinical care as more fundamental to well-being than other attributes such as connection, relatedness, belonging etc?

If we are creating a joined up and integrated system we are going to have to start asking about the equality of access, affordability, contribution and capacity.

If we are to have a right to health, free at the point of access, then we are going to have to start asking not just how we finance social care but whether in a w(holistic) system which is truly integrated why should one part be free for some treatments and some conditions, and another part of the system be chargeable?

In essence if we are to have a right to health I believe that also means we need to have to develop a ‘right to health and (social) care’. In some sense in her speech which highlights the human rights bestowed by self-directed support legislation, the First Minister is making that same assumption. So what does a right to health and social care mean for the way we finance our joint system? What does it mean for the way we reward and recognise the value of the workforce in that integrated system? What does it mean for the contribution of the third and independent sector not just in social care but also in health?

So, all in all, an interesting trip south.

Donald Macaskill

@DrDMacaskill