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A view from West Dunbartonshire & Inverclyde

My name is Brian Polding-Clyde, and I’m the Local Integration Lead for West Dunbartonshire and Inverclyde Health and Social Care Partnerships. I have worked in both areas for over four years and this has offered me the opportunity to work and influence across every sector of health and social care.

As a key Scottish Care partner, I was an invited to the Employee Recognition Awards for a colleague, Wendy Jack (Planning Improvement Manager, HSCP), who received a commendation under the Team Leader of the Year category. Wendy, along with Selina Ross (Chief Executive of CVS West Dunbartonshire), are instrumental members of a strategic partnership that helps to build ever closer links between the statutory, third, and independent care sectors. I was also invited to the Scottish Association of Social Workers (SASW) awards last week, where West Dunbartonshire’s HSCP’s Care at Home Team won the Special Award for ‘Best example of collaboration in an integrated setting’, recognising not only the worth of the team itself, but its impact as part of the wider integrated health and social care provision for adults and older people in area.

Wendy, Selina, and I, hosted a participation event in West Dunbartonshire which brought together Care at Home and statutory providers and commissioners. At the event, Chris McNeil, (Head of Health and Care) provided an overview of West Dunbartonshire’s present demographics and how the future may look. Chris was clear in noting the crucial role of the Independent sector in the ongoing delivery of care to the local population. Selina highlighted the role of the third sector and the ‘Link-Up’ programme, a single call telephone advice line run by well-trained local older volunteers, in helping to support people within their community. Link-Up, in addition to offering advice, also follows up on calls ensuring users are satisfied with the resolution. Lynne McKnight (Integrated Operations Manager for Care at Home) and I then gave a joint and integrated presentation on what we saw as the challenges and opportunities in delivering a Care at Home service. The room agreed that one of the key ways for us to move forward is to share resources and training. To be able to do this effectively will require the development of a Practice and Development Forum co-facilitated by the independent and statutory sectors.

In Inverclyde, we recently made a successful bid to have Care at Home and Housing Support Services become part of the Care Inspectorate’s ‘Care About Physical Activity Programme’. With partners in the third, statutory and independent sector we are developing awareness and interest in the programme, which will allow the Care Inspectorate to recruit fully committed participants.

Also in Inverclyde, we’re close to publishing ‘Come On In’, a resource developed to enhance the experience of visiting a care home. The publication has grown organically from the shared experiences of visiting family and friends, nursing staff, and reflections from Heather Edwards (Care Inspectorate), and myself.

Over the four years I have been working in West Dunbartonshire and Inverclyde, it has become apparent that the success of the work we’re involved in is dependent on closer partnership working and a commitment to joint leadership across all sectors. This will give us a better understanding of the complexity of the landscape we work in and the role we can play in enhancing the care of the people for whom we work.

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Five Nations Care Forum issue Statement on Severe Underfunding in Social Care

Following a meeting in Scotland, the Five Nations Care Forum is calling for remedial action to the severe underfunding of the social care sector.

People are living longer, often with more complex needs, and demand for care is increasing all the time.

At the same time, the funding of social care across the five nations remains wholly inadequate. This has resulted in serious constraints on the delivery of social care services to individuals who need state support.

We know that these people want reliable, sustainable services, delivered consistently by people known to them who understand their needs, preferences and aspirations. The current funding shortage has a number of negative impacts:

  • State funded support being delivered too little, too late, meaning that opportunities are missed to support people in a way that anticipates their current and future care needs and prevents them receiving inappropriate support
  • People being admitted to hospital unnecessarily and remaining there too long, resulting in negative impacts on individuals’ health and wellbeing, delays for those who do require hospital support and additional costs being incurred by health services
  • Staff shortages resulting from low salaries and poor terms and conditions
  • Providers of social care withdrawing from the market, causing changes in or complete removal of support to individuals who require it
  • More individuals and their families having to bear the cost burdens and physical, emotional and time outlays of providing care, which will stack up problems for the future.

This is not acceptable for a civilised society – it does not adequately support people’s rights and interests, and undermines the dignity, value and worth of people who need care and support.

Social care is a sector of national strategic importance; being a major employer, providing essential support to individuals and families, and enabling family carers to remain economically active.

The Five Nations Care Forum calls on the five governments to take urgent corrective action to protect people’s rights and to ensure a sustainable social care sector now and for the future.

ENDS

The Five Nations Care Forum is an alliance of representative independent sector care organisations across England, Northern Ireland, the Republic of Ireland, Scotland and Wales.

The Forum meets twice annually, providing a platform to discuss and inform practice in each administration, challenge and share successes.  In doing this, the Forum also seeks to identify opportunities for cross-country collaboration and learning where this will be of value to service users and citizens.

The Five Nations Care Forum met on 27-28 March 2017 in Edinburgh, where this statement was agreed. The meeting was attended by representatives from:

  • Scottish Care
  • United Kingdom Home Care Association
  • Care England
  • National Care Forum
  • Care Forum Wales
  • Independent Health and Care Providers (IHCP) Northern Ireland
  • Nursing Homes Ireland

For more information, please see: http://www.fivenationscareforum.com/

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Pilotlight self-directed support project concludes

Pilotlight was a five year programme funded by the Scottish Government as part of the implementation of self-directed support.

Pilotlight co-designed seven pathways to self-directed support focusing on mental health, risk, self-employment, young people in transition, older people in transition, people with younger onset dementia and people in recovery from substance misuse.

The project tested and refined a model for successful power sharing, produced tools and resources, and developed solutions for the implementation of self-directed support. Each pathway included people who access support, local authorities and support providers.

On the homepage of the project website, we’ve published a short, animated video entitled, ‘Are you in the dark about self-directed support?‘ It provides a summary of project. Please watch, enjoy and share.

Thanks to partners and those who have supported and/or been involved in the Pilotlight project since its inception.

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SSSC consultation on supervisory and management qualification requirements for adult services

The SSSC are considering increasing supervisory and management qualification requirements for registration for all supervisors and managers in adult services.

The proposal is to change the minimum requirement for qualifications for supervisors and managers from 15 SCQF credits to 30 SCQF for new registrants (and possibly existing staff).

Although Scottish Care will be submitting a response, it is very important that our members recognise what these proposed changes mean in reality and engage with this consultation process.

The consultation closes on 16th April.

The SSSC also wants this consultation to inform the wider support provided to managers and supervisors. The questionnaire can be found through the link below:

http://www.sssc.uk.com/consultations/consultations/current-consultations/consultation-on-the- supervisory-and- management-qualification- requirements-for- adult-services

For further information please contact Robert Kelman – Learning and Development Advisor at the SSSC on 01382 346469 or [email protected]

If you would like to discuss this with a member of the Scottish Care Workforce Matters Team please contact Katharine – [email protected] or Paul –[email protected]

 

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‘Human rights do not have a use by date’: Scottish Care CEO calls for protection of older people’s rights

What do a ticking time bomb, a silver tsunami and a population apocalypse all have in common? No, they aren’t the latest plotline from an episode of Sherlock but rather they are phrases used to describe the fact that we are living longer. They are highly negative descriptions of a reality that most of us would or should want to celebrate – we are dying older and healthier than at any time in Scottish history. So why the negativity? Why is it that so much of our cultural and political discourse about old age paints such a dark and depressing picture?

Old age is something which should be valued, but alarmist attitudes fail to recognise the benefits and potential of older age and feed into the myth that getting old is about losing something rather than gaining something new and potentially positive. Old age is seen as a challenge rather than an opportunity.

Ageism as a concept was first coined in 1969, and describes a context where there is discrimination against, contempt for, abuse, stereotyping, and avoidance of older people.

Everywhere you look there are negative stereotypes which perpetuate the myth that older people are incapable and dependent, have nothing to contribute but rather are a burden and a drain on society. We see this in many of the current debates about social care and health which count up the costs an ageing population results in but fail to recognise that over 90% of care delivered in this country comes from the hands of people who are themselves old thus saving the taxpayer countless millions.

In Scotland I am sure we would like to believe that we treat all peoples as equal, regardless of colour, creed, disability, sexual orientation and we have indeed made great strides in addressing discrimination and hate. But have we made the same progress against negative stereotyping and discrimination which is based on age? I think not – why is it that a child in receipt of residential care will have nearly double the amount of public resource allocated to their care than an older person of 90 in a care home? Why is it that countless individuals talk about not even getting the chance of an interview if they are over 60 and are seeking employment? Why is it that at the age of 65 people who are accessing social care support move from being an adult onto being an ‘older person’ and in some areas such as mental health services they tell us they suddenly find the level of their support diminishes? Do we feel it is adequate that for thousands of older people in the last few months of their life that we allocate the sum of £3.85 an hour to provide 24/7 intensive nursing care home support? That’s less than the cost of a packet of 10 cigarettes!

Many of us feel that Scotland needs to address the challenges of the silent, pervasive and systemic age discrimination which impacts on the lives of countless of our fellow citizens. We are not alone. Last September the United Nation’s Expert on Older Age, Rosa Kornfeld-Matte, stated that current international provisions are not sufficient to fully protect older people’s rights, and she called on states to consider a new convention. A few weeks later I chaired initial discussions with interested parties to explore whether Scotland needs its own Convention of the Rights of Older Persons and/or an Older Persons Commissioner as Wales and Northern Ireland have.

The creation of a convention for older people in Scotland would not add new laws and rights but would go a long way to ensure equal treatment for older citizens, not least by demanding adequate financial provision for that group of the population.

Equally an Older Person’s Commissioner would be a champion and advocate for the human rights and equal treatment of older persons. Older Scots should not be the victims of discrimination in employment, in accessing public services, in social care or in hospital treatment.

The time has come for us in Scotland to join the campaign to create a framework of rights which recognises the distinctive discriminatory experience, both at societal and personal levels, which all too many older Scots endure and experience.

We need to take off the heather-tinted glasses and face up to the reality that Scotland is as ageist a nation as many others in the world but rather than just recognise this we need to act and both a Convention and Commissioner for Older Persons would be positive steps to take. Human rights do not have a use by date – they do not diminish with age.

 

Dr Donald Macaskill

Chief Executive, Scottish Care

 

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Scottish Care Workforce Development Strategy Group

The next Scottish Care Workforce Development Strategy Group event will take place on Wednesday 3rd May.

If you would like to attend please email Katharine Ross directly
– [email protected] by Friday 14 April.

We expect this to be a popular event so we would appreciate you confirming as soon as possible.

Please also let Katharine know if you have any dietary requirements.

If you would like further information please contact Katharine by email or telephone – 07427 615880.

The full programme can be found here.

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How do you explain dementia to a six year old?

 

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The Ally Bally Bee Project is the world’s first personalised children’s book about dementia.

We launched a 2-minute fundraising video three weeks ago and reached our target within three days. During that time we also featured in The Sunday post (online and print), STV news and Third Force News.

As you will see from our video and press coverage, this is very much a family project but one with worldwide appeal. It’s all in aid of a good cause: to educate children about dementia and raise money for charities across the globe.

So far, we have attracted two gold corporate sponsors – one from the US and one from Australia. These organisations will now benefit from having their names and logos feature in every book we publish, on our website and across all our communications.

We would love to have a third, UK, sponsor on board. We truly think this is an amazing opportunity and, although we’ve achieved so much as a family, with your support we could do so much more.

A few other highlight of our project include:

  • More than 16,000 Twitter followers, 550 email sign ups and almost 4,000 Instragram followers
  • Award winning presentation at the Alzheimer Europe Conference in Copenhagen 2016
  • Abstract for the Alzheimer’s Disease International conference in Japan 2017 accepted for presentation

Please watch our video and find out how you can get involved. We would love for you to be involved in this truly unique and innovative project.

Together, we can make those difficult conversations a little easier.

Thank you,

Nina, Matthew and wee Lana

The Ally Bally Bee Project – the world’s first personalised children’s book about dementia

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Katharine Ross’s talk on realistic palliative care

The following is the text of an address Katharine Ross, Scottish Care’s National Project Lead on Workforce, gave this evening to the Scottish Parliament’s Cross Party Group on Palliative Care. The theme was ‘Realistic Medicine.’

I would like to thank the Scottish Partnership for Palliative Care for inviting me to speak this evening.

I’d like to discuss the principles and ethos behind Realistic Medicine, and how it relates to the people who delivers the greatest volume of palliative and end of life care in Scotland – front line social care support workers.

The principles of Realistic Medicine as we all know are:

time, open conversations, honesty – putting the person receiving health and care at the centre of decision making and creating a personalised approach to their care.

In the context of this evening’s discussion, I’d like to explore how good we are in Scotland at putting our older citizens who are dying at the centre of decisions being made which enable a personalised approach to their death.

At the end of 2016, Scottish Care undertook a significant piece of research which sought to explore and describe the experiences of front line support workers employed in care homes and care at home organisations who were involved in the delivery of palliative and end of life care.

At four locations across the country I, along with my Scottish Care colleagues, were privileged – and often moved to tears – listening to examples of compassionate end of life care. We heard extraordinary stories of physical, practical, social, emotional and spiritual support being given to older people.

All of which was being delivered by front line support workers.

We captured stories such as the care home staff who formed a guard of honour as a resident left their home for the last time.

We heard of the importance of time and honesty. One participant said quietly:

“I want to be able to explain to somebody exactly what’s going to happen (when they die). I want to be able to stop someone being afraid”

We also heard the challenges involved in having open conversations about dying. As another support worker said:

“I don’t know what to say….it can be overwhelming. We try and say what we think is right. It just comes out.

 …You feel like you’re apologising all the time”

I suppose what we really captured was the human impact of delivering care at the end of someone’s life, and of doing this in challenging conditions on a regular basis – for multiple people.

Indeed a focus group participant was the inspiration for the title of our publication. “We are the trees that bend in the wind” is how this person described a workforce which adapts, changes and flexes to the journey of palliative and end of life care, and experiences it with the supported person.

But this phrase also relates to a workforce under sometimes intolerable pressure and strain, at risk of breaking, or at least of losing part of oneself in the process of providing end of life care.

Delivering palliative and end of life care to older people requires highly skilled, technical and practical interventions. It also involves providing emotional support, a familiar face, a hand to hold, family liaison and so many more forms of care and support that cannot be captured in any job title, not least ‘a support worker’.

In our report, Scottish Care have made 12 recommendations. Some relate to the individual who is dying – for example the development of work which embeds a human rights-based approach to the exercising of choice and control at the end of life, especially relating to the rights of older people. Dying of frailty or dementia, for example, should have a specific pathway in the same manner as those which have been successfully developed for cancer and other conditions.

Other recommendations relate to the workforce, and to the policy conditions which ultimately dictate practice.

There has to be a greater emphasis on honest & open conversations about how we pay for and commission palliative and end of life care. Can we honestly say that we adequately resource the social care sector to train its staff to an appropriate palliative level? Do we ensure sufficient time is given for a care at home support worker, to listen, to have open conversations, hold somebody’s hand, to comfort, provide love, to wipe a tear of fear away?

The answer is no.

The ethos of Realistic Medicine – time, open conversations, honesty – are critically important for all of us in this room to have, to ensure that all older people in Scotland experience a person centred death.

 

 

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First of five Directed by North Merchiston films launched

Today (Monday 20 March), May: This is Your Life was launched online.  

This beautiful short film is part of a series of five short films entitled Directed by North Merchiston, made with the collaboration of the residents at North Merchiston Care Home, a Four Seasons Health Care home in Edinburgh.

Each of the residents' films - May, Charlie, Edith, John and Margaret - will be made available online on consecutive Mondays over the next 5 weeks.

Lead by BAFTA award winning filmmaker Duncan Cowles, each resident was encouraged to take control of the film-making process and decide upon the direction and what content they'd like to be included and focused on within the films.

This film project was commissioned through Luminate Creative Ageing Festival in association with Scottish Care.

Please feel free to share this information and the films more widely.   We'd also love for you to share your response to them through Twitter at @scottishcare or @DuncanCowles

For more information, please visit: duncancowles.com/directed-by-north-merchiston

May: This is Your Life

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Scottish Care statement on BBC Panorama expose on Care At Home services

Scottish Care has issued a statement relating to the BBC Panorama programme and its research highlighting that many care at home providers were handing back contracts because they could not afford to deliver them.

The story is described on the BBC news website at http://www.bbc.co.uk/news/uk-39321579

“Sadly this research does not come as any surprise to us.

We know that a good number of our providers have handed back work as what they have been offered by the local authorities and Integrated Joint Boards simply could not enable them to deliver dignified, safe and adequate care. They would rather lose the work than drive standards even lower.

We are still in Scotland dominated by a political culture which tries to get the most amount of care for the cheapest price. This is a shameful way for the care of our vulnerable older people to be delivered. We have to find a better way of purchasing care than a model which is driving good organisations out of business.

A lot has been said of the funding for the Scottish Living Wage and this has indeed been welcomed, but it is on its own never going to be the answer to a critically underfunded sector. Indeed in practice this has not had the positive effect we had hoped for as 9 out of 10 of our care at home providers are struggling to recruit staff as competition with better paid sectors like hospitality and retail increases.

More pessimistically a survey which has just closed shows that 1 in 5 of our care at home providers are not confident being in business this time next year.

We cannot continue to allow this crisis to grow as the people who suffer the most will be those who have the least ability to speak out.”