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Care Home Week 17: Guest blog from Fiona Collie (Carers Scotland)

Carers, families and care homes

Moving into a care home can be a big decision that brings about many changes to people’s daily lives. Some of these changes will be welcomed by people and their families because they bring more safety and security, as well as the friendship and companionship that may be found from being around peers.

Carers often say that they have conflicting feelings about making a decision with or for a person that they have to move into residential care.  Carers have told us that they experience a mixture of sadness and guilt, whilst also feeling some relief that the person they are looking after will be given a level of practical care and assistance that is now too difficult to maintain at home.

 “I know the feeling of having a huge weight lifted off your shoulders.  It’s what I felt when I made the decision that my brother had to be in a care home, and simply could not live independently any longer.  I also know the guilt that comes with that decision.”

Anon: Carers UK Carers Forum user.

For some carers, the person moving into a care home will be their spouse or partner.  In the case of older people, very often, they will have been married and living together for 50 or even 60 years. For both, the idea of living apart may be unimaginable and heart-breaking.

 “After 42 years of marriage, I miss her beyond belief.  For even when she was ill, she was a presence in the home.”[1]

It’s important that staff in care homes recognise these difficult feelings and the fact that, for many carers, caring simply continues but in a different way.  Many carers say they visit every day, help at mealtimes and in activities and take their loved one out on trips.  Involving carers and families can be crucial to the wellbeing of the person living there.

It’s important to encourage and support family life.

Care homes do and should actively work to involve carers and families and they should be encouraged to be a key part of their loved ones lives. Carers can help in bringing in personal items to decorate the person’s room, with advice on the person’s likes and dislikes, and information about what the person does as part of their normal routine.

Families, especially couples, should have time and space for private, undisturbed time together.  Where possible they should also be encouraged to take the person out to visit local places such as cafés and shops and local events… or to help them maintain interests, hobbies or clubs.

Care homes can set up a carers and families group (if there isn’t one already), where all the carers who feel like it could get together to support each other and perhaps work together for the home – fundraising or organising outings are often popular. Also they can share their concerns, and come to staff together with any issues.[2]

Useful resources for carers, families and people working in care homes:

  • Video: Living in a care home: a positive outcome for a person with dementia

http://www.scie.org.uk/dementia/supporting-people-with-dementia/living-care-home-positive-outcome.asp

  •  The Relatives and Residents Association has a range of resources for families, carers and workers. http://www.relres.org/

 

NOTES:

 

[1] Read more: http://www.dailymail.co.uk/femail/article-2537556/I-wife-care-home-I-bear-guilt.html#ixzz4jVqVitHk
[2] Taken from (amended) http://www.scie.org.uk/dementia/carers-of-people-with-dementia/supporting-carers/hospital-and-care-homes.asp

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Care Home Week 17: Guest blog from Sue Northrop

Ordinary life is extraordinarily precious when someone we love is in a care home. It’s the little things that make life sweet for people in care homes, families and friends.

When Mum went into a lovely care home, we were both exhausted. I had stopped being a daughter and become a carer; ever on duty, an unpaid care-worker. The move was a relief. Mum is well cared for and happy and I was involved from the start in discussing her care and our family chose things for her room. It was wonderful to watch Mum make friends and build relationships with staff, she began to feel at home.

I’d got my Mum back, plus over the years I’ve acquired a host of other residents as honorary relatives. I was no longer Mum’s carer, I was her daughter and Mum was smiling and happy. When you love someone with dementia, that sense of getting the person back is very special.

My current caring role is less physical and more emotional and social. I do the family phone calls; birthday cards, photos and videos; I keep alive and share old and new family stories and songs. We’ve created a new way of being a family and new memories.

The care home staff have been critical. At the heart is an open and honest relationship. I can share (almost) any concerns and they will tell me almost immediately if Mum falls or gets ill. I can visit any time.

Little things help us retain and create a new sense of ordinary family life. I buy Mum’s clothes and arrange regular family chats and share photos. I visit at coffee time - my family does nothing without a cup of tea. When the family comes down, the manager gives us a big room and enough tea and biscuits to refresh an army. These are precious family times, when we are just ordinary people.

Caring is for life, it doesn’t start when we call ourselves a carer or end when someone we love goes into a care home or dies. Going into a care home can make it really hard to maintain a sense of connection to family and ordinary life. What makes it work? Care home staff involve me, we have an honest relationship, we talk. I trust them and Mum feels at home and is clearly happy because the staff show her they care.

The home enables us to keep doing the simple family things we have always done and show our love and mutual support in many small ways. At the biannual review we focus on our common cause - Mum’s health and happiness.

If everyone in a care home is to have a positive experience, we need a culture and practice which value relationships equally with physical care. We need to understand that relationships can be damaged by how care is delivered and transitions managed. Our relationships are precious and last beyond our lifetimes, we need to care for them.

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Care Home Week 17: Blog from Paul O’Reilly (Workforce Development Consultant)

Since beginning my role as Workforce Development Consultant with Scottish Care in March this year I have been so impressed by the dedication and passion exhibited by the many people I have met from organisations across the country.

In particular, the enthusiasm for delivering the highest standards of care by our front line colleagues has been humbling and energising.

Scottish Care’s Workforce Groups have been very well attended by representatives of every level within services. From Directors and Managers of services, the commitment to improving the experience for every one involved (both those receiving care and their families, to their own employees) has been evident and so encouraging. The positive attitude to innovation and the extra lengths services are prepared to go to in order to ensure people receive care and support that truly addresses their needs is something that we need to be more vocal about.

We have a sector full of ideas, energy and courage. Having the bravery to attempt new things when gaps in provision are apparent and there is little or no resource to fill them shows just how caring the Independent Sector is.

There will be other blogs this week which capture this, not least the one by Alison McPherson. Alison is Home Manager at Hillview Care Home and has prepared a blog that I would insist everyone should read. I will say no more than that as I could not do it justice!

While the commitment to care of senior staff has been so refreshing, as I said at the beginning of this piece, I have been most impressed by the front line workers that I have met and heard speak at groups and events.

We live and work in a time where the number of people requiring care is increasing daily. With this comes the heightened responsibilities of providing more and more critical levels of care to individuals who are living in their own homes longer. As a result, an increasing number of individuals are moving into care homes at a point where needs are far more complex than in previous times.

Despite the amount of differing pressures that our workforce are faced with each hour of every day, the dedication to improve the lives of everyone they work with has been imprinted on our Workforce Groups like words through a stick of rock.

From workers acting as Dementia Ambassadors attending our Promoting Excellence Group and speaking with such conviction and passion about what they do, would like to do, and what needs to happen to enable it – to care at home and care home colleagues speaking with such care and compassion about the palliative and end of life care they provide so frequently and want to improve on, it is evident that our workforce have the knowledge and drive to care for us all long into old age and beyond.

At a time when care services are more embattled by challenges than ever, the voices of the workforce tell me that we are in good, caring, hands.

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Care Home Week 17: Guest blog from Gail Melville at Balhousie Lisden Care

Personalisation, Participation and Activities

My name is Gail Melville, I am the activities co-ordinator at the Balhousie Lisden Care Home in Kirriemuir. It is a genuine pleasure to spend time with residents, assisting and entertaining them in their home. As such, I take my role here seriously, and know firsthand how important participation and activities are in a care setting to enhance a person’s well being.

What my job entails:
My job includes lots of planning, budgeting and time management. I make sure residents’ birthdays, special occasions and seasonal occasions are celebrated, with parties, concerts or events to honour them such as Burns Suppers, Halloween, Easter and Christmas Parties, Open Day Summer Fete etc. A lot of this involves effective relationship building and communication with local community groups and organisations, as social engagement and inclusion for our residents is a high priority. Sourcing and planning outings for residents to various places is also part of my role. This can be from a one-to-one visit into town to do some shopping, right up to taking residents to our local ‘Music Cafe’ for song and community singing, joining the ‘Friday Fling’ dancing and socialising group organised by Alzheimer Scotland or taking residents to visit local landmarks and organisations such as The Guide Dogs for the Blind Association and Kirriemuir Connections etc. I also plan activities and groups involving the community such as a monthly Reminiscence Group in association with Angus Alive and Kirriemuir Library, as well as intergenerational projects involving nurseries, schools and community groups such as DD8 Music and Kirriemuir Connections, and arrange and attend meetings to make these happen.

Planning activities to meet the different needs of residents can be quite challenging at times, however, working alongside residents, their friends and families to find out their likes, dislikes, past and present hobbies and interests, and by communicating with them and compiling participation care plans, all help me in getting to know everyone’s individual needs and desires and planning accordingly.

My job role includes facilitating and carrying out activities for residents, ensuring they are enjoying what they are participating in and adapting activities to meet individual needs. I regularly communicate with residents and staff to inform them of the activities going on, when and where, and I make up and distribute a weekly activity guide, along with posters and information for our display boards around the home.

I also help to guide and mentor volunteers we have working within the home, such as senior pupils from Websters High School who assist with group activities.

Activities I carry out on a regular basis include:
General Knowledge Quiz, Movement to Music and Seated Exercises, Arts & Crafts, Bingo and other group games, Hand Therapy and Manicure, Skittles and Golf, Music Therapy, Gardening Group, Cooking & Baking, Pet Therapy, Cinema Afternoon, Accessing Outdoors, Weaving & Wool Crafts, One to One Time etc.

Another important aspect of my job is logging the activities I do every day in my Residents Activities Records folder. This folder contains a participation and engagement file for each resident, where I record their engagement and participation i.e. activities they have attended, how they engaged, any positive or negative outcomes, and improvements or suggestions etc. This folder contains no medical information and I regularly encourage staff, friends and relatives to read or add any information that is of benefit to resident’s participation.

Why I enjoy my job and do what I do:
There are many reasons I enjoy my job, but the main one for me is the reward of making someone happy. I know firsthand how important participation and activities are in enhancing a person’s well being. In my experience, it is often the littlest things in life that bring the highest of rewards, and if I can play some part in contributing to making our residents day a happy and fulfilling one, contributing to their self esteem, confidence and spiritual wellbeing, then I know I have succeeded in my role.

Dementia Ambassador:
My background prior to working with Balhousie Care Group is in Mentoring and Team Management and also facilitating non medical Mental Health Care i.e. alternative therapies e.g. Art Therapy, Music Therapy, Design, Meditation, Diet, Physical and Mental Exercise, Yoga, Pilates etc.

Over the past 3 months I have taken on the additional role as Dementia Ambassador within Lisden Balhousie. I feel that the additional knowledge I am learning ties in very well with Personalisation, Participation and Activities in the Care Home setting.

A large number of our residents have dementia, varying from early onset right up to advanced stages. Taking a personalised approach regarding everyone we care for is vitally important in delivering the highest standard of care and in understanding each of our residents needs are met.

As much as the facilitation of activities is important, in my experience, it is vitally important to provide our residents with the right environment to suit their needs. This can be something as simple as making sure that furniture is arranged in the correct way; that contrasting cushions are placed on chairs; areas of access are open and visible; noise levels are appropriate etc. I am always mindful also of the changing needs of those I care for. As their dementia may progress, so too may their needs change, therefore it is necessary to update my care plans accordingly, and to always be mindful that a success one day may be unsuccessful another day, so adaptation, an open mind, understanding, patience and resourcefulness are key to everything I do.

My Daily Moto:
• “Treat others with the care, compassion and understanding as you wish to be treated yourself”
• “See the person, not the illness”

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Care Home Week 17: guest blog from Anne-Marie McKeich on North Merchiston films

North Merchiston Films

North Merchiston Care Home was privileged to be asked to be the host for Duncan’s project. A BAFTA Award winning film maker in their midst – wow!!!

The staff were excited that some of the residents would be able to tell their stories, and showcase care homes in a positive light, as the press surrounding care homes is often very negative.

There were a few reservations from the staff: would there be any residents able and willing to tell their stories on camera?  Would this upset the day-to-day running of the home? After all, it is the residents’ home.

There was no need to worry though.  Residents were more than willing to become involved and share their stories with Duncan and as you can see from the films, thoroughly enjoyed the experience.  The benefits far exceeded our expectations; we found out more about our residents and their past lives and it was a reminder to all care staff that the residents they care for are like them, with hopes, dreams and plans….

Duncan was a gentleman; he was sensitive to the needs of the residents and the day to day workings within the care home.  He was able to bring out the best in the residents as you can see in the films.

At the initial screening for the residents, their families and the staff, I don’t think there was a dry eye in the house by the end.

The films have been shown at Four Seasons Health Care conferences, Awards ceremonies and the Scottish Care Conference.  They have been uploaded to the home’s website and Four Seasons Healthcare Facebook site and used to highlight to staff that their residents were and are people with histories, and to learn about that will enhance how they care for them.

I would definitely be willing to participate again in a project like this and would encourage other care homes to do so also.

 

Anne-Marie McKeich

Regional Manager, Four Seasons Health Care

 

#carehomeweek17

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Latest blog from our CEO: Real homes, real lives

Real homes, real lives

In these days of cheap television where maximum revenue return is expected from the lowest creative input, programmes about designing, re-designing, buying and selling your home seem to dominate our TV schedules.

As a nation we spend billions of pounds on altering and improving our homes especially at times when house prices are challenging and mortgages are hard to get. We worry a lot about how our homes look and even if we don’t necessarily want to keep up with the Joneses it matters to many of us that our homes are the way that we want them to be.

But the things that make a house into a home are things we cannot buy. It is how our homes make us feel emotionally that is probably what matters most of all. We want our homes to be places which protect us from stress and give us a sense of belonging. We look for our homes to be places of safety and privacy, places we can be who we are, spaces which nourish and feed us in every sense of our being. And if we are lucky that is what we have. The bricks and mortar hold within them the stories of our time, the memories of celebration and sometimes of sadness; the voices, hopes and aspirations of the generations who have shared the place.

So it is not surprising that when we have to leave our own special place, our home, built up over years, that it is a journey which for many of us is both hard and emotional, not least because it is often undertaken at a time of ill health and distress. For many people in Scotland, at some time in their life their home becomes a ‘care home’ and it is those places of home that we celebrate this week.

I am proud to launch the first ever Care Home Week. This is a week which is designed to celebrate the thousand plus care homes across Scotland which today are the ‘homes’ of over 36,000 individuals.

And yes, we acknowledge that many people enter care homes at times of difficulty in their lives. We cannot do anything about that reality of illness and decline, but what we can do is as far as possible to make sure that their new home encapsulates the best of what made their former house into their home. That is what we celebrate.

Join with us this week and celebrate care homes as places of safety. When disease and illness crowds in on our living, the care home is a place where professional care and support keeps those we love safe and secure, treated with dignity and respect, with individuality and distinctiveness. So let’s celebrate care homes.

Join us this week and celebrate care homes as places of nurture. We always grow and change throughout our life. Residents in care homes do not stop dreaming and growing and changing. They continue to have new experiences, discover new talents and abilities, and some will participate in activities they have always wanted to do but never had the chance. So let’s celebrate care homes.

Join us this week and celebrate care homes as places of friendship. Being in the company of others is so important to many of us and care homes are places where it is possible to form new relationships and friendships, they provide a space where we can continue to socialise with family and friends. They are spaces which banish the fear of loneliness and the emptiness of isolation. So let’s celebrate care homes.

Join with us this week and celebrate care homes as places of surprise. Take the chance this week on Friday to visit a local care home and allow the myths you might have to be shattered. These are the homes of unique individuals, they are not hospital wards but surprising, unique and different places. The people who work in them and who live in our care homes are ordinary and extraordinary. So let’s celebrate care homes.

Join with us this week and celebrate care homes as places of peace. We recognise that for many the care home is a place where they will spend their last few months and weeks of life. They are places where the fear of parting can be held in supporting solace; where pain, both physical and emotional, can be controlled; and where individuals die in the company of those who care for them and in a manner that dignifies their living. So let’s celebrate care homes.

So, I wonder, would it not be good in all this age of reality TV for us to have a make-over programme not on the physical bricks and mortar of a building but on the myths and stereotypes which attach to care homes? It would be great to show the highs and lows, the joys and sorrows, the fall-outs and fall-ins, the real and the raw of life in a care home. In that sense it is the drama of life and love, and from the lives and work of thousands in our communities today across Scotland we have much to learn and have much to celebrate.

Join us and enjoy Care Home Week 2017.

Donald Macaskill

@DrDMacaskill

 

 

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Guest post from Local Integration Lead, Rene Rigby

Are all people living with a diagnosis of dementia treated equally?

There are thought to be around 650,000 people in the UK who are estimated to experience some degree of gender non-conformity (Gender Identity Research and Education Society).

It is widely recognised that there is limited evidence on the experiences of transgender people in Scotland and even less information regarding transgender people who have now developed Dementia.

For the first time, there is an ageing transgender population and as a result, many health and social care professionals are working with older transgender clients for the first time, many of whom have complex cognitive, social or bodily needs relating to their gender reassignment. We are only now seeing the first generation of transgender people in their 60s and over who have taken hormone therapy for 30 years or more, many of whom are living with gender reassignment surgeries performed using the very different techniques of the 1960s and 70s. Care is something that is often taken for granted. Illness and disability can occur without warning through accident or old age and the opportunity to arrange and to inform local caring services about their lifestyle or past as a male or female may not be possible. If the person in need of care is unable to wash, dress or manage basic care requirements then health and social care services will be involved, whether care at home services or care home services.

Many health and social care services are ill-equipped to deal with the needs of transgender seniors, and have had little exposure and so have little understanding of their history or the unique needs of transgender people, who fear that a move to assisted living or receiving care within their own home may leave them vulnerable to discrimination and harassment.

When we think about sexual orientation, gender identity and older people, we overwhelmingly assume that the older people who use our services are heterosexual and non-transgender. As a result, issues of sexual orientation and gender identity have often been invisible in the planning and commissioning of services for older people. The issue is further complicated through a societal culture which seldom seems to recognise or empower older people’s sexuality. This is particularly true in instances where the older person is perceived as vulnerable, specifically in a residential or nursing care setting where issues of capacity and consent may make the nurturing of an individual’s sexuality more complex. The progressive deterioration of the most recent memory for a transgender person could mean only remembering living in another gender, including not remembering having had gender affirmation procedures or surgery. A real concern of many transgender people is that they will be misgendered in the event that they become reliant on others for care.

One thing, though, is clear – for transgender people, ageing into the later years of life can present a unique set of challenges.

An example of this is older transgender people were reported to have become distressed within care settings because they couldn’t remember whether or not they have come out to fellow residents or staff and that this was causing significant anxietyto them.

There is limited understanding of how transgender people are affected by dementia. Whilst cultural awareness training for service providers is  required to improve the understanding of transgender clients and how appropriate and respectful care can be provided. Service providers also need resources and information to optimise culturally appropriate care for transgender people

There is a long way to go however, we must ensure that transgender people are protected against discrimination, harassment and victimisation on the grounds of gender reassignment.

To this end the Scottish government has begun engaging with transgender people to advise on trans-specific policies, thus enabling full participation in everyday, and public life by empowering transgender people, changing hearts and minds and creating a network of allies.

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Latest blog from our CEO: Care beyond political sound bites

It is just a little over a week before we will be going to the polls to cast our vote in the General Election. It’s been an Election dominated by a range of issues in which, unusually, social care has featured quite prominently. I recognise that social care is a devolved matter and that it is the Scottish Elections which impact most significantly upon decision making for care and support. However, the political parties seem to have blurred this line by making commitments to spend and policy even on devolved matters. Mind you some political parties are so focused on the NHS and the health service that they are almost blind to the fundamental role of social care for our nation’s health and wellbeing. But it would appear there has at least been the start of a debate on the role of social care.

And my goodness I have found the whole debate about the care and support of some of the most vulnerable individuals in our society to be immensely depressing. The discussion has been framed, by the media and many politicians, within a discourse of pessimism and crisis. Language about the old has been discriminatory and stereotypical. Old age has been portrayed as a ‘problem’ to be solved; the solutions offered usually calculated as financial responses. The concern has been less about the quality of care for the minority than a desire to reduce the cost of that care upon the majority.

Coupled with this there has been a singular lack of positive vision about what social care and care and support of our older citizens needs to look like. Those of us working in the ‘system’ know that we cannot carry on the way we are. We recognise the need for radical change and reform but alongside that, if we are serious, we also acknowledge the glaring gaps in adequate resourcing and financing for our sector.

It has saddened me that the debate on social care across the United Kingdom has been undertaken with so little grasp of the real issues and a singular absence of dynamic thought-through vision. But then again when care becomes a political football, considered solutions to complex challenges are often sacrificed to political sound bites.

So as I go to the polls next week I am looking for a candidate or a party who amongst others things will:

Celebrate the reality of more of us growing older.
Old age needs to be seen as something to be proud of. We need to identify and declare the contribution, capacity and creativity of age rather than its drain, diminishment and dependency.

Not play the old and young off against each other.
The old are not the enemy of the young. We should not have to make choices between valuing the voices of the young, their education and development against the right of the old to be heard, to influence and to be supported.

Celebrate that the work of care is a fundamentally critical work and should be rewarded accordingly.
Caring as a career needs to be promoted and given priority. Working with and for people should be recognised as intrinsic to basic humanity. We should not be paying the basic, even a living, wage to those who dedicate their abilities to enabling the health and purpose of others. We should call out the perversity of a society that rewards those who pursue wealth for the self more than those who nurture wellbeing in others.

Do something to reassure the thousands of citizens of Europe caring today for our old and young.
As a society we are enriched by the work of thousands of carers from Europe who have become the friends and advocates of those being cared for in our communities. They deserve the dignity of knowing they are welcome and having their presence enshrined in immediate commitment rather than used as a bargaining chip at the tables of Brexit negotiations.

Work with older individuals, their carers and those who provide support to re-shape care fit for the 21st century.
A vision of care at home which allows people to have time to be, which helps to diminish the emptiness of loneliness by presence, and enables staff to identify preventable illness is a vision of a care system where we are focused on what’s best for individuals, not what is best for the ‘system’.
A vision of nursing and residential care where people are enabled to live their later lives with dignity, where individual needs are addressed and palliative support is adequately resourced should be the mark of what it means to describe ourselves as a real community. We should not have to struggle to justify the resourcing of this.

Work with providers of care to build trustful, dignified right-based care.
The current system is devoid of trust. Commissioners use systems to monitor providers and their workforce which serve to strip out dignity and respect. We have to move towards a mutual, co-responsible, trust-full delivery of care where the rights of the person cared for are upheld by a workforce itself treated with dignity and value.

Start to make hard decisions that might involve vanity projects being sacrificed and social care being prioritised.
We have to challenge the casual assumption that there is enough resource in the health and social care system – there is not enough to deal with demands today, never mind increased need tomorrow. That involves politicians and wider society making challenging decisions and choices, realigning priorities and objectives. Social care matters, contributes to and deserves to be valued just as much as finance, engineering, higher education or defence.

So just seven aspirations for the final week of campaigning. Will I find a candidate or party who on June 8th will help me be closer to achieving a human rights enshrined, adequately resourced, societally respected, older people led, delivery of care in Scotland?

It’s for you and all voters to decide.

Dr Donald Macaskill

@DrDMacaskill

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Guest post from Local Integration Lead, Nanette Paterson

My name is Nanette Paterson and I am the recently appointed Local Integration Lead for South Lanarkshire Health and Social Care Partnership. I previously held this post in East Renfrewshire and Glasgow (2.5 days in each area).

As the crow flies it is but a hop, skip and a jump from Glasgow to South Lanarkshire and in fact there is an area whose community align themselves with Glasgow when in actuality they are part of South Lanarkshire, which can make things very interesting.

Having now held this post in three different geographical areas, I feel that I am in a strong position to share the related strengths and challenges associated with such a large geographical area, which encompasses large rural areas as well as urban conurbations.

In the landscape of Health and Social care it had become increasingly clear that change was necessary for NHS Scotland to effectively respond to future care needs for people living with long term conditions. There was recognition that pro active approaches such as anticipatory care planning were required and this should incorporate joint working with service users and providers in all care settings to address the above implications, whilst being mutually beneficial to all.

Anticipatory care planning is about empowering, enabling and enhancing care and leading the way to better healthcare. Anticipatory Care planning demonstrates shared decision making through collaborative process to support a self management approach to personal health. Encouraging individuals with long term health needs to be cognisant of potential changes in their own health and wellbeing and to prioritise what is important to them. This process also allows effective communication of personal choice, practical need and sharing of key information with all those who deliver care.

In South Lanarkshire it was very refreshing to see that they have appointed an ACP Project Manager who has been in post since October 2016. She is currently raising awareness to the general public, wider community and carers, as well as updating health professionals throughout Lanarkshire in both acute and community settings. She has also been working with the emergency services to raise the importance of the Anticipatory Care Plan. Awareness sessions have been held across Lanarkshire in Leisure centres etc. giving active people the opportunity to find out more about the anticipatory care plan, and the importance of Power of Attorney is also being highlighted at this time.

All care homes have been given training and guidance on the use of these plans and it is now evident that, if residents do not have an anticipatory care plan in place when they arrive in a care home then these are being routinely completed after admission to care homes.

Local information has indicated that there have been incidents where care home residents have been admitted to hospital at the end of their lives despite anticipatory care wishes to the contrary.  Our cross-party working group continues to work to resolve these issues.

The timeous launch of the new National Anticipatory Care Plan on 7th June should be a positive vehicle for  improvement and standardisation.