The Spring Edition of the Scottish Care Bulletin is now available and has been sent to Scottish Care members.
To read the latest edition of the Bulletin, click here.
Latest Blog from our CEO: An Ant’s Tale
You may have noticed in the last couple of weeks one of the augurs of summer- ants have started to appear. In fact they are appearing in numbers and at a time which is a bit unusual but I am reliably informed this is as a result of a mild winter and not a sign of impending environmental disaster.
Explaining the role and nature of ants to a very young child has been an interesting challenge for me over the last few days. They are both fascinating and annoying insects. They are on the one level irritating, getting into homes and places where they are not wanted or desired. But they also carry out a significant role in cleaning the environment. They have abilities beyond their size. An ant can lift 20 times its own body weight. They have a complex and developed sense of communication in that whilst they don’t have ears they nonetheless “hear” by feeling vibrations in the ground through their feet. As well as this when foraging, ants leave a pheromone trail so that they know where they’ve been. Most of all they are profoundly social insects, which means they live in large colonies or groups. Depending on the species, ant colonies can consist of millions of ants.
So what’s this all got to do with anything I hear you ponder. Well I’ve been reflecting a fair bit over the last week about the year that’s just passed. The reason for this pondering was that the 1st April has been the subject of much media reminiscing- chiefly around the first anniversary of Health and Social Care Integration.
It just seems like yesterday that the much heralded process of Integration started – never mind a year. Prominent figures have been making comment in the media.
Writing in Holyrood Today the Health Secretary Shona Robsion said she was ‘extremely proud’ of integration, stating:
‘I think it’s entirely reasonable to think that most of us would rather receive support and care at home or in a homely setting when we need it. Too often, frail older people in particular are admitted to hospital as an emergency when earlier provision of a package of care in their own home or community would have been better.
I’ve heard from people who have said they would have felt more comfortable in their own home rather than an unfamiliar hospital ward. We want to do all we can to ensure that care and recovery takes those feelings into account, which is what integration is all about.
It’s built around the needs of the individual, and it’s often not about medical needs – it can be about providing support to people to remain part of and connected to their families and communities, allowing people to carry on doing the things they love with some additional help.’
I have written a number of times in the last year about the potential which Integration offers for achieving a truly person focussed approach to health and care. But the lessons of the last year show that for all the first steps of innovation there have been not a few stumbles and failings. So how might we avoid the second year toddler tantrums and blues? I’ll take some insight from my ant friends to make brief suggestions:
Shared vision: One of the real strengths of the ant colony is the sense of shared purpose, direction and vision. I’m not convinced that those of us who work in any health and social care sector have yet grasped the magnitude of the vision of truly integrating supports and care around the person. We need to start to robustly influence a debate which has to date been still dominated by the preservation of local health services at all costs. If we want people to be supported and cared for where they want to be rather than where another decides they should be, then that will involve some uncomfortable home truths and choices. We cannot keep preserving the acute health sector in its present composition at the cost of developing social care supports and provision. We need to own and share the vision.
Shared risk: Every worker ant in a colony shares in the risks of the whole. If the ant heap is attacked or at risk then all suffer. This doesn’t always feel like the reality for those who work in integrated health and social care. The protected terms and conditions of health and statutory social care workers are a life-time away from the often fragile experience of frontline staff in commissioned social care services. The largest social care workforce of over 100,000 staff is continually beset by changes in commissioning practice whereby providers, private or charitable, risk being unsustainable and going out of business. We desperately need continuity of commissioning beyond the vicissitudes of a tendering cycle to provide continuity of care.
Shared workforce: Every ant in a colony has a role, a value and a purpose. There may indeed be some degree of priority but there is a natural acceptance that there is an inter-dependency and relationship one with the other. We desperately need for there to be a whole systems approach to valuing the distinctive role of the social care workforce. It should not be that someone wearing a stethoscope is considered as more important in the economy of care than someone who is a home care worker or a care home nurse. Yet that is what it feels like to so many – that is what they have told Scottish Care staff over the last year. If we are serious about achieving person centred care for individuals then we have to work at person centred valuing of the independent sector care workforce.
Shared communication: The way in which ants communicate using sight, touch and pheromones is truly astonishing. This socialised communication means that subtle changes are instantly recognised and the direction of travel is literally altered and changed. Lets face it we are not good at communicating in health and social care. We need to get better whether that is through shared assessments, the development of anticipatory care planning or simply the development of shared collaborative working.
Shared resource: For any system to work there has to be a recognition not only of inter-dependency but the need to support all elements and parts of the system. We are not there and need to get there soon. Transferring resources to the community is one of the primary areas of focus for Integration. The independent sector is brim full of ideas around innovation and new models and forms of care and support. These need recognition and resourcing. Care purchased on a shoestring suffocates innovation and leads to poor quality provision.
So at the start of summer – let us learn from the ants in my back garden and make the second year of integration a success. Let’s communicate, share our vision, work collaboratively and resource equitably. Then we might get to what Ms Robison desires, namely pride in a system of health and care that puts the person as the driver of the support they need rather than the accidental insect caught in the system’s web.
Dr Donald Macaskill
@DrDMacaskill
Revised Guidance on Charging for Residential Accommodation (CRAG)
The new revised guidance on charging for residential accommodation has just been issued. Please click on the following link to access the guidance:
Scottish Care Statement on Care Home Negotiations
Scottish Care has issued the following Media Statement following recent negotiations with COSLA and the Integrated Joint Boards.
Care home providers have been forced to accept a marginal uplift of 2.8 % to the funding of care home placements made by Local Authorities.
The 2.8% offer from COSLA includes delivering the new Scottish Living Wage of £8.45 to adult social care workers in care homes from May 1st 2017, which means in effect, providers have been presented with a net 1% uplift in funding for care homes at a time when they are faced with significant cost pressures which have increased by approximately 8.5%.
Providers were faced with an immensely hard and challenging decision, either to accept this unreasonable offer or abandon the National Care Home Contract entirely, therefore potentially jeopardising the stability of the care they provide for older people. An overwhelming majority of those who voted to accept did so under considerable protest, feeling caught between a rock and a hard place. However, they felt that the preservation of the National Care Home Contract was their main priority in order that the people they support were best protected against further cuts to the funding of their care.
Dr Donald Macaskill, CEO of Scottish Care who negotiate the Contract on behalf of care home providers, said:
“We believe that this level of funding endangers not only the survival of the National Care Home Contract but risks huge instability within the whole Health and Social Care environment in Scotland.
“Many providers have expressed not only their disappointment with this funding but their sense of dismay and hurt. As they see it, the contribution of the care home sector to wider health and social care provision, is clearly viewed with such low esteem that the viability concerns for the sector have been so easily dismissed.
“We are profoundly concerned about the survival of some of our care homes and will want to work vigorously with COSLA and Integrated Joint Boards to ensure that quality provision is not lost to the sector as a result of accepting this offer. We are immensely disappointed in the level of this uplift and what we consider to be the grossly inadequate funding of social care by Scottish Government.
“COSLA have indicated that the limited finances available mean they are unable to further improve this funding package. Therefore we can only conclude that it is the failure of Scottish Government to adequately fund the settlement that risks a significantly detrimental impact on provision for older people in Scotland.
“The unwillingness to invest directly into the care home is resonant of a failure to grasp the significance of the issue and a wholehearted lack of valuing of the sector and thus older people’s care and support.
“This is not only about money. It is about the rights, dignity and choice of older people. Scottish Care and its members believe this deal is completely unacceptable, and will work hard to ensure that older people’s human rights and care services cannot be jeopardised in this way again.”
A missed opportunity – Scotland’s new Mental Health Strategy
Statement from Scottish Care:
The Scottish Government launched its much awaited Mental Health Strategy on the 30th March.
It has a great deal which is positive within its 40 action points including increasing the mental health workforce in A&E, GP practices, police stations and prisons and reviewing counselling and guidance services in schools. In particular we welcome the planned reform of the adults with incapacity legislation so that it complies with the best international human rights standards.
However as an organisation with the rights and dignity of older persons at our core Scottish Care regrets the lack of focus in the Strategy on the mental health needs of our older population.
When the Mental Health Framework was published last year, Scottish Care with others welcomed its particular focus on the lifespan especially its recognition of the needs of older persons. We see little of this reflected in the Strategy.
Our ageing population will and its increase by 86% by 2037 will inevitably mean a higher proportion of those with mental health needs being over the age of 65 and also a higher proportion of these individuals requiring the support of elderly care services. It is therefore crucial that we ensure high quality mental health care and support is built into the provision of these services, which nearly 100,000 people across Scotland access. To fail to adequately recognise, plan for and seek to improve the mental health needs and supports for this population through the Strategy would amount to a serious human rights and equalities issue. We are not convinced the published strategy achieves this.
Scottish Care regrets the complete lack of a dedicated focus on the mental health needs of older Scots in the new Strategy. We are calling for more focussed work to identify the current gaps in support for older people with mental health conditions including social care gaps,
and prioritised support and training of staff in care services to deliver positive outcomes for individuals with mental health conditions.
Scottish Care has identified four areas where we believe more specific attention needs to be paid to mental health priorities for both older people and individuals receiving and working in social care services:
1.
Recognising mental health conditions in older people as wider than dementia.
Whilst dementia is an undoubtedly crucial element of mental health which the Strategy rightly recognises, it is important to recognise that the spectrum of mental health conditions that an older person may be living with is much wider and these conditions may even be undiagnosed. By narrowing our lens to dementia support only, we risk failing to improve the availability, appropriateness and quality of support for older people living with other conditions, including but not limited to depression, anxiety, eating disorders, bipolar disorder, schizophrenia. The fact that people are living longer does not diminish the range of conditions they may be living with nor the requirement for tailored, effective support to be available to those over 65.
2.
Ensuring appropriate support for those living with enduring mental health conditions who access social care services
One of the current shortcomings of mental health care and support which the new Strategy does little to acknowledge is the way in which both formal and informal support is available to individuals when they start receiving social care services, particularly within a care home setting. The current infrastructure and professional relationships between care services, GP services, pharmacy services, Allied Health Professionals and primary care mean, at best, multi-disciplinary support to individuals in care homes settings is a postcode lottery.
Additionally, more effective planning needs to be in place to ensure those who have moved into a care home setting can have continuation of community support available to them before they entered the care home. Finally, care home staff do a fantastic job in promoting personalised care to deliver positive outcomes for residents, but there may be additional support and training they need to ensure they fully understand how best to support individuals living with different mental health conditions. The integration of health and social care certainly presents opportunities to improve shared learning, multi-disciplinary and cross-sector working, better professional dialogue and person-centred rather than location-centred care, but this will require culture change which could be progressed more effectively by recognising it through the Strategy.
3.
Awareness of the risk of developing mental health conditions in periods of transition, change and trauma, particularly in older age
As well as the current challenges around effectively supporting older people with enduring mental health conditions, it is important to recognise the particular factors relating to older people and social care which may prompt or exacerbate mental health conditions. For instance, older people are more likely to experience bereavement through the loss of friends, spouses and relations which can require mental health support. Additionally, individuals who go through transitions such as moving into a care home or another care setting may experience difficulties in adjusting to a loss of home or a perceived loss of identity. It is therefore crucial that we recognise the risk factors and pressure points for older people, where they may require additional expert support in order to maintain or restore positive mental health.
4.
Transitions between adult services and older peoples services
The new Strategy recognises the particular risks faced by young people moving into adulthood – it does not do the same for the move from adult to older persons services.
As articulated in the above two points, there are risks to positive mental health associated with transitional phases and it is recognised that transition phases can lead to a breakdown in communication and quality of care and support, leading to further uncertainty and anxiety for individuals at the centre of that support.
Scottish Care believes that, as a society, we still have an inherent inequity in older people’s care and support compared to other types of care and support and unfortunately, discriminatory practice can still prevail. Whilst positive progress is being made around outcomes and personalisation, and human rights-based approaches can support this, there remain challenges for how we support older people with mental health needs to live well and what resources (including funding) are available within older people’s services to do this effectively. Attention must therefore be paid to how we support people with mental health needs through care transitions effectively so that they do not experience a diminishing of quality support based on their age or location.
Whilst the new Strategy is a clear step in the right direction it is nevertheless still falling short.
Scottish Care would want to see more explicit actions relating to older people and social care to ensure that real progress is made through the strategy in addressing their mental health care and support provision challenges.
Scottish Care will be commencing a piece of work in autumn 2017 exploring the unmet mental health needs of older people in receipt of social care services. This work will explore both what these unmet needs are and what needs to be in place to address these gaps, whether they relate to awareness and understanding, care and support availability and appropriateness, or staff capacity, skill mix and training.
Job: Scottish Care National Director
An exciting opportunity has arisen within Scottish Care for a National Director to join its Senior Management Team.
Scottish Care is the representative body for the largest group of health and social care sector independent providers across Scotland delivering residential care, day care, care at home and housing support.
Applicants must be qualified to degree level or equivalent and have significant experience of working at a senior level in health or social services or a related area. Current knowledge of commissioning and procurement practice, social care business and financial management systems, and experience of negotiating and liaising with senior stakeholders are essential.
The post-holder will operate at a national strategic level; create significant collaborations for independent care sector organisations; contribute to national policy groups and consultations and work across the sector nationally.
The position is based in Ayr but it is anticipated that the post-holder will spend a substantial amount of their time attending meetings and events throughout Scotland.
The post directly reports to the Chief Executive, Dr Donald Macaskill.
The remuneration package is £55,000 plus a 5% pension contribution.
Application Process
An Application Form and Equal Opportunities Monitoring Form is available at www.scottishcare.org and directly from Cath Balmer, Office Manager, Scottish Care, 54a Holmston Road, Ayr KA7 3BE or by email from [email protected]. Completed forms should be returned to her no later than 12 noon on 3rd April 2017
Interviews will be held in Glasgow on Thursday 13th April 2017.
Download the job profile here.
Download the application form here.
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Keep Your Eyes Open and Your Mouth Shut: second Directed by North Merchiston film now available
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.
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.
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:
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]
