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.

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]

 

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.

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.

 

 

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.”

Scottish Care calls for urgent Government intervention to protect care homes

 

Each year Scottish Care as the representative body of providers of care homes for older people is involved in discussions with Cosla and representatives of the new Integrated Health and Social Care Boards (IJBs) to set the annual fees for nursing and residential care in Scotland.

This year these discussions have reached a particularly challenging position and are at the stage of virtual collapse. The offer made by Cosla and the IJBs is limited by the funds made available to them by Scottish Government and the impact of a reduced Local Government Settlement.

Scottish Care believes that it will be impossible for its membership, which includes several hundred family run care homes and many care charities, to accept what is in effect the offer of a 1% increase, without putting their homes at very real risk of closure.

Scottish Care has argued for some time that there is a chronic underfunding of the care home sector in Scotland which endangers the delivery of quality care and support to our older population. We believe that this is essentially about the dignity, value and worth of our older population. Failure to adequately fund their care needs speaks volumes about what priority we give to older people and demonstrates that inherent ageism exists in our society, particularly in our approach to social care provision.
Dr Donald Macaskill, the Chief Executive of Scottish Care stated today:

“It is with very deep regret that we have decided to make public the virtual breakdown of our discussions with Scottish Government and others. We believe that it is no longer acceptable for us to remain silent about the lack of investment which the Government is prepared to make in the care home sector in Scotland. Despite new monies being allocated in England following last week’s budget there is no indication that Scottish Government will seek to benefit social care in Scotland.”

He continued:

“In recent months providers have been faced with substantial increases in the cost of fuel, food and other commodities, averaging around 8.5%. A 1% increase will simply not enable care homes to stay in business. Together with that many nursing homes are finding it impossible to recruit nurses. We have a 1 in 4 vacancy level and to meet gaps care homes are having to pay as much as £800 a night to find a nurse.”

Dr Macaskill highlighted that:

“I recognise that we live in hard times faced as we all are with austerity and public sector cuts. But at present a nursing home is allocated only £3.85 per hour for the 24/7 nursing care of thousands of our vulnerable older people, the majority of whom are in a palliative or end of life context. For me this isn’t so much about finance but about the price we are prepared to pay for preserving the dignity of our older Scots and enabling them to exercise choice and control over their options for high quality care provision.”