Strategic Framework for Scotland and Visiting in Adult Care Homes

Please see below for correspondence from the Cabinet Secretary for Health and Sport outlining the alignment of the Strategic Framework for Scotland’s Levels with Adult Care Homes visiting guidance.

This guidance also includes updates on

  • Guidance on travel to and from Level 3 or 4 areas to visit people in care homes
  • Support for visiting arrangements
  • Communications on updates to national protection level advice
  • Forthcoming further guidance on visiting

This updated guidance is now available on the Scottish Government Covid-19 Care Homes guidance web page.

171120 JF to Sector - Strategic Framework Tiers and Care Home Visiting Guidance

Flexible Workforce Development Fund

The Flexible Workforce Development Fund (FWDF) will now be offered to both levy payers and SMEs, across the private, public and third sectors. This will allow employers to utilise funding for upskilling and reskilling their workforce.  An initial £13 million was made available to allow colleges to provider additional support for levy paying employers. Now the second £7million phase has been announced, with £5million available to support SMEs through a college and Open University in Scotland partnership, while Skills Development Scotland will offer a new option testing the use of private training providers for levy paying businesses who require specialist training. Applications are expected to open on 16th November.

More information is available here:

https://www.skillsdevelopmentscotland.co.uk/news-events/2020/november/fresh-funding-helps-employers-access-training/

Perseverance through pain: a Covid reflection.

Last Saturday like many I suspect I watched scenes of celebration and happiness, and some of regret and disappointment flicker across my television screen with the announcement that Joe Biden was destined to become the next President of the United States. In the days that followed, despite the antics of the present incumbent, the President-elect has gone about his business quietly preparing for government and reconciliation, using words to bring healing and purpose.

In the last week I have discovered a lot more about this man who will doubtless play a significant role in all our lives even though most of us will never meet him. His loss of a wife and infant daughter in a car crash, the more recent death of an adult son to cancer, the agony of parenting through grief and sadness, all have given me an impression of a man who keeps going with quiet but strong determination, one who is intimate with heartache and the pain of loss. I may be wrong but there has to be something more than just the narcissisms of personal ambition to present yourself several times for election and to taste rejection and failure but to keep going. His prize, the office of presidential leadership, will be a hard one but one which I hope he will live up to, so that hope can indeed be incarnate in kindness.

The past week has also brought us the positive news that a vaccine is close to being signed off. Political, media and popular talk has changed from ‘if’ to ‘when’, phrases like ‘light at the end of the tunnel’,  a ‘new spring’ and ‘fresh dawn’ have become commonplace.

Despite my Hebridean Calvinist origins I am an optimist at heart, a glass half-full person, so I warm to the positivity of the moment. But I cannot help harbouring a concern that in rushing towards the light we lose sight of the need to continue to struggle and persevere, to remain resilient and cautious. I cannot help but agree with clinicians and commentators who urge us to remember that the path ahead is one which requires us to continue to abide by what we know works, namely the need to act in a way which suppresses the virus. Doubtless we will hear of more vaccines able to offer positive hope of a return to a new normality, but they are a horizon to pull us forward not a support on which we must lean upon today. Our actions in this moment, in the days and weeks ahead, are the only bulwark we have against the viciousness of this disease.

I know that is easier said than done. I have had several conversations with folks this week where I have been struck by their sense that our lives are in routines and ruts, predictable paths of behaviour and conduct, and that for some getting up every morning to do the same things, in the same space, with the same people and with little physical discourse with others, has become a real struggle. It might be the shortness of days and the flow of the seasons into coldness, but I detect a real weariness and tiredness. Many are desperately wanting something new and novel, something which disrupts our familiarity and the pattern of our hours, something unplanned and unexpected.

Yet deep within me I know the truth that we have to remain steadfast and despite all the difficulties, and doubtless the times of failure and disappointment ahead, the only way in which we can achieve a positive future is by our own hands and behaviour. This is the time for perseverance not for letting up, losing control, or falling away.

I was a teenager when on a wet afternoon Edwin Morgan sat in front of my class and read his poem ‘In the Snack Bar’. You should read it if you get the chance. https://www.scottishpoetrylibrary.org.uk/poem/snack-bar/

When I first heard Morgan read the poem it struck me that this was about a life determined to continue, to grasp the ordinariness of breathing and remain dignified despite dependency. It depicts the poet’s encounter with a disabled man who asks him for help in going to the toilet. Its honesty in describing the minute mechanics of a basic task from the perspective of someone who cannot see is searing. The poet has to change the rhythm of his movement to the pace of another. They have to go downstairs slowly, and then after the act is complete to climb again. Every detail is magnified with meaning, echoing towards a conclusion.

‘Inch by inch we drift towards the stairs.
A few yards of floor are like a landscape
to be negotiated, in the slow setting out
time has almost stopped. I concentrate
my life to his: …

And later the poet says:

‘He climbs, and steadily enough.
He climbs, we climb. He climbs
with many pauses but with that one
persisting patience of the undefeated
which is the nature of man when all is said.
And slowly we go up. And slowly we go up.’

The poem for me is the essence of perseverance, the ‘persisting patience of the undefeated.’

This is the perseverance through mundanity and routine, the determination to renew through pain and sadness which we so need at this time as we face Covid through the dark days of winter. It is a perseverance which determines to go on despite all.

But it is also a perseverance where we need the help and support of others. We need to have someone to take our arm, to lean on when we are uncertain and unsure. This is what ‘In It Together’ is all about – not a slogan or soundbite, but a way of being one into the other, one alongside each other.

So, there is a light dawning into the future, offering hope to drag us forward. It will come no doubt, but we must support one another in that journey from the present into the dawn of belonging.

I always remember being told by my old uncle as I confidently climbed yet another childhood ‘Everest’– typically just a Skye moor! – that it was harder to come down than it was to ascend. There is such truth in that as anyone involved in the hills will know – the tiredness and fatigue of descent is always harder than the thrill of ascent. You can lose your feet far more easily when you are on the way home than when you are aspiring for the summit. So it is that the next few weeks and months as we move towards a prize of being together once again, that the work and the walking, the journeying and the edging to that future will perhaps be much harder than arriving at the point of this day at which we can spy hope on the horizon. This is why we need perseverance.

It is the sort of perseverance captured by another poet, Mary Anne Radmacher  who once wrote that ‘Courage doesn’t always roar. Sometimes courage is the quiet voice at the end of the day saying ‘I will try again tomorrow.

‘And slowly we go up.’

Donald Macaskill

Scottish Care’s submission to the Independent Review of Adult Social Care

On 1 September 2020, an Independent Review of Adult Social Care was announced by the Scottish Government, chaired by Derek Feeley and tasked with reporting by January 2021.

Scottish Care developed a submission of key recommendations to inform the Independent Review, which outlined what we deem to be priority areas for focus.  These areas are as follows:

  • The distinctive role of social care
  • Choice and SDS
  • Commissioning and business models
  • Cost and return
  • Human rights and equalities
  • Consistent regulation
  • Workforce value
  • Creativity and innovation

Building on this submission, Scottish Care was invited to develop an ‘ideas-focused’ paper as a further input to the Review by the deadline of 6 November 2020.

Given that the challenges and barriers that exist in a social care context have been articulated and documented at length – including by Scottish Care – we recognise the need for a Review to move beyond recommendations towards action and commitment to enact change.

We have therefore developed this paper, entitled ‘What If and Why Not? Making the Future of Social Care A Reality’, as an opportunity to present a positive yet actionable future perspective and encourage dialogue and debate on what the future could and should look like. The paper represents a different approach than usual Scottish Care reports and responses, but we see it as an important part of a wider approach to ensuring the specific experiences, concerns and aspirations of Scottish Care members and different parts of the sector are represented in such a critical process of review.

This paper is designed to be complementary to the series of engagement sessions which Scottish Care members took part in as part of the Review process.  These sessions provided a direct opportunity to present the challenges and experiences of the social care reality from the perspective of social care providers and other stakeholders.  The paper reframes the challenges that are documented extensively in previous research and reports to present these as possibilities to inform the review process.

In the paper we offer a collection of social care narratives and ‘what if’ questions, underpinned by a Scottish Care evidence review, as a way to engage imaginations across all sectors and stakeholders towards creating a positive future for social care in Scotland.

We hope to use the paper as part of wider discussions and collaborative work with stakeholders and partners across Scotland in order to positively shape the future of social care.

If you would like to discuss the paper further, please contact Becca Young or Dr Tara French at [email protected]

SC What If and Why Not Making the Future of Social Care a Reality Nov 20

ELVIS COVID-19 Study

Could a simple salt water solution help to reduce the early symptoms and progression of COVID-19?

COVID-19 has quickly spread all over the world. It usually causes a fever, cough and other symptoms and can be severe in some people. Although a few treatment options are now available for individuals who are hospitalised with severe disease, there are currently no effective treatments for those who are managing COVID-19 at home and self-isolating.

The University of Edinburgh are running a study called ELVIS COVID-19 to find out if nasal washout and gargling with salt water helps individuals with COVID-19 get better faster by helping to ease the symptoms of the virus.

Scottish Care supports this ELVIS COVID-19 study and encourages those who are suitable to take part in it.

This study is for any adult in the UK who has developed COVID-19 symptoms in the last 48 hours, is isolating at home, and has not been advised to go to the hospital. We will gather information of symptoms throughout the period of illness and will use this to see if nasal washout and gargling with salt water has helped.

Visit the study website for more information and to check if you can get involved.

 

What does connection mean to you? – November nursing blog/poem

What does connection mean to you?

As we approach the end of 2020 I have chosen to look at the need for and the recognition of connection and how important this is in our daily lives. We are connected on many different levels from our past and present, and it is these connections that perhaps give us the strength to cope in difficult times .The loss of connection has been none more evident than in these recent months due to the impact of the pandemic on our lives. Social isolation, social distancing and grief have all compounded the ability for us as humans to connect. I have decided this month for my monthly blog to pull a short poem together to reflect what connection means to me. I found this comforting at a time when we are reminded daily of the need for connection and the sadness that comes from its loss.

Jacqui Neil

Transforming Workforce Lead

Deadline extended for Graduate Diploma in Integrated Community Nursing

We are delighted to advise that cohort 2 for the New Graduate Diploma in Integrated Community Nursing is now open and we would welcome applications from care home nurses. There are currently no limitations on places therefore hope we can get a level of interest to ensure this funding continues. Please use the link to navigate the information and process for applicants: https://www.nes.scot.nhs.uk/our-work/community-nursing-graduate-diploma/

How to submit your nomination

  1. Complete spreadsheet with nomination (which is available further down this page) and send back to NES email [email protected]
  2.  Once funding agreed you will received confirmation email from NES
  3. Once funding confirmed, then complete application for course with preferred university ie UWS /QMU.

Please send the completed nomination sheet to [email protected] by Friday 13 November.

Care Home funding letter GDICN_Oct20

EU Exit – Stay in Scotland Toolkit Launch

Following decisions by the UK Government the UK has now left the EU.  EU citizens and their families will have to apply to the UK Government’s EU Settlement Scheme by 30 June 2021 in order to continue living, working and studying in the UK after that date.

Scotland deeply values the contribution EU Citizens make to our society, culture and economy and we want people to stay in Scotland. We have produced a package of support to help guide people on how to apply to the EU Settlement Scheme.

We need your help to get the word out to all EU citizens living in Scotland.  To help you do this we have created a Stay in Scotland Toolkit with a range of materials:

  • A3 poster
  • A5 information leaflets (available in English and 21 additional languages)
  • EU Exit Fact Sheet
  • Guides for EU Citizens and Employers
  • Radio advert
  • Animated gif
  • Static images
  • Suggested copy for use on website and social media channels

Download all the assets and toolkit via WeTransfer here: https://we.tl/t-yR4hkIr2me

We would be most grateful if you can print and display these in public spaces and areas visible to EU citizens and share across your networks using #WeAreScotland, pointing people to www.mygov.scot/stayinscotland

20-21 - Stakeholder Toolkit - EU Exit - Stay in Scotland - Final - 9 Nov 2020

The season of remembrance: the power of story.

Remembering is in the air. Today marks the end of the ‘To Absent Friends Week ‘ which is an astonishingly creative and vibrant festival. The festival is based on the premise that people who have died remain a part of our lives – their stories are our stories, yet many Scottish traditions relating to the expression of loss and remembrance have faded over time.  To Absent Friends gives people across Scotland an excuse to remember, to tell stories, to celebrate and to reminisce about people we love who have died. To Absent Friends, a People’s Festival of Storytelling and Remembrance is an opportunity to revive lost traditions and create new ones.

But today is also a day which falls in the midst of Remembrance Week as we approach the  11th November when at 11 am we engage in a very long tradition of acts of national remembrance for all those who have lost their lives in war. Even that process though will be very different this year with many public acts now not taking place because of Coronavirus.

Remembrance Day will provide many with the opportunity across the world to stop and in silence think of all who have died or been scarred by humanity’s inhumanity. It is a time for recollection and story, albeit that those with first-hand experience of the wars of the 20th century are becoming fewer in number by the year.

For me Remembrance Day is indeed a day of story and recollection. A day when I especially remember my own grandfather who left his Skye village as a boy at the start of the First World War and returned years later a man.  But although he returned with a box of medals for his bravery, he also brought back the scars of encounters and experiences that would fragment his living and mark his heart until he died. I was young when he died, but I always felt an air of distant melancholy surrounded him, a sense of absence for those gone from his life.

Remembrance is many things to many people. It is both an act of literally ‘re-membering’, of putting back together the stories of a broken past but it is also about a resolve and a conviction that the lessons of that painful past need to be so real and so vital that the journey into darkness can never be repeated.

Many years ago, in Orkney I spent an afternoon on the week before Remembrance Day in the company of two men who had just recently got to know one another. They were unlikely friends but one thing, their experience of war and their desire not to talk about it, joined them into a life-long friendship. One was in his sixties and bore the literal scars of years of brutality and torture as a Japanese Prisoner of War. Every movement jarred his present with the pain of those days. But he was a man of astonishing positivity and optimism. He never talked about the war or his experiences. The other man was much younger, a soldier during the Falklands War when he would have been really young. He too had been forever changed by his days of battle. His scars were inside him. He spoke about never being able to have a night’s sleep without the sounds of crying and fear waking him into a sweat. Anxious and manic in movement and gesture he was continually agitated. But he too was silent about his suffering. For both men Remembrance Day was something they simply could not thole – they wanted not to remember but to forget.

But that afternoon and well into the evening something happened. I don’t know what it was. Maybe the sense of calm, or the warmth of the place, or the drinks that were shared. But they started to talk. At first slowly and with hesitation and reluctance but then freely and openly, almost with a need to expel the memories from inside, a catharsis of inner pain. They spoke and told their story and what I saw in the telling was a healing of wounds, a discovery of togetherness and the creating of a bond that would never break. They spoke that day but that was it; emptied of memory they never spoke about their experiences again, but they were changed, one with the other, a connection which brought a peace only they could understand.

Finding another to tell our story to, to be authentic, open and honest, to be who we really are without mask and pretence, is perhaps something we are all searching for. Those two men found each other that day and by the power that comes from togetherness, they upheld one another in the days and nights to come until one of them died. The story healed … it bound them … and once told it was enough.

Story has a real almost primordial power within it. It is not simply in the act of re-telling or re-membering our story that we are changed but in the way in which story enables us to be honest and real, raw and truthful. In the next few days it might be harder for many to find a face to face encounter, it might be hard to find the normal routes to tell our story and find connection, but there are so many ways to re-member and tell and talk. For it has never been more important to find space and place to tell our story even if it is to ourselves for the first time, even if it is into the silence of the day or the emptiness of the night. For in the telling there is healing.

This last year has brought so much pain and hurt for too many; lives lost to Covid19 before they had left their mark or finished their tale; hardness and heartache of those left behind, those who have spent themselves in care and giving; those anxious and worried, detached and separated. We need not just to remember but to use the energy of memory to create purpose to change, to do different and be better. That is what remembrance is for me – not an act of precision and poise, of stiffness and formality, but a movement of memory and re-making.

So as I go for a walk on Remembrance Day I will sit and ponder, reflect and remember, and I will allow my story to be told inside my heart, and like my two Orcadian friends I will seek to memorialise those who I have lost not in words but in action, in a commitment to be and to do better.

The bench

I look out at the sea

crying in the dark tonight,

shedding its tears on the shore;

washing down the face of the land,

hiding in the shadows,

yet never silent,

always roaming around

desperate for welcome and warmth.

 

and I close my eyes and think

who are you nameless one on whose seat

strangers come and settle in loving embrace;

your future folded forever

in slatted curves of wooden shape

overlooking the encroaching tide?

 

for here you rest in silence,

28 years old the plaque proclaims

but yet hushes the laughter,

tears and story of your days;

as your name nakedly

witnesses untold tales,

as gossip and truth mingle here.

 

how many of your lovers have forgotten

your touch and smell?

how many now strain to the memory of your

voice welcoming response?

how many come and sit

and weep at your going too soon?

 

I do not know

and can only close my eyes and imagine

 

for like the sea you are here

in season and out

taking tears and turning them tender

accepting brokenness and moulding forgiveness

sharing joy and directing hope

recognising fear and caressing sadness.

 

and like the sea you smuggle

love into my imagination,

washing away my anger

showing me that in death you rest in my living

and become my future.

 

Donald Macaskill

Care Inspectorate: Report on the Medicine Improvement Project

The Care Inspectorate has published the final report from their medicine improvement project.

The Care Inspectorate’s vision is that every person in Scotland receives high-quality, safe and compassionate care from care services that are continually improving.

The management of medicines in care homes for older people, and its effect on resident’s health and welfare, remains a concern.

In support of this vision and with the help of Scottish Care, the Care Inspectorate undertook a project with 10 care homes, aiming to reduce medicines issues using quality improvement tools.

The care homes’ commitment to improve was reflected in their positive relationships with each other and the Care Inspectorate. All homes embraced the use of data over time to drive forward behavioural and system change, and most homes reduced defined medicines issues by a significant amount, despite the interrupted nature of the project. The interventions used to achieve this should offer a good starting point for any homes looking to improve their handling of medicines to support residents’ health and wellbeing.

Elements of the framework used in this project may also offer benefits to both the sector and us as the regulator in the post Covid-19 scrutiny landscape.

This report was prepared by Dr David Marshall Health Improvement Adviser, Care Inspectorate, who would like to offer special thanks to Scottish Care, the managers and staff of the homes involved, and the individual Care Inspectorate inspectors of the homes for their support and enthusiasm for this project.

The report is available here.