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.

Scottish Care responds to the Adult Social Care Winter Plan

Scottish Care welcomes the first ever Winter Plan for Adult Social Care as an indication that there is now a recognition of the importance of social care for all citizens. We are pleased to see that there is a particular emphasis upon collaboration and look forward to future plans more directly engaging with and involving those with operational and frontline responsibility.

We are pleased to see within the Plan a real sense of value of and an emphasis upon the dedicated and professional social care workforce who not just during COVID-19 but throughout the years have been professional and highly skilled in supporting individuals regardless of locations.

Details of the Winter Plan:

We welcome the additional £7 million allocated to Nurse Directors to enable IPC support and training and want to underline the critical and distinctive nature of IPC in care homes and community settings. We will work closely to ensure that IPC training and models are appropriate to the setting and that we do not simply embed acute hospital and NHS based IPC practice. Such adoption of IPC has not only to be context specific but enhancing of the rights and autonomy of individual care home residents or those who live in their own homes.

The majority of care homes already undertake a daily review of COVID-19 symptoms, and we note this in the Plan and look forward to sharing the clinical experience of care home staff with the Clinical and Professional Advisory Group.

We support the imperative around the flu vaccination whilst urging all stakeholders to learn the lessons of what has at times been an ineffective and haphazard implementation of the vaccination strategy, failing at times to recognise the distinctive realities of care at home and housing support staff and the skills and experience of care home nursing staff. We look forward to closer collaboration as we plan the roll out of the COVID-19 vaccine.

The care home sector is fully supportive of ensuring that visiting guidance is implemented in a manner which maximises safety and reduces risk. Providers recognise and value the truth that family members are intrinsic to the mental and emotional wellbeing of residents. However, there is both an understandable desire on the part of providers to protect residents and a fear about introducing infections. We acknowledge that the introduction of a robust and effective testing system will help to allay the fears of providers of care. This urgently needs to include family members alongside staff, and all those who visit care homes for whatever reason, in a manner which is as timely and effective as possible in terms of testing access and turnaround of test results. As a whole system we need also to address the challenges brought about by emerging difficulties in gaining insurance and indemnity, the stresses and overwork created by Operation Koper, and the capacity of a stretched workforce to support visiting in practical ways.

We note the evidence of staff movement in relation to outbreaks. We recognise the desire to create cohorts of staff regardless of settings. Achieving this outcome will not be easy. Individuals who work in social care are amongst some of the lowest paid within our society and they frequently have multiple jobs not because they want to but because they need to. This is especially true in homecare where we are already noting a drift from full-time employment to part-time working because staff are exhausted by the efforts of the last few months.

Great care needs to be taken that to ensure that restricting the right to employment and requiring individuals to isolate for 14 days between employment does not disproportionately penalise individual workers.

In addition, there has to be a realistic appreciation that there is a limited supply of workers. Before the pandemic providers of care – regardless of sector – struggled to recruit, most especially nursing staff. We have all to work closely at local level to ensure that there is adequacy of workforce supply to ensure safety and quality practice. The roles involved are highly skilled and cannot simply be undertaken by individuals without experience, skill or training.

Further the creation of any legislation which effectively limits employment opportunity within a sector which has struggled to recruit, and which is likely to be negatively impacted by future immigration restrictions, will require to be carefully considered and thought through. The consequences of disproportionate restriction regardless of the robust grounds for their introduction may be hugely damaging.

We note the allocation of £50 million to meet these proposals but want to understand how this figure has been calculated and whether it is sufficient, what it will be used to pay for and how we will collectively compensate workers and organisations faced with additional restrictions on staffing.

Testing remains critical. In addition to our comments above we want as a sector to see urgent and immediate plans as to how care at home and housing support staff will be prioritised for asymptomatic testing. It is now seven months since we called for this to become the norm and we still have not seen this commence.

In the community we welcome the emphasis on ensuring people remain independent and at home for as long as possible. With others we continue to urge the re-introduction of care packages for those who have not been supported for a long period of time. We remain concerned that there needs to be significant improvement in practice around communication and information for homecare providers when an individual with COVID-19 is released from hospital. We continue to be concerned that effective winter care in the community will not be achieved as long as some local authorities continue to insist on 15-minute visits during which personal care and other tasks are required and the staff member has to don and doff PPE in a safe manner. Such restrictive packages of care together with the electronic monitoring of homecare staff should stop. They are hardly illustrative of our shared aim for Fair Work.

We welcome the continuation of the Social Care Support Fund which goes some of the way towards plugging the unfair terms and conditions within publicly commissioned social care contracts.

We are also grateful for the continued commitment to the supply of PPE where providers are unable to access these through business as usual routes, and especially in light of the reprehensible re-introduction of VAT on the 1st November.

We look forward to continuing to work with colleagues in the roll out of digital devices to care homes to improve connection and welcome the commitment of £500k to support this work.

Any Plan is only as effective as the commitment and resource to enable it to be enacted. Social care providers continue to prioritise not just keeping people safe and well but ensuring individuals achieve their fullest potential and live life to the full. We agree with the aims of the Plan and commit to demonstrating integrity to resolve challenges in a supportive and empathetic manner in the months ahead.  Its success will be premised on true and meaningful partnership with social care providers at national and local levels.


The Adult Social Care Winter Preparedness Plan 2020-21  is available here.

Find out more about the Plan on the Scottish Government website.

Job Opportunity – Independent Sector Lead: Scottish Borders

INDEPENDENT SECTOR LEAD – Scottish Borders

PARTNERS FOR INTEGRATION AND IMPROVEMENT

SCOTTISH CARE

Health and Social Care Integration

£43,622 (pro rata) per annum – 14 hours per week

Fixed term contract funded till March 2021 (initially) subject to funding may be extended to March 2022

Do you have an interest in improving the quality of care, can you COLLABORATE, INNOVATE AND COMMUNICATE, and would you like to join a successful, committed and highly motivated team? This could be the opportunity you have been waiting for.

We are seeking to engage an Independent Sector Lead to support the Integration of Health and Social Care in the Scottish Borders.  Hosted by Scottish Care and working closely with care providers and partners, the post involves ensuring sector involvement in the delivery of the integrating of health and social care in Scotland’s HSCPs

The post holder must be highly motivated, be able to use initiative, possess excellent communication and networking skills, demonstrate success and experience working at strategic level with policy makers, providers, regulators, people supported by services and carers. Qualifications and experience at a senior management level would be a significant advantage.

The post holder will be expected to create and support significant collaborations across the independent care sector while contributing to the development of new care pathways which will result in the delivery of improved outcomes for people who access care and support. The post holder will ensure the Independent sector’s contribution is fundamental to integrated services and transformational change and be able to evidence their impact. The role requires considerable and skilful collaboration with our key partners in the NHS, Local Authority, Carers, third sector organisations and other forums.

The post is home-based with travel where necessary, based and is hosted by Scottish Care.

To request an application pack, please contact Colette Law at Scottish Care by email [email protected]

Closing date 4pm on Thursday 12th November 2020.  Interviews will be held by video conference – date to be confirmed.

To Absent Friends – a festival to remember in times of covid

A collective of charities and interested organisations will shine a light on bereavement this week, as they launch the To Absent Friends festival 2020.  Heralded as a ‘people’s festival of storytelling and remembrance’ the festival takes place from 1-7 November across Scotland – online, in public spaces and in people’s hearts and minds.

The festival will see the launch of the To Absent Friends Cookbook – a collection of recipes and stories for those loved and lost. (https://www.toabsentfriends.org.uk/cookbook/) The virtual book has been put together by Cruse Bereavement Care Scotland, Macmillan Cancer Support, Marie Curie, Scottish Care, Scottish Partnership for Palliative Care and Sue Ryder.

“Working to support people who are bereaved, we see how important it is to make time in our lives to remember people who have died.  2020 has brought loss and grief to many, while also preventing people from getting their usual support from friends and family.  We’ve seen how hard this has made life for people who are grieving.  The To Absent Friends festival is an opportunity and an excuse for people to take a moment in their busy lives to remember people who have died, whether recently or long ago.” said Nicola Reed of Cruse Bereavement Care Scotland, who shared a her Dad’s special stew recipe for the Cookbook.

The To Absent Friends Cookbook brings together stories of people who have died, alongside recipes that have special significance for the people they left behind.  A mother’s recipe for stovies, a friend’s delicious traybake, a much-loved daughter’s favourite pie.

“When we were compiling the cookbook, we noticed that most of the food people connect with loving memories is delicious, homely and comforting, like a shepherd’s pie, or a simple occasion cake.  And the stories that come with the recipes are a delightful mix of love, laughter and tears. It is particularly poignant to be publishing this book this year, in times of covid-19, when so much loss has been suffered by so many.” said Rebecca Patterson, Director of Good Life, Good Death, Good Grief.

The launch of the To Absent Friends Cookbook is just one of many activities taking place as part of the festival this week, as communities from across Scotland hold local remembrance events. With most face-to-face gatherings out of the question this year, much is taking place online and planners are finding innovative ways of creating time and space for remembrance.

For example people living in Willowbrae, Edinburgh are creating a ‘wanderland’ of home window displays in memory of people who have died; Action Porty are providing individual kits to enable households to have beach bonfires of remembrance; and North Argyll Carers Centre has invited bereaved carers to contribute to a beautiful light installation which will be suspended within North Argyll Carers Centre to be viewed from the windows during the festival.

“I think that this year most of us have been craving human connection.  And that is what this festival is about – connecting with each other over shared memories and stories.  Perhaps this year, when it is hardest to organise a festival, it is more needed than ever before.”  said Richard Meade, Head of Policy and Public Affairs Scotland at Marie Curie.

To Absent Friends is a reminder, an opportunity and an excuse to create time and space to remember the important people in our lives who have died.  Festival organisers are inviting members of the public to get involved, even at short notice, from the comfort of their armchair.

They invite people to visit the festival website www.toabsentfriends.org.uk to share their memories on the online wall of remembrance, add songs to the Remembrance Playlist, or tweet #ToAbsentFriendss throughout the week. A full list of this year’s events is available here: https://www.toabsentfriends.org.uk/blogs/festival-events-2020/

For more information, contact Rebecca Patterson on [email protected] or find out more via the website www.toabsentfriends.org.uk