Our CEO speaks to the Telegraph about the use of tech in care homes

How care homes are using tech to  ward off loneliness for the elderly

As the older part of the population get ready to isolate for months on end, technology can play a key role in keeping them connected


They were the images that touched the heart of a nation at a time when it needed it the most. 

Over the weekend, carers at Bentley Manor Care Home in Crewe created uplifting clips and photos of elderly residents sending virtual well wishes to their family of friends amid the coronavirus lockdown. 

“[The images] went mad on Facebook,” says Home manager Andrea Fjodor, 52. “Everyone kept commenting ‘please keep putting the pictures on!’ because they love the messages.

“We just wanted to keep up with communication because without it, it would have a detrimental effect on our residents, and to send out messages to tell their families we’re ok.”

Bentley Manor is just one of many care homes using technology to help its elderly residents stay connected with the outside world. 

Donald Macaskill is the chief executive of care sector representative group Scottish Care. He says that some care homes have been using technology for some time to keep people in touch but that its necessity now was more paramount than ever before.

“We’re hearing of family members coming in with iPads and tablets once they’re cleaned and appropriately checked. There are people giving spare tablets into different care homes across the country.”

Such is the generosity of people across the country that a centralised tablet bank system is being considered in order to manage the donations and equally benefit the care community.

He explains that calls are made to loved ones predominantly using tablets and through apps like FaceTime, Skype, and Zoom.

“Given the age of the individuals we’re talking about it’s mainly the tablet. Phones aren’t really useful because of visual impairments,” he says.

“It always amazed me that we have this presumption that older individuals can’t cope with technology. But I’ve met very few who, once are supported and understand how to use it, don’t find it a benefit and asset to them.”

Loneliness is often cited as a hidden “killer” among older people. With stunted mobility and being typically less connected through the internet like the rest of us, social interactions can be more taxing.

Isolation and loneliness are already considered to be an epidemic among the elderly in the UK. Estimations from Age Uk suggest that around two million people in England live alone, and that more than half of them go without speaking to a friend, neighbor, or family member for a month.

As Health Secretary Matt Hancock has flagged, people over the age of 70 will be asked to self-isolate themselves from society for up to four months to protect against the virus.

But with that enormous ask comes a big chance for technology to address a social issue that has plagued society for generations. Can it bridge the gap between loved ones, distant relatives, old friends?

The looming isolation has forced families into planning sessions around how they’re going to care for their loved ones during this unprecedented period. New plans have been hatched and new responsibilities formed as the country’s most vulnerable are kept away from the deadly virus.

Cera Care is a high-flying home care start-up. In February it raised £53m to fund the expansion of its business. It uses technology to monitor patients’ conditions and match them with the most-appropriate carer. It also uses artificial intelligence to detect a problem with a patient before it develops into something more serious.

Co-founder Dr Ben Maruthappu says that its staff have been covered up with face masks, aprons, and gloves while checking in on patients on a daily basis.

“The health system is obviously under tremendous pressure but I think social care providers are in a brilliant position to look after people who are now on the verge of facing quarantine for a number of months,” he says.

“There are over a million people in this country over the age of 70 who stay in their homes and will need some help. Some of them will need groceries and all sorts of amenities and some will require support in their living to allow them to be protected at home.”

Dr Maruthappu says that technology has allowed the company to become much more “rapid” in its response to queries. Loved ones can also be updated on the status of their elderly relatives regularly. 

Similarly Anchor Hanover, one of the country’s largest care home providers, is using other technologies to keep people entertained. One of its systems, Memoride, connects Google Street View to a motion sensor to allow residents to cycle along roads they know, thus stimulating memories.

“Even though the doors are shut, there are other ways to keep them open,” says Ms Fjodor. “Technology is brilliant.”

A front-line care worker’s story on Covid-19

This was sent after the Prime Minister’s speech on Monday evening when obviously carers were rightfully scared.

Tracy is a carer on a double up run who works with Lucerne Scotland. These are her words:

“Just a little word from me with having this virus.

I found out last Saturday I had it, it was confirmed at the hospital.

I have never felt so crap in my life, a really bad strain of the cold or flu, depends how each individual reacts to it, well mines was pretty serious.

I’m still getting over it and hope to be back at work next week, symptoms are now starting to subside so there is light at the end of the tunnel, which is the important thing.  

I’ve followed all the advice there is and can honestly say as long as you don’t let all this pandemic and lockdown get into your head you will be fine. 

Stay strong, stay safe and remember why you do this job. We are naturally caring people that can deal with difficult situations, don’t let the virus win even if you are unfortunate to come down with it. Positive thinking is the key to progress and our clients will need us more than ever now. 

People will see carers differently after all of this passes and you should be proud of yourselves to be what is essentially going to be in the history books! 

I’ve been reading the constant shift cover messages since I’ve been off and the support you are giving each other and working extra hard to ensure the client’s needs have been met is just amazing. 

 It’s ok to feel scared but there is so much support out there just now for these circumstances you won’t be alone. 

I’m happy to give advice separately from this chat if it will help anyone that is feeling anxious. Telephone …….. if you need a chat, confidential of course.  

Take care all.”

Announcement of Social Care Support

Scottish Care is pleased that the Scottish Government issued a statement this afternoon (23rd March) indicating that social care was at the heart of the fight against Coronavirus. We look forward too working with colleagues in COSLA to ensure that this support gets to hard hit providers and frontline care workers. 

The statement reads:

Scottish Government to meet increased costs.

Councils have been asked to increase support for care at home, nursing homes and care homes to reduce delayed discharges and free up hospital beds.

Health Secretary Jeane Freeman has confirmed to COSLA that, subject to expenditure being aligned to local plans, the Scottish Government will meet additional costs to increase support and staff capacity in social care.

The move aims to help the care system adapt to increased pressure placed on it by COVID -19, with many people requiring continued support for daily living, even if they have not contracted the virus.

Ms Freeman said:

“We have placed the NHS on an emergency footing and we also need to increase the capacity in our social care sector.

“Extensive work is already underway by health and social care partnerships to free up hospital beds and care for older people, and others in need of support, in care homes and in our communities.

“We have now informed councils that any additional expenditure to maximise the care available to our communities, aligned to work that is already underway, will be covered by the Scottish Government.”

COSLA’s Health and Social Care spokesperson Councillor Stuart Currie said: “COVID-19 represents an unprecedented challenge to anyone working in caring professions in Scotland.

“The Scottish Government and local government have shared leadership to ensure the entire system is working together to optimise the impact on the wellbeing of our communities.  Work is underway locally to do this and today’s announcement gives welcome assurance to the sector about the steps which will be taken to maximise the care available to our communities.

“COSLA guidance will be issued shortly to support commissioners to work collaboratively to protect the resilience of the social care sector and ensure they remain operationally and financially viable.” 

Stepping stones: a coronavirus update from our CEO Dr Donald Macaskill

Stepping stones 

I’ve been asked to summarise for Scottish Care members some of the steps we’ve seen taken in the social care sector in the last week in response to the Coronavirus. These thoughts are ‘stepping stones’ to cross the currents of uncertainty we are now experiencing confident that if we support one another we will get to the other side.

Care homes

Guidance for care homes facing coronavirus were issued at the end of last week and Health Protection Scotland has issued further guidance last night. Together both make clear the actions which care home organisations and staff need to take in order to ensure as much protection as possible. I have recorded a brief video blog to explain the key measures.

It is of course wholly unnatural for places which are first and foremost home for the 40,000 residents across Scotland, to adopt measures which restrict normal life, exchange and encounter. Sadly, these measures are essential to ensure that folks remain healthy, safe and secure. The key measures include steps to reduce the number of non-essential visits into our care homes and approaches to create social distancing within the care homes to reduce the risk of cross infection.

Everyone acknowledges that this is not going to be easy. We are asking families to have a nominated individual who will visit but on a much-reduced frequency and for shorter times. We are asking those individuals to be prepared to have their temperature taken, to sign a declaration that they are not symptomatic and if requested to wear PPE equipment. Can I stress – because there has been some uncertainty over this – that we are encouraging ALL care homes to be open to family members visiting a relative at the end of life. This is extremely important for everyone’s sake and I know that care homes are taking steps to ensure this vital support is continued. We all need to show compassion to one another.

The past week has also seen great strides in working with partners and others who have volunteered supports into our care home sector. Next week Luminate Scotland’s national arts body for older citizens, hope to launch sessions which will bring exercise, participation and activity back into care homes and into the wider community to support those unable to have physical contact. More information in the coming days on this and on plans to link up technology to ensure folks keep in contact will appear on our public section of the website.

Homecare 

Over the next couple of days, it is hoped that we will – with colleagues in Government – be able to issue specific Guidance for those working in the homecare sector across Scotland. It is the women and men who work by going into the homes of our fellow citizens who are often isolated and lonely at the best of times –  it is they who are undertaking one of the hardest challenges in facing this pandemic. We are working hard to ensure that these workers are adequately supported and trained to ensure not only their own personal safety but the safety of those whom they visit.

Supply chain

Since Thursday morning at 8 am there has been a triage system in place to enable, through a telephone helpline, social care providers to access PPE equipment and other essential supplies. A huge debt of thanks goes out to NHS National Services Scotland (NSS), Scottish Government and my Scottish Care colleagues in establishing this system. At the moment priority is being given to ensure that equipment is targeted at instances where there is a confirmed or suspected case of Covid-19. I very much hope that a preventative approach to equip staff where there is no confirmed case will commence in the next few days. Scottish Care has surveyed our members to identify where the shortages are and has fed this information into those organising the supply system. It is clearly in everybody’s best interests to ensure that we not only keep our care staff safe but that we can reduce the spread of this virus by the use of appropriate PPE equipment.

Economic sustainability 

The economic impact of this outbreak has been the focus of much of the attention in the media in the last 24-48 hours. The social care sector in Scotland is far from immune to these same pressures and indeed before this outbreak Scottish Care and others have been shouting loudly about how fragile the homecare and care home sectors have been. Meeting the challenge of the present and future weeks will cause huge economic impact on care organisations. We have been working with Government to ensure that social care providers have access to the business support schemes which have been established. Equally importantly we await Guidance for Commissioners from COSLA, the local government umbrella body, which we very much hope will ensure that in these challenging times there will be appropriate support, partnership and financial alleviation for the homecare and care home sectors. This simply has to happen, or dedicated care organisations will not be able to continue working.

Workforce issues: 

Perhaps the biggest set of issues being faced by providers are those related to workforce. The institution of the 7 then the 14-day self-isolation periods is already having a significant impact on the availability of care workers. We are an older workforce with the majority of workers being over the age of 50 and are also a female dominated workforce at 86%. Taken together with the introduction of requirements for pregnant women, staff with underlying conditions for which they receive the flu vaccine and workers over the age of 70, many of our members are deeply concerned about the inability to have sufficient staff to continue operating. We are working actively with Scottish Government to ensure that there are potential routes into care for those who are being called back, who are in non-essential public sector roles and those who have volunteered their skills. We are grateful for the work of the Scottish Social Services Council and NHS Education Scotland in this regard.

Some of the greatest uncertainty in the last few days has been in relation to childcare for social care workers following the decision to close schools. We are pleased that the Deputy First Minister has prioritised social care staff as Category 1 to ensure that children are looked after. However, we are disappointed that many local authorities are making decisions for cover based on the need for ALL adults in a household to be in an essential service. Whilst we acknowledge that these support measures have to balance the need for social distancing for children and are not there to provide free childcare we would point to the reality that social care staff are often poorly paid and are unlikely to be the main bread-winner in the household. The risk is that a household may prioritise the work of other adults which will mean the carer cannot get out to work because he/she is looking after children especially as older relatives if they are around are rightly unavailable. We hope that we can address this in the days ahead.

It is an absolute truism to say that the women and men who work in our care homes and homecare services are the life-blood of the sector, they enable us to do absolutely everything that we deliver and without prioritising their care and support we will fail to meet the challenge presented by coronavirus. Over the next week it will be a particular focus of Scottish Care to signpost ways in which we can support the emotional, mental and physical well-being of women and men who will be facing untold challenges in the next few weeks.

Regulation 

Over the last week we have seen responsive and practical help offered by both the Care Inspectorate and by the Scottish Social Services Council and professional bodies such as the Nursing and Midwifery Council. Whilst there may still be areas where we are concerned that there is unnecessary reporting and duplication of red tape at a time in which providers need to be able to be responsive – it is our hope that these can be positively addressed in the next few days.

Food access:

It has become clear in the last few days in particular that food and the ability to access food has become a major issue. Together with NHS colleagues care staff have been working long shifts and at the end of these have been unable to purchase food in the supermarkets and local shops because of the ‘over-zealousness’ of the general public. We have called upon the major stores and others to prioritise health and social care staff – and I might add informal carers – and yet at the time of writing only Sainsburys has come up to the plate. We are working with Scottish Government colleagues to try to address this issue.

A related issue is the increased inability of care homes to access local food stock because they are being offered small quantities. The care home sector is a diverse one in Scotland. There are larger groups and organisations who utilise national supply companies for food delivery, but the majority of care homes are smaller, often family run SMEs. It is these care homes which have built up the practice to be local and sustainable in their purchase of food especially in rural communities. Ironically it is these organisations that are currently struggling because the local sources and now the supermarkets cannot support them. We have called for these issues to be urgently addressed.

Transport

In the last 24 hours transport companies both on road and rail have intimated that they are going to be running a reduced timetable. Whilst some like Scotrail have indicated that they will run more trains during peak times, we are really very worried indeed that our workers will not be able to get to their work places because of the reduction in public transport. This especially affects homecare workers who do not follow a traditional shift pattern because care is delivered to individuals when they need and want it. They also frequently use transport to get to different homes. It is these workers who often finish – with their care home colleagues – very late at night and are now faced with the possibility of not being able to get home. We urgently need to address this and potentially to create systems where we can utilise taxi services which are being negatively impacted by the loss of other earnings. We need carers to be able to travel or they cannot care.

Palliative care and ethical choice 

Over the last few days a lot of work has been undertaken with palliative and acute specialists to re-design palliative and end of life care guideless to face the challenge of Covid-19. This includes the importance of developing Anticipatory Care Plans for Covid which communicate the wishes of individuals who might become seriously ill as a result of the virus. It also includes the desire for flexible access to medication in our care homes. Over the next few days these Guidelines and associated practice will be much reflected upon and discussed. Readers will have seen some of the heart-wrenching images which have come from Italy and will be aware of some of the extremely challenging clinical decisions which have had to be made in Italy.

Scottish Care would wish to clearly state that we consider the use of age as the ‘sole criteria’ for any decisions on accessing respiratory or other life-saving supports to be wholly unacceptable and inadequate. The next few weeks and the decisions we take on clinical life-saving intervention and the extent to which we enable palliation of the dying will mould us not just in our Covid response but as a society and as human beings. An approach which is ethically based, human rights respecting and validating of the citizenship and autonomy of all regardless of age needs to be at the heart of palliative and end of life care during the Covid outbreak.

Positive partnership 

It would be inappropriate to finish this brief update without noting that across Health and Social Care Partnerships, Scottish Government, NHS Boards  and local authorities there has been a real collective desire to remove barriers and obstacles and to focus on quick , appropriate and practical responses to issues as they arise. This last week at its best has evidenced what the integration of health and social care can look like and in the weeks ahead it is this understanding of the other perspective, listening with respect, leadership which is collaborative and honest, and authentic human integrity which will see us through to the other side.

And lastly alcohol or to be more precise alcohol gel.

Many of you will have read the story of Mike Bain from Deeside Distillers who has single-handedly  got together distillers to use alcohol in order to make alcohol gel. This has been a brilliant example of how citizens create change and challenge systems for the greater good.  I have no doubt that in the next weeks we will face obstacles and challenges, but I have equal certainty that there will be folks like Mike who will help us overcome them.

Thank you

Donald

Scottish Care statement on food shortages during Covid-19

Care homes and care workers across Scotland are facing food shortages. We all know that nutrition is important, so at this critical time we are calling to supermarkets and food suppliers to include social care when they are prioritising access to food and supplies.

Many of our care homes have relationships with local shops who sadly are unable to support them because their own stock is diminished as a result of overzealous ‘stock-pilers’ and other supply chain issues. We heard about one supermarket who insisted on applying a ‘2 items per buyer’ rule despite the shopper needing to buy food for over 50 people.

Our social care workers continue to go above and beyond, working long shifts to support our vulnerable and loved ones in care homes or in their own homes at a time of need. At the end of such a day, they need access to food to provide them, with the energy and nourishment to continue in such a role which is why they must be included in any offering of support.

We are hoping this call will also stimulate networks which could benefit both social care providers and the hospitality industry. Last week in reaction to a supply shortage of hand sanitiser, a movement on social media initiated by Mike Bain of Ardent Spirits led to an overwhelming response by distillers to divert some of their alcohol production to make hand gel. A similar community-led response could mean that local hotels and restaurants deliver meals to care homes. This would mean continued employment for hospitality staff, and that their fridges of food do not go to waste because of social distancing instigated as a result of Covid-19.

Coronavirus has brought out both the best and the worst in people yet it is clear that whilst we are facing many challenges, new connections and collaborations, and our recognition of value will remain. This is time for us all to become part of history and support those most in need.

Karen Hedge, National Director

20/03/2020

Citation Webinar – Updated agenda: COVID-19 & The Good Work Plan

Webinar:  COVID-19 and how this relates to The Good Work Plan 

First identified in Wuhan City, China, you’ve no doubt been following the rapid rise in cases of coronavirus in the news over the last few weeks.

In light of this, Citation will be giving a brief update regarding on the topic, particularly given the questions this raises regarding employment status, rights and sick pay entitlement.

Click here to read Citation’s answers to some of most frequently asked questions they’ve had around both the Health & Safety and HR and Employment Law implications of coronavirus, plus their practical steps on how to move forward safely and keep your people and premises safe.

Gillian McAteer – experienced solicitor and the Head of Employment Law of Preferred Supplier, Citation – will be hosting a webinar discussing The Good Work Plan, dubbed as ‘the biggest overhaul of employment law in 20 years’. This webinar will take place on Friday 20th March at 11:00am. It will specifically discuss how the programme of reforms will affect care providers in Scotland.

As the news agenda of 2019 was been dominated by Brexit and the general election, these legislative changes have somewhat gone under the radar – with research carried out by Citation suggesting one-third of employers are still unaware of the Good Work Plan, some are incorrectly calculating holiday pay, and many are not prepared for the changes.

Notable changes that Gill will discuss include:

  • An increase in the holiday pay calculation period;
  • Increased protection for agency workers;
  • A written statement of particulars of employment from day one.

Link to join: https://zoom.us/j/694995065

Webinar ID: 694-995-065

Free guides and resources for Scottish Care Members

Ahead of the webinar, Scottish Care members are free-to-access Citation’s most popular relevant resources:

Citation’s complete archive of free guides and resources can be accessed here.

Message from our CEO on Covid-19 guidance for community & residential settings

Last week, the Scottish Government, in conjunction with the Care Inspectorate, Healthcare Improvement Scotland and Scottish Care,  issued further guidance for social or community care and residential settings on Coronavirus (COVID-19). Our CEO, Dr Donald Macaskill has recorded a vlog regarding this guidance. Please see below for vlog and guidance.

 

‘Who inspired you to be a nurse?” – Nursing Blog by Transforming Workforce Lead

In this the International year of the Nurse/Midwife we can look back in history and see examples of nurses who have been inspirational in encouraging people to make nursing their career.

There are some women and men who have been instrumental in making nursing and midwifery what it is today.

Some historians would argue that as far back as 250AD, men were in fact predominantly the ones who provided nursing care to the sick and the poor, with the first nursing school thought to be all male in India.

St Agatha of Sicily is the most well known patron saint of nurses, with three other patron saints, St Catherine, St Elizabeth with St Camillus de Lellis being a male. In fact, he is one of the first male nurses of the profession. He decided to become a priest only to resign in 1607 to continue to care for people affected with alcoholism. All these saints were known to inspire nurses.

Despite this, many view Florence Nightingale as the founder of modern nursing. However she was thought to hold the view that nursing was more natural to a woman and this was detrimental to the acceptance of males into the profession. More recently there was Clara Barton who was the founder of the American Red Cross and was an inspiration for going into the battlefields to help those needing first aid. Males were also present on the frontlines but were thought to have had less training.

Elizabeth Grace Neill was responsible amongst other things for creating the nurse register that ensured nursing was seen as a profession. In 1919 males also were recognised by a register.

The Nursing Theory was developed by Avenel Henderson, who was considered as the most famous nurse of the 20th Century , with all her contributions and influence to American and international nursing education, practice, research as well as its implications.

There was also Mary Eliza Mahoney who was the first registered black nurse, who continued to work throughout her career to fight discrimination and co-founded the National Asssociation of Colored Graduate Nurses in 1908 .The NACGN became Mahoney’s instrument in improving the status of black nurses in the profession nationwide.

In relation to recognising mental health issues, Dorothea Dix was the first advocate nurse who fought to improve care for people with mental health issues, with Margaret Sangar who was instrumental in ensuring the rights of women and worked for over 40 years to ensure birth control was available to women from the 1950s.

Edward Lyon in 1955 became the very first male nurse to be commissioned in the Army Nurse Corps in the US as a reserve officer.

These are only a selection of international nurses who worked tirelessly to ensure the rights of all people, alongside challenging legislation to establish nursing and midwifery as it is today, which is now devoid of discrimination . Nurses can now work and lead in all fields which offer positive career pathways, regardless of background, race, ethnicity or gender.

Nowadays we often see the young student nurse who has spent their whole childhood dreaming of being a nurse, but for many their decision comes out of a personal or family situation that changed them in such a way that they  were inspired to want to be an nurse themselves.

The more I explore this subject, the one thing that can’t be disputed is that those who choose nursing as a profession want to make a difference, to give back, they are determined and genuinely care for people, often going above and beyond.

For me personally, my childhood dream was to be a police officer, not a nurse, because I felt that by joining the police it was the one job I could help people, keep them safe and which would challenge me and make me a stronger person.

I believed this was the job that I would get the most satisfaction from and that would make me a better person in the process.

The year before I applied, my gran suffered a stroke in her late 70s. Post-stroke despite still being mobile, she was no longer able to look after herself and she subsequently came to live with us.

Psychologically she had changed due to the stroke, as did our relationship. My gran was my inspiration and to see her dependent changed my whole mindset and view on what really mattered in life.

I was always close to my gran, but our roles had reversed,  having to care for her and hold her hand and comfort her, to help her understand things and still to enjoy life despite its frustrations,  as well as being beside her, 3 years later, when she passed away peacefully at home .

Alongside this, I watched my mother with two teenagers take on the role of carer, give up her job and manage all the dynamics of the family.

It made me realise that nursing someone can give so much joy and gave me everything that being a police officer would’ve and more importantly gave me the empathy that ultimately directed me into nursing. Nursing someone you love is different, as its personal, but it gives you the insight to understand what the families of those you nurse are going through. Never underestimate this.

I believe her illness gave me the best gift. I started my training in 1987 and haven’t looked back.

Our patients and residents without question remind us every day why we are nurses, they let us into their lives, tell us their secrets and trust us to provide the care they need, literally for some, putting their lives in our hands.

The nurse-patient/resident relationship differs depending on which area of nursing you choose to work in, but can teach you how to be compassionate, and develop a patient centred approach, which ensures people’s needs and rights are met.

We know these are challenging times and there will be points in your career that you question if you still want to be in nursing, but I ask you to stop and remember why you became a nurse, and maybe  consider that you may just need a change of environment, not a change of job.

As the workforce lead for Nursing at Scottish Care I would promote  working with older people in care home nursing, as it offers a homely environment to build relationships with residents and families and provides the potential for an exceptional career pathway for you as a nurse. We do need an increase of younger people, men and people over the age of 40 years, as well as more people from Black, Asian and ethnic minority backgrounds to continue to join the profession, to ensure future workforce stability.

As nurses we hope we inspire others to do their best, nothing more or less and others to continue to inspire us in the same way.

 

Jacqui Neil

Transforming Workforce Lead for Nursing, Scottish Care

@TransformNurse