At the 2018 Care Home Conference & Exhibition, Scottish Care launched our latest research report entitled ‘Care homes: then, now and the uncertain future’.

We undertook this research because it is Scottish Care’s belief that care home services have a fundamentally important strategic role to play in creating a person-centred, rights based pathway of care and support fit for Scotland’s citizens in the 21^st century.

But we know that the historical and recent development of care home services has shaped the sector in particular ways, both positively and negatively.  It has led to a popular understanding of care homes that is often at odds with the reality of life and work in these services, especially as these services continue to change and develop to meet the needs and wishes of individuals and communities.

This research therefore sought to track the development of care homes in order to paint a descriptive picture of the reality of modern care homes, from the perspective of care home providers, managers and front-line nurses and carers.

The findings highlight the reality that care homes have changed beyond recognition from their origins in the ‘workhouses’ of the 18^th century  – but public perception hasn’t necessarily evolved at the same rate.  Myths still abound about care homes being places of neglect, inactivity and ‘last resort’ – either as a care option or a career option.

The report therefore outlines various areas of work that need progressed urgently to ensure that the future of care homes is a more positive and sustainable one:

• Care homes understood and treated as a key component in integrated service provision
• Work undertaken on understanding resident needs
• The transformation of workforce support
• Development of proportionate and flexible scrutiny underpinned by a robust resourcing model
• The need for greater public awareness and understanding of care homes

We are clear that the publication of this research needs to be the start of a process, not the end of it.  Scottish Care is committed to ensuring that this report gets to every individual and organisation, nationally and locally, who needs to understand what the care home reality is, in all its glory and all its challenges.  And for that information sharing to lead to a more engaged and informed dialogue.

Please read the report and share your feedback with us.

We look forward to working with all providers and stakeholders to ensure that future of care homes is one grounded in information and knowledge rather than emotions and stereotypes.

If there are any individuals or organisations who you think would benefit from receiving a copy of the report in your local area, please email [email protected]

Thank you to all individuals and organisations who participated in the research through attendance at focus groups and completion of Scottish Care surveys.

You can read the report here.

We have also created an accompanying animation, with the help of Rosie McIntosh at Third Sector Lab.  You can view the short animation below:

REAL THREAT TO THE SUSTAINABILITY OF THE CARE HOME SECTOR – THE ‘CINDERELLA’ SERVICE OF HEALTH AND SOCIAL CARE – SCOTTISH GOVERNMENT NEEDS TO INCREASE FUNDING BY 6-8 PER CENT 

 

CARE HOME SECTOR CALLS FOR URGENT DEBATE ON THE FUTURE OF SOCIAL CARE 

Care home operators say more needs to be done to recognise the crucial roles that care homes play in supporting vulnerable people and to ensure a sustainable future for care home services and the people that work in them. 

The message will be delivered at the National Care Home Conference in Glasgow today (FRI NOV 16) by Dr Donald Macaskill, Chief Executive of Scottish Care, the representative body for the country’s independent social care services. The 450-delegate event, which is sponsored by the Clydesdale & Yorkshire Bank, will include an address by Cabinet Secretary for Health & Sport Jeane Freeman. 

Unveiling a new report ‘Care homes: then, now and the uncertain future’ – Dr Macaskill said that research with front line staff has highlighted just how much people still don’t understand about the reality of care home provision in 2018.  

He said:  

“This report demonstrates the dramatic and unappreciated changes which the care home sector has undergone over the last few years. It challenges myth and stereotype and calls for the development of a mature understanding of the invaluable role which care homes play in our health and social care system in Scotland. It argues forcibly for the need for us to challenge the societal and popular negativity which ignores the fact of the brilliant care and support given by tens of thousands of staff in care homes throughout Scotland today.” 

Highlighting that a lack of understanding of the skilled and important work that takes place in care homes is putting people off working in them, Dr Macaskill will tell delegates:  

“The most immediate challenge care homes face is getting enough of the right people to see caring as something they want to dedicate their life to.” 

What’s more, the continued under-resourcing of care homes means not only are care staff not being sufficiently rewarded but that services themselves are at very real risk of closure. 

Dr Macaskill said a 6-8% Scottish Government increase in social care funding is needed would provide the system our citizens deserve:  

“I cannot remember a period of such real threat to the sustainability of the care home sector. Things are very fragile indeed.  Care homes are truly the Cinderella service of health and social care. 

“Yet again Scottish Care is calling on our politicians to put down their party political megaphones and start talking to one another, to providers, to citizens, about how we are going to fund social care.”  

ENDS 

 

 

The Scottish Government today announced nursing student intake figures for the academic year 2019/20.

Commenting on the news that the number of student nurses starting their course in the autumn is set to increase by nearly 8 per cent, Dr Donald Macaskill, Chief Executive of Scottish Care said:

“The independent care home sector employs nearly 10% of Scotland’s nurses. The sector is facing a critical shortage of nurses with an increase in vacancies over the last year and care homes struggling to recruit skilled nursing staff. Added to this is real concern over the impact of Brexit and any future immigration restrictions.

 

“The care home sector in Scotland needs more nurses.

 

“I am therefore pleased to welcome today’s announcement on student places for 2019/20.

 

“We are grateful that the Scottish Government has listened to our concerns and is working with Scottish Care and other partners to address both the immediate and future nursing challenges facing social care. This announcement together with other initiatives will begin to address the critical shortage which our care homes are facing.

 

“Nursing in a care home setting is a rewarding and immensely fulfilling profession and we look forward to ensuring that many of those who will start their training next year will see older people’s nursing as a priority for their careers.”

The Life Changes Trust has announced a new funding award of £135k to help ensure the rights of people living with dementia in care homes.

For the full details please see the news release from Life Changes Trust below:

 

Rights Made Real in Care Homes media release FINAL

Bereavement is part and parcel of what it means to deliver quality care at home and housing support services. The Scottish Care report  ‘Trees that Bend in the Wind’ published last year spoke eloquently of the experience of frontline workers who built strong and personal relationships with those they cared for in the community, to then be faced with the upset and trauma of loss and the emptiness that comes with death.

In our work here at Scottish Care we have been trying to raise attention and focus on the impact that continual loss and experience of bereavement has upon the mental health and wellbeing of our frontline staff. Compounding this is the reality that there are very few opportunities for staff to be supported in their grieving and to have access to immediate bereavement care and support.

We were therefore very pleased to see a recent publication from Sue Ryder and Hospice UK adding weight to our analysis and concerns. ‘Bereavement support in Scotland’ published in October 2018 highlighted that as many as 53,000 people in Scotland could be missing out on the support which could help to support them in their bereavement. Scottish Care believes there is a particular challenge being faced by those who work every day with those who are receiving palliative care and those who are at the end of life. This is especially true for homecare staff.

The report states:

‘Nearly one third (31 per cent) of respondents say they needed additional support beyond family and friends to manage their bereavement. But:

• Only 6 per cent of all respondents accessed bereavement support.

• A further quarter (23 per cent) of respondents would have liked support but couldn’t access it because: they didn’t know how (12 per cent); felt uncomfortable asking for it (8 per cent); or couldn’t get the type of support they wanted (3 per cent).’

We need to get better at a structured and national approach to providing bereavement support to the 230,000 people in Scotland who are bereaved each year.

I am therefore pleased to be chairing a group of representatives from national bodies who have started to work on drawing up National Bereavement Standards which we hope will be adopted by Scottish Government and wider stakeholders. To date the group consists of, amongst others, representatives from NHS Education Scotland, the Integrated Joint Boards, Scottish Care, mental health organisations, the Care Inspectorate, Health Improvement Scotland, the Scottish Ambulance Service and voices from General Practice and specialist palliative and end of life care.

It is our hope that we have started a journey which will help to give greater focus to and priority around bereavement across Scotland. As I have stated elsewhere:

‘Good bereavement support is no optional extra, it is rather fundamental to a society basing its character on dignity and human rights. Good bereavement support renews and restores, it can give a sense of purpose and direction, for many it’s what has literally saved their lives.

‘I fear that if as a society in Scotland we fail to enable and resource those who do the work of care to grieve properly and to enrich them through good bereavement support then we are sowing the seeds of a harvest of regret and despair.’

https://www.scottishcare.org/scottish-care-news/blogs/bereavement-support-is-not-an-option-latest-blog-from-our-ceo/

Dr Donald Macaskill

 

Developing local partnerships and improving palliative care provision in the community

A good death at home requires integrated health and social care services to prioritise person-centredness and to nurture the workforce who support death and dying.  Scottish Care recognise that there are a number of resources to support staff care for people at the end of their lives, but through our Supporting Solace research it was identified that there is little co-ordination of these resources, and access to them varies considerably.  As a result, one of the recommendations contained in our Trees that bend in the wind report was the need to maximise the timely and effective use of palliative and end of life care at a local level and develop more joint working and learning.

This recommendation was embraced by Scottish Care’s Elaine Rae (Local Integration and Improvement Lead for Glasgow), Baillieston Community Care and the Prince and Princess of Wales Hospice.  They undertook a test of change which involved care at home staff experiencing working life in the hospice, and hospice staff shadowing workers involved in PEOLC in the community.   It was hoped that the learning from this process would play a small part in developing the wider narrative of effective change and better joint working, learning and collaboration in Glasgow.

It achieved this – and more!  Activities and learning are on-going, but there continues to be a real sense that joint working is an effective way to plan and develop learning opportunities which will support staff across the workforce to transfer and integrated knowledge into observable improvements in practice.

We’re delighted to share some reflections from one of the participants in this test of change.

Thank you to the following:

David Reilly – Baillieston Community Care

Lorna Harrison – Baillieston Community Care

Gillian Sherwood – Prince and Princess of Wales Hospice

Jane Miller – Prince and Princess of Wales Hospice

Elaine Rae – Local Integration and Improvement Lead (Glasgow) and Regional Lead – Scottish Care

 

Reflections by Lorna Harrison – Baillieston Community Care

I have mixed feelings about my experience at The Prince and Princess of Wales Hospice.  I knew this wasn’t going to be easy, although didn’t think it would affect me the way it had. 

After leaving the hospice on the first day I thought I could keep my emotions together until I got home but barely made it to my car.  This was upsetting for me and I can’t begin to imagine what these patients have in front of them.  So many questions were going through my mind.  There were so many emotions I had witnessed in the first day alone and I felt some of the emotions that these people were going through.  Acceptance, peace, anger, anxiety and fear. 

The two patients I sat in with on the first day were two totally different situations.  How can one person be ok with dying and the other person be so frightened and upset?  There is a lot of factors that I didn’t really think about up until now ie not wanting to be a burden to others, the fear of upsetting relatives, not wanting to face the truth and the thought of being cheated of life?

Most of all being able to talk about dying.

Jane had kindly given us the anticipatory care plan which we can now talk to our service users about.  I have been working along with my colleagues to create a new care plan of our which now incorporates some of the questions in the anticipatory care plan. 

I feel we as a provider need to get better at talking about dying.  We need to liaise more with heath care agencies and more importantly they need to liaise more with providers as we seem to be the last to know important information on how to care for people in the community who are receiving palliative care.  

We can all talk about dying;  I think it is the fact that no one likes to talk about it that is the problem.  I used to think of dying as a taboo subject but after my experience at The Prince & Princess of Wales Hospice, I can talk about dying and I will talk about dying.