I am very pleased to be writing this blog for the second ever Care Home Week. I’ve been asked to write about human rights and admittedly it’s a theme I have commented on not a few times since I took over as Scottish Care CEO in April 2016.

Indeed there has been a lot that’s changed in Scottish Care in that time. Carlyn Miller developed two fantastic human rights conventions alongside people who use services and supports; she also wrote a great report on the implementation of self-directed support using the PANEL human rights model; we’ve had two Care Cameos directly touching on human rights issues – one on dementia and another on social care and human rights in general; and in August we will be publishing a report on human rights and technology in care.

In addition Scottish Care has been delighted to partner the Life Changes Trust in a new grant scheme which has enabled some care homes to access grants to enable them to embed human rights projects. As these start we look forward to being joined in the future by a colleague to further promote the work of human rights in care homes across Scotland.

Outside of Scottish Care the creation and now the implementation of the new National Care Standards is evidence that Human Rights are very much at the heart of the delivery of care home services in Scotland.

So a huge amount has already happened and yet more is still taking place. With all this positive direction, however, I have cause to reflect upon the words of Eleanor Roosevelt, Chair of the United Nations Human Rights Commission who said after the United Nations Declaration of Human Rights had been developed seventy years ago this year:

“Documents expressing ideals carry no weight unless the people know them, unless the people understand them, unless the people demand that they be lived…”

I suspect that that is where we are at in Scotland in general and in the care home sector in specific at this moment in time. I am convinced that without an extensive national awareness campaign that people who are resident in care homes will remain largely ignorant of their rights and the new rights-based Standards. But it goes even further than awareness raising.

We have absolutely no chance of achieving a truly human rights based system of care and support in Scotland unless we are as a society and as politicians in particular prepared to put a resource behind all the good words and human rights rhetoric. Dynamic change and re-orientation to embed rights demands the acknowledgement that financial resource is needed.

It’s needed so that our fantastic care home staff can become human rights workers in their job of care and support, learning how to balance competing rights, and how to further promote dignity, choice and autonomy in the work they already do.

It’s needed so that we adequately resource, from a human rights perspective, the delivery of increasingly complex and demanding care home services, delivering person led care across the range of conditions and co-morbidities, from dementia to delirium; from multiple sclerosis to muscular dystrophy.

It’s needed so that we properly resource our nursing staff not only so that we have sufficient numbers of them but also that we can re-envision their role at the heart of human rights based clinical care.

Care homes are fantastic places where individuals are able to live their lives to the fullest until their very last breath. From the moment they enter till the moment they leave they have the potential to be supported in a human rights setting – but the reality of that requires a human rights based approach to resourcing and budgeting. It speaks ill of a society where 24/7 nursing care is being delivered at a cost of £4.10 an hour.

Human rights are the life-blood that courses through all care and support in a care home or elsewhere. But just as a human being needs nutrients and energy to maximise potential so too human rights need to be fed, nurtured and resourced. They cannot remain paper based aspirations.

We have come a long way, we have the Conventions, the legislation, the Standards, the policies and the projects. All that remains to paraphrase a fellow human rights contemporary of Eleanor Roosevelt is to ‘give us the tools and we will finish the job.’

Enjoy Care Home Week

Dr Donald Macaskill

@DrDMacaskill

 

#carehomeweek

Mythbusting

It’s Care Home Week when we celebrate our care homes, the people who live and work in them, and the communities which they serve. So it seemed like the perfect time to bust some myths about Care Homes, and the sector as a whole – there’s one for every day of care home week.

Myth 1. If I go into a care home I have to leave everything behind
It’s in the name, it is a care HOME, and that means it should be all of the things that your home should be. With all of the capabilities of a noun, an adjective, a verb and even an adverb; your home can be and can mean many things. I find some of the poetry from warzones or from emigrants like Emily Dickenson particularly emotive in articulating the emotions and complexities that attach us to home. Most of them invoking the sense of a place which provides a feeling of security, a place of relaxation, a place of love. A care home should feel no different. To challenge the pop song, it’s not just ‘wherever you lay your hat’; it’s a place where you feel safe, a place where friendships can be made, a place where you can surround yourself with your own belongings, and where people you love can come and visit freely. Just last week, Balhousie Care Home won a Scottish Social Services Award because of the way that they create a personal environment for each individual who stays there, and where dementia ambassadors work with residents to make people feel safe. A care home is a caring home.

Myth 2. If I go into a care home I will lose my independence
Quite the opposite, we know that human beings thrive when they are active. It keeps us healthy and happy. The new Health and Social Care Standards promote a human rights based approach to social care, and seek to offer better outcomes for people amidst a context of dignity and respect.
Care should be person led, which means that you have choice and control over the care and support that you access, and that it should focus upon capability and potential. You may even get involved in initiatives like the Care About Physical Activity (CAPA) programme, whereby social care staff are trained in supporting people who access care and support to increase their activity. This approach has been proven to support self-management, and results in fewer hospital admissions.

Myth 3. Social Care staff are unskilled
In Scotland, social services staff have to register with the Scottish Social Services Council (SSSC), and must have a qualification such as SVQ Social Services and Healthcare. Social services staff also need to complete and record with the SSSC their Post Registration Training and Learning (PRTL). This is a way of making sure that the staff who work with some of our most vulnerable citizens are known to the authorities, and take time to complete appropriate levels of training on a continuous basis. It has the aim of driving higher standards in the care sector, and plays a part in safeguarding.
The majority of staff have been in the role for many years, and built up close relationships with the person that they care for, and are often considered to be, and value being ‘part of the family’. Because social care staff often spend every working day with the same people they are often best placed to advise in delivering their care and support and this can be invaluable to other professionals who may also support the person accessing care, such as a GP. This will be explored further in our report ‘The Experience of the Experienced’ due to be launched at our upcoming Workforce event on June 28.

Myth 4. Social Care is a drain on society
Last week, the SSSC in collaboration with others, published a report entitled The Economic Value of Social Care in Scotland. It shows that the adult social care sector can be valued not only by the high quality care and support offered to our most vulnerable citizens, but also by its economic contribution to society.
According to the report, the sector employs 148,000 people in Scotland, which is 6% of the total workforce, making it comparable in size to the entire NHS, and with the largest employer being the independent sector. In addition, when an individual is offered regular care and support, the sector enables unpaid carers to remain in employment, and supports a further 29,400 jobs relating to the purchase of services or goods made by the sector (indirect effect).
At £2.2 Billion, the Gross Value Added (GVA) which is the value of the goods and services that a sector produces, is higher than Agriculture, forestry and fishing, Arts, entertainment and recreation, and Water supply; sewerage and waste management. It is the 5th largest contributor. The GVA increases to £3.4 Billion when taking into account the indirect effect of the sector. The report also mentions the additional benefits the sector offers by reducing hospital admissions and delayed discharge. This has impact both on lifestyle and the economy.

Myth 5. Care homes are an ‘old-fashioned’ way to deliver care
A real positive of the social care system and legal framework that we have in Scotland is that we can choose how we access our care, so having different services on offer helps to ensure that everyone can access the type of care and support they prefer. For some this may be staying in their own home, for others it may be moving to a care home, or indeed something completely different.
Care Homes are constantly evolving to keep up with the needs and wishes of the people who live in them, introducing new services and activities because the people who live there want them. And in terms of specialised support, many homes are now equipped to care for the increasing number of people with multiple comorbidities now that we are living longer. Previously these people may have had to go to hospital, but now they can have the benefits of staying in a care home (see Myth 1.).
And this evolution doesn’t just apply to the care and support that they offer, but also to the systems that they run. For instance, many care homes use technology to develop which frees up their staff to spend more time just ‘being’ with the people who live there, to focus purely on the human aspect of care. This ranges from digital monitoring, digital care planning and staffing, to diagnosing health needs and more. To find out more, come along to our event ‘Tech Care Take Care’ on August 24.

I hope this has helped to challenge some misconceptions about care homes and what they offer. They are a part of our society, and many are having open doors as part of care home week. I urge you to get involved and take the mythbusting challenge yourself.

Karen Hedge, Scottish Care National Director

@Hegeit

#carehomeweek