Highland has one of the most advanced cross sector collaborative relationships when we talk about care at home.  Since 2014 the independent care at home sector has collaborated with the NHS and with each other to ensure that high quality care at home provision is accessible and sustainable across Highland.

We are now taking our next big leap in this collaborative relationship and working more closely as a sector and with our NHS colleagues to develop a quality and improvement process and to begin the shift to an outcome focused approach.

The NHS commissioners have worked alongside the independent sector, via our Scottish Care Development Officers, to design and begin to implement a new outcome focused approach to both the commissioning and delivery of care at home services.  In this collaboration the NHS commissioners have co-designed and co-produced a new commissioning approach which is based on meeting personalised outcomes for service users - rather than the traditional “time and task” focus.  The whole sector has been involved in the design of this new way of working – to ensure that it is effective, efficient and achievable. 

In Highland we really are ahead of the game in terms of working in collaboration across sectors and planning for development of pan-Highland coverage.

In order to develop person centred, outcome focused care we have to work in collaboration - commissioning needs to be outcome focused and more flexible in order to allow the providers to deliver more outcome focused and flexible care which in turn allows the service user to experience personalised, flexible care to meet personal outcomes

Julie Fraser

Care at Home Development Officer, North and West Highland

Partners for Integration and Improvement

Scottish Care

@partnersforhsci

#homecare17

As part of Home Care Day's Workforce hour, we're sharing some SSSC case studies from home care workers who have achieved qualifications to meet their registration requirements.

Take a look here: http://ssscnews.uk.com/2017/07/19/are-your-workers-concerned-about-gaining-a-qualification-for-registration-hear-from-some-workers-who-say-there-is-nothing-to-worry-about/

The SSSC also recently undertook a Q&A with a home care support worker about her role and her recent return to studying.  Read all about it here: http://ssscnews.uk.com/2017/10/25/celebrate-careathome-housingsupport/

#homecare17

Do you know someone who works in home care who should be celebrated for the amazing work they do?  Let's shout about it!  #homecare17

When asked to contribute a piece for Home Care Day in my role as Workforce Development Consultant with Scottish Care I was filled with trepidation.

I appreciate that this is not the most positive start to a blog, but please bear with me.

Having previously held a senior role within the Care at Home service of a Local Authority and currently welcoming a Care at Home service into my own home four days a week, my concern was just what to highlight and how to do justice to the work carried out from the earliest hours of the morning to the latest hours of the night, 365 days a year.

It is my belief that the thousands of care at home workers doing their job all over the country are the unsung heroes of social care.

We live and work in a time when the demand for care services is unprecedented, while the financial resources to provide them has never been more strained.

As a nation we are living longer – which is extremely positive!  However we are not necessarily any healthier, with the same level of critical health needs per head of capita as before.

This means that there are many more of us needing care and support to maintain our independence than at any other time in history – and the people at the forefront of the action are our care at home colleagues.

It has often irked me over the years when the work of home-carers has been discussed almost dismissively by those who have had no experience of either carrying out the work or of receiving the excellent services provided.  Never more so than when the carer themselves have uttered the self-deprecatory line 'I'm just the carer'..!

The role of home-carer has always been incredibly complex and has become increasingly more so over recent years as people live in their own homes longer with more needs to be met.

To enter someone's home is a deeply personal thing; to then provide intimate personal care intensifies this.  Add to this providing nutrition, emotional support and assistance with the medicines that keep people well and we get a sense of the importance of the role and of the individual carrying it out.  And all measured out in minutes.

The people who carry out care at home begin work before many of us have pressed 'snooze' on our alarms for the first time and finish work when most of us have turned off our bedside lamp and closed our eyes.  At this time of year they are being soaked by rain and chilled by wind as they go about their business of providing the precious gift of being in their own home to the most vulnerable of us.

Could you do it? And with good cheer?

It takes a very special person to be a good care at home worker. They are our unsung heroes.

 

Paul O'Reilly

Workforce Development Consultant, Scottish Care

@WorkforceMatte1

#homecare17

Today is Home Care Day, a day where we can all come together to raise awareness and champion everyone and everything which makes the Scottish care industry great.

Over the course of today Scottish Care will be celebrating a different aspect of home care, and over the next hour there we are focusing on vision.

Having a strong and clear vision of where we take care in the future is important as it gives us direction and ultimately helps us improve the wellbeing of those in need of care.

We have got involved today to help promote this message, but also to get our colleagues within the home care industry to think about our own vision in the sense of how we see the world around us, and how together we can really make a significant difference to the lives of so many people in care today.

Our core belief here at Visioncall is to enrich people’s lives through better vision, and we are able to make this a reality for so many people in care across the country every day.

But there is still so many more we can be helping see the world better and improve their daily lives:

• Currently 50% of older people living in care are believed to have some form of sight loss, and 70% of people in care are living with dementia or severe memory problems.
• Living with poor vision has a significant impact on most daily activities we can easily take for granted.
• Reading, identifying hazards and even seeing the food on our plate, all becomes a major challenge if you are living with poor vision.

For someone living with a form of dementia this only becomes a more urgent need.  Dementia itself is the common term applied to describe a range of losses in brain function.  This means that the person will have a condition which will severely impact their personal, social and occupational life.

Our vision greatly impacts how we are able to interact and better understand the world around us.

Helping a person to see better simply means that they can better engage with the world around them, promote their independence and have a better quality of life

At all stages of life it is so important that you receive regular sight tests to maintain and improve your vision.  A simple sight test can achieve this and also help to identify some underlying health issues.  Our skilled optometrists do this every day in comfortable and familiar surroundings within the person’s residence.

Visioncall are proud to assist thousands throughout the country to help those most in need to achieve better vision.

Last year along we helped an elderly person see the world better every two minutes and 42 seconds.  We aim to beat this time moving forward and help even more people live a better life with improved vision.

If you currently oversee someone’s care and want to help them achieve better vision, click here: http://www.vision-call.co.uk/campaigns/free-home-visit.php

 @VisionCall

#homecare17

To celebrate 'Vision' hour of Home Care Day 2017, Scottish Care will be hosting a Twitter discussion between 12pm and 1pm.

Throughout this hour, we hope as many people as possible will engage with us and share their hopes for the future of home care in Scotland.

Join us at @ScottishCare and tweet your thoughts using the hashtag #homecare17

We'll be kicking off the hour by asking:

The project and research aims to improve the understanding of the issues impacting the care and support of people at home across Scotland.  Working across sectors and with national and local partners, it will support an improved understanding of the challenges and the reasons behind them.  It will produce an evidenced based, informed set of recommendations to address these challenges.  Throughout it aims to identify and evaluate innovative and sustainable models of care and support at home, workforce compositions and commissioning and procurement methods.

Throughout the study some key principles have emerged. The research has shown that Health and Social Care Partnerships (HSCPs) and providers are struggling to deliver services where there is a continuing increase on demand both in terms of volume of people and more complex needs.  The evidence suggests that services for older people are much less outcomes focussed and personalised and that if things to do not change this pressure will only result in reduced quality services for older people in Scotland

In order to alleviate pressure on the system whilst delivering the best quality and outcome focussed support we need to start thinking a little differently. Although a lot of the principles outlined in the research are not new, it is about ensuring we deliver consistent quality services across Scotland.

Services and systems which focus on prevention and promoting independence deliver better quality support.  Some of the evidence suggests people with individual budgets or just more choice and control actually have reduced packages of support.  A one size fits all approach is much more common in older people services compared to other adult social care.  This is unfair and unnecessary.

Services which are joined up and include a holistic assessment process also produce better outcomes for individuals and reduce resource requirements. This assessment process should also have Technology Enabled Care embedded into it. It is not about replacing the human aspect or cutting costs. Although evidence shows TEC can provide cost savings. It is about promoting self-management and independence.

We need to empower the frontline staff to be able to make decision and have level of autonomy to make services flexible.  This does reduce pressure on the system and ensures people receive the most appropriate support at the right time.

We also need to have a strength based approach to assessment, support planning and managing ongoing support.  Understanding someone’s own capabilities, their networks and the community provisions can change their life whilst providing clear efficiencies in the system

These things are not easy – otherwise we would all be doing it.

There are financial challenges and in some cases change will require upfront cost and restricting a system. However, long term a focus on prevention, self-management and strengths will provide savings whilst continuing to meet people’s needs. But the whole thing works when we recognise each stakeholder’s role and value their contribution.

We need to be brave – think differently.  Share information and best practice.  We also need to understand we can deliver personalised support in the current financial climate if we all work together.  Care and support at home services are literally changing lives and will continue to do so.  The value of the work being carried out cannot be underestimated and I hope we continue to create a system that delivers on more people’s outcomes.

Quotes from individuals when asked, 'what difference does your care and support at home service make to you?':

‘It has been phenomenal’ – Carer for elderly mum and partner

‘I couldn’t have managed at all’ – Individual in older person’s service

‘I really appreciate every day they are here’ – Individual in older person’s service

‘Everything! No way I could do without it’ – Individual in older people’s service

‘I wouldn’t be able to get washed, dressed or even do my make-up. Stuff other people take for granted’ - Individual with physical disability

‘It cheers me up’ – Individual in older people’s service

‘It stops you having to go back to hospital. It keeps you sane’ – Individual in mental health housing support service

‘I wouldn’t be here without it -’ Individual in learning disability service.

 

Maggie Dowe

Care and Support at Home Development Officer

@socworkscot

#homecare17

I was fortunate to be asked to judge this year’s Care at Home Annual Care Awards for Scottish Care.  This is a humbling and daunting task not only given the number of entries for the individual categories but also in having to choose a winner when so many dedicated and inspiring people have contributed to supporting and caring for people at home.

As someone who has worked with the sector for several years I am well aware of the challenges and complexities of providing individual, person-centred, quality care in someone’s home environment.  People working in this sector have to possess a broad spectrum of abilities and a caring compassion for fellow human beings. 

I live in a small quiet rural village in South Ayrshire and there are a large number of retired and elderly amongst the population.  I have a neighbour with dementia and know of another resident in my street who is bed ridden and been house bound in the 4 years I have lived there.  In walking round the village in a morning, lunchtime or early evening there is always a hive of activity with numerous care at home workers arriving at various cottages and houses to carry out their duties.  What strikes you is how cheery and friendly they are no matter what time of day and in hearing them opening the door and warmly greeting the resident inside.  What that must mean to the individual receiving the visit cannot be imagined.  Never mind the care, even just that interaction and a friendly face must be a huge tonic.

These rural villages have many people who have grown up there and probably never moved far.  They are part of the fabric, the community, the very demographic that attracts people to retire to the country.  How different it would be if they could not be cared for in their home.  The nearest care home facility is small and 4 miles away with the remainder some 10 miles plus within the nearest main town.  Many of these people still manage out to the local village shop or to the church and continue to support village activity and the community.

The positive impact therefore not only for the cared for but also the wider village is significant and is probably underestimated by the very dedicated people who provide the necessary care. 

So a judge tasked with picking a winning care at home business or a care at home employee is indeed put in a difficult position because so many do so much every day, seven days a week, every week of the year for someone’s neighbour, friend or family member.

 

Derek Breingan

Head of Health and Social Care Sector UK
Corporate and Structured Finance
Clydesdale and Yorkshire Bank plc

@DerekBreingan

#homecare17

Do you know an extraordinary individual who receives home care support?  Tell us about them!  #homecare17

Hamish, 82, has Parkinson’s Disease but remains cognitively sound. For four years he has had support visits three times a day: morning personal care, lunch time and a combined teatime/night settling visit.

Every morning, Hamish walked with his Zimmer frame to the bathroom sink where he stood to shave himself. He then went back to his bedroom to wait for his support staff to arrive. They would bring him a basin of water and soap and help him to wash. They would then dress him and he then walked to the living room where he sat in his riser/recliner chair. Hamish agreed very cautiously to try changing his routine to a more enabling one and his personalised support plan was put in place.

2 months later:

• He was totally independent with his morning routine, washing himself at the sink in the bathroom and dressing in the bedroom. He needed assistance only to put on his shoes.
• He set out his own clothes, something he did not do before. He also wiped down the sink after his daily wash.
• He asked to learn how to operate the washing machine and always had a fresh load for staff to hang up.
• He made his snacks and drinks by himself and asked for a tray for his Zimmer frame so he could carry it from kitchen to living room. He wanted to learn how to operate the microwave.
• For the first time in two years, he ventured out alone to the local shops to buy his newspaper. In the warmer weather, he planned to spend time in his garden.

#homecare17