Latest Blog from our CEO: Facing up to care reality
Speaking at a fringe meeting of the Conservative Party conference the Social Care Minister Jackie Doyle-Price suggested that people should not expect that the houses they live in should be able to be passed on to the next generation as an inheritance. She said that it should not be seen as the role of the state to pay for our care in old age if we can afford to do so ourselves.
Her intervention has led to the start of a strident debate and media discussion. Language such as ‘dementia tax‘ has reappeared in the political lexicon. Inescapably, however, as I said on the BBC last week this is a discussion we badly need to have in Scotland.
Over the past year Scottish Care has continually articulated a message that the older peoples care sector in Scotland is at a point of real challenge if not crisis. We have a nursing shortage of 28% average vacancies; 9 out of 10 care at home providers are unable to recruit to key posts, and nursing care home providers have recently told me they are paying £1000 for one agency nurse to do a night-shift in some parts of the country. Pressures from growing costs, increased registration and regulatory requirements and increasing levels of clinical demand are pushing providers to the very edge.
Faced with such realities people can react in diverse ways.
There might be a tendency on the part of some to bury their heads and assume things will get better without any strategic intervention. They won’t!
There is an equal tendency to seek to do less for more – however, any short term financial gains achieved by such an approach will soon evaporate as individuals no longer deemed eligible for support become more and more unwell and are put at increasing risk. The reduction in the use of care home placements combined with a lack of adequately resourcing care at home and housing support is a game of care roulette with only one victim, the vulnerable older person desperately in need of support and care.
Another reaction is the desire to reform and change. This is undeniably necessary not least in the way we purchase care and treat older people in a discriminatory manner with regards to choice and control such as through the operation of self-directed support. Equally important is the desire to innovate and re-design but if ‘new models of care’ are viewed as some sort of panacea for our current ills we risk losing creative innovation and care entrepreneurship as fatigue and failure take root. Even with progressive use of technology we aren’t going to find a magic chic of gold at the bottom of the care garden.
Overarching all this is a response which says we are doing a lot anyway, we are doing better than others and that we are spending more than we ever have. All of these might very well be true as is the oft heard statement that we need to transfer resources from acute clinical delivery into primary and community health and social care.
But …
and it is a big but. The fact is we have not robustly undertaken an analysis of whether even with reformed, dynamic, localised, non- institutionalised interventions, there will indeed be sufficiency of financial resource it is difficult not to conclude that there is a substantial inadequacy of resource in social care. That is what frontline staff and providers are telling me up and down the country. In particular as we live for longer and with better health, how will we pay for increased dependencies and an even greater volume of care and health need?
Integration is part of the answer to that puzzle but so too is a serious debate about the mechanisms needed to be able to pay for health and care. We need to collectively have a debate about the ethics of being treated free at the point of care if you develop one condition such as cancer but if you live with dementia there will be a greater likelihood you will have to pay. We need to have a debate about the ethics of inheritance and contribution. We need to start to shape the nature of decisions around personal insurance, income tax, separate taxation for care etc.
And we need to do so urgently. This goes way way beyond our politicians. In no way should the care and support of the most vulnerable be used as a party political football. We deserve better and need to find political and societal consensus, agreement and collective resolve.
The debate is urgent. The decisions are necessary. The desired resolution desperately needed.
In our capital city you can now earn more from being a dog walker than supporting the old in their home to live independently and with dignity.
I’m not sure that is the sort of society most of us would want but that is what is our real inheritance unless we act to change it.
Donald Macaskill
@DrDMacaskill
Action on Elder Abuse Scotland National Conference – 27 October
Palliative Care training for front line staff – 6th December, Edinburgh
NHS Education for Scotland (NES) are looking for front line workers involved in the palliative and end of life care of people with dementia to attend their training in Edinburgh.
This free, one-day course is aimed at health and social care staff from care homes and care at home services who are working at the Dementia Skilled Level of Promoting Excellence.
Recent Scottish Care focus on palliative and end of life care has shown that our workforce are keen to develop their knowledge and understanding in this area, and we would encourage as many of you as possible to attend.
For more information, see the attached flyer.
Care in Mind – Event Report
On Tuesday 26th September Scottish Care held Care in Mind, a workshop designed to explore how we can manage and promote good mental health and wellbeing for those working in care homes and care at home organisations.
The physical and mental wellbeing of our workforce is critical if high quality health and social care services are to be delivered to the most vulnerable in our society. Recent research by Scottish Care has indicated that the pressure and demands facing the social care workforce are creating significant recruitment and retention challenges for employers.
The day began with Scottish Care’s National Workforce Lead, Katharine Ross, opening proceedings with a warm welcome and introducing the themes for the day. Louise Wilson and Anne Connor of Outside the Box then presented the outcomes of their research exploring the mental health and wellbeing of older people in receipt of care and support.
Louise explained how conversations with older people across the country has shown that loss of personal independence, loneliness, transitions as well as grieving for loved ones, has the biggest impact on the mental health and wellbeing of those we are caring for. In order to feel positive and well, older people have said that structure, meaningful activity, relationships – maintaining existing ones as well as building new ones – communication and freedom are among the most significant factors. The full report from Outside the Box’s research can be found here.
Following this Becca Gatherum, Policy and Research Manager at Scottish Care, discussed Scottish Care’s mental health research project. As we headed to the interval Becca encouraged all present to let us know their own thoughts, comments and experiences of mental wellbeing and the workplace by writing them down and attaching them to the different themed parts of the room. The response to this request was incredibly well taken up, with the walls being covered in a thick coat of post-it notes that will inform our Mental Health report – which will launch at Scottish Care’s Annual Care Home Conference on 17th November.
Between refreshment and lunch breaks saw our own Chief Executive Officer, Dr Donald Macaskill, exploring How well is our frontline workforce? Having conversations about mental health within your organisations. In this informative and thought provoking session Donald advised that, in 2015, 15.3% of the total UK workforce had identified themselves as being affected by a common mental health illness such as stress, depression or anxiety – meaning the actual figure is likely to be far higher. With this number representing an estimated 12.1% of overall GDP, workers living with mental health problems are making a significant contribution to the economy.
This being the case, Donald challenged employers to develop robust mental health policies for their organisations with a culture of compassion and positive communication embedded throughout to support the workforce, and provided helpful tips as to how this can be progressed.
As it can be with day-long events, some of those in attendance perhaps felt a little sluggish as they returned to their seats from lunch. Luckily we had Dr Tara French from the Digital Health and Care Institute, Glasgow School of Art, to lead us in her session of full-audience participation.
Entitled How can you look after yourself? Exploring music, creativity and wellness, Tara’s presentation focussed on the positive impact of music and singing to our mental wellbeing. With the use of a keyboard Tara moulded those congregated into what is believed to be Scotland’s first ever social care choir. More than this, it actually sounded really good as you can see for yourself by watching the video here!
New report highlights extent of care being delivered at end of life by independent sector in Scotland
Opportunities for Care Home Nurses from General Nursing Council
SCHOLARSHIP OPPORTUNITIES: GENERAL NURSING COUNCIL FOR SCOTLAND (EDUCATION) FUND 1983 AND MARGARET CALLUM RODGER MIDWIFERY AWARD
NHS Education for Scotland has announced that applications are now being invited for the above award. The 2018-2019 scholarships are open to registered nurses and midwives resident and practising in Scotland. Applications from registered nurses across health and social care are welcomed.
Information on the funding opportunities available, a copy of the fund flyer, how to apply for funding, the application form and scholarship information for applicants can be accessed by going to the GNC webpage http://www.nes.scot.nhs.uk/education-and-training/by-discipline/nursing-and-midwifery/information-for-practitioners/general-nursing-council.aspx
A learning resource to support application writing has also been developed and can be accessed here.
The closing date for applications is 5pm on Wednesday 17th January 2018.
CMA care home provider survey
Scottish Care has agreed to facilitate a short survey of our care home members on behalf of the Competition and Markets Authority (CMA). It should not take more than a few minutes to complete and the results will be fully anonymised.
The survey, which focusses on your business practices with residents (in particular self-funders), will help to inform the CMA’s market study – the study is considering whether the market for the provision of care home and nursing home services (to the over-65s in the UK) is working well for residents and for fairly competing businesses. Further information about the CMA and this work can be found at this link: https://www.gov.uk/cma-cases/care-homes-market-study
Please note that if you are a provider who operates more than one care home, you should only submit a single corporate response on behalf of all the care homes in your group.
Please be assured that the responses to this survey are anonymous at the point of submission . The CMA will not be able to identify which responses came from which provider, nor will Scottish Care.
We encourage you to answer the questions honestly as your feedback will help shape the CMA’s work in the care homes sector. However, if there are any questions you prefer not to answer, then you can simply go to the next question, by clicking ‘Next’ at the bottom of the page.
For this survey, no personal information is being sought, and as previously stated, responses will be anonymous. Nevertheless, if you wish to know more about how the CMA handles the information it receives as part of its market study, then further details can be found at the Annex (Use of Information provided to the CMA) to this link: https://assets.publishing.service.gov.uk/media/58414134ed915d0b1200003b/carehomes-statement-of-scope.pdf
Clicking on the link below will take you to the CMA’s short questionnaire:
https://www.surveymonkey.co.uk/r/CMAcarehomessurvey
We would be grateful if you would please submit your responses to the CMA by no later than midnight on Monday 30th October.
If you have any concerns or queries, you may contact the CMA at this generic e-mail address: [email protected]
Scottish Care Autumn Bulletin
Courses on Sexuality from the Terrence Higgins Trust
Scottish Care has been undertaking work on sexuality and dementia with the Terrence Higgins Trust and Alzheimer Scotland and we are pleased to support the work of the trust in the sector.
Some of the courses running in the autumn and delivered by the Terrence Higgins Trust may be of interest to those delivering training and delivering care in the sector.
The Trust is offering a range of informative and accessible courses on HIV, sexual health and related topics. For more information about any of the courses, just click on the links below. You can also visit Learning Centre Scotland, email [email protected] or call 014 1332 3838.
Understanding HIV & AIDS
The PDA in HIV is ideal for anyone who works in healthcare, social care, sexual health, or HIV. The course is also relevant to early childcare workers and anyone who supports at-risk populations or high prevalence communities. It is comprised of two units:
Unit one: HIV – An Introduction (Tuesday 17 October)
Unit two: HIV – Treatment & Lifestyle Management (Tuesday 14 November)
Cost £187.50 – £195 per unit (includes VAT, SQA fees and a light lunch)
‘I learned lots and this will definitely improve my support for individuals living with HIV’ (Participant attending Understanding HIV & AIDS)
Delivering Sexual Health Training
The PDA in Sexual Health Training is ideal for anyone who delivers Sexual Health Training. It is comprised of two units:
Unit 1: Sexual Health Training – An Introduction (Thursday 26 October)
Unit 2: Sexual Health Training – Experiential Learning (Thursday 23 November)
Cost £187.50 – £195 per unit (includes VAT, SQA fees and a light lunch)
“The trainer was excellent – very knowledgeable, supportive, approachable and encouraging.” (Participant attending Sexual Health Training)
