Job Opportunity: Development Officer – Dumfries & Galloway

Development Officer -Dumfries & Galloway

PARTNERS FOR INTEGRATION

SCOTTISH CARE

Health and Social Care Integration

£32,472 (pro rata) per annum – 21hours per week

Fixed term contract funded till March 2022

Scottish Care are seeking to engage a Development Officer to work alongside our Independent Sector Lead to help support the Integration of Health and Social Care agenda in Dumfries & Galloway HSCP.

This post will be hosted by Scottish Care and working closely with care providers and partners, the post involves ensuring sector involvement in the delivery of the integrating of health and social care.

You will be the first point of contact for care providers, responsible for building and maintaining relationships, responding to enquiries, developing effective team working.

You will ensure the voice of providers and service users is heard. You will support care providers by ensuring they are informed, and solution focused, developing, or identifying opportunities for training and research

Effective communication and sharing of best practise is at the heart of what we do and critical to partnership working, as such you will support participation and leadership from the Independent Sector.

This is an exciting opportunity to be part of the established and dynamic Partners for Integration team within Scottish Care.

We are looking for someone who is highly motivated and passionate about improving care for older adults within a collaborative and innovative environment.

The post will home-based on a fixed term contract until March 2022 and hosted through Scottish Care.

To request and application form please contact Colette Law at [email protected]

Closing date 4pm Thursday 15th July 2021.  Interviews will be held by Microsoft Teams on 26th July 2021.

 

Nursing Event (24 June) – Programme now available

We will be hosting a virtual nursing event on 24th June from 10:00 am – 2:00 pm.

This event will look at the future vision for health and social care nursing. We have a full programme of speakers including presentations from frontline staff, and representation from professional bodies: NMC around the new standards and RCN in supporting revalidation. We also have a panel session that centres around education and leadership, in supporting our future leaders.

The event will be supported by the CNO, the Scottish Government, as well as the Chief Nurse with the Care Inspectorate.

Please note that the session on ‘Collaborative Leadership Development’ at 12:30 is interactive. We kindly ask participants to have a second device ready (such as a mobile phone or tablet) to allow them to take part in this interactive session.

If you have any questions on this event, please contact our Transforming Workforce Lead for Nursing, Jacqui Neil at [email protected].

Time for change – Opening up prescribing for care home nurses in Scotland

This article was first published on Nursing in Practice.

Authors: Jacqui Neil  – Transforming Workforce Lead for Nursing (Scottish Care), Derek T Barron – Director of Care (Erskine Homes), Jane Harris – Head of Programme,  Postgraduate and Post-registration Education and Continuing Professional Development (NHS Education for Scotland)


Nurse prescribing was introduced in the UK in 1998 when district nurses and health visitors were given the authority to prescribe from a limited national formulary. Since its introduction in the United States in the late 1960s, (Clarke et al 2019), nurse prescribing has increased worldwide. As other professions have gained prescribing rights, the term ‘non-medical prescribing’ (NMP) is used to describe any prescribing completed by a healthcare professional other than a doctor or dentist (Maier 2020).

In 2006, the Nursing and Midwifery Council published Standards of Proficiency for Nurse and Midwife Prescribers, which drove prescribing forward for all nurses and midwives across the UK. The Scottish Government developed guidance to support the roll-out of non-medical prescribing in Scotland in the publication ‘Non-Medical Prescribing in Scotland: Guidance for Nurse Independent Prescribers and for Community Practitioner Nurse Prescribers in Scotland‘ (Ness et al 2015).

Non-medical prescribing is defined as prescribing by an appropriate practitioner (doctor, dentist, paramedic, nurse, midwife, pharmacist, physiotherapist, podiatrists optometrist, diagnostic and therapeutic radiographer) responsible and accountable for the assessment of patients with undiagnosed or diagnosed conditions and for decisions about the clinical management required (DOH 2006). In August 2010 the Scottish Government published a progress report on nurse prescribing in Scotland showing that nurse prescribing produced better care for patients, faster access to medicines, better use of nurses’ and doctors’ time RCN (2014), NMP was viewed as improving communication between health professionals and supportive of key health care policy in Scotland, particularly in relation to shifting the balance of care from acute to community services.

In addition, prescribing was seen as responsive to assessment in relation to older people with more complex needs. Cope et al (2016) highlighted that students training to become non medical prescribers felt the programme provided them with adequate knowledge to prescribe with some stating that the period of learning in practice was ‘the most valuable part of the course’.  Nurse prescribing is now well established in Scotland.

Care home nurses in Scotland left behind

Non-medical prescribing is a key step in the chief nursing officer’s 2030 vision to ensure personalising care, preparing nurses for the future. (CNOD 2017).  Nurse who NMP work predominantly within the NHS.  A literature review showed no data regarding NMP in UK care homes.  This indicates the sector’s exclusion from NMP, despite the potential positive impact on delivering responsive care at the right time, a key driver within many policy documents (Scottish Government 2010, 2017).  In addition, having on-site prescribers reduces the need and workload for GPs or external advanced nurse practitioners (ANP).

One reason for ‘being left behind’, include the lack of investment in the independent sector to support NMP, resulting in a nursing workforce which has been left behind by their NHS counterparts. Despite numerous calls for this to be addressed over the years it has failed to be achieved (Merryfield 2015).

The pandemic has amplified how crucial a skilled workforce is to deliver safe, effective, person-centred care. Care home nurses are in a prime position as they know their residents better than most external prescribers.  In providing 24-hour care to residents, they can notice and act on subtle changes that would prevent unnecessary deterioration, if acted on promptly.

This gap was noted as a frustration in the Scottish Care 2021 Nursing Survey which asked if the organisations supported registered nurses to undertake a prescribing course, if it were available: 89.5 % of respondents said ‘yes’. If this was facilitated, it could promote nurse leadership and autonomy within the sector, which is intrinsic to the sustainability of social care nursing as well as community nursing.

The difficulties for employers

There are difficulties faced by care home nurses who wish to carry out NMP. Although highly skilled and knowledgeable expert generalists, they face a number of systemic challenges.  In 2017 Erskine Veterans care, invested in NMP in two of its homes. Despite NMP being within the registered nurses’ scope of practice for many years embedding it within the care home environment was not easy.

Prescribing liability insurance for NMPs within NHS Scotland is covered by CNORIS (Clinical Negligence and Other Risks Indemnity Scheme).  No such universal cover exists within care homes, as such Erskine required to take out separate cover to insure the NMP duties of their ANPs. The ANPs, although full independent (V300) prescribers, only prescribe from a limited ‘care home’ formulary, developed in Erskine with input from our GPs (Boyd & Barron, 2019).  The insurance industry does not consider NMP part of the every-day duties of a registered nurse, which is covered by the generic nursing duties cover every care home will have.

The most basic pieces of equipment that the NMP requires is a prescription pad.  The local GP practice would not issue a pad for fear that they may be vicariously liable for the prescribing of someone they did not employ.  That left Erskine in the situation of negotiating with the local Health & Social Care Partnership to have a ‘community’ prescription pad issued, in the same way a district nurse has a prescription pad issued. While there are other hurdles to overcome, the journey has been worthwhile. It has led to early intervention from the ANPs when a resident deteriorates, this can be in situations of infection, as well as at end of life. It has led to regular, 12 weekly review of psychotropic medications and covert meds, ensuring both are used as little as possible for as short at time as possible. This puts the residents at the centre of care decisions rather than having medication prescribed and then continued simply because no review had taken place.

The Transforming Roles programme

NHS Education for Scotland (NES) has established education and development pathways from registration through to advanced and consultant practice that support changing service needs.  One such pathway, the Integrated Community Nursing (ICN) Pathway, offers targeted post-registration education aiming to maximise the potential of the nurses’ role in Scottish care homes. The Graduate Diploma in Integrated Community Nursing forms the foundation of NES’s ICN pathway. This centrally funded, two year part-time practice-based programme is designed for nurses working in care home, district, prison health or general practice nursing at level 5 (Agenda for Change Band 5 equivalent) of the NES Nursing, Midwifery and Allied Health Professions Development Framework (NES 2021).  Nurses develop a range of new knowledge and skills to enhance their practice and meet people’s physical, mental health, and social care needs.

This new approach puts care home nursing on an equal footing with more established community nursing specialities in terms of access to education and role development. Care home nurses may continue through the pathway completing studies at postgraduate level, first qualifying in their speciality and then with the option to qualify as advanced and consultant nurses.  Safe and timely access to appropriate medication as part of the personalised, rights-based and compassionate care and support that care home nurses deliver is a key outcome of the new pathway. It was designed to include Nurse Independent Prescribing as an optional module in the Graduate Diploma ICN and an essential component of the specialist postgraduate stage. The benefits of a structured and sustainable model for education and development for care home nurses that includes Nurse Independent Prescribing gives employers, education providers, the multidisciplinary team and the nurses themselves the incentive to overcome the current barriers and enable prescribing to become part of care home nurses’ practice.


References

Boyd, J. & Barron, D. (2019) Employing an advanced nurse practitioner in a care home. Nursing Times Vol 115 Issue 6 pp 45-47

Cope, L. Abuzour, S and Tully, M.  (2016) Nonmedical prescribing: where are we now?  First Published April 2016

Department of Health (2006) Improving patients’ access to medicines. Department of Health and Social care ,UK Gov web archives London

Graham-Clarke, E. Rushton, A. Noblet, T. Marriott, J. (2019) Non-medical prescribing in the United Kingdom National Health Service: A systematic policy review accessed online

Maier, C.B. (2020) Nurse prescribing of medicines in 13 European countries. NIH National library of medicines 2019 Dec 9;17(1):95. doi: 10.1186/s12960-019-0429-6. PubMed.gov

Merryfield, N. (2015) Call to tackle barriers to nurse prescribing in care homes Nursing Times online archives.

Ness, V. Malcolm, W. McGivern, G. Reilly, J  (2007) Growth in nurse prescribing of antibiotics: the Growth in nurse prescribing of antibiotics: the Scottish experience 2007–13. Journal of Antimicrobial Chemotherapy, Volume 70, Issue 12, December 2015, Pages 3384–3389, https://doi.org/10.1093/jac/dkv255

NHS Education for Scotland (2021) Nursing, Midwifery and Allied Health Professions Development Framework Available at: https://www.careerframework.nes.scot.nhs.uk/  last accessed: 21.05.2021

RCN (2012) RCN Factsheet on nurse prescribing in the UK (updated 2014)  Policy & International Dept.  last updated 2014 accessed online 2021.

Scottish Care (2021) unpublished Nursing survey

Scottish Government (2010) The Healthcare Quality Strategy for NHS Scotland. Available at: https://www.gov.scot/publications/healthcare-quality-strategy-nhsscotland/ last accessed 21.05.2021

Scottish Government (2010) Everyone Matters, 2020 Workforce Vision. Available at:https://www.workforcevision.scot.nhs.uk/challenges/2020-vision-for-healthcare-in-scotland  Last accessed 21.05.2021

Scottish Government (2017) Health and social care standards, My support, my life.  Available at: https://www.gov.scot/publications/health-social-care-standards-support-life/ Last accessed 21.05.2021

Scottish Government (2017) Nursing 2030 Vision. Chief Nursing Directorate Nursing. Available at: https://www.gov.scot/publications/nursing-2030-vision-9781788511001/  Last access 21.05.2021

Interview with Bandrum Nursing Home’s General Manager

By Rachel Payne – Managing Director

Somehow a year has passed since we first had to lockdown. There has been huge change, loss, grief and also amazing camaraderie and compassion. Here, I interview our General Manager, Katharine Spence to hear her reflection on a most challenging year….

What is your role within Bandrum?

As General Manager I’m responsible for leading the delivery of care and the staff team within Bandrum.

How has your role changed over the past year?

I have become a more visible leader – providing extra support to residents, staff, and relatives.

Because Covid was a new and unfamiliar disease, and guidance was developing (and changing daily at times) I had to get more involved in clinical decisions that were out with the knowledge of our very – experienced nurses.  Restrictions meant that our relatives could not be as involved as before, so we had to find new ways to keep in touch.  There was an increase in the layers of scrutiny and reporting, which has been an extra pressure. 

I am now in regular personal contact with our relatives to try to keep them up to date with all the changes and re-assure them about their loved ones.  This has been very important.

What are you most proud of?

I’m so very proud of the high-quality care we delivered despite the challenges that the year has brought. I am immensely proud of the staff – they have been fantastic and I’m also so proud in the way relatives have supported us.

What have you learnt?

I’ve learn that I’m quite resilient, and that if you are honest and try your best then people will trust you. We have been open and transparent throughout the year and our relatives now know that we will be in touch if there is a concern. Also, as a leader, you have to be brave and make difficult decisions!

Bandrum has learnt that we can do change! It wasn’t our best skill, but we have all embraced it very well. Some of the changes include the addition of our Nurse Assistant role, activation of Wi-Fi throughout the home, which has enabled all the video contact, and our ever-expanding Facebook page with all the interactions. We have also developed outdoor activities in our lovely grounds to support social distancing while keeping folk entertained.   

Is there a moment that you’d like to share?

Yes, we’ve been so resourceful and found loads of great ways to make our own entertainment.   We have had to be resourceful to support social distancing,  and made great use of the courtyard to provide entertainment such as Body – Boosting Bingo,  Going for Gold and dancing.  The sight of residents and staff dancing together,  in the sunshine,  really cheered us all up.      

Id like to share a heartfelt THANK YOU to Katharine for the non-stop, tireless dedication she has given to Bandrum. Every resident, relative and staff member has benefited from her expertise and compassionate leadership. We are very lucky to have her.

 

 

Bandrum Nursing Home – A Place to Talk

As we commemorate the anniversary of the Covid -19 pandemic and lockdown, I wanted to share some photographs of our picnic area which we created last year, on the beautiful grounds of Bandrum.

We wanted to commemorate a unique moment in time,  and also to remember the highs and low of this year- the dedication of staff,  the loss of loved ones and the support which we received.  The estates’ team created this lovely space, near to the river which staff and residents could walk to, and then sit and talk, or just listen to the river,   and try to escape the stress of the day.

This peaceful place has been life-enhancing during the lockdown.  We look forward to sharing it with friends when we can.

Katharine Spence  – General Manager

Bandrum Nursing Home

Redeem Exchange

The Redeem Exchange team came up with a simple yet innovative idea to reduce plastic waste in the shape and form of empty hand sanitiser bottles. We offer a collect, wash, refill and return service for empty bottles to help save the environment whilst keeping those around us safe.

Redeem Exchange launched because of COVID-19, and the increased number of (very much needed) plastic bottles in circulation – and we were involved in this, as we ourselves were producing hand sanitiser for the NHS.

These bottles are usually thrown away, and very few make it to be recycled. We realised we could reuse bottles and keep them in circulation longer, which helps also to reduce costs would you believe! A win for everyone!

The Scottish Government, NHS NSS, and Zero Waste Scotland have supported us to bring this Redeem Exchange to where we are today, and we now have capacity to run this programme across Scotland. The most exciting part is what we learn, and what goes on behind the scenes. We get to know all our customers incredibly well through this process, and as we are a non-profit social enterprise, we get to support local communities where it’s needed.

Our main hub is in Greenock, but as we grow, we will work with our network to open hubs throughout Scotland. This will provide jobs for people living in SIMD areas. We have designed an employability programme for those who join us, giving them valuable skills and knowledge to reach their full potential.

We have big plans to make our world better for future generations both environmentally and socially. It is an exciting time for Redeem Exchange – we wanted to share this, and some positive feedback we received recently. AND, if you would like to get in touch to hear more, you can contact Bev on [email protected] or call 07901 427 190.

“Our service has used Redeem exchange as a means to reduce the environmental impact of used plastics, this sits very well with our wider organisational goals on sustainability. The local connection is also valuable to us in having a local point of contact and easy to access service for what is an essential PPE product for staff”Richmond Fellowship

And we have a superhero – nearly forgot to mention that!!

 *The photo above was taken last year, prior to the need to wear face masks in a work environment.

Fife’s Health & Social Care Partnership shines a light on the care homes in Fife

To support Care Home Day 2020, Fife’s Health & Social Care Partnership wanted to shine a light on the wonderful care homes in Fife.

Care homes are communities within communities and every member of staff, every resident and families and friends all play a valuable role.  It really is an extended family. As an integral part of our communities, care homes provide high quality person-centred care to support the health and wellbeing of residents.

Cllr David Graham, Fife Council Spokesperson for Health said:

“Our care home staff really are amazing, and I would like to thank every care home worker for the commitment and passion they show in supporting residents and their families, not only through this pandemic but every day. Staff have come up with so many different ways of keeping residents entertained and families and friends have been very supportive of the care and attention that their families have received, and they continue to receive.”

Cllr Graham joined Fife’s Health & Social Care Director Nicky Connor and Divisional General Manager David Heaney at Ostlers House Care Home today in Kirkcaldy.

Caption: From left Cllr David Graham, Nicky Connor, John Cooper, Service Manager, FHSCP, David Heaney, Divisional General Manager, FHSCP and Ostlers House staff Kirsten Wilkie, Helen Oliver, Eddie Hepburn and Elaine Patrick. Kneeling is Elaine Siggers with the star of the show Ozzie the home’s therapet.

Nicky Connor, Director of Fife HSCP added: “It really was very humbling speaking to staff. They are an inspiring group of people and what they have done to keep families connected throughout this period whilst visiting was cancelled has been really innovative. Having the ability to use iPads to connect with families and friends has made a huge difference and residents adapted well to using Facetime. Visiting has now resumed, although this looks a little different with physical distancing measures and PPE now the norm. I can’t thank care home staff enough for their commitment to keeping their communities safe and well”.

Scottish Care’s Paul Dundas and Fiona Mckay, Head of Strategic Planning, Performance and Commissioning. FHSCP also popped along to Bandrum Care Home in Saline to catch up with staff.

Fiona added: “We work closely with our independent care providers and relationships have been enhanced throughout the pandemic, supporting each other and working together has been key to everything we have achieved. The generosity also received from local organisations who have helped out during this crisis has been appreciated. This really is partnership working at its’ best”

Paul also added: “Care homes are an essential part of our communities and staff demonstrate their commitment and compassion every day, always putting those they care for at the heart of everything they do. Their dedication and professionalism are inspirational, and I can’t thank them enough.”

Photo from left: Fiona McKay, Paul Dundas, Rachel Payne (Bandrum), Jacquie Stringer, Service Manager and PPE Lead, FHSCP and Katerine Spence (Bandrum)

We need a National Day of Mourning and Remembrance – a personal reflection

Today is the 4th July and memories of a few years ago when I was in Boston where events changed the history of the United States of America live on in my mind. It is a special day for many citizens of the United States and later today I will no doubt chat to American family as they celebrate the 4th. Closer to home it is a day which in the past week has built in the public consciousness with a growing clamour in England around the opening of pubs! And that’s been hard for so many.

As I have mentioned over the last few months I receive a lot of correspondence from folks who have kept in touch with me during the pandemic. One of those wrote to me this week about how hard it has been reading the newspapers and seeing the news on TV in the build-up to what has become this self-styled ‘Independence Day’ and ‘Super Saturday.’ For her it is a day of real insensitivity because like countless thousands she is one of those who have lost her husband to Covid19, her husband being one of the people who died as a result of the virus in a care home.

She is not alone. Many have spoken, written or messaged me from their places of hurt. They have found it hard to reconcile a return to ‘normal’ with the loss and emptiness which is a constant ache in their waking moments and restless nights. They have spoken of the way in which they feel as if they have been put to the side in their grieving as the world rushes by in its race back to normality. They have spoken about becoming the invisible grieving, those whose story is an uncomfortable and constant reminder of the vicious pain and raw absence that this virus has and is causing.

Mourning is an essential part of the rhythm of life – it’s moves are individual and it’s actions are determined by our own character. For some there is a desire to be busy and active, using routine and familiarity to contain our lostness;  for others a need to withdraw and hold pain close; for yet others there is consolation and comfort in the presence of family and friends. But the problem has been that we have been prevented or blocked in so much of the ways in which we traditionally mourn and grieve. Mourning has become unnatural and painfully hard during the pandemic with all the restrictions on funerals, on being together, or on simply being free to wander in our hurt.

As things begin to ease through lockdown then it will undoubtedly become easier for people to reconnect and nurture their own grieving. But I think we all of us have to recognise that those who have lost someone to Covid19 need to be supported and upheld by the wider community. There is something painfully distinctive about losing someone in and to the pandemic and we need to acknowledge that and take action to address these issues. This in part has started already through the resourcing of more focussed grief and bereavement support. But increasingly I feel that this support and recognition needs to be broader and wider.

The messages I have been getting are from people who feel as if society is in danger of creating a stigma around Covid19 and especially around dying from Covid19. We saw a similar trend after the Spanish Flu in the 1920s. They speak of the bereaved unable or unwilling to say to others that their relative has died from the virus. I very much hope that those are a minority, but I also fear that we need to recognise better  the reality of these feelings than we are doing.

Whether you have been bereaved because of Covid19 or someone has died during the lockdown period I believe that there needs to be not solely a restoration of personal grieving support but that we now need to do something at a community and national level. My concern is that if we do not do so there will be far too many with unresolved and blocked grieving which will only serve to cause hurt and harbour pain into the future.

So today I am calling for a National Day of Mourning and Remembrance  for all those impacted by Covid19 in Scotland. I am asking all Members of the Scottish Parliament to agree in principle to the idea of such a day.

  • A day to mourn all those who have died in care homes, in hospital and in community
  • A day to mourn all those who have died during Lockdown for whom we have been unable to grieve and remember as we might have done
  • A day to remember all those who have worked tirelessly in the care of others sharing compassion, giving professionalism and sacrificial service.
  • A day to remember all those who have had their lives changed and turned upside down by this virus.

I am not naming a day, but I think we need to as a community identify the need to have such a day in the future when we can be together to focus on those we need to remember. We need to create a point in the horizon ahead to which those who are lost in their grief can find the energy to pull themselves toward in the hope that society will hear their story, will listen to their loss and will be silent in remembrance.

We need to have a day when in silence and in action, in country and in city, in streets and in homes people have the opportunity to pause and reflect for from such comes healing and renewal both individually and as a community.

Above the din and noise of rushing back to a normal future we must give space and place for people to remember, to picture their loved ones and to cradle a moment in time which is theirs to grieve. We owe them no less.

After the silence of loss, the memories come, the tears fall, the sadness echoes and  mourning and remembrance sounds.

Donald Macaskill