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Urgent information on NCHC – 12 November 2019

Dear Member, I am writing to inform you of the result of the Members Vote which closed on Friday and which the Scottish Care Executive Committee considered late yesterday afternoon. The result of the Vote was in favour of Option 2 which was to accept the elements of the Care Home Cost Model (CHCM) as agreed with COSLA. Further the vote in accepting that the CHCM was unable to be completed has instructed the Executive to enter into negotiation with COSLA on the following areas:

  1.  The issue of occupancy
  2.  The issue of efficiency
  3. The level of return for the provision of a complaint care home room – capital return
  4. The level of providers return for the provision of the care home service.

I have written to inform COSLA of the vote and to ask them to agree to the above areas for negotiation and to commence these as soon as is practicable. In addition, it was agreed that, alongside this negotiation stage, Scottish Care and Scotland Excel should complete the work required on the Residential Model and thereafter to populate models for both Nursing and Residential once the National Minimum Wage is announced. Further updates will be placed on the Members area of the website and members are encouraged to raise any questions that you may have on the Discussion Board which can be found there. Kind regards   Dr Donald Macaskill CEO, Scottish Care

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Updated guidance to support the real living wage commitment for adult social care workers

Below is a letter from Ms Freeman, Cabinet Secretary for Health and Sport, and Cllr Peter Johnston, COSLA Health and Social Care Spokesperson, with updated guidance on the shared commitment to support payment of the real Living Wage to everyone delivering adult social care in Scotland.  The guidance has been developed by the Living Wage in Care Implementation Group which was established to support. The group comprises representatives from Scottish Government, COSLA, Coalition of Care and Support Providers (CCPS), Scottish Care, the STUC and Integration Authorities.

Guidance to support real living wage commitment - Letter from Scottish Government COSLA October 2019 - final PDF
 Guidance to Support Commitment of the Real Living Wage for Adult Social Care Workers October 2019 - final PDF copy
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News release: Call for action as people with sight loss miss out on Self-directed Support

Research by Scotland’s biggest sight loss charity Royal Blind has revealed low awareness among blind and partially sighted people of the Scottish Government’s flagship social care policy.  The findings have prompted fears that people with sight loss who could benefit from Self-directed Support are missing out, and led to a joint call from Royal Blind and Scottish Care for Scottish Ministers to take action to ensure people living with visual impairment are aware of their right to benefit from the policy.

Royal Blind surveyed over 100 people with sight loss to get their views and experiences of Self-directed Support. The charity found that:

    • Almost two thirds of people with sight loss participating in the survey had not heard of Self-directed Support.
    • Only five respondents to the survey had a support plan funded through Self-directed Support.
    • Over 60% of respondents had never been informed of the budget available to them for their care and support.

The research follows previous findings published by Audit Scotland in 2017 which reported that at least 53,000 people were accessing Self-directed Support, but more people should benefit from the policy and more information should be available on how to apply.

Royal Blind and Scottish Care are now calling on the Scottish Government to take further action to raise awareness of Self-directed Support including through providing accessible information on the policy for people with visual impairment. The organisations are also urging local authorities to develop plans to increase access to Self-directed Support for people with visual impairment, including through providing more training to staff on supporting people with sight loss to have the information they need on the policy.

Mark O’Donnell, Chief Executive of Royal Blind and Scottish War Blinded said:

“Self Directed Support is a great policy initiative by the Scottish Government which could benefit thousands of people living with sight loss. That is why it is so disappointing that there appears to be low awareness of the policy among blind and partially sighted people, and also why we are backing the call by Scottish Care for more action to raise awareness that it is available. With the numbers of people with sight loss in Scotland set to increase significantly, it is vital they can access the specialist care they need and have access to Self-directed Support which can help them live well with visual impairment.”

Dr Donald Macaskill, Chief Executive Officer of Scottish Care said:

“Self-directed Support is one of the most progressive pieces of law in Scotland. It gives people choice and control over their care and their lives. It is therefore hugely disappointing that five years on since it started this survey shows that hundreds perhaps thousands of older Scots with a visual impairment they are not benefiting from these rights. The excuses from local authorities and Integrated Joint Boards are running out and we are left with the conclusion that this human rights based policy is being consciously ignored, blocked and underfunded, or that only those who shout the loudest are being given choice and control.

There is little point in having fantastic legislation if there are is a collective failure to put it into practice. There is little point in having rights under the law if the obstacles to exercising those rights are growing every day.

Scotland needs to get serious about the denial of the human rights of our fellow citizens with visual impairment.”

 

ENDS

Note to editors

1.Details of the survey by Royal Blind and Scottish War Blinded:

    • The survey was promoted to people with sight loss using Royal Blind and Scottish War Blinded services in August and September. Responses were from people with visual impairment or a carer or family member on their behalf. There were 110 respondents to the survey, although not all respondents answered all questions.
    • 109 people responded to the question “have you heard of Self-Directed Support.” 68 (62%) said they had not.
    • 81 people answered the question “Are you currently receiving care services” with almost half (39 people) stating that they were.
    • Only 5 respondents said they had a support plan funded through Self-Directed Support. Four of the five people who received care through Self-Directed Support said the system had worked well for them.
    • Around a fifth (19%) of respondents felt SDS was something they could benefit from, while 57% did not know whether they would.
    • Around a third (30%) of respondents said they had been given an explanation of SDS options, while 60% said they had not had the options explained to them.
    • A majority (63%) of respondents had never been informed of the budget available to them for their care and support.

2. Royal Blind is Scotland’s largest visual impairment organisation. We create life changing opportunities for visually impaired children and adults from across Scotland and the rest of the UK with the following services: The Royal Blind School and Learning Hub, Adult Services, Care for Older People, the Scottish Braille Press and Kidscene After School and Holiday Club.www.royalblind.org

3. Royal Blind’s sister charity is Scottish War Blinded. Together, we operate as the Royal Blind Group. Each organisation has its own management, and both are overseen by the Royal Blind Board and Chief Executive.

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Latest blog from our CEO: Time to raise awareness of Self-directed Support

Reform of our health and social care services cannot only be an ambition but is an urgent requirement. The recent annual report from the Auditor General on NHS Scotland made this extremely clear. If we are to meet the current and future health and care needs of our country, we have to change how we deliver care and treatment, with more services based in our communities, meeting individual care needs. Audit Scotland’s annual report said the NHS was “seriously struggling to become financially sustainable” and the Auditor General Caroline Gardner said the integration of health and social care was too slow and staff were under intense pressure. The conclusion was that Scotland could face a £1.8bn shortfall in less than five years if it is not reformed. Change is urgently needed but the pace of change is too slow. We have achieved a consensus on the need to integrate health and social care services and reform social care. Health and Social Care Partnerships have been established to bring about more effective collaboration, but progress is patchy. Yet by embracing rather than resisting reform of health and social care, we have the opportunity for transformational change which will benefit the thousands of people in our country who are supported by care services. For me social care has always been profoundly about human rights. It is about giving the citizen control and choice, voice and agency, decision and empowerment. These principles underpin the Scottish Government’s flagship social policy of Self-directed Support, which seeks to give people more control over the care services they receive.  The policy means local authorities now have a legal duty to offer people eligible for social care four options on how to use their personal budget. The four options are direct payments; an Individual Service Fund held by the local authority and allocated to a provider of your choice; the local authority arranging support on your behalf; or a mix of these options. Human rights and social care practice come together in our Self-directed Support legislation in Scotland which unapologetically grew out of the independent living movement of the learning and physical disabled communities in the 1970s. With the closure of large-scale institutions there was an emphasis on enabling individuals to live more independent lives. Policies and practice at the time and since emphasised the importance of building social care supports around the life of the individual rather than expecting the individual to fit into what services were available. A one size fits all approach was replaced by the urge to develop and offer bespoke individual services and supports. A personalised approach has the potential to benefit and empower people with a range of conditions and care needs. This is why we have been keen to assess levels of awareness of Self-directed support among those groups of people who could potentially benefit most. We have been working with Royal Blind to research awareness of Self-directed Support among people with visual impairment. People living with sight loss require care which meets their specific needs to enable them to flourish and foster their full contribution. Self-directed Support offers them the potential to ensure they are provided with specialist support, equipment and accessible information to help them live well with visual impairment. There are around 188,000 people in Scotland living with significant sight loss, around three quarters of whom are over 65, and this number is projected to increase to over 200,000 by 2030. This means Scotland requires a social care system which can support an increasing number of people with sight loss. Self-directed Support has the potential to benefit thousands of people with sight loss, enabling many to maintain their independence and live at home for longer. So it is disappointing to learn that there is low awareness of Self-directed Support among many people with sight loss. Over 100 people with sight loss were surveyed by Royal Blind and Scottish War Blinded to learn their views and experiences of Self-directed Support. When asked the question “have you heard of Self-directed Support,” two thirds of respondents said they had not. Only five respondents said they had a support plan funded through Self-directed Support.  Over 60 percent of respondents had never been informed of the budget available to them for their care and support. If I am living with a lifelong condition or need support in any way because of life circumstances or age then I most certainly do want to have more choice and control both over who is in my life as a carer and what the nature of that support and care might be. The critical importance of legislation like Self-directed Support is all about embedding that control and choice, building those rights with the citizen including fiscal and budgetary control. This is why it so frustrating that for too many people, including people with sight loss, the promise of Self-directed Support is not being realised. The legislation is now in its fifth year – bedding down should have long since passed. The excuses are running out and we are left with the conclusion that this human rights-based policy is being consciously ignored, blocked and underfunded, or that only those who shout the loudest are being given choice and control. We are still defaulting to models and a provision of assessment and care which too often do not meet individual need and are economically unsustainable.  This situation needs to change urgently if we are to secure sustainable models of care and the rights of people accessing care services to be fully included in our communities. There is little point in having fantastic legislation if there are is a collective failure to put it into practice. There is little point in having rights under the law if the obstacles to exercising those rights are growing every day. Dr Donald Macaskill  CEO @DrDMacaskill

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Exploring and Developing Palliative and End of Life Care

The Scottish Government vision is that by 2021 everyone in Scotland will have access to high quality palliative and end of life care no matter where they are cared for – at home, in the community, in residential care, in hospital or in a hospice. For this to happen there is a need for staff in all areas to become more confident in delivering end of life care that helps people to live well and die well and to meet individualised needs and wishes.

The University of the Highlands and Islands has developed a new continuing professional development award for health and social care workers that is designed to provide candidates with the  knowledge and skills base set out in the NHS Education for Scotland Palliative and End of Life Framework for staff who regularly provide care and support to people with palliative and end of life care needs, their families and carers. This is a SCQF Level 7 award (HNC/ first year undergraduate level) and has a nominal 200 hours of learning over 15 weeks, which equates to 20 credits. The award will be delivered online using the university virtual learning environment. Online learning may seem a little daunting, but candidates will be fully supported by an online tutor who will guide students through the content and assessments. Studying online allows students to study at a time and place that fits in with their work and family commitments.

The first presentation of the course will start in January 2020. We are pleased to advise that there will be a limited number of free places funded by the Scottish Funding Council for this first cohort of students.

If you are interested in undertaking this award, then please discuss this with your line manager. If you wish to know more about the award or need further details, please contact Jacqui Allison at Perth College UHI – [email protected].

Palliative Care A5 leaflet (003)
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To Absent Friends festival

What is it?

To Absent Friends is a people’s festival of storytelling and remembrance. It aims to reignite traditions of remembering the dead as a way to support those who are experiencing grief and bereavement and to encourage greater openness about death and dying.

Why is it happening?

Everyone has a story to tell of someone who is dead who they miss – a grandparent who had a fascinating life; a friend with a unique sense of humour; a child who loved to dance.

A person’s death does not lessen the meaning of the relationship we have with them.

But our culture doesn’t really support active remembrance of dead people. Talking openly about someone who is dead can often cause discomfort or embarrassment.

In a culture where death is seen as being too morbid, too difficult or too disturbing to mention, how do we remember and pay our respects to the dead?

When is it?

It takes place from 1-7 November 2019

Where is it?

Public events are taking place across Scotland, but people can also get involved via the To Absent Friends website and on social media.

Who is organising it?

The festival forms part of a year round initiative called Good Life Good Death Good Grief, led by the Scottish Partnership for Palliative Care.

What is happening?

Public events have been planned by various organisations and community groups across Scotland, beginning with a launch with an illuminated lilies garden at Dundee University on Thursday 31 October. Other events include cafes of reminiscence, poetry nights, concerts and craft workshops. For a full list see the event listings on the website.

How can I get involved?

If you’re doing anything for To Absent Friends, please share it on social media with the hashtag #ToAbsentFriends and copy us in. We’re also asking people to join in online in the following ways:

Profile Pictures – During the week, we’re asking people to change their profile pictures to someone who has died, and to update their status/tweet to say why.

Remembrance Playlist – Remember someone through a song. On the To Absent Friends website, we are collating a list of musical tributes to absent friends. Visit the website and send in your suggestions of a song.

https://www.toabsentfriends.org.uk/content/songs/

Wall of Remembrance – For those who want to leave an anonymous tribute to someone they have lost, there is a place on the website for them to do so. https://www.toabsentfriends.org.uk/content/remembrance/ 

Online Storytelling – We have an online space for people to share longer stories about those they love who have died.

https://www.toabsentfriends.org.uk/content/storytelling/

Please encourage people to participate in these activities via social media using the links above. We have prepared graphics you can share alongside them which can be accessed via Dropbox:

https://www.dropbox.com/sh/mu6x9ioxs2rag6x/AADmj65dkZJ0S7Ps8D6j4Rmya?dl=0

How do I get in touch?

Website: www.toabsentfriends.org.uk

Twitter: @2absentfriends

Hashtag: #ToAbsentFriends

E-mail: [email protected]

The team at To Absent Friends would love to hear from you if you are holding an event or have an act of remembrance which you wish to share.

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News Release: Trust Housing and Scottish Care launch new Care Cameo Report

“Keeping body and soul together’ reports on the challenges faced by Scotland’s ethnic minority older people

Trust Housing and Scottish Care, today (31st October, 2019) launch the 9th Care Cameo in the Care Cameo series, a programme of papers by care professionals, designed to foster debate on some of the most important issues associated with the delivery of care and support for older people across Scotland. It was launched at the Scottish Parliament event, sponsored by Bill Kidd MSP.

Today’s Care Cameo, entitled “Keeping body and soul together”, reviews the physical, emotional, cultural and spiritual care needs of ethnic minority older people in Scotland and has been researched and written by Rohini Sharma Joshi FICH, Equality, Diversity & Inclusion Manager for Trust Housing.

Rohini has extensive experience of working and engaging with hundreds of ethnic minority older people to listen to their concerns about care and housing and to define what they needed to restore their dignity, self-esteem and independence. “Keeping body and soul together” draws together some of the key concerns that were reported directly by older people.

Rohini Sharma Joshi said:

“We are failing our ethnic minority older people in Scotland. Older people who have worked hard all their lives in this country are now finding themselves isolated, lonely and discouraged. They are often unable to access services, they are estranged from the wider community because of language barriers and can no longer depend on traditional family support networks. Many of these older people do not live in appropriate accommodation, yet there is no sheltered housing and care home accommodation available to meet their needs. Today’s Care Cameo gives Scotland’s ethnic minority older people a voice. It is imperative that we listen to them and take action.”

Dr Donald Macaskill, CEO Scottish Care, said:

“As an organisation our vision is to shape the environment in which care services can operate and thrive. One of the ways we can do this is by working co-operatively with care providers and most importantly, with the people who use the services. The ethnic minority older people who have contributed to today’s Care Cameo have articulated the challenges they face and the care and services they are unable to access with heartbreaking candour. We are very grateful for their contribution to both this care cameo and to the wider debate in Scotland.

If Scotland is serious about including all citizens regardless of race or ethnicity then we must adequately resource the already stretched care sector to develop services, train staff and work with people to create services which meet the needs of all our citizens. At the moment Scotland is failing to be racially inclusive.”

CARE CAMEO FINAL WEBSITE
Download Care Cameo
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Rights Made Real – Addressing fears around human rights

Am I violating this resident’s human rights? The balance between encouragement and enforcement

One member of staff was anxious and asked, “Am I violating human rights if the resident says they do not want to take part in an activity but I encourage them to do it because I know they have enjoyed it in the past?”

We explored this scenario and balanced out the person’s right of self-determination: (article 8 of the Human Rights Act 1998 which covers personal autonomy) coupled with the staff’s knowledge that the individual’s diagnosis of dementia can make her apathetic but when she joins in she really enjoys the activity and it gives her a boost for the rest of the day and improves her mental and physical wellbeing.

The staff member said that she would never force the resident to go but would encourage her and observe the resident and if they were getting anxious or upset during the activity, she would support the resident to leave. However, this has never happened and she has always enjoyed herself when she has attended.

We also explored how our approach can have a profound effect on how someone perceives the idea of doing an activity – a fresh face can help if someone has been having an unsettled morning with the same support worker. We also spoke about never assuming – just because someone has said no 100 times in the past, we could naturally assume they don’t want to try an activity – or by having an “this is the way it has always been” attitude we can hinder someone’s right to personal choice of trying new experiences. It is very important to remember to be curious and never assume you know what a person’s reaction will be, they might just surprise you. This is as much true of relationships in care as it is in everyday life. What remains important is that the encouragement is balanced and proportionate and never gets to the stage of enforced coercion, bullying and manipulation. To achieve to our potential and to gain psychological and physical integrity is a core part of the realisation of our Article 8 rights.

The idea of balance and proportionality lies at the heart of most caring and support relationships. We often become who we are and reach our potential through the encouragement and support of others to go that extra mile. We concluded in this case that gently encouraging someone to do an activity you know they have enjoyed before is not a violation of their human rights. PHEW! However, staff need to remember that the person has the right to not participate too if they really show they do not want to or are not enjoying it.

The staff team said this was really bothering them and they were happy now that they had the knowledge and confidence that they were working within the right ethical boundaries

Wellbeing 1.25: “I can choose to have an active life and participate in a range of recreational, social, creative, physical and learning activities every day, both indoors and outdoors.”

1.26: “I can choose to spend time alone.”

 

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EGM – 30 October

On 30th October at 1.00pm – 3.00pm at the Renfield Centre, 260 Bath Street, Glasgow there will be an Extraordinary General Meeting of the membership of Scottish Care to hear about the state of discussions on the National Care Home Contract,  the development of the Care Home Cost Model and to consider proposals from COSLA and partners.

This is an important meeting and all care home members are encouraged to attend. A full and detailed paper will be sent to members one week prior to the event and this will also be available on the Members section of the new website.

Please intimate your attendance at the EGM to [email protected] as soon as you can.