‘Sharing good practice in Krakow’, Blog from Margaret McKeith

What is the link between Prof. Jason Leitch, pressure ulcers and Krakow? Up until March of this year I would have said “none”. However, an invitation to co-present a poster at this year’s European Wound Management Association Conference (EWMA) made the link very clear and was an excellent opportunity to fly the flag for Scotland’s independent sector on an international platform.

Prof. Jason Leitch (Clinical Director, The Quality Unit, Scottish Government) announced his aim that pressure ulcers were to be reduced by 50% in all care settings by December 2017. He shared this with delegates at the NHS Scotland event in 2015 and set the Reducing Pressure Ulcers in Care Homes Improvement programme’s wheels in motion.

This programme was a collaboration between the Care Inspectorate, Healthcare Improvement Scotland (Scottish Patient Safety programme) and Scottish Care, and saw for the first time, our three organisations working on such an improvement project. This is detailed on the microsite developed as part of the process www.pressureulcers.scot.

Having being involved in this since the onset and very aware of its success, I was delighted when Joyce O’Hare (Improvement Advisor, Care Inspectorate) took the lead in developing a poster abstract to be submitted to the EWMA conference being held in Krakow. Joyce’s abstract was accepted and we were invited to prepare a poster. With an emphasis on collaborative working, integration of health and social care and improvement methodology, Joyce worked with Jill Gillies (HIS) and me in preparing and submitting the poster. We were delighted when this was selected and we were invited to present this to delegates from around Europe. With support from Scottish Care and the Care Inspectorate, Joyce and I set off for Krakow on 9th May.

RPUCH postert Krakow 2018

 

Although our presentation was short our poster was on display for the duration of the conference. Our collaborative approach, the independent care home sector, the role of the Local Integration Leads, our commitment to improvement and the opportunities created by integration were all shared. With an audience consisting of such a wide range of health professionals from across Europe we feel we certainly put our sector and organisations we represent on the map.

 

Margaret McKeith

National Lead

Partners for Integration and Improvement

 

Going the extra mile – CWC event

Each year Scottish Care has a nominated charity we support in various ways – as some of you may be aware, in 2018 that charity is the Care Workers Charity.

CWC are launching a national ‘Care Workers Charity Day’ on the 30th of July. As part of this they are asking the care sector to put on some kind of event, ideally a mile walk, to raise awareness, publicity for the care sector and essential funds for the charity. If you’d like to get involved or are looking for more details please see the event pack below.

Event pack - going the extra mile

Guest Post from Local Integration Lead, Rene Rigby

Test of Change

We are living and working in an inter-connected environment. The use of email for sending messages, exchanging information and assisting with workflow is common place across the public sector. There are many links between the health and care system, but it’s often difficult for health and care professionals to share information. Access to the right information about patients and users of services at the right time is essential to ensure continuity of care.

When patients are discharged from hospital, care homes are still receiving information about that individual by fax, in person or post. Often, key pieces of information are not received at all. This makes it difficult for care homes to prepare for a new patient’s/resident’s arrival or the return of a resident who has been in hospital. As well as being inefficient and slow, paper-based communication is not a secure delivery method.

Lothian Unscheduled Care Board have agreed to fund costs for a one year test of change –Secure emails access for all care independent care homes (circa 103) in Lothian. Each care home will be provided with up to three nhs.net accounts for a period of one year. Care homes coming on stream during the next few months have also been included in this test of change.

CEO’s or equivalent of each individual independent care home must sign the Data Sharing Contract, as must the staff identified as secure email recipients. Following on from this each identified recipient must sign a NHS Lothian User ID Request Form

The provision of secure emails to all care homes in Lothian will markedly improve communications between care homes general practice and social work. Specifically, it will enable faster discharge of patients through the electronic communication of patient assessments and subsequent discussions rather than this being by post.

Secure email will transform how healthcare organizations in Lothian share and work collectively to provide coherent joined up services for the people concerned the public. Good timeous information underpins good care and on-going support.

Care homes will benefit greatly from having a consistent electronic transfer of medical discharge summaries (typically sent to a GP within 24 hours). This will enable the care home to fully prepare their service for supporting people discharged from hospital by preparing for the persons needs well in advance of their arrival.

Pre admission assessments will be carried out and shared timeously thus supporting early discharge to the care home and help improve the efficiency of the discharge process generally.

Secure emails offers the potential to share Anticipatory Care Plans from statutory services. E.g Person moving into a care home. Referrals, assessments, multidisciplinary review summaries, flu vaccine consent forms will be immediately accessible to care homes. Opportunities for Tissue Viability, Health Protection, Care Home Liaison, CPN’s and pharmacy specialists instant ability to network and support and safely communicate sensitive information with care home staff.

Other benefits are the ability to send and receive patient/resident information quickly and securely. No confusion from messages taken over the phone or illegible writing on faxes. Improved awareness of care home staff in relation to  information governance rules on handling patient information. Secure paper trail in place for example, time emails were sent, removal of fax machines which are costly and require maintenance. Costs of postage for partnership reduced. Reciprocal communication time by health and social care professionals markedly reduced and this initiative supports positive change in service.

This test of change Secure e-mail access for care homes in Lothian should seek to demonstrate measurable improvement in outcomes either directly to individuals or indirectly through improved service design and delivery. There will be on going monitoring to make sure the project is achieving the desired results and to demonstrate the impact of the project to others; as well as to identify issues or problems as they arise within the project so that actions can be taken to change or redesign the project while it is in progress.

 

Rene Rigby

Local Integration Lead, Edinburgh City

‘The Experience of the Experienced’ – Scottish Care launches new workforce report

Recently (Thursday 28 June), Scottish Care launched a new report on the independent social care workforce at our Workforce Matters event in Glasgow.

‘The Experience of the Experienced’ explores the employment journeys of experienced and older individuals working in nursing home, care home, care at home and housing support organisations.

It is based on interviews with 9 social care workers, aged 41-71, who have either entered the care sector later in life or have worked in the sector for a long time.

Following the report launch, CEO Dr Donald Macaskill said:

“Our experienced social care staff are our experts.  As we seek to address the challenges of re-designing roles, of recruiting a new generation of carers, of reshaping how we support and care for people we forget the voice of experience at our peril.

“We need to mould our systems of regulation, registration, learning and qualification to enable those entering later into social care to know that their skills and experience is valued and validated.”

Katharine Ross, National Workforce Lead, added:

“We welcome the opportunity to work in partnership with providers, front line staff and partners across the health and social care sector to not only attempt to answer some of the challenging questions that the report raises but to ensure that the experience of the experienced is respected, appreciated and celebrated.”

The report can be accessed here: https://www.scottishcare.org/wp-content/uploads/2018/06/SC-The-Experience-of-the-Experienced.pdf

You can follow discussions from the event on Twitter using the hashtag #exPEERience

If you would like to discuss the report and its findings in more detail, please contact Katharine Ross, Paul O’Reilly or Becca Gatherum.

Big Community: the return of the Big Society – Latest Blog from our CEO

Big Community: the return of the Big Society

In recent months there has been a developing discourse which goes somewhat like this:

‘In the face of the growing demographic challenge and pressure on health and social care services coupled with acute financial austerity, we need individuals in their communities to take more responsibility for the care and support of their family members and neighbours. This is after all not the responsibility of the State but rather the individual. If you are ill, we will treat you as a last resort after you have self-managed your condition and used whatever technology that is available which will avoid expensive direct human intervention. We are no longer able to pay for you to be fully independent and achieve what you may want because we simply cannot afford it.’

Maybe I am being a little generalist and overly simplistic in that description, but I suspect not that much. Is this not broadly the message which the Edinburgh Integrated Joint Board has been communicating to the good folk of the capital? Is this not the underlying message from the Westminster administration?  Is this not the message which landed Glasgow’s HSCP on the front page of the newspapers with their threat to remove (after minimum consultation of)  sleepovers in the lives of some of that city’s most disabled citizens?

So somewhere out there at the bottom of the garden is an empathic, time-rich, resource-endowed group of individuals just waiting to step in because the State (also known as that group of individuals created and employed through the taxation of the populace) chooses no longer to afford the cost of care. Oh and as in the past, it is the role of the female members of the community to do all this work. After all care is a woman’s work.

And as I hear and read this developing and subtle narrative where some of our most vulnerable are expected to be supported for less resource by utilising the untapped potential of the community, accessing community ‘assets’  then part of me philosophically says “Yes, it’s good that people have more control and choice, autonomy and power; that people do need take responsibility and collaborate with professionals, to self-manage and exercise responsibility. But ….”

Are we in danger here of unintentionally slipping into a new mode of social responsibility and a new model of social care without having thought through the full consequences of such a move? Is there a danger that decisions essentially made on financial grounds and dressed up in the rags of a social philosophy, are taken without a robust and appropriate moral, ethical or human rights underpinning? Is this idea of the Big Community not somewhat resonant with the failed and flawed concept of the Big Society? Remember the Big Society?

Every political era and every politician looks for a catchy phrase, slogan or idea which will capture the public mood and define them as distinctive and visionary. For Tony Blair in the halcyon days of New Labour it was the Third Way, though we weren’t that sure what the other two were. For Bill Clinton it was ‘community’ – a word which appeared more in his pre-presidential speeches than any other idea. For Gordon Brown it was a brief flirtation with the idea of Britishness. For Obama every change was possible. For Trump it’s the myth of ‘false news.’ But for David Cameron it was at least before the Brexit Fall– the Big Society.

‘The Government indicated that the Big Society is communities feeling empowered to solve problems in their neighbourhood, having the freedom to influence and discuss topics that matter to them, and a more local approach to social action and responsibility.’

The term “Big Society’ aimed to create a climate that empowered local people and communities, building a “big society” that would take power away from politicians and give it to people. It aimed at “integrating the free market with a theory of social solidarity based on hierarchy and voluntarism”.

Doesn’t that all sound remarkably similar to some of the political rhetoric that we are hearing today about the need for social care to be devolved to the individual; for communities to use their assets rather than the State to support and provide anything other than life and limb supports?

I think we are in the midst of an unarticulated political paradigm which I will term as the ‘Big Community.’ Its failings are not insignificantly the failings of the Big Society. Primarily it is a concept based on a naïve and utopian understanding of community or society. Its foundations are therefore weak and insubstantial. We are not in a bucolic age where people are living in families in geographically proximate communities. We are not living in an era where individuals have so much time that they can spend it in activities to help communities become more cohesive. Most are doing two or three jobs to pay for the mortgage. We are not living in a time when we can be assured that skilled clinical health and social care is being delivered by the State and what we do is an added extra in an individual’s life. Indeed it is an insult to the professionalisation of social care work to suggest that ‘care’ can be undertaken by anyone – that it doesn’t require training, ability and developed skill.

I am more and more convinced that just as the Big Society was called out as a naïve political mantra divorced from the reality of fractured and failing communities, that we now need to challenge the rhetoric of the Big Community and insist that we adequately fund social care beyond our already high levels of eligibility; that we adequately remunerate and resource social care staff and organisations so that we attract the best and deliver real quality; and that we help to use community assets to really advance our togetherness and not to paper over the cracks caused by austerity and fill in the gaps of a failing national health and care system. If not then neither community nor society are big but detached, distant and absent.

 

Dr Donald Macaskill

@DrDMacaskill

Scottish Care Comment on Government Appointment – Jeanne Freeman

Scottish Care notes the decision of the First Minister to appoint a new Cabinet Secretary for Health and Sport.

We would like to put on record our appreciation of the work of Ms Shona Robison. In challenging times she has sought to engage and include the independent care sector recognising the critical and central role social care and its workforce play in the health and well-being of our citizens. We wish her well in the future.

We welcome the appointment of Ms Jeanne Freeman to her new position. Scottish Care has supported the development of the Social Security legislation and has commended the emphasis on the principles of control, choice and human rights which lie at the centre of that Act. We believe that core principles of equal treatment and human rights should be at the heart of all integrated health and care provision. We look forward to working with the new Cabinet Secretary in advancing the care and support of older people, not least through quality Care Home, Care at Home and Housing Support services.

We are also pleased to see the appointment of a Minister for Older People: a new post which Scottish Care believes will be important in driving forward the progress we have been calling for in recognising, valuing and supporting older people in Scotland. We are delighted to see that older people have been prioritised in the reshuffle and we look forward to working with Ms Shirley-Anne Somerville in ensuring that Scotland is a positive country to grow old in.
 

Palliative & End of Life Care: NES event

Due to demand, NES (NHS Education Scotland) are running another workshop specifically for front line workers and would welcome applicants from care homes and care at home organisations.

The workshop is to take place on 29 August, 2018.

To register please follow: https://response.questback.com/isa/qbv.dll/ShowQuest?QuestID=5222834&sid=bTt2wYKviY

See full event details below: