By Debbie le Quesne

Archive for January 2014

Dignity Action Day – the event that should never end

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Just incase you’ve missed the news, it’s Dignity Action Day tomorrow (Saturday) – a campaign that attempts to vastly improve the lives of those who need social, nursing and health care.

Dame Joan Bakewell, Dignity in Care ambassador sums up the goals perfectly: “Dignity Action Day highlights a more respectful way of behaving towards vulnerable people. The very old and the very young clearly need our respect, but it wouldn’t do any harm to spread the dignity message across the population then we can all benefit.”

Upholding people’s rights for dignity is surely a duty for all of us, whether in the care sector or not. To this end, events to promote the campaign have been happening all over the UK – everything from champagne and canapés afternoons to senior disco dances have been held.

Treating fellow members of our community with respect is something most of us do automatically – but sometimes in our enthusiasm to help, or just speed things along, we can steal the dignity of those who are most vulnerable.

I recall one training session where West Midlands Care Association had feedback on their workshop from carers. They were good students and some had been in care settings for many years, but one admitted to “struggling to not be in full control.”

Dignity in action is not necessarily about grand gestures, it’s about remaining aware of others’ needs and supporting their abilities . . . it’s about treating others the way we would wish to be treated.

Dignity Champions pledge to challenge poor care and act as good role models to others. They include health and social care managers and frontline staff, doctors, nurses, MPs, councillors, members of local action groups and people from voluntary groups, who believe being treated with dignity is a basic human right, not an optional extra.

There’s a 10 point Dignity Challenge we can commit to:

1. Have a zero tolerance of all forms of abuse.

2. Support people with the same respect you would want for yourself or a member of your family.

3. Treat each person as an individual by offering a personalised service.

4. Enable people to maintain the maximum possible level of independence, choice and control.

5. Listen and support people to express their needs and wants.

6. Respect people’s right to privacy.

7. Ensure people feel able to complain without fear of retribution.

8. Engage with family members and carers as care partners.

9. Assist people to maintain confidence and positive self-esteem.

10. Act to alleviate people’s loneliness and isolation.

One thing that has thrilled me during this campaign and it’s this: It doesn’t seem to have an end in sight. Dignity events are still on calendars – and long may they be so.

Have a good weekend . . . and for those who have trouble to enhance the dignity cause, a huge thank you.

How Albert, 87, gets in the groove to spread the dignity message

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If you’re looking for music from the 50s, 60s and 70s, it’s time to met veteran DJ Albert Taylor.

Probably the oldest swinger ‘in the mix’ in Britain, he had everyone on their feet at a National Dignity Action Day bash in Sandwell.

The spritely 87-year-old provided the entertainment for 200 people at Goldfield Court, a development of extra care apartments in the heart of West Bromwich.

The Eagles fan regularly used to DJ for the Greets Green Partnership, a scheme to improve the health, well-being and quality of life of residents in the West Bromwich district, and at tea dances at local community centres.

Sandwell Council and social enterprise Housing 21’s extra care housing organised the event as part of celebrations across the country, led by the National Dignity Council.

Don’t you just love this stuff – 87 and still the life and soul of the party, promoting dignity and doing his bit to spread the message to help make a difference in people’s lives.

Other entertainment included a sing well choir, a barber shop choir and dancers from Disability Day Opportunities Performing Arts Group.

As part of the event people could add a pledge on how they would uphold dignity or say how they would like to be treated.

Albert’s story is one of thousands across the country as people embrace the Dignity Action Day campaign.

At West Midlands Care Association we held a training event at Kelvedon House in Clarkson Road, Wednesbury. The home hosted the awareness workshop where our trainer, Wendy, who encouraged carers to support residents to do things for themselves.

The temptation always is to intervene too early and take control back, or perhaps unwittingly not fully explain what is being done. Preserving dignity is a positive action and if we can create prompts for people to remember the campaign is all worth while.

Image credit: Sandwell MBC website


CQC: A new way of inspection

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The National Care Association has been fighting the corner for care providers as the regulators finalise details for their spring consultation on their new style of inspections.

Everything will be rolled out in the autumn, but until then we can only hope that the Commission is listening to what we have to say.

The NCA attended a “re-consultation workshop” to ensure that “the voice of the smaller independent sector” is heard.

Along with the National Care Forum and UKHCA, the national team challenged CQC to ensure that any proposed changes to inspection regimes were fair, proportionate and delivered equitably across the country and across provider types.

Already plenty of debate has been aired and in the mix with the care experts are the Royal College of Nursing and advocacy groups such as Age UK. Hopefully, our voices will be heard.

Under proposals so far the CQC inspectors will focus on five key areas, known as lines of enquiry (LOE). These are: Is an organisation Caring, Safe, Effective, Responsive and Well-led?

These enquiries will be judged taking into consideration personalisation, care, staffing, premises and equipment, quality and management, nutrition, health, involvement and infection control.

Central to everything is user engagement in designing the right framework for inspection and provider engagement is fundamental to improving quality, the workshop heard.

This all sounds good and a viable alternative to the tick-box inspections we currently go through.

I despise the ‘us and them’ culture that is so endemic regarding the relationship between CQC and care providers. Thankfully it is slowly changing. Let’s hope we can build on this with the inspection charter.

Apps help to co-ordinate caring – simply a great concept

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I don’t belong to the generation fascinated by the latest tablet or mobile phone. Phones are a vast improvement on pigeon post and for my use are primarily for calls, texting and taking snaps.

Computers, of one kind or another appear to be surgically attached to me as work is just a keyboard away.

Technology is central to our lives and in the care sector is getting a broader platform daily. Everything from the latest Facebook app to recipe ideas can be found on someone’s tablet or phone.

So I was not in the least surprised to read that Carers UK has made a pioneering move into the app market with the launch of Jointly – a tool to help families manage care for loved ones alongside increasingly complex lives.

It gives patient profile details, messaging, medication regime and much more. It’s been created by carers for carers.

You can visit www.jointlyapp.com or download the app for free and access a user guide and a list of questions and answers.

You can purchase a Jointly circle with a one-off payment of £2.99 either through the Apple or Google Play stores or at www.jointlyapp.com. This allows for care group networking.

The technology baffles me, but as a working tool I’m already on the hook. Jointly offers an easy information stream among an invited circle of helpers and carers and helps co-ordinate tasks.

Across the UK there are 6.5 million carers – half juggling care with work and a third caring for older relatives alongside raising children.

We live with geographical and time availability issues and it’s no different for those trying to organise care between family, friends and professionals. It’s called distant caring or sandwich caring and I can see a huge benefit in embracing this technology so that everyone, at all times, is kept in the loop with a shared calendar of duties.

Technology will never replace hands-on care, but I’ll help promote support all I can – goodness knows, it’s needed more than ever.

Third sector – a crucial role in caring for elderly

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Third sector organisations are key to providing preventative support for the elderly.

Yes, you’ve got it – charities, non-government groups and anything from community groups to WI meetings – are doing a great job delivering innovative ideas to promote wellbeing with the aged.

Such groups have a unique selling point – “a willingness to work holistically and flexibly to achieve better outcomes for their beneficiaries,” so says an article in the Guardian by Robin Miller, a senior fellow at the Health Service Management Centre, University of Birmingham

There are many examples of third sector organisations successfully providing innovative preventative support that are valued by older people and also by commissioners, Miller adds.

And I must agree.

A study funded by the NIHR School for Social Care Research explored the perspectives of both public and third sectors in regards to preventative services for older people.

Miller writes: “In contrast with the tensions that are often described, it found that third sector organisations and their commissioners enjoyed positive relationships and had shared understandings of their respective roles which were largely met.

“Commissioners’ priorities were preventing older people needing social care services in the future, while for third sector organisations the emphasis was on improved quality of life for individuals.”

The conclusion was that although priorities were different they were “reconciled in practice.”

Interesting both groups appeared to struggle to understand how to “set outcomes for preventative services and gather appropriate data, which meant both found it difficult to review and improve the impacts achieved from the resources available.”

But whatever is being done it appears to be working and benefit from working together.

“Commissioners believed that third sector organisations used the funding provided effectively, and the organisations saw these grants and contracts as enabling them to accomplish their overall missions,” the article says.

So far, so good – but happy endings are hard to find these days . . .

There are real concerns that that the overall funding pot for preventative services may be significantly reduced and most third sector organisations significantly rely on public sector support – not least West Midlands Care Association.

Miller rightly observes that health and wellbeing boards are tasked with improving overall outcomes and supporting older people in minimising their reliance on publicly funded services.

“To achieve this, they need to have a detailed knowledge of the work of the third sector in their area and think through how this can be effectively integrated with the statutory services,” he says.

This latest research, carried out at the University of Birmingham, suggests that third sector organisations are keen to contribute to this process and would embrace more robust monitoring, as this will better demonstrate their impact and justify the continuation of their funding.

Interesting! I’m all for accountability, but in my experience the margins between monitoring and policing are often blurred. I will always welcome transparency, advice and take counsel from those with more specialist knowledge than my own, but I have a nagging thought that more “robust monitoring” could kill this goose that appears to have laid a golden egg.

Sustaining dignity with a Sunday lunch special

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Dignity Action Day (February 1) is almost here – the chance to make difference in the way we think about those who are most vulnerable.

I find one of the most undignified things is loneliness, particularly with the elderly. Image having no-one to visit, most of your relatives live far away and the majority of your old friends have passed away.

For many of us, Sunday is a day to relax with friends and family and enjoy Sunday lunch before re-starting the working week.

But for 1million people aged 65 and over in Britain, Sunday is the loneliest day of the week.

How horribly sad.

A study conducted by charity the Royal Voluntary Service (formerly WRVS), shows that loneliness experienced by older people is compounded by lack of contact with their family and 13 per cent always feel lonely on a Sunday because it’s such a family day.

Previous research by the charity found that, for ten per cent of older people, their nearest child lives more than an hour’s drive away (40 miles plus), making that daily or weekly contact even more difficult.

The survey also showed that 33 per cent of older people miss sitting down to a meal with their family and 37 per cent of older people don’t enjoy eating a meal without being able to share it with someone.

These heart-rending facts are released as the Royal Voluntary Service launches the Big Sunday Lunch.

The initiative runs form February 7 – 9 and its aim is to encourage people to host a meal and invite along older friends, family or neighbours to raise money to help older people in their community.

Big Sunday Lunch gets backing from MasterChef presenter and 2 Michelin star Chef Michel Roux Jnr, who has suggested a favourite recipe for those holding an event.

Albert Roux said: “Food is a really important way of bringing people together to enjoy each other’s company and have a great time. It can be all too easy to take for granted the pleasure of sharing food; many older people don’t have the luxury of enjoying a meal with their family or friends. Holding a Big Sunday Lunch event is a great excuse to gather your nearest and dearest to enjoy breaking bread together and raise money to help tackle loneliness among older people at the same time.”

Sharing a meal is not too difficult for most of us. It’s a simple act of hospitality. What’s not to like? Food is on the menu.

Anyone interested in taking part can download a fundraising pack to help with ideas, along with tips on how to organise and promote their own event by visiting www.royalvoluntaryservice.org.uk/bigsundaylunch.

Many of the care issues surrounding the dignity of our older people, especially those in need of care, will involve training – and the WMCA does a good deal of it.

But this event is the price of a meal or two, needs no special training and anyone can contribute.

Royal Voluntary Service supports over 100,000 older people each month to stay independent in their own homes for longer – a central pillar of dignity in the community.

I think it’s time to get the cookery books out.

CQC and its first dementia care review

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The Care Quality Commission will be carrying out unannounced inspections to review how people with dementia are cared for in England.

Some 150 homes and hospitals will be targeted over the coming months.

The commission says it will examine the care and support these services provide for people with dementia and establish what is working and what needs to improve,

CQC chief executive David Behan, reported in Caring Times, says there is a real need to explore why people with dementia may not be receiving high quality care, as well as how the different services work together.

The review – a first for the CQC – will address the key issues these people face, such as why admissions to hospital from care homes are higher for people who have dementia compared to those who do not have the condition.

“Our findings will draw conclusions on a national scale about what works well and where improvements are required,” Mr Behan is reported as saying.

Checks will zone in on:

  • How people living with dementia are supported to maintain their physical and mental wellbeing
  • How effective care can reduce admissions to hospital from care homes and avoid unnecessarily lengthy stays;
  • How care services can work together when there is a need for people to move between services.

By May the CQC will publish a report detailing its judgments. Meanwhile, the regulatory body is asking for people with dementia, or the relatives and friends of people with dementia to tell them about their experienced.

Carers comments are also valued. All feedback can be entered on CQC’s website or through Age UK, Dementia Action Alliance, Regional Voices, Dementia Advocacy Network and the Race Equality Foundation.

We are overburdened with regulation and now we have more – well, at least 150 service providers do. I would have hoped for a less invasive route, but there is a strong argument to support the unannounced approach. At least that way a realistic picture can be established.

It is, however, the providers – be they care homes, nursing homes or hospitals – for which I am concerned. What we don’t want are for those delivering below standard care to be hung out to dry. We have spent many hours trying to tear down the ‘us and them’ culture that has existed between CQC and care providers for many years and I wonder whether this spot-check technique will not undo some of the good work we have done. Trust takes a long, long time to build . . .

Was not a more co-operative approach considered? Let’s hope the review will bring some positive input into care, but at the risk of banging a very old drum, care excellence – especially dementia care – is a costly business.

Although we had Mr Cameron launch the dementia summit in December and pledges to deal with its catastrophic social implications, I am still awaiting financial resources to be improved to meet the challenges.

Making a pledge for a better future for the elderly

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Age Alliance in Dudley is calling on all parts of the public sector, such as council departments, the NHS, Fire Service, Police, ambulance services, youth services, schools, colleges leisure centres and parks to ‘Pledge An Action’ on how they can help to keep older people safe.

Commitment to make a ‘pledge’ is also being sought from the voluntary and community organisations as well as the business sector.

Not surprisingly, the West Midlands Care Association has also been asked to get involved – something I am more than pleased to do.

The initiative centres on providing help for a better life experience for elderly people. Simple, but profound, the theory is that if we begin making changes now the future for our own old age is brighter.

Age Alliance Dudley is calling for organisations across the borough to think about how their work impacts on older people and to develop ways in which they will make a difference over the next 12 months.

Where do I begin?

To help, Age Alliance have listed a number of areas where we could make a difference, but they are also keen to hear about what is already planned or underway. Areas could include:

  • Staying safe at home – security, lighting, alarms, rogue traders, care agencies
  • Staying safe whilst out and about – shopping, carrying money, pavements, street lighting
  • Using public transport, visiting leisure or social facilities, in the car.
  • Staying safe mentally – being involved and engaged not isolated.
  • Staying safe financially – not in debt, receiving all the benefits/services they are entitled to, the simplification of forms
  • Staying safe while accessing services such as GPs, dentists, staying in hospital, Fire Service and Police

Age Alliance in Dudley is a partnership made up of statutory, community and voluntary sector organisations and older people with the aim of improving the lives of older people living and working in Dudley Borough by encouraging a wide range of bodies to make a pledge of action.

There are nearly 59,000 people over the age of 65 in Dudley, which is 18 per cent of the total population of the borough. These older people may be customers, clients, patients, relatives, residents or neighbours.

You must hurry with your pledge – they need to be made today (Jan 22) but I’m sure no-one will complain if you join the initiative later.

Send your pledges to: Sally Huband (sally.huband@ageukdudley.org.uk) or (jill.cloves@ageukdudley.org.uk).

Organisations will also be expected to share the outcomes of their pledges at a showcase event on 1 October 2014 Older People’s Day.

See: http://makingitrealindudley.org/wp-content/uploads/2014/01/Pledge-An-Action-Age-Alliance.pdf

Resolutions to change the way we are delivering our care

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It may be a little late for New Year resolutions, but if they’re going to help our care sector bring them on please . . .

Mike Padgham. chairman of the UK’s biggest homecare organization, has called for fewer words and more action to tackle the care of the country’s older and vulnerable people.

The boss of the United Kingdom Homecare Association, says he is fed up of endless reports and condemnation of the sector, according to a report on the Care Industry news website magazine.

In a hard-hitting approach this is what he has to say on the post: “Over a decade or more we have had endless reports and endless talk about caring for people in their own home, about improving commissioning practices and about tackling funding in the care sector.

“It is time instead to see some action taken to tackle these things rather than just passing round one report after another.

“We are like the England cricket team at the moment – under fire from all sides and no sign of help in sight.”

Quite rightly he pointed out that Government promises has resulted in little real action.

He adds: “We see little real understanding of what it is like delivering care at the sharp end

“Having to provide home care when commissioners are paying £9 £10 or £11 an hour! Dashing across busy cities to fit in visit after visit and not even getting paid for that travel time! Having to squeeze a visit into 15 minutes when humanity and common decency cry out that it should be longer.

“We are an easy target and get very little support or recognition – despite the fact that caring for people in their own home is a central plank in Government policy.”

And here’s the list of resolutions:

“I want the inspection of commissioners by the CQC returned to the Care Bill,” he said.

“I want those commissioners to take the full cost of providing care into account when setting fees with providers – including travel time. I want them to consider quality and the quality of life of the clients.

“I want the Government to recognise the great human and economic contribution social care makes in this country and support it like it supports other industries.

“And above all, I want social care to get the funding it deserves so that we can start providing homecare that we can all be even more proud of.”

“At the end of 2013 we had our annual conference and the feedback from that was that homecare providers are fed up of being criticised for the care they are able to provide in a social care system that is starved of money and struggling.”

Hmm  . . . follow that. I agree with it all. We are, indeed, an easy target, but more so are those for whom we care. What is it with this government? It seems we will fund everything from opera to the HS2 project and still we see social care, in my opinion, left with the ‘dog ends’ of provision.

Our profession needs greater status and massively improved recognition and I can see little at present from the coalition that serves these two essential pillars.

Dignity Action Day on February 1 looms ever nearer. Dignity comes at a cost – though I know some will disagree. To deliver dignified care, whether in the domiciliary market of in residential or nursing homes, needs resources and those resources cost.

“We’re all this this together . . .” was Mr Cameron’s claim as we entered into austerity measures. Along with others in the Cabinet, I don’t believe he has a clue. Perhaps he could spend a week working alongside any one of my members’ employees and engage the challenges of caring without sufficient resources.

It will never happen, I know, and even if it did, there would be a timeframe – a start and an end – and he could return to his own life. Mr Cameron, can you imagine what it’s like to desperately want to deliver care excellence and being forever compromised?

Is there someone out there, with a large influential profile, who will be our champion?

Dignity: Blowing the whistle on bad practice and poor care

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I’ve been troubled all week over the Hillcroft Nursing Home case in Lancaster where rogue carers have been jailed for pelting residents’ heads with beanbags “for their entertainment.”

These kind of crimes are sickening, they erode public confidence in the care sector and serve only to devalue the excellent service so many providers give.

How do we stop such cruelty? Often it has been through media intervention but it shouldn’t be that way.

It’s a sad, but true, fact that there are bad carers and I believe it is every good carers’ duty to help weed them out.

As part of the run into Dignity Action Day on February 1, I want to encourage a culture of whistle-blowing. Enlightened organisation know it makes sense in preserving reputation and business.

Employees need to feel free to challenge bad practice and poor behavior but blowing the whistle is never easy. It is, however, a vital part of safeguarding in social care environments.

Terry Bryan, the whistleblower and former senior nurse at Winterbourne View, was initially ignored by his manager, senior Castlebeck staff and the Care Quality Commission (CQC).

His tenacity, however, paid off, and the resulting BBC Panorama exposé resulted in real change for the better.

The residents were moved to safety, the abusers were prosecuted, the home was closed and ultimately the provider went out of business. The CQC also changed its practice in relation to whistleblowers. A since act produced monumental changes for good.

Events like the abuse of residents at Winterbourne View and the failings at Mid Staffordshire NHS Foundation Trust, have strengthened the argument that there is inadequate protection. These events serve as a stark reminder; both that employees may choose not to raise concerns for fear of the consequences and that employers may fail to respond. These cases have also raised serious concerns about the role of the regulator.

No-one really wants to talk about having a rogue employee in the ranks and the possibility of a culture that does not uphold dignity. But we must foster an environment of trust and respond to any allegation with supportive actions.

The National Minimum Training Standards for Healthcare Support Workers and Adult Social Care Workers in England require workers to know how and when to escalate any concerns; this includes use of whistleblowing policies.

The standards tell workers: “You must report things that you feel are not right, are illegal or if anyone at work is neglecting their duties. This includes when someone’s health and safety is in danger; damage to the environment; a criminal offence; that the company is not obeying the law (like not having the right insurance); or covering up wrongdoing’ (Skills for Care and Skills for Health, 2013).”