Caroline urges for more resident-centred care homes

What are the most important qualities a care home professional should have?

The answers are all in the title really.

Firstly, they need to care.  They need to care about all of the people they work with, both colleagues and residents. They should be compassionate and attentive. Care home professionals need to find out about each other and those they care for as individuals.  Everyone needs to ensure they know what is meant by ‘person-centred care’.  It’s about everyone in that environment. They need to be egalitarian and treat other people, fairly, with respect and kindness.  Anyone working with other people needs to be in touch with their own feelings, to be able to empathise with others and have good listening skills. They are not looking after relics in a museum they are caring for and working with some very special people.

Secondly, the place they work in is a ‘home’ not just a work-place. People who work in care homes should emanate a sense of intimate security to add to the atmosphere of being at home.  In just the same way as they run their own homes they need to be flexible in their organisation of meals etc. to allow for personal choices and requirements. Staff need to bring a feeling of domesticity in to the building, where everyone is involved in helping to get the ‘jobs’ done.  Maintaining the opportunities for meaningful occupation.  A care home should not feel like a hospital or a hotel.

Care home professionals should be professional and by that I mean that they should respect their own profession.  They should be keen learners that are motivated to keep up to date with information available, on research and models of care etc.  We need reflective practitioners who are not afraid to admit that they have made mistakes; that they are still learning, along with the rest of us. We need people who are resourceful, open to new innovations and ready to change their models of care for the benefit of those using their services. Changes cannot happen if they are treated like a ‘quick fix’. It takes time to ensure that the desired outcomes are recognised and worked towards as a long term goal.  It takes a team of professional people who recognise the strengths and weaknesses of each member and encourages each person to take part in achieving those outcomes.

We are asking for a lot from care home professionals, we need to recognise this and ensure that we are giving back what they deserve.  Allowing care staff to work set hours, so that they can plan their home lives accordingly, and allowing them to be salaried would be a good start.

 

What are some of the areas that the care home industry can improve?

My work takes me into a variety of care home settings and the ones that strike me as getting it right are those where they work as a team.  I’m talking about housekeepers, gardeners, activity co-ordinators, kitchen staff, management, office workers, everybody working together to give the best service they can.  These are the places where I can recognise true person-centred care, where everyone matters.

To enable all of the staff to give of their best, there is a real need for training. The government are making headway through Dementia Friends to ensure that the general public dementia aware.  This puts the onus on our profession to ensure that all staff are trained beyond the stage of ‘dementia aware’.  It is beneficial for the care home to have staff fully trained in Cognitive Stimulation and confident in the appropriate usage of Reality Orientation and Reminiscence Therapy.

Care home managers triumph when they invite staff, visitors and residents to look at the home with new eyes, encouraging feedback on any improvements that can be made to the environment.  Looking for ways of enabling residents to remain independent for longer or items which will stimulate feelings or conversations.  It’s wonderful to see these ideas in practice in some of the homes I have visited.   This is where staff can be at their most resourceful, lots of these ideas are cheap and cheerful.  The environment can benefit dramatically when we implement small changes which will enhance the quality of life for those living and working in the home.

 

What is the key issue facing the care home industry in this country?

I know I’m going to leave myself wide open to an onslaught of disagreements here.  I know so many people will say it is a lack of funding.  Whilst I acknowledge that this is a factor, I honestly think the key issue in this country is the number of care home owners and managers who truly believe they are doing a good job when the simple truth of the matter is that they are not delivering person-centred care in the true sense.

There are, of course, lots of owners and managers in the industry who are doing a fabulous job, but, if you asked them what they would do to improve their care homes, they wouldn’t look at you ‘gob-smacked’ and tell you that they believe they have one of the best in the area.  They are the people who will immediately give you a list of goals they would like to incorporate in to their homes and also tell you what research they would like to know more about.

Sadly, there are still too many who have been doing the job for a long time and haven’t learnt anything new in the process, they are still constantly playing music from the 1930s – 1940s because they believe that is what their residents want to listen to. They haven’t asked the residents. They fail to explore the possibility of someone liking Cliff Richard, Barbara Streisand, The Isley Brothers, or, heaven forbid, Abba,  (dare I even mention Pink Floyd, Led Zepplin or London Grammar)and yet there are many people living in care homes today who’s popular music tastes don’t include ‘Roll out the barrel’.  Personal tastes in music are as varied as the different genres available.

So many managers just want to ‘tick the box’ for training their employees in dementia care.  They only want the very basic awareness course, they’re not interested in courses about ‘Activities’ because they already do bingo twice a week and they have someone in once a fortnight to run armchair exercises. (Oh, and once a month a man comes in and sings to them).  They don’t have art materials, or poetry books, a video player in the lounge, or pens to do the crosswords in the paper. There are no dolls to be seen, or pets in the home.  In fact there is very little of any interest in the rooms at all.  The managers will ask ‘Do you do a course for behaviour problems, or how to restrain difficult residents?’  They don’t appreciate that improved environments will reduce these problems drastically, allowing them to concentrate on the niche requirements of individuals (perhaps something as simple as a doll or teddy bear to cuddle, or someone to talk to for a while at certain times of the day). They have very little understanding of how individuals with dementia can be helped to make sense of what is going on around them.

Activity Co-ordinators are crying out for training which is relevant to their role, their managers however, are spending the money on flower arrangements in the reception area.  They haven’t even thought about finding out if there is a lady who did the flower arranging for church each Sunday living in their home. There are too many care homes still working to timetables, with the importance placed on what the home looks like to visitors rather than models of care which have been adapted to suit the choices of their current residents.

If we wish to make any inroads into improved care for older people we need to listen to what people want for themselves in their new homes, as well as employing staff who engage with customers, people who endeavour to understand and facilitate the personal needs of those living with dementia.

care-home-caroline-benham

 

Caroline Benham has extensive experience in the care home industry, worked for Anchor in the past and currently a volunteer for Alzheimer’s. She is currently studying towards a degree on Dementia Studies while working as a dementia care trainer.

 

Dr. Raja shares his passion and knowledge with CHJ

What do you enjoy the most about working in care home industry?

For me, working in the care industry is a passion and a vocation giving me an opportunity to make a positive difference to the lives of vulnerable people every day whilst affording me a tremendous amount of satisfaction and achievement. Of course, it is incredibly challenging but because of the diversity and uniqueness of every person we support and the situations faced, no one day is the same and its great to be able to apply my passion and creativity with a team equally as dedicated and driven, to achieve positive outcomes.
What is the key issue facing the care home industry in this country?

Senior couple at home with many bills

Clearly the main headline grabber is rightly the underfunding of the sector whilst costs escalate. This takes providing excellent services to the breaking point where staff aren’t paid meaningfully and services cannot be further invested in to improve. To make matters worse, the ever changing and ever increasing burdens of bureaucracy and red tape are stifling at best and confusing and demotivating at worst.

There are examples of good quality services that have closed and are facing distress. Staff morale and improvements within others are problematic and the media’s negative portrayal of the sector is disheartening. The threats and challenges from all sides diminish further the capacity and resilience to continue the fight to improve the lives of the most vulnerable in society. Everybody in the sector is affected from front line care staff through management to owners and directors. In fact the sector deserves credit more than ever for its compassion, warmth and care when it feels very exploitative since so much is built upon the extra mile….. above and beyond that is given by those, most often women, that enter the profession because of a heartfelt commitment to caring.

In a world where austerity rules supreme where government support is reducing and health costs are rising, how challenging has it been for the care home industry? What are some steps you home have taken to manage through the current climate of economic uncertainty?


We have focussed our efforts even more on being closer to service users and front line staff and to empower and support them to assist in maintaining excellent relationships and communication which helps to improve the service experienced by all. We have applied technology to take the burden of many aspects that previously distracted from the time and costs of managing and administering the service including introduction of computer systems, iPads and mobile phones for remote staff which link in with planning and finance.

We have streamlined and restructured our management and moved more people from the office out into the places where people receive care and support and have adopted management functions that break away from service lines but are more responsive in terms of the support people and the organisation needs.

What are some of the areas that the care home industry can improve?

Individual homes and organisations have often been isolated and very bunkered in their outlook and it is now more important than ever for greater unity in the sector. From keeping in touch with local providers, sharing knowledge and resources through to formal membership of local and national trade associations, will help keep knowledge up to date with best and innovative practice whilst possibly opening up opportunities for growth and development and reduction of costs and improving quality as a result.

We as a sector need to celebrate success better. So much happens day in day out within our services we provide yet we too are modest and humble to the point that the only stories that are heard are the bad ones. We should shout from the rooftops about our achievements and success and make sure the local community is engaged and aware of what we do. So many of us hold and take part in Open days, craft fairs, are involved with local churches, colleges and other community groups and activities for example but how many of these feature in news articles let alone interviews?

A strong unified voice representing providers in the sector, sending clear messages to stakeholders including the public as well as commissioners and the government is needed now more than ever and Care England will undoubtedly build on the success of the National Care Association and the English Community Care Association following merger on the 1st january 2014 and will help shape the sector in a way that works for service users and service providers.

 

Care-home-asif-raja

 

Dr. Asif Raja bio:

A lifelong commitment to health and social care has seen Dr Raja apply himself to make a positive difference as a founder and Managing Director of SummerCare. He has championed improvements in the quality of services and is a Director of the National Care Association, a Board Member of the Care England Transition Board, trustee of Shields people parliament, Board Member of the National Leadership Forum and a member of the steering group of the Driving up Quality Alliance.

care-home-great british care awardsHe was recognised as the Best Employer in the country by The Great British Care Awards in 2013 as well as for excellence in customer service in the 2013 Business Awards as well as for his contribution to the community in the 2012 Business Awards.  A prominent national contribution has seen him recognised as one of the top 30 Social Care Leaders in the country as well as a Care Personality in the National Care Awards 2012.

Samaritans to save care homes in Scotland

 

care-home-One Step at a Time-Samaritans to save care homes in Scotland

Approximately 100 volunteers from the public are planned to be called up to help improve elderly care home standards: Samaritans to save care homes in Scotland!

The campaign started in the aftermath of several high-profile cases of abuses in the elderly care homes during the past few years. This autumn it will launch a campaign to recruit another 100 volunteers who will mostly inspect care homes for the elderly, in particular, the rural areas. Their roles are to talk to residents and their families to find out how they feel about the care they are receiving.

A spokeswoman for Age Scotland welcomed the increase in scrutiny the extra lay assessors would bring, but cautioned it should not just be a “box-ticking exercise”. She stressed that it is a stressful time when people make the decision to move into a care home, and many have concerns about how they or their family members will be treated and whether their rights, preferences and lifestyle choices will be respected. Most care homes do perform well, but often the biggest reason for something going wrong is that somebody somewhere didn’t ask the people being cared for – and that is exactly what our lay assessors do