Wearing our hearts on our sleeves - thoughts on the Social Care in Partnership (SE) conference, Cardiff January 2012

How fitting that the venue for last month's Social Care in Partnership (SE) conference should be in a church.  It seemed that as I saw each person leave for the day, they were filled with faith and inspiration, believing that we can really make changes to social care that make lives better.

There was so much to take in at the event and in this post I'm going to centre on the presentation given by Dr. David Sheard and his 'Battle for Compassionate Dementia Care".

I don't know if anyone one was expecting such an emotive and passionate call for dementia care to come from the carer's heart and not from process.  You may know David from BBC Panorama's 'Can Sir Gerry Robinson save dementia care homes'.   

He's been all over Britain and beyond examining the lives of people in these homes and he knows what makes people happy but believes we have a battle to make it happen. Yesterday, he told us there are battles of different models, ideology, professionalism and corporate world. But most of the battles are:

• Finding leaders
• Removing 'them and us'
• Modernising nurses
• Recognising emotional labour
• Creating engaging places to live

So David took us through how homes need not to be like hotels or hospitals - they should have 'stuff' in them. They need to be clinical in that they are clean but homes with things in them make more engaging places to live.  Hooks with coats on them, ornaments, scarves and coats, they all go to make a place a home.  He talked of nurses who had separate eating places and toilets - why is this?  The facilities should be good enough for everyone to share. 

He said that nurses responding to their emotions is important and the support should be there for them to do that. Without it we become distanced from conditions that we wouldn't want to live in and we will learn not to recognise when something is not right and strips people of their dignity.

David believes compassion is the radicalism of our time.  He gave us lots of heartfelt insight into his philosophy and practices and everyone at the conference was blown away.

A question from the audience got us all really thinking. Cheryl Haskell from Monmouthshire Council asked - how do we have time to make this possible? 

David's answer was an interesting example for a home he runs. He said that they prioritise, not by having rota and schedules for when task need to be done but by the needs of the people that live in the home. He said that it didn't matter that everyone eats breakfast at the same time, in fact sometimes you could find some people having lunch while others were just starting breakfast. Does that matter as long as everyone is eating when they're ready and living their day in their own time? He said that if somebody wants to wear three dresses back to front if that's what she felt like that day? There's no need to spend time coaxing someone to do something if they're happy doing it their own way. Do you have to ensure all beds are made by 2pm? This relaxing of attitudes can free enough time to get the things that matter to people done and as long as beds are made not by by a set time but in time for someone to sleep in carers can get the most important work done.

So, what do you think? Is it OK to have breakfast and lunch going on at the same time? Is it ok if your mum is wearing three dresses inside out if that's what she wanted and ages happy?

We'd love to hear your thoughts on the conference and also your answers to these questions - how do you feel you can make the way you work more emotional and what are the battles you think should be taken on first?


Here's a short film from YouTube: 'Feelings Matter Most: An Introduction by David Sheard':

Posted by Helen Reynolds from the Dare2Care Wales team

Code of practice 5: As a social service worker you must uphold public trust and confidence in social services

So, in particular we must not:

• Abuse, neglect or harm service users, carers or colleagues;
• Exploit service users, carers or colleagues in any way;
• Abuse the trust of service users and carers or the access you have to personal information about them, or to their property, home or workplace;
• Form inappropriate personal relationships with services users;
• Discriminate unlawfully or unjustifiably against service users, carers or colleagues;
• Condone any unlawful or unjustifiable discrimination by service users, carers or colleagues;
• Put yourself or other people at unnecessary risk; or,
• 
  Behave in a way, in work or outside work, which would call into question your suitability to work in social services.

This headline appeared in a recent Health Service Journal:

"Hundreds of care home deaths caused by dehydration"
The article went on to reveal that new statistics show that more than 650 elderly residents in care homes have died of dehydration in the past five years.

Do you think that those working in home were aware of code of practice 5? And what do you think that the care workers could have done to ensure that their service users were not neglected or harmed ?

So we're like penguins are we?

A few weeks ago communitycare.co.uk reported that outspoken Birmingham councillor Len Clark, executive member for children's social care, allegedly described children's social workers in the city as having a "penguin mentality".

Cllr Len Clark's comments use a 'penguin mentality' analogy that made us reflect on the film 'March of the Penguins' narrated by Morgan Freeman.

This film shows penguins as having a strong protective ethic towards their vulnerable and as having clear, tried and tested behaviour patterns to meet the challenges of their environment - they form a huddle and turn their backs when they are vulnerable in their environment:

The Care Council for Wales Code of Practice underpins the aim to provide quality, safe care services that show dignity and respect.

If the penguin analogy is to be used by Cllr Clarke maybe what should be asked is:

1) Are social workers feeling vulnerable in their roles?

2) If they are, how can we help and support their roles?

Code of Practice 4: As a social care worker, you must respect the rights of service users whilst seeking to ensure that their behaviour does not harm themselves of other people

Happy New Year readers! It's 2011 at last and we're still examining the code of practice and what it might mean to us - as social care workers or the people who recieve social care.  Code 4 includes:

1. recognising that service users have the right to take risks and helping them identify and manage potential and actual risks to themselves and others;
2. following risk assessment policies and procedures to assess whether the behaviour of service users presents a risk of harm to themselves or others;
3. talking necessary steps to minimise the risks of service users from doing actual or potential harm to themselves or other people; and,
4. ensuring that relevant colleagues and agencies are informed about the outcomes and implications of risk assessments.

CASE STUDY

Angela is 18 years old and has a mental health problem. She is also on strong pain relief medication for her arthritis. She is not supposed to drink alcohol whilst taking this medication.

Whilst attending a live gig Angela asks her support worker to purchase a beer for her. The support worker refuses and Angela is angry as she regards this as her choice. Later, the support worker and Angela use the Code of Practice for Social Care Workers, and in particular point 4:

 "As a social care worker, you must respect the rights of service users whilst seeking to ensure that their behaviour does not harm themselves or other people", to discuss their different perspectives.

Do you agree with the way this situation was handled? Have you experience of a similar situation, what did you do?

Code of Practice 3: As a social care worker, you must promote the independence of service users while protecting them as far as possible from danger or harm.

So, here are the details of what that means and a case study that shows how it can work in practice:

1. promoting the independence of service users and assisting  them to understand and exercise their rights;
2. using established processes and procedures to challenge and report dangerous, abusive, discriminatory or exploitative behaviour and practice;
3. following practice and procedure designed to keep you and other people safe from violent and abusive behaviour at work;
4. brining to the attention of your employer or the appropriate authority resource or operational difficulties that might get in the way of delivery of safe care;
5. informing your employer or an appropriate authority where the practice of colleagues may be unsafe or adversely affecting standards of care;
6. complying with employers health and safety policies including those relating to substance abuse;
7. helping service users and carers to make complaints, taking complaints seriously and responding to them or passing them to the appropriate person; and,
8. recognising and using responsibly the power that comes from your work with service users and carers

CASE STUDY

Ann is a home care assistant working with older people with dementia. Ann noticed that one of her clients, Mr Hughes, may not be eating properly; he is leaving his meals and drinks half finished.

Ann is concerned that her current work rota means she is not able to give Mr Hughes sufficient time and encouragement at meal times, even though this support is included in the Care Plan.

Ann reports these concerns to her line manager and they agree changes to Ann’s schedule which will allow her to spend sufficient time with Mr Hughes, in particular over the lunch time period.

Also, arrangements are made to monitor the situation in case Mr Hughes’ needs are changing. In discussing concerns with her manager, Ann  was able to draw on point 3.4 of the Code of Practice for Social Care Workers: “bringing to the attention of your employer or the appropriate

authority resource or operational difficulties that might get in the way of the safe delivery of care”.

In responding to Ann’s concerns, her employer draws on point 2.3 of the Code of Practice for Employers of Social Care Workers, “having systems in place to enable social care workers to report inadequate resources or operational  difficulties which might impede the delivery of safe care and working with them and relevant authorities to address those issues”.

Would the code help you in a similar way?

Dare2Care Wales – who are we and how can we help you?

We’ve been asking our Facebook fans, blog readers and Twitter followers to tell us about their experience of care and social work, so we thought it was about time we told you about us!

We want to give Welsh care workers a chance to use websites like Facebook and Twitter to learn more about the industry and share experiences.

Our Dare2CareWales project is a joint initiative across the four Regional Social Care Partnerships in Wales and aims to promote the Care Council for Wales Code of Practice for Care Workers & Employers and get feedback on how the code reflects their day-to-day work. The project also aims to hear about the experiences of carers and those who receive care.

Penny Copner, Social Care Partnership Co-ordinator at Monmouthshire County Council, is one of the team who talks to care workers on Facebook and Twitter.

She said:

“We really want to hear real life issues that affect those who work in and receive care.

“The Care Council for Wales identified an opportunity to use social media to engage with the social care workforce and help with their need to understand their responsibilities.

“Our team is working together, using social media to give us an opportunity to talk to people in places they already visit.  People will be able to contact us conveniently and we’ve tried to make information informal and relevant. 

“We are really looking forward to hearing the views and experiences of those dedicated people who work so hard to care for people in Wales and from the people who they work with.

“We hope anyone with an interest in care will comment on our blog so we can give the Care Council for Wales some real life stories and data that they can use to inform their work.  Also, by sharing experiences we hope that we can all learn from each other and be able to offer each other advice.

"We believe care should be safe, it should show dignity and respect and quality care should be given."

The project is a joint initiative between the four Regional Social Care Partnerships in Wales and has been funded by the Care Council for Wales and is managed and moderated by the Partnership Co-ordinators (Jane Guest (Mid Wales), Annie O’Reilly (SW Wales), Penny Copner (SE Wales), Clare Hughes (NW) and Helen Reynolds the Communications Officer at Monmouthshire County Council.

Please don't be shy - tell us what you think or ask us a question!

TWITTER http://www.twitter.com/dare2carewales

FACEBOOK http://on.fb.me/aZpWoS

Code of Practice 2 : As a social care worker, you must strive to establish and maintain the trust and confidence of service users and carers.

The second code means:

1. being honest and trustworthy;
2. communicating in an appropriate, open, accurate and straight forward way;
3. respecting confidential information and clearly explaining agency policies and confidentiality to service users and carers;
4. being reliable and dependable;
5. honouring work commitments, agreements and arrangements and when it is not possible to do so, explaining why to service users and carers;
6. declaring issues that might create conflicts of interest and making sure that they do not influence your judgement or practice; and,
7. adhering to policies and procedures about accepting gifts and money from service users and carers

　

Here's a case study that illustrates how important these principles can be in practice:

　

Mr Phillips is 24 and attends a work opportunities scheme for people with a learning disability. The work helps Mr Phillips to learn new skills and to use them to do his job.

He works as part of a team and has made new friends, he enjoys the camaraderie of the work environment and during the days he works the team rely on him to perform specific tasks.

His main carer is his mother and on the days he's at his work placement his mum makes arrangements to engage in activities she can't usually commit to because of her caring responsibilities.

On three occasions in the last month, Mr Phillips’ support worker has failed to arrive on time to take him to his work placement at a local supermarket. This meant that. Mr Phillips was disappointed and he felt he had left his colleagues down.  Also his mother had to cancel the arrangements that she had made.

　

Do you think that the carer may have breached some of these codes?

In your experience, do things like this happen often? If you had been Mr Phillip’s social care worker and you knew that you were going to be late picking him for his work placement – how would you deal with the situation?