Monthly Archives: June 2021

Double down on “double ups” –maximise choice, control and moving with dignity by Ritchie Maxwell

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Double down on “double ups” –maximise choice, control and moving with dignity 

Ritchie Maxwell, Manual Handling Advisor 

Following on from the Delayed Discharge Performance (DDP) report from the IJB in May 2019 the impact of how we provide moving and handling support was a demonstrable delay factor. Waiting for ‘Double ups’ (2 staff to move and handle) generated delays for home care packages, placement or return to a care home and impacted on what mattered to people to live not exist.   Our beliefs, our historical practice, to default to requiring 2 people to safely move and handle a person were having a significant impact on NHS D&G’s ability to discharge people safely and efficiently. It was recognised from national publications that across Allied Health Professionals, Nursing and Carer workforce that staff felt ill equipped or trained to carry out assessments to reduce 2 carers to 1 or include informal carers in moving and handling (Harrison, 2020). The DDP report noted that delays were significantly higher for people requiring Care at Home ‘double up ‘packages. This prompted an idea for Sustainability and Modernisation programme (SAM).   

SAM idea94 – ‘FAIR’ Care 

To work with the integrated health and social care (H&SC) team and partner agencies/organisations to review the approach taken for people who currently require assistance involving 2 Carers. This would involve a change of mindset from the conventional starting point of 2 people through joint risk assessments.   The ‘default 2 staff approach’ requires change to assess if one Carer, and the appropriate equipment, could improve the person’s experience and meet their needs. This could support timely discharge, availability of carers and demonstrate best use of resources.  An approach already successfully tested in England. 

Why modernise? 

Moving and Handling equipment has continued to evolve with new ways of working through Assistive and Inclusive (AIT) practice.  Single Handed care involves the use of specific pieces of equipment to safely assist an individual to transfer with one person (following a robust risk assessment) rather than two.  Locally this is referred to as FAIR (flexible, achievable, individualised and risk assessed) care which: 

  • Enables and empowers a ‘Moving with Dignity’ approach and ethos to ensure safe moving and handling, comfort, dignity and respect. 
  • Supports increased flexibility with one person whilst improving staff resources to increase caring capacity 
  • Promotes positive experiences for people of inclusion, quality and confidence to maintain as much independence as possible, moving with dignity and participation  
  • Can identify where a safe reduction in care is possible whilst positively impacting on a person’s health and well-being outcomes and minimising costs 

How sustainable? 

In turn, staff providing care can support more people whilst assuring the quality of care they provide. Evidence shows, if single handed care is carried out in the right manner it can better meet 40% of people’s needs. Investing in the right equipment has been shown to be cost effective in the long run and can help moving with dignity less complicated and time consuming than double handed care.  FAIR care equipment includes but is not limited to: 

  • Stand Assist, Stand Aid Compact 
  • Positioning wedge  
  • Repositioning system  
  • Easy glide board   
  • Twin Turner(sling)  
  • Gantry portable hoist   
  • Comfort turn mattress  
  • in bed patient turning system   
  • RotoFlex Chair/Bed  

A FAIR Start 

A working group was formed in Jan 2020 involving members of the multi-disciplinary team including health and social care (H&SC) services.  This was underpinned by previous excellent evidence-based work across H&SC including partnership work across paediatric Occupational Therapy, Social Work Occupational Therapy and Social Workers.  This led to tests of change aiming to: 

  • Explain FAIR and undertake risk assessments for each client to ensure their safety, needs and choices as well as that of the family and carers were understood 
  • Underpin reviews with enablement approach to maximise participation and independence 
  • Improve the capacity of care providers to meet current demand 
  • Ensure staff understood and felt supported with robust training as part of mandatory updates and dispel the myth that ‘specialised’ courses were required 
  • Reduce patient waiting time for moving with dignity needs within their own homes 
  • Review current equipment provision to ensure it was appropriate and contemporary for patients needs 
  • Identify cost saving benefits 

FAIR Progress 

Since March 2021 we have started to roll out FAIR care training to all staff within NHS Dumfries and Galloway.  Integrated within our moving and handling training.  We are initially working with local authority in-house Care at Home (CASS), Care providers and Short Term Rehab (STARS) to ensure our shared aims are met across rehabilitation, support and care – to double down on double ups.  Let’s embrace flexible, achievable, individualised and risk assessed (FAIR) approaches to moving with dignity.  Lets support people to maximise their independence.  

Ritchie Maxwell is a Manual Handling Advisor for NHS Dumfries and Galloway and can be contacted at  Ritchie.Maxwell@nhs.scot  

CARERS WEEK 2021 – MAKING CARING VISIBLE AND VALUED by Clark Adams

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This week is Carers Week (7th – 13th June 2021). Carers Week is an annual awareness campaign that celebrates and recognises the vital role of unpaid Carers across the UK.

The theme for Carers Week 2021 is ‘Making Caring Visible and Valued’.

You may have seen this film which was featured on BBC Breakfast earlier this week. It is a powerful illustration of the importance of Carers and highlights the particular challenges that they have faced during the pandemic: https://youtu.be/GOJligcFdEc

A Carer is someone who provides unpaid care and support to a family member or friend who has a disability, mental or physical illness, substance misuse issue, or who needs extra help as they grow older.

For some, taking on a caring role can be sudden: someone in your family has an accident or your child is born with a disability. For others, caring responsibilities can grow gradually over time: your parents can’t manage on their own any longer or your partner’s mental or physical health gradually worsens.

The amount and type of support that carers provide varies considerably. It can range from a few hours a week, such as picking up prescriptions and preparing meals, to providing emotional support or personal care day and night.

Caring will touch each and every one of us in our lifetime, whether we become a Carer or need care ourselves. Whilst caring can be a rewarding experience, it can also have a huge impact on a person’s health, finances and relationships.

Did you know that there are approximately 15,000 Carers in Dumfries and Galloway who provide at least 410,000 hours of care and support each week?  This is more than the care and support provided by the NHS and Council combined. Without this army of unpaid Carers the rest of the health and social care system would simply not be able to function.

We know that the Covid-19 pandemic has disproportionally affected Carers across the UK. Helen Walker, Chief Executive of Carers UK, has reflected:

“Throughout the COVID-19 pandemic unpaid Carers have played an essential role supporting older, disabled and seriously ill relatives and friends, doing so most of the year on their own behind closed doors. They have forgone breaks from caring and much of the support they would normally have relied on.

“As restrictions ease it is vital that we acknowledge the enormous contribution that unpaid carers continue to make day in day out. I am delighted that many individuals and organisations are getting involved with virtual activities, helping Carers to connect to others and access advice and information locally. 

“Looking after someone can be a hugely rewarding experience, but it sometimes comes with difficulties, including getting the right support. This Carers Week I hope all parts of the community – family and friends, employers, businesses, schools, health and care services – do their bit to make caring visible and show it is valued.”

Making unpaid Carers more visible and valued is something that we can all help to do something about.

The Independent Review of Adult Social Care in Scotland, published in February 2021, reflected the reality of the lived experience for many Carers in Scotland.

“Carers feel invisible, that they are just left to “get on with it” and that no one cares or appreciates them…. now is the time to act and make carers count, treated as equal partners in care with professionals.”

In our daily working lives, there are opportunities to recognise Carers as fellow Health and Social Care colleagues. Here are five easy things you can do to help make unpaid Carers more visible and valued.

  1. Ask someone if they are a Carer.
  2. Say ‘thank you’ for their hard work in their caring role.
  3. Ask some questions about their caring role – do they feel they have a good balance between their caring role and other things in their life? Do they feel supported to continue with their caring role?
  4. If you consider that they would benefit from some advice and support, signpost them to the Dumfries and Galloway Carers Centre.
  5. For more information on how best to support Carers, look at the Carer Awareness Training module called ‘Equal Partners in Care (EpiC) available on the TURAS e-learning site or contact me – Clark Adams, Carer Facilitator at Clark.Adams2@nhs.scot

The Dumfries and Galloway Carers Centre can be contacted in various ways. You can call 01387 248600 between 10.00am and 3.00pm or leave a message if outside these times. The Carers Centre can also be contacted by email at info@dgalcarers.org.

For more information you can visit their website at www.dgalcarers.org

This Carers Week, we should all take a moment to reflect on the significant contribution that Carers make across Dumfries and Galloway and how we can play a part in helping to make our unpaid Carer colleagues across Dumfries and Galloway feel more visible and valued.

If you are a Carer, thank you. Most of us will know someone who is a Carer. Please take a moment today to get in touch with them and thank them for all their hard work and dedication to their caring role. The change to make Carers more visible and valued starts with each and every one of us.

Clark Adams is a Carer Facilitator based at Dumfries and Galloway Royal Infirmary

Keep the conversation going….by Liz Forsyth

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To improve people’s wellbeing outcomes and meet the challenge of sustaining health and social care and support into the future, the Dumfries and Galloway Integration Joint Board (IJB) is developing their next Strategic Commissioning Plan (SCP) 2022 – 2025.

The SCP is being created by engaging with and involving as many local people as possible, including people who deliver and access health and social care and support across Dumfries and Galloway, and using their feedback to shape the document.

The Draft SCP, currently out for consultation, sets out the IJB’s

  • vision for health and social care in Dumfries and Galloway
  • overarching model of health and social care and support
  • strategic commissioning intentions (SCIs)
  • tactical priorities that sit below each of the SCIs
  • key, high level actions to address the tactical priorities
  • enablers that will help deliver the SCP
  • risks, challenges and barriers 

Below is the ‘Plan on a Page’ overview of the SCP

To join the conversation and help shape the future of health and social care and support you can

Share your thoughts and views with us through any of the ways shown below

Due to Covid-19 precautions, paper copies of the Draft SCP and Easy Read Draft SCP are only available on request and all engagement sessions will be undertaken online.

Engagement sessions are taking place on MSTeams on the dates shown below. Please contact us to register or request a presentation for your group or meeting or a chat about the Draft SCP with one of the team on an alternative date or time.

 

The closing date for comments on the Draft SCP is 15 August 2021

The closing date for comments on the Easy Read Draft SCP is 29 August 2021

Liz Forsyth is Strategic Programme Manager with the Strategic, Commissioning and Performance Team at NHS Dumfries and Galloway