Be Inspired! Shirley Ayres Consulting

I feel privileged that through my blog I have connected with people from all walks of life across the world. I have had great conversations and been asked many challenging questions.  My thanks to everyone who has shared their thoughts and inspirations with me this year and contributed guest posts.  I will continue to provide an independent voice promoting excellence in social care and children’s services in 2011. With the urgent need for closer working between health and care I am pleased to share the thoughts of a student nurse on #demo2010.

“I have never felt moved to write an article about anything before but watching the recent developments with the student protests I felt the overwhelming need to write something more than the 140 characters that twitter allows.

I am a student, but before you back away in fear I would like to point out that I am not a “normal” student. I am a student nurse. I tweet under the guise of @justa2ndyear, though that is a relatively new venture for me.

As a student nurse I differ from other students in many ways, like my colleagues in social work; teaching or medicine, I have a longer academic year but I also (whispers) have my tuition fee’s paid for me AND I receive a bursary. Not that the bursary comes close to covering the cost of living for myself, my husband and my 2 children. In fact I also do regular night shifts and frequently will do the required 30 hours on placement (earning the equivalent of  £4.29per hour from NHS Bursaries) and then between 12-36 hours night shift work too. This is before I even attempt the academic work or spend time with my family.

Admittedly, I am probably viewed as a bit of a “tuition fee anti-Christ”, I do not have to worry about finding £3,375 a year to fund my studies, let alone the £9,000 proposed by the current government. The reason I support the protests is not for me but for my son. He is 12 and that means in 6 years he will be university age.

Unfortunately for him I am training to be a nurse in a country that has yet to value its key workers. Where bankers and footballers earn more in a week than nurses and teachers do in a year. This means that if i’m very lucky, when he goes to university in 6 years, I may be earning £34,189 (that is if i reach the top of band 6 – which is highly unlikely given the current spending freeze within the NHS), so best case scenario means that his tuition fee’s will equal 26% of my gross annual wage. The more likely scenario is that I will be middle of band 5, earning about £24, 554 which would mean paying about 36% on tuition fee’s. Lets hope those lottery numbers come up soon.

I come from a family where education is highly valued. Higher education was, for both of my parents, a privilege gained through hard work rather than money. I hope I have instilled in my son the same sense of drive and ambition that my parents gave me. The belief that if you work hard you can achieve. I would hate to have to tell my son that despite his hard work (he is currently fourth overall in his year) I cannot afford to send him to university.

It is for this reason that I fully support the actions of many students, including those who were in occupation at University College London (who can be followed on twitter @ucloccupation). I firmly believe we have a right to protest against issues we believe are wrong. If we didn’t it would all be a bit too Orwell ’1984′ for my liking.

However, I watched in horror the coverage of the protests and the actions of a few that have tainted the message of so many. I appreciate that the media present the story in a way that will maximise sales and that one must take a balanced view of what is reported. However, sometimes you just cant argue with the evidence.

The photograph of David Gilmour’s (of Pink Floyd fame) son Charlie swinging from the Cenotaph on a union jack sealed the deal in terms of the nations feelings towards the students cause. And thats without even mentioning all the other vandalism and destruction that was caused, all in the name of a “demonstration”.

What upsets me the most with all this is the total lack of thought demonstrated by these young people. I’m sure it didn’t even cross their minds that some of the people named on that memorial were the same age, if not younger, than they were when they died fighting for the freedom they so easily abused. 

I believe education should be available for those who work hard and are capable of achieving, not just those who can afford it. However, in a time of economic crisis when cuts have to be made, should we even be considering offering any support to those who feel that violence and destruction is an appropriate way to behave?”

Tags: #demo2010, education and training, student nurse, student protests

Related Posts:

• Should dementia training be compulsory for all staff in adult social care?
• Can Gerry Robinson fix Dementia Care Homes?

Watching the second part of “Can Gerry Robinson fix Dementia Care Homes?” it was painful to acknowledge the vulnerability of people with dementia.  This was balanced by the visionary leadership shown by Anne Fretwell and the commitment of the staff at Merevale House. The home has an inspiring focus on person-centred dementia care and a passion for empowering residents by providing opportunities to live their lives with meaning, dignity and respect.  (photo credit Merevale House)

The issue of inspired and passionate leadership is a challenge for the whole of the care sector. There is an urgent need to develop strategic performance management systems which will drive quality and improve care services. A very clear message from the programme is the importance of education and training for staff. Fortunately there are an increasing number of  accessible and free specialist training resources and my previous post identified a number of online resources. I would also recommend the innovative Social care TV dementia videos

Dr Carol Komaromy, a senior lecturer in health studies and one of the Open University academic advisors to the programme, writes: “People who live in care homes for older people are often hidden from the public view. Coping with the complex care demands of people with dementia requires a high level of skill and compassion and yet carers are often underpaid and the value of what they do remains unrecognised. The programme highlights the need for specialist training and the difference this can make to the experience of living with dementia. It is a sad indictment of society that providing care resources for people with dementia seems to have a low level of priority. More than this, as the series shows, there is so much more that could be done even within limited resources.
“I would argue that a culture of care would need to support paid carers in a direct engagement with the needs of people with dementia and recognise that they are also people with diverse emotional needs who need to feel supported and valued. While it is clearly the case that protocols and resources need to be in place for this to happen, homes need to shift to a culture of care that places people with dementia at the centre. A key element in making this happen is education and training.”
The Open University has produced a free leaflet, Dementia Care: Sustaining The Person Within, to accompany the programmes. It lists the help and support available when making decisions affecting the care of people with dementia and can be ordered through the following link 

The Commission for Social Care Inspection provided the first public benchmark for quality in care homes in what had been a largely unregulated sector. I hope that the Care Quality Commission (CQC) recognises the important role of the care homes inspectorate and provides the resources to strengthen their role and extend their remit. Since staff are the biggest cost and the most vulnerable to cutbacks is it time for a review of the CQC regulatory requirements for staffing and qualifications? An equally urgent question is whether local authorities should refuse to place residents in dementia homes rated as “poor or adequate by the CQC.

In this digital age I believe that all care homes should have internet access for resident and staff. The SCIE get connected investment project for adult social care is distributing £12 million to registered providers of adult social care in England to assist them with their information, communications and technology. They will focus on providers who do not have good access to the internet. The initiative is to allow those who use, visit or work in adult social care services to benefit from the learning, knowledge and access that the internet can bring.

In the next 20 years over a million of us will have dementia, we need a serious debate about our expectations and aspirations for the care which will be provided to one of the most vulnerable groups in society. 

Part Two of “Can Gerry Robinson fix Dementia Care Homes?”  can be seen on BBC iplayer 

Telling Tales About Dementia – Experiences of Caring which is edited by Lucy Whitman explores how it feels when someone clsoe develops dementia? How do you cope with the shock, the stress and the grief? Can you be sure that you and your family will receive the support you need? In Telling Tales About Dementia, thirty carers from different backgrounds and in different circumstances share their experiences of caring for a parent, partner or friend with dementia. They speak from the heart about love and loss: ‘I still find it hard to believe that Alzheimer’s has happened to us,’ writes one contributor, ‘as if we were sent the wrong script.’ The stories told here vividly reflect the tragedy of dementia, the gravity of loss, and instances of unsatisfactory diagnosis, treatment and care. But they contain hope and optimism too: clear indications that the quality of people’s lives can be enhanced by sensitive support services, by improved understanding of the impact of dementia, by recognising the importance of valuing us all as human beings, and by embracing and sustaining the connections between us.

Tags: alzheimer's disease, be inspired, dementia, education and training, families, Leadership and Management, older people, social care, vulnerable adults

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A very timely BBC 2 documentary in which businessman Gerry Robinson explores what can be done to help improve services within care homes dedicated to looking after people with dementia.  I have always found Gerry Robinson’s  approach thoughtful and probing and I am delighted he is exploring an area of care which both requires and deserves more scrutiny. If you work in this area or are faced with making a decision about finding care for a person with dementia I recommend that you watch this programme which is available for the next seven days on BBC iplayer.

The Alzheimer’s Society states that ‘In less than two generations one in three of us will either have dementia ourselves or be related to, or caring for, a person with dementia.’ The significance of this statistic and the implications for society require a transformation of perceptions and strategies. One of the biggest challenges facing society today is the funding and care of older people, a growing number of whom will have dementia. 

“We are in the dark ages of dementia care”, “Keeping people alive rather than helping them to live”, “dementia farms” and “granny warehousing” some of the terms used in the programme to describe current provision. Shameful comments about how we treat some of the most vulnerable people in society but does it have to be like this? One of the major challenges with ¼ million people in dementia care homes is that they are mostly paid for out of public funds but run by private companies. 

Should we be shocked that anyone can buy a care home provided they have the money, do not have a criminal record and can demonstrate that they are suitable to be a “registered person” with the Care Quality Commission?  Yes the services are regulated but there are no minimum standards in terms of the specialist dementia knowledge and skills required. It would appear that homes are judged on their capacity to manage risk rather than the fundamentals of care which can leave residents spending hours just staring at the walls.

“Life could be so much better” is the conclusion from the first programme. It is not that complicated to make a difference: staff who feel valued and have additional training in understanding dementia, one to one contact and encouraging the involvement of family and friends and involving residents in the running of the home all create a more positive and rich experience. 

When my mother had dementia we were fortunate in finding an excellent home. I would have no hesitation in recommending Lakeside Nursing Home  SE19 2DR. The manager is passionate about ensuring that dignity and respect underpin the quality of care provided. The ethos of the home centres on the recognition of the individuality of the resident and the importance of actively involving friends and families.

When looking for a residential care home I always advise people to start by reading the latest report and quality ratings from the Care Quality Commission which provides a number of useful indicators. There is a big question about whether any of us would want to place a vulnerable person in a dementia home with a rating of poor or adequate and should local authorities even be suggesting this as an option?
  
The Social Care Institute for Excellence has an excellent online resource in the Dementia Gateway if you work with people with dementia in nursing, residential or domiciliary settings. There are lots of practical tips, tools and activities in the sections below that will help you with your daily work. Each section has been written by a national dementia expert so you can be sure the information and guidance is up to date and reflects what we know about best practices in dementia care. Another section lists Useful Dementia Resources where you can find out more about dementia, research studies, reports and policies, resources for people with dementia, carers and professionals

What training is provided for staff is an important question to ask when considering a dementia care home placement. Encouragingly there are a lot of training programmes available to address the skills and knowledge gaps identified by Gerry Robinson.

The Open Dementia e-Learning Programme is aimed at anyone who comes into contact with someone with dementia and provides a general introduction to the disease and the experience of living with dementia. This programme is designed to be accessible to a wide audience and to make learning as enjoyable as possible and so allows users to fully interact with the content and includes video, audio and graphics to make the content come alive. In particular the programme includes a considerable amount of new video footage shot by both the Alzheimer’s Society and SCIE where people with dementia and their carers share their views and feelings on camera.

Skills for Care have developed a Knowledge Set for Dementia Care. Knowledge sets provide key learning outcomes for specific areas of work within adult social care. They are designed to improve consistency in the underpinning knowledge learnt by the adult social care workforce in England. In addition to the knowledge set documents, staff can download a ‘progress log’. Both documents are freely downloadable at  Skills for Care. The progress log will be required for each individual worker/learner for each knowledge set. Individuals can keep copies of their progress logs showing their ‘signed off’ progress for their NVQ portfolios.

The Alzheimer’s Society provide factsheets which cover a wide range of dementia-related topics. The online sheets can be saved as a PDF or emailed to a friend.

The Open University has produced a free leaflet, Dementia Care: Sustaining The Person Within, to accompany the programmes. It lists the help and support available when making decisions affecting the care of people with dementia. Centred on the life story of one woman with dementia, the leaflet explores challenges and opportunities for good practice, from a diverse range of perspectives of people involved in dementia care. The aim of the booklet is to encourage people to ask: What is good quality dementia care? How can it be provided? What resources are needed? What organisational cultures are needed to achieve this type of care?

I have always believed that how we care for the most vulnerable members is the mark of a civilised society.  It is in all of our interests to ask questions and challenge poor and inadequate care services on both a personal and a professional level. I would like to see exemplars of best practice promoted and published by the Department of Health. This would establish a benchmark of what we should be aspiring to now and in the future. Public funding is an important consideration but is it the only critical factor in delivering quality care? Research which explores the link between costs and quality care would be a useful starting point.

What will it take to sort out our care homes? An interview with Gerry Robinson in the Daily Telegraph

Tags: alzheimer's society, BBC documentary, care quality commission, dementia care, education and training, encouraging innovation, free on line learning, Gerry Robinson, leadership, mental health, residential care, safeguarding adults, scie, skills for care, Social Work, vulnerable people

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