Residential, Nursing & Care Newsletter Spring Edition

Residential, Nursing & Care Newsletter Spring 2018 Care Home Newsletter

has been healthcare the 1950’s. en Awards.

March 2018

DOCUMENTATION Could your staff end up in court?

SINGLE HANDED CARE Can you make it work in your home?

CONTINENCE ISSUES Clinical and practical support

DONKEYS TO INNOVATORS What's this about?

Charity number: 224742

Welcome to our May newsletter Welcome to Disabled Living’s first e-newsletter dedicated to the Residential, Nursing and Care home sector.

Disabled Living is a charity providing information and advice about equipment and services. With a team of health and social care professionals – occupational therapists, nurses, physiotherapists, continence specialist, moving and handling advisors and knowledgeable information coordinators we can offer practical solutions to enhance the quality of life of the people you care for.

Disabled Living, have for many years disseminated a generic monthly newsletter to over 70,000 people.

However, our colleagues working in the care environment requested a newsletter with information specifically tailored to them and we are only happy to oblige. The newsletter will be sent quarterly.

Regular features of the newsletters will include: a focus on a current and relevant topic for care homes and we will always have an equipment special with new equipment for you to browse. Continence corner will give you tips and information about continence issues in care homes. The OT Guru will have tips and ideas you may want or need in your home. And our latest training courses will be offered. Ring us if you want to shout about anything at all on: 0161 607 8200 and we will try to get you in the next issue.

Deborah Bell, Enablement Team Manager

Explore our key features

Disabled Living's services............................................................................................................4 Can You Adopt Single Handed Care in Your Care Home?.........................................................6 Pyjama Paralysis........................................................................................................................12 Product News.............................................................................................................................16 The OT Guru..............................................................................................................................18 From Donkeys to Innovators......................................................................................................20 New Workshop for Health & Social Care professionals ‘In the Dock’ – What to expect if you are called to give evidence...................................................................................................22 Continence Corner......................................................................................................................24 Kath's experience working on a NICE Guideline.........................................................................27

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Disabled Living Services Disabled Living is a charity which provides impartial information and advice about products, equipment (assistive technology) and services for disabled children, adults, older people, carers and the professionals who support them. We have a range of services which you can access via our helpline, through the website or at our Kidz to Adultz Exhibitions.

Equipz The team comprise occupational therapists, trusted assessors, moving and handling specialists, physiotherapists, nurses, continence specialists who together with knowledgeable information co-ordinators offer practical solutions to what may seem like unmanageable problems. The staff, respond to enquiries throughout the UK, primarily via our helpline and website, with some people opting to make an appointment to visit the Disabled Living Centre based in Manchester for a free equipment assessment.

Helpline: 0161 607 8200 Bladder and Bowel UK The team provide information and advice for children, young people and adults with Bladder and Bowel problems. We provide a confidential helpline managed by a team of specialist nurses and knowledgeable information staff. In addition, the website offers a wide range of downloadable free resources.

Helpline: 0161 607 8219 Kidz to Adultz Exhibitions Disabled Living organise the largest FREE UK exhibitions totally dedicated to disabled children, young adults, their families, carers and the professionals who support them. With over 100 exhibitors at each event, offering a ’One Stop Shop’ for equipment products and services to enhance the quality of life. We deliver 5 events throughout the UK in: Farnborough, Bristol, Coventry, Manchester and Edinburgh.

Training Disabled Living provides a comprehensive training programme for professionals and carers. Most of our courses are accredited by Open Awards and others provide CPD opportunities. Our training courses can be ‘tailor made’ to suit your organisations requirements and can be delivered throughout the UK for more detailed information on the courses we provide please visit the Disabled Living website.

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Disabled Living hold regular tea dances for people with dementia and their carers

Disabled Living Host 1950's Tea Dance and Jive The Afternoon Away This was the second tea dance that we have hosted since July and we are pleased to say it was another enjoyable day for all. We were joined by our wonderful volunteers from the League of Jewish Women, guests from Future Directions (service users at Redbank House’s multi-sensory rooms), tenants from Bourke Gardens, and other people with dementia and their carers.

The room was full of 1950’s decor including neon food and drink signs, a diner girl and chequered pattern wall, small plastic vinyl discs hanging from the ceiling and much more. Once again, we provided our guests with lots of sandwiches, cake, tea, coffee, and juice. This must be where they got their energy from to sing and dance away!

We're absolutely delighted to have received a lot of positive feedback on the event Diane Knowles: "Thank you so much for yesterday we had a wonderful time. You all go to so much trouble to make it lovely for us all. The pictures are great and I will show dad them to help him remember.

Many thanks, to you all."

Jacqui Woodall: "I wanted to thank you and staff/volunteers for a fabulous afternoon and for making us feel so welcome! Myself and our customers really enjoyed ourselves. Your hospitality was second to none and the entertainment girls were brilliant too."

Disabled Living were proud to kick start celebrations for 120 years in 2017 with our 1940's tea dance.

We look forward to arranging our 1960's themed tea dance.

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Can You Adopt Single Handed Care in Your Care Home?

Would your staff really embrace Single Handed Care?

Could you answer all their objections by the time you have finished reading this article?

Single Handed Care is being bandied about like a new hot topic. Everybody is looking to save money and thinking this may be the best way to go. Are you? Bringing about change is never easy and introducing single handed care is no exception.

What is Single Handed Care?

Quite simply it's the practice of one person delivering care to the client as opposed to double handed care which is two people. It's not rocket science and it's not new. I'm sure there are more than a few people reading this who will agree we have been looking after people on our own forever. So what's new?

More pressure at work, less staff available, and ageing population. So there are more clients to look after to name but a few.

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Why do we need Single Handed Care in Nursing / Care Homes?

The answer to this can be found in just a few of the features and benefits of single handed care: Families and clients can build trust with one person, bonding improves, everyone more relaxed, and clients feel less invaded. This all leads to fewer complaints.

As a manager you could be more efficient with time, money and effort, and free up staff to care for more people.

Confident, well trained employees, who feel

valued, are less likely to leave their job.

Your good reputation improves even more which leads to more work.

Your staff would be able to develop great bonds with the client, leads to better risk assessments, better compliance, preventative measures more likely to have an effect.

At Disabled Living we can help you to understand and articulate your responses to common objections.

We can help to train you and your staff how to be safe and innovative at the same time.

So, let's take a look at some objections and how you could approach them: Objections

What you would say

It's unsafe to hoist with one person.

There is no evidence to say it is less safe.

Training will empower staff and give the necessary skills and confidence and using the correct equipment will reassure your client and families.

I'm not trained to do Single Handed Care.

You can attend a train the trainer course, so you can teach your staff or outsource the training to a reputable company. Support will be ongoing to keep current and relevant, work with our equipment reps or trainers o keep abreast of new developments.

I don't know how to risk assess for Single Handed Care.

It's not necessarily more complex, if you understand the process and use your whole team, we do not work alone. You can involves physios, occupational therapists, moving and handling advisors, equipment reps and colleagues.

The client might be scared the staff don't know how to do it by themselves, if they are used to two carers they may become upset.

Effective communication will help; talking about your client getting more focused one to one attention. Using effective staff rosters with the same carers allocated will help.

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I might get injured if I'm by myself.

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There is no evidence to back this up. Also, will become more aware of and own the manoeuvres so less likely to make poor decisions when relying on another person. There is evidence some equipment is easier to use so reducing risk of injury (see further reading).

It will take longer to look after my client if I am by myself, what about my other work?

It will take longer but there will then be more staff available to do other tasks.

I refuse to do it, I will leave.

There is no evidence to back this up. Also, will become more aware of and own the manoeuvres so less likely to make poor decisions when relying on another person. There is evidence some equipment is easier to use so reducing risk of injury (see further reading).

Our client's behaviour is too challenging.

This will form part of the risk assessments of course but one carer may form a very trusting bond. Your client may feel less threatened, with continuity of care could lead to less distressed behaviour.

How will I physically do the manoeuvres, for example put in a sling and keep someone on their side whilst I do personal care?

This all down to technique which you can learn and having the correct equipment.

How can we carry out Single Handed Care for plus size people when it normally takes 3 or 4 carers?

Good risk assessment, the correct equipment and training.

I don't have enough experience, I'm new to care.

Good risk assessment involves the staff, proper induction, and mentoring/supervision. A novice would never be working alone until competent.

Ideal time to train correctly.

If there is only one person in the room how will any bad practice be picked up?

It won't pick up bad practice but regular efficient training and updates will encourage good standards. All good homes will have their own safe systems to check care which will still be used e.g. spot checks.

I am scared I will miss things if I am working alone

When working alone a person is often more alert and more careful as they double check themselves. By not relying on each other to double check everything risk may be decreased.

It will increase complaints and safeguarding, we will be more liable.

There is no effective increase in complaints if there is effective communication with everyone involved.

It's against our policy to hoist with one person. It's illegal, I won't be insured.

There is no legal requirement for two people to be present when hoisting. The number needed comes from a good risk assessment. Is it possible to review and change your policy? Can you check the exact wording of your insurance policy. It will probably not mention numbers used to hoist if risk assessment doesn't deem it necessary.

Of course, Single Handed Care is not suitable for everyone. As I have mentioned several times, a good risk assessment is essential and will be the system used to determine where it is an option to be considered.

At Disabled Living we have a training team that is delivering some excellent courses to help you and your staff work the best way you can. I know we will be able to work together to develop the skills in your organisation that will benefit your clients, your staff and your business.

I would like to acknowledge and thank Deborah Harrison for creating Manual Handling: Train the Trainer and Risk Assessor course in Single Handed Care which via Disabled Living, can be delivered in your workplace along with general moving and handling people using Single Handed Care techniques. We can also help with specific risk assessments of your clients.

Please call me to discuss how we can help on 0161 607 8200.

Further reading Forster K. (2017) One in three UK nursing homes failing safety checks, inspections find - available here. Accessed 05/02/18.

Department of Health, Safety and Social Care (2015) Care Standards for Nursing Homes - available here. Accessed 04/02/18.

RCN (2010) Guidance on safe nurse staffing levels in the UK - available here. Accessed 04/02/18.

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Product Focus In each issue we will be introducing a new piece of equipment which you may not be familiar with. This equipment has been demonstrated at our equipment centre.

The Turna by Accora What is the Turna?

Turna, as an in-bed patient turner, is a unique combination of a powered turning sheet and two bed rails. The system is controlled using a handset which rotates one roller at a time, causing the sheet to turn the person lying on it.

This reduces the strain of turning a person as it is no longer just a manual task but a task that is controlled at the press of a button.

Turna Benefits 1. Increase service user dignity and comfort when being turned 2. Enables one carer to turn a service user in bed 3. Reduce the physical effort and strain for carers How is incontinence managed?

For incontinent users, we recommend placing an incontinence sheet under the patient. This will reduce the need to change the turning sheet so regularly. If soiled, the turning sheet will need to be changed just like a normal bed sheet.

Make sure the incontinence sheet is not rolled on to the Turna rolls.

Can you move the patient up the bed as well?

Yes. With the Turna you can move someone up the bed – although it may 10

take a few times to get used to the method.

What is the weight limit of the system?

31 stone / 200kg When turning is there a risk of sheer on the patient’s heels?

If you are concerned about the risk of sheer when turning on the patient’s malleolus and/or heels we recommend slipping in a slide sheet under the patient feet. However, the risk of sheer is very minimal, it does depend on the client’s skin condition. Always seek a clinical judgement.

Is there a risk of the patient slipping down the bed if the bed is profiled?

Yes. There is always a risk the patient may slip slightly down the bed when the bed is profiled. We recommend raising the knee break and the backrest to minimise the risk of slipping.

What beds does it fit?

The Turna fits most community profiling beds. The technical specification of the bed must comply with EN 60601-2-52 and can be only mounted on beds with square side bars on the lying surface. Please get in touch and we will happily come and try the system on your bed.

Do all the profiling functions still work as normal with the system?

turning a service user to ensure less friction and greater comfort for the client.

Is it easy to change the sheet?

Yes. Just the same process as changing a normal bed sheet – however you must detach a sheet from the turning roller and then attach a new one – meaning you have two sheets to tuck under the service user not one. You have the soiled or old turning sheet and the new turning sheet.

Yes. As long as you loosen the turning sheet before using the profile functions.

Is the sheet washable?

Can you use air mattresses with the system?

Yes, both the slide sheet and the turning sheet can be washed at 95 degrees and machine dried at a low temperature.

Yes. When using the alternating air mattress, it is recommended that it is turned to “auto firm” or “static” with max pressure before

Do we like it? Yes we do!

Visit Disabled Living's Online Shop

Visit: www.disabledliving.co.uk/online-shop/ or call: 0330 053 5930.

We are delighted to be working in partnership with Complete Care Shop to provide you with a comprehensive online shopping facility for equipment and products to make life easier.

Complete Care Shop has over 250,000 in stock items at competitive prices offering you choice from a wide range of manufacturers including mobility aids, daily living products, continence supplies together with telecare and telehealth equipment. In addition, Complete Care Shop has a reputation for excellent customer service which made the decision to enter into this partnership an easy decision to make!

The main advantage of purchasing via the Disabled Living website, is the opportunity for you or your clients to speak to Occupational Therapists or Continence Specialists for free impartial help and advice, ensuring unnecessary purchases are not made.

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Pyjama Paralysis - Staying Well

The Chief Nursing Officer for England backs a campaign to get patients out of their pyjamas and up and out of bed. England’s top nurse has launched a drive to end ‘pyjama paralysis‘ to give patients back one million days of their precious time that would otherwise be wasted in bed in a hospital or care home.

Professor Jane Cummings, Chief Nursing Officer for England, launched the largest ever national campaign to get patients up, dressed in their own clothes, and moving to boost their recovery at her 2018 Chief Nursing Officer summit.

The campaign aims to get older people back home to their loved ones living much happier and fuller lives. Making the most of valuable patient time is particularly important – as figures show nearly half of people aged over 85 die within one year of a hospital admission.

Professor Cummings said: “For many wearing pyjamas reinforces feeling unwell and can prevent a speedy recovery. One of the most valuable resources is a patients’ time and getting 12

people up and dressed is a vital step in ensuring that they do not spend any longer than is clinically necessary in hospital. I urge all those caring for our older patients to help end PJ Paralysis and get involved in the 70-day challenge and show the impact they can make.”

A recent pilot gave patients back 91,728 days or 250 years’ worth of time across nine trusts in the East of England as result of getting patients up and dressed.

The Chief Nursing Officer will build on its success – by rolling out a national 70-day challenge – with an ambition to have a million patient days captured in just 70 days.

For many, wearing pyjamas reinforces being sick and can prevent recovery. Studies show that three-infive immobile, older patients in hospital had no medical reason that required bed rest and doubling the amount of walking while in hospital reduces the length of stay.

She is urging all those who care for older people, nationwide, to encourage them to get up and active especially if they are in hospital. The campaign will run from 17 April to 26 June 2018 to finish in time for the NHS 70th anniversary celebrations on 5 July.

Ward H8 on Salford Royal’s Intestinal Failure Unit have been putting an end to PJ paralysis.

On why getting up out of bed and dressed matters, Jack Burns aged 69 a patient on the ward, said: “I’d encourage anyone to get up and about, not stay in pyjamas. I can get myself dressed, go for a walk, and even brew up here. It helps me feel right, it gets me ready for going home.”

Professor Brian Dolan, Visiting Professor of Nursing, Oxford Institute of Nursing, Midwifery & Allied Health Research (OxINMAHR), Oxford, said: “End PJ paralysis has galvanised nurses, therapists, doctors and managers in a way I’ve not witnessed in a 30 plus year career and so many are passionate about doing the right thing.

“Patients wearing their own clothes in hospital further enhances their dignity, safety and retains their sense of identity and when something works well for patients it works for staff too. Encouraging patients to get dressed everyday rather than remaining in their pyjamas or hospital gown when they do not need to boosts recovery and makes the most of precious time so it can be better spent with loved ones.”

Professor Jane Cummings

Read more on #endpjparalysis here.

Disabled Living Supplier Directory

The Directory provides information about companies and organisations that provide equipment, products and services to support disabled children, adults and older people.

Access to the Supplier Directory is via the Disabled Living website.

This month we welcome...

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Product Demonstrations at the Disabled Living Centre Everybody is welcome to attend our FREE Wednesday afternoon demonstration days 2.00pm - 3.00pm. Attending our product demonstrations will help you improve your equipment knowledge and boost your CPD. Places are limited. Please advise if you are interested in attending.

30th May - Murrays Aktiv UK Murrays UK will demonstrate the safety sleeping system.

6th June - Medipage/Easylink Medipage/Easylink will demonstrate telecare equipment including: Fit watches – which reads blood pressure as well as all the other functions of a fit watch, epilepsy products, and sensory products.

13th June - Carebase Carebase will demonstrate their new Snug.

SEPTEMBER 2017

27th June Ornamin Ornamin will demonstrate their range of family tableware including cups, plates and bowls.

11th July - Care & Independence Care & Independence will be demonstrating the Glove Sling.

25th July - Astraline Astraline will be demonstrating telecare products.

Home Delivery Service & Free Radar Key Bladder and Bowel UK is a service of Disabled Living and provides support for adults, children and young people with bladder and bowel problems.

We are working in partnership with Bullen Healthcare to offer people a home delivery service for stoma, urology and wound care appliances. Bullen Healthcare can also provide medication prescriptions for customers using their home care delivery service.

The Bullen Healthcare team take care of everything including dealing with the GP and keeping you informed throughout.

Available free with every order: Available on request or with your Wet wipes first order: Dry wipes Radar key Scentees Mattress protector Sealaway disposable bags Mirror Bed pads Hand sanitiser Free phone: 0800 0315411 Email: bbuk@bullens.com

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Product News The team at Disabled Living want to draw your attention to new and innovative equipment which will support you to provide the best possible care for your residents.

The Stabilo Smart Cradle

The Stabilo Smart Cradle has been developed to offer an extra level of comfort and support for users who have conditions such as curvature of the spine. Click here to learn more.

The LiftSeat

SEPTEMBER 2017 The LiftSeat is a high quality powered lift designed to help the user to and from the toilet with just the push of a button. Similar to the lift of an electric armchair the LiftSeat raises and lowers the user comfortably in a safe smooth action to a neutral/standing position. Click here to learn more.

The Java Plinth The Java Plinth has been developed to be used as a support over the Geberit range of wash/dry toilets for users who may otherwise struggle with the stability of standard toilets. The specially designed stainless steel frame gives the plinth the ability to withstand much heavier weights making it highly robust. Click here to learn more.

Lento Care Chair The Lento is our very own care chair, and is adjustable to fit about 80% of the population. We have been designing and developing the Lento for over 2 years, and it’s the most cost-effective and adaptable care chair on the market. Click here to learn more.

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Somna Products

Somna are a Swedish company who develop and provide research for cognitive products. They have many retailers across the world including: Sensory Calm, Sensory Bound, and O Neill Healthcare Ltd. Somna products are available to the public.

Weighted Gillet To begin, we were presented with a child’s weighted gillet. This product is available in kids and adults sizes in a choice of 4 different colours for both male and females.

Afterwards, we were presented with products where members of staff began to feel more involved to try out the products (as the child’s gillet was too small to try on but we did get to feel the texture and weight of this item).

Somna Comforter Heavy Duty This product is heavier than the regular Somna Comforter. Weighing 15kg, its deep grey fabric is strong and easy to maintain keeping it clean. The zips allow the comforter to be opened so that it can be split into two parts making it easier for washing.

Somna Comforter Jan explained that, the Somna Comforter Heavy Duty is able to warm and cool the body accordingly. The deep pressure therapy allows a relaxing sensation and these can easily be stored in our living rooms. They

are available in different sizes (4, 5, and 7) and are really beneficial for people who suffer from insomnia. The Somna Comforter is smaller than the Heavy Duty. It can be used on your lap or to wrap around your shoulders.

Somna Blanket This Somna Blanket comes with a wash bag and washing instructions. This product provides a sense of safety and comfort. It is guaranteed to give you a relaxing, peaceful night’s sleep.

Somna Comforter Active This product lies on your lap. Jan said: "The Somna Comforter Active has received brilliant feedback especially with its pocket feature."

Somna Collar This product goes around your neck. We learnt that the Somna Collar can increase body awareness and improve posture.

All of Somna’s products are available to view on their website.

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The OT Guru

Favourite holiday destinations / places travelled?

What style of clothes do they like to wear?

What do they like to read or watch?

Where did they grow up?

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Occupational Therapy in Care Homes My name is Angela Christian. I work for Disabled Living and have a varied role as an Occupational Therapist. I qualified in 2001 and have worked in the UK and abroad in various health and social care settings. From personal experience working as an Occupational Therapist in a care home, I would like to share my thoughts and provide helpful tips for all staff working with individuals in residential and care home environments.

An occupational therapist will consider all needs - physical, psychological, social and environmental. This support can make a real difference giving people a renewed sense of purpose, opening up new horizons, and changing the way people feel about the future. Â Royal College of Occupational TherapistsÂ

Favourite perfume or aftershave?

What was their main job?

Who are the most important people in their lives?

Favourite drink tea, coffee, juice, alcoholic drink?

The OT Guru

How well do you know your residents?

Name two of their particular hobbies.

Getting to know the individuals you work with on a daily basis, will be beneficial for all involved.

What's the first thing they like to do when waking up?

I would like to highlight the importance of getting to know residents, that does not mean all staff must complete a Life Story book for each resident, as this can prove to be time consuming. However, every resident should be encouraged to actively engage in conversations to find out important facts about themselves. Having said that, Life Story books do have their place and can provide a valuable tool for staff, family and friends, particularly for residents with Dementia or memory loss.

Significant life events?

You will find listed below a number of resources to support your work with residents with dementia. https://www.alzheimers.org.uk/downloads/download/855/remembering_togethe r_making_a_life_history_book https://www.dementiauk.org/for-professionals/free-resources/ http://www.careuk.com/care-homes/good-to-go/case-studies https://www.carehome.co.uk/news/article.cfm/id/1578196/Facebook-for-carehomes-Storii-app-for-care-homes https://www.dailysparkle.co.uk/2016712benefits-and-barriers-to-using-lifestory-work/n https://www.scie.org.uk/dementia/after-diagnosis/communication/person.asp Do they have grandchildren, nieces, nephews or siblings?

What do they dislike more than anything?

Did they ever own a pet? What type of music do they like?

Preferred name?

Did they have particular habits or routines?

Favourite food/snack?

Preferred times to eat?

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Donkeys to Innovators: 120 Years of Disabled Living

The Lord Mayor of Manchester and the Ceremonial Mayor of the City of Salford raised a toast to Disabled Living in officially opening our exhibition. The exhibition comprises a timeline highlighting our heritage, together with the opportunity to view some of our archived materials. It celebrates 120 years of independence and innovation by our charity. Ana Osborne from the Heritage Lottery Fund and Kui Man Gerry Yeung OBE DL, President of Disabled Living, also gave a speech.

We encouraged people to write their ideas for the future on our Innovation Tree. It was great to see many guests adding their ideas on the leaves.

Throughout the year, we’ve made a series of short films primarily about the services we have provided. Another film was produced by young people with disabilities and additional needs.

They interviewed older people and discussed their aspirations for the future.

Cherylee Houston (Izzy Armstrong from Coronation Street) worked with the young people during their filming adventure.

We also interviewed a number of people who shared their memories of our charity. These oral history interviews are available to listen to via SoundCloud.

We’ve had staff members, community curators, designers, printers, oral history experts, film makers, archivist, Heather Roberts, and creative cultural consultant, Claire Turner involved in the project. And we’ve also had members of the 20

public, social media tweeters, and new volunteers that have been amazed by the facts we’ve discovered. Through our marketing, events, and word of mouth, we’ve really generated a lot of engagement with our history.

Debra Evans, Chief Executive of Disabled Living said: I’ve enjoyed meeting new people and hearing their stories. It’s amazing to see how one story leads onto another story. There’s so many fascinating facts I’ve come across throughout this project. Thank you to everybody who has made From Donkeys to Innovators a huge success.

Watch our Donkeys To Innovators Film

Watch Our Donkeys to Innovators Film

SEPTEMBER 2017

Please click here to subscribe to our YouTube channel.

Public viewing dates for Exhibition Our next public viewing date to visit our Exhibition is on Thursday 24th May 6.00pm until 8.30pm.

For future viewing dates please contact Redbank House on 0161 214 5959.

We look forward to seeing you.

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In the Dock with an Expert Witness NEW COURSE!

Recording keeping Your responsibilities

Reporting

Civil negligence

Expert witnesses and solicitors

Improve your practice

Come to this workshop and find out what it feels like when asked to be in court!

There are different scenarios which could end up with someone being summonsed as a witness.

Whether it is a coroner's court or a civil negligence case this workshop will help you to understand what will be required and how to improve your practice so that a court appearance will be less intimidating. Using real life scenarios, expert witnesses and solicitors will lead you through the process and highlight areas you can improve and share good practice in.

On this interactive day you will work on a project which culminates in you appearing in the dock in front of a Judge and Jury. Find out how to protect yourself in your reporting and recording at work, what your responsibilities are and how to be confident in your work and not be afraid of being taken to court.

Please visit our website to book your place and for more information.

If you require more information please email: training@disabledliving.co.uk.

Date: Tuesday 2nd October Time: 09.30am - 4.00pm Venue: Redbank House, St Chads Street, Cheetham, Manchester, M8 8QA Price: Cost: ÂŁ35 + VAT (includes light lunch and refreshments) 22

Training dates for your diary Moving and Handling, Trainers and Assessors Course Date: Wednesday 12th, 19th, 26th September and Thursday 4th & 11th October Venue: Disabled Living, Burrows House, 10 Priestley Road, Worsley M28 2LY Price: ÂŁ650 + VAT (includes light lunch and refreshments, Open Awards registration and extensive handouts).

The trainers and assessors course will give you knowledge and confidence to perform your role as a manual handling trainer and assessor.

More information and dates can be found here.

Emergency First Aid Price: ÂŁ95 +VAT This bespoke course will enable you to deliver effective emergency treatment before professional help arrives. This course is the 1 day Level 3 Award in Emergency First Aid at Work (RQF) and complies with HSE requirements.

Accredited by Qualsafe.

For more information please contact: training@disabledliving.co.uk or call: 0161 607 8200

Click here to view our Training Diary

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Continence Corner How can a Continence Specialist Nurse help you?

As a specialist nurse with lots of experience of looking after individuals who have bladder and bowel problems I am able to offer support and advice through training on all aspects of catheterisation, Bowel assessment and Management and continence assessment to name a few. Bespoke training to meet individual education needs of groups of individual clinician s can also be arranged. Attending training always leads to positive networking which in turn assists with support for staff that may have an interest in continence issues but may feel they are working in isolation.

Another part of my role and the role of the team is been part of national groups such as NICE, RCN continence care forum so always aware of good practice at national levels or any new directives at national level so using the BBUK website for this up to the minute information will support clinical care and the very best care for the residents you are looking after.

SEPTEMBER 2017

Joanne Hoyle, Continence Specialist Nurse

Incontinence is a Symptom, Not a Disease

Optimising Care for People with Bladder and Bowel Problems In the UK there are over 14 million adults who have bladder control problems and it is estimated about six and a half million people have bowel problems. Although the risk of incontinence increases with age, assumptions are often made that bladder and bowel problems occur as an inevitable part of growing older. With an ageing population, greater prevalence and a wide range of care groups being affected, it is important that we understand the continence needs of individuals.

Incontinence is a symptom, not a disease or diagnosis and as such, has several possible causes. Many bladder and bowel problems can be cured or managed better. Those who present with a bladder and/or bowel problem should be offered a full holistic assessment. Dignity and quality of care is at the heart of continence care provision, with skilled and trained staff in bladder and bowel assessment, across health and social care communities being in a key position to identify those experiencing problems and deliver care, assess and evaluate resident’s continence needs, ensuring that individualised treatment and management approaches are implemented.

All groups should have the opportunity for treatment, before containment management and alternative collection devices are considered. If treatment is not achievable, it remains important to optimise methods of continence management.

Here at Bladder and Bowel UK, we have a team of Continence Specialist Nurses and Continence Product Information Staff, who offer impartial advice and information on bladder and bowel problems, practical tips on symptom management and offer solutions to help manage problems to promote quality of life and independent living. We also want to ensure that people including health and social care professionals accessing our services are informed and directed to other appropriate services for further help.

National Confidential Bladder and Bowel UK helpline (0161 607 8219) Email: bladderandboweluk@disabledliving.co.uk 25

A Practical Guide: Pads in a Care Home There is an extensive range of incontinence pads available. The following principles can be applied to use of all pads and if followed you will get optimum performance from pads you use with your residents.

Pad allocation Only ever use the product prescribed for an individual. All continence pads should be provided based upon a clinical assessment and will be provided specifically to meet those needs.

Storage - store in a dry place such as a chest of drawers or wardrobe Do not store in a bathroom or cellar as the dampness will affect the overall absorbency of the product leading to potential leakage, loss of dignity and skin related problems. Pads can be removed from the packaging into a drawer, for example, up to 24 hours prior to use to aid activation of the fibres responsible for absorbing urine.

Fitting - the pads should be fitted per manufacturer's instructions. Here are further hints and tips to aid fitting: If the pad has an adhesive strip these should be worn in close fitting underwear. e.g. Sloggi pants, with the strip removed and the pad attached to the gusset area of the pants.

If the pad does not have an adhesive strip these should be won with close fitting underwear, as described above, or with fixation pants that can be sourced from all pad companies.

Underwear is important, if the pad is not held in place effectively there will be leakage and

the pad will not hold the amount of urine it should.

For all in one products that fasten with side tabs these must be provided based upon hip and waist measurements as they should fit like a pair of pants.

If the product fits at the waist but appears to leak from the leg area due to leg thins, for example then fixation pants can be worn over the product to aid a better fit.

Before fitting any pad fold lengthways as this aids close fitting to the body promoting better absorption of urine and containment of faeces whilst activating anti leak cuffs, if present.

If more absorbency is needed it may be worth looking for an alternative style of pad as going up a size to gain absorbency does not work. Leakage and poor fitting will occur.

Creams - creams should be avoided when pads are worn.

Only prescribed creams should be used in the affected area and applied in a very thin film. Water based creams should be used not oil based as these can greatly interfere with the absorbency of the pads. Do not use talc as this clogs the pad.

If all of the above good practice has been followed and the pad is leaking or you observe a skin related issue please consult with the prescribing nurse as soon as possible. And request a reassessment of needs.

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Kath’s Experience of Almost 4 Years Working on a NICE Guideline

This article explores Kath’s experience of working on a National Institute for Health and Care Excellence (NICE) Guideline. Her journey began almost 4 years ago. This is when Kath became a Lay Committee Member on transitions from hospital to home for people with social care needs.

It was very interesting to see that despite us all coming from such different backgrounds (professionally and personally), we all agreed that things needed to change, and the person always needed to be at the centre of the decisions made about their lives.

As well as my own experiences of having multiple impairments and high support needs, I believe my work as an advocate for people with complex impairment related difficulties stood me in very good stead. i was able to make practical, common sense suggestions of possible ways to resolve difficult issues. The work was very rewarding, as I could raise issues that may not have been considered had I not been there. I was also able to suggest ways that would strongly benefit the individual and their caregivers, whilst ensuring that staff were supported to carry out their work in an integrated and coordinated way, and without unnecessary delays.

It is challenging but ‘well worth the final result’ I have to admit the work on a guideline is exceptionally challenging, simply due to the

amount of papers that need to be reviewed. But, it is well worth the final result!

The production of essential guidelines and standards for health and social care, which is substantially strengthened by the voice of lay members (including disabled people, people with long term health conditions and carers) is priceless. In fact, I found the work so rewarding that I went on to join my second NICE Guideline Committee, which focused on Intermediate Care including Reablement.

Again, this was something close to my heart as effective intermediate care services ensure that people are supported to learn safe strategies to regain their confidence in performing daily living tasks. In this way, they can remain in their own homes, if they wish to do so. This is vital when it prevents unwanted placements in residential homes and could be responsible to keeping people in hospital unnecessarily. And most importantly, it is far less distressing and disempowering for the individual and their families.

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Gaining a better understanding of practical ways I believe that I benefited personally from the work on the guidelines, as I gained a much better understanding of the practical ways in which health and social care systems worked. However, I have also been able to support many people to gain access to appropriate and timely intermediate care services, which has made a massive difference to the quality of their lives and the long-term impact of their impairment.

I was therefore delighted to be asked to assist in the shaping the Quick Guide for the guideline. It provides you with plain English information about the types of service available, the stages of intermediate care and the professionals who may be involved in providing care. It is designed to give anyone who may need to access intermediate care services the information they need to make an informed decision about whether intermediate care is right for them. In this way, more people know about the value of intermediate care services and how to access them appropriately.

And as intermediate care can make a massive difference to people’s lives, if it is implemented in a co-produced way with the individual, why wouldn’t you want to know about it?

Learn more about Public Involvement at NICE and follow NICEGetInvolved on Twitter.

In our next newsletter...

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Funding for your residents

Walking frames

Do your residents need new equipment? We'll include a list of charitable trusts (many you will never have heard of) who provide funding.

Research findings - hot off the press

Free Occupational Therapy Assessments Do you want to be involved in our pilot study?

Constipation Advice from our Specialist Nurse And much more.........

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Disabled Living Head Office - Disabled Living, Burrows House, 10 Priestley Road, Wardley Industrial Estate, Worsley, Manchester M28 2LY Tel: 0161 607 8200 Email: info@disabledliving.co.uk Website: www.disabledliving.co.uk