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The Carer Digital
Health Chiefs Deny Care Home Discharge Policy Was 'Recklessness'
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Discharging 25,000 patients into care homes in England at the beginning of April, when the number of coronavirus cases was precipitously increasing, was neither reckless nor wrong, the Department of Health and Social Care’s most senior civil servant said stating that guidance for discharge was correct based on the information available at the time. The care sector has been highly critical of the government’s guidance instructing hospitals to discharge elderly residents to free up beds, which saw the death
rate in care homes due to the coronavirus increase significantly. A government document advised hospitals, ‘to free up NHS capacity via rapid discharge into the community and reducing planned care.’ The strategy, drafted on March 17, cautioned NHS hospitals that ‘timely discharge’ was important, urging care homes to accept patients who had not been tested for coronavirus.
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PAGE 2 | THE CARER DIGITAL | ISSUE 12
EDITOR'S VIEWPOINT Welcome to the twelth edition of The Carer Digital! â€œKindness can transform someone's dark moment with a blaze of light. You'll never know how much your caring matters.â€? AMY LEIGH MERCREE
Welcome to the latest edition of THE CARER DIGITAL. Our next printed issue of THE CARER is on the presses this weekend - we are distributed to residential and nursing care homes in England and Wales, so if you are a care home/care environment and would like a complimentary copy sent to your care home please email us at firstname.lastname@example.org Once again it is great to hear that deaths in care homes remain on a downward trend. Latest figures reveal that Englandâ€™s care homes have reported 258 COVID-19 deaths to the Care Quality Commission for the week ending 19 June, down from 407 deaths reported the previous week (w/e 12 June), and in Wales 4 care home residents died of confirmed or suspected COVID-19 in the week ending 19 June, according to data reported to the Care Inspectorate Wales.This is a fall from 15 deaths in Welsh care homes reported the week
before (w/e 12 June). I have been following the recent Public Accounts Committee meeting (see front page). I think we all saw this coming. I have been highlighting in recent weeks that there will be â€œa day of reckoningâ€?, and this is just the beginning. It is understandable to acknowledge that this was a crisis not seen in living memory, hence we were not only underprepared, but unsure on how to tackle it. This is not only in the care sector. In my hometown of Liverpool it is now universally acknowledged that permitting the Liverpool-Athletico Madrid game to go ahead when Madrid was seeing a surge in coronavirus cases was a gross error, resulting in a disproportionate number of infections. That aside, the care environment is totally separate, and I was rather astonished at the answer Conservative MP Sir Geoffrey Clifton-Brown received when he posed the question to Sir Chris Wormald, permanent secretary at the DHSC: â€œYou were discharging them from hospital into care homes when care homes were already in dire trouble, some of the most vulnerable people in society, the testing wasnâ€™t available, PPE [personal protective equipment] wasnâ€™t available, the training wasnâ€™t available. Wasnâ€™t this a pretty reckless policy by the government?â€? Wormald replied: â€œWe donâ€™t believe that. Now, as Prof Powis (national medical director of NHS England) described, at this point Covid was not considered to be widespread in the community.â€? Note the word community! Maybe the case, but these were people being released from a hospital environment. Alarm bells were already ringing when the government issued guidance to release patient into care homes on April 2, the lockdown began on March 23. At that time Italy was struggling with the coronavirus outbreak the care sector, where it was dubbed â€œthe Silent Massacreâ€?. As the crisis unfolded, Filippo Anelli, president of the National Medical Association in Italy said that nursing homes are â€œperfect places for the proliferation of the virus, adding that, â€œNo test swabs were done, dozens of workers who were not given proper protection fell ill, becoming carriers of the disease, and confirmed
cases were not isolated soon enough.â€? Hindsight is a wonderful thing, but the warning signs were there. While, according to Chris Wormald, risks were assessed, it is inconceivable that when a pandemic breaks out patients are released without testing into an environment where the nationâ€™s most sick and vulnerable reside. I despise the term â€œlessons must be learnedâ€?. One that is rolled out after every crisis outrage - but as the long-awaited social distancing is now eased the warning by the NHS Confederation that â€œviruses can return with a vengeanceâ€? must be heeded. Second waves, I understand, are always more dangerous. The governmentâ€™s newly appointed COVID-19 taskforce, set up to help the social care sector in England navigate the challenges presented by the pandemic going forward, is to be commended. Its aim. I understand. is to minimise further outbreaks of coronavirus in care homes in the coming year and ensure the social care action plan is fully implemented. There are really is no hiding place now. The care sector will keep up intense pressure on the government. In fact, in the age of data, the internet and 24-hour a day news bulletins across the world, every future government will find themselves in the court of public opinion. It is these stark unadulterated and accessible statistics that governments and advisers will most immediately be judged on. So, it is, I think, fair to say that the first round of questions into the governmentâ€™s handling the crisis and the answers given are inexcusable! Once again I would draw your attention to our Unsung Hero award this issue on page 15. No frills, no gimmicks, no fancy award ceremony - a straightforward no-nonsense recognition award for somebody in the sector from any department who deserves to be recognised for what they have done. It isnâ€™t much, I know, given the current circumstances, and how we wish we could award everybody! So please get nominating! This lockdown is not going to last forever and the hotels will be open for business soon - a luxury two night break for two people in a choice of over 300 hotels awaits! - email@example.com Nominations close on July 6th. Say hello to some of our previous winners:
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THE CARER DIGITAL | ISSUE 12 | PAGE 3
Health Chiefs Deny Care Home Discharge Policy Was 'Recklessness' (...CONTINUED FROM FRONT COVER) Department of Health and Social Care permanent secretary Sir Chris Wormald told MPs on the public accounts committee (PAC): ‘We didn’t want to keep clinically fit patients in hospital where they could get the virus. The decision we took around discharge was taken on clinical advice and was rational at the time.’ “There were clearly risks in whatever we did in these circumstances,” Sir Chris said, adding there was “no no-risk option”. The National Audit Office reported that between 9 March and 17 May, around 5,900 (38%) care homes across England reported an outbreak peaking at just over 1,000 homes in the first week of April. Between 17 March and 15 April, around 25,000 people were discharged from hospitals into care homes, compared to around 35,000 over this period in 2019. It is not known how many had COVID19 at the point of discharge. Conservative MP Geoffrey Clifton-Brown told Sir Chris: 'You were sending people from hospitals in quite large numbers into the care home sector which you knew was already facing a substantial and increasing number of Covid patients of their own. 'They didn't have sufficient PPE, they didn't have sufficient testing and they were the most vulnerable group in society. How could that have made any sense whatsoever?' Sir Chris said hospitals were expecting 'large numbers of Covid patients' and people who were clinically
able to be discharged should have been. He acknowledged there had been 'huge challenges' in care homes but 'considerable progress' had been made. He later added: 'We are in a process of learning as we go along about these issues. I am confident that based on the information that we had at the time our guidance was correct. That is not the same as saying we would do the same again.' NHS England's national medical director Steve Powis told the PAC that modelling projected that an serious epidemic would have overwhelmed the health service. He said patients who were 'clinically fit' were discharged, but Sir Geoffrey questioned how this could have been known without a coronavirus testing regime in place. Prof Powis said the NHS was following the testing advice provided by Public Health England (PHE). Professor Paul Johnstone of PHE told the committee that 3,500 tests a day were available at the time. The NAO report said that until mid-April, there was a policy to test no more than five symptomatic residents in any one care home. Sir Chris told the committee that - particularly during March - the number of available tests was 'quite limited and much smaller than we would have wanted'. NHS England chief executive Sir Simon Stevens said it was presently in discussions about extending the contract with the independent sector to supply 8,000 hospital beds to the NHS on an 'at-cost' basis. He said that while the initial contract agreed in March was to provide a reserve capacity if the NHS was overwhelmed with coronavirus cases, in future it was likely to be to provide back-up for other services. 'We do expect that we will want to continue to make use of independent sector capacity for the balance of the year in order to give more buffer for routine surgery, cancer care and other conditions,' he said. We are in discussion with Government about that but my hunch is that we will want to sustain a relationship with the independent hospitals.'
Care Sector Launches #StarsInMemory Campaign to Remember the Lives Lost by COVID The care sector has joined together to launch the #StarsInMemory campaign, which encourages everyone who has experienced loss and bereavement in their lives to connect by making a star and placing it in their window, or posting on social media on 30 June 2020. The COVID-19 pandemic has produced widespread personal loss and tragedy, with the Care sector often located at the centre of this. Each person who has died during the pandemic leaves enduring memories amongst their loved ones and those that they have touched in their lives. However, despite the daily statistics, the personal losses remain largely invisible and there have been few opportunities for people to share their grief collectively, or to link this grief to previous and existing loss and bereavement. Stars can be any size, made in any material and decorated according to individual preference. We recommend that you follow the basic form of any of the stars suggested below. Dr Denise Turner, Senior Lecturer in Social Work at London Metropolitan University said: “As the world moves slowly out of lockdown, we hope to create a moment to connect by care and unite in loss. Whilst we recognise that
the pandemic is not over, we hope that this mutual act of remembrance will help to recognise the many losses that people have experienced and to make these visible through the metaphorical light cast by the collective stars.” Vic Rayner, Executive Director, National Care Forum, said: “Loss is a very personal thing and affects us all in many different ways. However, across care we have also felt and responded to this loss as only a community can. Coming together, sharing our strength and sharing our tears. In some small way, we hope that by recognising this loss together, we can show not only our individual pain, but also shine on a light on how we are united in our love, respect and regard for those who are no longer with us”. We welcome any individuals, groups and organisations joining with us. At present #StarsInMemory is supported by: London Metropolitan University, Queen’s University Belfast, the National Activity Providers Association, the National Care Forum, Care England, ARC England, the Care Provider Alliance, My Home Life, retirement community company ARCO, and the Care Workers’ Charity.
PAGE 4 | THE CARER DIGITAL | ISSUE 12
The Impact Of Person-Centred Training On People Living With Dementia
By Tracey Carter, Dementia Care Quality Manager at Exemplar Health Care
Individuals experience dementia in their own unique way, which is why it’s important to take a person-centred approach when supporting people who are living with dementia. Part of my work at Exemplar Health Care is to ensure that our 32 care homes have dementia-friendly living environments and that our staff receive the right training to be able to support people living with dementia in a person-centred way. With the right skills and knowledge, our Support Workers play a vital role in ensuring that people can continue to have a good quality of life at every stage of the condition, so that they can remain active and engaged for as long as possible.
we deliver tailored dementia training to staff, covering an array of topics and subjects, which have proven to be very effective for caring for residents living with this condition. Training includes; learning how the brain is impacted, the different types of dementia, and the Kitwood model of person-centred care, which focuses on knowing the individual (personality, life history and health), social psychology, and detractions and enhancers to delivering care. Putting people first is our priority, so we often involve families in our training to better understand the needs and behaviours of their loved ones, as well as helping them to nourish and maintain positive relationships too. In addition to this in-depth training, we make extra resources available to staff who want to complete their CPD or refresh their memories, including through our online eLearning platform. I personally review this training plan on a regular basis – utilising new meaningful research to bring fresh insights, which helps the team to deliver even better-quality care.
HOW CAN STAFF BETTER SUPPORT PEOPLE WHO ARE LIVING WITH DEMENTIA?
The knowledge and skills that colleagues learn during the training promotes a person-centred culture and ethos within our homes. We use real-life examples and situations, or deliver bespoke training around individuals, so that after training has been delivered, staff can confidently put their new knowledge and skills to good use.
Dementia is a complex condition, so having the right skills and knowledge plays a huge part in supporting residents. At Exemplar Health Care
USING TRAINING TO CREATE PERSONAL CARE PLANS
As an example, staff at our Longley Park View home in Sheffield, noticed that a few of our residents felt more anxious or distressed after breakfast time. We set up a bespoke dementia training session and explored the idea that breakfast time can often be busy and noisy, which can often be overwhelming for people living with dementia. Knowing this, the team decided to start a Breakfast Club in the home’s conservatory for those who found the bustle of the dining room difficult to understand and tolerate. After three months, colleagues saw an improvement for many of the residents. For example, for one resident, breakfast had previously made her feel quite anxious and agitated, putting her and others at risk, missing meals, and requiring extra support from staff. After the Breakfast Club was implemented, she was calmer, willing to have her breakfast each morning and socialised with other residents and colleagues. She now likes to go for a walk or visit local shops after her morning meal, and is taking her morning medication willingly, which didn’t happen previously. Three months later we were very proud to say her weight stabilised as she was previously at significant risk of malnutrition.
FIND OUT MORE Exemplar Health Care is a quality provider of specialist nursing care for adults living with a range complex needs including complex dementia. Find out more on the website: www.exemplarhc.com
The Triumph Over Adversity Category Added to NACC Awards 2020 The National Association of Care Catering (NACC) has added a new category to the NACC Awards for 2020: The Triumph Over Adversity Award The new award specifically honours the extraordinary efforts of care caterers during the coronavirus pandemic – from those working in care homes to those supporting the vulnerable in the community. The Triumph Over Adversity Award, sponsored by CaterCloud, is open for nominations from NACC members. It recognises and celebrates teams and individuals from the care sector (from care establishments and community services to businesses and suppliers associated with the sector), who have overcome significant business and/or personal difficulties to ensure the continued delivery of a quality meal service for residents and customers since the coronavirus pandemic. Following the introduction of the new award, the deadline for entries for all categories of the NACC Awards has been extended until 17 July 2020. Sue Cawthray, National Chair, NACC, said: “The coronavirus pandemic has made 2020 an incredibly challenging year, especially for the care sector at
the forefront of caring for and protecting the most vulnerable in our society. Care caterers up and down the country have more than stepped up to the challenge. They’ve ensured residents who suddenly found themselves isolated from the outside world continue to receive nutritious meals and met the increased demand for meals delivery to the vulnerable older population in the community confined to their own homes. We could not let the selfless dedication, compassion and ingenuity of these frontline workers go unrecognised. The Triumph Over Adversity Award is an exceptional award for exceptional times and our way of saying thank you to all our colleagues for their outstanding response to this period of national crisis. We’re very, very proud of the care catering sector.” The Triumph Over Adversity Award will be announced, along with the other eight NACC Awards*, later in the year. The NACC Awards 2020 nominations are open to members of the NACC. The nomination brochure with full category details and entry requirements can be downloaded at https://tinyurl.com/yaajcs3e For more information about becoming a member visit www.thenacc.co.uk.
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THE CARER DIGITAL | ISSUE 12 | PAGE 5
Releasing Hospital Patients Into Care Homes ‘Not Illegal’ Says Government Releasing hospital patients into care home environments without undergoing Covid-19 tests was not illegal according lawyers for the UK health secretary Matt Hancock, in response to a high court challenge to the government’s handling of the coronavirus pandemic in care homes. Earlier this month lawyers under instruction from Dr Cathy Gardner whose father died in a care home at the beginning of April filed a legal claim at the High Court and sent Health Secretary Matt Hancock a letter before action earlier this month calling for him to take back his claim that he provided a “protective ring” around care homes. In her action, Dr Gardner contends that both the Government and the NHS were in breach of four separate articles of the European Convention on Human Rights, and says the government allowed patients to be sent back into their care homes after being in hospital with covid-19 symptoms, branding it a ‘national disgrace’. Dr Gardner says she wants an admission that the Government failed to take proactive measures to protect vulnerable care home residents and that the guidelines allowing Covid-19 patients to be discharged into care homes was unlawful. Speaking earlier today on television, Dr Gardner said: “It was extremely distressing, obviously I wasn’t allowed to visit him – all I could do was look through the window and see him about 24 hours before he died. It was absolutely heartbreaking. “We’ve sent a letter to three defendants – that’s the secretary of state for health and social care, his department, NHS England and Public Health England (PHE). “We got responses back at the end of last week and those responses are completely inadequate. They absolutely fail to address or even acknowledge any wrongdoing of any kind.
“We allege they have breached various aspects of human rights law, and also the equalities act in failing to protect the most vulnerable people in our society, those in care homes. “There is no evidence that there was ever a ‘protective ring’ (around care homes), in fact there is very much evidence to the contrary. “One of the things that we asked them to provide was evidence to support that statement made by Matt Hancock, but they failed to do that. “We’re seeking an admission of wrongdoing. We’re also seeking, very importantly, steps to be put in place to protect people in the future – because this isn’t over. “We also want statements like that ‘protective ring’ and others made by the prime minister to be retracted. Responding to the challenge the government has denied Dr Gardner’s allegation that it breached the European convention on human rights to manage risks posed by Covid-19 to care home staff and residents, and also told Dr Gardner’s legal team, it was right to change policies as new information emerged during the COVID-19 pandemic. In response to the refutation of the allegations by the Health Secretary, Public Health England and NHS England to her legal team, Dr Gardner said: “They dispute that I have legal standing to bring my claim, argue that the claim is brought too late and, most surprisingly of all assert that it is not in the public interest for my claim to be heard.” To fund a challenge Dr Gardner has begun a crowdfunding page on CrowdJustice which has currently raised in excess of £56,000
In This Time of Crisis, Nominate YOUR Unsung Hero A 2 night luxury break for 2 people in a choice of over 300 hotels awaits the Summer Carer Unsung Hero! Once again we here at The Carer are looking for an Unsung Hero! To say that the healthcare /social care system has been under pressure recently would be stating the obvious, and we are all to aware of many thousands of Unsung Heroes at this time! The current health crisis has highlighted all the hard work and dedication that those working in the sector deliver on a daily basis. There is no doubt that there are many heroes working in the social care sector and we are offering a chance to nominate yours - that person who has gone that extra mile and whose work deserves recognition. Over the past couple of years we have invited residential and nursing care homes to nominate somebody in their home who they believe is that “Unsung Hero”. Every care home will have somebody who goes that extra mile, and often receives little recognise or reward, and, over the past two years we have had
a phenomenal response to our Unsung Hero award, with some absolutely heartwarming and uplifting stories. With the current health crisis we thought that it was only right that we should once again add to our Unsung Hero winners. Once again we have have a fantastic luxury break for two in a choice of over 300 hotels for that lucky Unsung Hero winner. No catches no rules no gimmicks, simply nominate somebody in your care environment who you think has done something you feel has made an impact and gone that extra mile and is worthy of a nomination. They can be from any department, frontline care, laundry, maintenance, kitchen, administration we will leave that up to you. We will be drawing a winner before the next print edition later in April, so please nominate with a short paragraph on why you are putting your nominee forward and send to:- firstname.lastname@example.org by Monday, July 6.
PAGE 6 | THE CARER DIGITAL | ISSUE 12
The Digital Carer – Do the Core Skills for a Career in Care Need a Re-Boot?
By William Britton, founder of AutonoMe (www.autono.me.uk)
Building a new and lasting relationship with vulnerable people is a role responsibility for many carers, and it can be challenging. Those of all ages whose conditions require them to have support and guidance in their home environment need trust, practical help and kindness. But, do they need technology, and if so, do the skills of the caring profession need to evolve to accommodate that need? Device literacy is important to those we care for Experienced carers know to quickly find areas where a rapport can be built with their clients and residents, and where better to start than using what’s in most of our pockets – a device. In 2019, Ofcom revealed that 70% of people with learning disabilities have a smartphone, and 69% have a tablet. The charity Sense reported as part of the Jo Cox Commission on Loneliness report in 2018 that 50% of disabled people will feel lonely on any given day. The MP Jo Cox, in whose name the Commission was established, said, ‘We have more in common than that which divides us’. A love for using our phones and tablets to stay connected is just that – something in common which carers can utilise as part of care packages and day to day communication with their clients. Device literacy has a vital role to play in the caring profession. Devices have an important role to play in building carer-client relationships and providing better support with more positive outcomes. Smartphones are the key to a world where disability is no barrier, particularly for young adults, regardless of learning capabilities. Gaming, social media, photography and video empower us and allow us to show ourselves to the people we want to hear our voices. So, involving some of those digital tools in care packages makes sense, and provides connections on a more level playing field. Digital literacy - a key role requirement for carers A sharper focus on tech literacy in carer roles sends a strong signal to people considering a career in care.
Young people are digital natives used to using devices in school and college to report and communicate and they expect tech to be part of their work – paper forms and records are not familiar. Shared media and shared experiences involve a device, and this should be the enabled when they are forming bonds at work with clients. The job description for caring roles could be less intimidating with more digital responsibilities, and we believe they must form a bigger part of the recruitment and training process for care providers. Technology should be used to inspire and motivate carers, and make their role more of a partnership with those they look after – recording progress or concerns, together. Adding digital to the care package Using apps, chat, and digital media to record progress has been proven in care settings to improve outcomes. We work with over 300 vulnerable people across the UK, in partnership with their carers, using a simple app with instructional videos which provide them with a way to record their levels of independence, their own impressions of their progress, and the carer’s observations. This can have significant wellbeing and satisfaction benefits for the carer as well as the client. Both are truly involved in, and responsible for outcomes. Digital evidence of care progress can also act as a record of personal development for the carer, too, and help manage and evaluate their work. What needs to change? It’s time for care commissioners to work with care providers to set new standards for tech literacy in the caring profession. Making digital skills a core competency for carers will attract applicants with wider experience and let younger workers know that their innate tech literacy is appreciated and required. Enthusiasm for and competency in working with phones and tablets will make many vulnerable people feel more comfortable, especially young adults. Acceptance of tech’s role in care is also key. Post Covid-19, the role of apps in a care package will grow. In person contact may need to be restricted, yet support and communication can continue with familiar tech. Outcomes can be evidenced and improved with a few simple clicks. Tech will never replace human care, ever, but the combination of technology and human support can help us find common ground and solve complex resourcing problems that we will undoubtedly face as the financial implications of the pandemic hit.
JCVI Includes Dementia in Priority Groups For COVID-19 Vaccination The Joint Committee on Vaccination and Immunisation (JCVI) has published interim advice on priority groups for COVID-19 vaccination. Frontline health and social care workers are to be the highest priority for vaccination as they are at increased personal risk of exposure to infection. JCVI have stated the next priority for a vaccine should be those at increased risk of serious disease and health, including people with dementia. This is the first official acknowledgment that people with dementia are at increased risk. Fiona Carragher, Director of Research and Influencing at Alzheimer’s Society said: “It’s welcome news that JCVI have included people with dementia in their list of priority groups for a Covid-19 vaccine. A quarter of all Covid-19 deaths have been people with dementia, and this is the first time it has been officially acknowledged that they are at greater risk.
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“Isolation has had a hugely damaging impact on people affected by dementia. The Alzheimer’s Society Dementia Connect support line is taking thousands of calls from people devastated by the effects of lockdown, reporting dementia symptoms getting worse, and family carers isolated and struggling to cope. An effective vaccine would allow people with dementia to get back out into the community, and prevent further devastating outbreaks in care homes. “Given the hugely disproportionate effect the virus has had on people living with dementia, the Government’s new social care taskforce must have dementia at its heart, and undertake an immediate and rapid review to understand why dementia deaths have been a terrifying 52% higher than expected. We must quickly learn lessons, and prevent more people with dementia dying before a vaccine arrives.”
THE CARER DIGITAL | ISSUE 12 | PAGE 7
Plans To Ease Guidance For Over 2 Million Shielding Millions of people shielding from coronavirus will be advised they can spend more time outside their homes from Monday 6 July, the Health Secretary announced today (Monday 22 June). Hailing the resilience of those who have been shielding, the Health Secretary confirmed from Monday 6 July they will be able to spend time outdoors in a group of up to six people including those outside of their household, while maintaining social distancing. Those who are shielding and live alone or are single parents with children will also be able to create a ‘support bubble’ with one other household of any size, following the same rules already in place for the wider population. This comes as the latest scientific evidence shows the chances of encountering the virus in the community continue to decline, but the Government is committed to continuing with the unprecedented package of support until the end of July to give those shielding time to adjust to these changes. From Saturday 1 August, the guidance will then be relaxed so clinically extremely vulnerable people will no longer be advised to shield, but support will remain available from NHS volunteers and local councils. People will retain their priority for supermarket delivery slots, and still be able to access help with shopping, medication, phone calls and transport to medical appointments. Whilst this group of clinically extremely vulnerable people should continue to follow strict social distancing measures, they will be able to participate in more activities such as visiting shops and places of worship. From 1 August, those who need to work and cannot do so from home will be able to return to work as long as their workplace is COVID secure, adhering to the guidance available. Deputy Chief Medical Officer Dr Jenny Harries said: “Shielding was introduced to safeguard those who, at the start of the epidemic in the UK, were thought to be most clinically vulnerable in our communities. We know how difficult this period has been and the impact shielding has
had on many people’s mental health. “The prevalence of the virus in the community is now lower and chances of getting infected are reduced, so we believe it is the right time to relax some of the advice so people can start to regain a degree of normality once more in their daily lives. “People should continue to follow social distancing guidance when outside their homes, as well as frequently washing their hands, to minimise the risk of becoming infected. We will continue to monitor the evidence closely and adjust the advice accordingly if there are any changes in the rates of infection that could impact on this group.” Health Secretary Matt Hancock said: “I want to thank all those who have been shielding for so many weeks for their commitment to the shielding programme. I know this has been incredibly tough. Shielding has involved not leaving your house for months, not seeing people you care about, not being able to wander to the park for some fresh air, or even pop to the shops for something you need. This sacrifice has been for a purpose, and I want to thank every single one of you. “We knew it was a difficult ask, but these measures have been vital in saving lives. Now, with infection rates continuing to fall in our communities, our medical experts have advised that we can now ease some of these measures, while keeping people safe.” The Government has worked closely with clinicians, GPs, charities, the voluntary sector and patient groups to consult on these changes and will continue to do so to provide support and advice to those they represent. Following this review of the shielding measures, the government will be writing to all individuals on the Shielded Patient List with updated information on shielding advice and the ongoing support that will be available to them. Communities Secretary RobertJenricksaid: “The resilience and fortitude shown by those that have needed to shield has been inspiring. It’s good news that we are now in a position to start easing some of the restrictions, which I know will be welcomed by many.
“I also want to reassure everyone that we will continueto deliver the unprecedented package ofsupportincluding food and medicine deliveriesuntil the end of July. You will be sent information that will explain what support is available after that, you will not be on your own. “I want to thank councils, health and care professionals, the food industry, key workers and volunteers for their staggering effort to deliver a programme on a scale not seen since the Second World War. Your combined efforts have supported millions of people during this difficult time.” The rates of the virus are now low enough to allow for our advice to be carefully and safely eased, as on average less than 1 in 1,700 in our communities are estimated to have the virus, down from 1 in 500 four weeks ago. Those identified as clinically extremely vulnerable should continue to remain at home as much as possible, taking particular care to minimise contact with others outside their household and practise good, frequent handwashing. We recognise that individuals unable to work from home, may feel uncertain about returning to work. Mindful of this, the Government is asking employers to ease the transition for their clinically extremely vulnerable employees, ensuring robust measures are put in place for those currently shielding to return to work when they are able to do so. For anyone concerned about returning to work once the guidance has eased, we recommend they speak with their employer to understand their specific policies in relation to COVID-19. We advise they discuss their situation, agree a plan for returning to work and adjustments that may be needed before they return. The NHS will maintain the Shielded Patient List to ensure we continue to provide the best advice to those identified as clinically extremely vulnerable. Should the level of the disease in the community rise in the future it may be necessary to advise that more restrictive measures should be taken in order for those at highest risk to keep themselves safe.
HMRC VAT Case Highlights Challenges Facing Specialist Healthcare Providers A VAT tribunal decision against HMRC highlights the challenges specialist health providers face in the daily treatment of VAT. The tribunal decision, which in this instance went against HMRC, will be of particular interest to pregnancy clinics, occupational health, daycare, and patient transport providers, says accountants Hillier Hopkins. Ruth Corkin, A VAT Director at Hillier Hopkins and member of the VAT Practitioners Group advising Government and HMRC on VAT matters explains. “The tribunal case was brought by Window to the Womb, a private 4D pregnancy scanning clinic that provides gender and foetal heath scanning together with pictures of unborn children for expecting mums and dads. “HMRC did not consider Window to the Womb to be a healthcare provider, meaning that it had to charge its customers VAT on the services it provides. Window to the Womb disagreed and took the case to Tribunal.
“The case hinged on whether there was a provision of care by a registered healthcare professional. If so, it would be exempt from VAT. If not, Window to the Womb products would be considered what HMRC calls general supplies with VAT charged at 20%. “HMRC has long argued that sonographers are not on the list of medical professionals so cannot provide care that is exempt. However, most sonographers are also registered radiographers and sonography is, by its definition, a form of radiography. Window to the Womb and other clinics are also regulated by the Care Quality Commission (CQC).” The decision has significant implications for all pregnancy scanning clinics and highlights the challenges specialist healthcare service providers face with regards HMRC and VAT, as Ruth explains. “Patient transport providers, for example, face the difference between VAT being zero-rated and exempt, depending on whether HMRC believes them to be providing passenger or patient transport services. It is complex, as patient transport providers tend to offer both
services. “Occupational health providers, such as those companies made available to their staff, are seen by HMRC as simply providing advice with VAT chargeable. Yet may occupational health specialists are qualified healthcare professionals who offer traditional medical procedures, for example, blood pressure tests. Services should, therefore, be exempt. “The provision of daycare in nursing and rest homes is often outsourced to specialist providers, yet HMRC considered those providers separate and unrelated to healthcare for VAT. Daycare providers and their customers quite naturally disagree, leading to often protracted discussions and tribunal cases. “VAT is complex at the best of times. It becomes even more so when there is the provision of specialist care. Specialist care providers should seek support and advice from an accountant that has a deep understanding of the sector and issues at hand.”
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PAGE 8 | THE CARER DIGITAL | ISSUE 12
Gloves Off: Stripping Back The Plastic In Social Care
By Sally Knocker, consultant for Meaningful Care Matters
In the UK, we may be beyond the spike in the coronavirus pandemic, but we are still reminded daily of the crisis through people’s very visible infection control choices. Take going to the local supermarket or shops, for example, you will surely come across many, if not most staff wearing protective plastic gloves. Initially, this safety procedure conveys confidence to us that the managers are looking after their staff and customers, and we therefore feel reassured. Next time you go to the shops, however, a quick observation of the cashier will reveal how that person uses the very same gloves to touch multiple customers’ shopping purchases. The gloves may not be changed for hours if at all for the duration of their shift. The use of gloves creates an illusion of safety, but in reality, this is not practical or effective in adhering to stringent infection control. In care settings, gloves are considered an essential component in terms of infection control practices, however just as the skin, they can be compromised and actually perpetuate infection if we do not use them correctly for single use. When gloves are changed, are people consistently undertaking rigorous hand hygiene before donning the next set for example? Great Ormond Street Hospital has been running a campaign called ‘Gloves off: safer in our hands’ to reduce the use of gloves in healthcare environments, not least because of the environmental and financial impact. Ironically, infection control audits at Great Ormond Street Hospital for Children NHS Foundation Trust found that one of the key
reasons clinical staff failed to comply to hand hygiene requirements was due to glove overuse. Whilst there will always be situations where gloves are essential in care environments, it is important to remember that there are also other ways of keeping people safe. In some care homes, for example, we are hearing about imaginative ways to encourage people living in the home to wash their hands regularly. Helping to wash up dishes or bathing a baby doll in hot soapy water, a technique used in many dementia care settings, have proven fun and creative ways to stay safe and avoid the unnecessary layers of plastic. At Meaningful Care Matters, our constant focus during this time with the care services with whom we work has been to ensure emotional wellbeing as well as physical safety. Human touch is a core part of connecting with another human being, and direct skin contact can communicate comfort, warmth and a loving intention. However, safety barriers such as gloves and other PPE can have the opposite effect. When supporting people living with dementia, for example, a person approaching wearing extensive PPE might look very frightening. I remember one incident in a care home where a woman who had spilt cornflakes and milk down her top was approached by two carers in blue gloves bearing swiftly down over her to clean her up. They meant well, but to the woman concerned, she felt under attack and lashed out in fear – a natural response to something unfamiliar. The carers were obviously upset and couldn’t understand what they had done wrong. What’s worse is that they blamed it on the woman’s deteriorating dementia. I asked them to sit down and repeat what had happened with me while I stood above them wearing blue plastic gloves and an apron, touching wiping their chest without any warning. They had a direct experience of how it had felt for the woman and immediately understood the situation. We agreed that the message behind the gloves was that “I am in charge” and “I have
a job to do”, rather than “I am here to help” and “I care about you.” Ultimately, the skin is our bodies’ primary defence system against infections which is similar to the purpose behind gloves. If we wash hands frequently following the correct guidance and safety procedures, we should surely not be prevented indefinitely from enjoying the skin-to-skin contact of loving and meaningful human touch that we are so accustomed to enjoying in social care settings. Let’s strip back the plastic! Sally Knocker is a consultant at Meaningful Care Matters, a leading care and organisational development group that specialises in helping health and social care providers to access a variety of support services. The group helps to facilitate the creation, reinvigoration and sustainable implementation of person-centred care cultures where people matter, feelings matter, and we are ‘Free to be Me’.
Basingstoke Care Home Helps Resident To Discover His Green Fingers Roman House, a residential care home for disabled adults in Basingstoke, has helped a resident discover a love for gardening during the UK’s lockdown due to the current pandemic. Before the lockdown, John Conway, a resident at Roman House, regularly enjoyed a trip to the town centre for lunch with friends at Mr Munch, and visited the market to buy fresh fruit and vegetables. When the UK went into lockdown, John was unable to follow his daily routine which unsettled him. To ensure John remained happy during a time when he couldn’t see his friends, Kerry Lettin, service manager at Roman House, and Ashleigh Young, team leader at Roman House, decided to help John discover some new hobbies. The home invested in a vegetable trough which grasped John’s attention immediately and every morning John now goes outside to water and tend to the homegrown carrots and peppers. John said: “At the start of lockdown, I was a little worried about not being able to go into the town centre and meet my friends for lunch because I really enjoy doing it. “I have loved experimenting with gardening, I can’t wait to eat the vegetables and I have now found a new hobby for life.” Kerry said: “Lockdown was a difficult concept for some of our residents to fully understand, but we worked hard as a team to develop different but none the less exciting activities. “John has invested a lot of his time into nurturing the vegetables and the outcome is fantastic, he should be very proud.”
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THE CARER DIGITAL | ISSUE 12 | PAGE 9
Save Our Homes After Covid-19 – Plea
Care and nursing homes closing in the wake of coronavirus, could spark a second crisis in the care of older and vulnerable adults, a campaigner has warned. Speaking as the number of deaths in care and nursing homes fell again, Mike Padgham, Chair of the Independent Care Group (ICG) warned that a fresh danger of home closures was now on the horizon. His warning came after a care home on the Yorkshire coast closed down. Today’s figures from the Office for National Statistics (ONS) show that 369 people in England and Wales died in care and nursing homes from Covid-19 in the week up to 12th June, down from 564 the week before. Previous weeks saw 705, 1,090, 1,660, 1,666, 2,423 and 2,800 deaths respectively. The ONS says a total of 14,404 people died in care and nursing homes from Covid-19 between 28 December last year and 12th June. ICG Chair Mike Padgham said: “The downward trend in care and nursing home deaths is very welcome and we are all pleased and relieved that we seem to be passing the peak. “But we also have to be mindful that for some, this crisis will have been the final straw and may well cause the closure of some care and nursing homes, causing a fresh issue in social care. “The Government will have to step up its support for the sector to avoid a sudden loss of provision, or we will have a second crisis on our hands through a lack of places. “Here in Scarborough we have seen the Grosvenor Hall Care Home, which looked after 23 people, close, which is dreadful for those resi-
dents, their relatives and the home’s staff. “We do not know the reasons, it may have been down to coronavirus it may have been down to the stresses on care homes that have existed now for some years.” Last week the Association of Directors of Adult Social Services (ADASS) said increased costs due to Covid-19 had exacerbated an existing crisis in social care. An ADASS report warns that increased spending due to coronavirus – for example, on personal protective equipment (PPE), staffing costs and sickness cover – means some private care providers may go out of business. ADASS called for a two-year ring-fenced funding settlement for adult social care as well as reform of the sector, including better pay and conditions for care workers. Mr Padgham added: “We have long been promised a Green Paper on social care but it has been repeatedly delayed. “The sources of the current problems are well documented, but almost £8bn cut from social care budgets since 2010 has left a sector on its knees, and that is bound to lead to some homes closing. “To ensure this doesn’t happen, we have to have greater financial support to the sector now, followed by root and branch reform of social care, matched by enough funding to bring it to parity with NHS healthcare, alongside which providers have been battling to defeat Covid-19.” The ICG’s suggestions for the future include: • A root and branch overhaul of the way social care is planned and funded • NHS health care and social care to be merged and managed either locally or nationally • Extra funding for social care, funded by taxation or National Insurance • A guarantee that people receiving publicly-funded care can receive it in their own home or close to where they live • A commissioner for older people and those with Learning Disabilities in England • A properly-costed national rate for care fees linked to a national career
pathway and salary framework for care staff • Dementia to be treated like other high profile, high priority illnesses, like cancer and heart disease • A fixed percentage of GDP to be spent on social care • A cap on social care costs, including ‘hotel’ charges • Local Enterprise Partnerships to prioritise social care • A national scheme to ensure people save for their own care, as they do for a pension • A new model of social care delivery based on catchment areas – like GPs • Social care businesses to be zero-rated for VAT so that they can claim it back, as other business sectors do • CQC to have much greater powers to oversee all commissioning practises such as per minute billing and 15-minute visits • Less duplication of inspection between CQC and local authorities/clinical commissioning groups • Greater recognition of the role of the independent sector and utilisation of its expertise in the commissioning and delivery of social care • Guaranteed equal partnership working through seats on Health and Well Being Boards, CCGs and NHS • Giving providers and CQC greater flexibility in delivering services • Providing telemedicine incentives • Allowing nurses and social care staff from overseas to work in the U.K. including lowering the salary cap • More nurse training and bursaries to encourage recruitment and end the shortage of nurses • Long term measures to integrate older and younger people in care settings and change the perception of the generations • Investment in research and development into new models of social care delivery • Funding to help upgrade older care homes to maintain a range of choice for the public and investment in domiciliary care • Funding for leadership training.
Covid-19 Death Rate in Care Homes Continues To Fall
The number of COVID-19 related deaths has continued to fall this month as the coronavirus pandemic begins to alleviate. Latest figures reveal that England’s care homes have reported 258 COVID-19 deaths to the Care Quality Commission for the week ending 19 June, down from 407 deaths reported the previous week (w/e 12 June), and in Wales 4 care home residents died of confirmed or suspected COVID-19 in the week ending 19 June, according to data reported to the Care Inspectorate Wales.This is a fall from 15 deaths in Welsh care homes reported the week before (w/e 12 June). In Week 23, the proportion of deaths occurring in care homes decreased to 22.6%, while deaths involving COVID-19 as a percentage of all deaths in care homes decreased to 23.4%. In Week 23, the number of deaths in care homes was 335 higher than the five-year average, while in hospitals the number of deaths was 538
fewer than the five-year average; the total number of excess deaths involving COVID-19 continued to decrease. Responding to the latest figures Cllr Ian Hudspeth, Chairman of the Local Government Association’s Community Wellbeing Board, said: “Every week we are painfully reminded of each one of the lives tragically lost to this dreadful disease. Our thoughts go out to those family and friends in mourning at this difficult time. “Social care remains the frontline in the fight against coronavirus and while it is clear we are now past the peak of the virus in care homes, it is still seriously concerning that nearly a third of all deaths from COVID-19 continues to happen in these settings. “We have also seen a slight weekly increase in the number of people dying from COVID-19 in their own homes and other communal settings, which is equally worrying. “Excess deaths in care homes and private homes continue to be higher
than the five-year average, compared to hospitals which have seen a
decline, leaving our older people and most vulnerable at risk. “Councils are doing all they can to protect those in care homes, as well as those receiving care in their own homes. Every council in England has prepared plans on how to support all care homes in their areas to control and prevent future infection outbreaks, working alongside the NHS locally and with Public Health England. “The Government needs to ensure that councils and social care services have all the resources they need for the weeks and months ahead. The LGA will also be working closely with the new National COVID-19 Social Care Support Taskforce to tackle these issues and help guide social care through this current crisis and beyond.”
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As The COVID-19 Pandemic Adds Increased Pressure To An Already Stretched Workforce, Care Providers Must Look To New Technologies To Empower Staff By Chris Proctor, CEO, Oneserve The COVID-19 pandemic has changed the world as we know it and organisations across all sectors are having to adapt, finding new ways to deliver services whilst ensuring staff and customer safety. For those working in the care sector, the current situation has highlighted long standing issues driving the need for change forward. It is imperative the sector remains resilient at a time when the public needs high-quality nursing and care to vulnerable people more than ever. The adult social care sector has long struggled to attract and retain staff with traditionally low wages and stressful working conditions often leaving carers feeling undervalued and demotivated. Lengthy paperwork and long-winded procedures continue to do little to inspire staff. The state of the adult social care sector and workforce in England report published in 2019, estimated there were around 122,000 vacant positions and a turnover rate of more than 30%. Fragility within the sector is very disruptive to the delivery of care services and the current pandemic adds further pressure highlighting the issues workers face more than ever. For care teams, recent social distancing measures have made mobile care provision and home visits extremely challenging. Limitations around face to face interactions with colleagues and patients does little to support communication, emphasising the need for alternative strategies and greater digitisation. Care England’s 2019 Manifesto highlighted the need for increased technology adoption and it is essential this commitment is fulfilled particularly in light of the additional challenges the pandemic is bringing to the nation’s carers. By adopting modern technology approaches, care providers will not only have access to the tools required to enable them to deliver improved services to patients, it will also improve carers’ working conditions by driving collaboration and increasing workforce confidence. Healthcare workers can really benefit from technology that automates time consuming procedures, removes the need for paperwork and
enhances communication. For the community care setting, technology solutions such as job management software can be particularly helpful. This type of software enables teams to access all the information they need about their appointments in real time via a mobile device. Technology can therefore enable mobile care teams to stay better connected with their colleagues whilst maximising efficiencies through always placing an appropriately qualified carer at the appointment, who is geographically located as close to the patient’s address as possible to reduce inefficient travel time. An additional benefit of this type of software is that the technology automatically generates a complete audit trail of the appointments carried out which provides a high level of reassurance from a record keeping and compliance perspective. By its very nature, the care sector is people centric with carers providing a vital lifeline for some of the most vulnerable members of society. By incorporating innovative technologies into the service delivery, carers workloads can be eased by improved process efficiencies being realised. This not only makes for a more fulfilling caring role; it ultimately allows carers to deliver a better level of patient care. Although lockdown measures are easing, the threat from coronavirus remains very real, particularly for individuals in the care system. Social connection is crucial in helping care teams and those that they care for feel safe and connected; technology makes this possible. Indeed, the added pressure of adhering to covid19 health & safety guidance is making it essential for organisations across all sectors to accelerate digitisation strategies that can be easily adapted to changing working environments. The care sector is no different and the time has come for the sector to embrace digital transformation. The Coronavirus pandemic has sent shockwaves throughout the world however as we pass the peak and cases begin to fall, key worker organisations must not renege on commitments to support vital service personnel. Technology improves care teams overall working conditions, empowering workers to deliver the most effective and accurate service to patients and must surely play a pivotal role in future strategies. Oneserve has created, “Oneserve Community” a free solution for key workers. It helps job planning for organisations or groups managing key workers during the COVID-19 pandemic. It is simple, easy to use software that helps you schedule and complete essential work without the need for paperwork, emails or phone calls. More here: https://www.oneserve.co.uk/oneserve-community/
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Urgent Call to Social Care Sector COVID-19 Support Taskforce The National Care Forum, the leading representative body for the not-for-profit adult social care sector, has sent an open letter to David Pearson, Chair of the new Social Care Sector Covid-19 Support Taskforce calling for urgent action on the key strands of work to address the impact of COVID-19 on those receiving social care. Vic Rayner, Executive Director of the National Care Forum says: “One of the first issues the taskforce must tackle as an absolute priority is funding for social care to cope with the enormous costs being experienced by social care providers as a result of the COVID pandemic. “The Government has passed £3.2bn to Local Authorities (LAs) to support the COVID response, the experience of our members is that this money is still not reliably and consistently reaching the frontline of care. “ADASS published their budget survey on 18 June, with some hard hitting messages we support about the fragility of the social care sector and the very serious implications for those who need and use care and support services. Despite this, their survey states that LAs had, at the point of response, committed only
£518m to providers, and had only actually paid out £194m to social care providers - a mere 6% of the total £3.2bn handed over by the Government. This is not sustainable. “We are fully aware that LAs face significant additional financial pressures including lost revenue and additional COVID responsibilities around shielding and homelessness to name a few, many of which emerged after the initial central government allocation. However, the government explicitly identified social care as a key priority for this funding. “The Infection Control Fund represented another key opportunity to get funding direct to the front line of care homes, but yet again the sector faces layers of bureaucracy via centralised constraining grant conditions and the inevitable spectre of variable interpretations and applications of the fund by 151 different local authorities – all the time taking away from the essential task of caring. “It is vital that the Taskforce looks urgently at obtaining this funding, and ensuring a responsive crisis appropriate system for distributing funds to make sure that providers of all types of services can have confidence that what they hear said at the Downing Street podium becomes swiftly a reality. “This is absolutely not a blame game. We recognise the very significant financial pressures that LAs are facing, and we need urgently to find a solution that doesn’t put authorities in a position of having to make extraordinarily difficult choices, which ultimately limit the distribution of the financial support that the Government intended to reach the frontline of care, and ensure that services continue to be provided to our most vulnerable citizens.”
Saints Legend Paul Sculthorpe Delivers Learning Disability Week Surprise Rugby League legend Paul Sculthorpe, Rugby League World Cup 2021 (RLWC2021) and Rhino Rugby League teamed up to bring a special surprise to people supported by the charity Community Integrated Care in St Helens, marking National Learning Disability Week. The Saints and Great Britain legend visited Mill Point, a newly launched service that is home to 12 people who have learning disabilities. The group, who moved into their new home in February, have experienced a more challenging journey to independent living than expected – with their first months coinciding with lockdown and the challenges of the Coronavirus pandemic. Bringing exclusive RLWC2021 gifts and enjoying socially-distanced socialising with the tenants and staff, who are all avid Saints fans, the two-time Man of Steel winner certainly lifted the sprits and gave the group a much needed boost. The visit was created as part of Community Integrated Care’s unique partnership with RLWC2021’s InsprirationALL legacy programme. The charity, which is one of the biggest and most successful care providers in the UK, is partnering with the tournament to support its commitment to making the event a beacon for inclusion. This commitment will see Community Integrated Care and RLWC2021 develop a series of unique opportunities that will enable people who have support needs, and the people who assist them, to connect them with the tournament. The tenants at Mill Point will be amongst the first beneficiaries of these projects, signing up to RLWC2021 inspired accessible social and employability clubs and creating a World Cup inspired garden in the coming weeks. The visit by Scully was described by one tenant at Mill Point as “the best day of my life.” With the legendary loose forward giving the team a range of rugby league activity equipment, it is hoped that they can
enjoy many more special days together through lockdown and beyond. Paul Sculthorpe said: “It was brilliant to see everyone’s face light up when I arrived. You could see how meant to them, being such massive fans. For me, it was important to show them some support at a tough time and to celebrate National Learning Disability Week. “This visit shows how important the RLWC2021 partnership with Community Integrated Care is. I am sure that it will create many more
great experiences for the people supported at Mill Point and hundreds of others across the country.” Rebecca Barton, Service Leader at Mill Point, said: “Rugby League is the biggest passion for most of the people we support and our colleagues. They love Saints, so to have their hero knock at the door and make a surprise visit was beyond belief. They were delighted to get photos and autographs with Paul and were thrilled with their gifts from RLWC2021. “The people we support at Mill Point had been so excited to move here and enjoy living independently, but clearly the impact of Coronavirus has made what should have been one of the happiest times of their life a lot more difficult. To have an experience like this has given everyone a real boost. I don’t think they’ll ever forget it! “We’re so proud of the work that Community Integrated Care and RLWC2021 are doing together. The tournament is giving the people we support the opportunity to volunteer, get fit, make friends and even create a special World Cup inspired garden together. The impact of projects like these is huge.” Tracy Power, Legacy Director for Rugby League World Cup 2021, added: “We’re proud to be working with Community Integrated Care to make a positive difference and further expand the work of our legacy programme to deliver genuine social impact across communities. Inclusivity is at the heart of everything we do, and we look forward to working together to engage people with a support need and their careers in the biggest and best Rugby League World Cup ever. “This visit wouldn’t have been possible without the support of Paul Sculthorpe and Rhino Rugby League, another of our legacy programme partners, and I’d like to thank them for their continued support.”
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Fo r m o r e i n f o r m a t i o n c a l l 0 1 1 3 2 7 9 5 8 5 4 o r e m a i l f r d p @ y e o m a n s h i e l d . c o m
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CQC Publishes Data on Deaths in Care Settings Broken Down by Ethnicity Care Quality Commission has completed a targeted piece of work to analyse the impact of coronavirus (COVID-19) on different ethnic groups Supported by ONS the CQC have completed a targeted piece of work to analyse the impact of coronavirus (COVID-19) on different ethnic groups in care settings. This data indicates a disproportionate number of deaths among people from BME groups. While the data held has they say, a number of limitations, the lack of data on ethnicity across adult social care as a whole makes it more important that any information in this area is shared – both to aid understanding and highlight the need for more robust data, as well as directing action. The data published last week includes death notifications in adult social care settings from 10 April -15 May 2020 (and the equivalent period in 2019). While the vast majority of all reported deaths from adult social care settings were White people the proportion of deaths in all adult social care services due to confirmed or suspected COVID-19 was higher for Black (49%) and Asian (42%) people compared to White people (41%) and people from mixed or multiple ethnic groups (41%). This difference increases when looking at care home settings only, where 54% of deaths amongst Black people and 49% of deaths amongst Asian people are related to COVID-19 compared to 44% of deaths of White people and 41% for mixed or multiple ethnic groups. Kate Terroni, Chief Inspector of Adult Social Care at the Care Quality Commission (CQC) said: “It is clear that urgent action is needed to fully understand the impact of COVID-19 on people from BME backgrounds in adult social care settings. This data indicates a disproportionate impact on people from BME backgrounds from COVID-19 in adult social care but the limitations of the data mean that much more work is needed. “More data is critical to understanding the actions that need to be taken across adult social care to ensure that all people are given safe, high quality care, appropriate for their individual needs. Today’s data also highlights the much wider question of how ethnicity is recorded across adult social care. “We are undertaking a targeted piece of work to review death notifications and how we work with
providers to ensure the data provided to us is both accurate and accessible. We will be looking at how we collect data on ethnicity as part of this.” “But data is only one part of the picture. Everyone involved in adult social care needs to be alert to the increased risk to people from BME backgrounds from COVID-19 in care settings. Every part of the sector needs to work together to look at what is behind the numbers and really examine the care people receive and what can be done to improve this situation.” The CQ C say that the figures cannot be contextualised due to the lack of data on ethnicity across the adult social care sector population as a whole since this data is not consistently collected on admission by care homes or by other adult social care providers. The data is also unadjusted, that means it does not take into account any other factors such as age structure, socio-economic status or geographical factors.
Hats Off to the Canterbury Care Home Residents Celebrating Royal Ascot Indoors All bets were off as a Canterbury care home got crafty and made their own hats and fascinators for a Royal Ascot-themed fun day. Residents at Highfield, based on Bekesbourne Lane, had shared their stories about previous visits to horse and dog racing venues, and with the help of activities co-ordinator Claire Handcock, decided to recreate the annual event. A main staple of Royal Ascot is, of course, the eye-catching headwear, and not wanting to be left out, the residents spent an afternoon creating fantastic fascinators and terrific top hats. During the morning, residents played a horse racing game with 50 matchsticks each, and Rita Turner was the outright winner, claiming around 90 percent of everyone else’s matchsticks. In the afternoon, everyone at Highfield sat down to watch the actual racing from Ascot on television, without making any bets, but picking prospective winners between them. Claire Handcock, activities co-ordinator at Highfield, said: “At Highfield, our residents are spontaneous and full of life. They like to have fun, play games and get involved with whatever we’re up to. Sadly, none of our residents had been to Royal Ascot before themselves, but they loved our version of it. “It’s one of our top priorities to make sure our residents are stimulated and feel involved with the local and wider community. During the recent weeks, this has been even more important, given restrictions around visitors or trips out. We’re delighted that everyone had such a brilliant time.”
Rita Turner, 72, said: “I thought it was such a good idea to have an Ascot day at Highfield, and who doesn’t love the beautiful headgear you spot at ladies’ day. “I didn’t realise I had such a talent for picking winners, but I did very well at the horse racing game. I can’t wait to try my luck at our next bingo game!”
Tel: 01495 772164 I 07967 402995 www.shophygiene.co.uk
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Coventry Care Home Shortage of Care Workers Couple Celebrate 70th Care England Addresses MAC Wedding Anniversary Mr and Mrs Stage who live together at HC One’s Victoria Manor care home, celebrated a fantastic 70 years of wedded bliss today! Colleagues at the Coventry care home wanted to make sure that the couple were able to celebrate this day together as best as they could, even though family could not be with them at this time. Family members sent gifts and cards to the home for the happy couple. Staff also set up and decorated a room just for Mr and Mrs Stage. There was banners and balloons placed around the room and a romantic meal for two was served. As they dined with their ultimate favourite of fish, chips and mushy peas from the local chippy, music played in the background as they each sipped a glass of cold beer too. A beautiful chocolate cake and some lovely personalised cupcakes from the family were presented to the couple afterwards. It was a lovely afternoon and both were so pleased at all the efforts from family and Colleagues at the home. The couple said “We cannot believe we have been together this long, it only feels like yesterday! Thank-you for helping us celebrate it together.” Colleagues at the home commented “It was so sweet to see how much they still love each other, and how special they both felt. To see them smile was so magical!”
The care sector potentially facing challenges new immigration rules following Brexit, Care England has submitted evidence to the Migration Advisory Committee (MAC) Professor Martin Green OBE, Chief Executive of Care England, says: “Recruitment and retention of staff are of paramount importance to providers of adult social care. Any future immigration system must take into account the realities of the adult social care sector including the valuable contribution of overseas nationals in providing care to some of society’s most vulnerable”. Care England has made its submission to the Migration Advisory Committee's call for evidence asking business organisations and employers to share their valuable recruitment experiences as part of a review of the shortage occupation lists. The responses will support the evidence based recommendations to be put to the Home Secretary in September 2020. The shortage occupation list is a government compiled list of occupations for which the evidence suggests there are not enough UK workers to fill vacancies. Whilst Skills for Care’s 2019 workforce data stated that 17% of the adult social care sector’s employees were non-British
nationals. In particular, 8% of the workforce according to this same data set were stated as being EU nationals. In light of the end of freedom of movement in 2021 as a result of the United Kingdom’s departure from the EU, the Government must consider the impact of such processes upon the adult social care sector. This is accentuated when one considers the longer-term demographic trends towards an older population. However, it is also of fundamental importance to ensure the attractiveness of adult social care for British nationals. Care England therefore supports the DHSCs’ adult social care recruitment campaigns, however, such campaigns must be backed up by more sustainable levels of funding and higher levels of fees for the sector. Martin Green continues: “Staff are our most precious resource and we need help to ensure that we have the systems in place to recruit and retain sufficient numbers to look after those in our care. Government must consider the additional pressures which COVID-19 has placed upon the adult social care workforce, but also, the sector as a whole. In turn, the Government must be mindful of this further shaping the United Kingdom’s future immigration systems."
Helping Care Home Residents to Stay Connected from a Distance Adherence to social distancing, getting used to a new routine, and other disruptions associated with lockdown present a unique set of challenges for those living in care homes. Maintaining strong social relationships with friends and family has never been more important. Seeing a loved one’s face as well as hearing their voice can help an older person to feel connected from a distance. As part of their commitment to helping the wider community, AYMES International (a market-leading manufacturer of delicious and cost-effective oral nutrition supplements) are delighted to announce they have a number of Facebook Portals to give to Care Homes in the UK. A Facebook Portal is a simple video-calling device that sits on a desk or table with a camera that follows as you walk around. It allows people to talk to others completely hands-free while doing other things. It’s an ideal way for older people to stay in touch with others and feel loved, supported and connected.
If you work in a Care Home and have residents who would benefit from a Facebook Portal, please email: firstname.lastname@example.org to claim one of 30 Facebook Portals. The first 30 to be drawn by 07.07.20 who have told us why their care home would like one, will each receive a Facebook Portal. For more information on AYMES International, please visit: https://aymes.com/ Terms and Conditions There are 30 Facebook Portals to be claimed. 2. All applications must be received by the closing date 30.06.20. 3. No Purchase Necessary 4. Facebook Portals can be claimed by any member of staff working in a UK Carehome. 5. A maximum of one Facebook Portal will be available to be claimed per care home. 6. Facebook Portals will only be made available to Care Home staff requesting them for resident use. 7. A full list of Care Homes who have received the Facebook Portals will be available by emailing AYMES after (one week the closing date) 8. Promoter - AYMES International Office Ff10, Brooklands House 58 Marlborough Road, Lancing Business Park, Lancing, West Sussex, England, BN15 8AF
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DO YOU KNOW THE CARER’S NEXT UNSUNG HERO? Regular readers will know we here at the Carer have been awarding an Unsung Hero each Summer and Christmas since 2016! Now, in these unprecedented and testing times we are looking for another Unsung Hero! (How we wish we could reward you all!)
Say hello to some previous ers! A two night luxury break for winn
Care Home urst of Cloverfield Marion Brockleh
Debbie Day of Cedars Care Home
two people in a choice of over 300 UK-wide hotels is the prize! £50 Marks & Spencer vouchers for two runners-up! e Boynes Care Centr Sam Buckley of The
Tina Higginson of Sam brook care home
A no-frills, no glitz or glamour competition - all we ask is for you to send us a paragraph or two nominating your Unsung Hero from any department with a brief description of how they've gone that extra mile and deserve to be recognised.
✓ Do you know our next Unsung Hero? Email your nomination to us by Monday, July 6 at
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Heatrae Considers the True Cost of Specification Delays in Healthcare Heatrae Sadia has worked closely with specifiers to design and supply hot water systems for several NHS and private healthcare facilities to meet demand created by the COVID-19 pandemic. Simon Russell, National Sales Manager at Heatrae Sadia, comments on the importance of swift specification action to avoid delays: “From the moment the lockdown began in the UK, extraordinary measures were taken to build and extend healthcare facilities in record time. With this came the essential need for effective and compliant hot water solutions to be specified, designed and installed rapidly. “Our specification support team were proactively involved from the outset and saw first-hand how consultants, building contractors and suppliers all pulled together to keep going even under considerable pressure and time constraints. Liaising closely with Heatrae Sadia’s manufacturing lines to swiftly adapt production, it was paramount to ensure product was available immediately. Moving forward, it is important that long-term plans are made to strengthen struggling supply chains. “The true cost of specification delays is not just a monetary one. In the healthcare sector, a minor delay in
one small aspect of the project can result in a facility not being able to open and lives could be potentially lost as a result. This is why Heatrae Sadia welcomes The Construction Leadership Council’s efforts to draft a ‘Roadmap to Recovery’ for the whole building and construction industry in England. “While consultation is in-progress with the Government to ‘restart, reset and reinvent’ the building and construction sector, the healthcare industry however, cannot wait. “A recent survey by RIBA paints a picture of widespread project delays across the industry, with a staggering 90% of construction projects during COVID-19 being impacted by any or all parties within a construction team. This includes delays caused by product manufacturers and suppliers, and shows how the industry is struggling. However, it simply can’t be at the expense of the NHS and other life-saving medical facilities. “As one of the key suppliers to numerous NHS Nightingale hospitals, care homes and private medical facilities during this time, Heatrae Sadia knows the importance of quick response time. Without access to reliable and hygienic hot water needed to sanitise hands and care for patients, facilities just cannot operate. “What’s for certain is that to be ready to face the ongoing challenges presented by COVID-19, we all need to plan ahead and remain resilient to change. Heatrae Sadia will be investing in its supply chain in order to continue to meet the hot water specification demands for crucial healthcare projects.” Heatrae Sadia has created a guide which covers the key points in hot water delivery, specifically in healthcare environments, which can be found here: www.heatraesadia.com/healthcare. Please also see Heatrae Sadia’s Biomaster in Healthcare video for more information about preventing the spread of bacteria on hot water system touch points to reduce cross-contamination at https://www.youtube.com/watch?v=6_xhTg4aJjE
Keeping Engaged During Lockdown: Care Homes & At Home
By Gillian Hesketh MA - MD Happy Days Dementia Workshop, Activities & Design
We all know good mental health is as important as eating a healthy diet and exercising our bodies according to our capabilities. That’s why, especially during lockdown, we have to ensure people living in residential or dementia care homes, and people at home who need care and companionship are encouraged to engage and continue to be as socially active as possible. With care and dementia homes closed to visitors and residents missing family members, the roles for care teams may have taken on different formats, adding shifts and multitasking to ensure residents are fully cared for. We’ve seen the wonderful work care teams are adding into their daily routines by regularly creating musical occasions for the people they care for. Some care teams have been able to help residents engage with family via social media which is ideal yet may only take up a small part of the day for a person who is living in residential care or alone at home.
Activity coordinators are busier than usual with days out cancelled, visiting entertainers, fitness instructors, hairdressers, unique visitors with hens, chicks, reptiles or pets to pat, all unavailable. For activity coordinators and life style facilitators, activities may need to be provided more often and with new options. Constantly inventing new activities can become daunting and time consuming. So here’s a few more ideas to help care teams continue to enrich social care during these difficult times: Create a Library Trolley - Add picture books and musical bird books. Ask around to locate original magazines from the sixties and seventies: Woman’s Own, Classic Car, Railway Magazines, Cook Books, Gardening Books … Wheel out your trolley daily - Observe resident choices for new and meaningful conversations now and in the future. Provide each resident with a triangular plain card or thick paper. Everyone can draw or colour - Create bunting for the corridors to cheer everyone up - Chat about celebrations. Knitting - Put together a basket of wool, knitting needles and patterns It’s amazing to see how many people can knit and will take you up on the offer of colourful wool. Some may just enjoy looking at the knitting patterns. Prompt stories about Make Do & Mend. Postcards - Ask relatives to send in postcards. Create a collection for people to enjoy. Ideal for prompting conversations around holidays and family events. Some residents may enjoy writing postcards to send to their families - or write the postcards with their words. Tool Boxes - At Happy Days, we know the gents like to remember their
days at work or at home repairing, decorating and creating; being in their shed or garden. We’ve put together ‘Fix It’ Boxes with imitation tools, sanding blocks, switches, gadgets and everyday reminders to help prompt conversations and stimulate activity. Encourage conversations around past interests and hobbies, sports teams, clubs joined, music choices, television programmes, books, films, celebrities, holiday destinations, family interests, friends and celebrations. Just chatting is an activity many people enjoy. Conversation Prompt Cards can often help prompt conversations and as everyone is busy caring, we have a range of chat and engagement packs available to despatch same day. Corridor Bingo - Each resident sits at their room’s doorway so they can see other people but remain socially distanced. Bingo callers are bound to become super-fit, calling the numbers up and down the corridors. See Happy Days Picture Bingo with large display images and large wipe-clean bingo cards. For Home Care - Create a Bag full of washable or wipe-clean nostalgic items to help engage and reminisce with the people you care for. Encourage board games, diaries, colouring, picture books, sorting, stacking, tidying drawers and cupboards. Maintain daily skills - share dusting, preparing food and repairs to boxes and everyday items. We understand the need to stay safe - most of Happy Days Dementia Workshop & Activity items are washable or wipe clean for infection control. For social activities and nostalgic games, chat prompts and themed displays - shop online at www.dementiaworkshop.co.uk
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Anger At Council Care Home Fees A “terrible ten” local authorities are being presented with Cheapskate Awards for paying the lowest care home fees in Wales amid the coronavirus crisis. They’re being awarded by Care Forum Wales who say the biggest difference between the highest and lowest weekly fee per person is more than £12,000 a year – equivalent to nearly £500,000 in a care home with 40 residents over a 12 month period. The “league table of shame” was revealed by the organisation which represents more than 450 social care providers in Wales and they are writing to all the members of the Senedd to point out the unfairness of the system. According to Care Forum Wales chair Mario Kreft MBE, the huge gulf between the top and the bottom payers was evidence of an unfair post code lottery which was threatening the well-being of the nation’s most vulnerable people and the future of social care in Wales. The First Minister, Mark Drakeford MS, had admitted the sector was fragile even before the Covid-19 pandemic struck and Mr Kreft is concerned that many care homes across Wales will not survive. Care Forum Wales say the root of the problem is that for more than 20 years the social care sector has been managed and funded separately by the 22 local councils and the seven health boards in Wales which was a recipe for disaster. They are calling for an urgent national action plan to sort out the mess and ensure fair funding for social care across Wales. Currently bottom of the heap in terms of funding is Powys County Council who increased the weekly fee for a person in a residential EMI care home for older people with mental frailty by 2.2 per cent to £559. In contrast, providers in Cardiff – where fees were already higher – will receive £793.48 a week for providing exactly the same level of service, a four per cent increase that works out as £12,192.96 more for every resident than in Powys over the course of a year. Even in Cardiff, says Mr Kreft, the fees do not cover the true cost of care and are on average £100 less than the amount paid by people receiving care privately. Five of the bottom 10 payers are the North Wales councils in Flintshire, Denbighshire, Anglesey, Wrexham and Gwynedd who are joined by Neath Port Talbot, Swansea, Carmarthenshire and Ceredigion. Just behind Cardiff at the top of the table are Torfaen Council followed by rising star Pembrokeshire who have increased their fees by a minimum of 12.8 per cent and up to 16.5 per cent this yar. The best-paying North Wales authority is Conwy who are the only North Wales council to pay above the Welsh average weekly fee. Newport negotiate separately with individual providers so it was not possible to include them in the table but they are in line with the generally higher rates paid in the South East of Wales.
Mr Kreft said: “The aim of the Cheapskate Awards is to highlight the really serious problems created by a crazy fee structure here in Wales “Some of these figures really amount to a kick in the teeth to dedicated people who have been showing tremendous courage as well as skill and kindness in the face of a frightening disease during this deadly global pandemic. “Are vulnerable people in Cardiff really worth £12,000 a year more than equally fragile people in Powys? Let’s face it, Powys are not the only offenders here, sadly their rates merely reflect the disdain shown to social care in many other part of Wales. If that’s the case, our values as a nation are completely wrong. “This mess has come about because the market has been mis-managed by the 22 local authorities in Wales for more than two decades of devolution. “As the First Minister himself pointed out, the social care sector was in a fragile state well before the pandemic and what we are calling for is an urgent national action plan which can ensure fairness and equity in the system, and it’s patently neither. “We need to build a sustainable care system that will truly be an effective scaffold for the NHS. “We have a similar postcode lottery in relation to the funding provided by health boards across Wales, so this is one almighty mess with essentially 29 varieties on a theme. It doesn’t make any sense at all. “The system is completely dysfunctional and has resulted in the sector suffering years of chronic underfunding since it was introduced. “We were seeing care homes and nursing homes closing across Wales even before the Covid-19 pandemic. “It is hard to see how many care providers can continue in business with fees at this level and they really represent an insult not just to the staff but also to the 20,000 care home residents across Wales. “We do welcome the commitment of authorities like Cardiff, Torfaen and Pembrokeshire for recognising the care, dedication and skill of care staff who have been in the front line of the battle against Covid-19. “I am personally saddened that in 1996 the then Clwyd County Council was the best paying authority for care homes in the whole of Wales and now were are no better than also-rans. “Not only do we underpin the NHS, the sector is a social and financial cornerstone for communities across Wales. It should be regarded as a treasured national asset and treated accordingly. “Social care is part of the foundation economy and, given the appropriate level of support, can help lead the economic recovery in Wales. “What we need as a matter of urgency is a national action plan to sort out the total hotch podge of fees so what we can provide the care that our vulnerable people deserve. “Social care should not be seen as a cost to society but rather as an asset that represents all that is best in our nation, notably its wonderful workforce.”
Pinehurst Care Home Staff Win Competition for Care During Covid-19 Staff at Pinehurst Care Home in Ilfracombe, North Devon, were thrilled to receive most nominations in a competition to find ‘Care Home Heroes’. They won pamper sets and gift vouchers for ‘going above and beyond the call of duty
Novellini launch BeSafe walls to help the UK return to work safely
Workplaces around the nation are preparing for when the UK can return to a kind of normality. The Novellini Group presents a solution that will help to create safe working environments that are hygienic and adaptable. The BeSafe wall is a protective device that companies with any office, desk space, trade counters, and food service areas can incorporate going forward. The primary benefit? Hygiene. Employees will feel protected with the BeSafe wall as it provides a barrier. Constructed from 6mm tempered glass, it’s easy to clean with any alcoholic disinfectant. In smaller spaces where it’s difficult to sit two meters away, the wall is a particularly helpful solution. Office teams aren’t the only ones who will be happy to see these walls put in place. BeSafe is a smart answer for all industries where contact with the public is required, such as pharmacies, retail counters, restaurants and public offices. Novellini can customise each barrier to suit the space with three versions (floor mounted, trade counter, and desks) and five different sizes. UK Sales Manager at Novellini, Stuart West says ‘We are looking to help the UK workforce where we can and these are a positive answer to those concerns about health and hygiene.’ As specialists in showers and design, Novellini are putting their skills to good use and many businesses across the UK will be pleased to find a safe and stylish solution. They are even available in several colours and glass finishes to suit the surroundings.
since the outbreak of Covid-19’ in the contest, which was organised by wholesaler Savona Foodservice. “As all care staff know, it is wonderful to be recognised and appreciated for the hard work we do, so winning the most nominations out of more than 30 care homes means a great deal to our team” said Julie Farrell, manager of the 23bed home for elderly residents.
For more information contact Novellini UK on 01727 229922 or visit the website at www.novellini.co.uk For brochure and advice please email email@example.com For large projects or orders, customized solutions can be evaluated. We are available to evaluate and propose BeSafe Wall solutions specific for your protection needs.
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Joy as Residents and Relatives Reunite at Royal Star & Garter Residents at Royal Star & Garter’s three Homes have enjoyed emotional reunions with loved ones. It was the first time they were able to meet face-to-face in three months, after visits to the Homes were stopped as part of the charity’s COVID-19 infection management protocol. The meetings took place outside in the grounds of the Solihull, Surbiton and High Wycombe Homes, with social distancing strictly adhered to and Personal Protective Equipment (PPE) worn by all relatives and staff involved. Visitors also had their temperatures taken on arrival and used hand sanitiser before meeting their relatives. The reunions lasted 30 minutes, and the area was cleaned with disinfectant wipes after each meeting. There were also decorations to mark the special occasion, with bunting and ribbons adorning the outside of the Homes. Among the visitors at Surbiton was Terrie, who met her mother Amy. Speaking afterwards, Terrie said: “It was absolutely wonderful. I was so looking forward to seeing her. She looked so well. I cried! It’s just reassuring to see her
in the flesh, and I wish I could have given her a big hug and a kiss but sadly not yet. But I’m looking forward to the day that I can do that. It was organised really well. Everybody felt safe and Royal Star & Garter has done a fantastic job.” And Elaine said after visiting mum Flo: “It’s the first time I’ve seen her since March 10, and it was lovely. I was convinced I wasn’t going to cry but of course I welled up. She looks great, it’s just been wonderful.” One resident said: “We’ve kept in touch through video calls, but it was special to finally meet my daughter after so many weeks. I have missed her terribly.” During lockdown the charity has invested heavily in new technology, allowing residents and relatives to keep in touch via WhatsApp and Skype video calls. Royal Star & Garter provides loving compassionate care to veterans and their partners living with disability of dementia. The decision to allow visits to take place followed the government’s guidance on easing lockdown measures to permit people to meet outside in England.
Plexus Innovation Provides GUARDIAN® To Help Safeguard Care Homes Plexus Innovation has forged links with Careline Lifestyles to take one of the job’s pressures off the nursing team at a time that is intense in the industry. Ian Murray and Steve Todd, directors of Plexus Innovation, are successfully rolling out its innovative GUARDIAN® technology. They were keen, during such unprecedented times, that a care company benefitted with no initial cost implications. GUARDIAN® is a remote, automated measurement and alert system that focuses on environmental data including temperature. Ideal in reducing the risk of legionella and ensuring temperature in water or refrigeration units is at an optimum level to protect health, Plexus Innovation’s technology comprises of a combination of hardware, with remote monitoring software. Plexus Innovation supplied training to Careline Lifestyle staff, enabling the user to simply plug in and activate the hardware in seconds, putting the data live onto the portal managed by the experienced team at Plexus Innovation. Provided initially for free, the arrangement covers nine of Careline Lifestyle’s homes across the North East. GUARDIAN® is now monitoring 37 measurement points, including medical fridges and ambient room temperatures, which must be kept at compliant levels. Ian said: “GUARDIAN® is cost effective, reliable and reduces risk. We are delighted to be remotely monitoring for Careline, where lack of compliance can be of detri-
ment to medications, dispensed to the people they care for. “Previously these critical assets would be checked manually, which leaves room for human error when people are busy or under pressure. Using GUARDIAN® the nurses can get on with looking after the people in their care and not worry about this detail. Our system identifies compliance issues, enabling us to keep clients informed, saving time, effort and often money! “Plexus Innovation can really help and support much of the health, social housing, care and even the hospitality industry perfectly.” Based in the North East, Careline Lifestyle is a leading independent provider of high quality nursing and residential care specialising in acquired brain injuries, neurological, mental health needs, learning and physical disabilities for persons over 18 years of age in addition to providing nursing, residential and social care for the elderly. Kirsty Nealis, Head of Care Delivery at Careline Lifestyles said: “With the extra pressures brought about by COVID-19 we couldn’t be more grateful for this GUARDIAN® helping hand to ensure our compliance measurements are done quickly, properly and even better, remotely. “We are always looking at innovative new ways to improve our services which frees up staff, allowing them more time to support our residence. “ “Thank you to Ian and Steve of Plexus Innovation for the free installation and remote monitoring over these first few months of a new and trying challenge!” More information on GUARDIAN® is available at www.plexus-innovation.com
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Analysis Reveals Councils Face Unsustainable Coronavirus Deficit A new report outlines the financial impact of Coronavirus on councils, which could run over several years, leaving England’s largest local authorities in an unsustainable position. The study, carried out by leading business and financial adviser Grant Thornton UK LLP, and based on data provided by county and unitary authorities, shows that all 39 of councils included in the study could use up their available reserves in 2021/22 to cover a funding shortfall of £2.5bn. The report sets out that England’s largest councils could be facing the prospect of ‘large scale reductions’ in services to set legal budgets this year. The report shows that county authorities will be particularly vulnerable to the fiscal impacts of a second wave of Coronavirus later, should this happen later this year, and a further outbreak and lockdown could increase the funding shortfall they face to an estimated £4.5bn over the next two years. The County Councils Network (CCN), who commissioned the study, says that the report provides robust evidence to Government on the financial challenges facing local government as a result of the pandemic. CCN says that Ministers are ‘alive’ to the challenges, and they want to work with government to design a ‘comprehensive’ plan to prevent these forecast scenarios becoming a reality. Using data provided by county and unitary authorities on estimated cost pressures and lost income resulting from the crisis, alongside projections on future revenues and legacy costs, Grant Thornton modelled the potential financial impact across three scenarios stretching to 2025. The analysis showed: • County authorities face a funding shortfall in 2020/21 of £752m due to COVID-19, which could be as high as £1.3bn. However, in the event of a
second wave of the pandemic later this year could cause this to rise to £1.9bn, with councils having to spend more on Coronavirus-related costs whilst losing income from services. Due to this shortfall a ‘significant number’ of county authorities could exhaust their usable reserves this year, meaning they could face in year cuts to services to prevent insolvency. • Lost council tax payments, business rates and ‘legacy costs’ – such as continuing costs in adult social care – as a result of the pandemic could create an additional funding shortfall of £1.8bn, which could be as high as £2.6bn. This includes a £1.1bn loss of council tax and business rates income, which could become a recurrent shortfall over the next few years if no guarantees on protecting councils against these shortfalls are forthcoming. • Although these deficits would largely affect council budgets in 2021/22, local authorities would need to anticipate this potential lost income this year and decide where cuts to services must be Without further support, all 39 councils could have depleted their available useable reserves by 2021/22. As a result, a significant number of these councils will be unable to balance their budgets and would have to enact further service reductions to prevent insolvency. Based on the financial projections, Grant Thornton observe that the projected financial pressures are not sustainable for a significant number of county authorities within their available financial resources, even if measures were taken to reduce costs. The report states that there is a risk that a significant number of councils will be forced to enact large scale service reductions and, as a last resort, issue a section 114 notice in the current year to meet their statutory duty to deliver a balanced budget in 2020/21 and 2021/22.
The report also suggests that it is necessary for the government to develop further packages of financial support and flexibilities as part of a wider medium-term plan to ensure that councils are adequately funded in the future and to prevent the forecasts on reserves being exhausted becoming a reality. It suggests that these measures could include further emergency funding to meet the immediate shortfall in funding in 2020/21, and an income guarantee to prevent the accumulation of lost council tax and business rates impacting council sustainability from 2021/22 onwards. Cllr Carl Les, finance spokesperson for the County Councils Network and leader of North Yorkshire County Council, said: “Councils across the country are grappling with increased cost pressures in adult social care and other core local services, whilst facing huge reductions in income due to the lockdown and the country entering a recession. “Grant Thornton’s analysis, based on council estimates on costs and their informed assumptions on how additional costs and lost revenue could develop over the short and medium term, show a significant funding gap opening up for county authorities due to the pandemic. This research shows the challenges facing county authorities and the severity of the potential impact on councils’ sustainability and provides important insights to inform government policy. “Building on this evidence, we want to work with government to develop a comprehensive plan to support councils over the coming months and years. We know ministers are alive to the challenge and hope this report is a valuable contribution to informing future interventions to support all councils.”
Sunrise of Frognal Hosts Drive-Through Event for Residents and Their Families On 17th June, Sunrise of Frognal hosted a drive-through event so residents could safely reunite with their families. As the home has been closed for visitors since the UK lockdown in mid-March, families have relied on technology to see their loved ones. 26 families came to the drive-through visit, where residents were seated at the entrance of the home. The weather cleared up as families stayed in their cars and slowly paraded past the residents, spending quality time with them. Many families decorated their cars with amazing messages of love, bunting and posters. Residents from all living accommodations at the home took part, including those living with dementia. One resident’s family had a very emotional reunion, as she called her daughter by name and recognised her even after three months in lockdown. Residents and their families enjoyed prosecco and strawberries and there were many happy tears and smiles. Families were so grateful to finally see the residents in person. This ingenious solution also ensured plenty of social distance, as the safety of residents is always Sunrise of Frognal’s top priority. Libby Hills, Daughter of a Resident said: “I want to thank the team for organising the get together yesterday. It was fantastic to see mummy (looking so glam and well!) and gave us all a huge boost. The event was so well organised, and the bubbly was an added bonus!
“Please send our thanks to everyone at Sunrise of Frognal for this special event and for all your hard work in making it a memorable day for us all.” Mel Boynton, Daughter of a Resident said: “I didn’t think that a drive through visit with my mum would be the social event of my year, but so far, it has been! “I really appreciate how much effort must have gone into the organisation, and think it’s great that the care home came together to make it possible for cars to arrive and process and allow families to see their loved ones again. “Once on site, the car park at Sunrise of Frognal had a carnival feel. It was wonderful to see mum and the staff who continue to care for her. It must have taken so much effort and I thank you. “Same time next week?” Tanya Riding, Director of Community Relations at Sunrise of Frognal added: “The weather pulled through for our fantastic event, after it had been torrential rain and lightning just an hour before. Everyone was so happy, and in many cases happy tears were shed “We had many lovely comments from family about the event, but largely heartfelt thanks to our team for looking after their loved ones so well during the past three months. “We know this visit meant so much to both residents and their families. We can’t wait to welcome them back properly when it is safe to do so.”
PAGE 20 | THE CARER DIGITAL | ISSUE 12
How Well Are YOU Protected? Hand Sanitisers
S. Awolesi, MSc, Senior Associate Member of the Royal Society of Medicine, Environmental Science Group Limited, Cambridge. Roy Simmons, BSc, Senior Consultant, Environmental Science Group Limited, March, Cambridge.
There is no doubt that Coronavirus is the main topic of conversation these days. The number of deaths reported in the media, in the UK and worldwide is alarming, causing us all to take positive steps in protecting ourselves. So how do we make sure that we are adequately protected? Firstly, government health officials and epidemiologists advocate ‘self-isolation’ and ‘social distancing’. Inevitably, daily tasks will bring some of us into contact with surfaces that are potentially contaminated with the virus. The advice is to thoroughly wash our hands with soap and water for at least 20 seconds. Washing with soap can inactivate viruses, especially the enveloped viruses such as Coronavirus, and it also has the added benefit of removing contamination from the skin surface (Fig. 1). Additional protection from potential contaminated surfaces (eg deliveries) would be to wear plastic gloves, leave the package outside the premises and wipe with a dilute solution of bleach (or spray). Leave for 10 minutes and then wipe dry before opening. Whilst still wearing plastic gloves, carefully dispose of the wipes as bleach solution is corrosive and harmful to the skin. (Note: in order to care for the environment plastic gloves do not have to be disposed after a single use. They can be cleaned with running water, dried and reused by the same person). In situations where washing facilities are not available and there is concern that hand contact has been made with a viruscontaminated object, the use of hand sanitiser (with the appropriate alcohol content) would be the best defence. These products are commercially available in various sizes and price (Fig. 2)
USE OF HAND SANITISERS Hand sanitiser is a gel or foam that is marketed as a biocide and is also effective for certain types of virus. It is used as an alternative to hand-washing and is commercially available either as sanitiser that is alcohol-based or sanitiser that is alcohol-free. Approved formulations of these products are given in a publication from the World Heath Organisation (WHO) (Ref. 1). In order to use hand sanitiser effectively, apply a small amount to the palm of one hand (read the label for the appropriate amount) and then rub both hands together so as to cover
all the surfaces of your hands and fingers until your hands are dry (Figs 3 & 4). Alcohol-based sanitiser acts by denaturing protein and dissolving lipid in bacterial cell walls and membranes. It also inactivates enveloped viruses and reduces the infectivity of some non-enveloped viruses. The majority of hand sanitizers contain a combination of isopropyl alcohol (rubbing alcohol) and ethanol. The percentage of alcohol present in hand sanitiser is key to its efficacy – those with less than 60% alcohol will be less effective at killing micro-organisms, and will just reduce their growth. Many studies have found that sanitisers with an alcohol concentration between 60 – 95% are more effective at killing microorganisms than those with a lower alcohol concentration or non-alcohol-based hand sanitisers (Refs. 2, 3, 4, 5, 6). It is well known that many chemical substances and mixtures when taken orally or applied to the skin can have side effects. This applies to hand sanitiser solutions as well. With repeated use over a long period of time, the active chemicals in these products can be absorbed through the skin. In sufficient quantities, they enter the blood stream and accumulations can occur such as to affect the normal functions of the body’s metabolism in liver and kidneys. The toxic effects of both ethanol and isopropyl alcohol (IPA) are well documented in ECHA (Ref. 7) registered chemical listings. The toxic effects of IPA are many times higher than that for ethanol alcohol, so the informed choice is obvious in favour of ethanol. A study (Ref. 8) reported an extensive survey of 18 retail chains (supermarkets, drug stores, general retailers, specialty shops) and exposed a substandard product at all three stores of a deep-discount chain. The marketing profile of deep-discount chains suggests that poorer segments of the community may be more at risk when it comes to the purchase of inadequate antiseptic gels. Moreover, products containing 40% ethanol may be stockpiled in homes and offices. However, it was noted that the less common brands of antiseptic gel did not state the alcohol content online. It is important that educational efforts should emphasize that effective
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sanitisers must be of a sufficient alcohol concentration. Consumers should be alerted to check the alcohol concentration in hand sanitisers because substandard products may be marketed to the public. The high demand for hand sanitisers at the present time means that the public may purchase these products, and due to the marketing, advertising and statements made on the product labelling, believe them to be substitutes for the conventional hand sanitiser products.
CHECKING FOR PRODUCT SAFETY AND EFFECTIVENESS It is vital that the manufacturer ensures that products on the market are effective and do not pose an unacceptable risk to people or the environment. The HSE has highlighted (Ref. 9) the fact that biocidal hand sanitisers that are made available in the UK to help protect people during the Coronavirus outbreak must be safe and effective. So how can consumers know what chemicals are in a certain product? A starting point is to request a Safety Data Sheet (SDS) which the supplier or manufacturer is legally obliged to issue to the end users. This is formalised today by the internationally accepted Global Harmonised System (GHS) (ref. 10). The document procedure and the details contained therein is directed by the United Nations. The information given in various sections of the SDS affords the declaration of a product’s hazardous classified contents along with other notations on any toxic properties and exposure limits. For hand sanitisers that comply with WHO formulations, Section 2 of the SDS should declare the product classification as highly flammable liquid and causing serious eye irritation. If the SDS is GHS compliant, Section 3 should list the main hazardous components and should include the name and concentration of the alcohol used in the product. If the level of alcohol declared is less than 60%, then the biocidal and virucidal level of protection will not be as effective as when the alcohol is more than 70%. Another way to check compliancy is to read the product label, which should include the type and amount of alcohol used in the hand sanitizer.
References 1. World Health Organisation Publication. Guide to local Production: WHO -recommended Hand rub Formulations. Revised April 2010. https://www.who.int/gpsc/5may /Guide_to_Local_Production.pdf 2. Todd ECD, Michaels BS, Holah J, Smith D, Grieg JD, Bartleson CA. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 10. Alcohol-based antiseptics for hand disinfection and a comparison of their effectiveness with soaps.external icon J Food Prot. 2010 Nov;73(11):2128-40. 3. Pickering AJ, Davis J, Boehm AB. Efficacy of alcohol-based hand sanitizer on hands soiled with dirt and cooking oil.external icon J Water Health. 2011 Sep;9(3):42933. 4. Pickering AJ, Boehm AB, Mwanjali M, Davis J. Efficacy of waterless hand hygiene compared with handwashing with soap: a field study in Dar es Salaam, Tanzania.external icon Am J Trop Med Hyg. 2010 Feb;82(2):270-8. 5. Coronado GD, Holte SE, Vigoren EM, Griffith WC, Barr DB, Faustman EM, Thompson B. Do workplace and home protective practices protect farm workers? Findings from the “For Healthy Kids” study. pdf icon[PDF 17 – pages]external icon J Occup Environ Med. 2012;54(9):1163-9. 6. Kampf G, Kramer A. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs.external icon Clin Microbiol Rev. 2004 Oct;17(4):863-93. 7. ECHA. European Chemical Hazard Association, Helsinki, Finland. https://echa.europa.eu/ 8. Reynolds SA, Levy F, Walker ES. Hand sanitizer alert [letter]. Emerg Infect Dis [serial on the Internet]. 2006 Mar [date cited]. http://dx.doi.org/10.3201/eid120 3.050955 9. www.hse.gov.uk/news/handsanitiser-manufacture-supplycoronavirus.htm 10. www.unece.org/fileadmin/DAM /trans/danger/publi/ghs/ghs_ rev04/English/ST-SG-AC1030-Rev4e.pdf
THE CARER DIGITAL | ISSUE 12 | PAGE 21
Scrutiny Committee Report Slams Council Care Home Response A report for Sheffield City Council Scrutiny Committee has slammed the Council’s response to COVID-19. The report highlights concerns raised by families, staff, advocates and care homes. The briefing papers reveal that there have been more deaths in Sheffield’s care homes than there have been in the city’s hospitals. Among the findings, the report criticises the Council for: • Increased bureaucracy, with an overload of requests for information and forms to fill in for various agencies • Incorrect information/guidance being sent out • A blame culture and lack of moral support • Difficulties in obtaining responses to queries on finance and funding • Delay in getting crisis funding to the frontline, and that the crisis funding is insufficient to cover the additional costs of the Covid-19 emergency • Accessing PPE has been difficult and expensive • Concerns about patients who had tested positive for Covid-19 being discharged back into care homes, or care home residents not being tested before hospital discharge • Availability and guidance around testing lacked clarity, and that the testing process was bureaucratic
The report also highlights Sheffield Care Association’s concern that at the height of the pandemic response (9th April), SCC announced a realterms cut in funding to the city’s care homes. Nicola Richards, Chair of the Sheffield Care Association, has been at the forefront of campaigning for better support for care home residents and staff during the pandemic. She runs Palms Row Health Care which operates three homes in the city. Ms Richards commented: “It makes for shocking reading to see the concerns of residents, staff, advocacy groups and care home providers laid bare in such a stark report. This represents the reality of front-line life during COVID-19. “The damning evidence presented to councillors should make them sit up and realise that they are presiding over a crisis in our care homes. “Urgent action is needed, especially in terms of ensuring the city is prepared for a second wave of COVID-19 and an independent review into the long-term funding of the city’s care sector is long overdue.” Among the recommendations made, the report suggests the Council considers: • Adequate emergency funding to tackle the Covid-19 pandemic and support emergency costs.
• An independent strategic review of care home funding in the city to ensure a viable future for care homes. • Recognition of the challenges faced by home care providers in terms of recruitment – particularly if the covid-19 emergency leads to an increase in demand for home care. • Consideration of the impact the ‘Test, Trace and Isolate’ system might have on staff absence in care homes and home care. Bal Kharia, owner of Vitality Care Homes, is also a member of the Sheffield Care Association and added: “Care homes in Sheffield have been in a fragile state for a number of years and this was before the COVID-19 crisis began. Recent events have put us under intense pressure and the Association is extremely concerned that care homes will soon face closure. “The people this will affect hardest are the most vulnerable in our communities – our residents. It will also have a huge impact on our dedicated and loyal staff who have worked miracles during the COVID19 response. “We need a cast iron commitment from the Council to guarantee funding levels, protect our services and an independent review of the cost of care in the city.”
Hertfordshire Care Home Inundated with Community Connections to its 19th-Century Building Following the launch of a ‘history hunt’ in April to help uncover the long and eventful timeline of its striking central building, Foxholes Care Home, near Hitchin, has been overwhelmed with information sent in by the public. While the 163-year-old building is known to have been a former maternity ward, Catholic boarding house, and care home, tying down its colourful history to fill the gaps has been quite the challenge, with a few blanks left scattered across its timeline. Foxholes launched the appeal for information in the hope of finally completing the timeline puzzle, so it can create a book on the history of Foxholes and a special ‘wall of memory’ in the entrance of the home that tells everyone’s story. With the help of the Hitchin community, the residential care home has managed the fill in the key dates of the below timeline: 1857 – The imposing building started life as a Manor House for Quaker William John Lucas and his family. There is a road named Lucas Lane after the family, just north of the care home. 1939 to 1951 – The building was converted into a maternity ward, serving the people of Hitchin and the surrounding area. 1960s – The building was used as a Catholic boarding house for boys who attended the nearby St Michael’s College, before entering the priesthood. During this time, the boarding house was also used as a home for retired priests, who would often help educate the children. 1987 – The building became a nursing home for the general public. 2010 – The old nursing home was demolished following significant investment to transform the building into a luxury residential care home. 2012 – Foxholes Care Home, as it stands proudly today, opens its doors. As well as helping to fill in the timeline, local residents have also been sharing their personal stories and memories connected to the building. One local resident, Gordan Woods, shared that he was born at Foxholes in 1944 when it was a maternity ward, and that an unexploded bomb caused plaster from the ceil-
ing to fall near to where he was sleeping when it landed nearby. Another local resident, Bob Sibley, sent in a photo of his boarding mates from when he attended St Michael’s College. He remembered the grounds back then having a football pitch, bullock stables, and an apple orchard. He described playing football in knee-high grass and avoiding the cow pats as quite the challenge! Bernie Cotton shared that he was born at Foxholes on 5th July 1948, five days before the NHS was founded, and that his mother, Helen Stewart Cotton, now resides at the home. North Hertfordshire Museum also contacted Foxholes to reveal that they have a collection of Roman objects on display that were excavated from the kitchen garden by the Lucas family. The artifacts include knives, jewellery, pottery, and cutlery. Neil Gandecha, Estate Manager at Foxholes, said: “The responses we’ve received since launching the appeal for information have been astonishing. So many people from the Hitchin area have got in touch to share their stories, and we’ve even had information sent in from as far afield as Switzerland and California! From this, we’ve managed to paint a clearer picture of how the building has been used over the past 163 years, and have pulled together a timeline of key dates. However, we still need to fill in some of the missing pieces.” Neil continued: “We’re still not entirely sure when the building was first used as a Catholic boarding house and when it closed, so any more information the public may have that would help us complete the timeline would be very much appreciated! “Also, please do keep sending in your connections to Foxholes. It can be an image of you, a relative or a friend in the building, or a story on your connection with it. We’ve received old photographs and birth certificates which has been really helpful in pulling the pieces together. So please keep them coming!” People can email their stories to email@example.com, or post them online via Facebook (@foxholescare), or Instagram (foxholescarehome).
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PAGE 22 | THE CARER DIGITAL | ISSUE 12
Borough Care Residents Mark Two of the Four Kew Care Group Care The Queen’s Official Birthday Homes are Now Rated Outstanding by CQC Residents and staff at Borough Care’s homes for older people across Stockport have marked the Queen’s official birthday, which takes place on the second Saturday of June each year. Reinbek, in Davenport, was decked out for the occasion in red, white and blue, along with Union Jack flags. Residents tucked into a buffet and toasted the Queen’s health with a few drinks. Afterwards, they participated in a quiz about the Royals. Residents at Bruce Lodge in Offerton enjoyed afternoon tea followed by a competitive quiz. Residents and staff teamed up and went head to head against each other to test their knowledge about the Queen. It was a double celebration at Shepley House in Hazel Grove, as it was also the 95th birthday of resident June Millett. Staff pulled out all stops and hosted a special party, followed by a quiz. Dr Mark Ward, CEO at Borough Care, says: “It was lovely for residents and staff to celebrate the Queen’s official birthday together. It was a chance for people to reminisce, chat about the Queen and have fun. Everyone had a great time.”
The Kew Care Group, a small family run operation now have 2 of their homes rated outstanding by the Care Quality Commission! The who group pride themselves high level service and dedicated person-centred care love good news, especially in these strange times, this particular good news being the CQC report for The Manor Cottage Care Home, Frenchay, Bristol, recognising and rating the home as OUTSTANDING! Another of the groups homes Cleeve Lodge, in Downend, Bristol, was rated Outstanding in 2019 and now The Manor Cottage shares this accolade. Green Willow in West Sussex and Westbourne in Gloucester are both Good rated services and they will continue working to share best practice and aim to join their sister homes in achieve the top rating. Regular Manager Away Days, teamwork with Residents and an open and transparent learning culture mean that this little group can provide a very special service. Director at Kew Care Group Josie Dalli said “We are delighted that the hard work, enthusiasm and kindness of the whole staff team at The Manor Cottage, is now being
recognised with it’s Outstanding rating making it among the top 3.7% of all homes. Our residents made a video to celebrate and this adds to their regular vlog on life in a care home – all available on our Facebook page. As our residents said in their video ‘We are Outstanding – but we knew that already’!
New ‘Resident Ambassadors’ Appointed at Gracewell of Edgbaston Two residents at Gracewell of Edgbaston have been appointed to the celebrated role of ‘Resident Ambassador’. Anne Morris and Gerry Foley, who moved in to Gracewell of Edgbaston in 2017 and 2018, are neighbours and close friends at the home. The team at Gracewell of Edgbaston say that Anne and Gerry are both natural fits to hold the position, having been current representatives of the home for almost a year. Whenever potential residents and their families visit the home, Anne and Gerry are often the first residents to welcome them in. They also offer to show visitors around their rooms and answer any questions they may have so they can have a personal view of life at Gracewell of Edgbaston. Anne and Gerry have also proved invaluable during the Covid19 pandemic, providing support and a friendly face to residents and their families while on FaceTime and Skype calls. Speaking of his new appointment, Gerry said that he is “honoured” to be given the opportunity, saying he feels a sense of purpose to be one of the home’s new Resident Ambassadors. Anne said that it makes her feel good to know that she can ease new residents into life at the home as she remembers when she
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first came to the home and how welcoming everyone was. The friendship between Anne and Gerry has grown so strong that even their families have become close friends and often have dinner parties together. Speaking of life at Gracewell of Edgbaston, Anne said: “The staff at Gracewell of Edgbaston are just wonderful, nothing is too much trouble and everything is done with attention to detail. The team provide great communication with my family and, in more usual times, they can visit whenever they like which is always so lovely. The cleanliness of the home is to perfection and I cannot praise the staff at the home enough. Team members attend to every need and I am very happy to call this my home. “The best thing about living in this home is the lovely gentleman I have met here which has made my stay even more special.” Gerry said “Gracewell of Edgbaston is an excellent home and I wouldn’t want to be anywhere else. The staff here are grand, and I have made some great friends. They keep us busy with activities and eating good food throughout the day. My family are happy because I am happy, anything I ask for or want is always an easy task for the staff here. Living at Gracewell of Edgbaston is like living with a big family.”
PAGE 24 | THE CARER DIGITAL | ISSUE 12
Veterans Prepare for Lands’ End to John O’Groats Bike Challenge second-to-none.” Staff will track the progress as they make their way across the country on a map. Meanwhile residents will enjoy local delicacies from the area they’re passing through, including Cornish pasties, Devonshire cream teas, Somerset cider and Lancashire hotpots. There will also be quizzes on the regions they’re cycling through, and a look at some of Britain’s iconic landmarks, such as Stonehenge. The event is being jointly organised by the Home’s Activities and Physiotherapy Teams. Activities Manager Hayley Helsdown said: “We’re doing this to raise awareness for the Home and funds. It seems appropriate to launch the challenge during Armed Forces Week as we celebrate our veterans. The residents are really looking forward to it and love the idea of helping raise money for our charity.” The Home hopes to complete the High Wycombe Tour of Britain before Friday 10 July.
Residents and staff at Royal Star & Garter in High Wycombe are taking part in a virtual cycle covering the length of Great Britain. They are pedalling the 874 miles from Lands’ End to John O’Groats on static bikes based in the Home’s in-house Physiotherapy Room. The High Wycombe Tour of Britain began on Monday 22 June, to tie-in with Armed Forces Week (22 June - 27 June). They aim to cover the distance in three weeks, and raise £874 for Royal Star & Garter, a charity which provides loving compassionate care to veterans and their partners living with disability or dementia. Around 15 residents will take part, including John, a 93-year-old World War II veteran who served in the Grenadier Guards, and 101-year-old Ena, whose husband was killed in action in Belgium in 1944. Residents and staff will cycle 15-minute sessions and will aim to cover 55 miles a day. Ena said: “It will be fun, and I hope we raise a lot of money. This Home is
RCP Presents Practical Solutions During the Pandemic
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HAND HYGIENE Healthcare facilities were considered the most
forthright proponents of hand hygiene prior to 2020 and have still seen a dramatic increase in the need for hand hygiene provisions. Existing standards such as the WHO’s 5 moments guidance for interacting with patients continues to define hand hygiene requirements in places where healthcare professionals and patients interact, such as wards and treatment areas. RCP’s contribution to the various settings of healthcare hand hygiene has been through freestanding hand hygiene stations and wall mounted dispensing solutions. Hand hygiene stations can be securely deployed wherever needed providing instant hand hygiene via alcohol or alcohol-free hand rubs. These stations are touch operated, eliminating cross contamination risks, while manual units mitigate contamination risk with antimicrobial touchpoints. RCP hygiene stations and wall mounted dispensers contain sealed soap refills rather than bulk soap systems. Sealed refills are preferred for all facilities as they eliminate the contamination risks inherent in bulk refill systems. The contamination potential of bulk soap systems was undesirable before the pandemic and is now unacceptable when we consider the transmission pathways for viruses, germs and bacteria. Whether in bathrooms, or elsewhere in a facility, efficient hand hygiene is achieved through quick and easy access to products that keep hands clean and safe without contamination risks.
ENHANCED CLEANING While hand hygiene can help prevent the spread of germs and bacteria, surfaces are also a primary point for cross contamination and should be attend-
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THE CARER DIGITAL | ISSUE 12 | PAGE 25
Patient Record Flag Can Positively Affect Care of People with Learning Disabilities Healthcare for people with a learning disability can be improved by a new flag on patient records, a pilot scheme has shown. NHS Digital introduced the Reasonable Adjustment Flag, which lets doctors, nurses and other health and care staff know that a patient has a disability or other impairment and has specific needs that require adjustments so they get the best care. These could include communication requirements, such as how to be contacted for appointments, or changes to the environment, for example the use of particular music to help reduce anxiety. During Learning Disability Week (15 to 21 June), NHS Digital has published initial results from the Reasonable Adjustment Flag pilots, which took place in Gloucestershire and Devon between June 2019 and March this year. In the trial, staff securely created, accessed and updated the information on the NHS Spine using the Summary Care Record application (SCRa), a program designed to share key information about patients to health and care staff with appropriate access rights. In the longer term, clinical and screening systems will be able to integrate with the capability so that staff will be able to see it on their screens in their own systems when they search for the patient. During the pilot, which took place in in various care settings including GP surgeries, hospitals and community services for learning disability, more than 70 flags were created by clinicians in conjunction with patients and carers. There were a wide range of adjustments identified, which could positively affect the experience and outcomes for patients and the experiences of carers and staff. Adding the Reasonable Adjustment Flag could also lead to other benefits, such as financial savings through reducing the number of missed appointments. Bev Farrar, Learning Disability Liaison Nurse at Gloucestershire Hospitals NHS Foundation Trust, said: “Being able to access the Reasonable Adjustment Flag means that we can get it right for our patients and we
have had really positive feedback on it so far. “The flag also promotes confidence in our healthcare team as it provides useful information about how to best to interact with our patients as individuals. Recently we were able to make a reasonable adjustment for a patient to have his appointment details texted to him and this helped him to attend.” Now that the technology has been tested and feedback gathered through the initial pilot, further development and testing is taking place. It is expected the capability will be more widely available from the end of the year. Clinicians say it could help many patients. Dr Iain Jarvis, a GP with a special interest in learning disabilities who works at Aspen Medical Practice in Gloucester, said: “The key impairment and adjustment information shared through the flag would be valuable beyond learning disability and autism patients. Patients with dementia, sensory disabilities, physical disabilities, non-visible impairments such as mental health conditions and those receiving palliative care at the end of their lives could all definitely benefit.” Dr Rob Jeeves, GP Clinical Lead for the project at NHS Digital, said: “The feedback from this pilot shows that the process to create and share reasonable adjustment information through the flag is well structured, simple and quick to follow. Patients, families and their carers were involved in discussions about the patient’s needs and adjustments to care. The initiative was warmly received, with enthusiasm for the benefits arising from the wider sharing of this key information. “The initiative also promoted collaboration between colleagues and across organisations as to how best to record well-formed reasonable adjustments on the flag and in local records. “With further evaluation and wider use, we will be able to explore the benefits when a patient with learning disabilities accesses healthcare and sees a particular clinician for the first time. We hope having a Reasonable Adjustment Flag will mean the patient has a better experience of care, with their needs being addressed earlier and more consistently.”
Young Horse Fan Raises Funds For Local Riding School With Home Show Jumping A young horse rider from Derbyshire with learning difficulties has used her time in lockdown to raise money for her local riding school by holding a show jumping competition at the care service in which she lives. Melissa, 25, who lives in Ash Lea House, a 14-bedroom home for people with both physical and learning difficulties, regularly attended horse riding sessions at Scropton Riding and Driving Centre prior to the coronavirus lockdown. Staff at the home had introduced her to horse riding three years ago through Scropton’s riding for the disabled programme and interacting with the animals has developed Melissa’s confidence and independence. Melissa was disappointed to find that an upcoming show jumping and dressage competition would have to be cancelled due to the lockdown restrictions, and decided to host her own competition at Ash Lea House to raise money for the centre. Unable to bring live horses to the home, Melissa used a hobby horse to stand in for her favourites from Scropton, in particular Jacko, who Melissa often feeds with carrots when she is able to visit him.
Melissa said: “Lorraine, the manager at Ash Lea, saw how disappointed I was and we talked about holding an event here. We came up with the show jumping fund raiser together, this made me feel much happier because I missed Scropton very much. “I was a little bit worried about the horses in the lockdown, I wondered if they were missing me as much as I was missing them and I wanted them to know how much I wanted to be able to go there again so that’s why I decided to do the fund raiser. I have raised £45 so far, and my family and everyone at Ash Lea are very proud of me. I am also proud of myself!” Zoe Brooks, deputy manager at Ash Lea House, said “Melissa has achieved some amazing goals. She has tried many interests since coming to Ash Lea, but horse riding is the one that she has really stuck with and she counts down the days every week until it’s her riding lesson day. “We are all very proud of Melissa and I know that she will continue to impress us all by what she will achieve while riding in the future. Well done Melissa, keep up the good work.”
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Sunrise of Sonning Care Home Surprises Staff With Personalised Cakes Sunrise of Sonning have surprised their team members with personalised cakes to celebrate Carers Week. The care home normally celebrates the annual awareness week through holding a raffle draw where every team member has the opportunity to win gifts. But this year, Sunrise of Sonning made 140 personalised cakes for them instead. The care home also made cakes for those team members who have been unable to come to work. Carmela Magbitang, General Manager of Sunrise of Sonning, then personally delivered these cakes to their muchmissed staff. Carmela Magbitang, said: “I was contemplating how I could make everyone happy, so I came up with the idea of extending our gratitude to the families of our team members. For me, the families of our staff play a vital role in maintaining the wellbeing and sanity of our team members. Cakes were suggested as a way for our team members to share a gift with their whole families. “I also believe that those who have been isolating or who have been unable to come to work for whatever reason, definitely miss us here at Sunrise. I wanted to let them know that they haven’t been forgotten as they are still members of the team. Therefore, I delivered their cakes to their
doorstep to remind them that their Sunrise family missed them too and that we are waiting for their return.” Speaking of when she received the cake, Sunrise of Sonning team member, Nathalie McLeish, said: “Being at home for three months sounds like a dream. However, the reality is it’s very tough. Knowing that because your family is shielding you cannot do the job you love and support your wonderful colleagues through this tough time, leaves a lot of guilt. “To know that, considering everything that is happening and how tirelessly everyone is working, they are still thinking about you and appreciate you, cannot be described in words. The cake is delicious and I’m sure won’t last long, but the gesture will never be forgotten.” Habiba Gara, another team member of Sunrise of Sonning, said: “I was expecting it to be an ordinary day, but then I was visited by my lovely manager. I didn’t know what to expect from the visit but I was still happy to see her. “I saw something in her hand and it was a cake, a delicious vanilla cake with strawberry. I loved it more than my kids did but that message made my day. It was so cute and heart-warming to read it, knowing I wasn’t forgotten. I was so, so happy and thankful.”
Lack of Support For People With Motor Neurone Disease Leaves Some Suicidal Research has found that a lack of palliative care provision for people with motor neurone disease (MND) following diagnosis can cause emotional distress and in extreme cases, lead to people experiencing suicidal thoughts. The research review, conducted by the University of York and cofunded by end of life charity Marie Curie and the MND Association, concludes that palliative care is commonly restricted to the last few days of life, despite MND being a terminal illness. The research also indicates that early access to palliative care would enhance emotional support for patients and their unpaid carers. The research highlights the experiences of many people with MND who reflect on the issues they have experienced through the course of their illness, including suicidal thoughts following diagnosis: “For many individuals, their diagnosis came as a shock; for others, it confirmed their expectations. Many negative reactions prevailed, including bewilderment, denial and a sense of loss and sadness. At the extremes were people who became very distressed by their position and those who experienced suicidal thoughts.” Throughout the review, early integration of palliative care was shown to improve people’s ability to adopt coping strategies during the continuous sense of loss and uncertainty they felt, alongside bouts of low mood that extend across their whole experience with the disease. Samantha Bolsher’s husband, David, died of MND in 2014. Having assisted with the research, she commented on her own experience as his carer: “I think having palliative support earlier would definitely make coping with MND easier. In our case it wasn’t driven through any of the caregivers until it really needed to be, and with this disease and the speed at which it progresses, you are always having to play catchup. I think if we’d started talking about things earlier, we perhaps could have got
our heads around what we were facing a little quicker. “If this disease is treated the same as other terminal diseases and people can have access to palliative care at an appropriate time, it would give both the patient and their family valuable decision making time. That was so important to David. When you are told that nothing more can be done and that the person you love is going to die you both want to have some say and control over how things are going to happen.” Kate Flemming, Professor of Hospice Practice, Department of Health Sciences, University of York, said: “To imagine that some people feel so unsupported after a diagnosis of MND that their distress may extend to suicidal thoughts is heartbreaking. It is a really hard time and this review shows that more needs to be done earlier to support people and make sure they get all the care that they and their loved ones need. “For some people there is still a sense of ‘there is nothing more we can do for you’ around palliative care, however this is far from the truth. Palliative care is care tailored to the individual, leading to more empowered decision-making and improved management of symptoms, be they physical or emotional. “Introducing palliative care in the early stages of motor neurone disease can make life significantly more comfortable for both the patient and their carers, enhance feelings of support and reduce feelings of distress.” Dr Brian Dickie, Director of Research, MND Association, said: “MND is a disease of low prevalence, but high need. This comprehensive review, covering studies from several countries around the world carried out over two decades, drills down into the real world of the many challenges faced by individuals and their families following a diagnosis of this devastating disease.
“There is much that can be done to support people and give them a greater degree of control over their condition, but it needs multidisciplinary, co-ordinated palliative care that is personalised to the needs of each individual. That’s exactly the kind of care the MND Association strives for through its 22 specialist multidisciplinary care centres and networks across England, Wales and Northern Ireland, with many working closely with their local hospice networks.“Given the speed at which MND can progress, care must not only be timely, to support the physical and psychological changes through the disease course, but ideally also anticipates the needs of people in advance, to avoid a crisis from occurring. The findings of this review will serve as an important benchmark to help drive further improvements in care and support.“ Dr Adrian Tookman, Medical Director at Marie Curie Hospice, Hampstead said: “The experiences highlighted in this paper feel very familiar to me. Many people I meet in my clinics, who have MND, have articulated the same feelings of a lack of control, fear around the progression of their disease and in the most extreme cases, suicidal thoughts. “Thankfully the team at the hospice can help people move forward with a greater feeling of control but this is dependent on timely referrals to the right specialists. There is still a lot to be done to educate people, healthcare professionals included, about the positive impact of palliative care to patients with MND and other terminal illnesses. An important message is that this care is not just for people with cancer and we need to reach more of the people who miss out. As this paper shows, the emotional stress for patients and their loved ones is profound when the right care and support isn’t there.”
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PRODUCTS AND SERVICES Adaptawear Clothing To Help Healthcare & Care Home Workers: Independent & Assisted Dressing If you are a healthcare or care home worker or Occupational Therapist and struggling to dress your patients during this Covid-19 pandemic; then take a look at our range of Adaptawear adapted clothing for both men and women. Adaptawear comfort clothing has been designed to help independent living and assisted dressing with the aim to make getting dressed easier and less painful for both the wearer and carer. Adaptawear designs and manufacturers a range of ladies and men’s open back and drop front trousers, magnetic & open back shirts and blouses, dresses, skirts, open back nighties and front fastening bras. We also sell a selection of everyday essentials aimed at making people comfortable day and night. Adaptawear clothes are ideal for
arthritis, stroke, Parkinson, incontinence and dementia sufferers as well as people of all ages who struggle with buttons and zips. The easy fit clothes are made from quality and natural fabrics to provide maximum comfort. Adaptawear Offers: • Discreetly Adapted Clothes • Independent & Assisted Dressing • Ladies & Men's Daywear and Nightwear • UK Nationwide and Overseas Deliveries • No Quibble 14 Day Returns • VAT Exemption where relevant • FREE Delivery on orders over £100 For more information on Adaptawear’s Product Range please visit www.adaptawear.com. Carer readers please quote TC141 for 10% discount off your first order.
Calibre Audio - Unleash the Power of Your Imagination Audiobooks offer a gateway to the world of independence when print is inaccessible. Reading books has many health benefits; from reducing anxiety and helping to combat memory loss, to boosting mental health. Books provide us with companionship, adventure, empathy and enjoyment, and listening to audiobooks extends all of this to people who cannot read printed books. A restricting disability can bring with it the sting of isolation, and being locked out of activities that were once enjoyed can create frustration and loneliness. However, research has shown that listening to audiobooks can boost mental health (ref. ncbi.nlm.nih.gov), helping to
counteract depression and other mental health issues. Escaping to audiobooks provides comfort and companionship as well as being a coping strategy in hard times. Calibre Audio is a charity, providing free audiobooks to anyone who struggles to read print, through sight loss, dyslexia or a physical disability. Our collection of over 11,500 audiobooks includes books from all genres, both fiction and non-fiction, from the classics to the latest blockbusters; from crime to autobiographies. Our books are available online for members or delivered to your door via a free postal service. It is free and easy to join. Visit calibreaudio.org.uk for more information or to join. See page 6 for details.
New Skincare and Incontinence Leaflet A new ‘Skincare management in incontinence’ leaflet is available from Thornton & Ross Pharmaceuticals – manufacturers of Zerolon® Barrier Cream. Accredited by the Association for Continence Advice (ACA), the leaflet is designed as a quick guide for all health professionals involved with continence care. Including recommendations from NICE, the leaflet also outlines factors to consider when selecting a barrier cream and advice on helping prevent incontinence-associated dermatitis (IAD). Zerolon® Barrier Cream is the latest addition to the Zeroderma emollients and barrier creams range, specially formulated to prevent irritation from bodily fluids including urine, faeces and exudate. To receive a free copy of the ‘Skincare management in incontinence’ leaflet, please email: email@example.com, email: 01484 842217 or www.zeroderma.co.uk
Workwear Experts For Over 100 Years Grahame Gardner has more than 100 years’ experience in clothing a broad spectrum of medical and healthcare professionals. Our knowledge and understanding of uniform demands ensure we remain one the UK’s most trusted and respected suppliers. We combine our extensive expertise with the latest innovations in technology and fabric and design, to offer you the highest quality garments to meet the demanding standards of healthcare professionals… all at exceptional prices! We also provide one of the most flexible embroidery services available from any clothing manufacturer using state-of-theart technologies that enable us to copy virtually any design or
logo directly onto your chosen uniforms. Whether you’re seeking a classic healthcare dress or tunic, or something from our bold and bright scrubwear range, you can find it with us. As one of the largest workwear providers in the UK, we are proud to be able to offer instant stock availability on 1,000s of workwear garments all in addition to our extensive range of ‘made to order’ items that can be manufactured on demand in a wide range of styles, fabrics and colours. To find out more, or for a no obligation discussion as to how we can help with your workwear requirements, please get in touch on 0116 255 6326 or email Info@grahamegardner.co.uk www.grahamegardner.co.uk
Renray Healthcare Design and Manufacture New COVID19 Response Beds for Temporary Hospitals Renray Healthcare has developed a field response bed to supply to temporary hospitals, with our design expertise and manufacturing capability we have been able to put the COVID-19 Response bed and mattress into production quickly, with deliveries going out across the country to help in the fight against COVID-19. Renray has been supplying beds, mattresses and furniture for over 50 years and due to the increasing spread of Coronavirus, we are proactively using Hydrogen Peroxide Vapour (HPV) decontamination system in all our Heavy Goods Vehicles prior to delivery of your goods to eliminate the virus or any potential contaminant, making deliveries safer for our staff, customers and users. Let us know if you require beds for temporary or permanent hospitals, to ensure you have everything you need to continue caring for patients in this difficult time. Download our brochure now for more information: The COVID-19 Response Bed Brochure at https://tinyurl.com/unofs42 Please contact customer service on 01606 593456 or firstname.lastname@example.org who will be happy to assist you.
New Pressure Relief Options from Airospring Medical
Airospring Medical manufactures a range of pressure relieving devices. Our flagship products are a range of lightweight and breathable pressure relief cushions and mattress overlays made from high-tech 3D Knitted Spacer Fabrics. Airospring has been awarded a full patent in August 2014 approving this ground breaking technology. Our pressure relief cushions distribute weight and allow maximum airflow. The cushions have been tested for the dissipation of perspiration, a key factor in the fight against pressure ulcers. Welcome to a new standard in healthy seating. Call: 0115 9322403 Email: email@example.com Visit: www.airospring.com
The Oxford Up from Joerns Healthcare The Oxford Up, from Joerns Healthcare is a manual stand-aid and seated transfer device, designed to support easy, safe and efficient patient transfers. Suitable for clients who require some assistance when standing but are able to participate in the process, the Up can play a key role in patient rehabilitation and promoting on-going independence. Manufactured from aluminium and weighing just 22.5kg, the Up is among the lightest and most nimble in its category; but don’t be fooled, a maximum safe working load of 200kg (31st) also places it among the elite. High-grade castors offer outstanding manoeuvrability across a range of floor surfaces
and ensures minimal exertion on the part of the caregiver. As with all Oxford products, injury reduction, fall prevention and ergonomic principles were fundamental considerations during the Up’s development phase. Perfect positioning of both the swing-away seat pads and knee support help ensure optimum patient positioning. Adjustable leg positioning and a contoured base allow excellent access for the patient and promotes better posture and ease of use. Contact Joerns Healthcare for more information on 0844 811 1156, send an email to firstname.lastname@example.org or visit our website at www.joerns.co.uk
The Benefits of Spillsafe Every year, thousands of working hours are lost to the sanitisation of furniture which ultimately can never be completely sanitised. This can feel like a losing battle to “beat the bugs” as any attempt to truly clean soiled furniture will inevitably only be scratching the surface. The true challenge lies inside the chair, a haven for contamination, but therein lies the problem. How do you clean the inside of a chair that has been soiled? The simple answer is “you don’t”. There is no way to truly clean a chair that has been soiled as liquids will find their way into every part of your furniture, absorbed by wood and languishing in foam and fabric. So, what is the solution to sanitising
your furniture? Simply, you stop anything from ever reaching the interior. The truest way of maintaining hygeine is to prevent unsanitary situations from ever reaching the areas that cannot be easily cleaned. Investing in hygienic barriers today not only saves time and money, but ensures the protection demanded by those who need it most. This was our maxim here at SpillSafe when developing our patentpending cassette system – Why allow the uncleanable to become unsanitary in the first place? Matthew Holmes, Director of SpillSafe Ltd. Contact Spillsafe Ltd on 0330 088 4851 or www.Spillsafe.co. See the advert on page 9.
Mattress Maintenance Services In order to bring a mattress back into service after use, it needs to be completely cleaned and decontaminated to approved standards that guarantee bacterium and viruses such as C.Diff and MRSA are killed, and no cross contamination occurs. A challenge with mattress cleaning is not only that it requires large commercial washing machines but that different mattress types also require different treatment. The right rental and maintenance service will not only provide you with an appropriate mattress when you need it, but offer fast cleaning, repairs, and replacements, ensuring mattresses are up to the required standards. This undoubtedly saves you money in the long term, provides the best possible levels of care to your patients and residents, and reassures all stakeholders that hygiene is a top priority; a must in the current climate.
WHAT SHOULD YOU LOOK FOR? So what should you look for in a rental service – apart from a wide range of special purpose mattresses? Here are a few key pointers: • Rapid breakdown response
• All work carried out by trained technicians • Mattresses returned in fully certified working order with free loans while repairs are carried out to allow you continuity of service • Servicing and/or repair offered in a hygiene controlled environment where mattresses are PAT tested, static pressure leak tested and cycle tested • Mattresses placed in an infection controlled 'Cold Storage' zone to control cross contamination • Mattresses completely cleaned and decontaminated using a specialist, certified decontamination system to approved standards • Transparent and clear results reporting for peace of mind In today’s ever-more pressurised care sector, ondemand mattress rental and maintenance services are playing a growing role in helping providers respond quickly to growing patient and resident intake. This allows you to maintain the highest possible standards of infection control practises in all areas. Visit www.spearheadhealthcare.com or see the advert on page 4.
C & S Seating Postural Management C & S Seating has been providing postural control equipment to hospitals, nursing homes, hospices and medical equipment services nationwide since 1991. With 9 different sizes of T-Rolls and Log Rolls in a removable and machine washable, waterproof Titex or Soft Knit material. These rolls are used to control posture and position of the body in either supine or side lying. Our Knee & Leg support wedges are available in 2 sizes. C & S Seating is the sole manufacturer of the Alternative Positioning Support (APS) system. Ideal when more control of the abducted lower limb is required (See photo) which has
removable side cushions and middle pommel; this is available in small or large. Our popular range of Soft Knit covers in a choice of 5 vibrant colours provide a softer alternative that fit easily over our standard waterproof rolls. It is recommended you seek professional advice to select the correct product depending on your needs. Contact us on 01424 853331 or visit us at www.cands-seating.co.uk to request or download a brochure, pricelist or order form, request an individualised quotation, speak to an advisor or to place an order. See the advert on page 13.
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HYGIENE & INFECTION CONTROL Free Coronavirus Awareness Face Shields In Stock Now Video by iHASCO iHASCO , a market-leading provider of workplace eLearning, have released a free Coronavirus awareness video to help offer organisations and the general public practical advice on what Coronavirus is, how to reduce the risk of the virus spreading and what to do if you’re showing symptoms. This free resource is for anyone wishing to find out more about Coronavirus and how to minimise its impact. Employers can now, in under 10 minutes, provide a short video to all of their employees, spread awareness and help them understand best hygiene practices. Access the video at www.youtube.com/watch?v=FJrpfmnOnpc or visit the free resource page on the iHASCO website at www.ihasco.co.uk/blog/entry/2716/covid-19. The free video contains information gathered from the NHS, the Direct Gov website, The World Health Organization, and it also includes a few useful tips from iHASCO’s Infection Prevention & Control course. As a leading provider of online Health & Safety, HR and Business Compliance training, iHASCO offers quality online training courses to over 10,000 UK businesses. With this in mind iHASCO felt it their duty to share this information in a short video.
Face Shields are now in full production and available for delivery from Numatic International, home of the famous Henry vacuum. Manufactured in the UK, the Face Shield offers a simple, comfortable and reusable solution. We are prioritising dispatch of these Face Shields to Healthcare settings, including Care Homes. In response to the COVID-19 outbreak, we have urgently re-tasked our Design & Manufacturing Teams to deliver a Non-profit PPE initiative, supplying PPE to those that need it as quickly as possible. For more information and to order: Call: 01460 269270 Email: PPE@numatic.co.uk Visit: www.numaticsupport.com/faceshield
“Being Health & Safety training experts, we have a duty to play our part in raising awareness to help reduce the risk of infection spread and keep people safe,” says Nathan Pitman, Director at iHASCO. “We know how to source quality information and present it in an engaging way to ensure the learner takes away the key points. Rather than focus on panic and frightening news headlines we want to provide information that is of use and provide practical steps organisations and the general public can digest, despite the uncertainty of things to come. Visit www.ihasco.co.uk for further information.
Fight Back Against Bacteria and Viruses If the global COVID-19 pandemic has taught us anything, it's that good personal and environmental hygiene and a deeper understanding of cleaning procedures is of the utmost importance in controlling the spread of pathogens. We know that having a thorough cleaning regime and the right cleaning equipment is important but how do you know which equipment is right and what a thorough clean actually is? Understanding more about the potential pathogens is a good place to start. Firstly, do you know what the difference is between antibacterial and antimicrobial? An antimicrobial agent protects against various types of microbes, including bacteria, viruses, mould and fungi, whereas an antibacterial specifically protects against bacteria. Knowing which products are best to use alongside chemicals, as manual cleaning is still vital, is also key. Some pathogens survive in different
conditions for different lengths of time and variations in temperature. For example, did you know, MRSA can survive up to 8 weeks on a mop head and 7 months on dust? Listeria Monocytogenes, (aka Listeria) which is known to cause fever, diarrhoea and can even affect your nervous system, is what is known as a resilient bacterium. That means it can harbour on seemingly clean surfaces and create a protective biofilm over itself that chemicals alone cannot remove. This is where the right cleaning equipment comes into play. Using a high-quality brush alongside the correct chemicals when cleaning will allow filaments to get into the crevices where bacteria may be harbouring and clean it away, creating a hygienic surface. For more information about the highest quality, anti-microbial brushes available for the job, visit https://bit.ly/39oRq5r or call +44 (0)17 4786 0494
Proven Technology Offers Greater Protection for Staff and Residents Against Covid-19
Care Homes are having to work around the clock to ensure their facilities are as clean and infection-free as possible, to try and prevent Covid-19 (and multiple other viruses and harmful bacteria) from entering their facility in the first place or containing it once it does. However, routine cleaning and disinfection, even with the use of other hand sanitisers and antibacterial surface cleaners, only sanitises the individual or surface for that moment in time, i.e. as soon as contact is made with an infected surface or introduced from the outside, the area or the person is no longer safe. In the tight confines of a Care Home, supporting one of the most vulnerable groups, cross infection via surface contamination is a major challenge. The transient nature of current cleaning regimes will always prove challenging, particularly as over 80% of germs are spread by hands. Now a proven, independently accredited technology that offers a protective barrier wherever there is a risk of infection is at the forefront of preventing and protecting against the spread of Covid-19. Once applied it stays active, providing up to 30 days protection on surfaces and 24 hours on the skin. In a
Care Home, this can dramatically reduce the chances of encountering a crisis by reducing the spread of dangerous pathogens either by hand or touch. OneSpray’s Hand Sanitiser offers 24 hours protection with one application, contains no alcohol, is ultragentle on the skin and won’t wash off during normal daily washing. This means it is very economical to use versus alcohol-based sanitisers, given that typically one person will apply those sanitisers up to 10 times per day. OneSpray’s Surface Sanitiser offers protection on nearly all surfaces including door handles, desks, door entry systems and keypads, touchscreens, phones, kitchens and taps. A single application forms an invisible barrier over the surface that lasts up to 30 days and will not wash off so normal, daily cleaning can continue. OneSpray products incorporate Zoono technology, world leaders in antimicrobial protection. Over 150 worldwide laboratory testing reports support the efficacy of their products. In earlier trials for London Underground a treated train came back 99.9% clear after 28 days of uninterrupted service. OneSpray is offering a Starter Outbreak-Prevention Package, specifically for Care Homes. It consists of a 5-litre Hand Sanitiser with two 1-litre dispensers, plus a 5-litre Surface Cleaner with two 500ml spray bottles. For more information contact 07811113108 or email email@example.com or see the advert on page 8.
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HYGIENE & INFECTION CONTROL Are You Using the Correct PPE? market and masks being sold with invalid certification has led to many users, including even the NHS, ending up with inadequate masks at disproportionate prices.
WHO ARE WE? Our company is called HealthHealth (www.healthhealth.co.uk), due to the ongoing pandemic many businesses have had to purchase PPE for the first time, we have transformed our distribution model from wholesale to supply the end-user directly to prevent price gouging via intermediaries and ensure the user receives the correct masks for their intended use.
WHAT MASKS SHOULD I BE USING?
Answering your questions on the type of mask to wear to reduce the risk of those you provide care for contracting Covid-19
THE CURRENT PROBLEM COVID 19 has led to a surge in demand for personal protective equipment throughout the UK, and in response, a multitude of UK businesses have established supply lines to try and fill this demand. Unfortunately, although millions of masks are now being brought in, many provide little or no protection against COVID 19. The confusing amount of variations of masks combined with the lack of information in the
The 2 main types of masks that provide protection against COVID 19 according to the World Health Organisation (WHO) are N95/KN95 masks and 3 Ply Surgical masks. KN95 masks are 4/5 ply (layers) masks that come in two grades; FFP2 and FFP3. The WHO recommends these masks be used by those who are symptomatic and otherwise should be reserved for and used by those in the healthcare sector, particularly those in and around patients who are most susceptible to Covid-19. These masks should be tested to
Haigh Engineering Resident and patient waste is a day to day practical matter that simply cannot become a problem for frontline carers and nursing staff. With the raised awareness of cross infection risks, the proven reliable waste disposal systems from Haigh are recognised more than ever as being a key part of the toolkit for ensuring that human waste is effectively and efficiently removed as a source of risk, day in day out, without the risks and complications of either washing pots or manual bagging waste for collection. The team from Haigh have been working hard to support this beyond just the manufacture of the
Incomaster and Quattro waste disposers here in the UK, but also developing innovative and safe methods to enhance the servicing provisions that are available to customers. The recently launched all-inclusive rental proposition has proven particularly effective and popular with new and existing customers alike, not least as it reduces the operational, maintenance and financing headaches from sites which have more critical matters to address. For more information about incontinence and bedpan waste disposal please feel free to contact the Haigh team on 01989 763131 or firstname.lastname@example.org
EN:149 standards by a PPE compliant non-voluntary body. There are four types of medical-grade 3 Ply surgical masks; Type I, Type IR, Type II and Type IIR. Type I and Type II masks are not fluid-resistant and hence are not ideal for use during the ongoing pandemic. Fluid resistance is the ability of a mask to catch the respiratory droplets discharged when a user coughs or sneezes. The WHO recommends fluid-resistant medical masks be worn by over 60s and those who have underlying health problems, as well as those who are in contact with these groups. Both masks have high fluid resistance and high breathability. The difference between the two is type IR has a bacterial filtration efficiency (BFE) of >95% and type IIR has a BFE of >98%. Type IIR is therefore preferable to type IR, although both provide protection against COVID 19. These masks should be tested to EN:14683 standard by a PPE compliant non-voluntary body.
WHICH MASKS SHOULD I BE WARY OF? A surgical 3 Ply mask that does not fit into the above two categories cannot be classified as medical. Although they may provide some protection, they are not tested by the relevant standards to qualify them as either type IR or Type IIR, and are hence not appropriate for care workers. Valve masks provide no protection for anyone but the user of the mask, they do not prevent respiratory droplets being emitted by the user, and are hence
not appropriate for care workers. Reusable cloth masks lose their integrity with every wash, a study by the WHO shows them as significantly less effective than medical masks, and are hence not appropriate for care workers.
HOW DO I AUTHENTICATE A MASK I’M BEING SOLD? 1. Ask for a test report and a CE certificate/conformity and make sure the mask is tested to the aforementioned standards (EN:14683 for surgical masks and EN:149 for KN95 masks) 2.Verify the test report and the CE certificate on the website of the testing body on the certificate, most testing bodies will allow you to do this online automatically.
ABOUT US We provide all the aforementioned masks via our website: www.healthhealth.co.uk . Our Type IR and Type IIR masks supersede the required standards and are made to fit comfortably on the face for elongated periods. Our KN95 masks are all individually sealed in sachets. Our focus is on high quality at wholesale prices. Our masks have been supplied to the UK Department of Health, the NHS, Care Homes, Dentists, to name but a few. Please email us at email@example.com for any bulk enquires. GET 10% OFF when you use the code CARERDIGITAL
Reduce Cross-Infection with Dorgard
As a measure to reduce the risk of cross infection care settings may introduce increased cleaning routines, but managing this with the increased workload can be difficult and easily overlooked. Preventing cross infection amongst residents and staff in care and nursing homes has never been more important. Staff may be concerned that contact with door handles and hand plates could increase the risk of spreading the coronavirus and finding a legal solution to hold your fire door open has never been more pressing than now. Dorgard Original and Dorgard SmartSound can offer you a quick and cost effective solution to this pressing dilemma. They can be fitted to your existing fire doors by your own handyman in around ten minutes, providing you with an effective solution to reduce the risks of cross infection. Once fitted, these fire door holders will hold
your fire door in the open position with the help of a foot plunger. The devices will constantly ‘listen’ for the sound of your fire alarm and on hearing it the Dorgard will automatically lift the plunger and allow the door closer, fitted as standard to all fire doors, to close the door, ensuring fire safety is maintained. By holding fire doors open in this way you remove the need for your staff to touch door handles and hand plates, reducing the risk of germs and viruses spreading. You can programme the Dorgard to automatically close at night should you require this. If you would like to know more about how Dorgard can help you meet your legal fire safety requirements and reduce the risk of cross infection, call our customer care team today 0800 612 6537 or visit www.safelincs.co.uk or see the advert on page 18.
PAGE 32 | THE CARER DIGITAL | ISSUE 12
HYGIENE & INFECTION CONTROL How Do You Control The Spread Of Infection? The severity of any build up of bacteria or pathogen could be fatal. At SFS Protect, high standards of hygiene are recognised and paramount to the ethos of our service. No sprays, no wipes, just vaporised Hydrogen Peroxide. The Nocospray 2, has been carefully developed around a heating and ionising turbine that transforms and emits the Nocolyse disinfectant into a non-corrosive, non allergenic, bio degradable gas – with no residue.
mint fragrance or with essential oils, should there be a requirement to remove odours. All Nocolyse gas when evenly distributed throughout isolated areas will eliminate dangerous viruses such as MRSA, Clostridium difficile, Norovirus, CPE, Coronavirus. In relation to the current Pandemic COVID-19 Coronavirus, our “Oxypharm One Shot” has now been fully accredited and a full copy of this declaration is available on our web site.
THE PRODUCTS The Nocospray 2 will eliminate 99.99% of all bacteria in as little time as 90 minutes. There is no requirement for the removal of electrical equipment, furniture, fixtures and fittings, just the room to be completely sealed for the gas to work effectively. Services At SFS, we offer 2 types of service. Curative “One Shot” Disinfection is where there is a known or recurring problem. Preventative Decontamination Disinfection is to maintain good levels of infection control. The “Decontimination” range is also available with a mild
OUR MISSION SFS Protect are dedicated to providing a caring and discreet service. Our mission is simple, to provide a safe and comfortable environment to work, play, learn and relax without the fear of contracting harmful viruses, bacteria and fungi.
TESTIMONIAL “SFS Protect are working with us to keep our employees safe by fumigating areas in any suspected COVID-19 cases. The team deliver a professional and efficient service, provide excellent technical support and respond quickly to any fumigation requests. Callout requests are fulfilled within 24 hours, leaving areas safe to return to within 40minutes of any suspected cases.” Book now on 07468 428530, email firstname.lastname@example.org or visit www.sfsprotect.co.uk
JET - A Powerful Sporicidal Disinfectant JET is a powerful sporicidal disinfectant for use on non-porous high-touch surfaces. JET is also a powerful cleaner destroying RNA and DNA in seconds. Its cleaning efficacy meets the requirements of a medical instrument cleaner, effectively reducing levels of protein and carbohydrate. JET is the best safeguard for residents and staff wherever the risks of infection are highest and is ideal for use in care homes. JET is sporicidal, mycobactericidal, virucidal, fungicidal and bactericidal in one minute. It has been tested in accredited laboratories and is proven effective against a wide range of microorganisms.
DOOR FRAMES & HANDLES
JET is built upon the same core chlorine dioxide technology as the Tristel medical device disinfectant products, but specially adapted for surface disinfection where cleaning and biofilm destruction are so important. Chlorine dioxide is widely regarded as one of the most effective disinfectants for biofilm removal and prevention. JET delivers chlorine dioxide as a foam. It creates no aerosols when used. Efficacy with the standard wipe in EN16615 means JET can be used with any sustainably sourced wipe, avoiding the use and waste of plastic wipes. Find out more: BIT.LY/JETCH20
CHAIRS & WORK SURFACES
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Clean Care Is In Your Hands Skin health and surface hygiene expert, GOJO Industries-Europe Ltd, has backed the World Health Organisation’s global call to action for health workers. The worldwide advocacy day for Hand Hygiene falls annually on 5th May, and this year its importance is even more significant, as the world battles COVID-19. As a member of the World Health Organization (WHO) Private Organizations for Patient Safety group, GOJO Industries-Europe has always been a strong advocate of making hand hygiene second nature to everyone. Once again, GOJO is supporting the WHO’s annual ‘Save Lives: Clean Your Hands’ campaign and encouraging everybody in the healthcare industry to get involved. As the World Health Assembly has designated 2020 the International Year of the Nurse and the Midwife, the campaign’s focus this year is on the central role played by nurses and midwives in achieving clean care. This includes hand hygiene best practices, as well as recognising their crucial contribution to strengthening quality health systems. The annual campaign and advocacy day targets a crosssection of influencers in the global healthcare sector, calling them to join together in celebrating and empowering nurses and midwives in the monumental work that they do to keep patients, families, and colleagues safe, by preventing healthcare associated infections. This year’s specific calls to action are: • Nurses: “Clean and safe care starts with you.” • Midwives: “Your hands make all the difference for mothers and babies.” • Policy Makers: “Increase nurse staffing levels to prevent infections and improve quality of care. Create the means to
empower nurses and midwives.” • Infection Prevention Control Leaders: "Empower nurses and midwives in providing clean care.” • Patients and Families: "Safer care for you, with you.” Chris Wakefield, Vice President, European Marketing & Product Development, GOJO IndustriesEurope Ltd comments, ‘Nurses and midwives account for nearly 50% of the global health workforce1 and play a vital role in providing health services and meeting everyday essential health needs. At GOJO, saving lives and making life better through well-being solutions is our mission and it continues to inspire our deep commitment to improving hand hygiene. In partnership with healthcare managers, we can help implement a tailored, effective, and total solution, which promotes compliant and healthy hand hygiene behaviour. ‘We are proud and loyal supporters of the WHO’s “Save Lives – Clean Your Hands” campaign, and urge everyone in the healthcare industry to join together in support of hand hygiene improvement globally.’ Free advocacy toolkits to support the WHO Save Lives: Clean Your Hands campaign are available on the WHO website: www.who.int/infectionprevention/campaigns/cleanhands/en/ WHO invites everyone to use the hashtags #SupportNursesAndMidwives #HandHygiene #InfectionPrevention on social media to ensure Save Lives: Clean Your Hands posts are picked up by the campaign. For more information, email infouk@GOJO.com or visit www.GOJO.com 1 https://www.who.int/news-room/ fact-sheets/detail/nursing-and-midwifery
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dangerous chemicals, as a liquid it is less toxic than vitamin C or coffee. This is truly the next generation of antimicrobial technology.
OneSpray Ltd. Abacus House, 14-18 Forest Road, Loughton, Essex. IG10 1DX t: 03300 577148 e: firstname.lastname@example.org
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THE CARER DIGITAL | ISSUE 12 | PAGE 35
TECHNOLOGY AND SOFTWARE Covid19: Accelerating the Use of Digital Technology in Healthcare As this crisis impacts every part of the health sector, significant vulnerabilities are being exposed. The NHS ‘digital revolution’ has long been touted as the key to futureproofing both Social Care and our health service in the face of increasing patient demand. That demand has now reached unprecedented levels and seems unlikely ever to revert to previous trends; against that background; there is an urgent requirement to move quickly to realise the opportunities which are available from digital technology. It is no longer an interesting speculation; it is an essential requirement to support staff and save lives. (Rt Hon Stephen Dorrell)
USING TECHNOLOGY TO IMPROVE EFFICIENCY Poor efficiencies in many areas of the sector are caused by the lack of investment in technology. Technology will improve the way your staff carry out tasks by either speed up existing processes or allowing new, more flexible and accurate ways of carrying out a job or process which will in turn enables live real time management information. Would you expect to check out of a hotel with an invoice and extras raised in Word
or Excel so why do many operators still use this method when invoicing? How many industries with shift workers rely on manual payroll processing outside the care sector? Repeatable systems should harness the power of technology to cut back the massive waste of man hours spent processing and checking manual tasks. In order to work out the best technology for your needs, you should assess your current systems against your requirements. Think about what inefficiencies exist in your homes and how you could: 1. Capture relevant information, such as resident/staff details, in a simple, time-efficient way. 2. Manage your documents to ensure that information is dealt with logically. 3. Avoid duplication at all costs; completing handwritten timesheets which then need to be manually inputted into payroll is a massive, unnecessary waste of time & manpower. 4. Address technological obstacles. The perception that your staffs are not IT literate is out of date; most people own a smart phone so yes they are! See www.fusion4care.com for details.
Using Technology to Manage the Prevention and Control of Infection in Care Homes For care home residents, infections can be serious, and in some cases, life-threatening. So, in the midst of a pandemic, the focus on good infection prevention and control practices has never been more important. Over the last few months, we have supported Radar Healthcare customers in the management of Covid-19 related incidents, helping them to map resident outbreaks, identify pockets of self-isolating staff and anticipate consequential risks as a result. The steps taken in care homes to protect residents and staff from infection represent an important element in the quality of care. So, knowledge and understanding of outbreak prevention, preparedness, detection and management is key.
PREVENT The dynamic management of emerging risks is a collective responsibility and one which ensures your workforce is fully involved in the process of preventing and controlling infection. Risk registers should be actively maintained and monitored with a standardised risk scoring mechanism to facilitate prioritisation. Risk stratification combined with regular audits and assessments to identify potential hazards can then support the creation of preventative action plans.
PREPARE Engaging with your workforce to co-create your strategic and
operational approach to infection prevention and control can support you to embed a culture of continuous improvement in this area. Education plays a critical role in the prevention and control of infection so it’s critical that you manage and track workforce capability and competency – giving you peace of mind that they understand the importance of infection control and the specific role they have to play.
DETECT Clear communication of symptoms, guidelines and procedures ensures staff are equipped to recognise an outbreak and take appropriate action. With standardised procedures for reporting active cases and incidents, you can develop a clear picture of the pace and spread of the infection.
DIGITALISING YOUR OUTBREAK MANAGEMENT PLAN Prompt investigation and control of infection outbreaks is critical to protect the safety of residents and staff but mobilising an infection outbreak response can be difficult if information is siloed or managed manually. Find out more about how Radar Healthcare can support your infection control processes at info.radarhealthcare.co.uk/infectioncontrol/
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t: 0 01133 1 1 33 979 555 e: email@example.com firstname.lastname@example.org • www.fusion4care.com www.fusion4care.com
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TECHNOLOGY AND SOFTWARE Mainteno Facilities Maintenance and Management Software Whether itâ€™s managing planned maintenance or dealing with fault repairs, Mainteno simplifies the day-today maintenance of almost any organisation. Mainteno also seamlessly incorporates asset management and tracking. Mainteno streamlines every aspect of the maintenance management process, saving your organisation time and money. Usability made affordable Mainteno was designed with practicality in mind. The interface is so intuitive that basic operation can be learned in minutes, and you can be a power user in one afternoon. Elegant usability usually means a hefty price tag. However, our pricing structure means that for small organisations, Mainteno can cost as
little as two cups of coffee a month. No set-up fees, no lengthy contracts and a free trial, all mean that the system starts paying for itself straight away. Dr Asif Raja, Bsc MBBS Summercare Managing Director says â€œFacing significant challenges of ever increasing quality and compliance demands upon time and resources as well considerable economic pressures, Summercare, an award winning provider of residential care and housing related support, sought to upgrade their systems for managing the property and environmental aspects of its service delivery. After an extensive period of investigation and research Mainteno was selected as the platform of choice for the entire organization based on its ease of use, very short-term contract, quick set up and ongoing support.â€? Visit www.mainteno.com, Tel: 020 8798 3713 or email email@example.com
We here at Edison Telecom Ltd have been providing specialist solutions to your call system requirements tailor-made to each customers needs for over 25 years, says director Bob Johnson. Is your current Nurse Call â€œlegacyâ€?, obsolete, so full of software bugs or commercially not viable for your current supplier/maintainer to maintain?
We may have just the part and expertise that you are looking for to give your nurse call a further extension to life, adds Bob, â€œEdison will treat your nurse call with the same compassion that you give to those in your care. There will come a time when your equipment is beyond repair but Edison are experts in extending the life of obsolete systems.â€? www.edisontelecom.co.uk
ITâ€™S NOT OBSOLETE UNTIL THE OPERA LADY SINGS
EDISON TELECOM LTD (IN BUSINESS SINCE 1984)
have spares, enhancements and expertise for wired and wireless systems abandoned by the original manufacturer, whoever they are.
Call us on 01252-330220 We can give most systems a new lease of life and maintain them into the future.
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THE CARER DIGITAL | ISSUE 12 | PAGE 37
TECHNOLOGY & SOFTWARE How Can Employers Help Improve The Work-Life Balance And Mental Health Of Social Care Workers?
Hailed as heroes during the pandemic, social care workers dedicate their lives to help the old, the weak and the sick. Often forgotten and under-valued, their mental health is under strain and COVID-19 has understandably worsened the situation. How can employers help their employees restore a healthier work-life balance?
THE STATE OF THE SOCIAL CARE WORKFORCE A new survey by Quinyx found that health and social care workers are amongst those most likely to have their mental health negatively impacted by their job. The pandemic has made it worse: 54% of those polled said that their work had negatively impacted their mental health over the past 12 months, versus 48% before the pandemic - a 12% increase.
LOW PAY, LONG HOURS AND HIGH EXPECTATIONS COVID-19 has seen them work longer hours and be in the spotlight, with high
expectations from their employers, the nation, the government, and to an extent, global scrutiny over which country will do “better” at handling the crisis. Added to the fear of getting sick or contaminating their loved ones, it is easy to imagine the mental burden on those who risk their lives to help others. Prior to the outbreak, the main reasons invoked by those who suffered poor mental health as a result of their job were low pay (42%) and managers’ expectations being too high (37%). Some concerns were alleviated during the pandemic though, with 72% of healthcare workers polled saying that they felt valued by their employer, versus 53% prior.
WHAT CAN EMPLOYERS DO TO IMPROVE THE SITUATION? While increasing wages may not always be possible, three areas can make a positive difference:
What Has COVID-19 Taught Us? During the last few months, the response to the COVID-19 pandemic by services and technology companies has been epic. Decision making processes which normally take months, even years took days. Massive co-ordinated efforts with care homes, hospital trusts, local authorities, manufacturers and suppliers all coming together on projects across the UK. We can certainly say, having been heavily involved in many projects in the UK and around the World, that Courtney Thorne are enormously proud and humbled to have played our part. One of the largest temporary Field Hospitals is the Dragon’s Heart Hospital inside the Principality Stadium in Cardiff. This vast stadium initially housed 335 emergency beds, when an additional 1200 beds were required Courtney Thorne was approached to supply,
install and commission nurse call points throughout the pitch and seating areas. These call points (including shower and toilet alarms) were supplied, installed and commissioned by Courtney Thorne’s own engineering team. Designed into 55 separate “wards” and integrated with paging systems. Completed in two weeks, it was a herculean effort by everyone involved. No one could have predicted what was going to happen when in January we heard of deaths in China spreading. The impact of the lock-down in March brought home the scale of the problem as business owners worried, not knowing what the consequences might be. This was true for those of us supplying the healthcare sectors, with hospitals focussing on the pandemic and care homes locking down to protect elderly residents.
- Two-ways communication channels, effective and open, to monitor and engage. - Allowing greater flexibility and control over work hours to restore a healthy balance. - Optimised schedules to improve efficiency, reduce the overall cost of labour and help both workers and managers plan ahead.
HOW TO SUCCEED? Using technology to improve your workers’ work-life balance and wellbeing is one way to stay ahead of the game. Technology can help keep your employees productive, connected and happy. A solution like Quinyx helps empower workers, while optimising communication, time management and resources. It can also ensure that employers comply with the new regulations around contact and tracing, all through a simple, userfriendly app.
www.quinyx.com/survey * Research conducted by Censuswide in two stages: the first was conducted with 1,200 deskless workers who work an hourly schedule in the following sectors: healthcare and social assistance, retail, hospitality and tourism, shipping/distribution, transportation and warehousing. It took place between 11.03.2020-23.03.2020. The second was conducted with 1,205 deskless UK workers in these same sectors.
As we reduce the lock down rules, for many people and businesses this means a degree of normality and returning to work, albeit with social distancing. Those in the care sectors however will be more cautious so not to risk the vulnerable and elderly. Where there are COVID-19 free hospitals some of the day to day maintenance, building work, refurbishment will re-start, and it is here that the health and care solution providers need to be ready to support these projects. Care homes need to make sure the safety of those in their care is not compromised by aging or failing nurse call systems. Courtney Thorne continued to provide full engineering, sales and support functions throughout the lock down period. A serious consideration when deciding who will supply business and person critical technology in the future. When we look back on this period, no doubt some of the practices learnt will stand the test of time, such as flexible working with more home working. Video conferencing has at last come of age, e-training, webinars, online meetings have been the savour of many
businesses. It therefore appears to have taken a pandemic to create a situation where communication technologies, readily available becomes normalised. Spending quality time with our closest family is favoured rather than spending hours sat in commuter traffic. Business leaders at last realise that they can trust colleagues to do the right thing. Maybe there is a compromise to be gained where work can be more flexible, coupled with face to face meetings, not for every individual nor every business, however it is a start. For more information about solutions for care, see Courtney Thorne's advert on page 11 or visit www.c-t.co.uk
THE CARER DIGITAL | ISSUE 12 | PAGE 39
TECHNOLOGY AND SOFTWARE Lotus Care Technology The NurseAlert pressure mat has been one of the most successful floor pressure mats due to it being non slip and carpeted which makes it feel very natural under a residents foot. Lotus Care Technology Ltd have many other fall saving devices that can give you peace of mind whilst caring for
this at risk of falls. Having many years of experience in fitting and maintaining Nurse Call Systems helps the guys at Lotus Care Technology understand that every home is different and has different needs. They can specify not only the best system for the environmental factors in the home but also take into consideration the best products that will make your carers and nurses jobs that little bit easier. Visit lctuk.com for details.
CARE VISION – Outstanding Care is at the Heart of Everything We Do At Carevision, outstanding care truly is at the heart of everything they do. They have combined over 40 years of hands on experience running care homes and working with some of the smartest mind in tech, they have created Care Vision - An all-in-one, cloud-based system that incorporates all your care and admin in to one easy to use system. Carers can compile resident notes, health observations and EMAR. Care home managers can manage rotas, accounts, HR and housekeeping tasks and log visitors using the digital visitor book. Residents can use the system to make personal choices on meals and activities and use the app to keep in touch with family and friends. Rishi Jawaheer, director at Care Vision says “The 100+ care homes that use our
system have seen its benefits – They are saving 2-4 hours of staff hours per resident, per week and they are achieving outstanding CQC results. Carers love it, residents and relatives love it, and care home managers can’t remember how challenging managing a care home was before it.” Of course, taking on a whole new system can seem daunting, that’s why Care Vision offer minimal investment, all round support and flexible hardware options. They don’t feel the need for long-term contracts, Rishi says “We have total confidence, once you use Care Vision, you will love it as much as we do.” The Care Vision team would love to talk to you about what the system can do for you. Contact at firstname.lastname@example.org or call 0208 768 9809.
Network Communication Systems Network Communication Systems Ltd ( NCS ) was established in 1992 and from the outset has provided Telecare and Security Products and Services, primarily to Local Government (Housing) and Housing Associations. Today we have many accreditations to our name including ISO 9001 Quality Management which ensures the company meets its quality commitments The company offers a full range of services encompassing Consultancy, Design, Project Management Installation and Maintenance The company supplies both 3rd party and own brand products for individual and grouped living. Grouped Living encompassing Sheltered Housing, Extra Care and Nursing Homes The Company offers maintenance on any make and model of
Telecare and Security Products/Systems, including system upgrades, partial and full, for better operation with the new digital telephone system being phased in by 2025. Maintenance can be offered on an ad-hoc basis or contractually via various packaged service agreements, depending on customer requirements Recently the company has just completed a design and installation project for Central Bedfordshire Council comprising over 50 CCTV cameras, some of which offer auto-tracking to get the best possible close up high quality image, Recording Equipment, Security Doors including Door Entry and Access Control and Automatic Swing Door Operators. All delivered to the client’s satisfaction. For further information, please visit www.nsgroup.co.uk
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THE CARER DIGITAL | ISSUE 12 | PAGE 41
CATERING FOR CARE
Tackling Malnutrition in Dementia Patients
By Gillian Farren, Registered Dietitian
NUTRITIONAL CHALLENGES Patients with dementia face numerous challenges, all of which can have a significant impact on their ability to eat and drink. In the UK alone, it is estimated that 3 million older people are malnourished or at risk of malnutrition.1 Alongside weight loss, key micronutrient deficiencies are recognised, with an estimated 35% of older people showing deficiencies in vitamins A, B12, iron and zinc.2 Although weight loss is part of the natural ageing process, dementia is recognised as a key contributor.3 Moreover, the link between dementia and weight loss strengthens as dementia becomes more severe.4,5 It is important to support dementia patients in eating and drinking well, as inadequate nutritional intake can make a person with dementia more confused.6 Recent guidance from NICE recommends that carers “encourage and support people living with dementia to eat and drink, taking into account their nutritional needs” and “consider involving a speech and language therapist if there are concerns about a person’s safety when eating and drinking”.7 However, dementia carers face specific challenges in supporting patients to eat and drink enough.8
DYSPHAGIA: A BARRIER FOR DEMENTIA SUFFERERS Dysphagia is a term used to describe difficulty or discomfort in swallowing food, fluids and saliva. Dementia is a well-recognised cause.9 Signs of dysphagia in people with dementia include coughing or choking; difficulties chewing; spitting out food; wet gurgling voice after eating; and food/drink spilling from or residue in the patient’s mouth after eating.10 If dysphagia is not managed appropriately, patients can suffer severe health consequences such as chest infections, aspiration pneumonia and choking-related death 9.
PROMOTING A SAFE SWALLOW The International Dysphagia Diet Standardisation Initiative (IDDSI) is a global standard that describes correct and appropriate thickening of liquids and food texture modification, to ensure that they are safe to offer to patients with differing degrees of dysphagia.11 IDDSI gives clear descriptors for all levels of consistency, from level 0 (thin/unthickened) up to 4 (extremely thick) for fluids, and from level 7 (regular) down to level 3 (liquidised) for foods.11 It is vital that patients with dementia are only offered foods and drinks that are a safe and appropriate texture for their current level of dysphagia. This should be assessed and regularly monitored by a registered speech and language therapist. Many dementia patients dislike the taste and texture of thickening agents. Thus, products which do not require added thickener may be more acceptable, and can make it easier when patients with dementia are preparing their own drinks. Interestingly, research suggests that use
products which do not require added thickener can lead to increased food and fluid intake.12
PERCEPTION, DEXTERITY AND DISTRACTIONS Dementia often changes how patients recognise once-familiar foods, drinks and utensils.6 Additionally, preference for sweeter tastes and contrasting colours are commonly observed 3. Involving patients in preparing their own foods and drinks, alongside the use of adapted utensils and cutlery, and a reduction in distracting sounds, sights and objects at mealtimes, can encourage independence and focus, while preventing wandering off during mealtimes.13
USING THE “FOOD FIRST APPROACH” For patients with small appetites, foods and drinks can be enriched by adding foods rich in fats and sugars – such as butter, jam, cheese and cream – to increase energy and protein intake without increasing the amount of food eaten. This is referred to as a “food first” approach.14 While this is the preferred first-line strategy to tackle malnutrition, dementia patients can still struggle to meet their needs from food alone, and oral nutritional supplements or nutrition shakes such as NuVu Life are often recommended to fill the gap.15
HOW NUVU LIFE CAN HELP Made up with 200ml whole milk, one 50g sachet of NuVu Life delivers an impressive 362 kcal and 27.5g protein. When mixed with water or milk, it is IDDSI level 2 consistency. For patients requiring level 2 thickened fluids, NuVu Life removes the need for added thickening agents, thus saving time and reducing risk of error for carers and patients alike. Moreover, NuVu Life is enriched with vitamins and minerals, including those identified earlier in the article (i.e. vitamins A, B12, iron and zinc), which are a specific concern for older people. Just one 50g sachet on NuVu Life provides 100% of the recommended daily intake for these key micronutrients. NuVu Life is available to purchase online (www.nuvulife.com), RRP depends on the quantity purchased. Use voucher code TC30 to claim 30% off your order. For sales enquiries, or to request a sample of NuVu Life, please email firstname.lastname@example.org or call: 07740 844 405.
REFERENCES: 1. Stratton R, Smith T, Gabe S. Managing malnutrition to improve lives and save money. BAPEN Report 2018. (available at http://www.bapen.org.uk/pdfs/reports/mag/managingmalnutrition.pdf ) [accessed 07 June 2020] 2. Maggini S, Pierre A, Calder P. Immune function and micronutrient requirements change over the life course. Nutrients. 2018; 10(10):1531. (Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212925/ ) [accessed 07 June 2020] 3. Prince M, Albanese E, Guerchet M, Prina M. Nutrition and dementia: a review of available research. Alzheimer’s Disease International 2014. (available at https://www.alz.co.uk/sites/default/files/pdfs/nutrition-and-dementia.pdf) [accessed 07 June 2020] 4. White H, Pieper C, Schmader K. The association of weight change in Alzheimer's disease with severity of disease and mortality: a longitudinal analysis. J Amer Geriatrics Soc 1998; 46(10):1223-7. (available at https://onlinelibrary.wiley.com/doi/10.1111/j.15325415.1998.tb04537.x) [accessed 07 June 2020] 5. Albanese E, Taylor C, Siervo M, Stewart R, Prince MJ, Acosta D. Dementia severity and weight loss: A comparison across eight cohorts. The 10/66 study. Alzheimer’s & dementia: the journal of the Alzheimer’s Association. 2013; 9:649-656. (Avaiable at https://alzjournals.onlinelibrary.wiley.com/doi/full/10.1016/j.jalz.2012.11.014) [accessed 07 June 2020] 6. Alzheimer’s Society. Caring for a person with dementia: a practical guide. 2019. (Available at: https://www.alzheimers.org.uk/sites/default/files/202003/caring_for_a_person_with_dementia_600.pdf ) [accessed 07 June 2020] 7. National Institute for Clinical Excellence. Dementia: assessment, management and support for people living with dementia and their carers (NG97). 2018. (Available at: https://www.nice.org.uk/guidance/ng97 ) [accessed 07 June 2020] 8. NHS Education for Scotland. Supporting People with Dementia in Acute Care: Learning Resource. 2016. (available at: https://www.knowledge.scot.nhs.uk/media/11866144/supporting%20people%20with%20dementia%20in%20acute%20care%20final%202016%20web.pdf) [accessed 07 June 2020] 9. Holdoway A, Smith A. Meeting nutritional need and managing patients with dysphagia. Journal of Community Nursing. 2020; 34(2):52-59. (Available at: https://www.jcn.co.uk/files/downloads/articles/12-nutritionalneed.pdf) [accessed 07 June 2020] 10. Hansjee D. 5 Fundamental Ms: cutting aspiration risk in dementia and dysphagia patients. Nursing Times. 2019; 115(4):38-41. (Available at: https://cdn.ps.emap.com/wp-content/uploads/sites/3/2019/03/190327-5-Fundamental-Ms-cutting-aspiration-risk-in-dementia-and-dysphagia-patients.pdf) [accessed 07 June 2020] 11. International Dysphagia Diet Standardisation Initiative. Complete IDDSI Framework detailed definitions 2.0. 2019. (Available at: https://ftp.iddsi.org/Documents/Complete_IDDSI_Framework_Final_31July2019.pdf ) [accessed 07 June 2020] 12. McCormick S, Stafford K, Saqib G, Ni Chronin D, Power D. The efficacy of pre-thickened fluids on total fluid and nutrient consumption among extended care residents requiring thickened fluids due to risk of aspiration. Age and Ageing. 2008; 37(6):714–715. (Available at: https://academic.oup.com/ageing/article/37/6/714/40923 ) [accessed 07 June 2020] 13. Crawley H, Hocking E. Eating well: supporting older people and older people with dementia. Caroline Walker Trust. 2011. (Available at: http://www.cwt.org.uk/wp-content/uploads/2014/07/EW-Old-Dementia-PracticalResource.pdf ) [accessed 07 June 2020] 14. Forbes C. The ‘food first’ approach to malnutrition. Nursing and Residential Care. 2014; 16(8): 442-445. (Available at: https://www.magonlinelibrary.com/doi/abs/10.12968/nrec.2014.16.8.442 ) [accessed 07 June 2020] 15. Robinson K. Nutrition and Dementia. Dietetics Today. Sept 2018; 42-43 (Available at: https://www.bda.uk.com/resource/nutrition-and-dementia.html ) [accessed 07 June 2020]
NUTILIS CLEAR • Transparent results • Simple to use • Amylase resistant1 • Does not continue to thicken2 • IDDSI compliant
The Dysphagia Act
NEW NUTILIS CLEAR RECIPE BOOK COMING SOON
AR NUTILIS CLE K RECIPE BOO
URABLE SAFE, PLEAS US FOOD IT AND NUTR IO LIVING FOR PEOPLE GIA A WITH DYSPH
THE CARER DIGITAL | ISSUE 12 | PAGE 43
CATERING FOR CARE Are You In Need Of Dysphagia Training*? *This training is intended for healthcare professionals only.
utes in total to complete, however you can complete one section at a time. How can this training help you? • Easy & convenient online solution to dysphagia training • Visibility to track progress in your care home • Raise the quality standard of dysphagia care in a consistent way
Did you know that between 50-75% of nursing home residents suffer from dysphagia1? Nutricia has a training solution for you, a FREE e-learning covering the fundamentals of dysphagia management using Nutilis Clear. The training is divided into 4 sections and has been specially designed for busy health and social care staff caring for people living with dysphagia. It takes 60 min-
The quality standards aim is for all new health and social care staff members caring for patients with Dysphagia to complete the modules as part of their induction programme. Existing health and social care staff members should also complete the learning to support their continuing professional development. There is a certificate that can be downloaded once the training has been successfully completed.
Caternet With care plans running up to 100 printed pages, providers are increasingly turning to kitchen software to support their CQC nutrition and allergen responsibilities. With Caternet, care organisations build recipes and menus using live data from their suppliers. Going paperless means nutrition per serving is automatically calculated, with allergenic ingredients tracked and cross-referenced - transforming Regulation 14 risk management.
Use the camera on your phone to scan the QR code to access the elearning and get started! For any questions contact your local Nutricia sales representative or our Resource Centre at email@example.com. Nutilis Clear is a Food for Special Medical Purposes for the dietary management of dysphagia and must be used under medical supervision. Reference: 1. O’Loughlin G, Shanley C. Swallowing problems in the nursing home: a novel training response. Dysphagia 1998; 13, 172-183.( https://www.rcslt.org/speech-and-languagetherapy/clinical-information/dysphagia)
Creating recipe cards using a bank of meal preparation steps saves a digital record, accessible to service users and care professionals alike. Organisations that share menus to apps or websites can build trust with families, removing dietary concerns around religious and cultural backgrounds. This saves time spent manually updating meal plans as menus change. Going paperless extends to purchasing with live prices and enforcing approved buying lists. Many organisations add in their HACCP food safety analysis guidelines to use as kitchen training packs. Included are forecasting tools that promote compliance across stock management too. Caternet is developed with operators, buyers and chefs, who have all experienced similar operational and financial challenges. It is specifically designed to help the sector remove manual processes. You will support nutrition and allergen compliance, buy more competitively, enjoy paperless financial administration, and reduce overheads. Start saving time and money today. 023 8212 4099 www.caternet.co.uk firstname.lastname@example.org
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Martin McKee’s Croque Madame Serves: 10 Allergens: Eggs, wheat, milk
Ingredients Sandwich • • • • •
20 slices of thick white bread 20 British Lion eggs 20 honey roast ham 2 red onions 150 grated mature cheddar
• 150 grated Gruyère cheese • 50g butter (soft)
Bechamel • • • • • •
90g butter (unsalted) 90g plain flour 1/4 tsp English mustard 100g milk powder 900ml milk (whole fat) 50g grated parmesan
1. To make the Béchamel, fortify the milk with milk powder in a pan. In a separate pan, combine the melted butter with flour. Slowly incorporate the butter on a medium heat until it’s smooth. Add the parmesan, mustard and salt and pepper. 2. To make the sandwich, spread each slice of bread with the Béchamel before adding some ham, red onion, Gruyère cheese, cheddar and pepper. 3. Spread the top slice of bread with butter. Heat a pan on a medium heat and place the sandwich butter side down with a little extra butter and fry on each side. 4. Remove from the heat, top with more Béchamel and cheese and place in the oven to finish cooking at 170°C for 3 – 4 minutes (fan oven). 5. Remove the fried sandwich and top with a sunny side up British Lion egg. 6. Serve with a fresh tossed mixed salad with red onion, mixed peppers, tomatoes, cucumber, radish and carrot. Recipe courtesy of www.eggrecipes.co.uk For more information please call the British Egg Information Service on 020 7052 8899 or see the advert on page 42..
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The Carer Digital is delivered to our readers online every week. This new online edition is available online for the duration of the COVID...
Published on Jun 24, 2020
The Carer Digital is delivered to our readers online every week. This new online edition is available online for the duration of the COVID...