PAGE 8 | THE CARER DIGITAL | ISSUE 16
Caring for Care Staff – Avoiding ‘Burnout’ By Leyla El Moudden, Naturopath (www.healthy.co.uk) There is ample statistical evidence that healthy well rested and happy staff, are more likely to remain in their jobs, make fewer errors, advance professionally, be more productive and take fewer sickness absences. In an environment such as a care home, one that is that is rife with demand, pressure, emotion – and now too the additional pressures of corona virus: how do care homes make sure their staff remain consistent, healthy and motivated to meet the demands of their day. In a holistic wellness system, there are three primary components that together create what we refer to as ‘wellness’. These three components are: mental, social and physical health. By being in tune with the early signs and signals that one of these elements are out of balance, managers and staff can prevent exhaustion, and maintain performance: even in tough times. Let’s take each element one by one. Mental health refers to a combination of stress, and emotional health. The earliest signs of stress tend to show up in sleep patterns. When staff appear in looking tired, or mentioning that they have been ‘awake since 3am’ for apparently no reason – this is an early signal that the stress hormone cortisol is disrupting the healthy balance of cortisol, a stress hormone. Stress induced cortisol imbalance often leads to coping strategies such as the use of stimulants such as caffeine or sugar to combat tiredness – eventually leading to state we in Naturopathy called ‘tired and wired’. Sleep deprived staff are depleted of the rest they need for their bodies to function well, but are being kept artificially animated with false energy from stimulants. Consider allowing staff to take sleep days, or sleep mornings to keep them well rested, and also to offset the build up of stress, and the disruptive cycle of stimulation and depletion that follows. Staying in a stress, sleep, stimulate cycle will eventually reduce immunity and overall health leading to unpredictable absences and loss of motivation.
Healthy staff are productive staff – so it is more advantageous to let a staff member sleep for a day or a morning, then to have unpredictable sickness absence for multiple days at a time. Social health is a reflection of our innate human need to be together with others. Longevity studies on centenarians (people who live past 100 years old) have researched populations all over the world to find out the habits that lead to long life. What they found was that whilst diet plays a role, what these centenarians had most in common was they spend a lot of time around other people – they spent a lot of time in the company of others. Your staff need to spend time with people to remain healthy and productive: their family, their loved ones, their children or marital partner. Isolation from these things leads to lower health and according to the research, shorter life as well. When staff request time to be with their families, try to avoid panicking or responding with negativity. Granting this time and space is giving your staff a source of health that is essential to their wellbeing, and therefore their loyalty and diligence in working for your organisation – they will come back from socialising happier and healthier and that is never a bad thing. Physical health in holistic health and wellness can be described simply as ‘having more than enough energy to meet the demands of your life’. Sensations of energy such as the ability to wake up and get out of bed with ease, to carry an item up and down the stairs with comfort – to have energy to go to that evening with friends, to finish that piece of work, to mow the lawn is a signal of health. Feeling tired, lethargic, sluggish or slower can all point to nutrient deficiency. Work, stress and lack of adequate rest will begin to deplete human nutrient stores such a bone and muscle leading to feelings of fragility and weakness, and eventually lowered immunity and sickness. The more depleted a person becomes the more difficult they find simple tasks like cooking a healthy meal, and drinking water leading to a cycle of nutrient depletion. A simple way of ensuring a person has adequate nutrition is to make sure that for as many days of the week they ‘eat a rainbow’. This means eating a food from every colour: red, purple, orange, yellow, green. A poster in the staff room is an easy way to encourage and remind staff to consume enough nutrition to generate the energy they need to meet the demands of the day.
How To Recommence Care Home Visits Safely By Charles Spencer, Principal Health & Safety Consultant at Ellis Whittam (www.elliswhittam.com)
We have reached a critical point in the coronavirus pandemic where the government feels that, if done safely, care home visits can now resume following the publication of new guidance on 22 July. It is imperative that visits are conducted in a safe manner to ensure that within the home environment, nobody is put at further risk. We are all too aware of the devastating effects of an on-site outbreak, and at the same time know just how detrimental loneliness can be to a resident’s health. As such, careful management is essential, and those involved in implementing safe visiting procedures should start by familiarising themselves with the government guidance before allowing visits to take place. The guidance emphasises the need for risk assessment, taking into
account the specifics of the care home and the community context, supported by a visitor policy. It then goes into detail on decision-making, infection control precautions and communication, which provides a useful starting point from which to develop your risk assessment. At Ellis Whittam, we are recommending that care homes consider the following areas when deciding on the most appropriate control measures to implement: • Ensure you follow the basics. Although we are still learning about COVID-19, we do know that social distancing, handwashing and cleaning measures can be very effective in the fight against the virus. • Reduce the chance of the virus entering the home. A suitable system will need to be put in place to manage visiting hours and the number of people that can visit at one time. Health screening is also vitally important, and it is essential to ask the visitor to provide details of any potential symptoms they have or have had to prevent the virus from entering the home. A visiting record will also need to be kept, including the name and contact details of visitors and the date of their visit, in order to assist with the NHS tracing of potential contacts. • Decide on the most comfortable but most effective place for visits to take place. The scientific data has shown that adequate and effective ventilation reduces the potential for the virus to spread via air droplets. Accordingly, being outside has been proven to be one of the most effective ways of preventing transmission. If visits cannot take place outside for whatever reason, a suitable room within the building should be chosen which can be well ventilated. Homes will also need to consider the entry and exits points and any areas where visitors could potentially come into contact with people other than the resident they are visiting. For this reason, we recommend that the visiting area be as close to the entrance as possible. Social distancing of two metres with-
in the visiting area will also need to be provided; although the guidance now advises a distance of one metre plus with additional controls, being that the care sector is so vulnerable to outbreaks, social distancing should be managed as stringently as possible. Screens have also been proven to be an effective method of stopping the spread between people. • Reduce the potential of spread within the home. Regular disinfections of the visiting area, corridors and entry points, as well as toilet facilities, will reduce the risk of virus being spread should it enter the home. Having suitable hand sanitiser stations within the entrance and exit areas, as well as in the visiting area, will also encourage good hygiene amongst visitors. It is also important to consider the furniture within this area, ensuring that it can be wiped down with ease. Visitors should also be encouraged to wear face coverings when entering and moving around the home; although this will not provide absolute protection from the virus, it will reduce the risk of them passing on the virus to others, especially those who are vulnerable. This is a crucial moment for care homes, and while it will require careful planning, recommencing visits is a sign that things are moving in the right direction. Provided the right decisions are made, thorough risk assessments are in place, and appropriate safety precautions are implemented, care homes can hope to return to some semblance of normality, ensuring that residents’ physical and mental health remain top priority. You can download free health and safety resources for care providers, including a Visiting Protocol, Visiting Proforma and Risk Assessment Templates, from the Coronavirus Advice Hub: https://elliswhittam.com/covid-19/register/?v=thecarer
Cambridgeshire Care Group’s Head of Rehab & Nursing Commended After Completing Master’s The head of rehabilitation and nursing at a Cambridgeshire care group has received certification of the completion of her Master’s degree – a rare level of achievement reached in the social care sector. Priscilla Masvipurwa, Head of Rehab & Nursing Services and Registered Manager at Askham Village Community, near Doddington in Cambridgeshire, used her Master’s dissertation to explore the role nurses play in care homes to deliver psychology interventions, an area previously uninvestigated in the mainstream and a topic close to her heart. Her work looked at the lack of framework and structure in place to capture, meet, and deliver the psychological needs of the residents and staff in care homes, finding that people tend to treat the physical health issues without looking into the mental health needs – a mind-set that needs shifting. Commenting on why she chose to write about the topic, Priscilla said: “No one had looked at the lack of psychological support for people living in care homes. Registered Nurses, more often than not, provide that much needed psychological support with limited resources, addressing such issues without a formalised structure in place. I want people to understand that mental health should be viewed on a continuum where mental health and mental illness are at two extremes. Depending on several factors including availability of support, people maintain good mental health or develop a mental illness. Hence the need for people to be supported to cope with psychological difficulties to reduce the likelihood of developing mental illness.” She added: “Ultimately, we live in a world where problems are easily medicalised. In care homes, Registered Nurses need to address symptoms of depression or anxiety, particularly establishing in a timely manner whether symptoms are secondary to physical health issues or a result of social issues. Registered Nurses must be equipped with resources including training to assist in early identification of symptoms. They must also provide support to people living in care homes, more so now with a rise in anxiety and depression resulting from the devastating effects of living with pandemic threat.”
During the course of her studies, Priscilla noted that in care homes, while Registered Nurses strive to meet the physical health needs of residents, what really drives recovery forward is good mental health and emotional wellbeing. If this is left unattended then it’s highly likely the individual will remain in care longer than they need to. She puts it down to the individual’s appraisal of the situation and that, no matter what physical health intervention they undergo, automatic negative thoughts that lead to anxiety will stop them from fulfilling their goals or reaching their full potential. Priscilla’s dissertation concluded that residents living in care homes would benefit from a model that focuses on the interplay between biological, psychological, and socio-environmental factors to give residents a better chance of recovery. The mother-of-two finished the final year of her Master’s while working full-time for Askham, completing her thesis just prior to the COVID-19 lockdown, which saw her effortlessly juggling appraising her entire team and working on business continuity plans while finishing and proofing her thesis. An achievement Askham’s Operations Director, Aliyyah-Begum Nasser, believes is a testament to her tenacity, curiosity, and competence. Priscilla, who supports the rehabilitation of people with acquired brain injury and other complex health care needs at Askham, said: “Care homes rarely invest in higher education programmes such as a Master’s degree, but Askham were unrelenting in their support for me from day one. I could have shelved my work when I joined but it made so much sense to write about the environment I was in. It’s only been one year but I’ve learned a lot and grown in an area that is very unique. I’m still learning and enjoying every single day. “I’ve definitely further developed my skills in carrying out Continuing Health Care, DST assessments, and more so people management from a coaching perspective. It was the right environment for my Master’s Degree in Mental Health Psychology and being able to work with people while studying has helped me hone my coaching skills.”