This post was written by Laura Dobie, the Living Well in Communities Knowledge and Information Skills Specialist. You can follow Laura on Twitter at @LauraKnowledge.
On Friday 21st October I went along to Scottish Care’s new models of care workshop. It was a really interesting day filled with discussions on the future of care delivery, which highlighted examples of innovation and good practice in care from across Scotland – and further afield.
Legislative and policy context
Donald Macaskill, CEO of Scottish Care, facilitated the workshop discussions and gave a summary of the myriad policy publications and legislation which are having an impact on the care sector:
- The Public Bodies (Joint Working) (Scotland) Act 2014
- Audit Scotland’s forthcoming review of self-directed support.
- The Carers (Scotland) Act 2016, which is influencing partnership working.
- The Human Rights Act 1998, which is being used to challenge practice.
- The Community Empowerment (Scotland) Act 2015, which has already seen examples of local communities buying out care homes.
- The Mental Health 10-year strategy, in which older people’s mental health will be a priority.
- The Review of primary care out of hours services. What is the potential of care homes in meeting out of hours care needs?
- The National Clinical Strategy, with its emphasis on multidisciplinary teams and, where possible, co-location.
- The Palliative and End of Life Care strategic framework for action, which raises the issue of training for social care staff, who need to have an awareness of, and the ability to deliver, palliative and end of life care. How do we do this without over-medicalising care homes, which are people’s homes?
- The third dementia strategy has a focus on advanced dementia and palliative and end of life care.
- The National Care Standards.
There was also the uncertainty of Brexit, and the possible impact that it could have on staffing and funding. The National Living Wage implementation, NHS cost efficiencies, the reform of the care home contract, reform of care at home and housing support, reform of NHS boards and local government elections in May 2017 will all have an impact on the sector. Continue reading “Discussions from the Scottish Care New Models of Care workshop”
In this article we look at a service which is aiming to prevent falls by supporting older people who have difficulty attending classes to take part in exercise.
Exercise has an important role to play in reducing the risk of falls among older people in the community. A recent BMJ review has indicated that exercise-based and tailored interventions are the most effective way to reduce falls and associated healthcare costs among older people in the community, while a recently updated Care Inspectorate good practice resource, Managing Falls and Fractures in Care Homes for Older People has stressed the importance of keeping mobile, doing regular exercise and being physically active.
The Cowal Befrienders’ falls prevention exercise classes are working towards the overall aim that “Older people have a reduced risk of falls that may affect their ability to live independently in the community”.
Cowal Befrienders host two strength and balance exercise classes per week for older people who require some help to get to the Befrienders’ drop-in centre where the classes are held and support to participate in exercise classes.
Classes are co-ordinated and delivered by Otago-qualified staff employed by Cowal Befrienders (the Otago exercise programme is designed to prevent falls). Referrals and assessments are managed by the NHS Highland physiotherapy team.
Clients are entitled to six free classes, and can continue to attend for a modest fee of £2.50 per session. There is a small charge for clients requesting transport to their classes to help offset the additional costs incurred to provide this service (£3 return for individuals living within Dunoon, and £5 return for those living outside of the town).
In addition to health and wellbeing benefits, such as increased strength, balance and mobility, and helping participants to feel more confident and independent, the classes also have a social aim: to help older people to expand their social networks and foster peer support, and to increase access to health-promoting information that meets their needs.
The social aspect of the classes has been particularly valued by participants, with 97% citing this as one of the things that they enjoyed most about the classes. Clients also particularly appreciated the encouragement that they were given by staff and volunteers, and the pace of the classes. Continue reading “Preventing falls in Argyll and Bute: Cowal Befrienders’ exercise classes”
By Laura Dobie, Knowledge and Information Skills Specialist, Healthcare Improvement Scotland
Argyll and Bute Health and Social Care partnership has been holding a series of quality improvement workshops for care home staff, in collaboration with Scottish Care. I went along to one of their workshops with care home staff in Dunoon on 10th May to find out more about the work that the partnership is doing with care homes.
All 20 care homes in Argyll and Bute are signed up to a quality improvement project to reduce falls. Funded by the Integrated Care Fund, and supported by health professionals in each locality, the project aims to support care home staff to address falls risks in their care home. A particular emphasis is on improving physical activity for health and wellbeing.
The quality improvement workshops
Dr Christine McArthur, NHS Highland Coordinator Prevention and Management of Falls, Jane Howe, Quality Improvement Manager, and Kirsty Brown, Assistant Practitioner (Physiotherapy), facilitated the workshops. The team worked collaboratively with Scottish Care to develop events which met the needs of care home staff. The care homes requested a series of smaller local workshops, rather than one big event, as some staff do not drive and it was easier them to attend local events.
The team held workshops in Bute, Oban, Campbeltown, Dunoon and Helensburgh. Having dedicated events for care home staff and small group sizes ensured that all participants were able to contribute to discussions and ask the team for advice. Continue reading “Working with care homes to reduce falls: Argyll and Bute Health and Social Care Partnership”
Managing Frailty the Fife Way took place on 17th March 2016 at the Carnegie Conference Centre. The event was an interesting and informative day which explored good practice in managing frailty from Fife, highlighting innovative ways of working and successful examples of integration. There was a lot of sharing and learning on Twitter throughout the day, and you can view a selection of tweets from the day on the event Storify. You can also view the agenda for the day.
Dr Graham Ellis, National Clinical Lead for Older People and Frailty, gave a lively introduction to the day and declared an ambition for Scotland to be the best place to grow old.
Professor Scott McLean, Chief Operating Officer (Acute Services) NHS Fife, gave an overview of acute care redesign in Fife. He argued that it is a myth that hospitals are places of safety and explained their decision not to open surge wards, commenting that they are not good for older people or staff.
Dr Seònaid McCallum discussed health and social redesign in Fife. She emphasised the importance of relationships and building bridges, and the continuous nature of the work.
Karen Goudie, Joy Reid and Louise Kellichan presented on Frailty at the Front Door, highlighting NHS Fife’s frailty screening tool, their frailty huddles and the Integrated Assessment Team’s journey to a 7-day service at the front door.
Avenue Care’s Francis Davidson discussed their work on the Short Term Supported Discharge project, which aimed to help people to recover in their own homes, eliminating the need for a stay in hospital or readmission to hospital. She highlighted the success of joint working on the project and argued that the project has demonstrated that integration really works.
Continue reading “Managing Frailty The Fife Way: Summary and Resources”
NHS Fife and the Fife Health and Social Care Partnership are hosting Managing Frailty the Fife Way (#fifefrailty), a learning event for managers and practitioners from acute, community and social care. The event will allow NHS boards and health and social care partnerships to explore the health and social care system in NHS Fife and learn from examples of good practice and local innovation.
Healthcare Improvement Scotland is supporting the event and Graham Ellis (National Clinical Lead for Older People) will be introducing the day.
On the Day
The event, which now has a waiting list, is taking place on Thursday 17 March 2016 at Carnegie Conference Centre, Dunfermline.
There will be four plenary sessions taking place in the morning by a variety of speakers including, Professor Scott McLean (Chief Operating Officer, NHS Fife Acute Services Division) and Seonaid McCallum (Associate Medical Director, Health and Social Care Partnership).
The afternoon session will be made up of four breakout sessions and a further plenary session with Professor Brendan McCormack (Head of Division of Nursing / Head of QMU Graduate School) before closing with a panel discussion.
Continue reading “Managing Frailty The Fife Way”
What is this event?
Bringing the world together to help improve the NHS.
The NHS Transformathon is a free, online event bringing together global health and care staff and service users to connect, share and learn from each other.
The NHS Transformathon will showcase the latest innovations, practices and methodologies to inspire you with ways to make change happen. As a global event, you’ll be able to connect with world-leading change experts and people of different disciplines from many countries, each sharing experiences of successes and lessons learned.
What are we doing?
Our presentation, Moving from QI as an activity to a QI culture, is the only opportunity you’ll have to hear from Scotland. We will focus on our quality improvement journey using an example from our older people’s improvement programme and share our experiences of the route to integrated health and social care.
Ruth Glassborow, Director of Safety and Improvement, June Wylie, Head of Implementation and Improvement and Karen Goudie and Geraldine Marsh, Improvement Advisors with the Older People’s Care team at Healthcare Improvement Scotland will present.
Continue reading “Moving From QI As An Activity To QI As Culture”
For the Living well in Later Life conference we invited our friends from the Scottish Older People’s Assembly (SOPA) to talk to us about the issues facing older people in Scotland during Plenary session two – Celebrating later life.
What ensued was a lively conversation with Rob Snodgrass, Val Bissland, Tom Burney and Helen Biggins. Each question asked was answered fully and frankly by the panel leaving us with no doubt as to the strong voice SOPA provides to the health and social care conversation in Scotland.
Throughout the session Anne Gallagher shared two poems she’d written for the occasion with us and Rob, Val, Tom and Helen all spoke to camera to answer the question – What are the biggest challenges facing older people? Watch the video of their responses here.
Continue reading “A Conversation With The Scottish Older People’s Assembly”
What sorts of things come to your mind when you read the phrase ‘Living well in later life’? How can quality improvement help achieve this and why is the QI community across health and social care getting involved?
Surely how one lives, is not something that anyone other than the individual can control? Living well is about making your own decisions, about exercising choice. So why, one might ask are the health and social care organisations developing a programme that seeks to focus attention on this?
In a nutshell, what we are trying to do, through a series of projects is to empower older people and their loved ones to make decisions about how to live well in later life and provide guidance to help them navigate through the maze of choice of care solutions so that informed decisions about how one wishes to live well can be reached.
Continue reading “Living Well In Later Life”