Let your actions be stronger than your excuses

For the past 8 weeks, I’ve managed to do something I thought would be impossible:  I’ve cut sugar out of my diet.  Now, I won’t go into the health and lifestyle reasons behind this bold decision in this blog, but if you catch me tucking into a tub of almonds at a meeting sometime soon I’ll happily discuss metabolism and insulin spikes with you in more detail!

In an office where I had a meeting last week I noticed a poster advertising a local boot camp which was enticing new members with the phrase ‘let your actions be stronger than your excuses’.  If I’m completely honest, I felt a surge of pride.  Who’d have thought I had such willpower!

I should emphasise that it’s not just refined sugars I’ve shunned.  Oh no.   I’m carefully avoiding all food which contain oodles of sugar but which is marketed as ‘low fat’ and ‘healthy’.  Also, a significant number of my meetings as the National Workforce Lead for Scottish Care take place in coffee shops which always have an enticing array of pastries and I must admit to having a terrible soft spot for almond croissants.  Mmmm…almond croissants…..

Anyway, back to the blog.

There is a growing recognition that the health and social care infrastructure in its current format is not delivering human rights based care and support to older citizens living in Scotland.  The system is broken and one of the reasons is chronic staff shortages.  A recent Scottish Care workforce research report entitled ‘The 4 Rs’ confirmed our fears; fewer people are entering the social care sector and more people are leaving.

And they’re not coming back.

The workforce that do stay are at breaking point, desperately trying to provide compassionate and person focused care – but finding themselves crumbling, physically and mentally, under unsustainable pressures.  This was captured in another Scottish Care report entitled ‘Fragile Foundations’.

I believe that the failure to embrace integration and to actively engage the independent sector is at the heart of the present-day problem.  85% of care homes in Scotland are independently owned and there are almost twice the number of people living in care homes in Scotland than there are in hospitals.    A new report about the economic impact of the adult social care sector highlighted the fact that the sector contributes £3.4 billion to the Scottish economy.

However, I’m not seeing much action to embrace the reality – and potential – of working in a collaborative, integrated way.

There always seems to be some excuse….

Don’t get me wrong, at a local level there are several examples of effective integration projects which are taking place.  There are two remarkable projects currently progressing which involve Scottish Care providers and the Prince and Princess of Wales Hospice – exploring anticipatory care plans and how best to maximise the potential of the new palliative and end of life care educational framework.  From a workforce perspective, it’s extremely encouraging that we’re involved in more cross sectoral activities and work closer than ever with the Scottish Government, the SSSC, Health Care Improvement Scotland and the Care Inspectorate on both operational and strategic developments and improvements.  Relationships are being built and meaningful changes are being seen.  This is all very positive because it’s widely acknowledged that transformational change is needed – not a little tinkering around the edges – if we are to maintain and improve health and social care provision.

However, tinkering around the edges is what I continue to see.

Strong decisions and policy implementation are eschewed in favour of “guidance”.  Health continues to dominate our national political discourse to the detriment of the social care sector.  Decisions are being made at a local level which could have significant unintended consequences to our dedicated, skilled yet dwindling workforce and providers.  Only last week the Edinburgh Health and Social Care Partnership announced a new approach in their attempt to address the significant number of older people waiting for a care package or who are inappropriately staying in hospital when their needs would be better met in their own home or a care home.  This approach is going to rely on relatives providing more preventative interventions and being more pro-active in their relative’s care. I would welcome a discussion with the HSCP to find out more – as I have a concern that an unintended consequence of this proposed approach is that it sends out the message that ‘anybody can do social care’.

Well, they can’t and it’s a very dangerous assumption to think that they can.

Care at home providers are now looking after vulnerable people who often have extremely complex physically and mental health conditions.  The workforce undergo a significant amount of training to enable them to carry out their job safely and competently.

Care home staff are delivering extraordinarily complex care and are actually the largest providers of palliative and end of life care in Scotland.  Sadly, this is still largely unacknowledged.  Our report Trees that bend in the wind shone a light on the needs of the workforce who are, day in day out, providing solace to hundreds of people in their last days and hours of their life.

So: have we come to a point where we can’t accept any more excuses for not embracing integration in a way that will transform the lives of the workforce and the people they support and care for?

 

Katharine Ross, National Lead – Workforce Matters

@kguthrieross

 

#carehomeweek