Social Care Staff Research Articles

Investigating the factors that affect the communication of death-related bad news to people with intellectual disabilities by staff in residential and supported living services: An interview study.

Most staff working in intellectual disability services will be confronted with people with intellectual disabilities who need support around death, dying and bereavement. Previous studies suggest that intellectual disability staff tend to protect clients from knowing about death and avoid communication about death. The aims of this study were to gain further insight into the individual, organisational and contextual factors that affect the communication of death-related bad news to people with intellectual disabilities by intellectual disability staff and to develop guidelines for services to enable appropriate communication with clients about death and dying. Semi-structured interviews were held with 20 social care staff working in intellectual disability residential or supported living services in London, who had supported a client affected by death-related bad news in the past 6months. Staff found supporting people with intellectual disabilities around death and dying extremely difficult and tended to avoid communication about death. The following factors had a particularly strong influence on staff practice around communicating death-related bad news: fear and distress around death; life and work experience; and organisational culture. Staff attitudes to death communication had a stronger influence than their client's level of cognitive or communicative abilities. Managers were important role models. Service managers should ensure not only that all their staff receive training in death, loss and communication but also that staff are enabled to reflect on their practice, through emotional support, supervision and team discussions. Future work should focus on the development and testing of strategies to enable intellectual disability staff to support their clients in the areas of dying, death and bereavement.

Is “transforming care” failing people with autism?

PurposeThe purpose of this paper is to comment on the development and implementation of transforming care (TC) and whether it has failed people with autism.Design/methodology/approachThis paper is a commentary.FindingsThe number of people with autism being admitted to assessment and treatment units is increasing despite the aims of TC. The authors argue that TC, in serving such a diverse group of people, may have failed to identify the heterogeneity of such groups or recognise the different needs of people with mental illness and people with behaviours that challenge; and that TC could be regarded as a policy that only affects people with an intellectual disability.Originality/valuePolicymakers, policy implementers and health and social care staff may consider reviewing their practice to ensure that TC works for people with autism and their family and carers.

Developing a Model for Pharmaceutical Palliative Care in Rural Areas—Experience from Scotland

Palliative care is increasingly delivered in the community but access to medicines, particularly ‘out of hours’ remains problematic. This paper describes the experience of developing a model to deliver pharmaceutical palliative care in rural Scotland via the MacMillan Rural Palliative Care Pharmacist Practitioner (MRPP) project. The focus of the service was better integration of the MRPP into different care settings and professional teams, and to develop educational resources for the wider MDT including Care Home and Social Care staff on medicine related issues in palliative care. A variety of integration activities are reported in the paper with advice on how to achieve this. Similarly, many resources were developed, including bespoke training on pharmaceutical matters for Care Home staff. The experience allowed for a three step service and sustainability model for community pharmacy palliative care services to be developed. Moving through the steps, the key roles and responsibilities of the MRPP gradually shift towards the local Community Pharmacist(s), with the MRPP starting from a locality-based hands-on role to a wider supportive facilitating role for local champions. It is acknowledged that successful delivery of the model is dependent on alignment of resources, infrastructure and local community support.

Training needed to tackle HIV stigma, charity urges.

An older woman with HIV says staff in her care home wore double gloves when examining her, and swiftly wiped down any items she had touched. In Wales, a man with HIV was refused a place by three care homes. These examples of poor knowledge and stigmatisation from health and social care staff feature in a report into the experiences of older people with HIV.

Making nurse education LGBT-Friendly.

One in ten health and social care staff involved in patient care say they have witnessed a colleague express the opinion that lesbian, gay or bisexual people can be 'cured'.

Nursing associate: a role is born

British Journal of Healthcare AssistantsVol. 11, No. 1 ProfessionalNursing associate: a role is bornPeter BradleyPeter BradleySearch for more papers by this authorPeter BradleyPublished Online:12 Jan 2017https://doi.org/10.12968/bjha.2017.11.1.22AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Aiken LH, Sloane D, Griffiths P et al. (2016) Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care. http://tinyurl.com/h4fys8z (accessed 16 November 2016) Google ScholarGov.UK (2016) What Qualification Levels Mean. http://tinyurl.com/zftfjsb (accessed 23 November 2016) Google ScholarHealth Education England (HEE) (2016) Building Capacity to Care and Capability to Treat. http://tinyurl.com/z435osh (accessed 24 November 2016) Google ScholarHunt J (2016) NHS Providers annual conference keynote speech. http://tinyurl.com/znbyrnx (accessed 30 November 2016) Google ScholarNHS England (2016a) Nursing Associate Test Site Programme: FAQs. http://tinyurl.com/h5dun9q (accessed 17 November 2016) Google ScholarNHS England (2016c) Nursing associate. www.england.nhs.uk/ourwork/leading-change/nursing-associate/ (accessed 21 November 2016) Google ScholarNHS England (2016d) Nursing associate curriculum framework. http://tinyurl.com/zwfpmsf (accessed 21 November 2016) Google ScholarNielsen F (2016) Council of Deans of Health: Apprenticeships. http://tinyurl.com/z9knl57 (accessed 24 November 2016) Google ScholarBBC News (2016) London's St George's hospital trust in special measures. www.bbc.co.uk/news/uk-england-london-37822649 (accessed 17 November 2016) Google ScholarNHS England (2016a) Nursing Associate Test Site Programme: FAQs. http://tinyurl.com/h5dun9q (accessed 17 November 2016) Google ScholarNHS England (2016b) Health Education England announces training places for over 2000 nursing associates. http://tinyurl.com/j5wqszr (accessed 17 November 2016) Google ScholarAiken LH, Sloane D, Griffiths P et al. (2016) Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care. http://tinyurl.com/h4fys8z (accessed 16 November 2016) Google ScholarBradley P (2013) Support workers after the Francis Report—a BJHCA survey. British Journal of Healthcare Assistants 7(4): 163–7 Link, Google ScholarDepartment of Health (2011) Enabling Excellence: Autonomy and Accountability for Health and Social Care Staff. http://tinyurl.com/q4o5xlc (accessed 13 December 2016) Google ScholarFord S, Middleton J, Lintern S (2016) Exclusive: CNO pledges to intervene in skill mix disputes. http://tinyurl.com/j2lnury (accessed 21 November 2016) Google ScholarHunt J (2016) NHS Providers annual conference keynote speech. www.gov.uk/government/speeches/nhs-providers-annual-conference-keynote-speech (accessed 30 November 2016) Google ScholarNHS England (2016c) Nursing associate. www.england.nhs.uk/ourwork/leading-change/nursing-associate/ (accessed 21 November 2016) Google ScholarNursing and Midwifery Council (NMC) (2016) Nursing and Midwifery Council (NMC) Response To Health Education England (HEE) Consultation: Building Capacity To Care And Capability To Treat—A New Team Member For Health And Social Care. http://tinyurl.com/j2ajd6m (accessed 16 November 2016) Google ScholarProfessional Standards Authority (2016) Interim Report on Oversight of Nursing Associates. http://tinyurl.com/jctd9nu (accessed 13 December 2016) Google ScholarAiken LH, Sloane D, Griffiths P et al. (2016) Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care. http://tinyurl.com/h4fys8z (accessed 16 November 2016) Google ScholarCampbell D (2016) NHS nursing assistants could raise risk of death for patients, says study. http://tinyurl.com/hh3zghf (accessed 16 November 2016) Google ScholarJohnston I (2016) Government accused of putting patients' lives at risk with one of lowest rates of qualified hospital nurses in Europe. http://tinyurl.com/hg6o3wp. (accessed 23 November 2016) Google ScholarGov.UK (2016) What qualification levels mean. www.gov.uk/what-different-qualification-levels-mean/list-of-qualification-levels (accessed 23 November 2016) Google ScholarNHS England (2016d) Nursing associate curriculum framework. http://tinyurl.com/zwfpmsf (accessed 21 November 2016) Google ScholarNHS Employers (2016) London Life for NHS Workers. www.nhsemployers.org/case-studies-and-resources/2016/03/london-life-for-nhs-workers (accessed 28 November 2016) Google Scholar FiguresReferencesRelatedDetailsCited byRegulation of nursing associates in England: have your sayDepartment of Health9 November 2017 | British Journal of Healthcare Assistants, Vol. 11, No. 11A tale of two countries: enrolled nurses in the UK and GibraltarIan Peate, Jane Lane9 March 2017 | British Journal of Healthcare Assistants, Vol. 11, No. 3 2 January 2017Volume 11Issue 1ISSN (print): 1753-1586ISSN (online): 2052-4420 Metrics History Published online 12 January 2017 Published in print 2 January 2017 Information© MA Healthcare LimitedPDF download

Promoting Care Giving Interventions through the Dance of Caring Persons (After Pross et al.)

Health and social care staff work in complex workplace cultures that expose them to human suffering, distress and ‘dis-ease’. To defend themselves from emotional and physical pain, staffs undertake tasks, rituals, customs and practices to ameliorate discomfort. This serves as psychological and physical protection from their clients; alien to the ethos of person centred compassionate care. The dance of caring persons is a metaphor for the physical and emotional interaction of a caring relationship. Being facilitated through each of the dance steps offers one way to reignite caring professions. We outline a workshop process aimed to re-engage care staff with an intention to care. Self-care is the first step, which at an intentional, meaningful level requires a moment of mindfulness as internal bodily awareness. Noticing one’s emotional state increases self-awareness and an ability to focus on the here and now, from which to relish the breadth and depth of human experience. The second step includes a moment of performance; through intentional use of non-verbal communication to welcome and engage with others. The third step of the dance is active and effective verbal communication used to purposefully enter into a caring relationship. The fourth step is critical creative discussion, following mutual reflection of what has gone before. Step five is resonance; delving deeper into understanding the emotional and body senses, exploring the words exchanged, their intention and ‘true’ meaning. Step six is the creation of a ‘collage of caring’. Fragments of mutual learning, emotive expression and reactions (impact) are captured in the final exchange undertaken by all involved in the caring process. The dance of caring persons aims to identify the dance steps each person contributes to the context of caring. Such a compendium of caring provokes a deeper understanding of self in relation to the other, within the context of health and social care interactions.

Will Direct Payments Make Adult Residential Care more Personalized? Views and Experiences of Social Care Staff in the Direct Payments in Residential Care Trailblazers

AbstractDirect payments, i.e. cash payments made directly to the individual in lieu of social care services, have become an established option in council‐funded domiciliary care as a means to better personalize care and support. As part of its agenda to modernize social care, the Government tested their use in long‐term residential care in 18 trailblazing councils in England.This article presents findings from the independent evaluation of this initiative, using interviews with project leads seconded to the programme in all participating councils, and with council and care home staff involved in implementing direct payments in residential care in five sites. Interviews were conducted between September 2014 and November 2015. They explored professionals' views and experiences of personalization in residential care and their thoughts on the potential contribution of direct payments to promoting personalization. Whilst there was agreement that good care takes personal preferences into account and that many care homes could provide a more personalized service, doubts were voiced about whether direct payments were an appropriate mechanism to achieve this aim. This was seen as particularly pertinent in relation to residents with very high care needs and limited capacity to exercise choice and control. Interviewees also identified a number of risks and challenges to implementation, including financial risks to care homes. The findings from these interviews suggest that the contribution of direct payments to personalizing residential care may be more modest than expected.

Parliamentary arguments on powers of access – the Care Bill debates

Purpose Opinion is divided on whether a new power of entry should be introduced for social workers in cases where individuals seem to be hindering safeguarding enquiries for community-dwelling adults at risk in England who have decision-making capacity. The purpose of this paper is to investigate the prevalence and circumstances of situations where access to an adult at risk is denied or difficult and what helps those in practice. The study consists of a literature review, a survey of adult safeguarding managers and interviews with social care staff in three case studies of local authorities. As part of the contextual literature review, during 2014 the authors located parliamentary debates on the subject and this paper reports on their analysis. Design/methodology/approach Following approaches were used in historical research, documentary analysis was carried out on transcripts of parliamentary debates available online from Hansard, supplemented by other materials that were referenced in speeches and set in the theoretical context of the representations of social problems. Findings The authors describe the content of debates on the risks and benefits of a new right to access for social workers and the role of parliamentary champions who determinedly pursued this policy, putting forward three unsuccessful amendments in efforts to insert such a new power into the Care Act 2014. Research limitations/implications There are limits to a focus on parliamentary reports and the limits of Hansard reporting are small but need to be acknowledged. However, adult safeguarding research has surprisingly not undertaken substantial analyses of political rhetoric despite the public theatre of the debate and the importance of legislative initiatives and monitoring. Originality/value This paper adds to the history of adult safeguarding in England. It also offers insight into politicians’ views on what is known/unknown about the prevalence and circumstances of the problems with gaining access to adults with capacity where there are safeguarding concerns and politicians’ views on the merits or hazards of a power of access.

Complexities of cultural difference in social care work in England

ABSTRACTThe ageing of the ethnic minority population in Britain has led to a more ethnically diverse older client group for social care services than has ever been the case. This article focuses on the issue of how social care staff in England experience working across differences of culture, ethnicity, religion, and language. First, the article critically discusses the concept of cultural competence. Then, it reports on the perspectives of social care staff on their attempts to work in a culturally competent way. Individual in-depth qualitative interviews were carried out with 39 social care practitioners, and thematically analysed. Themes related to professional competence, appropriate behaviour, and training needs. Some practitioners felt unable to perform to their accustomed skill level when working across diversity, which has implications for the quality of care provided and job satisfaction. Other practitioners were confident in working across diversity. The key difference between these practitioners was a degree of cultural reflexivity. Recommendations for training are provided.

Diagnosing autism/autism spectrum disorders

Abstract Awareness of autism spectrum disorder (ASD) within public and medical domains has increased. Demand on services is high as children and young people are being presented for earlier advice, assessment and diagnosis. To maximise detection and minimise harm it is essential for all clinicians working with children including primary care teams, allied healthcare professionals, educational and social care staff to have a sound knowledge of the presentation and assessment of autism spectrum disorders (ASD) and an understanding of the co-morbidities. Whilst routes of entry for referrals can vary due to a diversity of presentation and local service provision, there are standards in the recognition, referral and diagnosis of autism. Early identification is advantageous in order to maximize the child's potential, provide appropriate support and targeted intervention for ASD and co-occurring conditions with the aim of improving outcomes. This review addresses the diagnosis of ASD and provides an assessment framework for professionals who encounter a child with a suspected autism spectrum disorder.

Scottish study urges health and social care staff to be alert to people’s risk of suicide

Scottish study urges health and social care staff to be alert to people’s risk of suicide

Developing a framework for gathering and using service user experiences to improve integrated health and social care: the SUFFICE framework.

BackgroundMore people than ever receive care and support from health and social care services. Initiatives to integrate the work of health and social care staff have increased rapidly across the UK but relatively little has been done to chart and improve their impact on service users. Our aim was to develop a framework for gathering and using service user feedback to improve integrated health and social care in one locality in the North of England.MethodsWe used published literature and interviews with health and social care managers to determine the expected service user experiences of local community-based integrated teams and the ways in which team members were expected to work together. We used the results to devise qualitative data collection and analysis tools for gathering and analyzing service user feedback. We used developmental evaluation and service improvement methodologies to devise a procedure for developing service improvement plans.FindingsWe identified six expected service user experiences of integrated care and 15 activities that health and social care teams were expected to undertake. We used these to develop logic models and tools for collecting and analysing service user experiences. These include a narrative interview schedule, a plan for analyzing data, and a method for synthesizing the results into a composite ‘story’. We devised a structured service improvement procedure which involves teams of health and social care staff listening to a composite service user story, identifying how their actions as a team may have contributed to the story and developing a service improvement plan.ConclusionsThis framework aims to put service user experiences at the heart of efforts to improve integration. It has been developed in collaboration with National Health Service (NHS) and Social Care managers. We expect it to be useful for evaluating and improving integrated care initiatives elsewhere.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2230-0) contains supplementary material, which is available to authorized users.

Meeting the health needs of older people with intellectual disabilities: exploring the experiences of residential social care staff.

Older people with intellectual disabilities often experience high levels of health needs and multiple morbidities but they may be supported by residential care staff with little or no previous experience of identifying and meeting health needs. Little is known regarding how they undertake this health-related role and this exploratory study seeks to address this gap. A purposive sample of 14 managers of supported living accommodation in Wales were interviewed in 2014 to determine their experiences of supporting tenants in relation to age-related health needs. The semi-structured interviews were transcribed and thematically analysed. Three of the emerging themes are reported in this paper: meeting health needs, the consequences of ageing and relationships. Findings indicate that residential care staff support older people with intellectual disabilities with complex and multiple health needs: they monitor health status, support access to healthcare, provide additional support arising from changing health needs and advocate for tenants in the context of healthcare. However, their role is often not understood by healthcare professionals. The importance of staff having a long-term relationship with those they support was identified as being important to identifying any health-related changes. The need to develop effective relationships with healthcare staff was also noted. It is concluded that there is a need for better understanding among health staff of the role of residential social care workers and for further research regarding health-related communication.

Advance care planning: the HCA's role

British Journal of Healthcare AssistantsVol. 10, No. 8 ProfessionalAdvance care planning: the HCA's roleMartin ShineMartin ShineSearch for more papers by this authorMartin ShinePublished Online:10 Aug 2016https://doi.org/10.12968/bjha.2016.10.8.374AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Calanzani N, Higginson IJ, Gomes B (2013) Current and Future Needs for Hospice Care: An Evidence-based Report. Cicely Saunders International, Kings College, London Google ScholarConnolly M, Perryman J, McKenna Y et al. (2010) Sage & Thyme: a model for training health and social care professionals in patient focused support. Patient Educ Couns 79(1): 87–93. doi: https://doi.org/10.1016/j.pec.2009.06.004. Epub 2009 Jul 22 Crossref, Google ScholarDepartment of Health (2008a) End Of Life Care Strategy: Promoting High Quality Care For Adults At The End Of Their Life. http://tinyurl.com/hurswwv (accessed 24 May 2016) Google ScholarDepartment of Health (2008b) Advance Care Planning: A Guide for Health and Social Care Staff. http://tinyurl.com/oral974s (accessed 24 May 2016) Google ScholarHerber OR, Johnston BM (2013) The role of healthcare support workers in providing palliative and end of life care in the community: a systematic review. Health Soc Care Community 21(3): 225–35. doi: https://doi.org/10.1111/j.1365-2524.2012.01092.x. Epub 2012 Sep 13 Crossref, Google ScholarLovatt M, Nanton V, Roberts J et al. (2015) The provision of emotional labour by healthcare assistants caring for dying patients in the community: a qualitative study into the experience of healthcare assistants and bereaved family care givers. Int J Nurs Stud 52(1): 271–9 Crossref, Google ScholarMarie Curie Cancer Care (2013) Death and Dying: Understanding the Data. http://tinyurl.com/o9lrgkp (accessed 27 July 2016) Google ScholarNHS End of Life Care Programme (2011) Preferred Priorities of Care. www.nhsiq.nhs.uk/resource-search/publications/eolc-ppc.aspx (accessed 24 May 2016) Google ScholarReed E (2015) What does end of life mean? In: Sadler C (ed). A Practical Guide to End of Life Care. Open University Press, Maidenhead Google ScholarSimon J, Porterfield P, Raffin Bouchal S, Heyland D (2015) ‘Not yet’ and ‘just ask’: barriers and facilitators to advance care planning—a qualitative descriptive study of the perspectives of seriously ill, older patients and their families. BMJ Support Palliat Care 5(1): 54–62. doi: https://doi.org/10.1136/bmjspcare-2013-000487. Epub 2013 Nov 19 Crossref, Google Scholar FiguresReferencesRelatedDetails 2 August 2016Volume 10Issue 8ISSN (print): 1753-1586ISSN (online): 2052-4420 Metrics History Published online 10 August 2016 Published in print 2 August 2016 Information© MA Healthcare LimitedPDF download

Lessons from abroad: Rebalancing accountability and pedagogy in the Irish social care sector through the use of effective leadership

Abstract A concern is emerging in Ireland that social care managers and staff are moving too far away from the ‘care’ in social ‘care’ work. In this paper a discussion of the impact of the bureaucratic procedures and regulation within the social work and social care work sectors is presented along with an exploration of leadership approaches. It is argued that certain leadership approaches, in particular pedagogical leadership, could not only help social care managers to negotiate the complex issues they are facing but also facilitate putting the ‘care’ back into social ‘care’ work. Pedagogical leadership is globally supported across a variety of human service disciplines: it facilitates the creation of a learning culture within the workplace where social care managers facilitate conversations with their teams to encourage reflection, critical thinking and contributions to the professional wisdom required for quality service. The purpose of this article is to contribute to the dialogue within leadership practice for social care professionals. This discourse is necessary if lessons are to be learned from past experiences in this country and others about how to balance the need for care, learning and compassion with accountability.

Inter-professional perspectives of dementia services and care in England: Outcomes of a focus group study.

Many people living with dementia are supported at home using a variety of health and social care services. This paper reports the findings from a focus group study undertaken with staff in community mental health teams to explore areas for improvement in relation to national policies and recommendations for dementia care. Two focus groups were held with staff (n = 23) in 2011 to discuss topics including service delivery, information and communication, and provision of health and community care for people with dementia. Respondents identified problems with information sharing and incompatible electronic systems; inflexibility in home care services; and poor recognition of dementia in hospital settings. General practitioners had developed a greater awareness of the disease and some community services worked well. They felt that budgetary constraints and a focus on quality indicators impeded good dementia care. Key areas suggested by staff for improvements in dementia care included the implementation of more flexible services, dementia training for health and social care staff, and better quality care in acute hospital settings.

Training of Residential Social Care Staff to Meet the Needs of Older People with Intellectual Disabilities who Develop Age-Related Health Problems: An Exploratory Study.

Despite awareness of the age related health needs of people with intellectual disabilities little is known regarding how residential social care staff are prepared to meet such needs. Data were gathered via semi-structured interviews from 14 managers of supported living settings. Transcripts were thematically analysed. Staff may work in supported living settings with no prior experience of care work, and previous knowledge/experience of supporting people in relation to their health is not required. Whilst health related training is provided there is a lack of specific training regarding healthy ageing, and training seems to be reactive to changing needs of tenants meaning that proactive monitoring for changes in health status may not occur. Whilst some training is provided for residential social care staff in relation to health and ageing a more proactive approach is required which should include a focus on healthy ageing.

Staff Training in Autism: The One-Eyed Wo/Man….

Having well-trained staff is key to ensuring good quality autism services, especially since people affected with autism generally tend to have higher support needs than other populations in terms of daily living, as well as their mental and physical health. Poorly-trained staff can have detrimental effects on service provision and staff morale and can lead to staff burn-out, as well as increased service user anxiety and stress. This paper reports on a survey with health, social care, and education staff who work within the statutory autism services sector in the UK that explored their knowledge and training with regards to autism. Interview data obtained from staff and service users offer qualitative illustrations of survey findings. Overall, the findings expose an acute lack of autism-specific training that has detrimental impacts. At best, this training was based on brief and very basic awareness raising rather than on in-depth understanding of issues related to autism or skills for evidence-based practice. Service users were concerned with the effects that the lack of staff training had on the services they received. The paper concludes with a discussion of policy routes to achieving quality staff training based on international best practice. The focus is on improving the quality of life and mental health for services users and staff, as well as making potentially significant cost-savings for governments.

End of life care: Everybody’s business

The Department of Health’s End of Life Care Strategy 2008, set out ways for improving people’s experience of dying in England and Wales. Hospice and specialist palliative care services were seen as having particular expertise and the strategy envisaged that their model of care should influence care in other generalist settings including social care. Palliative care social workers were identified as having knowledge and skills which could be drawn on to develop the end of life knowledge and skills of their colleagues in non-specialist settings. However, drawing on the ideas of Brown and Walter, 2013, that suggest social work has a pivotal role in remodelling hospice and palliative care, this paper examines their argument. To develop our thinking we have drawn on our experiences of sharing our expertise, through a hospice based, social work led, education and workforce development project for social care staff working in non-specialist settings.