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Training – is it good enough?

Training – is it good enough?

Quite simply, no.

The Edith Ellen Foundation has its concerns over the standard, quality and level of training Care Home Providers are obtaining to train their staff.

Training currently for Healthcare Assistants is not in the UK regulated, there is no requirement for evidence based training audits and a large proportion of UK Care Homes use this lack of regulation to the disadvantage of their own services and to the detriment of their staff.

Largely, the paperwork for staff training is a “tick sheet” process, if they tick to say it’s been completed no one will check, until in some cases it is too late.

We also have concerns over the Government decision to charge fees to nursing students in England and replace NHS bursaries with student loan.  The Government is gambling on the future of the nursing workforce.

This lack of regulation means that some care homes are cutting corners on their staff training and not giving training the necessary consideration is deserves as a fundamental part of their business.  In some cases, training is based on eLearning modules where there is no personal touch, no ability to discuss or communicate and no possibility of interaction within a group setting.  These elements are in fact essential and key to learning and development more so within the Care Sector where communication on interaction are key skills for developing care staff in the role of dealing with real people, with real thoughts and feelings.

In many areas of training only half of the information is covered and communicated in ½ day training sessions where a full day or more is needed.  An example of such is Dementia Awareness Training, looking at The Alzheimer’s Society they offer a full days training on Dementia Awareness, this introductory skill based course is designed for anyone who comes into contact with people living with dementia and who would like a better understanding of how to support them in their daily lives.  Therefore, why do many Care Providers only provide a ½ day training course on Dementia Awareness, when Dementia is their business and the full day would be of better use to their own staff and services?

Tips for people with dementia with a sensory impairment

Tips for people with dementia with a sensory impairment

Sight loss

·         Make the most of the person's sight - make things such as a calendar or clock bigger, bolder (use contrasting backgrounds) and brighter (use good lighting).

·         If the person with dementia needs glasses, make sure they are the correct ones and that they are clean. It may help to label them.

·         Reduce physical and visual clutter and obstacles.

·         Good communication is important - describe what is happening, for example that you have just come into the room, or what they are eating.

·         Use other senses such as scent, sound, touch and movement. This could include massage, cookery and music.

Think about using versions of daily living aids that have been adapted to make them more accessible such as:

·         audio versions of some newspapers, magazines and books

·         tactile and large-print games

·         audio guides (you can create your own) if going out and about

·         kitchen utensils and equipment.

Tips for helping a person with dementia with a task or activity

Tips for helping a person with dementia with a task or activity

If you spend time with someone with dementia, you can support and encourage them to do whatever they can for themselves, by only offering as much help as they need. This is not always easy - it can be frustrating watching something being done slowly when you could do it quicker and easier yourself. But even if the person is struggling with a task, try to avoid the temptation to take over. If you do, they may lose confidence and withdraw from engaging in activities.

·         If you do need to offer help, try to do things with, rather than for, the person. This will help them feel more involved and show that you are not taking over or questioning their abilities.

·         Focus on what the person can do rather than what they can't.

·         Adjust activities as necessary based on a person's interests and abilities.

·         Their concentration may be affected and they may find it difficult to follow instructions. Try to be patient and allow plenty of time for tasks. Take breaks if necessary.

·         Offer praise, reassurance and encouragement.

·         It is the sense of belonging and involvement that is important, not necessarily the activity itself.

·         Try breaking tasks down into sections. For example, the person may find it easier to continue dressing themselves if you put the clothes out for them in the order that they need to put them on. Or you could pass the next garment to the person, holding it out ready for them to grasp at the right place. You could also encourage them to put their vest on over their head before you straighten it down for them.

care home workers are 'crying out' for dementia training

Care failures reveal care home workers are 'crying out' for dementia training

Identifiable through recent reports within the national press and on national TV, a lack of training and understanding for care home workers is leaving people with dementia in soiled clothing, without food or water or in hospitals and care homes when they should be at home.

In a recent visit, we highlighted failures by identifying insufficiently trained care home workers which was resulting in poor care for those with dementia.  This includes not properly supporting people to eat or take medication, leaving people in dirty clothes for days or unwashed for weeks.

Those with dementia are also getting infections which are not identified by staff resulting in emergency hospital admission.  Because they are unable to recognise when a person is “not themselves” and refuse to listen to relatives who raise concerns.

A lack of dementia care training and understanding is also forcing people to move into care homes because home care workers cannot cope with people's needs.

Sensory stimulation

Sensory stimulation

Sensory stimulation is important for people with dementia, and can improve wellbeing and quality of life. During the later stages of dementia, people often develop increased difficulties with reasoning and language, meaning that they may be unable to process information or communicate through words. They will still have some or all of their senses. There are various things you can do to stimulate these senses:

·         Encourage the person to touch or stroke pieces of fabric, dolls or cuddly toys.

·         Try giving the person a hand massage. This can be very soothing for those who enjoy touch. Some people may enjoy using a scented oil such as lavender, although not everyone will like the feel of the oil.

·         Continue to take the time to sit and talk to the person or to read out loud. Being with somebody sends out a powerful message that they are valued.

·         Help the person to position themselves so that they can see a fish tank, or a window with a nice view. This may have a calming effect.

·         Make sure the person has a regular change of scenery and the stimulation of fresh air and the outdoor environment.

·         If you are visiting a person living in a care home, you can help the person to feel included and active. You might like to take a short walk with them, even if it is just down the corridor, or to bring in something of interest from outside the care home such as flowers or a seashell.

Government to scrap 'bureaucratic nightmare' of Deprivation of Liberty Safeguard coroner inquests

The Government are to scrap 'bureaucratic nightmare' of Deprivation of Liberty Safeguard coroner inquests it has been announced.

Maybe I’m too close to this topic, and maybe I am wrong in my belief but I find that I am slightly skeptical of a recent decision to scrap Deprivation of Liberty Safeguard coroner inquests.

Coroners will no longer be required to carry out inquests for anyone who dies while under Deprivation of Liberty Safeguards (DoLS), under an amendment to the Policing and Crime Bill.

The Government has ruled that a person who dies while subject to a DoLS order will no longer be considered to have died in ‘state detention’ and, as such, will not be subject to an automatic coroner inquest if they die of natural causes.

Whilst we understand that families might not want to suffer all the heartache of a Coroner's Inquest into a long and extended wait for the cases to be heard and outcomes to be determined, this decision worries me when families do have concerns about the level of care prior to their loved one’s death, and whether justice might no longer to seen to be done. 

Activities during the later stages of dementia

Activities during the later stages of dementia

As a person's dementia progresses, they will still be able to carry out some tasks that are very familiar to them, but will probably be more interested in the process of doing the activity than in the end result. Activities can be simplified so they are still manageable.

Tips for finding an activity

·         Look for activities that are stimulating but that don't involve too many challenges or choices.

·         Dementia often affects people's concentration so they may not be able to focus on what they are doing for very long. It may be a good idea to do activities in short bursts.

·         Dementia can affect a person's motivation. You may have to help them get started, but try not to be disheartened if they seem uninterested in the activity. It may be worth coming back to the activity later or trying a different activity.

·         Break instructions down and try to make sure each step of the task is simple.

·         Try to think of activities that involve an easy, repetitive action and simple steps, such as sweeping, dusting or watering plants.

·         People with dementia can sometimes crave a sense of structure, so folding or sorting things can be simple but rewarding tasks.

·         Focusing on 'normal' everyday life, such as helping to dust or tidy up the garden, is important in giving people a sense of feeling useful and valued.

The Value of Care

As I sit researching the facts for this article I find myself asking the same questions

1. Care Providers record their profit in various forms – The profit from properties, the profit from individual services operating under their umbrella and profit from capital.  Where’s this profit going?

2.    How much of this profit is reinvested back into their business?

3.    How much of this profit goes on the purchasing of company cars and other perks for Directors or other staff?

4.     How many care providers advertise are you seeking a care home or nursing home where people receive high-quality care in safety, comfort and a welcoming atmosphere?

5.   Or state claims that their personal activity coordinator ensures the people living here can follow the pastimes and pursuits they know and love. And they also encourage new interests inside and outside the home?

6.     How many of those residents are involved in their own care?

What is in fact the true value of Care?