Two weeks ago I launched a series of blogs on social care, explaining I wanted to look at this issue from a political, professional and personal perspective - today's post sees the recent personal
glimpses I've had of the impact of social care. There is a real interface between someone’s health and social care needs. As a local housing provider working closely with our customers in their homes and neighbourhoods we often have a real understanding of their needs. This week I want to use a couple of examples to highlight that perhaps not that much has changed since I told you about Freda’s story in an earlier blog. The two people that I am going to tell you about highlight what happens on the ground and are real life case studies where if the voice of the housing professional had been heard and responded to, then a different outcome could have been achieved.
Let me start with James who lived in one of our sheltered schemes. James was suffering from terminal leukaemia and was taken to hospital on Sunday because he had not eaten. His clear preference was to be able to come home as soon as possible as he was worried about catching infections in hospital so he was discharged that day with the promise of a care package on Monday that would involve his GP, district nurse, Macmillan nurses and a rapid response team. James’s family contacted our scheme manager on the Monday morning concerned that nobody had yet turned up.
What followed was a maze of bureaucracy as the scheme manager contacted various organisations in an increasingly desperate attempt to resolve the situation. James needed his medication and the support of a nursing and care team and whilst he would have received this in hospital his wish was to receive this in his own home so he could be in familiar surroundings with people he knew. His GP did not have any information about the case, the District Nurse did not appear to have a record of the case and agreed to visit the following day, the MacMillan nurses needed a referral from the District nurse before they could respond and the social work assessment team had the wrong address and could not confirm what they planned to do next.
Unfortunately, the scheme manager could not get anyone else to visit that day. Nobody seemed to accept the urgency of the situation or accept the opinion of a fellow professional concerned for the health of one of her residents. James was left with one of his friends overnight. The morning James was taken to hospital in an ambulance where he later died. James’s family and friends felt very stressed and let down by the situation and felt that if only what had been promised had been delivered James would have been able to die with care and dignity in his own home. If some other professionals had listened and reacted to the voice from housing perhaps this could have happened.
May’s story is equally sad. Twelve months ago May was a confident outgoing person, always socialising, and ready to pass on a bit of gossip. Today she is unrecognisable from that lady: staying in bed, unwilling to get up, frightened to go out and totally dependant on her daughter. She has had a series of hospital admissions, some quite prolonged and some of the care she has received when coming out of hospital has sometimes failed to address the most basic of needs. Her first set of carers kept preparing her solid food when she was unable to eat solid food following her treatment. She is suffering from incontinence, yet her bed was unmade and soiled bedding was left on the floor. With time slots for care being strictly adhered too the carers are unable to get her out of bed. Again with the scheme manager on site each day able to observe the effectiveness of care being delivered there is scope to involve a housing partner in this process to try and find a solution that better meets May’s needs.
I think the key to both May and James' stories is that care is often seen as a dichotomy between the carers and the cared for, but that overlooks a simple truth - namely that the carers are different people and don't present themselves to the cared for as a united team - often this is because they're not.
Bemoaning the fact that multi-agency work often means that people fall through the gaps is certainly nothing novel, but it seems to me that we have reached a crisis point. In an earlier blog I spoke about the fact that there was a real appetite for improving the way different groups try and work together. However, we can be as eager as we like, but without real investment and support from a Governmental level, the gaps we try to fill will simply prove impossibly wide.
Let me start with James who lived in one of our sheltered schemes. James was suffering from terminal leukaemia and was taken to hospital on Sunday because he had not eaten. His clear preference was to be able to come home as soon as possible as he was worried about catching infections in hospital so he was discharged that day with the promise of a care package on Monday that would involve his GP, district nurse, Macmillan nurses and a rapid response team. James’s family contacted our scheme manager on the Monday morning concerned that nobody had yet turned up.
What followed was a maze of bureaucracy as the scheme manager contacted various organisations in an increasingly desperate attempt to resolve the situation. James needed his medication and the support of a nursing and care team and whilst he would have received this in hospital his wish was to receive this in his own home so he could be in familiar surroundings with people he knew. His GP did not have any information about the case, the District Nurse did not appear to have a record of the case and agreed to visit the following day, the MacMillan nurses needed a referral from the District nurse before they could respond and the social work assessment team had the wrong address and could not confirm what they planned to do next.
Unfortunately, the scheme manager could not get anyone else to visit that day. Nobody seemed to accept the urgency of the situation or accept the opinion of a fellow professional concerned for the health of one of her residents. James was left with one of his friends overnight. The morning James was taken to hospital in an ambulance where he later died. James’s family and friends felt very stressed and let down by the situation and felt that if only what had been promised had been delivered James would have been able to die with care and dignity in his own home. If some other professionals had listened and reacted to the voice from housing perhaps this could have happened.
May’s story is equally sad. Twelve months ago May was a confident outgoing person, always socialising, and ready to pass on a bit of gossip. Today she is unrecognisable from that lady: staying in bed, unwilling to get up, frightened to go out and totally dependant on her daughter. She has had a series of hospital admissions, some quite prolonged and some of the care she has received when coming out of hospital has sometimes failed to address the most basic of needs. Her first set of carers kept preparing her solid food when she was unable to eat solid food following her treatment. She is suffering from incontinence, yet her bed was unmade and soiled bedding was left on the floor. With time slots for care being strictly adhered too the carers are unable to get her out of bed. Again with the scheme manager on site each day able to observe the effectiveness of care being delivered there is scope to involve a housing partner in this process to try and find a solution that better meets May’s needs.
I think the key to both May and James' stories is that care is often seen as a dichotomy between the carers and the cared for, but that overlooks a simple truth - namely that the carers are different people and don't present themselves to the cared for as a united team - often this is because they're not.
Bemoaning the fact that multi-agency work often means that people fall through the gaps is certainly nothing novel, but it seems to me that we have reached a crisis point. In an earlier blog I spoke about the fact that there was a real appetite for improving the way different groups try and work together. However, we can be as eager as we like, but without real investment and support from a Governmental level, the gaps we try to fill will simply prove impossibly wide.
I read this with empathy and sadness.Anyone that works in the care sector, will agree, that that there is a huge crevace that needs to be filled.
ReplyDeleteWe try in our hearts to work together as teams, although we work in some cases for different organisations, we do try!We are told not to get involved,'Its not our problem', 'were not paid to do that', move on to the next customer', ' In and out as fast as you can'.
I have only one thing more to add about this article that I feel should be heard.
When discussed what the problem is when out and about meeting different sectors, wether it be social services, occupational therapy, physiotherapy etc. We all voice the same opinion. This seems to be that teams are very much understaffed for the workloads that these contracts deliver. We are forced to drive the work capacity at high speed to cover as many customers as we can in one day. Ofcourse things are going to be missed if we are always driving at high speed. We need to go back to before the invention of the wheel,scrap the idea before it gets out of control and learn how to walk again.
From the very top down we are conditioned to make savings. Sadening that some would see this as a sense of achievement in their role.
This only leads to one conclusion!
'We put savings and profit before our staff and customer needs'.
We need to slow things down and give our staff the breathing space they need to evaluate the best solutions for our customers.
Lets start listening to what we all really want! Not what we all really want to hear!