Historically, care homes and nursing homes followed the hospital model of rigid visiting times.  This in turn meant that families may not have been considered to be intrinsic in the planning of care pathways or, in fact, in the individual’s life inside a care environment.  Today, things are changing for the better but there is always more work to be done.

Apple House care homes embrace an ethos of inclusion.  Families and loved ones have a hugely crucial role to play and, as such, are our partners and never an inconvenience.

Apple House are proud to have signed up to John’s Campaign who champion family inclusion in care settings, and to have been featured in their blog. These are just some of the ways in which we include families of the individuals entrusted to our care:

• Decision making: From the moment that we receive a referral for a placement at our homes we establish communication with the individual’s family unless they do not wish to be involved in the assessment process.  This means that we invite the family and the individual to the home for an initial look at the facilities offered and to meet our team.  An open line of dialogue is created so that families feel empowered to ask any questions and to express concerns or wishes.  Often close family members advocate on behalf of their loved one or have worries about how the individual will adapt to their new home environment.  After all, change is scary for all of us and we understand that.  Only by being fully informed can families and their loved one make a decision that is right for them.
• Partnerships: We believe that families and friends are an invaluable source of information.  No-one knows an individual as well as those closest to them.  Insights and preferences, life history, hobbies and matters that are important to the individual can sometimes be shared with us more fully by family members, especially if their loved one finds verbal communication to be a challenge or if their memory is poor.  Memories are precious and we would like to learn about the memorable moments that are important to the person – all of this makes the individual who they are today. Working in partnership with families as well as the individual in care planning produces a more holistic and comprehensive pathway.
• Approachable: Communication is key.  Three words that summarise the entire partnership between ourselves and the loved ones of the individuals we support.  It is essential that strong communication is in place to form a bridge between families and staff teams.  That bridge helps to avoid rocky roads where anxiety and disharmony could take hold.  After all, it can be stressful and emotional entrusting the care and support of someone you love into the hands of others.  By us being approachable–letting families know that we are there to support them, that they can talk to us at any time–we hope to alleviate concerns, discuss expectations and to be friendly and flexible.
• Flexible: The people who live at Apple House homes are not living in our workplace.  We are working in their home.  They are free to invite their families and friends into their home for a cuppa or to enjoy their gardens with them.  We minimise rules about visiting to, for example,  the need to sign in which is a legal requirement, and to the consideration of others living alongside the individual.  There will always be a warm, genuine welcome from staff.  We have an ‘open door’ approach to visiting, just as we all expect within our own homes outside of care.
• Homely:  We work hard to ensure that Apple House homes are exactly that – homely!  To achieve this, we choose furnishings for our public areas such as lounges that are not clinical or generic in style.  We encourage the displaying of items and pictures that have meaning to the individuals who live there.  Our gardens are created and maintained with the help of those individuals who are able and wish to, for example our chickens are cared for by residents who collect the eggs and bake with them.  There are sensory areas and places to simply sit and be.  Where we are required to display certificates of registration, fire, health and safety etc, we endeavour to do so discretely.  Individuals are encouraged and empowered to decide how they wish their bedroom to look (and we’ve certainly painted some wild and varied colours!).
• Communication: We understand that it is not always possible to visit and so we ensure that alternative means of communication are accessible.  These include Skype video calls, email and telephone calls between individuals and their loved ones.
• Participation: Invitations are extended to families to events within the homes that are varied and regular.  These include invitations to birthday celebrations, BBQs, seasonal parties, special activities such as visiting owls and birds of prey and charity fund-raiser coffee mornings.

This list is not exhaustive – there are so many diverse ways of ensuring that we are family friendly.

–– Jane Montrose, Managing Director.

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At the most basic level, stress is our body’s response to pressures from a situation or life event. Some common features of things that can make us feel stress include experiencing something new or unexpected, something that threatens your feeling of self, or feeling you have little control over a situation. [Mental Health Foundation]

In the following article, Jayne Jackson, registered manager at Apple House care home, writes an open and very insightful reflection on how stress plans can and do have a profoundly positive impact for a gentleman she supports:

Our care plans are person centred and very individual to each of the people we support.
I was looking at environmental risk assessments & policies for stress. This centred around how we could look after staff’s health and what they/we could do to help in their day-to-day working environment, which we know at times can be stressful.This prompted me to look at the people we support [in relation to stresss]. We looked at easy read documents and set up a meeting.

The easy read document comprised general things to help lower stress/anxieties. We wanted our support plans to be personalised to suit the needs of the individual.

We worked with each person individually and discussed what we could do to help them stay settled and reduce their stress levels.

For one individual this was a massive achievement as in the past just discussing and writing information could cause him to experience high levels of stress.

We worked very closely over many years with the gentleman to help him learn to trust us. We use the phrase ‘it’s good to talk’ and this person now quotes this phrase.

This plan would not have worked for this person if they did not sign up to it.

He spent time with us, we listened to him, we built ‘his’ support plan. It is important that the person has ownership over ‘their’ plan. When he is feeling stressed we refer to the plan and this keeps it fresh in his mind. We all stick to the plan; this is key in keeping his well-being stable.

This plan cannot work without the individual being involved, it is not a paper exercise, it is a live tool.

The stress support plan runs alongside others that all interlink. He is now beginning to recognise when he is feeling troubled, or finding things difficult and, with our support, he is starting to work them out.
The individual works with us. We ensure he has time to reflect, to identify what is worrying him.

Breathing exercises, conversation and space are used; usually after 10 minutes he feels able to talk about what is happening. We must ensure that the person and staff have clarification that they have settled as this prevents further stress. A physical change can be seen within him – his body language and speech will return to pre-stressed levels, and he appears calmer. This is not just a one-off thing as this may happen a few times a day, or weeks may pass without presentation of stress.

Because of the trust we have built, continuity of the team and knowing and respecting the individual it could be said that he has a better quality of life. Sure, there are stressful days for him, we all have those, but learning to cope with them is what we support him to do.

I cannot tell you how proud I feel of him and the team; it is lovely to see the person more involved in day to day things, and by doing this it also helps him to have a renewed sense of purpose and to feel valued, staying focused forming part of his routine.

This individual wrote an additional support plan with staff which was linked to additional stress; he took it to a meeting with his psychiatric team and asked them to sign up to it which they did.

He then wrote to his link mental health team and asked to be discharged. We supported him in writing a letter and discussed the benefits, including self-esteem, that he would feel. His mental health team told us they never thought they would see they day this gentleman would be signed off [from their care].

This is a massive achievement for him!

Due to the hard work and commitment of my staff, their link team and the individual himself, he has stayed settled for over a year following years of mental health decline.

In our compliment folder, the person’s mental health team praised Apple House. They commented how well we had supported the person when they had deteriorated in their mental health and suffered episodes of depression and mania, they had never see this person doing so well. This was signed by the person’s community nurse. This person was told if they remained stable for the next year they would be signed off.

Jumping forwards a year, well its happened, he has been discharged!

We look forward to maintaining his wellbeing and will continue to encourage him to further develop and reach his personal goals.

— Jayne Jackson, registered manager, Apple House care home, Bournemouth.

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Pet therapy, or more correctly, Animal Assisted Therapy (AAT) is a type of therapy that involves animals as a form of treatment. The goal of AAT is to improve a person’s social, emotional, or cognitive functioning –Wiki.

In Apple House care homes, AAT is used as part of an holistic aproach to care and support.  Touch, social integration, sight, scent…the benefits of pet therapy are too numerous to list.  The smile on our residents’ faces as their fingers stroke a loving dog’s fur really, for us, sums the benefits up nicely.

Finalist for The Frontline Leader Award

 Rebecca Blackmore:

Here are some of the things that our manager Sharron and the team have to say about Bex:

Rebecca who is known as Bex started working in our company in 2014.

Caring, compassionate and focused on helping and supporting people to be the best they can possibly be.

One of her strengths is also her cooking ability. Utilising this skill Bex is able to support individuals with healthy eating. She uses aids such as easy read menu’s and supportive technology, supporting individuals to understand the types of foods in their meals and understanding healthy options.

Bex has also inspired the individuals during house meetings to: choose a country, plan shopping lists, discuss a menu from the country, discuss utensils needed to make the meal, along with looking up information with individuals regarding the culture or the country. This will culminate once a month with the  person preparing the meal and hosting a lovely party. This creative use of skills in enhancing peoples lives and teaching independent living skills is wonderful and a real credit to Bex.

Her confidence has grown immensely, and this has transpired into Bex working and now achieving a senior role within Redcroft, taking on extra responsibilities such as Fire Marshal. Along with supporting staff as our advocate for dysphasia, oral health and supporting staff to be more confident in themselves.

She goes the extra mile when it comes to looking for fun ways to raise money for charities; Bex has helped to raise money for Macmillan, Red Nose Day and local Dorset charities. She rallies the residents round and gets them fully involved which gives people a sense of purpose and well-being. Bex has helped to raise awareness of these good causes and wanted the people she supports to feel a part of that experience. She is a shining example of a brilliant support worker and we are proud to nominate her for this award.

Thank you Bex for everything you do and we are all very proud of you.

The National Learning Disabilities & Autism Awards offer a unique opportunity to showcase and celebrate the successes of individuals, teams and businesses in the learning disabilities and autism sector – people and organisations who really do make a positive impact on people’s lives. They aim to pay tribute to people who specifically support those with learning disabilities and autism and recognise inspirational individuals with a learning disability and/or autism who make a real difference within their communities.

— Romaine Lawson, Director of Operations

I was thinking about what to talk about on our company blog. I could have written something funny or about an interest that I have.  But instead I thought I would share something.

I have a brother who is four years older than me who has a learning disability.  Since I was a little girl I have always been very protective towards him.

I have worked in care for over 30 years now, and so I have seen almost all there is to see from the care provider’s perspective.

Recently I have found myself having to stand up for my brother once again.  It has helped that I have the knowledge of how things are done from a care provider’s side.

This has made me stop and think!

We provide care for residents to the best of our ability and I think we all do an excellent job.  But, there is something very special about the support of family, especially a parent.

Sometimes we [carers] need to remember even more how precious those we support are to their families.

Sit back and reflect on how difficult it is to hand over the care of that person to complete strangers.

Families often find it difficult and feel guilty that they are unable to provide the care themselves. So, when you have contact with a family member that seems overly anxious or seems to be asking for the impossible, bear in mind:

How would you cope with handing over the life of a family member to people you don’t know?

How do we help promote confidence in us and what we do as a provider?

— Pam, Support Worker, Summerwood care home, Hants.

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Huge thanks to Pam for sharing such a heartfelt and insightful post with thoughts which are deeply personal to her and so valid. In fact, what Pam eludes to is that we, as a provider of care, are in a hugely privileged and responsible position of trust.  Trust between the family, the individual and us. We consider that trust to be a circle which must never be broken.

Trust underpins the essence of care.

Families are our partners, and we theirs.  We joined John’s Campaign (click HERE to read a Guardian newspaper article on their success) to deepen our commitment to the loved ones of those we support, and were delighted to be featured in their blog.  Please take a moment with a cuppa to read our post: Family Friendly, What Does it Mean? where we share ways in which we encourage and nurture close partnerships with families.

‘No-one knows an individual as well as those closest to them.’

— Jane Montrose, Managing Director, Apple House care homes.

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Historically, care homes and nursing homes followed the hospital model of rigid visiting times.  This in turn meant that families may not have been considered to be intrinsic in the planning of care pathways or, in fact, in the individual’s life inside a care environment.  Today, things are changing for the better but there is always more work to be done.

Apple House care homes embrace an ethos of inclusion.  Families and loved ones have a hugely crucial role to play and, as such, are our partners and never an inconvenience.

These are just some of the ways in which we include families of the individuals entrusted to our care:

• Decision making: From the moment that we receive a referral for a placement at our homes we establish communication with the individual’s family unless they do not wish to be involved in the assessment process.  This means that we invite the family and the individual to the home for an initial look at the facilities offered and to meet our team.  An open line of dialogue is created so that families feel empowered to ask any questions and to express concerns or wishes.  Often close family members advocate on behalf of their loved one or have worries about how the individual will adapt to their new home environment.  After all, change is scary for all of us and we understand that.  Only by being fully informed can families and their loved one make a decision that is right for them.
• Partnerships: We believe that families and friends are an invaluable source of information.  No-one knows an individual as well as those closest to them.  Insights and preferences, life history, hobbies and matters that are important to the individual can sometimes be shared with us more fully by family members, especially if their loved one finds verbal communication to be a challenge or if their memory is poor.  Memories are precious and we would like to learn about the memorable moments that are important to the person – all of this makes the individual who they are today. Working in partnership with families as well as the individual in care planning produces a more holistic and comprehensive pathway.
• Approachable: Communication is key.  Three words that summarise the entire partnership between ourselves and the loved ones of the individuals we support.  It is essential that strong communication is in place to form a bridge between families and staff teams.  That bridge helps to avoid rocky roads where anxiety and disharmony could take hold.  After all, it can be stressful and emotional entrusting the care and support of someone you love into the hands of others.  By us being approachable–letting families know that we are there to support them, that they can talk to us at any time–we hope to alleviate concerns, discuss expectations and to be friendly and flexible.
• Flexible: The people who live at Apple House homes are not living in our workplace.  We are working in their home.  They are free to invite their families and friends into their home for a cuppa or to enjoy their gardens with them.  We minimise rules about visiting to, for example,  the need to sign in which is a legal requirement, and to the consideration of others living alongside the individual.  There will always be a warm, genuine welcome from staff.  We have an ‘open door’ approach to visiting, just as we all expect within our own homes outside of care.
• Homely:  We work hard to ensure that Apple House homes are exactly that – homely!  To achieve this, we choose furnishings for our public areas such as lounges that are not clinical or generic in style.  We encourage the displaying of items and pictures that have meaning to the individuals who live there.  Our gardens are created and maintained with the help of those individuals who are able and wish to, for example our chickens are cared for by residents who collect the eggs and bake with them.  There are sensory areas and places to simply sit and be.  Where we are required to display certificates of registration, fire, health and safety etc, we endeavour to do so discretely.  Individuals are encouraged and empowered to decide how they wish their bedroom to look (and we’ve certainly painted some wild and varied colours!).
• Communication: We understand that it is not always possible to visit and so we ensure that alternative means of communication are accessible.  These include Skype video calls, email and telephone calls between individuals and their loved ones.
• Participation: Invitations are extended to families to events within the homes that are varied and regular.  These include invitations to birthday celebrations, BBQs, seasonal parties, special activities such as visiting owls and birds of prey and charity fund-raiser coffee mornings.

This list is not exhaustive – there are so many diverse ways of ensuring that we are family friendly.

–– Jane Montrose, Managing Director.

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Ms. Sutcliffe’s tweet followed a CQC national press release today announcing Summerwood care home’s ‘Outstanding’ rating, the highest rating possible.  Following the press release, Apple House Ltd were delighted to be contacted by local press taking up this good news story in an age when, all too often, the care sector is in the spotlight for more negative reasons.

Apple House will be holding a celebratory party at Summerwood next month.

Please follow us on social media: @AppleHouseLtd and https://www.facebook.com/AppleHouseCare/

“Staff [in care homes] should do all within their power to make access easy for family carers and utilise their expert knowledge and their love.” —John’s Campaign

We posted an article right here on our blog back in March 2017, about John’s Campaign, about our reasons for signing up to it, the importance of really welcoming families and friends of residents in residential care.  Not doing so as visitors, but as an intrinsic part of the wider team that encompasses the individual themselves, care staff, and the circle of family and friends who often know the individual in a far deeper and meaningful way than even the most diligent carers can.

Next month we’ll be featuring another post on this very topic because it’s so dear to our hearts (and we’ve plenty more to say!).  In the meantime, can I please ask that you make a cuppa and take a moment to read Julia Jones’s fascinating article on the John’s Campaign blog? Please click HERE to read about The “Third Force” in Residential Care.

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“Paying for sleep-ins at an hourly rate means that the sector is faced with a real and potentially overwhelming funding crisis.” — Mencap, July 2017

Apple House, as a responsible employer, has been paying its sleep duty staff the NLW since its introduction.  This had a huge impact on our staffing budget.  We, like most providers, see scant if any increases in fees in spite of the introduction of compulsory pension schemes and a further hike in the NLW this April.  So, while employment costs spiral, fee increases are not forthcoming from local authority funders while inflation soared and led to, in real terms, a reduction in fees in comparison to escalating costs.  Surely a recipe for disaster…an economic ticking bomb?

Local authorities are struggling too! Their pot of money is finite and already allocated to meeting the essential needs under a duty of care.  

A report by The Independent this month stated, ‘Uk on brink of social care crisis, Government warned.’ Although the article focuses on care of the elderly, its stark warning has been echoed across all corners of social care including learning disability care provision.

Whilst this blog post isn’t a political rant, I think we all see that funding for social care in the UK has to be increased, ring fenced, targeted to the front line if a real crisis is to be averted and the most vulnerable in our society are to be respected, supported, protected, empowered.

So, what’s the real situation with funding sleep duty, with rightfully paying staff the NLW?

Good question!  At a providers’ forum I attended some months ago, approximately 60-70% of care providers stated they were not paying the NLW hourly rate for sleep duty.  They continued to use the old model of paying a fixed wage to night staff for the sleep element of their shift.  Ah ha! some exclaimed, Be careful! It’s only a matter of time before you’re hauled before a tribunal and forced to back-pay those sleep staff. Humph! replied some.  We’re not paying people by the hour to sleep!  I listened and felt rather relieved that we had taken it upon ourselves to bite the bullet, to pay by the hour right from the get-go.  Yes, it was painful, but to us it seemed logical and fair and right.

Now, those tribunals have started.  Care providers are facing an HMRC crack-down, are being told to pay up to six years back pay.  Mencap are calling for HMRC to hold a stay of execution, for a definitive answer on the whole issue of sleep-in pay.  Meanwhile, what of agencies, of care homes and domiciliary care? What of Grandpa’s sleep-in support worker, your neighbour’s sleep-in support worker, of the workers who sleep-in to keep people safe and cared for, to assist their independence and aid wellbeing…at night in care homes, nursing homes, our parents’ homes? 

What happens to that tier of critical support if the cost of sleep duty increases exponentially while there is no additional funding available to pay for it?  What becomes of the rights of the disabled who are seemingly adrift amidst this brewing storm that everyone is warning is inevitable?

“Already chronically-underfunded care providers and local authorities have to find additional money that simply isn’t there currently.” — Mencap, July 2017

What can we do?

Share share share on social media.  Raise awareness of the impending crisis and please do support Mencap’s initiative to have a stay of execution for social care providers who haven’t been paying the NLW for sleep duty, who face crippling back-pay costs which could lead to home closures.  Lobby your MP so that there is an inquiry that will lead to a definitive decision on sleep duty pay and additional funding for social care.

And, to end on a positive note, let’s not forget all the wonderful and dedicated support workers who work the sleep duty: Thank you!  

— Jane Montrose, Managing Director

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