Dr Karen Franks, Consultant in Old Age Psychiatry Gateshead Health Foundation Trust Dr Kate Andrews, Counselling Psychologist Northumberland, Tyne and Wear Foundation Mental Health Trust
Our involvement Both have long-standing interest in dementia care, especially behaviour that challenges and care in 24 hour settings. Have long noted that care home managers are key, but poorly recognised as such by the healthcare system and poorly supported. In the past we have run managers forums with variable success. Closer working in Gateshead into care homes with Gateshead Care Homes Initiative has reinforced these views. KF now dementia lead for Gateshead/Newcastle Care Homes Vanguard. This role may enable us to influence the system more widely.
Background We were curious to know what Care Home Managers perceived about their role and the level of support they were currently receiving from the NHS. We were also curious to explore the myths that exist around managing a care home and how these, if they did, impacted upon their sense of identity.
Method We re-invigorated the previous care manager forum. 6 care managers attended and we conducted a focus group with a semistructured interview which explored their experience of leadership, their role-identity. We also sent out a questionnaire to those managers who did not attend to capture their experiences. The average time as a care manager was 8.4 years (range was 0.3 months to 25 years)
Results Not Confident to Very Confident 13 12 11 10 9 8 7 6 5 4 3 2 1 2 3 4 5 1 "I feel confident that all my staff have had appropriate training"
13 12 Results Not Confident to Very Confident 11 10 9 8 7 6 5 4 3 2 1 1 2 3 4 5 "I feel confident in my leadership skills" "I feel confident that my organisation supports my practice in the home" I feel confident that the CQC is there to support my work"
What things do you wish you could change about your role and what stops you? more time with clients and working alongside with the staff. paperwork stops me repeating the same information for different agencies. No-one communicates more input from professionals to cater for the problems and issues in the care home a quicker response time to referrals always too busy and never enough time to give proper attention to all residents and staff
Emergent Themes Lack of acknowledgement and validation for the complexity of the roles that managers have. General Public have a negative perception sit in the office and drink tea easy life don t know the residents always bad publicity never any good things said Families perception the home is responsible for everything give them a tablet to calm down
Emergent Themes NHS not recognising the key roles managers/homes have in life and care of a resident. not family so hospital won t share information not seen as part of the person s network and not included Inappropriate discharges with limited information sent back to the home Information goes with the person and appears to be rarely communicated in the person s admission in hospital Reluctance by health professionals to accept that what you are reporting is accurate and to share their diagnosis the home not being seen as part of that person s care even though we are now the primary carer for that person
What needs to be improved and how? Better communication between home and hospital Homes are not in competition with each other and that we share good practice
Gateshead/ Newcastle Care Homes Vanguard programme Includes a big piece of work on transfer of care (rather than discharge ) Lots of education needed for NHS staff too Workforce and education is a specific workstream Culture change Manager involvement in many areas of the programme Some issues with this though..
Thoughts and Questions?
Thank you Newcastle Gateshead CCG