A Dignified Revolution
Alone we can do so little; together we achieve so much!
NEWS UPDATE: FEBRUARY 2009
Welcome to the February news update. As ever, we have much information and news to report and we welcome your comments, suggestions and enquiries. If you have any information that you would like to share with others please let us know and we will be happy to circulate it in the next newsletter
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A Dignified Revolution, Britannia House, High Street, Cowbridge, CF71 7AD
FORTHCOMING EVENTS
Perceptive Professionals Embedding Dignity and Respect in a Care Environment
Monday 22 June, RNIB Cymru, Cardiff
Tuesday, 23 June, 2009, Talardy Hotel, St Asaph
The workshop is focused on fine tuning communication and listening skills to enrich relationships between patients/clients, relatives and carers and colleagues. If you would like further information about these events please email info@dignifiedrevolution.org.uk
(Please note that the March and May dates publicised in the last newsletter are fully booked)
On Monday 26 January 2009 we ran the first of our workshops entitled
Perceptive Professionals Embedding Dignity and Respect in a Care Environment, which is focused around effective communication and listening skills. This workshop was well received by those participating and the evaluation has been posted on our website
You can help us to challenge behaviour that diminishes dignity
We want to develop a training course that helps people to challenge care that is provided without respect and does not meet the needs of patients. As part of the design of the course we want to hold a forum to gain input from people who have wanted to challenge inappropriate behaviour, but did not feel able to do so. Examples, could range from feeling unable to give simple feedback to complex scenarios that involve poor group culture and perhaps bullying. The aim of the forum will be to help determine the content of the training that is needed. It is being held in Cardiff on Monday, 13 July 2009. There is no charge for attendance, but numbers will be strictly limited. If you feel you can help, please email info@dignifiedrevolution.org.uk
ACTIVITIES
Insular Welsh thinking in a global community
You will be aware from previous news updates that we had a situation last year where one of our representatives was asked to stand down from a Welsh Assembly Government Dignity in Care Social Care sub group because she lives in England, although her mother lived and was cared for in Wales. This situation poses much debate and raises an number of issues. For example, how are the needs of vulnerable older people, who live in Wales whilst their relatives live in England, represented at a national level? We have drafted an article on the issue, which is available to download from the website. We would welcome your views, suggestions, personal experiences etc. Please send any comments to info@dignifiedrevolution.org.uk
During the last few weeks:
m we received a request from a nurse and principal lecturer at the University of Winchester who would like to use our case studies in a training pack that she is developing. As part of a secondment to the Health and Social Care Advisory Service (HASCAS) she is producing a learning package: 'Dignity and the Older Person', aimed primarily at care assistants and including nurses. The package will include a 1 day Dignity Workshop
m we gave a presentation at the re-launch of Rhondda Cynon Taff County Borough Councils Pathways to Adapted Housing initiative which was held in Pontypridd. We received a number of offers of help to raise awareness, from members of the audience, and officers from the local authority will be circulating our presentation and contact details through internal organisational networks
m we had an article published in Yours Magazine
m we received an enquiry from a consultancy who are undertaking a piece of work for the Health Foundation on patient experience. They are interested in hearing about initiatives that use the patient experience to enhance services
m Founder Member, Lorraine Morgan, who is also a member of the Welsh Nursing Academy is setting up a professional interest group of nurses (retired and working) who work with older people in all care environments. The aim is to independently support and inform the public about what nurses do when working with older people and to establish some clear, simple and useful products to inform good and notable practice. The first step is to compose a statement of Dignified Nursing Care. For more information email J.L.Morgan@open.ac.uk
The Welsh Assembly Government has issued a consultation document
on the number and functions of Community Health Councils (CHCs), which will come into effect from 1 October 2009. The Assembly, is looking for feedback, not only from statutory sector, but also from the general public on the role of CHCs. A Dignified Revolution is planning a response so if anyone would like to contribute in collaboration with us please let us know. The closing date for comments on the consultation is 24 April 2009
CAN YOU HELP?
As some of you may already be aware we have been approached by producers from Lion TV. They are making a Channel 4 dispatches programme that explores what life is like for nurses and midwives working in NHS hospitals across the country. The programme will portray what nurses really feel about their jobs, and describe the reality of day to day nursing from their own testimony. It will also convey the experiences and opinions of patients (and their relatives) who need and depend on nurses and midwives when they are in hospital Whatever information is shared will be treated confidentially and anonymously where necessary. The aim is to make an fair and balanced programme about experiences in NHS hospitals today. If you have a story to tell or if you would like to know more please feel free to get in touch by emailing karolina.mottram@liontv.co.uk or you can call 0208 846 2116
We have received an enquiry from a senior nurse who is asking whether we have received any comments or feedback on the use of mobile phones in a care environment. The nature of the enquiry is particularly around the use of mobile phones with a camera facility and the use of phones in ward areas where patients require a peaceful environment e.g. palliative, post-op or acutely ill. If you have any comments, advice or experiences to share please email info@dignifiedrevolution.org.uk and we will pass them on
We have also received an enquiry from an occupational therapist who is undertaking his MSc dissertation in palliative care. His area of interest is patient dignity, and whether patient's perceive that their dignity is respected during interventions. Despite a literature search, he has been unable to find a tool to measure/assess dignity (apart from Chochinov). If anyone is able to provide any relevant information email info@dignifiedrevolution.org.uk and we will pass your information on
GOOD NEWS CORNER
Feedback from a relative:
"my husbands Dad was in hospital recently - thank goodness he was treated with the utmost respect and good care "
Feedback from a patient
“I had a minor operation last week at the QE11 Hospital, Welwyn Garden City and the care right across the board was excellent”
Addressing dignity at Abertawe Bromorgannwg (ABM) NHS Trust
The Trust is focusing on the fundamentals of health care and on increasing the visibility of senior nurses in clinical areas. To achieve this it has introduced a project called the Patient Orientated Initiative to Nurture Teams (POINT) to make sure patients are checked regularly, and that senior nurses ensure that this is happening. A "walkabout" timetable has been developed to ensure that nurses of all levels are seen and patients have access to them.
All patients are checked at least once an hour by a nurse, or, if they are busy, a delegated healthcare assistant. Such checks involve making sure patients have a drink and a call buzzer to hand and that they receive regular attention.
Every three hours, ward managers must check care is being given properly and once a week, senior nurses have to walk on to every unit and check standards of hygiene or nursing documentation and talk to patients about the attitudes of nursing staff. Early indications are that there is increased visibility and patient satisfaction has improved.
Judith Allen, a former education adviser for the RCN in Wales and Founder Member of A Dignified Revolution (ADR), has been involved with the work. Her 87-year-old mother was in the Princess of Wales Hospital for five months before she died. Ms Allen was so angry about her mother’s treatment that she wrote a diary on the subject, of which extracts were published in Nursing Standard. Judith’s article and case study can be downloaded from the ADR website
Sharing patient/carer experiences
We have received the following news from Sue Davies, an active supporter of A Dignified Revolution Sue has recently:
m been appointed as the West Midlands Area representative on the Alzheimer's Society Advisory Council
m given a talk on the carers experience at the Liverpool Medical Institute on behalf of the Royal College of Psychiatrists
Support from the public
We have received a number of enquiries from individuals this month who are interested to find out more about A Dignified Revolution and help spread the word about dignified care for older people in hospital. For example, someone has been in touch to ask if he can raise awareness of A Dignified Revolution in his local area in Staffordshire. He has also informed us that there is a campaign called 'Cure the NHS' in Staffordshire, which has similar interests
Another person in Barnt Green is circulating information locally and keeping us informed by sending local news and information.
These are just two examples of the many offers of help that we receive. We are most grateful for any support that is offered and would like to thank everyone who has provided their time, commitment and expertise in supporting our cause
CONCERNS ABOUT CARE
Whilst it is good, and appropriate, to celebrate the positive work that is underway to ensure good quality care, it is evident from the many discussions that we have with people, correspondence that we receive, and from meetings and events that we attend, there are numerous concerns about the quality of care that not only vulnerable older people, but also their families and carers experience. We have drawn together some of these concerns below.
Care and Nursing Homes Concerns
Concerns that have been raised about the local hospital services include:
m the lack of understanding by hospital staff of the needs of people with dementia and cognitive impairment
m information handover by the care home to staff in assessment units is not passed on when the patient is transferred to the ward
m patients are catheterised when they are continent. They are then discharged from hospital with a catheter but with no catheter pathway plan
m residents who are admitted to hospital rapidly develop pressure sores when they have previously had none
m transferred from hospital unshaven and dirty
m not helped with meals and drinks and transferred back to the home with evident weight loss
m excessive use of POVA by hospital staff – reporting care homes when hospital does not use POVA itself to report concerns/formal complaints about its own staff
m patients are transferred to care home when they are actively dying
Patients/Relatives and Carers Concerns
m the services are set up for the benefit of the organisation and the staff, not the patient
m the nursing care is the most important part of the process but is the least valued
m loved ones left to lie and/or sit in their own urine for periods of over four hours
m dinners left by the caterers and collected, un-touched, half an hour later
m if you complain to staff on behalf of a relative they suffer as a consequence after you have left
m there is no point in complaining because you just get a standard letter back and nothing changes
m do organisations have policies on timescales for responding to correspondence? If so, they don’t adhere to them
m “doctors and nurses accept low standards and claim that they are ‘forced on them’ by the managers. Surely a senior consultant together with the nurses on a ward can say it is a health hazard to put beds so close together when elderly patients are suffering from C-Diff and MRSA? But no – they seem to acquiesce and follow the management directives even if their patients die”
m “why do staff not wear name badges?”
m “those who do nothing about the problem, are a part of the problem".
Nurses Concerns
m patients told to use an incontinence pad rather than being taken to the toilet
m community healthcare assistant being asked to learn to catheterise a patient and administer diazepam rectally
m staff with an attitude that an elderly patient is going to die anyway, so why make the effort
m regulatory body for nurses not acting on complaint
"We have had 3 replies back from the NMC, the reason that they have given for the delay is that they were changing offices, changing over to a new case officer and Christmas holidays, yet they were supposed to reply to us by the beginning of November, so none of this applies to our case"
m nurse training needs to be reviewed
“basic, all-important nurse training must be given back to the hospitals. It inspires loyalty and on-the-job training that is much more relevant than learning from a distance in a university lecture hall. Then nurses might not think themselves too grand to empty a bedpan”
m attitude of business manager
"your problem is - your standards are too high"
"patients should be fed, watered and medicated - anything else is a luxury"
FEEDBACK
Over the last month we have received the following feedback:
m "Thanks for these news update and the information links etc ,these are now regularly disseminated across our Directorate and are well received. Keep up the great work"
m "I think what you're doing is really important and we all need to be reminded of treating people with dignity at times as the overload of work can make you lose sight of the human aspect if you let it"
m "Wow! I'm almost exhausted to even read about everything you're involved with! Fabulous, though, to feel the energy of so many people committed to making things better. Thank you so much for sending me this"
m "Thank you, there is a lot of information to digest this month "
m "Many thanks for the latest newsletter - it is inspiring to hear of all the activity underway in this important area"
m "I think your newsletter is very good, congratulations!"
m "Please could you forward me a regular monthly copy of this update, as I have found it to be interesting and informative"
m "I was very impressed with your talk and with everything that A Dignified Revolution stands for. If the opportunity arises I will certainly pass on all your details"
NEWS
People's award for dignity in care 2009
The People's Award for Dignity in Care gives the opportunity to acknowledge the exceptional care that health & social care for the care provide to their clients, a friend or a member family member. The judges are looking for health & social care staff who have gone the extra mile to provide care that respects people's dignity. These awards only apply to England
Community nurse suspended for prayer offer
A community nurse has been suspended from her work for offering to pray for an elderly patient. She is facing dismissal for an alleged breach of her code of conduct on equality and diversity
Carers cleared of pensioner neglect
Three women were found not guilty of neglect at Leeds Crown Court after an 87-year-old woman with Alzheimer's in their care suffered third degree burns
Ex-Tory leader's wife Sandra Howard reveals her anger at how her mother was treated
Sandra Howard, wife of former Tory Party leader Michael, describes how watching her mother suffering has shattered her faith in the NHS. “My mother was a brilliant woman who, in her youth, had won a scholarship to Oxford to study physiology and went on to train as a doctor. At the time of her accident, she was 89, a widow, and in an excellent care home where she was treated with dignity and allowed the whisky and cigarettes she loved. The home called me in the small hours one night to say she'd had a fall and been taken into hospital in Chertsey in Surrey. I spent all the next day with her perched on that blasted trolley - alongside many other patients in the same predicament. It was only in the evening, when I'd made enough fuss, that she was assigned a bed. Others were less lucky”
Nurses to face scrutiny of NHS Choices patient feedback
Nurses could find themselves facing disciplinary action if found at fault through patient feedback to NHS Choices. NHS Choices, the information website for NHS patients, will be 'duty bound' to report individual nurses to their trust if conduct considered dangerous is exposed by a new scheme for patients to post comments about their healthcare experience. Each NHS organisation will receive all comments about itself posted on the NHS Choices website and ministers expect trust chief executives to act where change is required to improve services
Specialist doctors label the NHS institutionally ageist
New research shows almost half (47 per cent) of doctors specialising in the care of older people think the NHS is institutionally ageist. Well over half (55 per cent) of the doctors from the British Geriatric Society said they themselves would be worried about how the NHS will treat them in old age
From ward to board
A programme of work developed by The King's Fund has focused on the role of nurse executives in helping boards assure themselves of the quality of clinical care. Based on observations at seven pilot sites, this report suggests there are valuable lessons to be learnt about the role and attributes of the nurse executive, but also lessons about the structure, processes and behaviours of boards
Vetting and barring scheme
If you work or volunteer, or seek to work or volunteer, with children or vulnerable adults, you need to be aware of a new scheme starting from October 2009. Under the terms of the Safeguarding Vulnerable Groups Act 2006 (SVG), a new vetting and barring scheme for Wales and England will be introduced. For more information on the scheme please visit the Independent Safeguarding Authority website
Memory clinics planned to spot and treat dementia
The government has unveiled plans for "memory clinics" to spot and treat dementia, as part of a new strategy. As well as improving diagnosis, the clinics will aim to raise the profile of dementia and improve the quality of treatment. Doctors will get extra training to recognise the early signs of dementia . And every hospital and care home should have a senior clinician with special responsibility for dementia care to ensure that the needs of people with dementia are addressed. Dementia advisors, who will act as a guides for patients and their families, will be piloted in the first year of the strategy
Improving end of life care in the community
February 2009 marks the launch of the first national audit of end of life care provided by GP practices. GP practices throughout the country will be looking at how they can give even better supportive care for people who may not have long to live. Over the next few months, more than 400 GP practices throughout England will use a simple online audit tool, known as ADA, to help find out what is going right and what still needs to be improved. Many people say that they want to live their final days in their own homes, rather than in hospital. The ADA tool will find out how often this happens and what else can be done to help people and their families cope.
A consultation on proposals to improve information sharing around multi-disciplinary assessment and care planning
This DH consultation document covers the rationale for improving information, how assessment and care planning should be undertaken, what information should be commonly shared and with whom and the IT approaches that would enable this to take place within appropriate arrangements for consent, confidentiality and security. The closing date for comments is 17 April 2009
Understanding the needs of older lesbian gay bisexual and transgender people
The Age Concern Cymru older LGBT forum is publishing a report that designed to raise awareness of the specific needs of the older lesbian gay bisexual and transgender (LGGT) people in the Welsh community.
It draws attention to the fact that there is a need for greater understanding of LGBT needs within the statutory sector agencies, particularly health and housing. A launch is planned at the Senedd in late February-early March. Anyone interested in receiving a copy of the report or attending the launch please contact Andrew Hinchliff email: andrwscar@aim.com
All Wales dental survey of residential and nursing home oral health
The Welsh Oral Health Information Unit, Cardiff University, has published the results of a survey of nursing and residential home oral health policy conducted in 2006-07
Housing, care and support needs of older people from BME groups
Housing services need to reflect the diversity of local populations.
This information is intended to help service commissioners and providers understand relevant policy and practice issues
A bleak future for all sheltered housing across England
Help the Aged has published a new report, ‘Nobody's Listening,' which looks at the state of the nation's sheltered accommodation. Research commissioned for the report found that over the next three years a third of sheltered housings schemes (31 per cent) will lose their on-site wardens and have them replaced with a floating service. This will leave many older people who moved into sheltered accommodation on the understanding they would have the support of a warden, feeling let down and at possible risk of a slower response to emergency calls
Britain is miserably failing many of its most vulnerable, elderly people
Our society pays a good deal of attention to the needs of newborn babies and disabled children, but woefully little to the most vulnerable people at the other end of life. The Times investigation into nursing homes suggests that we are failing the elderly on a massive scale. Building a more humane care system is an absolute moral imperative
RESOURCES
Factsheet on continuing healthcare
Counsel and Care have produced a factsheet entitled continuing healthcare: should the NHS be paying for your care? It applies essentially to England but may have similarities with systems in Wales, Scotland and Northern Ireland
Delayed discharge and continuing care
Wales Audit Office has posted case studies related to delayed discharge and continuing care on its website
Advanced care planning: national guideline
The aim of this guideline is to inform health and social care professionals on how best to manage advance care planning (ACP) in clinical practice. The guideline contains a number of recommendations, such as training for and implementation of ACP, when and with whom to consider having ACP discussions, the context and content of discussions, preparing ACP documents and cognitive impairment.
Making referrals to the POVA list
This good practice guide builds on the experience of those who have made referrals in the Protection of Vulnerable Adults (POVA) scheme’s early years of operation and who have been able to suggest what works best in these important, and often sensitive, procedures. It also explains the role and responsibilities of the Independent Safeguarding Authority in the transitional arrangements to the Vetting and Barring scheme to be fully administered by the Authority from October 2009
Deprivation of liberty safeguards
These guides have been produced for PCTs, local authorities, hospitals and care homes to help them understand and fulfil their statutory obligations under the Mental Capacity Act: Deprivation of Liberty Safeguards legislation. Three versions have been published: one for hospitals and care homes, one for PCTs and local authorities and another for relevant person's representatives
Religion or Belief: a practical guide for the NHS
The guidance is designed to assist NHS organisations to implement and comply with the requirements of legislation on religion or belief enacted recently, but it also provides general practical guidance to help staff care for patients whatever their religious beliefs
Care to Learn - training resource pack for end of life care
This training programme is a pack designed to be delivered in the workplace, in a flexible and practical format that fits with staff and organisational needs. It is a cost-effective way of providing in-house training to introduce staff to end of life care without having to leave the workplace. The programme is relevant to all staff caring for people at the end of life and in particular people working in care homes, housing organisations, other community settings and hospitals as well as people in hospices who deliver support and education to staff in other services.
New DVD - HOME
Amanda Waring, producer of the DVD What Do You See?, has produced another short film entitled HOME. It looks at the emotional aspects of transitions into care homes. The DVD can be purchased online. A training pack to promote person centered care will be available March 2009
Experience based design
Healthcare organisations have demonstrated that they have significant skills in improving the performance and reliability of services but they have not always placed equal focus on the aesthetics of the experience - how it feels to use or be part of the service. The EBD approach provides the opportunity to build on previous successes by focusing more attention on this third component - the experience of care. The tools and templates in this guide can be customised for local use. T complement the guide and toolkit there is the EBD approach - an introductory DVD and a concepts and case studies book
EffectiveOlderPeopleCare.org
EffectiveOlderPeopleCare.org is a continually updated source of current best evidence from Cochrane systematic reviews which relate to the health care of older people. It focuses on common health problems in old age and different models of service organisation for older people. EffectiveOlderPeopleCare.org has been developed in an attempt to break down the barriers that prevent health professionals keeping up to date with rapidly increasing volumes of high quality research, and to provide clear evidence-based answers to the clinical questions asked by health professionals working in the field.
Evidence Based Digest
The NHS Centre for Involvement produces an Evidence Based Digest several times each year, looking at research that relates to patient and public involvement. The latest issue includes a digest of an article from Health Expectations which tested a 'transparent, accountable process for formulating recommendations based on scientific, theoretical, practical and expert evidence, with the added potential to enhance implementation
TRAINING
Accessible Wales training
Accessible Wales training provides an introduction to Disability Awareness. It is aimed at addressing day to day issues relating to disability within the workplace. The course covers an introduction and overview of disability, hands on experience of issues facing people with disabilities in the workplace, good and poor communication, appropriate language and signage, and an overview of legislation relating to people with disabilities. For more information email info@accessible-wales.co.uk or tel: 01685 814252
Carers Wales
Carers Wales offer a range of in-house, tailored training workshops
On carers rights and legislation; carers assessments best practice and
carers and employment issues. For further information, contact Carers Wales on 029 2081 1370 or info@carerswales.org
EVENTS
Dementia, dignity and the challenge of an ageing society
Thursday, 26 February, 2009, Central London
For more information tel: 020 7347 3574
Dignity in Care, Co-operative solutions and social care
26 February 2009
The Open University in Wales, Cardiff
For more information visit http://www.welshfoodalliance.org.uk
Safeguarding in the NHS
16 March 2009
Manchester Conference Centre
For more information tel: 0870 890 1080
Action on Elder Abuse National Conference 2009
Monday, 23-24 March 2009
East Midlands Conference Centre, University Park, Nottingham
For more information email daisygoodstien@elderabuse.org.uk
Sharing knowledge about safeguarding: a four country conference
Thursday, 26 March, 2009
The Teacher Building, Glasgow
For more information tel: 0870 890 1080
RCN Nursing Older People conference
Wednesday, 1 April 2009
For more information email pat.anslow@rcn.org.uk
World Elder Abuse Awareness Day - 15 June 2009
World Elder Abuse Day is now appoaching its 4th year and Action on Elder Abuse want to make it an important date in everyone’s diary. For more information email worldelderabuseday@elderabuse.org.uk or call 0208 765 7000. Action on Elder Abuse has launched a series of exciting challenge events, including skydiving, trekking and running. If you've ever wanted to trek the Inca Trail, freefall from 10,000 feet or sledge across Lapland with huskies (to name but a few), visit http://www.elderabuse.org.uk/ for more information
Perceptive Professionals Embedding Dignity and Respect in a Care Environment
Monday 22 June, RNIB Cymru, Cardiff
Tuesday, 23 June, 2009, Talardy Hotel, St Asaph
The workshop is focused on fine tuning communication and listening skills to enrich relationships between patients/clients, relatives and carers and colleagues. If you would like further information about these events please email info@dignifiedrevolution.org.uk
THE FUNDING OF A DIGNIFIED REVOLUTION
The common experience of how close relatives, whilst in hospital, had not been treated with respect and, as a result, lost their dignity led a group of individuals to establish A Dignified Revolution in January 2008.
A Dignified Revolution aims to ensure that older people are cared for with dignity and respect in hospital. We do this by raising awareness of dignity and respect issues to health professionals and to the general public
If you would like to help, we would like your time most of all. However, some cash would also be useful. £15 covers the cost of a person attending an awareness day; £30 covers the cost of printing and posting 100 leaflets; £100 covers the cost of one trip between North and South Wales to raise awareness of A Dignified Revolution.
Donations will help us to continue our work – so please give generously if you think our cause is worthwhile. Not a penny will be spent on administration or overheads – we don’t have any!
Cheques should be made payable to A Dignified Revolution.
We want to remain focussed on our goal of helping older people retain their dignity whilst in hospital. In order to avoid being diverted onto other issues and priorities, we do not seek statutory sector funding (although unsolicited grants will be accepted). So your support is important and will help to make a difference.
ACKNOWLEDGEMENTS
We would like to thank the following people for giving their time and expertise to help develop resources to support A Dignified Revolution:
Lance Webster – for the design of our logo
John Dixon – for the development of the website
An individual (who would like to remain anonymous) for her production of our leaflet
The Welsh Language Board – for the translation of our leaflet
An individual (who wishes to remain anonymous) for her production of the bilingual leaflet
Howard Hunt Group, Dartford, Kent for printing 1,000 copies of our bilingual leaflet
CONTACT DETAILS
A Dignified Revolution
Britannia House, 11 High St, Cowbridge CF71 7AD
Tel: 07811 159800
Fax: 01446 774864
Email: info@dignifiedrevolution.org.uk
Website: www.dignifiedrevolution.org.uk
