North West and North Wales Back Exchange Conference

ONE DAY CONFERENCE ORGANISED BY THE NORTH WEST AND NORTH WALES BACK EXCHANGE IN ASSOCIATION WITH THE WORKING WELL TOGETHER GROUP AND NORTH WEST WALES HEALTH AND SAFETY GROUP.

The above conference took place on Wednesday, 10 April 2013, at Bangor University in Gwynedd.  It was extremely well attended and very well organised.

After the initial introductory speech by Ellen Beard, Chair of the North West and North Wales Back Exchange Group, the conference began.  The first presentation was by Lisa Fowlie, Health and Safety Adviser for Bangor University, and was entitled "Setting The Scene".

This was followed by a very good presentation from Dr Iain Lea, a qualified chiropractor and Director of North Wales Spine Clinic.  He presented considerable evidence regarding musculo skeletal injuries citing that 80% of back injuries are disc related with 20% being related to the sacro iliac joint.  There were lots of useful tips on managing back injuries including getting the right treatment as quickly as possible and not relying on pain killing medication which can often lead to chronic back problems.  He talked about core muscle stability and strength being essential in preventing back problems and also helping in recovery.  He also talked about the "10,000 paces a day rule" being a good guide as to general health and prevention of major life style illnesses such as obesity, diabetes and heart disease and urged everyone to go out and buy a pedometer!

Matthew Birtles, Senior Ergonomist, Health and Safety Laboratory, finished the morning presentations by giving an excellent talk about ergonomics in the work place stating that most cumulative back problems happen at work as that is the time when we are more likely to do the same task over and over again whereas at home we tend to carry out different tasks and therefore adopt different postures.  He explained that variation in posture is actually more important than necessarily having everything at just the right height and position as in sitting at a desk and working on a computer i.e. "The best posture is the next posture".  He also highlighted the importance of keeping joints in the neutral position as much as possible as employing forces when the joint is out of neutral is when injuries occur.

The afternoon sessions that I attended were also very good.   Julia Love, Chair of the National Back Exchange, gave a presentation on "Accidents with Hoists" and the common mistakes that staff make e.g. putting the brakes on a mobile hoist when fully hoisting someone, not having the correct sling, attaching the wrong loops to the hoist and having the client attached to the hoist in a lopsided manner.

The final presentation which I attended in the afternoon was a presentation from Sheenagh Orchard, a registered nurse and Moving and Handling Specialist.  She has done a considerable amount of work on single carer handling, a topic on which I have written another blog. 

There was another workshop in the afternoon entitled "The Heavier Person and People with Challenging Behaviour" presented by Hakan Skenhede, Sonja Conway and Mark Ripley.  Although I was unable to attend this work shop, I understand that it was well presented and offered useful information.

A number of companies attended with moving and handling equipment and lunch was provided.  The overall feedback from the attendees was very favourable.  Here's to the next one!!

Helen Sheard, Consultant Occupational Therapist

Single Carer Handling

I recently attended a presentation by Sheenagh Orchard, a registered nurse and Moving and Handling Specialist at a conference organised North West and North Wales Back Exchange.  Sheenagh has done a considerable amount of work on single carer handling which has involved training staff and working with carers and managers to change the culture away from utilising two staff as being the default position for some manual handling techniques such as hoisting. 

She stated that she aimed to reduce the care packages to one carer packages by 45% with most authorities she has worked with and has managed that in a number of areas.  The provision of specific equipment is vital to ensure that one carer packages are realistic and workable, e.g. ceiling track hoist systems, gantry hoists, in bed re-positioning systems like the Phil-eSlide etc. 

Sheenagh does acknowledge that one carer handling is not always possible and that in almost all situations where a mobile hoist has to be used two carers will likely be needed.  The assessment is all important in determining where single carer handling is possible and appropriate.  This is something that we at Personal Care Consultants wholeheartedly agree with.  We feel that one carer support is likely to become more common in the future as staff resources become increasingly stretched and the elderly population increases.

Helen Sheard, Consultant Occupational Therapist

“Cradle to Grave” Manual Handling - Back Exchange conference

Last week I attended the Lancashire and Greater Manchester Back Exchange group’s AGM and “Cradle to Grave” manual handling conference.  There were several presentations as follows:

Posture and Positioning in Midwifery Practice

Picked up some useful information from this talk - like other health care professions back injuries are the main cause of sickness among midwives with 44% being around assisting mothers with breast feeding and 31% around assisting with the birth.  The recent trend towards home births and mothers having the preference of the position they want to be in when giving birth has put more midwives at risk.  Another interesting fact is that a posture is designated as static if held for longer than 4 seconds! (Standard DIN 1005-1 (2000)).  There was a lot of discussion afterwards about getting the balance right between allowing the mother choice and safeguarding the midwives - lots to be done in that area it seems! 

Manual Handling Children - Beth Hallows

A thoughtful presentation with Beth emphasising the need for empathy with parents and accepting that for parents the issues of handling are likely to be different with children responding differently to them than to professionals, time factors when other siblings are around, family wanting to experience outside activities together etc.  As she said, often it takes a long time to gain respect and trust with the professional involved and it may be that we start with introducing something very small to begin with and reduce risks over a longer period of time accepting that the family want to have as “normal” a family life as possible - particularly when the child is very young - with perhaps more substantial equipment being put in place later on when they are larger and more difficult to manage. 

Challenging Behaviour - a unified Approach

This presentation emphasised the need to identify the triggers of the behaviour which may be environmental or involve interaction with carers etc.  The presenter also made the point about the need for consistency of approach and the need for constant evaluation, good staff training etc. 

The conference offered a good opportunity to consider manual handling issues at different stages in life and also to explore some new equipment at the exhibitor stands. 

Social care training budgets - necessity or luxury?

There have been a number of high profile cases highlighting poor care within nursing homes, residential homes and with domiciliary care providers. A local authority (Wirral Borough Council) has changed its leadership directly as a result of a ‘whistle blowing’ issues over social care provision.

Even this week, it has been widely reported in the media that the manager and deputy manager of Speke Care Home in Liverpool stole the life savings of vulnerable residents, some of whom had dementia.  These are difficult situations to think and write about, whether it is verbal, physical or even financial, abuse should not be tolerated within the social care sector.

One has to wonder, how these situations occurred and more importantly, why they continued undiscovered for considerable periods of time.

With the Wirral Borough Council case, an employee highlighted the issues early on, however, it has been reported that the employee who raised concerns lost his job as a direct result of his ‘whistle blowing’.  The issues of poor care and abuse in other domiciliary or residential settings, raises many questions, the most important being, how did this happen?

We can assume staffing levels may be a factor, where staff simply do not have the time to realise what is happening, or is it an issue of staff not being aware, because they do not know what should be happening?  With the current economic change, many organisations are feeling ‘the pinch’ with budgets. When considering what necessary expenditure is required, too often we see that the training budget is cut or simply disappears.

It’s an easy target for finance directors and training is often seen only as a luxury. 

One must therefore ask a question, is it a luxury or a necessity?

If a company cuts a sales team due to poor sales, initially it will appear as a quick fix, however, when the company tries to increase revenue and push for sales in the future, they struggle as they do not have the personnel required.

We can use a similar analogy with training, yes cut the training budget and initially save the organisation money. However, when the staff are not trained to high standards in the delivery of care, good practice and awareness of many conditions, then the organisation cannot provide the service required and will be unable to compete with other organisations in the tendering process.

Provision of care training improves confidence and competence in staff, highlights the employer's or service provider’s commitment and most importantly, ensures that clients receive high quality care, which is monitored, observed and significantly reduces the risk of poor delivery and abuse.

If you require information on the comprehensive range of social and healthcare course provided by Personal Care Consultants, then please contact us on Tel: 01244 390 677 or via email on info@thecareplan.com.

Home care often fails to meet older people's basic human rights says inquiry

Once again in a new inquiry we hear about Vulnerable people receiving poor care at the hands of Homecare staff, staff that older people often feel they have no choice but to trust.  Since the Human Rights Act came into force in 2000, the home care industry has changed from having 56 per cent of care delivered by the private and voluntary sector to 84 per cent.

As a result of court decisions, the legal safety net provided by the Human Rights Act does not extend to older people receiving home care from private and voluntary sector agencies. This means that the majority of older people using home care services have no direct human rights protection.

The recent inquiry by the Equality and Human Rights Commission found that around half of the older people and relatives interviewed were highly satisfied with their standard of care. However, in a minority of cases there were significant lapses in the care some received.

The Commission's inquiry into the home care system in England reveals disturbing evidence that the poor treatment of many older people is breaching their human rights and too many are struggling to voice their concerns about their care or be listened to about what kind of support they want.

I understand that very few local authority contracts for home care specify that the provider must comply with the Human Rights Act. This is undermining the quality of care that older people are getting. In response to the findings of its inquiry, the Commission says that legislation and regulation needs to be updated to reflect huge shifts in how care is provided.  Its recommendations from the inquiry fall under three broad categories: -

• Proper protection: Closing the loophole in the Human Rights Act which would give protection to the growing number of older people receiving home care from private and voluntary sector agencies. The law was changed in this way in 2008 to protect residents of care homes who are funded by the state.

• Effective monitoring: The government, Care Quality Commission and local authorities need to work together better to build human rights into home care and make sure that abuses are detected faster and dealt with more effectively.

• Clear guidance: Clear and robust guidance on human rights is needed for councils so they can use the opportunities they have to promote and protect older people's human rights in commissioning; older people also need guidance to help them make choices about care and to explain how their human rights should be protected.

Sally Greengross, Commissioner for the Equality and Human Rights Commission, said:

'It is essential that care services respect people's basic human rights. This is not about burdensome red tape, it is about protecting people from the kind of dehumanising treatment we have uncovered. The emphasis is on saving pennies rather than providing a service which will meet the very real needs of our grandparents, our parents, and eventually all of us.

'This inquiry proposes some steps that would make sure human rights are protected in future – including changes to the law so that, at a minimum, all people getting publically funded home care are protected by the Human Rights Act.  Currently this is not the case.

'Most of us will want to carry on living in our own homes in later life, even if we need help to do so. When implemented, the recommendations from this inquiry will provide secure foundations for a home care system that will let us do so safely, with dignity and independence.'

Human rights law in home care
The Human Rights Act states that public authorities must comply with the European Convention on Human Rights when they are carrying out their powers and duties. Centrally important for home care is the cluster of rights protected by Article 8 of the European Convention on Human Rights, which guarantees respect for dignity and personal autonomy, family life and social relationships. Other important rights include the prohibition on inhuman or degrading treatment (Article 3); and the right to life (Article 2).

Bare compliance with the Human Rights Act is not enough; public authorities also have ‘positive obligations’ to promote and protect human rights, meaning that they should take active steps to promote and protect human rights when they are carrying out their powers and duties. These positive human rights obligations are particularly important when local authorities are commissioning services from private and third sector organisations.

Equality and Human Rights Commission
The Commission is a statutory body established under the Equality Act 2006, which took over the responsibilities of Commission for Racial Equality, Disability Rights Commission and Equal Opportunities Commission. It is the independent advocate for equality and human rights in Britain. It aims to reduce inequality, eliminate discrimination, strengthen good relations between people, and promote and protect human rights. The Commission enforces equality legislation on age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation, and encourages compliance with the Human Rights Act. It also gives advice and guidance to businesses, the voluntary and public sectors, and to individuals. 

It is time we ensured all staff are offered high quality training and are trained in all aspects of their role so that they can provide the sort of care vulnerable adults require and value.

Personal Care Consultants can offer a tailored training package to Private and Voluntary sector homecare managers and their staff to refresh and improve skill levels and knowledge in all or any of the following areas:-

• Human Rights Act
• Mental Capacity Act
• Dignity, Respect and Privacy
• Personal Care
• Promoting Independence and Reablement
• Outcome focused care planning
• Health and Nutrition
• Catheter Care
• Infection Control
• Administration of Medication  
• Record Keeping & Reporting
• Risk Assessment
• Pressure Sore Prevention and Treatment
• Principles of Care
• Manual Handling of People
• Dementia Awareness
• Diabetes Awareness

For more information please visit our Training pages or e-mail training@thecareplan.com or call us on 01244 390677 for an informal discussion of your requirements.