Thursday, 17 September 2015

Advisory or Mandatory?

When is mandatory training not mandatory?
Apparently when it applies to the social care sector.

There’s something a bit wishy washy about labelling training as mandatory when there is no actual requirement to complete said training. Or worse still, when there is a stated ‘requirement’ to do the training (by the CQC) but there are no real consequences when the training is not completed. Unless you count a slightly lower inspection rating as a real consequence. Is it just me or is it slightly baffling that there is no legal requirement to complete any training in the delivery of social care?

Care providers themselves determine whether a training course is mandatory or not. Some will deem it mandatory while others will consider it optional. While the CQC may require that a service trains their staff to a minimum standard, this is not legally binding. It seems training is a ‘should do?’ rather than a ‘MUST DO!’

The training of care workers in the new Care Certificate is advisory rather than mandatory. The Care Certificate which is promoted as the basic or minimum entry level course is not actually a qualification as we understand the term.  It is not on the National Qualification Framework (NQF) but it is considered a Continuing Professional Development (CPD) course. This is a fantastic introduction to the world of care work and is indeed a minimum requirement for care workers. It is not, alas, mandatory unless deemed mandatory by the care provider.

We have a long way to go before we have a professionalised and regulated social care workforce. There are many reasons why it is important to achieve this. First and foremost is the quality it will bring to the care of the growing number of elderly and vulnerable people in our society. Secondly it will attach a greater value to this incredibly important work and allow carers to follow a career path with pay scales that reflect the importance of this work.  Is it the case that the current status of care work is an accurate reflection of how we as a society value care work? That is, not very highly. We are quick to jump on stories of poor care and express horror and outrage when people are abused and otherwise mistreated but when we scratch the surface a little and look at the way workers are trained and what they are paid, it is clear that the explanations for these behaviours cannot be simply dismissed as the actions of ‘rogue carers’.

Better pay will in turn attract and hold on to the right calibre of person needed by this growing social care sector. The resulting lower turnover of staff will add to the stability of the workforce which, again, will benefit the end users.

A better trained workforce with professional status will help care workers achieve something approaching parity with their health sector counterparts. This in itself will go a small way to greasing the wheels on the journey to an integrated health and social care system. The disparity in training, pay and conditions does nothing to facilitate the team spirit needed when workers are required to work across professional and organisational boundaries in the pursuit of an integrated health and social care system.


There’s an old adage that ‘Ignorance is no defence in law but training is’. I’m sure the day will come when training is, itself, a legal requirement. 

Thursday, 10 September 2015

Integrating Health and Social Care

Integration of health and social care has been on the agenda since the turn of the century and has been talked about for a good deal longer. Will we still be talking about it at the turn of the next century or will someone actually be doing something about it?
Is your organisation doing something about it or are you, like the majority, merely paying lip service to what is, admittedly, a noble cause?
The logic is faultless but the application seems to be a good deal more complicated than some would have us believe. We know it’s desirable but is it really possible to bring two systems together to work seamlessly in the delivery of care? It can be difficult enough to get professionals of a similar discipline to work as a team when managing complex health and care packages. When we ask them to work across professional and organisational boundaries we’d better make sure the infrastructure is there to support them. But what is this infrastructure? What does it consist of and who is going to take responsibility for maintaining it? Are the differences in culture so different that we will never truly have an integrated system?
Multidisciplinary teams already exist to manage complex needs. We only need to look at the cases of NHS continuing healthcare to see that it is possible for decisions about health and social care to be made coherently and it is a credit to many of those teams that they can unpick the myriad of needs affecting patients and put together packages of care that meet the needs of the whole person and indeed the needs of those around them. It strikes me however, that it is not so much the decision-making or the ‘design’ but the implementation of those decisions and designs that is the real challenge of integrating health and social care. I wonder whether the fundamental differences in a)culture and b)training for clinicians in healthcare, as opposed to those in social care,  are such that there will never really be a genuinely integrated health and social care system. This sounds defeatist from the outset but I think it highlights just two areas (and there are many more), that need to be addressed if we are going to achieve this holy grail of a truly integrated health and social care system.
It’s worth shining the spotlight on some of the most complex cases requiring input from health and social care services. The provision of NHS continuing healthcare, by definition, applies to people with long term health and social care needs where the dominant need is deemed to be a ‘health care need’ as opposed to a ‘social care need’. So here’s the thing, what is the difference between health and social care? When does one begin and the other end?  As with many other things, it is the boundary, the borderline, the areas that are most difficult to define, where clarity is needed. It is at these professional and organisational boundaries where problems arise and where problems must be resolved in order for integration to occur.

We will consistently be returning to the questions of infrastructure and health versus care culture. It is surely a given that training will be key to any integrated system of health and social care. It is clear that joined up working can only be enhanced by joined up training. It is not entirely clear to me at present which organisations are really taking the lead in this integration of health and social care at a local level. NHS organisations and Local Authorities certainly have responsibility to design such a system but where is the guiding light? Where is the beacon that shows that people are receiving a genuinely joined up, integrated health and social care system? Is such a thing possible?

Sunday, 25 January 2015


James Gallagher, BBC Health Editor, has written a thought-provoking article about research into the history of post-traumatic stress. He concludes that it is not a new phenomenon. Professor Jamie Hacker Hughes, a former consultant clinical psychologist for the Ministry of Defence, who led the research, said: "As long as there has been civilisation and as long as there has been warfare, there has been post-traumatic symptoms."



An anonymous article by a care team worker on the fourth year of redundancies and the effects on team morale. The pertinent question is raised of why after four years of drip-fed redundancies, there has been no change to management staffing levels? Surely there are far fewer people to manage now.

Management decision making (or the lack of it) is also addressed, raising further questions.


Thursday, 22 January 2015


An uplifting account written by family support worker Bobby Owen, who offers emotional support and practical advice about sibling care, employment and housing when a child is in hospital.



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Tuesday, 20 January 2015


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Our e-learning courses can be issued by GPs to patients by e-learning prescription. To find out more, please call 0161 928 9987 and visit our online course library: http://goo.gl/wVmnWq

An examination of the state of the social care profession. With an anticipated extra million social care jobs by 2025, action needs to be taken if these positions are to be filled. How this is to be funded is considered in some depth here by Laura Gardiner. The challenges she identifies that need to be faced include:

- Eradicating zero hours contracts
- Ensuring that at least the minimum wage is met, by paying care workers for time spent travelling
- The provision of adequate training in, for example, caring for those with dementia.


Monday, 19 January 2015


Sue Brown, head of public policy at deafblind charity Sense, offers tips to for social workers on implementing the Care Act for deafblind people. The categories she includes are first contact, assessment, eligibility, and prevention duties.

There’s also a useful link to Sense's free guide to helping local authorities implement the Act.



For information about our comprehensive and informative e-learning course about all you need to know about the new Care Act, please follow this link: http://www.embrace-learning.com/the_care_act_2014_e-learning.php


Saturday, 17 January 2015



Are you ready for the Care Certificate?

 The National Care Forum has announced that Skills for Care, together with Aged Care Channel (ACC) TV are hosting a free live TV Event on Thursday 12 February 2015 at 10:45am and 2pm. You will be able to watch the broadcast, and participate, on any device with an Internet connection.


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How will the #CareAct affect you and your family? Surrey County Council have produced this useful and informative video as an introductory guide. It includes information specific to Surrey, but a lot of it is relevant to everyone in the UK.


Are you ready for the new Care Act?

Carers UK and Embrace-learning have joined forces to develop this key learning resource. With three easy-to-follow study units you can learn about the changes to practice that will happen when the new Act comes into force in April 2015.


Thursday, 15 January 2015


The mystery of shellshock solved

 

This is a very interesting and moving account of how war affects the people ‘we’ send as a country to defend us and to attack the threats our governments perceive as existing worldwide: In this article, you can find out how scientists have identified the unique brain injury caused by war.


Tuesday, 13 January 2015


Would you like to gain nationally-recognised qualifications to open opportunities for you to work and/or advance further in the health and social sector? If so, please follow this link http://goo.gl/wVmnWq to our extensive e-learning course library, or give us a call on
0161 928 9987. #elearning #socialcare #careact


A look at how Google Glass could help transform health, social care and social work. Benefits of the emergent technology include:

- Bridging language barriers using real time translation
- Comparing food labels with nutritional requirements/dietary restrictions
- Livestreaming to remotely access colleagues/family members/carers
- Information sharing amongst professionals
- Cost-cutting


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Monday, 12 January 2015




An informative article on mental health first aid training. Developed in Australia and now available in the USA and the UK, trainees learn to spot when someone is having an 'episode' and intervene.


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Author Gayle Forman on changing attitudes to depression. She argues cogently that depression is as treatable and as potentially lethal as leukaemia. The question is raised as to whether depression is as much a physical health issue as it is a mental one.


Sunday, 11 January 2015



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From Monday 5th to Friday 9th January, Tom Shakespeare broadcast a series of essays on Radio 3 in which he challenged stereotypical ideas about creativity and disability. Through the course of the week, he celebrated a number of artists, including painters Bryan Pearce (who has phenylketonuria) and Lucy Jones (who was born with cerebral palsy), and explored how their ‘impairments’ fuel their genius. These informative and thought-provoking episodes of ‘Essay’ are available for download at http://www.bbc.co.uk/podcasts/series/essay

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Thursday, 8 January 2015


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At the first session of a broad inquiry by the department of work and pensions select committee, pleas were made to the government to suspend the benefit sanctions regime. There are worries that over the last two parliaments, not enough has been done to monitor the effects of sanctions, amid concerns that it has created a climate of fear, particularly among the disabled. 


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SCIE chief executive Tony Hunter shares his hopes for 2015. He would like people no longer to be the passive recipients of care, but to be enabled to contribute to community life, what he terms 'co-production'. The Care Act, he sees as an opportunity to embrace this ideal. The question is changing from "What's the matter with you?" to "What matters to you?"


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Tuesday, 6 January 2015


Director of Think Local Act Personal, Isabelle Trowler, on her hopes for the transformation of social care in 2015. Stressing the need for action rather than words, she highlights three principal areas where change is necessary:

1) A shift in emphasis onto the promotion of individual wellbeing within inclusive communities

2) The nurturing of a strong Integrated Personal Commissioning (IPC) programme that can work effectively for those with the most complex needs

3) An effective partnership between health, care, housing and beyond.

Underpinning all this is a strong desire to see a new funding settlement for social care, to match increased funding for the NHS. In an election year we can expect plenty of positive posturing from our politicians, but which party would come closest to delivering her ideal? That is the question.


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An examination of why there has not been a greater uptake of personal budgets in mental health. Despite evidence that personal budgets provide improved mental health, it appears that there are systematic barriers preventing their more widespread use. These include:

- professionals who still perceive risk in allowing people with mental health problems controlling their own support
- a reluctance to shift from an emphasis on diagnoses and conditions
- a lack of NHS focus on personalisation, coupled with
- a growing trend among local authorities to distance themselves from mental health

It appears that without a concerted national focus within the social care sector itself, mental health provision in England will at best stagnate. What are your thoughts?


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Monday, 5 January 2015


All of us at Embrace-learning would like to wish you a happy New Year and we hope you have a very positive and uplifting 2015. Thank you for all your messages and contributions to our discussions and we look forward very much to hearing more from you! Embrace-learning: http://goo.gl/Di7ciT



In 2014 the School for Social Care Research published "Care Home Managers: A scoping review of evidence". Authored by Katharine Orellana, the booklet attempts to provide for adults in England, an overview of evidence concerning the role and experience of the care home manager. Starting by addressing the question of who care managers are, attention then focuses on:
- their practice, experience and skills
- the supervision and support they receive from their superiors/home owners
- the challenges they face in practice
- gaps in the evidence base

Often alluded to as 'shadowy' figures, they have a defining impact on the culture of care.


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Peter Beresford's critique of the state of social care provision is essential reading. Frequently he makes reference to the ambiguity of political posturing in the face of an increasing state of emergency in the caring sector.

He calls for a radical policy review of personalisation and personal budgets; berates the abuse of 'eligibility criteria' as the smoke and mirrors of political expediency, which allows the likes of Paul Burstow to claim that there is "no funding gap", when estimates put it at £7billion; and describes, "... a fragmented social work education system ... what's most needed are skilled social workers spending more time with service users”.


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To browse our wide range of accredited e-learning courses, including those relating to #disability, #abi and #dementia awareness, and guidance about the new #CareAct, please visit: http://goo.gl/wVmnWq or give us a call on 0161 928 9987.


BBC Health Correspondent, Nick Triggle, reports on what the NHS needs to address at the start of 2015. Figures, which will be released later this week, are expected to reveal that performance in Accident and Emergency units in England has dropped to its worst level in a decade.


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