Local views on social care in Nottingham
We work with care providers from all over the country, but we’re equally interested in the care that’s being delivered right on our doorstep here in Nottinghamshire. Is social care in Nottingham any different to the rest of the country?
Here at Insequa we are in dialogue with the care providing community at all times. It’s what we do. One of our team, Matthew, was recently chatting to someone on the phone who is a local to our Nottinghamshire head office. As they chatted, it became apparent to Matthew that Esther Godfrey was a person holding strong opinions on the provision of care delivery. We are always keen to listen and learn from people on the front line of care as it informs perfectly the work we do. Esther generously agreed to sharing some of her experience in an Insequa blog interview.
Tell us about your care journey, Esther.
My family purchased Richmand House in West Bridgford, Nottingham, thirty years ago. At that time, it was registered for six services users, and over the last 30 years that has increased to twelve residents. We care for older people, some of them living with dementia. It has remained a small, family operated concern and my mum is the registered manager. It’s very much a labour of love as different family members hold various roles in the organisation. At one point we looked at a property next door to look into expanding our services but realised we wouldn’t be able to deliver the kind of bespoke, person centred care we do now so effectively if we were to become a bigger organisation. So, we’ve stayed registered for just 12 residents at Richmand House.
Have you offered any other care services?
Yes, we also offer a day care service where service users can access a full day at Richmand House including meals, activities day trips and in some cases personal care such as showering, chiropody, reflexology or a hair dressing service. Four and a half years ago we launched a community care team providing personal care services to people living in their own homes. Operating as a micro scheme we pretty much emulate what we do at Richmand House. When we first started this service there was an element of excitement around it in the community because Richmand House has a good reputation for doing what it does. We then expanded and quickly learned that care in the community is a whole different ball game, how you operate it in terms of the environment. Although we were and are competent in delivering care for older people and those with dementia and we have a long history of knowing how to operate in and to guidance legislation and national policy and procedures, care in the community is different. Richmand House is a static entity, it doesn’t move. At any one time you know what’s happening under the roof of Richmand House. We experienced some new concepts and adapted to make sure care delivery matched the Richmand House standard as far as possible. We decided to downscale, last year for two main reasons: Firstly we wanted to emulate the bespoke specialised person-centred service we deliver at Richmand House, secondly, what we learned in the four and a half years especially with people living in their own homes, is that early intervention is key.
What did you learn?
I learned that most people access care at a crisis point because something’s happened. Nine times out of ten it’s the result of a fall that has led to surgery and then post-surgical care that’s then carried on. I believe that culturally we are reactive rather than proactive. This needs to change because early intervention with older people is crucial in maintaining quality of life. It doesn’t have to be because there’s a crisis, it could just be that more support is needed, for example in areas such as domestic tasks like housekeeping and shopping. With a skilled, trained and knowledgeable workforce, which I’ve got, you can keep people at home much longer and mitigate risks. Because you’ve got staff with that training and knowledge that are going in to people’s homes, maybe only a couple of times a week initially, so not a fully blown care package, but just enough to mitigate risks, monitor change and address concerns and issues long before they escalate and become high level.
The social care sector has difficulties finding and keeping hold of staff. How do you deal with this?
We don’t have the same problems with retention and recruitment. Two reasons for this, we are a family owned and operated business so we’re fortunate there are family members who work here. We also pay over and above the minimum wage – and if we’re paying over the odds, we expect a high level of care for that. We like to invest in our workforce. Not just the mandatory training, but training that helps staff build their expertise. In thirty years, we’ve used bank staff twice, and that was to get cover whilst staff attended weddings for those in the staff team – that tells you a little about staff cohesion in the Richmand House family.
Organisations such as NACAS are lobbying hard to get care worker roles professional recognition. What do you think?
I think it is a good idea because it will raise the profile of care workers. Care work is generally considered an easy job insofar as skills and tools needed, but also a role that culturally and socially is perhaps considered a manual, non skilled role that commonly doesn’t pay well. In terms of the complexity of the needs of service users and how carers need to think on their feet and address those needs whilst being skilled in practical application, knowledgeable, and underpinned with policies and procedure, it’s a lot for a care worker to take on as a base line training. A care worker is not going to be equipped with what they need with just basic training, and that’s what professional care qualifications could bring to the caring role. Also, I think there are some employers who perhaps exploit and take advantage of the fact that care work is not recognised as a professional role requiring training, skill and knowledge. We’ve had staff who have come to Richmand House who have been in care for between two and eight years and never been put forward for care qualifications. To have care worker roles recognised as a profession and regulated as such, would improve the situation for care workers and service users alike, recruitment and retention of staff from a business perspective.
Do you adopt an intergenerational approach at Richmand House?
We don’t consciously pursue intergenerational methods but we attract a broad age range of visitors into the home. Guests of all ages are always welcome. We have good links with the local schools, and frequently have year 13 and year 11 children coming in to do work experience. On Mother’s Day in March we had fifteen visitors of all ages. The benefits of blending young and old are huge, so we always encourage it where we can.
Would you like to grow old in Nottingham?
The Borough of Rushcliffe in Nottingham is a lovely place for people to grow older. It’s a quiet affluent area with a lot going on. There are parks and river walks and it’s safe for older people. Add to that the fact that there are lively church groups, lots of dining out options and a Memory Cafe – so, yes, I think I would like to grow old in the Rushcliffe area.
How about accessing what’s out there?
That’s a crucial point. It depends a lot on the support you’re getting. You can have all these things in place locally, be able to access all these community groups, but it all depends on whether the people you’re employing to provide your care are plugged in to all the stuff that’s available locally so they can expand your care package in those areas. We are very proactive for our residents and encourage them to access the wider community. They go out for coffee and cake, on shopping trips and recently we took some ladies from Richmand House and some other locals from the community to a Nottingham garden centre. It’s important to talk with relatives and family members, too. Are they aware of all the resources and initiatives available to help their loved ones? Often, people don’t know where to start or where to go with accessing basic care, let alone knowing what is available in the wider community to enhance and augment their care experience.
This interview is in two parts, the second part will be published next week.
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