Safeguarding Adults Practice Officers, Durham County Council and County Durham Primary Care Trust
Aims of the service
This team, consisting of two nurses and two social workers, was set up in 2008 to work with residential and nursing homes in County Durham. The aim of the team is to respond to safeguarding incidents that have occurred in care homes and to work proactively with providers to reduce the number of safeguarding incidents. The team works collaboratively with providers to share best practice, promote dignity in care principles, and to ensure care practices within care homes in County Durham are of the highest quality.
Description of what the service has done:
The team works with care homes where issues have been raised through safeguarding to develop action plans and support care homes in improving practice which may have contributed to safeguarding concerns. This includes signposting homes to other available resources such as pharmacy services, training organisations and occupational therapy. The team has recently been awarded funding for an occupational therapist to work alongside the team to support homes with issues relating to moving and handling, use of restraint, application of equipment and associated risk assessment and care planning. The team also provide advice and support on issues which affect the care of residents with dementia, including person centred care planning and providing a dementia friendly environment.
Team members have been actively networking with home managers to introduce the team and to ensure that a proactive approach is used to raise and maintain good standards of care, including care for residents with dementia, within care homes. The team have started running home managers forums as a method of sharing good practice to which guest speakers are invited, including from Durham Employers Care and Health Alliance, to discuss training, the lead on implementation of Deprivation of Liberties for Durham County Council and tissue viability nurses.
The team has also been providing Dignity in Care awareness sessions to care home staff at all levels. These one hour sessions encourage staff to think about how they work with residents to promote dignity and to look at changes to their practice that could improve dignity for the people they look after. During these sessions examples are discussed that include caring for people with dementia in a way that promotes dignity. The team will also be offering safeguarding alerter training to care homes.
Members of the team ensure they keep up to date with new developments. This has included attendance at conferences, including the Dignity Matters conference, conferences on end of life care and dementia care matters. All members of the team are Dignity in Care Champions and encourage staff within the homes to support the dignity challenge.
What are the resource implications of this example? How has it been funded?
These permanent posts are joint funded by County Durham PCT and Durham County Council.
What have been the challenges and solutions in setting up and maintaining this?
Initially the team spent some time giving information on the purpose and remit and to overcome the perception of some providers that they would be another inspection and regulatory body. There was some difficulty in the team engaging directly and freely with staff in homes as some managers and operation managers initially wanted to tightly control the parameters of visits. This was overcome by holding awareness raising sessions with staff on dignity and safeguarding issues. This has made the team accessible to all staff in care homes, not just management, with the consequence that the team have been able to inform staff at all levels about our role.
As there are approximately one hundred and ninety homes in Durham the team had to initially prioritise work with homes where there had been safeguarding issues, whilst setting up systems to communicate with and visit other providers.
Outcomes :
Recruitment to the team was complete in September 2008. Outcomes for the team will be measured by measuring the number of residential homes where safeguarding executive strategies have been instigated. Any decrease can then be correlated with the work of the team.
Regular updates on the work of the team are shared with Durham Safeguarding Adults Board.
Evaluation from care home managers who have had input from the team has shown that they have found the input effective and supportive. This has included where changes to environment in units for those with dementia has had a positive effect on the care given to those with dementia.
Audit of the teams work will be undertaken along with evaluation of whether there are any positive changes to the star ratings of homes given by CSCI or CQC after intervention by the team.
Plans for the future:
This is a permanent team, which is continuing to develop. Work will continue in developing positive links with providers with the aim of improving standards of care. In doing so the team aims to have a positive impact by reducing the prevalence of safeguarding incidents with care homes.