Transcript Presentation Title - Buckinghamshire New University

Relationship Activated Care:
The 360 Standard Framework
Defining and Transforming Care Cultures
Patricia Duff OBE, MSc, BA, RN, RM, PGCEA
Rosemary Hurtley MSc, Dip COT, FRSA
Using measurable outcome standards to exemplify
and protect Human Rights in care settings
Rosemary Hurtley MSc, Dip COT, FRSA
Royal College of Medicine, Summer School 2013
360 Forward provides :
Diagnostic assessment
Consultancy, education,
coaching & training services
Working with managers and
staff at all levels
Health and social care
Our aim is to establish
dynamic, sustainable person
centred cultures in their
organisations in line with the
philosophy and principles of
The 360 Standard
Framework.
Patricia Duff OBE, MSc, BA, RN, RM, PGCEA
Rosemary Hurtley MSc, Dip COT, FRSA
What is the 360 Standard Framework?
A diagnostic assessment framework that shows care organisations how
to establish and maintain person-centred cultures from the perspective
of the cared for person, their families and carers
An outcomes based practice development framework for achieving
continuous improvement
Defining and Transforming
the Care Experience
Assessment Framework –
Residents' Measures
1. Receiving person-centred care
2. Opportunities for social/occupational activity
3. Influencing meals and drink
4. Meeting spiritual needs
5. Resolving concerns and complaints
Staff and Relatives’ Measures
Staff measures
1. Finding the work fulfilling
2. Having time to deliver good care
Relative measures
1. Welcoming ambience of the home
3. Equipped to do the job
2. Communicating with staff and
managers
4. Feeling valued as a staff member
3. Being fully informed
4. Seeking to resolve concerns and
complaints
5. Contributing to the care of the
family member and the community
of the home
Managers making it happen
• Enabling /facilitative management style - clear channels of
communication, positive relationship building, collaboration with
other professionals and agencies
• Pivotal leadership role in change management
– Operational management
– Practice development
– Quality improvement
– Business planning
Example : Resident Standard 3:1
The resident has a choice of culturally acceptable food and drink that meet his/her dietary
requirements
Structure
Process
Outcome
Characteristics
of the 360 Standard Framework
 Delivers continuous quality improvement and demonstrates
measurable change
 Involves the cared-for person, relatives and staff
 A Standard of excellence in relationship activated care for
person-centred outcomes
 Underpins all other service and practice standards
 Incorporates evidence from research and empirical studies
 Diagnostic with measurable outcomes
1 - Client
Decision
Routes : The 10 Step Cycle
2Preparing
and
Planning
7. Internal
Implement
Action Plans.
3 - Data
Collection
4 - Data
Analysis
8. Internal
Evaluation
9. 360
Foundation
Commitment
Award
6. Action
Plan
5Feedback
10. 360
Foundation
Outstanding
Progress Award
Why is the 360 Standard Framework
important to the NHS?
Good patient outcomes - Create a patient-centred NHS
Quality Improvement - Focus on improving their
experience and their health outcomes
Value added benefits: effectiveness and efficiency
Leadership and management enabling tools - Empower
professionals – end top-down control
Work-based Learning Key topic areas
For delivering quality compassionate
care
1. Understanding ageism in society
2. Understanding chronic conditions and their effects on the
person –identity, significance, continuity, purposefulness,
belonging and being understood
3. Building positive relationships –the triangle
4. Specialist communication skills
5. Understanding transition, loss and adapting
6. Understanding and preventing institutionalisation
7. Inter professional co-operation and collaboration INTEGRATION
The Elizabeth project
Justine Cawley
Independent Consultant
Associate at Bucks New University
Background
• Developing a career pathway for people working with
older people
• From apprenticeship to post-registration nursing
• Mid Staffordshire and other incidents of unacceptable
care
• Over the years older people have been moved out of
hospital into residential care and as a result the health
input has diminished
The Structure of the pathway
•Post apprenticeship course
•Elizabeth practitioner – Foundation degree
•Elizabeth Nurse – Post qualifying degree
Why is this needed?
• Increase in complexity of care – dementia, long term
conditions
• Need to have higher standards in health and social
care
• No dedicated career pathway for older people
• Need to give the sector and their staff more status
and recognition
Issues in the sector
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Societal
Organisational
Operational
Practice- knowledge, skills, behaviours
Lack of funding for socio-health nurse
development
• No career pathway to higher education
qualification in care of older
people
Why training is essential:
• 65% of people in hospital are over 65. 80% of people in care
homes have dementia or cognitive impairment (Alzheimer’s
Society, 2013)
• Residents of care homes have complex healthcare needs,
reflecting multiple long-term conditions, significant disability and
frailty.(BGS, 2011)
• All health and social care providers need training in the complex
management of people with multiple long-term conditions (BGS,
2013)
• People living in a care home and suffering from dementia are more
likely to go to hospital with avoidable conditions such as urinary
infections.(CQC, 2012- Care Update)
• The social care model is central but insufficient to meet residents’
health needs.(BGS, 2011)
Impact
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More young people coming into the Sector
A more educated and adaptable workforce
A career pathway that young people want to enter
Work based learning and an alternative to University
Less turnover of staff
More profitable sector
Happier staff
More career opportunities
More customer satisfaction
Enabling the Willis and Francis Report
Recommendations
The culture of healthcare provider organisations is routinely assessed
More family and user involvement in education
Streamline communication skills to provide dignity for people with
dementia, mental health and chronic disease
Flexible education programmes for nurses and carers, people and their
families
Work-based learning
New status of nurse for older people (Francis Report)
Integration
• Integration is essential if we are going to give older people the care
they deserve.
• Partnership is essential – Partnership which are equal
• Social Care sector is very fragmented.
• NHS have the money and Commissioners have the power
• Social care have less qualified staff
Social Care Sector
• Predominantly SMEs who are fighting to
survive
• High turnover of staff
• Lack of awareness of partnership – lose
staff to NHS
• High drop-out rate with young people
Partnership and integration
• Partnerships are sustainable
• They are equal
• They have good foundations and have
identified core common goals
• They have common training routes
Building Bridges
Construction began in 1831 but the project was beset by political
and financial difficulties.
By 1843, with only the towers completed, the project was
abandoned.
The bridge was finally completed and opened in 1864.
Bridges and innovation
• Underpin foundations of the weaker side
or use strengthening members across it
• Victorians great engineers and innovators
• We have to be a different sort of innovator
by being builders of social structures that
work and provide excellent care.
‘
Thank you
Rosemary Hurtley [email protected]
01483 275555
Justine Cawley [email protected] 07767 442136