12 ways that Wellbeing Teams are different to traditional homecare

Carol works in the care sector visiting clients in their own homes for which she receives the National Minimum Wage and 7p a mile mileage. She has been doing it for three years, but says she is increasingly thinking of leaving because in her view the industry is getting worse. She says that the central frustration in her working life is not the pay, but that her employer schedules three half-hour visits every hour, meaning she is constantly late for each appointment and feels that she is short-changing the clients. She says of her job:

You always feel you are letting everyone down. You are always late and always apologising. You never get to know people as well as you could do and they have to put up with constantly changing staff.

There are always one or two who would like to talk to you while they have their breakfast or whatever, but it’s not really encouraged.

The work typically involves getting people up, supporting them to go to the toilet and getting them to take their medicine. She says she has nearly left twice, but “likes being able to help people”. In one case she became friendly with an elderly lady and used to take extra time with her to do her paperwork while the client did her embroidery. “Everyone knows there are major problems in this industry and I know clients do not always get what they should, but it’s really not always the carer’s fault.”

Carol’s story is part of research undertaken by New Economy as part of the ‘Market Shapers’ work, funded by the North West Association of Directors of Adult Services (NWADASS) to inform new models of care. Her story was shared by Lucy Woodbine at a recent NWADASS event, and there are many similar stories in the national press. Carol (not her real name) poignantly describes a system that does not enable people to work in ways that enhance either the wellbeing of the people they support or of themselves. This challenged me to try and describe how Wellbeing Teams are trying to address this.

Before I try and explain how they are different, let’s look at how are they the same. You still deliver the same personal care to people – whether that is supporting people to have a shower in the morning, making a meal at lunchtime or helping people go to bed in the evening.

So what is different? Wellbeing Teams are different in two ways – how they deliver care and support to older people in their own homes, and how they work in a team to organise this support.

Ways that the care and support they provide is different

  • As a Wellbeing Worker, you know what matters to each older person, not just the tasks that you have to deliver. You know what people’s strengths, passions and interests are, and you usually have a hobby or interest in common because the person chose you to be part of their team. For example, you and Ted both love gardening and talk about tasks in the garden at this time of year.
  • You work to outcomes, not just to deliver tasks. You know what the bigger picture is, and your role in this. This means that you can work flexibly to make the desired outcome a reality, rather than just following a list of set instructions. For example, Mrs. Jones wants to be part of her faith community again. On Thursdays you support her to go to the luncheon club at her church. You know that your job is not just to make sure she has a meal, but to help her connect with people there, and find out if there are other things going on that she could be part of.
  • You work in partnership with Community Circles. There is a Community Circles Connector who is part of the team and they match a volunteer facilitator to provide community support in partnership with the team. Mrs Jones has a Community Circle with her daughter, a neighbour and a community circle facilitator. You pick up a leaflet about an organ recital at the church in a few weeks time and make sure that the facilitator knows about it so that they can see if Mrs. Jones can attend. You feel part of something bigger that is making a difference in Mrs. Jones’s life.
  • You provide support to a smaller number of people in a local area. This usually means that you spend less time travelling. At the moment you support seven people.
  • The length of the visits vary, according to what the person needs (based on their outcomes). You know what has to be achieved on each call, but you are not watching the clock all the time. Sometimes you need to spend an extra 10 minutes with someone, but this gets balanced out with leaving 10 minutes early another time. You don’t feel rushed. There is no electronic monitoring – instead you are trusted to get the job done, and you are accountable to the person to do this.
  • You can be creative. You are clear about what your core responsibilities are and where you can use your judgement. Last week you picked up fish and chips on the way to see Mrs. Jones because she mentioned that she used to love them but hadn’t had any for years.

Way that how they work in a team and organise their work is different

  • You are part of a small team, or no more than 12 other people, working in partnership with the Community Circles Connector. You have a weekly team meeting. These are not like any other meetings you have ever been part of. As well as making sure that everyone has all the information to do a great job, the meeting is a way to identify ‘tensions’ and deal with them before they can become big problems.
  • You are not given a rota, you work it out together as a team. You make sure that people you provide care and support to get the support they need each day, and see how you can also accommodate another team member who wants to see their child in a school play, and so that you can keep refereeing your sons football team on a Sunday morning. There is give and take across the team to make sure this works for everyone.
  • You give and get feedback to and from each other. This is an expectation of everyone in the team. You were taught a way to do this in induction (called Compassionate Communication).
  • Your wellbeing matters. The team pays attention to the ‘Five Ways to Wellbeing’ and in some team meetings there are sessions to help people develop their own wellbeing.
  • You are the on-call person for a week once every couple of weeks depending on the size of your team. If there is a problem, you work it out. You have support to do this, but you know you have the responsibility to get it sorted  – you cannot pass this to a co-ordinator or manager. But as the team work so well together, this is not a problem.
  • You have a coach for the team to help with problem-solving and development, and you have a buddy too. You and your buddy help each other by giving feedback and problem-solving issues. There are specific roles within the team too, for example, one person is the meeting facilitator.

How it’s working in practice

I asked one of the first Wellbeing Workers to describe the role.

Ann said:

‘It’s a bit like being an entrepreneur – keeping looking at ways to make things better, and thinking of ways to make sure that local people know about the team. You have to learn a new way of working.f you have done traditional care, you will see that the care is the same in lots of ways, but the way we work together is completely different.’

We are learning about how to make this work in practice, and there are teams already starting up in Preston, Doncaster,  and Paignton, as well as two in Dumfries and Galloway in Scotland. We want to make wellbeing not just something that we work to for older people, but for carers like Carol too.

If you’d like to find out more about Wellbeing Teams, what makes them different and how you could get involved in our work, please e-mail helen@helensandersonassociates.co.uk.

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