I am a bit of a quality nerd. I did a masters in Quality Assurance in Health and Social Care at Leeds in the 1980’s. I would enthusiastically tell people about my course to be met with facial expressions of mild disbelief and comments that questioned whether anyone could find QA interesting. Mark Cannon, a colleague from Here introduced me to Andy Brogan from EasierInc, as someone who could be helpful around systems, quality improvement and governance in Wellbeing Teams. I heard that as an opportunity to talk to someone who could be as fascinated about quality and systems as I am. I was right.
I am learning about new models and ways to deliver support to people at home. Over the last few weeks I have been learning about co-operatives and employee ownership and what this could mean for Wellbeing Teams. Wellbeing Teams are a social enterprise, which is a “business that has primarily social objectives whose surpluses are principally reinvested for that purpose in the business or in the community, rather than being driven by the need to maximise profit for shareholders and owners”.
This week I am looking at community ownership and community businesses, so naturally the first place I looked was Power to Change’s website. The website says that there are four features to a community business. They are locally rooted, trading for the benefit of the community, accountable to the community, and have broad community impact. Here are some ways that I can see how these could apply to Wellbeing Teams.
I am working with commissioners in England and Wales who are taking a different approach to working in partnership with providers to improve care homes. There are three ways that they are doing this, buying membership to The Butterfly Community, investing in Community Circles and using the self-assessment tool Progress for Providers.
My colleague Jackie LeFevre is a values specialist, and part of the Minessence Values Framework co-operative. We have been working together to define and demonstrate values within Wellbeing Teams. Here she shares her thoughts on the values underpinning Co-ops and Wellbeing Teams.
Co-operatives have been around since the 19th Century, and still feel relevant today. I am interested in them because of my work with Wellbeing Teams: both share a common thread of self-management.
There are some exciting co-ops emerging in health and care, and there are three examples that colleagues of mine have established. Neatly, we also think there are three reasons to take a closer look at both co-operatives and Wellbeing Teams.
Yesterday I met with colleagues from Macmillann, to share how Wellbeing Teams are working, and what could be possible in relation to people experiencing cancer. I am excited that the next two Wellbeing Teams are getting started within GP practices. We think there are five ways that Community Circles and Wellbeing Teams can support people to come home from hospital or to avoid hospital admission. Here is a summary of the approaches, and what we have tried so far.
This morning I read ‘How we can start a social care revolution in seven easy steps’ by Katie Johnson, KPMG, in the Guardian Social Care Network. I agree with her ideas, but not that it is easy. If it was easy, it would have been done by now. I am one of the many, many people who want to see this change, and be part of this change. Here I want to share what I am see my colleagues doing to actually move towards the steps she describes. I want to call out the people who are making it happen, and what else we need – some of the detail to deliver the big ideas.
My colleague Gill Bailey is the person who made me more aware of dementia, and kept nudging me to prioritise it in our work. This led to us working together in Bruce Lodge, a care home where about forty people who have a dementia live. Here we learned what it took to make sure people knew what mattered to everyone who lived there, and what good support meant – the little things and the big things. We introduced one-page profiles to the staff team, and ‘individual time’ where each person had two hours a month that they used to follow an interest, like football, or swimming or simply to have their nails done and a glass of wine. We started to explore what Community Circles could look like, and I am still part of May’s circle today. This was my plan – that we could share what we had learned at Bruce Lodge (in a book, through animates, through conferences) and then other people would invite us to do the same, and this is how we can make a contribution. That same year, a large national provider asked us to work with six of their care homes and this confirmed my thinking, that this was the way we could make change.
But it wasn’t.
Gill’s other nudge to me was around David Sheard and Dementia Care Matters. David’s strategy was also to support care homes to change, to become Butterfly Homes, with well-thought out process and evaluation. The first time we met was when we were both speaking at a staff conference for Community Integrated Care two years ago. We then connected over email and soon David asked me to speak at his 10th anniversary Dementia Care Matters conference. I felt honoured.
What I learned was that David and I were at similar places in our journeys. Both of us wanted to make a contribution in the lives of people living with a dementia and support staff. Both of us had demonstrated what was possible, David a hundred times more than I. Both of us realised that if we did more of the same, we could make a difference to some care homes, but we could never contribute to making change at scale.
At the same time training budgets have got smaller and attendance at conferences is difficult to fund. At H S A we have been looking at other ways to connect and learn together. We have been experimenting with technologies for building communities through Groupsite and Slack, using the more informal Zoom to connect as well as webinars and online courses. We had been learning what works, and what had not worked, and the challenges of using online forums and discussion groups.
I got in touch with David and Peter after speaking at his conference, to see if there was a way we could build a future contribution together.
These are the questions we asked ourselves. Could we:
- Find a way for people to learn from outstanding Butterfly Homes about the best practices they could try and use in their care home?
- Help people get an understanding of where they are now – their culture, their practices, so that it is clear what they may want to focus on next?
- Get support about what they can do to move forward and make change?
- Enable people to ask questions and have them answered live be connected to a wider community, internationally.
- Could we go beyond discussion groups and forums and make it very easy for people to get the information they need and connect in other ways?
- Get together each year in person and learn together in a different way and co-create what the community wanted to focus on the following year?
Last week we reached out to Dementia Care Matter’s existing membership group to share our idea. It is called The Butterfly Community. David describes this as the 5th significant event of his career. Please join our webinar if you want to join the conversation or visit the website if you want to learn more.
In Dementia Awareness week let’s stretch our awareness of what is possible, of how we can connect as a community, and how together we could make change at scale.
All five Wellbeing Teams have now completed their induction and are up and running. Like our recruitment process, we realised that how we approached induction would need to be very different. We wanted to create a process that built a team, got them started with self-management, and confident to support people at home. In this blog I invited my colleague and values expert, Jackie le Fevre to think with me about the role of values in induction, and what this means in Wellbeing Teams.
The Guardian, in November last year, tells story of Jean. Jean works for a home care agency in the north of England. She starts work at 6.30 am, and completes 23 calls in 12 hours. She drives 20 miles between appointments, and is not paid for her travel time, and earns £64.80 before tax. Jean is on a zero hours contract. She does not know how many appointments she will have each week, and therefore how much she will be paid. Her list of appointments comes through on a Friday. How can we change this and enable carers in home care to flourish?