Practice Team Leader Induction Training. Objectives of session Overview of strategic plan 10 key themes Improving practice and service quality Sustaining

Practice Team LeaderInduction Training

Objectives of session

• Overview of strategic plan 10 key themes

• Improving practice and service quality

• Sustaining and developing local services

• Increasing reach and local presence

• Explore what are our practice strengths, challenges and opportunities

• How can you build on these and continue to improve?

Strategic Plan- Ten Themes

• Raising awareness• Influencing change and promoting rights• Sustaining and developing local services• Increasing reach and local presence• Improving practice and service quality• Investing in our people• Research and collaboration• Efficiency and effectiveness• Raising funds and increasing support• Developing innovations and creating new opportunities

Improving practice and service quality• Introduce, train and support new service role of Practice Team Leader (PTL)• Every member of service staff will be trained to the appropriate level on Promoting

Excellence Framework• Introduce a leadership training programme for all managers• Ensure maximum use of professional development fund• Support all staff to attain relevant level of Scottish Vocational Qualification (SVQ)

and registration• Ensure that the quality, delivery and content of training programme is of the

highest standard and relevant to the issues faced by local staff and services• Support services to develop and improve: transition planning; post diagnostic

support; service audit and quality approaches; and person centred support• Engage with relevant lesbian, gay, bisexual and transgender (LGBT) organisations

and develop an organisational strategy to ensure equality of access and treatment• Engage with relevant black and minority ethnic (BME) organisations and develop

an organisational strategy to ensure equality of access and treatment

Sustaining and developing local services• Develop new Enhanced Sensory Community Care (ESCC) therapeutic model for

people with advanced dementia using our services and use this to inform 2015 policy report

• Open three new Dementia Resource Centres (DRCs) each year• Develop a strategy for each region to promote personalised support services and

self-directed support• Consolidate and build on the role of Link Worker ensuring all Link Workers deliver

on the 5 pillar model and meet the new Post Diagnostic Support HEAT target• Ensure that each service area provides a balance of peer support activity and

therapeutic group activity• Ensure that the Dementia Advisor Network continues to offer a high quality local

service, reaching as many people and carers as possible• Ensure that our services are financially competitive and sustainable and local

fundraised contributions are used to add value• Make sure our services are the best possible quality

Increasing reach and local presence• Recruit, induct and train six new Deputy Regional Manager (DRM) posts• Each Regional Manager will develop a regional strategy that will include:

supporting new and existing membership engagement; liaison and links with branches; regional fundraising focus and strategy; ensuring representation and policy engagement in new integrated bodies

• Develop a national campaign to increase members and develop an on-going engagement strategy to link members into both national and local activity

• Use social media to engage regionally & locally and extend reach• Develop Alzheimer Scotland online community – groups, blogs, live chat and Q&A• Put in place a clear database strategy – profiling, data capture, re-segmentation

and re-targeting• Review and develop Alzheimer Scotland’s brand and introduce across each region

and nationally

LOCAL

Membership, recruitment and

engagement

Local strategic fundraising

Supporting and working with

branches

Representation and policy

development

What are our practice strengths

• What do we mean by dementia specific?• How do we evidence this in our day services and individual

support?• What type of activities best support this and how does this

relate to each person's support plan?• Do we explain this to partners and families?

What are our practice challenges?

• How do we deal with more complex care within same staffing and budgets?

• How do we continue to demonstrate we offer better value for money in this funding climate?

• How do we ensure all staff are driven by our practice values and provide best possible standard of care at all times?

Role of Practice Team Leader

• So what’s different?• What do you want to change or improve?• What is your role as a leader and change agent?• What will you need to help you in this?• What will your personal action plan be?

Policy into Practice

Human rights based approach

• Participation• Accountability• Non Discrimination• Empowerment• Legality

Personalised supports

• Mandatory training aligned to ‘Promoting Excellence Framework’

• Peer Support • Person Power Module

Support for carers

• Lloyd’s Live Well Officer - 3 year post• Creative Breaks Fund - into year 3 (helping to inform Self-

Directed Support activities; self-design)

What else?

• Getting to know me• KIS (NHS Key Information Summary)• Sensory Programme (ESCC)• LGBT champions• Black Minority Ethnic (BME) work• Telecare e.g. GPS systems• Induction revision (training for trainers)

Innovation in Practice:From dogs to clocks

Valuable Digital Applications for people affected by Dementia

the game jam

Title of presentation in footer

Pocket Pal allows people to record personalized support prompts for their daily tasks, such as making coffee and washing clothes.

Transitions

People may need to consider

• What information they need to make their decision• What are their options• What are the potential costs and benefits of each option

(this may be financial, emotional, practical)• Do they have any experience of making similar decisions or

would they like to speak to someone who has had a similar experience or is there a resource you can signpost them to.

Making transitions easier

• Always tell people from the outset about transitions and how they will be informed and supported during these times

• What are the person’s preferences – what is practical and possible to achieve within their chosen preference?

• Who is in their circle of support and how will they be involved in assisting the person to make their decision?

• How can the person be supported to maintain links to their community, spirituality and their social networks?

• What type of activities interest the person and how can they be supported to engage in them?


Identifying and communicating potential transition points i.e when your service would no longer be suitable for the person.

Talk to the person, their family and people who know them well to gather information about how they have managed

other transitions in their life and what their personal preferences are

Discuss transitions with the person and record who else they may wish to consider involving at these times

Advise when they likely major transitions points will be and how you will communicate when those points are

approaching.

If there is a clear pathway in place for people to transition, let people know what the pathway is.

Keeping the person and their family/ supporters and other professionals informed when possible transitions are

approaching and discuss their feelings about it.

Discuss the possible options available at the transition point, ensure the person has the right information, advice and support to enable them to make an informed choice and

agree a plan for the transition.

Discuss possible transitions at outcomes focused review session.

Consider the impact of the transition on the person’s sense of identity, independence and self-esteem and agree a plan to

minimise any negative effects. Ensure family/carers/supporters feelings are addressed within the

transition support plan.

Ensure support is in place for the person to adapt to their new circumstances

Risk Enablement

‘Risks should be taken to achieve specific goals in the light of possible harms occurring’

(David Carson 1988)

‘Pursue a course of action in order to realise one or more beneficial outcomes, in the knowledge that there are

consequences or outcomes that would be perceived as negative or harmful in nature should they occur’

(Saunders 1998)

The Law

• The Health & Safety at Work Act 1974• The Management of Health and Safety at Work

Regulations 1999 (Risk Assessment)• The Human Rights Act 1998• The law requires reasonable professional conduct

according to appropriate standards

The Law

No law prohibits safe ‘risk-taking’

Legal areas which affect practice:

•Recklessness (criminal)•Negligence (civil)

Risk – a matter of balance?

Potential beneficial results

Harms that might result


Justifying Risk Taking

Make the possible positive outcomes explicit! Why are we taking these risks?

Ethics and Benefits of Risk Taking

• Benefits judged more important than possible harms• Risk taking is value laden but should consider moral values • Outcomes can be beneficial, harmful or both

Rights and Risks

• The right to exercise informed choice• There may be tension between physical safety and right to

self-determination• There may be differing agendas• Recognise strengths and abilities as well as difficulties


Decision Making

• A process:• Must be shared• Must be monitored and reviewed• Needs to be modified by people/circumstances• Needs relevant expertise


Risk Management

• Risk will not • usually be eliminated!

Formal Approaches

When:•Very serious outcomes are possible•The situation is very complex•Opinions differ and a consensus is not easily reached•An existing plan is not working or is not adhered to•On basis of experience – probability of high risk

The Planning Meeting

• Must be recorded• Assessments and opinions shared• Identify key ‘stakeholders’• What do people have to gain or lose?• Information available considered• Recommendations made: plan of action; roles and

responsibilities; arrangements to monitor and review


Be a Risk Taker

• Support pwd in the taking of risks• Feel good about the decisions you have made• Understand and be able to explain to others why you have

made these decisions – include values/principles that underlie your decisions

Case Study

• Mrs D has been attending your day service for 2 years. She has Alzheimer’s disease and you have noted a marked change in recent months in Mrs D’s abilities

• One of the few activities Mrs D still enjoys is being in the kitchen and helping with cooking and clearing up. She now shows a greatly reduced awareness of factors relating to her own safety and that of others. She moves very quickly, lifting and laying hot items and becomes very irritated with anyone who tries to help her or guide her away from hazardous activities. At home, Mrs D’s husband has fitted a lock to their kitchen door and doesn’t let her in there at all. He reports that although this keeps her safe, she becomes extremely agitated and angry with him. You have decided to carry out a risk assessment because Mrs D says she loves being at the centre so that she can be in the kitchen

• Complete a risk assessment & enablement plan for Mrs D

Being Person Centred and Planning Outcomes

A good life for Alastair…

• Case study

• How could Alastair• be best supported?

What do we mean by being person-centred?

• Person-centred thinking and planning is a set of values and skills that involves asking questions that keep the focus on the person and the person’s priorities for their own life.

• The person is kept at the centre, and the expertise of the person and those closest to them are valued as key sources of person-centred information about how the person wishes to live, their hopes and dreams, their gifts and skills, what is important to them, and what makes good support for them.

• Person-centred approaches provide an agenda that is focused on the values of inclusion and on enabling the person to live a valued life as a contributing citizen and friend in the community – on their own terms.

Person Power(person centred thinking (& acting))

• What’s important to/for you?

• The power of relationships – friendship

• Circle of Support

Personalising support

• The power of contribution!• ‘Gifts’

Loneliness and isolation



Outcomes

• The impact or end result of services/supports on a person’s life

• The person or carer is involved in identifying desired outcomes = setting goals in partnership with services


A good life?

What makes life worth living for you?

Any themes emerging?



Talking Points Outcomes


Having an outcomes focused conversation….

What do you say?

Therapeutic Interventions? (8 Pillars model)

• What kinds of things are we doing?• Cognitive Stimulation Therapy (CST) ?

• Inheritance tracks• http://www.playlistforlife.org.uk/

The Nun Study

• Aging with Grace• The Nun Study and the Science of Old Age: How we can all

live longer, healthier and more vital lives • By David Snowdon

• http://www.youtube.com/watch?v=nw2lafKIEio

Capturing the Outcomes

Participation & empowerment

“Whole layout is fantastic. Bigger than was led to believe. Great place. Should be replicated. “gardens are kept nice”- lovely”

“If choice between something like building being painted and other staff, would

choose staff – how building looks is not a priority.”

“Agreement that everyone is very enthusiastic about the group with the men saying that of themselves and of the staff

and volunteers ”

“Always like outings so more of them would be welcome”

How do we do this at the moment?

Could we be more creative?

Managing Staff

Topics

• Personalising approaches to recruitment• Increasing staff retention & satisfaction• Balancing contracted/sessional staff• Managing ‘banked’ hours

Personalising Approaches to Recruitment

• Standardised recruitment procedures• Care Inspectorate requirements• Areas to be standardised:• Advertising• Application Form • Shortlisting and interviewing• Pre-employment checks

Areas that can be personalised•Where to advertise•Recruitment tests

• Staff Retention• Average length of service is 14 years.• Key areas of turnover occur:• Within the first 6 months• Between 3 – 4 years service• Initiatives to reduce help improve retention• Remember – not all turnover is negative.

Increasing staff retention & satisfaction continued

• Staff Satisfaction• 2013 Staff Survey - 86.4% level of satisfaction• Line managers impact on staff satisfaction• Communication – team meetings• Support & Guidance – supervision & appraisals• Autonomy & control – experienced staff• Team working

Balancing contracted/sessional staff

• Service Dependent• Flexibility• Risks:• High contracted hours/low availability• Sessional staff can refuse shifts• Employment law status

Managing ‘banked’ hours

• Key points when managing flexible contracts:• Regular monitoring• Availability • Review contract hours• Communications• Ownership

Questions?

Quality Control

Service Audit

• Tool is currently being reviewed• Can be used as a checklist to ensure standards and

procedures are being followed• Includes• Self-assessment section (pre service audit)• Main audit sections – general quality check• Personnel file audit template• Enhanced Performance Checklist (spot checks)• Carried out by Regional Manager or another Service

Manager

Care Inspectorate (CI)

• 2 sets of guidance on intranet (care at home / not care at home)

• Guidance follows CI quality themes / statements• Includes suggestions of possible evidence sources from• Alzheimer Scotland policies and procedures• Local service approaches• Legislation and external guidance• Be aware of different terminology used by CI (personal

plan)• Can be useful to gather documented ‘evidence’ on ongoing

basis to present at inspection

Customer Satisfaction Questionnaires

• Strategic Plan(2013-2016)...90% of people with dementia and carers using our services rate them very good or excellent

• Results fed into Survey Monkey • Services produce local summary report (template on

intranet)• Organisation-wide summary report produced by PDT

Participation & empowerment


Support Worker Feedback

• Vital aspect of evidencing quality of service• Guidance on intranet for this• Use of case studies/examples in how to feedback

effectively• Can be used at support & supervision to facilitate

discussion and capture outcomes• Feed into review process and updating of support plans as

required

Reviews

• Initial review at 6 weeks after service starting• Ongoing reviews must be no less than 6 monthly• Need to capture both outputs and outcomes of support• Don’t need to be face to face meetings – be guided by

individual preference (recorded in Support Agreement)• Can do telephone reviews• Any changes to Support Plan/Risk Enablement Plans must

be signed and dated

Feedback and questions

Documents

Practice Team Leader Induction Training. Objectives of session Overview of strategic plan 10 key themes Improving practice and service quality Sustaining