Vlog: Celebrating care home skills

22 December 2021

In this video blog, Mike Nicholson, an Edinburgh-based writer and social researcher, tells some of the real life stories of those living and working in care homes during the pandemic. Mike tweets at @writerblighter.

These stories were commissioned by Edinburgh Napier University and told at their Care Home Conference and we are grateful to them for allowing us to share them.

Video transcript

On Wednesday 19th May this year Edinburgh Napier University hosted People and Practice: a one day conference where they celebrating all the people working throughout Scotland in the care home sector. It was a great day – with 8 skills-based workshops on for example managing delirium, pain assessment, inclusivity and staff wellbeing. Participants at the conference heard from frontline practitioners – for example physiotherapists, geriatricians and nurses but most importantly also heard from frontline care staff who brought their lived experience to enhance the learning.

Dr Jane Douglas, the new Care Inspectorate’s Chief Nurse discussed the importance of seeing skills and recognising them, supporting their use and development and strengthening the skills base of this sector. Professor Adam Gordon of Nottingham talked about the importance of inter-professional care teams.

For this event, Edinburgh Napier University commissioned Mike Nicholson is an Edinburgh-based writer and social researcher to write and tell a good news story as part of the celebrations. They wanted to tell the real care home stories of the pandemic, the stories behind the headlines – the real stories of living and working in care homes over the last year.

Mike worked for many years in the third sector working in a range of posts with overseas volunteers, young homeless people, and then for 12 years running an information and training network for befriending projects throughout Scotland.

For the last ten years he has worked as a consultant, undertaking research and evaluation across diverse projects working with young people, carers, older people, people with mental health problems and many others.

Mike began writing in the early 2000s and this became part of his work when his first children’s novel ‘Catscape’ won the Kelpies Prize in 2005. Since then he has published a further 10 books, all for early years and primary aged children.

His two worlds of writing and social research come together on occasion when he’s asked to write specific pieces for organisations or events; writing a book with and about single parents at Children in Scotland, or writing the diary of a young person affected by family imprisonment for Families Outside, or the personal stories of carers and their creative use of small respite grants.

'Here is the news'

They said/I said

‘Can you write a piece for us,’ they said. ‘Help us tell the story of Care Homes.

Write about the good things that have happened – so we can celebrate stories which have gone unheard.’

‘Care homes?’ I said. ‘The ones in the news?’ The hour-by-hour gloomy news. the

‘not sure if I can take much more of this’ news. those care homes?’

‘Yep,’ they said. ‘Those care homes!’

‘So... you mean the places where the reporter is suitably distanced and masked in

front of some locked doors and talking to people through windows. ‘Yes, those places,’ they said.

‘The care homes with the scary numbers and the fear of what’s happening and what might come next? You want good news stories?’

‘Yes those care homes’ they said.

‘Well I’ve not seen or heard a lot of good news in those reports,’ I said.

‘Exactly,’ they said.

Untold tales

So I began to think, to read, to ask, to listen.

Because beyond the grimness of it all there are other stories. Stories less known. Stories that have gone unheard.

Behind the very same doors that appear over that masked reporter’s shoulder. There are untold tales underlying all of those daily numbers we get bombarded with.

Those graphs with their fearsome spikes where our eyes search for a more reassuring gradient.

But forget these charts and the numbing six figure numbers.

Because behind every single statistic and beyond those doors that we can’t see past in a 3minute news report, there’s an industry of kindness and care for which there is no footage.

The doorstep moment

Some small part of us, those of us on the outside of what’s gone on, do know there’s a bigger story - sometimes we’ve been pricked into a response.

There was a time when we clapped on our doorsteps and banged our pots.

Some small recognition of the toil of others in circumstances we could hardly conceive of.

But... even this ‘effort’ was badged as ‘for the NHS’ – so as we stood perhaps we thought of hospitals and wards and ambulances – we thought of nurses, doctors, paramedics... and maybe GPs if they were lucky.

But did we clap for care staff?

And even this was just a moment, wasn’t it?

A few weeks of Thursday evening togetherness. And then it went. Quietly. Back inside.

Pots returned to the cupboard where they belonged. Banging pots on your doorstep. What were we thinking? We probably weren’t thinking about care homes.

We slipped away and left everyone to get on with it once again.

Behind the doors

To get on with what? What was going on behind those doors?

Those of you working in care homes were doing what you had always done – every day of every week.

You were looking after people. Making them comfortable. The clue’s in the name.

CARE HOME

But...and it was a big but... the goalposts had changed.

And not just a shift of the goalposts...this was a new bewildering sporting arena with endless complex and ever-changing rules. Goalposts moving? More like extreme Quidditch!

The Job Descriptions you had applied to do had whole new unwritten sections.

....the place of work you’d been shown around on your first day in the job...

....so much had to change...

The shared spaces, the staff rooms, the things people wore, who could go where and when...

....everything re-visited, re-shaped, re-defined. Doors closed.

Families barred.

Communal areas sealed off. Music stopped.

Residents confined to rooms. Friendships on hold.

Everything interrupted.

And what was there in place of all of these? The unsatisfactory rustle of plastic aprons.

The slightly muffled voices and smiles made invisible behind masks. The fear....

of an invisible enemy.

of what might come next, of ‘the floodgates opening’ of ‘a ticking timebomb’

Rules and role changing

And amidst it all the guidance changing – you could finish your shift and come in the next day and have a new rule book to digest. Blink and it changed again!

PPE

Infection control Risk assessments

Visitors/no visitors/yes visitors but only outside Safety huddle

Data entry Oversight visits

Those writing and sending out the rules each time would have thought ‘job done...but interpreting them for each care home, and implementing them was a whole other piece of work.

And as the rules changed, the roles changed too.

Care workers feeling like prison officers as they closed doors on residents’ rooms A physiotherapist becoming a care worker

An activity coordinator holding the hand of a resident in their last few hours

Students on placement becoming healthcare assistants on the steepest learning curve of their lives

Everyone becoming like family members in the absence of visitors

Everyone doing everything that needed to be done – temperatures being taken, tests done again and again and again, cleaning, wiping, cleaning, wiping, wiping, cleaning.

And then there was the job of supporting relatives - trying to connect them online or reassuring them on the phone – telling them their loved one wasn’t alone

....sometimes even in their last few hours.

“Don’t worry – your Mum has Helen with her, holding her hand.” “Oh good – Mum really likes her”

“Your Dad is comfortable – we’ve just put his Sinatra CD on for him.” “Thank you – that will make him happy.”

As the list of tasks grew, you were stretched way beyond what you were used to. Perhaps beyond what you believed yourself to be capable of.

And working in a new reality where death had become so possible, some days so probable, and in some places so frequent.

You didn’t sign up for this.

And yet you had... without realising it... so you got on and did it, possibly not even knowing how much you were giving and learning as you went.

And then.... even when you’d clocked off ...well...you hadn’t really had you? Because it’s not that simple.

Switching off from work became impossible. Worrying about what you might bring home. Talking about work became harder to do.

Dreaming about work became normal. So did waking up thinking about it.

And the tiredness that came from all of that.

Not to mention for some of you time off actually meant that you took the lead on home-schooling.

You became exhausted of being exhausted.

As lots of other people adjusted to working from home or being furloughed, this was your ‘new normal’.

Where's the good news?

I’m sorry but this was to be good news wasn’t it?

But that’s just the thing. Underneath all of this is the good news.

Through all this time you’ve clocked on for shifts and been there and brought care and kindness and love and companionship and friendship.

And somehow, after the toughest year in the toughest environment - publicized, scrutinized, politicised – you’re still here.

Months of immense challenge and hard graft punctuated by fears and tears – yet you’re still here.

Good news

So here is the news...the good news. You’re still here...because you care.

Still here because of how you feel about the people you care for. Still here because you know these residents intimately.

Still here because this is what you do well. Still here despite everything thrown at you. Still here.

So let’s be still……here. Right now.

Let’s be still....here.....

Reflection

For a moment, let’s think about what you’ve done

the difference made and who it was all for.

You know their faces.

You know the look in their eyes.

You know feel of their hands.

They are not just some anonymous group. The frail elderly.

They are mothers, fathers, sisters, brothers. They are aunts and uncles and grandparents – they are nanas and papas.

You know them - your residents.

Your family away from your own family;

They are Harry, or they might be Mary or Monique.

Perhaps it was Eileen who you helped to feed or Norman who you walked with in his room to keep him exercising.

Or maybe you brushed or cut Joyce or Rab’s thinning hair.

Was it Joan or Margaret who you helped to wash after they had a bit of an accident?

It could have been Betty who you sang with or Lucille who you unwrapped her favourite toffees for.

It was Doris who you talked to about her family photos – every day – the same photos – the same conversation.

It was Alice and Arthur who you wrote letters with to the primary school children who had sent cards.

It was Jim and Stan and Isa who all had birthdays and you lit the candle on their individual cupcake.

Maybe it was Peggy or Donald who got especially agitated ‘Who are you’...’I want to go home’... and you calmed them, because it was you, it was your voice, that they responded to.

Your voice every day with Muriel or Frank as you said ‘good morning’ or ‘goodnight’.

And it was all of them... for some with changing moods or appetites diminishing or bewilderment increasing with everything going on..it was every single one of them who you explained patiently what was happening, sowing whatever seeds of reassurance you could – spreading calm.

It wasn’t easy. But it was necessary and you did it.

These are the moments, the conversations, the small actions, the relationships on which the real good news story is built – the story of continuing kindness and care and love and of still being here.

You being the light in these dark times, through the simplest and most personal of ways.

New numbers

So here are some new numbers.

Because I for one am tired of those daily figures on the news - the infections, the hospital admissions, the bedspaces filled in ITU, the deaths...the vaccinations.

Cheerio!

Let’s have the 6 o’clock news or the 10 O’Clock News or the whatever news marching to a different count.

Let’s have Huw Edwards leaning casually on his desk as he does, announcing in the last 24 hours

825, 332 care home staff exhibited exceptional levels of kindness. 1,649, 212 care home staff showed extraordinary teamwork

946,445 care home staff willingly stepped into roles they hadn’t been expecting to do 3,100 staff teams emerged more united and supportive of each other

1, 833, 211 care home staff showed levels of love and commitment equivalent to some kind of superpower

The good news numbers.

Teamwork, kindness, care, staying power – in extraordinary times.

Funny

Perhaps most extraordinary of all is how crazy all of this has been from how things used to be.

I mean since when was love expressed through double glazing Since when were staff meetings held at a 2m distance

Since when did a wave from strangers passing the window become a highlight in a day.

And when you think about it, some of it has just been so ridiculous that there have even been some laughs.

After all the careful plans for outdoor visiting you end up chasing after the new gazebo which had blown down the street – since when was ‘chasing a gazebo’ in your job description.

The exercise class which still found a way to take place - along the corridor with everyone seated in the open doorways of their rooms. Reunited over a few leg lifts. “Oh look at you! Your hair’s getting long.

What’s that?

I said your hair’s getting long. Isn’t everyone’s?’

Then there was your patient explanation to Alice on a zoom call with her family, but she kept looking at over the top of the screen to find her relatives because she thought they must be behind the ipad.

A year peppered with those moments of hilarity, moments of hysteria, moments of horror, but still some moments of hope.

Through them all you’re still here

The good news story. You’re it.

The good news in care homes is you.

More information

Aug

2021

Ambitions for change: Improving healthcare in care homes

This document describes the care home sector across the UK as it currently stands, how health and wellbeing has traditionally been supported in care homes and sets out what good healthcare provisio