Integrated care
NHS Care Home Wellbeing Service: integrated care in action
In October 2020, Tees, Esk and Wear Valley NHS Trust commissioned the Care Home Wellbeing Service in response to the challenges facing care homes during the Covid pandemic. Here, counselling psychologist Dr. Clare Winter explains how it is an example of what health and social care can achieve when working in partnership
The pandemic has had a significant and at times devastating impact on our care homes. The challenge of Covid-19 has not only threatened care staff’s physical health but has also had detrimental impacts on mental health and wellbeing. During the early stages of the pandemic, Dr. Joanna Marshall, consultant psychologist with the Durham and Darlington Care Home Liaison Hub, observed this impact of the pandemic on staff and was compelled to act. Dr. Marshall drew up a proposal and made a bid to set up a Care Home Wellbeing Service (CHWS) as a part of the Tees, Esk and Wear Valley NHS Trust’s Mental Health Services for Older People (MHSOP). The bid was successful and in October 2020 the service was commissioned to improve the wellbeing of care home residents and staff and support recovery from the impacts of the pandemic. Dr. Marshall clinically leads the service staff with myself and assistant psychologists Amie Collins, Lewis Miller and Claire Youds. The service was originally commissioned until the end of March 2021 but later gained further funding until 31 March 2022. CHWS supports 121 care homes throughout County Durham and Darlington, a geographical area of approximately 870 square miles.
Relationships
At the core of this service are relationships. In our early months, our priority was building relationship with our 121 care
homes. Assistant psychologists carried out weekly/fortnightly telephone wellbeing checks. This provided our homes with a named point of contact and the consistency and regularity of these calls, while not seeking to disrupt the day, were important for building trust in the service. These contacts also enabled home managers to request ‘on the floor’ support from our team without them having to go looking for it. Alongside our work with the five care home liaison teams, another crucial way we identified homes where face-to-face support would be most useful was through Durham County Council’s Mutual Aid group. This group was made up of council, CCG, CQC and IPC representatives and met twice-weekly to share information and ascertain what support homes required. Through the relationships built on this call, the reach of the CHWS was able to expand its reach. IPC and CQC representatives visiting homes would advertise the CHWS and would frequently advise us of homes where wellbeing support may be useful. As a service we were able to respond to these requests for support within 24 hours and often on the same day.
Staff support
Staff 1:1 support is a key part of the support provided by the CHWS. This has been advertised, available and accessed from the start. However, we are also aware of how alien it can often feel for caregivers to
While we cannot rewrite what has happened, we hope by sticking in for the difficult conversations, by being there for the anger, we can find ways to move forward together – health and social care working in real partnership
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be offered care themselves and how alien a concept that can feel. For this reason, as a service, we have prioritised time spent with staff on the floor as a way of building relationship and hopefully breaking down some of the obstacles to accessing support. We frequently found that requests for 1:1
support would increase following a whole home support visit and this has confirmed to us that one of the benefits of our service has been the ability for us to directly connect with our carers. These 1:1 supports will range from one-off ‘venting’ sessions to more regular support conversations and when we are contacted for support we will be able to offer an appointments within 48 hours.
We also recognise that not everyone
wants to talk. For this reason, we set up a Facebook group, Durham and Darlington Care Home Wellbeing Service, where we post daily wellbeing advice. These daily posts are complemented by our Winter Wellbeing newsletters, which are emailed out weekly to homes over the November – February period for display in our care homes. Again, they offer bite-size wellbeing material and are intended to be able to provide something useful in the time it takes to don or doff PPE or change ready to go on shift or go home. We also recognise as a team the importance of the environment we work in for our wellbeing. So much has changed in our environments over the pandemic and so funding was sourced for us to offer and create wobble rooms for a number of our homes identified using the OPEL (Operational Pressures Escalation Levels) tool. These spaces were designed to provide an area of calm for our carers to be able to take time out either on shift or prior to
www.thecarehomeenvironment.com February 2022
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