Integrated care


messages: a message about what makes them feel hopeful, what they think hope means, and a message to care home staff for all the hard work and dedication in the pandemic. These cards were completed in the classroom and collected from the school by CHWS. The cards were quarantined under the appropriate guidelines and collated onto a display board. A board was given to each home as a


thank you gesture from the community; these boards were widely appreciated and today remain on displayed in care homes. One care home was so touched by the gesture that they created their own ‘Thank you to the community’ board and displayed it in the window. Such was the success of the project we have facilitated a ‘Christmas Card of Hope’ campaign across all of our five areas and in so doing our care homes can continue to be held in mind by their communities during a time when necessary restrictions still make some previously held interactions more difficult.


Lessons learnt


The last 14 months have given us the opportunity to learn and reflect on a wide number of issues. Challenge has brought us opportunity. While technology has brought us different options, we have also recognised how important face-to-face, on- the-floor work is to the success of a service such as ours. We have learnt that speed of response is crucial as is flexibility and creativity, not just in what we do but how we do it. We have learnt that crucial to success is ensuring ease of access and that requires covering the miles, making the calls and physically getting in to our homes. In doing so, we have learnt a tremendous amount from our care staff and residents. It has been a real privilege to learn in this way from the experience, expertise and dedication of these people. We feel hugely privileged to have been welcomed into home communities. Along the way there have been tears, frustrations and laughter. We have learnt the importance of embracing


all of these in order to continue to develop a service, and, crucially, we have realised that it really is all about the relationships – it is by these that we stand or fail.


Relationships are about the tough


conversations too. As an NHS service, we have experienced the anger and disappointment at times in the lived experience of social care staff. The felt differences in how health and social care have been portrayed has been tough to hear but right that we must. 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.


Importance going forward The government’s Integration and innovation: working together to improve health and social care for all White Paper, published in February 2021, described the importance of ‘collaborative relationships’ where health and social care ‘work together, flexibly’ in ‘integrated care systems’ in order to meet ‘the greatest challenge our health and care system has ever faced’. Similarly, the CQC’s report, The state of


health care and adult social care in England 2020/21, stressed that ‘closer collaboration will be vital’, recognising that those working in health and social care ‘cannot work harder’ but rather ‘need support to work differently’ or otherwise we will face ‘a tsunami of unmet need’. We hope that the collaborative work of the CHWS and the care homes of Durham and Darlington may provide an innovative


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example of what integrative health and social care can and do achieve when working in partnership. In particular, we believe that the Covid-19 pandemic has provided us with an opportunity to spotlight the tremendous work of our care home staff and to recognise the ongoing need for their support.


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The author would like to thank Tees, Esk and Wear Valleys NHS Foundation Trust assistant psychologist Lewis Miller for his assistance with this article.


Dr. Clare Winter


Dr. Clare Winter is counselling psychologist at Tees, Esk and Wear Valley NHS Trust. Having taught in secondary schools for over ten years, Clare re-trained as a counselling psychologist. She first worked with an independent organisation providing psychological support and training to employees of organisations located across the north-east of England, including the North East Ambulance Service, before joining the Care Home Wellbeing Service.


www.thecarehomeenvironment.com February 2022


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