The Sunderland Standard

25 February 2015

Yesterday I was in Sunderland. We were building on earlier work that Gill had done across the North East, designing a training programme for managers from nearly 200 regional care homes for people living with dementia. Whilst there have been some great examples of change in some care homes, for example, introducing one-page profiles, there had been little change in others. The programme worked for the early adopters, the motivated managers who seized this as an opportunity to create change through simple practical person-centred practices. For others, it was number 254 on their to-do list, and never quite made it.

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We know that training alone cannot create cultural change, so yesterday we were reviewing the outcomes from the programme and exploring how to move forward, with limited money but great ambitions. What recommendations do we want to make to Association of Directors of Adult Social Services (ADASS) at the meeting next month? What other levers could we use to make it easier for managers to ‘do the right thing’?

We began thinking about this at a systems level. One of the issues raised by the managers in the programme was the perennial issue of the paperwork challenge. Everyone seems to want different paperwork. What the compliance officers want differs from what CQC want to see, so paperwork gets duplicated or just longer, and longer and longer. This means more time in the office and less time supporting people well.

So our first step it to get everyone who has paperwork expectations of care homes together and simply ask they question,

“What can we do together, to reduce and streamline the amount of paperwork required?”

This is a macro version of work I am doing in a hospital, and also a hospice working with different professionals to streamline paperwork, so that it focuses on the person and still addresses the information that professionals need to record but without duplication. As I write it, it sounds so simple and do-able, but the reality is a much bigger challenge.

The second change we are exploring is whether Sunderland could become the first place where the expectation on care homes is that everyone they support has a one-page profile. Does that sound like a contradiction to the previous point about reducing paperwork, adding another page? Not to me, as a one-page profile can replace the usual scattering of personal information about what matters to the person mixed with clinical and other information throughout care files. It means that in one place, on the first page, you instantly ‘meet’ the person – what others appreciate about them, what matters the them, and how they want their service to be delivered¬† – what good support means to them. This is the foundation to delivering a personalised service.

For managers this would then move it from that ‘it would be nice if I had time’ list, to ‘this is an expectation I need to deliver on’. We are looking at whether this could be embedded into the Local Authorities bronze, silver and gold system for care homes, where if you are a gold care home, you can charge more. We want one-page profiles at the bronze level. There are meetings booked, and plans underway, I will keep you posted. This would become the Sunderland Standard.

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