Director of Care and Services Simon Pedzisi shares how he aims to turn Jewish care home provider Nightingale Hammerson into a centre of excellence.
During his eight years with Nightingale Hammerson, four of which have been in a directorial role, Simon has been at the forefront of developing the provider into a beacon of best practice and innovation.
As well as being recently rated ‘outstanding’ by the CQC and being named Gold Standard Framework (GSF) Care Home of the Year, the provider’s sole operating care home (the other is closed for a major redevelopment project) Nightingale House, has been celebrated as the first to introduce an on-site nursery.
The 215-bed home, which supports a range of complex elderly care needs across six units in Clapham, South London, launched the innovative project in September 2017.
“The intergenerational programme has been a positive surprise to us,” Simon told CHP.
“Having the children mix with the residents has provided a spark in terms of meaningful engagement because we have residents who are suddenly finding an occupation and a sense of purpose.”
Simon, whose daughter was one of the first children to enroll in the nursery, said staff had seen impacts on the well-being of residents over a sustained period of time.
Children and residents at the home engage on a daily basis in a range of activities, ranging from reading and singing, to animal petting, pottery and cake baking.
Activities have been structured to integrate into the Early Childhood Curriculum so that they benefit both children and residents.
With the project having successfully completed its first year, Simon said his team were now carrying out research into what provided most benefit to residents so that it can be fully incorporated into a care model. The research is also focusing on how interaction with children can help residents living with dementia.
“We are looking at using this as an alternative to the clinical route of treating depression,” Simon told CHP.
Following its successful implementation, Nightingale House and Apples & Honey are thinking of the next step to further expand the intergenerational project, while the provider also aims to roll-out an intergenerational programme at its forthcoming Hammerson House, which is due to open in North London in 2021.
Simon’s ambitious plans for Nightingale House, meanwhile, envisage developing it into a ‘teaching care home’ over the next five years in order to provide a career route for staff and improve staff retention.
“Training is not working for us,” Simon told CHP.
“We need to be able to inspire staff members and empower them to deliver excellent care in a different way. We were looking at different ways in which we can actually achieve that because we want Beacon status and to become a centre of excellence.”
With an average age of 92 and 10% of people over 100, staff at Nightingale House require a multiple set of skills to care for residents, Simon explained.
“I was looking at different models that are used by different care homes and education providers within the care setting,” Simon said.
“I was also aware of the challenges and constraints of supporting care staff with some of them not having completed their mainstream education.”
In preparing his proposal to create a learning environment at Nightingale House, Simon spoke with organisations in Holland, Belgium and Australia to understand how they had integrated education into a care setting.
The Nightingale House programme will entail continuous practice development with the provider assessing the competencies that it needs, the competencies it has and then setting individual carer targets for the next five years and how it can support them.
“If we can help people become nurses in the long run it helps improve retention, commitment, consistency and skills to help us reach our vision of becoming a centre of excellence,” Simon said.
“We want to develop not just certificates but accredited education so if you want to become a nurse you can use that in your continuous practice development (CPD).
Simon said he wanted to create a “super empowered carer” that becomes the basis of Nightingale’s care standards.
“They will know exactly what they need to know, including early warning triggers and be able to communicate it and refer to everybody else, including the GP and nurses so forth,” he said.
While not taking on any nursing responsibilities, carers will be working at an enhanced level, Simon explained.
“They will contribute to the multi-disciplinary decision making process,” he said.
“You will have a carer who understands what person centred care is so that if somebody is showing signs of dehydration the carer is able to know exactly what intervention needs to take place immediately and evaluate whether it works or not.”
City University, King’s College and St Christopher’s Hospice have been selected as partners for the programme with digital business Altura chosen as its learning platform provider.
“In order to create a learning environment I wanted to change the culture of education away from traditional training which offers mandatory courses,” Simon noted.
Altura learning modules will be integrated with Person Centred Software’s (PCS) Mobile Care Monitoring hand-held system which is being rolled out to carers over the coming months.
“By aiming to integrate Altura with the PCS mobile system, we will be able to provide our carers with learning on the go,” Simon said.
“If, for example, a carer doesn’t remember how to use a hoist when they enter a resident’s room, they can instantly look it up on their hand-held device.”
With around 90,000 care staff vacancies in England and turnover standing at 30%, innovative solutions have never been in greater need for care home providers.
Agency workers account for around 15-20% of hours worked at Nightingale House.
“About 80% of our residents have dementia and 40% of these have advanced levels,” Simon explained.
“They are people who require one-to-one monitoring, 24/7, because of complex care needs, so to staff up for that we use agency carers.
“Agency is a stop gap. You lose the philosophy of care; you lose the relationship aspect and continuity of care. We want to have zero agency.
“One of the things that attracted to me to Nightingale when I came a few years ago was that there was no agency at all.
“It has become more difficult over the years.”
Turnover at Nightingale House is currently 15-20%, reflecting agency use.
“I know from my conversations with other care providers that the recruitment of carers is a big challenge,” Simon noted.
“That is something we have never experienced before.”
Simon highlighted increasing competition from retailers as a major challenge to carer recruitment.
He called for a reclassification of carers as skilled workers in order to boost access to the overseas workforce.