Recently appointed Brunelcare CEO, Oona Goldsworthy, says one positive from the coronavirus pandemic has been that it has supported the charity’s goal of forging closer links with its communities.
Speaking to CHP at the height of the coronavirus crisis last month, Oona, who took on her role in October 2019, having previously been CEO of the United Communities housing association, said the current crisis had made her introduction to care a baptism of fire.
“Brunelcare was first founded during the war with the Blitz spirit of ‘how can we help ourselves?’ And I have seen a lot of that during this crisis,” Oona observed.
The charity, which has been providing housing, care and support for older people in the south-west for nearly 80-years, offers the full range of care services, ranging from reablement and supported housing to day centres, extra care, home care and its five care homes.
At the time of writing, with the nation in the grip of the coronavirus crisis, Oona said Brunelcare was continuing with its open admissions policy that reflected its founding commitments to serving the local community.
She cautioned that changes to government guidance on PPE use were putting increasing strain on this policy, however.
“We are nearly full at all of our care homes and are staying open for new admissions, but if we don’t get the PPE and testing we require, we’ll have to make decisions about not remaining open for admissions,” Oona said. “If we can’t be safe, we can’t run our service effectively.”
The CEO said admissions policies at her homes were being brought under further strain by changes in government guidance demanding that care homes immediately take people in from hospitals who were COVID-19 positive.
“The new guidance is concerning to us,” Oona told us. “We had an agreement with acutes that they would keep COVID-19 positive residents for 14 days before we admitted them, but that changed and the advice now is to take people straight away. We are resisting this as it’s just not safe without adequate PPE and testing.”
Oona said the charity had had just two residents admitted to hospital with COVID-19 symptoms at the time of writing, one of whom had sadly died. Additionally, one staff member had also been hospitalised which had brought home the fact to Oona that people could be being placed in situations that weren’t safe.
She said the charity had maintained a good relationship with local acute services during the pandemic, however. In April, Brunelcare officially opened its new 64 bed Little Heath Care Home and 24-bed Reablement Centre to help take pressure off NHS services, working in partnership with University Hospitals Bristol and Weston NHS Foundation Trust (UHBW).
Oona noted one positive outcome of the devastating pandemic had been that it had helped Brunelcare towards its goal of bringing its residents closer to their communities.
“What we don’t want to have is gated communities that are set apart from the outside community,” Oona stressed. “We’re about breaking down some of those barriers between our supported housing schemes and their surrounding communities.”
The charity’s successful volunteer recruitment campaign during the crisis has been a key component of building ties with the community. Oona revealed that Brunelcare had reached its five-year goal of recruiting 200 volunteers in just three weeks during the crisis.
“It’s interesting that during this time of crisis we are reaching out to our local communities because they are coming in to support some of our older people,” Oona noted. “We are completely reliant on those communities to support some of our residents. Our supported housing schemes are embedded right in the community. What we are finding is that local residents around us are coming to us and saying ‘can we help?’”
Oona said volunteers were providing a vital range of support to residents such as buying food shopping and befriending, and even delivering PPE.
She observed that the new friendships and bonds with people in the local community would be one positive legacy to come out of the pandemic.
“I don’t think the friendships we are seeing being made will go,” Oona added.
“We are all locked down now so maybe we will have some greater appreciation of what loneliness feels like for others. The state and charities, such as ours don’t need to be a top down service model. It’s moved on now to be much more about mutual aid and developing relationships. Wouldn’t it be fantastic if that could carry on?”
Breaking down barriers between people in terms of communities and generations was central to Oona’s goal of reimagining the next era for Brunelcare when she took up her post six months ago.
During previous research for her Churchill Fellowship on global housing infrastructure, Oona had witnessed pioneering intergenerational care in the Netherlands and Germany, which she has pledged to use to inform the future direction of Brunelcare.
“One of the key lessons I learnt from my research was the importance of mixing people up so you are not having young people in one place and older people in another,” Oona explained.
“Intergenerational care is not a new concept. It’s how most of us live. We don’t think anything of it but for some reason, in terms of our new builds and where we plan new communities, we often don’t take that into consideration.”
The CEO said she hoped to introduce European housing models where students and young people live amongst elderly communities at Brunelcare.
“I saw how these communities enable younger people to get help from older people in terms of childcare and other things and how that allowed the older people to feel they were still useful and had a role to play in shaping that community,” Oona observed.
“I came away thinking that was the kind of community I want to live in. Most people have that same reaction. They don’t want to live in a gated community and be apart from other people. The pandemic has helped us appreciate our mutual dependency.”
Another central tenet of Brunelcare’s five-year strategy will be to focus on better utilising the charity’s ageing housing stock.
“We have homes and supported housing that were largely built in the 1960s and 70s,” Oona observed.
“They need a lot of care and attention and investment so part of our strategy over the next five years is to look at all of those schemes and where they are in the right location we can mix people up a bit.
“We are not looking to acquire new land at the moment because we have 31 sheltered housing sites across Bristol already, some of which are really nice suburbs so we are looking at what we can do to improve those. Others are in student areas so we can look at bringing them in to live alongside older people.
“We have about 30 homes per site. Some of them still have bedsits. Whilst they are in high demand, they aren’t the greatest accommodation for people to make their permanent homes, but they might be good for young people looking for somewhere in transition.”
The care and housing provider has begun discussions with developers and the communities surrounding its sheltered housing schemes about how it can best share its communal facilities.
“The facilities are often empty and not being used much,” Oona pointed out. “It’s about seeing ourselves as not apart from the wider community but being a part of it.”
Oona cited Legal & General’s retirement communities as an interesting model to follow where developments have been successfully located in urban centres.
Brunelcare’s newly opened Little Heath Care Home is based on the pioneering Dutch De Hogeweyk dementia care model, where residents are cared for and supported in individual households which make up a larger community.
“We have five different households of 12 people which means we can structure them and staff them in a different way,” Oona explained. “We can flex the model over time if we get a particular need for younger people or have people with different types of support needs. It could be people living with autism or learning difficulties. We also looked at how younger people with low support needs in Holland came into the care homes to associate and formed relationships with residents, which is something we also want to explore.”
The Little Heath households, which have their own living rooms, are set around communal gardens and facilities where people can come together.
It’s a model that was also informed by Brunelcare’s innovatively designed Saffron Gardens nursing and dementia care home, which opened in 2012.
Designed and constructed with EG Carter Builders, the home was based on a circular model that enhances the independence of people living with dementia. The model has also been deployed effectively at Abbeyfield Society’s Winnersh care home in Berkshire, which opened in September 2016.
Looking towards the longer term, Oona said providing more extra care housing was a priority for the charity. She added that Brunelcare would also consider developing more care homes, though that would be dependent on demand and whether the right sites became available. While also signalling she would like to offer more homecare, Oona said it was just not sustainable under the current funding model.
Taking a broader view of the sector as a whole, Oona stressed the urgent need for a more transparent and understandable social care funding model, and a new social contract that had to be the legacy to emerge from the devastating impact of the pandemic.
“It won›t be good enough to return to the status quo,” Oona stressed. “There has been too much harm and the glare of media attention has put a spotlight on the decades’ long neglect of social care. Our staff and residents deserve better.”
In terms of technology, Oona said that, with the hope for eventual return to normality following the coronavirus crisis, Brunelcare would resume the roll-out of its ‘Everyday I’m ok’ digital systems that enable residents to tell staff how they are and whether they require support with a push of a button. The provider has also successfully introduced Amazon Alexa devices throughout its services.
Issuing an innovation to possible tech and design partners, Oona said she was always open to new ideas for further care innovations.
“I would love to work with some designers and bring them into our care home settings and get them to look at what we need,” she concluded.