This past week has been full on but brilliant. I have had back to back appointments with some lovely people. My contact at Hepburn Health was unfortunately off sick, but her colleagues made sure I was accommodated. Then a day spent with Pam Kennedy as she delivered the fourth session in the How To… programme which is a precursor to the Rainbow Tick. Pam then let me spend the morning with her the following day so she could talk me through the Rainbow Tick Accreditation process before I headed off the the Matrix Guild in the afternoon. Matrix Guild are an organisation who champion the rights and needs of older lesbians. We had an interesting discussion about TERF wars which warrants a blog of its own. Below is a photo of the How To… gang :)\
I had a bit of a gap on Thursday morning so spent some time in the State Library. The idea was that I would start writing stuff up but in fact the building is so beautiful, I ate my lunch outside whilst listening to a rather good busker. The inside is just as lovely so you end up spending too much time looking at the exhibitions and art installations than writing up. I can’t wait to go back if I have time. Although time is something I seem to be constantly short of so I doubt I’ll get to visit again.
Friday was a long but fabulous day spent with Lifeview in Chelsea, a coastal suburb of Melbourne. I still cannot get to grips with space here. An organisation can be ‘in Melbourne’ but also be a 2+ hour trip away. (I equally cannot get Australian’s to understand ‘small town’. When I was in Adelaide my family were saying things like ‘well, Adelaide is small because it has a population of 2 million’. I live in a small town with a population of 15000. On this point, we are never going to understand each other J). Travelling to Chelsea was a bit of a trek from where I am staying but I LOVE the trains here. For a start they are clean, cheap and unless you are in super peak times you can get a seat. I also love the stations, they stop at sleepy suburbs with wooden houses with stoops which are decorated with lattice metalwork which reminds me of some bygone era. They just invite you to enjoy a glass of something whilst sunning yourself and watch the world go by. It’s hard to feel stressed here.
But trek to Chelsea I did and was greeted by a beautiful neighbourhood, the station was a spit from the beach and I was early for my appointment so spent some time dipping my toes into warm sea and getting sandy feet. It wasn’t a bad start to the day by any means and I couldn’t help but wonder how quickly someone would step in if I was toe dipping in the North Sea in September… I wrenched myself away from this gorgeousness and headed to Lifeview.
I was made so welcome from the moment I walked in. Lifeview have 4 homes across Melbourne, Chelsea being the smallest with 45 beds. They operate a Home 2 Home model of care and whilst I was predominantly there to see Rainbow Tick in practice, I was so glad to bear witness to their Home 2 Home model. The Home 2 Home model moves away from what the Lifeview staff refer to as the Hotel model, where residents are waiting on hand and foot. Here, the ethos is different. The Chelsea home is divided into three neighbourhoods with about 15 residents in each. Residents are welcome to visit the other neighbourhoods if they wish. Each neighbourhood has 2 ‘housemates’ who are paid staff.
Lifeview has previously had a more traditional model of care with PCA’s and nursing staff providing care to the residents. Lots of work was done to ‘untrain’ these staff when moving from traditional to Home 2 Home. Housemates were recruited not only from existing nursing and PCA staff but was also offered to housekeepers and hospitality staff too. I like this idea. From my observations in various institutions, it seems to me that it’s the person who collects the laundry or takes the menu that has the most conversational time for residents so why not enable them to work more closely with them. There was some concern that people were not qualified within the organisation at this time, but I would argue you can’t teach someone to be respectful, considerate, empathetic. For sure there was a period of stress and concern during the early phases of transition to the new model of care but this was short lived and managed well by all accounts. In the run up to changing the model of care, Lifeview observed the numbers of different staff who came into contact with residents in an intimate space over a 24 hour period. They found their was the potential for 19 different staff to attend the personal care of each resident. The average was 10 different members of staff. Bear in mind this is just personal care support, if you include all interactions the number of different staff would be much, much higher. This result was a driver behind the more relational care model that Home 2 Home offers.
The residents equally felt unsure of this new model. They liked being waited on and having things done for them and were reluctant about changing this. Spending time with everyone on Friday made me think that the model seemed to be working pretty well. What I saw looked a lot like friendship between residents and staff. There was lots of laughter, probably helped a little by Happy Hour when the drinks trolley comes out and an entertainer is brought in, lots of hugs and more than a dollop of silliness. If the time comes, I would want to stay somewhere like this please!
The management reported that the incidence of falls had fallen as had the incidence of infections since the new model of care was introduced. I asked about staff retention which is often cited as an issue in the UK when we talk about training needs in care homes. I think I’m right in saying that their staff turnover used to be 21% and had dropped to 3% since the new model (don’t quote me on that, that’s from memory I’ll have to listen to the recording again). I also interviewed a staff member who said she had always worked in aged care and was now dedicated to Lifeview and the Home 2 Home model.
I’m interested in resident experience too, so after a brief tour I was invited to join the Marigold Circle. The Marigold Circle is a small group (photo to come!) who meet fortnightly to talk about LGBTI+ issues. They have a different topic every week and is hosted by the what would be called Activities Co-Ordinator at home, I guess. This particular Marigold Circle had been put on just for me because my availability didn’t fit with their usual schedule. I felt very honoured and a little but humble that the residents would accommodate me like this. The topic for this week is the postal vote about same sex marriage. To be honest, it’s pretty much the topic wherever I go in Australia 🙂 The discussion is facilitated by the use of statements which are then discussed by the table – things like ‘If we legalise same sex marriage, children will grow up gay’ (the use of children’s wellbeing in this debate is a particularly underhanded tactic being adopted by the No campaign) or ‘Will churches be forced to conduct same sex marriage services’. You get the idea. It was great to be part of this discussion and to hear other people’s experiences and opinions. The upshot is that the Marigold Circle will be posting a resounding Yes in the campaign. The Circle is open to all residents regardless of sexual orientation. Staff told me that the motivation for some was to enjoy a forum where they could openly talk about their gay son or lesbian daughter as well as their own relationships.
For this particular Marigold Circle – and I suspect because I was visiting – they had a special guest from another Lifeview home. As an openly gay man, he contributed to the discussion and was bloody good company. I was lucky enough to interview him about his life and I hope to see him again at the 3rd LGBTI Conference we are both attending in a couple of weeks.
I was then invited to have lunch with the residents. All staff eat lunch with the residents. I’m just going to say that again – All staff eat lunch with the residents. Apologies for my excitement about this, but it reminds me of the all too short stint I had working for my local hospital. One of the initiatives which I was trying to instigate was around helping patients with dementia to eat more/better. I suggested that staff eat with patients but this was met with several barriers, including no space for tables, infection control, too busy, etc. etc. I was therefore delighted to see this in practice.
Under the Home 2 Home model, residents choose the food they would like to eat. There is a kind of working group who meet with the chef regularly and discuss what sorts of things they would like. Chelsea opted for fish and chips on a Friday and I have to say it was pretty darn good. Chunky chips with homemade coleslaw and crispy battered fish – made me homesick but happy. Staff told me that one of the residents had asked for sardines on toast one week as he used to enjoy this as a kid. Before they knew it half the residents were asking for the same, so sardines on toast is now a regular feature on the menu. I’m guessing from a budget point of view this works pretty well too! The assumption that when you give people the choice they will always try to screw you for something expensive certainly wasn’t played out here.
The residents are expected to help around the home as much as possible, so place mats are cleared, dishes put away, and tables wiped. Residents who I would probably see being fed in a UK care home, were encouraged to feed themselves even if they got a bit messy. I sat next to a lovely man who had some difficulty with communication and coordination but winked and smiled at me throughout lunch which he fed himself. Conversation over lunch was about how everyone was feeling, telling me about the various adventures they had in the home – including one about Joan (80+) dressing up in a sequinned thong bikini, she advised me never to dare her to do anything, because, and I quote “I bloody well will” – and what they were looking forward to. Mostly they were looking forward to a bit of a post lunch snooze so they would be suitably rested for happy hour.
I was invited to join in for Happy Hour which mostly involved drinking wine and beer and having a pretty good time. This week’s turn was a guy singing country songs in a cowboy hat. Some weeks he leaves the hat behind and channels Tom Jones, but this week it was all Neil Diamond and Johnny Cash. Watching the two centenarians in the room busting their moves was a joy. One thing that struck me was that, yes there were several walkers some with oxygen tanks but that was about it for ‘equipment’. There were no drug trolleys, no hoists looming over people. This place feels like home.
As the rhinestone cowboy was packing his guitar away, one of the residents, Vince, was invited to sing to us. Staff told me that this particular gent had been an entertainer in his youth – he claimed rock and roll ruined his career – but he had not sung in 50 years when he arrived at the Chelsea home. With staff encouragement, he had slowly built up the confidence to sing again and to sing in front of the other residents. We were treated to a rendition of Moonlight Becomes You which had me welling up because it reminded me of my children who I love to the moon and back – God I miss them. Vince went to sit back in his chair but was asked if he would do another number, he didn’t take much convincing to then sing You’re Young at Heart which reminded me of the best boyfriend in the world who I adore. Goodness knows how I kept myself together, I’m at a very funny age…
After Vince’s wonderful singing a call goes out over a tannoy ‘Can all available staff come to the dining room. Can all available staff come to the dining room.’ I’m on alert a bit as this kind of announcement would normally indicate some sort of crisis. Here though it alerts staff to the fact that its dance time. The corporate song ‘We are Family’ is cranked up and all available staff get their groove on, soon to be joined by residents. It was pretty cool.
Not all residents enjoyed the hullaballoo so made their leave and inhabited quieter spaces for a while. Vince the lovely crooner showed us a montage of photos from a recent masquerade ball which Lifeview had hosted. He had edited it all together on his computer and put some soft jazz over the top. Another resident, hearing the music came back to the dining room to dance and tell us this was ‘real music’. She also told us her husband used to host a radio show back in the day. Staff noted this and promised to find out more.
What struck me too was that those residents living with dementia were included in the population. As I was leaving at around 4pm, most residents were chilling in their rooms, snoozing off the effects of Happy Hour and more time and attention could be focused on those with dementia who were still pretty active. All was calm. It was a pretty awesome day/week.
There is so much more I could write. About the numerous hugs from a member of the Marigold Circle, the relational care, the inclusive care of the LGBTI community, the five ways you can make my day, the drunken pig roast story and the big plans moving forward but I really need to write those presentations I’m expected to deliver in a few days whilst I’ve still got full wi-fi access to email them to the various organisations.
I’m jetting off to Sydney next week and have just looked at the reviews for the only motel I could get short notice. I always tell myself not to read reviews after making the booking, but I always do. It’s a mixed bag to be honest and reminds me of the time I spent in Hebden Bridge the first time I ever travelled alone. I was in my room writing up notes from the days training I had had, when a man unlocked my hotel room door and walked in with a pint of lager in his hand. We were both a little startled but being British, he simply apologised and left and I carried on working. I slept with a chair wedged under the door handle and only mentioned it to staff when I checked out the next day. Apparently, they have two keys for each room and their had been some mix up. Luckily it wasn’t the middle of the night as I have visions of waking up to a man getting into bed a la British sit com. So, I look forward to my slightly dodgy motel in Sydney and just hope I have a chair to wedge in my room 🙂 Every day is an adventure.
Jane Youell Consultancy 