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11th March 2018 – A Professional Carer is Not Just for A Snowy Stormy Day! #Respect

This time last week we were all just about getting over the impact of the 'Beast from the East and Storm Emma. This adverse weather created havoc that left most services shot, there were people that couldn't get to work for days. But this was not an option for those that work in social care.

For those of us that work in social care, not going to work meant that the most vulnerable of our society – whose condition has been exacerbated by the weather – will be at even more significant risk. Therefore, care workers had no option but to risk their own safety to get to their clients. We all read or heard heroic stories of carers walking miles to get to their client, or carers sleeping at work to ensure they could care for the people they are responsible for. I even know of care workers who fell down; though feeling bruised and battered they continued until they were sure their clients were ok.

There were acknowledgements and commendation in the media and from people of authority for the heroism of the care workforce... rightfully so! However, the fact of the matter is that professional carers need to be appreciated for the day-to-day challenges faced in delivering care to the most vulnerable of our society. Challenges faced daily include lack of respect and recognition, and abusive and demeaning behaviour, not to mention the poor working condition most care workers endure.

There is no recognition of the professionalism of the care workforce nor do we get the reward deserved for such an essential role in our community. To most people out there, being a care or support worker is considered a low-skills job, probably done by people with no qualifications or better prospects. This belief is reinforced by the lack of positive action by those in authority. The skills and experience required to be a professional care worker are immense; as a care worker you need to have clinical skills to be able to make split seconds decisions in life and death situations, interpersonal skills to be able to strike up a trusting relationship with the people we care for, and psychological skills in other to be able to provide emotional support to the people we support who may be going through traumatic situations. Yet, this is poorly recognised with no clear career path or formal accreditation. The wages in the sector is still extremely low in comparison to other roles with similar skill sets. Most care workers have no job security, Skills for Care estimates that a quarter of the workforce is engaged on zero hours contracts, meaning there is no guaranteed income. The use of zero hours contracts in the social care sector is promoted by a Local Authority Commission that uses an hourly and task-specific commissioning model.

The lack of recognition and respect mean that very good colleagues are walking away from the sector. There is already a shortage of people taking up caring as a career. Not being able to retain those of us already in the system will only exacerbate the situation. An estimated 900 colleagues are walking away from the profession on a daily basis. The National Audit Office published its report into the social care workforce in February 2018 highlighting how precarious the situation is. The fact is nothing in the report was new, at least not to those of us working in the sector. This was followed by the Public Accounts Committee hearing on the same subject. Listening to the hearing, I couldn't but wonder why the care workforce was not represented or invited to participate in this hearing. I also kept wondering where is the bold transformation that is obviously required to raise the profile of the workforce.

I am aware that most of my colleagues felt valued and respected for the generosity and support such as free transportation offered by the public and their employers. Positive coverage in the media of the social care workforce was a breath of fresh air. But it is worth remembering that a professional care worker faces daily challenges, and will go the extra mile irrespective of whether it is snowing or not to provide valuable support to those vulnerable members of our society, sometimes at a significant personal risk to the their wellbeing.

Appreciation of the professionalism of the care workforce should not be reserved for the snowy days. No matter the weather conditions, a professional care worker will be there to fulfil their duties and should be respected and recognised.

Mohammed Gbadamosi

Professional Care Worker and Co-Founder of NACAS

4th March 2018 – What a Carer Can Do

My friend's grandmother was diagnosed with lung cancer this week.

It came as a shock. She is a very fit lady who has never had any serious health problems. Not that long ago she was swimming a mile a day.

She has a wonderful family trying to look after her, but they felt helpless, not really knowing or having been told yet what to do.

We made a quick decision to go and see her this weekend. My friend was equally uncertain how to help, but myself - as someone who has worked in care for a few years now - I knew that the family will have many questions keeping them awake at night, and I knew that I could help.

In my time as a carer, over the last seven years, I have learnt a lot. When you look after people as a job you don't just pick up a lot of knowledge and skills, you learn how to put other people first. You learn to listen and empathise, and use soft words in moments of tough decisions.

When visiting Wyn, I had to put my knowledge and skills into practice all at once.

One thing that I think of a lot when looking after people with cancer is comfort. The best thing that we can do for them is to make sure that they are warm, content and as pain free as possible, especially if they are not offered any treatment. With Wyn, it was a matter of buying fluffy, warm socks and a height-regulated back support that she could use in her bed. I ordered those before our arrival so Wyn could have them as soon as possible. Wyn had a nasty and tiring cough - a good back support made her more comfortable and made sleeping easier.

Wyn lost a lot of weight recently and didn't feel great moving about. Activities tired her easily and she needed a lot of rest. Her weight loss has weakened her, far from the accounts of the stalwart Scot I had heard. As a carer, I often work with other medical professionals, and pick up a thing or two: an occupational therapist taught me how to assess her muscle strength, and although she can still walk, I warned her family that she was at risk of falling and that remaining strength in her legs can be quickly lost. I showed Wyn some exercises that a physiotherapist taught me, to help her get stronger and prevent deconditioning in her thigh muscles. I also showed her daughters how to do passive exercise with her on days when she cannot manage by herself.

Her daughters were distraught, although proudly firm and optimistic in her presence. Simply knowing that a professional was at hand eased their worry, and - more importantly - allowed them to ask the questions that no-one else had time for.

Wyn's weakness and tiredness meant she had spent lot of time in bed recently. I knew that, together with weight loss, that put her in high risk of pressure ulcers. Despite being in hospital only last week, no-one had checked her skin, so I gently suggested she let me help her shower and check it for her. I found a big red pressure ulcer on her sacrum. I bought a barrier cream recommended to me by district nurses that I have used with my clients many times. I advised her to avoid lying on that part and to try and turn more often. I also explained to her daughters what to look out for and how to look after her skin better now it is fragile and more sensitive.

As many ladies her age that I know, Wyn likes to look good and control her food. Her current state of health seems to have taken a lot of joy out of eating, and bouts of nausea that she has been having have almost completely put her off food. With the weight loss that she experienced in such a short time, healthy eating is not as important as simply eating enough, so I went shopping with her daughters and got her all of her favourite food. We delivered this to her in little bits so as not to overwhelm her with big portions. I also got her protein powder with vitamins that the family could add to almost anything to bulk it up. I put a few big scoops in vegetable soup that I made for her that I fortified with butter and chicken stock. I also ordered some protein drinks that doctors have often prescribed for my clients with eating issues in the past. Wyn didn't take to the drinks very well but we worked out that if they are diluted she could drink them.

The next step was the hardest: discussing the current situation with her daughters. Understandably, they were very emotional and upset, but determined to get things right and look after her in the best possible way. Using my experience of working with lung cancer patients I explained to them some possible scenarios and issues that could arise. I did not make false promises or kill their hope, I simply spoke of my experience and what I learnt, and answered their questions. Giving support to families is such a big part of carers' jobs. It takes time and experience to know what to say. I ensured that they knew that looking after themselves was an essential part of looking after their mum. I was able to direct them to specific services that are available for mobility equipment, continence assessments and respite care, both to help Wyn and to ease the strain on the family.

I always think that beds make ill people look and feel even more ill. I am a strong believer that, where possible, we should encourage patients and clients to get dressed for the day and try and stay out of bed. It took some jokes and patience but one morning Wyn agreed to a shower (which she hasn't had in a while) and getting dressed. She loved having a shower and perked up straight away. Getting dressed made her feel more normal and less sick. She smiled more and ate and drank like a champion.

In this country people don't really talk about dying and health decisions much. We tend to leave things until it's too late. I have seen the impact it can have on both my clients and their families. I was determined to help my friend's family avoid that suffering.

I took Wyn a cup of tea and asked her if we could talk about some practicalities. She was very happy to. I asked her some personal questions about some important arrangements that I believe all of us should have in place no matter the age or health; I explained the power of attorney and lasting power of attorney to her. - it was something she was not aware of and she said she will put it in place.

We discussed a DNR that she already has in place, which will help take painful decisions away from her children. I explained to her about the living will and how she should discuss with the doctors and her family different possible scenarios and make decisions about what she would like or wouldn't like done. As a mother, Wyn said she was willing to take uncomfortable and painful treatment 'because she owes it to her family' and I discussed with her how that attitude will likely affect everybody. Her daughters told me they did not want her to suffer just for them and that they want her to have as good quality of life as possible.

These conversations are always difficult because they make people face the finality of death. As a practical person, Wyn took it quite well and I think it was easier for her to talk about for the first time to me rather than her family. Being a carer, and a professional, I provided a buffer that made the harder decisions easier - but by no means easy.

During this weekend I used all of my caring knowledge and experience to save a lovely family worry, pain and suffering. I gave them information that would have otherwise taken them ages to reach, in weeks of referrals and appointments. I gave them a peace of mind over some issues and important tools to deal with the rest. Most of all I gave them holistic help that was solely about their family, not targets, numbers or statistics, or budgets.

Next time you meet a professional carer remember that we don't only "wipe old peoples' bums". Next time you meet a professional carer remember that we bring comfort, emotional support, skills, peace and care into peoples' lives and that we put those we look after before anything else.

Karolina Gerlich

Proud carer and NACAS Director

15th February 2018 – Introducing NACAS

The National Association of Care & Support Workers was founded in 2016. The association is directed by care workers and aims to improve health and social care through our members. We are working hard to improve training standards and ensure that care profession gets the respect and recognition it deserves.

There is a variety of titles given to those who provide care professionally; our members are home-carers, care-home carers, personal assistants, support workers, healthcare assistants, as well as managerial staff. Regardless of the job title, we all provide care to people, and often spend a great deal of time with them.

In this time, we really get to know the person - their needs and their preferences - often participating in very private and intimate aspects of their life.

We support those we care for physically, mentally and socially, and frequently form close relationships. To be able to deliver care, we work hard to establish trust, and continuously reinforce mutual respect and understanding.

We spend extended periods of time with people in our care. The time spent with them and the close relationships that result mean that we have a thorough understanding of their needs; we are a familiar face, helping them feel safe.

We are a valuable resource that - we believe - should be used widely in medical and social care. Always happy to help, we can explain our client's issues and needs, and recommend best practices for interacting with them. We can provide medical history, as well as details of medication intake, exercise and diet, moods and even embarrassing symptoms that they hesitate to share. We get to know their hobbies, likes, dislikes and things that make them laugh and cry. Professional carers help with feeding, personal care, and encourage people to eat and take on fluids, reducing the burden on the health service. We provide companionship and emotional support through difficult times and we make sure we give that support to families and friends too.

NACAS thinks that by working together, health and social care professionals and carers can improve the care for the elderly, make people feel less isolated in medical settings and reduce the number of days they are away from home. We would like to invite the community to help us provide better care, and capitalise on our skills and experience.

We are looking for people to work with us on improving training, creating additional courses that we can provide to our members. We would like to hear your thoughts and opinions on working with professional carers, and to open a dialogue where together we can improve care.

Karolina Gerlich

Proud carer and NACAS Director

Contact: karolina@nacas.org.uk if you would like to get involved, especially in producing training materials.