Delivering dignity in our services

Yesterday a draft report was published Delivering dignity. http://www.nhsconfed.org/Documents/dignity.pdf It sets out what good looks like when it comes to the care of older people whether in hospital or in a care home. It makes 10 key recommendations for care homes. There are eight that directly pertain to care home providers and are within our ability to influence. It does seem that there are a plethora of reports about the care of older people and what should be done. Much of what is recommended does not necessarily cost much but is about the values of those caring for the older person. It was put well on Radio 4 by Sir Keith Pearson, Chair of the NHS Confederation who said recruit for value but train for skills. At our Trust, that is what we try to do. We do not always get it right but we are clear that compassion and understanding is something more innate in the individual that you cannot necessarily teach but you can train someone how to lift or bathe someone.

The report is timely as we will endeavour to inform our plans for the coming year to ensure that those who have chosen to live with us have happy and fulfilling lives. The eight pertinent recommendations are:
· to involve older people to shape their daily lives,
· to build links with the local community and develop a culture of openness,
· to invest in technology to improve the quality of care,
· all staff must put the person who they are caring for first and challenge poor practice,
· managers should be well trained,
· buildings should be fit for the purpose of caring of older people,
· access to medical care is as important for people living in a care home as anyone else,
· residents should be allowed to die in their care home if that is what they wish.

Parkhaven Trust will certainly assess what further it needs to do to ensure that our care homes do deliver care with dignity.


Hilary Rowland
Chief Executive
1.3.12

As we approach the new financial year, our thoughts turn to the plans for the coming year. The Trust launches this process by starting with the people at the heart of the service; particularly those that use our services and those that we employ. It is for this reason that we start the process with surveys of both staff and service users and their families, to find out what they think about the services and to elicit from them what we need to do differently. These views inform our plans and priorities for the coming year.

So what do service users say? Generally it would seem that we are along the right track. Those that live with us generally feel their rooms are of a good quality. They like the food and the choice they are given. Families are also very positive. There is still room to offer more activities and this will be a focus of our attention in the coming twelve months. These activities must reflect the rich range of interests people do have. This objective builds on the crucial importance of Dignity in Care which was highlighted last week when there was a Dignity in Action day (1.2.12) (www.dignityincare.org.uk). We are also going to work harder at communication with families who use our services for the day, so they know what their relative did, and how they were.

Two recent independent assessments assessed the homes as the top 5*. We hope that this reflects the importance the Trust affords to the dignity of the individual which we believe is paramount in the delivery of excellent care and support. There is no doubt that it is often the little things that can make the biggest difference, like taking the time to notice.

We look forward to raising the bar again next year, to improve the experience of all those that use the services of the Trust.


Hilary Rowland
Chief Executive
9.2.12

Social care back in the news

Earlier this week a letter to the Prime Minister urged politicians to find a way to overhaul the failing social care system. Apparently cross party talks are about to start again. So from the perspective of a local small to medium sized charity, what are the issues.

Firstly we notice that people who are coming into our residential homes are frailer and yet the charity is being paid no more. Over the past two years the Trust has had no uplift in fees. This will eventually compromise the quality of care that can be given.

Secondly the staff are the key to excellent services. Our aim is to achieve 90% of our staff trained to at least level 2. We are an Investor in People to the top gold standard. It is important that our staff feel valued and are appropriately rewarded. Politicians from all parties need to consider this in their deliberations. These staff deserve to be paid a proper living wage.

Thirdly the impact of changing local authority financial assessments and the subsequent payments that service users have to pay should not be underestimated. Locally for example the percentage the local authority now charge/ recover from service users has increased. These increased payments are putting potential clients and or their families off from using services. The long term effect of this could be significant. Situations will break down, emergencies will happen and people will ultimately require more care than if the appropriate care packages are put in place early on.

Social care is often not afforded the priority it should be. Some difficult questions need to be addressed and some bold answers found so that we as a society make the appropriate investment in services to support older people and those with disabilities.

Hilary Rowland
Chief Executive
5.1.12

Parkhaven Trust Works Council

The New Willow Centre

Last week saw the opening of our new Willow centre. The timing was particularly apposite given all the news about the needs of people with dementia. The centre will provide older people an opportunity to come for the day and in a separate area, there is a specialist service for younger people with dementia. The facilities include a kitchen for baking, a hairdresser’s room to match Vidal Sassoon’s, a gardening room, a few quiet corners and a large dining room, lounge and lots of safe open space. We hope the excellent environment will enable staff to engage in the most meaningful way offering a range of activities so every different interest and need is met.

There are also six bedrooms for people to stay the night. These rooms compare with the very best that can be accessed in 5* hotels but with an eye for the detail that will help people with dementia orientate themselves.

We expect over 200 people a year will access these services, whether coming for a day staying overnight or using our horticultural services.

This building has been funded primarily by the charity itself supported by some grants from national charities and Sefton Council. We are immensely grateful to them for their support.

We hope this significant investment will ensure that people with dementia and their families feel supported and cared for through accessing this creative project.

Hilary Rowland
Chief Executive
28.11.11

Allotment Week and our growing patches

This week is allotment week. It is particularly apposite for the Trust because finally after several years of waiting our allotments /growing patches are going to become a reality. There are no allotments for the people of Maghull at a time when growing your own has soared. The patches will be ready for the start of the next growing cycle. The project is being led by Richard Ayres our horticultural therapy manager.

A patch of land 75m x 50m has now been fenced and weeded (see picture below). It will soon be sown with clover to suppress further weed growth and create good growing conditions. There are 29 individual plots to be laid out, to around half the size of a standard allotment, either 100m2 or 130m2: they’re to be called ‘Growing patches’, to emphasise that they are not ordinary allotments. These plots have been allocated to the first 28 names on the waiting list: the 29th plot will be offered to a local charity. Two meetings with potential plotholders have been held.

Each plot will come equipped with a 2m x 2m potting shed, 2 compost bins, a water butt and shared use of a gravelled path: the intention is to create an orderly, well-equipped site with excellent growing conditions, landscaped with mixed native hedging and fruit trees. There will be a water supply (6 taps) and a composting toilet. Rules for plotholders which we discussed at the meetings will reinforce the maintenance of a peaceful, orderly environment, appropriate to the nature of the site.

This development is part of the Trust’s commitment to working with our local community. It will help promote the physical and mental health, diet and social inclusion of the people who live locally.

Hilary Rowland
Chief executive
11.8.11

The Countdown Begins

As the country counts down to the opening of the Olympics, only 365 days to the opening ceremony, we at Parkhaven are counting down to the opening of our new Dementia centre. This is an exciting £1.8 m development funded by the Trust, several generous charitable trusts and a small grant from the local authority. The centre is due to open in early November.

This centre will be the hub of a range of activities and services. It will include somewhere to come for day, to have a freshly cooked meal, somewhere to have fun and companionship, to take up or try new interests including baking, gardening, yoga and painting. The centre will be open 24 hours a day and 7 days a week. It will be there whenever it is needed.

There will also be a specialist service for younger people who have dementia. Again there will a range of activities to try and days out to enjoy. This will be a modern leading edge service. It will also have a dedicated respite service for young people. No longer will they have to access a respite service in a residential home designed for older people.

The centre will also provide respite for older people. It will move from our Kyffin Taylor home. The centre will also be the base for the short breaks service another form of respite and immensely popular.

Continuity of care, knowing who you care for is immensely important. Our services are designed with that in mind. So someone may come and spend the day with us, they may stay with us or go on a short break. They may also need help in their own home. One staff team trained to a high standard will care and support that person. In that way we know what they like, how they like things done, what their interests are; it is a truly person centred service. An excellent is not only about the staff and their skills and empathy but also about the environment. In November we will have a building to match the excellence of our staff team. So Parkhaven is also counting down…

Hilary Rowland
27.7.11

A GOLD AWARD

Yesterday the Trust heard that not only had it retained its Investors In People Award it achieved this at the highest possible level, the gold standard. We are delighted because this recognises and acknowledges the efforts the Trust puts in to valuing, supporting and training its staff. Excellent services are achieved by investing in staff and investing in the environment in which people use our services. We firmly believe we do both. The gold award is certainly evidence of our investment in the staff.

The recent events in the news about the appalling scenes witnessed in the Panorama programme highlights the importance of training staff, of having good policies and a culture that will listen. There are long waiting lists for our services but we are not complacent we can always do things better and we will continue to do so.

The Southern Cross issue speaks to the importance of having the right model for the ownership of the buildings. Our three registered residential homes: the James Page Nursing Home, the Kyffin Taylor Home and Harrison House are all owned by the charity. We are constantly investing in these buildings and planning for the future in a prudent way to ensure high standards but also financial security. Our services are built on a firm financial footing. This is crucial for the well being of those who choose to use our services. We will endeavour to achieve gold in all that we do.

Hilary Rowland
Chief Executive
23.6.11

Changing Landscapes

This evening the Board of Trustees of Parkhaven meets. It is one of 5 Board meetings a year. The Trust is very fortunate in the range of skills and experience that it has on the board. Trustees are volunteers, they do not get paid for their contribution and commitment. (The background of our Trustees can be found at www.parkhaven.org.uk.)

This particular meeting in the cycle of Trustee meetings has a similar feel each year. It is the time when the Trust reflects back on the achievements of the previous year and looks forward and agrees the objectives and priorities for the coming year. It is a time to take stock.

In reflecting on the previous 12 months, the Trust can be proud of what it has achieved. Plans that have been in the pipeline for sometime have come to fruition. There is now an extra care scheme on the site, developed in partnership with Arena housing. One of our small residential homes has become a tenancy arrangement in partnership with Adactus housing. Planning permission was obtained for the new dementia centre and funding is in place. The scheme will be operational in November, 2011; another exciting new development changing the landscape of the Trust.

Other important achievements included a reducing sickness absence rate amongst staff. This is important because it ensures continuity of care for people who use our services. We are also hopeful that the recent Investors in People assessment will consider that the Trust has obtained the very highest award. The Trust has also managed to balance income with expenditure which is an achievement given the stringent financial conditions that currently prevail. But in the end what is important is what people think about the services they have used, some of the feedback I have received is very humbling and a credit to the staff teams involved. Very high occupancy and waiting lists for our services reinforce these sentiments. In essence a very good year, but no room for complacency, There is still much more to do which will be agreed by Trustees tonight.

Hilary Rowland

Chief Executive
16.5.11

The Courtyard at Parkhaven Court

Old and young, they all bring something special

Last week the new policy on removing the default retirement age came into force. Thus people who reach 65 years old no longer have to retire. For both employee and employer, there are many benefits.

For the employer, it maintains the wealth of experience that staff who reach that age have. It also enables their skills to be retained for longer. It can also provide continuity within the organisation, that history and narrative can be very important in understanding an organisation and why past decisions were made.

For the employee, it provides an alternative to that somewhat artificial arbitrary moment in time when work needs to cease. In our Trust many staff have been afforded the opportunity to work part time or perhaps in a less pressurised role. Staff have welcomed these opportunities; the continued social contacts, the opportunity for continued financial benefit and the structure and value that work affords.

However with youth unemployment at 1 in 5 of people between 16 and 25, it does seem concerning that young people are embarking on their working lives with gloomy prospects of securing employment. The change in the default retirement age clearly exacerbates this and reduces the opportunities that are available to the young people. Not only does it affect them directly, our service users also miss out. Many of our older people enjoy their contact with younger people. They bring something different, energetic and fresh. But also they are the staff of the future. We need to encourage the very best of them to make a career of social care. Thus the implementation of this new policy will create a challenge to organisations like ours.

Hilary Rowland
Chief Executive

A service user celebrated 100 years of age

Equity of access

Over the past few days there has been considerable discussion regarding the principle equitable access to university places for young people from a range of backgrounds. Those who come from less well off backgrounds should be able to go to Oxford and Cambridge and the established Russell group of universities and not be deterred by ability to pay. It brought to mind the issue of equity of access to residential homes for older people.

We pride ourselves at Parkhaven Trust that the fees for our homes are set at such a level that anyone can come irrespective of their ability to pay. Thus everyone has the opportunity to access the very best in residential care. With the cuts in public services and the changing assessment criteria, the financial burden of residential care will get more difficult for service users and their families.

In the midst of the debate about university education we should not forget the implications of these searing cuts for older people and their families and the importance of ensuring that all older people have equal access to the very best of residential care irrespective of their ability to pay. Equal access is as important for young people starting out on their life journeys as it is for people whose lives are coming to an end. It is a mark of a civilized society that we do support people well at this stage in their lives.

Hilary Rowland
Chief executive
10.3.11

Kyffin Taylor House

Learning from the health ombudsman's report

This week the Health Service Ombudsman published a report in to 10 investigations into the NHS care of older people (see www.ombudsman.org.uk/care-and-compassion/home). The discussions and commentary that ensued were about the innate empathy and the respect for dignity that is required in the staff that care for older people. This is just as much the case in the provision of residential care for older people as it is in the NHS. It is fundamental to providing excellent care. The report highlighted that these older people were in unnecessary pain, neglect and distress and that the NHS was failing to meet the most basic standards of care. It is important that all providers of care for older people, in whatever setting, take cognisance of these harrowing accounts and ensure that all our services uphold the best possible standards.

A recent survey of those that live in our homes, or relatives of those that live with us, indicated their high degree of satisfaction with the services they receive. However we are not complacent. Importantly the survey indicated that without exception people knew how to complain. It is then crucial that when people go to the trouble of complaining we listen, learn and change. We should encourage complaints, and track the trends. Complaints should be seen as a learning tool, and this is certainly one of the tools we use to help improve Parkhaven Trust services. Others are training, a clear policy framework, and audit. All of these need to be brought to bear to ensure that those older people, or their relatives, who choose to use our services have confidence that the standard of care will be consistently high and that respect and dignity of the people we care for is at the heart of all we do.


Hilary Rowland
Chief executive
18.2.11

New year, new developments

At Parkhaven Trust we are looking forward to the new year. It promises to be an exciting one as we continue to progress our modernisation strategy. On 16th December, 2010 nine people moved from their residential home to new apartments where they are now tenants and have their own front doors but have the comfort and reassurance of knowing that there is 24 hour staff support. This type of service is known as an extra care scheme. Several people have lived with us for 30 or 40 years, so it was a very exciting time for them and us; tears were certainly shed.

But we don’t rest on our laurels. This week work began on our £1.8m dementia centre. This is an exciting, new and innovative scheme which brings together a range of support services which will enable the many people who we support to stay at home longer. It will include opportunities to come for the day and engage in a range of activities including yoga, music and singing, bakery and the opportunity for a hair do and feet done. And for those who like the outdoors, there is our Haven gardening project. We expect the new centre to open in November, 2011.

We constantly review what we do, to ensure that the services that we do provide are what those who use our services want and value. Our long waiting lists for our residential services would suggest that we are going in the right direction. But just to make sure, over these past weeks we have engaged in a survey of all those that use our services. Our resolution for 2011 is to build on, listen, develop and keep on improving the range of services we offer so we are the provider of choice and a valued resource in our local community.

Hilary Rowland
Chief Executive
11th January 2011

Parkhaven Court - We can't promise the snow !

Parkhaven Trust is an investor in its people

Last week the Trust was reassessed to confirm its status as an investor in people. The Trust was first assessed three years ago. The assessment confirmed that it does invest in its staff and generally achieves standards well in excess of the basic award. We hope that we will shortly receive additional recognition for that investment. Social care is about its staff, if the Trust wants to provide an excellent service then it does need to invest in its staff at all levels. This we do.

Staff who are appointed to work at the Trust do so after an interview, references are taken up and then subject to a criminal records bureau check before appointment is confirmed. Once appointed, there is a three day induction checklist which the manager goes through with a new member of staff to ensure that new staff are made aware of, and become familiar with, the important things in the their first days. Then the member of staff attends a two day induction and is given an induction handbook which she/he has to complete. Staff are appointed for a three month probationary period. Each month a probationary interview is undertaken, only after successful completion of the probationary period is a member of staff considered a substantive appointment. Subsequently most of our staff are then enrolled on to NVQ 2 or 3, or now the apprenticeship courses. Annually all our staff have to attend the mandatory training, which following staff feedback we will be changing each year. The purpose is to freshen up and reflect changing priorities of the Trust. In addition other staff have the opportunity to attend other training to ensure their needs and the needs of the Trust are met. Regular supervision and annual appraisal ensure standards are maintained and staff are supported.

We are determined that all staff that work at Parkhaven Trust should be clear about their role, have a job description, have regular supervision and support, have the training to do the job and receive feedback from their Manager to ensure they know how they are doing. It is only in this way will the Trust be able to deliver excellent services. We are, we believe, an investor in people for the people who use our services.

Hilary Rowland

Chief Executive

16.12.10

Quality not Quantity

A briefing published last month by the Care Quality Commission (CQC), Market profile, quality of provision and commissioning of adult social care services (November 2010 http://www.cqc.org.uk/), summarised the improving quality of adult social care services assessed by CQC. Several headlines emerged.

They noticed that smaller homes performed better, although all homes had improved between 2008 and 2010, and those that were run by the voluntary sector had the highest percentage of good and excellent services.

The paper provided a profile of the changing provision between 2004 to 2010. The report noted that the number of residential homes had reduced during this period but the number of overall places had increased, which reflected a shift from the smaller residential homes to larger nursing homes. The increase in the number of nursing homes reflects the growing demand, as people with complex needs are living longer.

The paper also noted that there was an increase in the number of home care services year on year, reflecting government policies aimed at supporting people to live in their own homes for as long as possible.

It is interesting to see how Parkhaven Trust is a microcosm of this report. The Trust, a registered charity, has reduced the number of registered homes it runs from 11 in 2004 to 6 on 2010. It has also reduced the number of places. All these homes have been assessed as good or excellent. And consistent with the national trend, the Trust developed its own domiciliary (home care) service, Parkhaven@home. Although not subject to the inspection and regulatory process and therefore not mentioned in this report, the trust developed a day service during this period for adults with dementia, a valued service which impacts on the lives of approximately 100 people a week. So changes at Parkhaven are definitely mirroring those observed nationally.

Hilary Rowland
Chief Executive
9.12.10

Kyffin Taylor House

The joy of the outdoors

Parkhaven Trust has the immense gift of acres of Parkland. Thus many of our services are located in a beautiful setting which undoubtedly rubs off in a positive way on our service users, whether by having a green expansive outlook or the opportunity to walk the grounds, or enjoy some gardening within the grounds.

Part of the vision for the Trust is to develop a health and social care park and a crucial component of that is our one mile path. This path meanders through our grounds and is open to the general public. In an article in the Times on the 17^th November 2010, its headline claimed that ‘a brisk half hour walk each day will keep you healthy and sane’.

Contributors to the article remarked on the creativity that is unlocked with walking, the sense of well being that is felt. It was said that you never come back from a walk feeling worse. ‘Walking restores awareness’. As a regular walker myself, you never get bored even on the same routes; the light may be different, the birds will be different, the trees will be different and underfoot will be different, whether it is the crisp snow or the leaf strewn paths. Walking can unblock blockages; it is a time for thinking and reflection.

Exercise is recommended as one of the activities to try and prevent, stave off dementia. Thus our one mile path is part of our array of services both to support people with dementia, but also as part of the prevention.

Hilary Rowland

Chief Executive

2.12.10

The Parkhaven Mile Path

Parkhaven Court – another new venture

Next month, Parkhaven Court opens on our Liverpool Road site, in Maghull. Parkhaven Court is a 24 apartment extra care housing scheme. It is a joint venture between Arena Housing, Sefton Council and Parkhaven Trust. This is another plank in the modernisation programme for the Trust and another first for us. Now the Trust will provide care to these extra care apartments.

An extra care scheme is a housing arrangement with 24 hour care available. There are 12 one and 12 two bedroom flats, all on the ground floor all with French doors on to a small garden area. There is also a large enclosed court yard, a communal lounge, kitchen and a small IT and library area. There is a hairdressing room and a bathroom with a special bath. Weekly activities such as coffee mornings, afternoon tea and shopping trips will take place. Our hope is that it will be a happy and safe place to live which will promote people’s independence and choice for longer.
It is a scheme specifically for older people with dementia. It also has the great gift of being in a beautiful parkland setting.

If you want to find out more, visit the Parkhaven Court page of the website, or email us at care@parkhaven.org.uk.

Next week the joys of walking!


Hilary Rowland
Chief executive
29.11.10

Beautiful surroundings of

Parkhaven Court

New Website Launched

This week we launched our new website. We hope that it provides all the information someone accessing the site would want. We hope it is easy to use and clear. So if you want to find a service for you, or a relative, it should tell you who to contact. Or if you want to work for the Trust, it will tell you the jobs that are currently vacant. The site also has new a volunteer page. Read what Jenny has to say about volunteering at Parkhaven.

Parkhaven Trust is a rapidly evolving organisation so the site will be regularly updated. However, if there is information that you would like to be on the site, that is not currently incorporated, please email care@parkhaven.org.uk and we will do our best to try and include it.

Next week we will report on the progress of Parkhaven Court, the new extra care housing for people with dementia.

Hilary Rowland
Chief executive

18.11.10

Parkhaven Court

World Mental Health Day: 10th October, 2010

As previous blogs have mentioned, Parkhaven Trust has developed an array of services to support the increasing numbers of people with dementia. We take great pride in the personalised and innovative services that have been developed. The latest contribution to this menu of services is an extra care housing scheme specifically designed and developed for people with dementia.

The building is nearly complete and now we are in discussion about the number of hours required to support the new tenants and what the cost of those hours will be to the local authority. The number of hours was a fairly amicable discussion resulting in a high degree of agreement which was reassuring. Although there was a discussion as to whether one member of staff on at night would be sufficient. I am absolutely clear that this is not acceptable and certainly to begin with social services accepted this view. The most interesting facet of the negotiation took place when we were discussing rates. We indicated that the rate would be the same as that which had been agreed to support people with learning disabilities. The social services representative suggested that this was possibly too high because the needs of older people with dementia are not as complex as those for people with a learning disability. The Trust is clear that this is a misguided view. People with dementia need a skilled and committed staff team to support them. People with dementia need continuity. Staff need to know how to support and enable people, what their backgrounds and interest are. Not just anyone can go in and support someone who is not able to articulate their likes and dislikes. People need to be respected and treated with dignity. People with dementia need to be accorded the highest respect and skill and this requires employers to pay staff good rates and in turn commissioners of services to pay acceptable rates for the domiciliary support of people with dementia. This cannot be bought on the cheap. It would seem that yet again people with mental health problems are not being afforded the priority they warrant.

The World Mental Health day is to raise the profile and priority of people with mental health problems and our recent local discussion would indicate that there is still work to do.

Hilary Rowland
Chief executive

The social care economic balance sheet

The admin team here at Parkhaven Trust has been keeping a tally of the impact of the constrained financial times on our services. It feels very diffficult at the moment. All discussions with our purchasers seem to result in very depressing financial outcomes; for example no uplift on the fees that have been received. No acknowledgement for some very specific financial pressures in one particular service. These pressures are very real. A reassessment of a service user at our nursing home who has been residing at the home for years.

However on the positive side, the turnover of staff has reduced by 4%. This reduced turnover is encouraging. Lower turnover provides greater continuity of staff, retention of skills, knowledge and experience and less pressure on the advertising budget and those responsible for recruiting staff. We are also hopeful that as we go out for tender for our new dementia centre, pencils will be sharpened and we will receive some competitive prices

Thus all is not gloom. It is important in these tough times that we do hold onto what is important and that is providing the best possible services for those that choose to use us. Hopefully these constrained times will prompt our creative juices into action! A further positive outcome!

Hilary Rowland
22.07.10

Personalisation agenda


The personalisation agenda is much talked about in social care. It is rather a mouthful. In doing the annual review of our year it became very evident that what we now provide has changed markedly and is a manifestation of the personalisation agenda. So how does it manifest itself in the services we provide? Six years ago Parkhaven Trust had 12 registered homes and all that we offered was the opportunity of residential care. Now an innovative array of services has been developed in response to the different individual needs.

For example our dementia day service continues to grow. 116 people used the service last year some coming daily, some twice weekly, it varies according to need. People enjoy a range of activities including gardening, yoga, baking and singing and dancing. Building on this the Trust developed its domiciliary service, Parkhaven@home which in its first full year provided over 1600 hours of care. The philosophy of this service is that staff from the centre will support people in their own homes; familiar faces in familiar places. A special gardening service was then developed for people with dementia and this has grown (pardon the pun)! A weekend away for people with dementia proved so popular we have done more and more. These services are personalisation in action!

If there are special personal services that you would like, then do let us know at care@parkhaven.org.uk. We will do all we can to respond to your needs and interests.



Hilary Rowland

09.06.10