I visited 14 services last week and was particularly impressed with the service at Willesden Lane in Brent. This is a supported living service supporting 5 people with profound and multiple learning disabilities. The staff team are extremely enthusiastic and positive and there is a real person centred atmosphere in the service which is reflected on how homely each person’s bedroom is and the great photos of the people we support in the communal areas. People who live there come from a range of cultural backgrounds and that is clearly reflected in the way that they are supported including the way in which their individual bedrooms are decorated.
The people we support have busy activity programmes, including in the community and with good support around their sensory needs. When I visited, staff and people we support had just returned from shopping and again I was impressed with the healthy fruit and vegetables which had been purchased.
As you know, I think social inclusion is very important. As well as people from Willesden Lane being out and about in the community regularly, they are also supported to attend the local church, where they have established relationships with other members of the congregation.
I would also like to mention 2 other initiatives which push the boundaries of what people we support with profound and multiple learning disabilities can achieve.
A lady we support at our Chandon service in Ashtead, has started doing voluntary work with animals and a person we support at our Dyke Road service in Brighton is going to be taking on a job as a ‘mystery shopper’ checking out the accessibility of pubs, clubs and shops for disabled people. With support from his keyworker, he will complete an accessible questionnaire after each visit.
We also held the amazing Supportive Therapies Day this week and I will post more on this in next week’s blog. It really is a fantastic event tailored specifically for our PMLD service users.
I’d like to dedicate this week’s blog to Katie Reid, our Healthcare Facilitator, who celebrates 20 years service with CMG this month. Katie started her career on the 7th July 1997 at Ceres House (CMG acquired the Ceres House services in 2004) as a Care Assistant, straight from school. She worked across the services, supporting children aged from 6 months to 18 years of age. Katie quickly made her mark and was promoted to Senior Care Assistant, then Deputy Manager at 289 Dyke Road which supported children with profound and multiple learning disabilities. Katie also helped to manage 283 Dyke Road (supporting children with ‘challenging behaviour’ and autism). In 2002 Katie was promoted to Manager of 289 Dyke road and was successfully interviewed by the Regulatory Body – at this time, aged 22 years, she was the youngest registered manager in East Sussex.
There are 9 people that Katie still supports in her current role that she has been involved in supporting since they were children. In addition, she worked closely with Sammy Boyle, for twenty years, since he was 11 years of age. Sammy lived at 287 Dyke Road and is recently deceased. Katie and Sammy had a wonderfully close relationship.
During her time working directly in the children’s homes, one of Katie’s proudest times is when she supported a little boy to be adopted. He had significant physical and learning disabilities, Katie worked hard with others to support him to use a standing frame and to actually ride a trike. He was adopted by a family in Dorset and Katie stayed with the family during the transition to make sure this was successful, and he was enjoying family life.
In 2006, Katie’s role changed. Given her skill and knowledge base, she moved from being a manager to taking on a new role as Care Co-Ordinator within CMG’s Therapy Team. This was a locally based role in Hove, which in 2009 turned into her current Healthcare Facilitator role, supporting CMG services in a much wider national role. The skills and knowledge Katie is able to offer to CMG staff teams has grown significantly. With a diverse range of interests and maintaining up to date research and evidence based practice, Katie is able to offer a lot of expertise to ensure CMG stay at the forefront of proactive support to people with a range of complex needs.
As if evidence of the many lives that Katie has so positively impacted in 20 years was needed, when we asked for a few testimonials for her, they came flooding in. Each is very moving and demonstrates Katie’s passion, dedication and knowledge. There are too many to show here, but I’d like to include extracts from a few:
“Katie always has a smile on her face and the way she conducts herself with colleagues and the service users is an example to the rest of the team and to me. Katie’s unique knowledge of every service user is invaluable and helps me enormously from a medical standpoint when trying to decide on any intervention or treatment plan. She has excellent clinical acumen and a down to earth and common sense approach.
I hope our professional relationship continues for many years.”
Dr Thomas Gayton, Montpelier Surgery
My son ‘S’ has been at CMG for 12 years. Katie has always advocated well for ‘S’ with other professionals. Katie always has his best interests at heart and always interacts with him well and he enjoys her company very much. I feel that Katie is a valued member of the staff who is always there when advice or support is needed.”
Sue El-Ziftawy, Mother
“I really liked Katie when she came to work with me around living a healthy lifestyle. She was very patient and listened to me. She listened to my suggestions and gave me good advice. Katie gave a hula hoop which I used for a few weeks. The main thing is since I worked with Katie I have lost a lot of weight and I have never looked back. I go for regular walks and I eat healthily. I am more confident and I am in employment and will soon be registering for an English course at college.
Thank you Katie.”
Nicola (Person we support at Perryn Road)
“Katie has an eye like an eagle, and a sixth sense when it comes to the people we support. We have always pushed the boundaries for our service users to achieve and live a quality life, and this would not have been possible without the support of Katie.
Katie’s 20 years in service is the equivalent of 40 years considering the dedication and commitment she gives.”
Romulo Fernandez, Manager, 290 Dyke Road
“While Katie’s role has grown considerably, her passion lies within the PMLD services. She is instrumental in promoting positive internal communication and supporting working relationships between the PMLD home managers and external health professionals. Katie’s knowledge is extensive and not just concerning health concerns as her title would suggest.
She is an amazing individual and her love, passion and enthusiasm for everything that she does is an inspiration to us all.”
Ten services every week, five-a-side football and STOMP film
Whilst I haven’t mentioned my weekly visits to CMG services in my blog recently, I do still ensure that I get round to at least ten services every week. I think it is extremely important for staff at services to be familiar with who their Chief Executive is. We do like to promote an open culture at CMG.
I had the pleasure of attending our annual five-a-side football match last week which was really well attended with some great fancy dress outfits on display. The sun was shining and as usual trophies were hotly contested which was great to see. There were three tournaments and whilst everyone took part with much enthusiasm, there were three overall winning teams:
Service User Team – Lewes Road
Staff Team – Kings Road
Mixed Service User and Staff Team – Wales
We are always keen to involve people we support in this tournament, so as well as taking part, the organisation of the event was very much helped by CMG’s Sports Ambassadors, Tomas Cardilo-Zallo and Stephen Adamson. Alex Roberts from CMG’s Cwrt-Y-Bella service in Wales, did a sterling job as referee and got very excited when he was able to issue a yellow card! Sadly Elvis, our Deputy Manager at Parchmore injured his knee and had to be taken to hospital in an ambulance. We send him our best wishes for a speedy recovery. A big thank you to everyone who took part and to Tooting and Mitcham Football Club for letting us use their excellent facilities.
As you know we held an important event in June at Church House in Westminster, alongside NHS England and hosted by Norman Lamb MP. The event focussed on promoting the STOMP programme (stopping the over medication of people with learning disabilities and/or Autism or both) and the launch of CMG’s Best Practice Guide which demonstrates the success that non-drug treatments can have on helping to manage challenging behaviour and drastically improve people’s quality of life. At the event we saw emotional presentations from family members who were featured in Channel 4’s recent Dispatches programme: Under Lock and Key. Their loved ones were sedated and chemically restrained whilst in hospital with devastating consequences. These individuals are now in the care of Alderwood (CMG’s subsidiary company) and are receiving excellent Autism specific, person centred care and are flourishing as a result. One even has a part time voluntary job.
I am really pleased that we were able to film this event and you can now see this short film here:
If you haven’t already seen it, you can also access a copy of CMG’s Best Practice Guide here.
I was really impressed this week when I saw our training room at CMG’s Head Office in Leatherhead lit up with an array of fantastically colourful sensory materials. This was in preparation for a 2 day training course that our clinical team had organised for managers and support staff at CMG’s PMLD services. The two day programme focussed on ‘Developing Your Sensory Lexiconary’ and ‘Sensory Engagement for Mental Well-being’ and was run by Joanna Grace, the founder of The Sensory Projects (some of our CMG managers may remember Joanna as she ran some sensory sessions at our Manager’s Conference a couple of years ago).
Whilst we run many training programmes at CMG (many run by our own Learning and Development and Clinical teams) we couldn’t fail to notice this one as there was such an impressive display of sensory materials!
As we all know, any training session is only ever as useful in so far as how it is used and implemented once back in the service to continuously improve person centred care. I’d therefore like to include some feedback of two CMG managers who attended:
“’Slow down and repeat’ is a phrase we’ll often remind ourselves of when planning sensory-based sessions at Deer Lodge; a day centre which runs activities for service users with PMLD in Brighton. We all know this is good practice when working within the field of PMLD, but perhaps we didn’t truly understand the reasons behind why we do this. Joanna’s sessions offered a fascinating insight into the unique ways in which people with PMLD understand, interpret and learn about the world around them. She offered a powerful message: we must use our privileged position as carers/teachers/parents/friends to facilitate the development and mental well-being of people with PMLD and appreciate how the world can be experienced primarily through the senses alone.”
“This sensory training was inspiring, interactive and informative. It has made us look at our tenants’ needs, presentation and personalities from a different perspective. For example we learnt that it may take up to 30 minutes for someone to engage in a sensory experience. Previously we may only have given them the chance to engage for 5 minutes before the experience was changed. We have gathered a vast range of simple yet very effective ways of creating sensory and communication experiences for all of the senses.
I’d also like to take this opportunity to remind everyone about the forthcoming Supportive Therapies Day on Thursday 20th July, an excellent annual event for all CMG’s PMLD service users. The event is run by Katie Reid, CMG’s Healthcare Facilitator and Erren Wheatland, CMG’s Clinical Trainer, and offers a brilliant range of activities for individuals to take part in including; sensory stories, massage, pet therapy, hydrotherapy, art classes, music therapy and drama sessions. The day also ends with a sensory disco and CMG’s infamous ‘Pimp my Chair’ competition!
I have decided to focus this week’s blog on the issue of abuse of vulnerable people in care homes. I was shocked and horrified when I watched Channel 4’s Dispatches programme on Monday evening which showed appalling scenes of physical and emotional abuse of vulnerable, older people in a BUPA care home. Whilst I appreciate there are differences between services for older people and services for people with learning disabilities, both groups are extremely vulnerable and can be treated badly by staff that support them. If you haven’t already watched the documentary, I would strongly urge you to watch it and for staff teams in CMG to discuss what they have seen in their next staff meeting.
We take abuse incredibly seriously in CMG; we train our staff in what abuse means and how to look out for warning signs and we monitor every case of alleged abuse at our safeguarding board every month. As our staff will know, every month we identify lessons to be learnt and these are cascaded throughout the organisation.
Abuse is insidious. Poor practices can creep into even the best services and because subtle changes may happen over time, people may not notice. When I was 19, I spent a summer working as a nursing assistant on an older people’s ward in a psychiatric hospital. Because I didn’t know any better, I didn’t realise how poor the practices were. Elderly people were sat all day in a chair with a fixed table on top which effectively locked them into their seat. Apart from being fed and taken to the toilet, they received no stimulation whatsoever. Staff would sit around a central table smoking, drinking coffee and chatting when they weren’t doing direct personal care tasks. One of the many problems with an abusive culture is that new staff just assume it’s the norm.
I would urge everybody to be vigilant and to trust their instincts and if it doesn’t seem right then you should report it. Fundamentally, we need to treat people we support with dignity and respect. Staff should not treat people in a disrespectful way and we shouldn’t let people sit in soiled pads or dirty clothing. I think one of the biggest issues in services for people with learning disabilities is the ‘challenging behaviour’ which is often treated as ‘naughty’ behaviour and a punitive approach applied like that given to a naughty child. I think people who present challenges are at the highest risk of abuse by staff and we should always be vigilant to make sure any punishment based approach is challenged and stopped.
I was very proud yesterday to be at the launch of CMG and Alderwood’s STOMP Best Practice Guide which took place at Church House, Westminster.
STOMP (Stopping the over-medication of people with learning disabilities and autism) is a national NHS England campaign which was launched last year due to the high numbers of people with learning disabilities, autism and challenging behaviours being over prescribed anti-psychotic medication as a form of ‘chemical restraint’ for their behaviours and the devastating consequences this can have.
This influential event which was organised by CMG and hosted by Norman Lamb MP was attended by over 120 clinical experts and industry professionals. Norman spoke about the fact that over medication of people with learning disabilities was a breach of their human rights. Speeches were given by NHS England representatives Anne Webster, Clinical Lead for the Learning Disability Programme; Dr David Branford, Pharmacists Adviser to the NHS England STOMP programme; and Carl Shaw, Learning Disability Adviser. Together, they highlighted the importance of co-production and involving experts by experience.
Relatives of Alderwood’s* service users, who featured in the ground-breaking Channel 4 Dispatches documentary ‘Under Lock and Key’, gave emotional accounts of the devastating impact that over-medication had had on their loved ones who had been locked up in Assessment and Treatment Units (ATU’s) after being sectioned under the MHA. They also spoke of the amazing autism specific, person centred, low arousal care they are now receiving at Alderwood and how this has changed their lives completely. As one relative said ‘the difference is like night and day’. Their loved ones are now enjoying life to the full and one individual had even got himself a voluntary job.
Other families, who still had children in ATU’s, spoke distressingly about the awful side effects that the over medication and sedation was continuing to have on their loved ones and the complete lack of Autism specific care that was available for these vulnerable children and adults.
Stuart Polman, who is a Registered Manager at one of CMG’s 120 services, also gave a presentation, providing a first-hand account of how the service and the change in non-drug methods has transformed a service user’s life.
CMG’s service user drama group, The Brelade Players, also gave a highly entertaining dance performance of their interpretation of STOMP.
CMG’s STOMP Best Practice Guide examines the success of non-drug methods of treatment and the need for autism specific care, as a way of managing challenging behaviour, rather than the reliance on the use of psychotropic medication. The Guide is based on real examples of people it has supported in CMG and Alderwood*.
*Alderwood is a subsidiary of CMG
You can see a copy of CMG’s Best Practice Guide here.
Here are just some of the quotes from family members that were presented at the conference.
“My son could hardly stand. The nurse in charge told me that if she gave him the next dose of medication, he would be in danger of going into respiratory distress.”
“My son is currently in an ATU, but I have him home every weekend. In hospital, they administer PRN and use restraint. Although I have no support and am a single parent, I have never had to do these things.”
“Seeing my little boy, only just 13 years old and mentally age five, slumped in a chair, falling in and out of sleep while I wiped the drool from his chin… I will forever have nightmares over seeing such distress.”
“For the last 8 years, E has been injected with Clopixol, a rarely used, controversial antipsychotic medication, as well as other anti-psychotics. And yet, he is not mentally ill. He has autism and learning difficulties.”
“S was put on Risperidone. His weight more than doubled (13 stone to 29 stone in six years). His liver was failing. There was no difference in the severity of his meltdowns pre -, during and post- medication.”
I am really pleased this week to announce the launch of our innovative Sports Ambassador programme. You may already know that CMG invests heavily in promoting healthy lifestyles and has launched a number of key initiatives in previous years around this. Not only that but our Clinical Director, Michael Fullerton, organises an annual Athletics Championship which is a hugely successful event whereby service users and staff can take part in a whole host of sporting activities from sensory wheelchair races to basketball and javelin! In previous years we have also had Olympic or Paralympic athletes hand out medals to winners at this event. Michael also organises annual football matches including the infamous ‘CMG England v Wales’ match!
The Sports Ambassador programme will see service user Ambassadors being employed by CMG to promote greater involvement in sports and leisure activities in CMG services. Their aim will be to enhance the physical and mental health of staff and service users and educate them on how to achieve this. They will also be responsible for organising sporting events and interviewing service users and staff on how they are progressing, using a motivational inventory tool. They will then report their findings to CMG’s management team to ensure continuous improvements.
So far we have employed two Ambassadors: Tomas Cardilo-Zallo (The Green, Sutton) and Stephen Adamson (Warminster Road, South Norwood). Both Tom and Stephen successfully completed the FA coaching training with Tottenham Hotspur Foundation last year, play regularly for the CMG football team and are excellent role models for sports and fitness. We hope that their input, inspiration and passion will encourage others in CMG to be more physically active.
Depending on its success, we plan for the Ambassador programme to be rolled out to other regions in the future. This is a great initiative and I’m really looking forward to hearing how it progresses. We all know that living a healthier and more active lifestyle can add so many positive benefits to both our physical and mental health and wellbeing.
If you would like further information on this programme, please contact Michael.email@example.com.
Positive Behaviour Support (PBS) strategies change lives and wins national award!
I want to begin my blog this week by congratulating Lynsey Way, CMG’s Positive Behaviour Support (PBS) Strategy Lead and Team Manager, who won the ‘Commended Award’ in the ‘Outstanding Practice in PBS’ category at the national BILD Leadership Awards this month. These awards recognise good practice in PBS nationally.
CMG’s journey with PBS started 4 years ago with the development of a PBS strategy which outlined key objectives around raising awareness of the complex needs of people with challenging behaviours in CMG. Other objectives included governance of restrictive practices and developing more intensive and targeted training for staff.
Since that time, we now have a PBS Team which consists of 5 full time posts under Lynsey’s leadership, who not only manage referrals in CMG and co-ordinate staff training, but also develop industry leading projects, just some of which include:
PASS+PORT, an exciting training pathway, which is currently undergoing BILD accreditation
Organising an innovative PBS Festival (a first for our industry) on 14th September in Surrey. I believe the tickets for this event sold out within a week, but if you would like more information, please contact firstname.lastname@example.org.
Actively engage in many local PBS networks as well as in national projects with The PBS Academy and Skills for Care.
Developing a quality audit for PBS to enable services to evidence how well they are doing at delivering and implementing plans.
There is so much more that I could say about the work that our PBS Team are doing, but perhaps the benefits of what they can achieve are best outlined in the lives that they change. Here are just a few short case studies:
J – through focused understanding of her mental health needs, creating a versatile support plan and reducing demands at certain times, J’s staff team have reduced challenging behaviours by over 90%, J is a lot happier and has reduced the need for PRN medications completely.
P- through a change of environment to a quieter residential service which could operate at his pace, and some significant decreases in medication, P is no longer considered a person with challenging behaviour, he has some amazing outcomes thanks to the staff team and is loving life!
D- was finding it hard to transition to a new placement with us. Through increasing structure and visual information, and building rapport with staff at a pace he could manage, his transition is now back on track and progressing well.
Our PBS team live and breathe PBS in such a positive and engaging way. They also do a fantastic job in continually keeping energised the whole purpose of positive support approaches that increase quality of life. The aims of which are that everyone we support: has plenty to do that interests them; are learning new skills; have friendships and relationships; have positive healthy lifestyles and can communicate effectively.
Where there is a good quality of life, there is less likely to be challenging behaviours.
There are so many instances when I visit services every week where I see fantastic examples of staff ‘going the extra mile’. So this week I want to concentrate my blog on all those staff who work so very hard, often doing extra shifts and overtime, to ensure the people we support are receiving good care.
This is particularly relevant given the huge recruitment challenges the social care sector currently faces. With increasing Local Authority budget cuts and austerity measures we have been unable to achieve any significant fee increases for some years and this is a challenge faced across the sector. You will no doubt have seen much exposure to this in the news recently with startling headlines such as: ‘social care system beginning to collapse as 900 carers quit every day.’ What is not said however is that approximately 1,000 people join the sector every day and of the 900 people that leave, most go to work for other providers rather than leave the sector. The problem is not only about underfunding but ‘churn’ rather than turnover.
Whilst I wholeheartedly agree that the government needs to invest more money and resources into the sector, what is often overlooked, are the many benefits of working in social care. It is an industry that you can join with absolutely no experience or qualifications and yet can be an outstanding support worker. These people have the right values and the right attitude towards working with people who need care and support and they never fail to impress me. They are the people who shine and are often willing to ‘go the extra mile’ for the people they support, especially when we are short staffed, which has unfortunately been the case all too often recently.
CMG has invested many resources into giving these staff every opportunity to develop their careers. Our Learning and Development and Clinical Teams (who I firmly believe are some of the best in the industry) regularly deliver training sessions to enhance skills. We also invest financially in supporting staff to undertake qualifications in social care. As a result we have countless examples of employees in CMG who have progressed very successfully from Support Workers to Leads, Deputies, Team Leaders, Managers and Regional Directors. There are few industries where this can be the case for people who initially join with no experience or qualifications (or indeed can be any age). Nor are there many industries where the reward of helping a vulnerable person improve their quality of life, is so great.
So my thanks go to all those staff who provide such excellent support in CMG on a day to day basis and especially those who are working particularly hard at the moment to cover shifts. I would urge all managers to make full use of our Employee of the Month scheme, Team of the Quarter scheme and Annual Staff Awards to ensure these individuals are individually recognised.
I know I have talked a lot recently in my blogs about our recent successes with CQC inspections, but this week I would like to acknowledge one of our managers, John Nicholson, who behind the scenes has been actively instrumental in some of these achievements. John’s story also demonstrates how someone can come into care with absolutely no experience and go on to achieve great things.
John joined CMG in June 2009 as a waking nights support worker with no experience in the care sector (he had a retail and hospitality background). The ‘rest is history’ as John would say. He fell in love with the job and loved making a difference to a person’s life instead of looking at bottom line profits and targets. Through hard work, support from his manager (Amanda Sharp, now one of CMG’s Regional Directors), CMG training and completion of his Health and Social Care Diploma, John became manager at Kings Road.
Whilst at Kings Road, John was involved in the roll out of the new regulatory inspection process from CQC. With a fantastic team behind him and a brilliant Deputy Manager (Sophie Hare, who is now the manager), Kings Road became CMG’s second service to receive a CQC ‘outstanding’ rating.
John then went on to manage a larger service, Chetwynd Road. Through identifying strengths within the team he made positive strides in driving the service forward. Chetwynd also had another excellent Deputy Manager in place (Lorraine Nash, now manager). Chetwynd has since gone on to receive CMG’s fourth ‘outstanding’ CQC rating.
Due to John’s continuing operational successes and his desire to seek new challenges and progress his career still further, we promoted him to Floating Manager in October last year, with a view to him providing management support to services which required additional help.
John has since done an excellent job of making improvements at our Cherry Tree service in Essex, which had previously been rated ‘requires improvement’ by CQC. Not only did John and his team dramatically reduce agency usage but they also made a real difference in the result of our recent CQC inspection. Cherry Tree is now rated ‘good’ in all 5 areas. My thanks to John, his staff team and Natalie, the manager at 57 Bury Road, for their contributions. I know John would also like me to thank his very understanding wife (also a lead support at Kings Road), whom he had to work 120 miles away from during this period.
There are always people in CMG who work extraordinarily hard behind the scenes, but I felt that John deserved special recognition. It just goes to show that anything is possible with the right skills, support and dedication. My thanks again to John and everyone else involved in the achievements made.
John can be seen in the photo below at the 2015 staff awards (in the purple tie)