helping marjorie case study health and social care

Helping Marjorie Activity

Read the detail below and answer the questions..

Marjorie is more than eighty years old. She lives in a two-bedroomed terraced house, built just before the First World War. She has always enjoyed good health. In fact, she has never been in hospital and rarely visits her GP. She lived for many years with her partner, Jean, who died 10 years ago. Marjorie has always been very independent and continued to be so after Jean died. Neighbours say she is proud and won’t accept help.

However, Marjorie is now very frail and has had several falls in the house, and this has made her very anxious about going out. She can’t do much in the kitchen and scalded herself recently when making a cup of tea. Marjorie has been reluctant to get help from social services, but has accepted a home care worker, Mandy, who visits twice a day. Marjorie has cooked meals delivered to ensure she has sufficient nutritious food.

People speak very highly of Mandy, but Marjorie thinks she is unreliable and is convinced she reads her letters and other private correspondence. It seems that before very long Marjorie will need residential care. She has no children and nobody to help her make decisions about her future.

Answer these questions thinking how to support Marjorie in a person-centred way

1. Identify six hazards for Marjorie in her house when she is at home on her own

2. Complete a risk assessment for the six hazards and calculate the level of risk (use the template provided in Microsoft Teams).

3. What control measures could be put into place to minimise these risks?

4. If Marjorie is really concerned about Mandy’s professional standards, who should Marjorie contact?

5. If Marjorie is to move to long-term residential care, which professional would take a key role in arranging this?

6. What approach should be taken to ensure that when planning this move, Marjorie maintains her dignity and right to choice, that she feels empowered, safe and retains her independence?

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Table of Contents

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Notes to Self

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Essentials of Mental Health Nursing

Student resources, answer 36.3.

Case study 36.3

Possible answer to: How could the care home staff justify the extra time it took to implement this care plan with Marjorie?

Will it actually take more time to help Marjorie dress herself than for staff to fight to dress her? Maybe it will take a few minutes more, but that will be compensated for by the staff feeling less stressed. Also, if Marjorie starts the day well, she may well be more settled and content for the rest of the day. Person-centred care is often about working ‘smarter not harder’, with a bit of short-term extra effort leading to less work for staff in the long term.

helping marjorie case study health and social care

Social Work Practice with Carers

Case Study 3: Susan

Download the whole case study as a PDF file

Susan is the carer for her partner Grace who is 82. Grace has become increasingly frail and, following hospital admission and rehabilitation, has agreed to a trial three months in a care home.

This case study examines the impact of going into a care home on the caring relationship, and the need to support transitions and respond to family conflict, including through mediation. It also considers issues of identity and sexuality .

When you have looked at the materials for the case study and considered these topics, you can use the critical reflection tool and the action planning tool to consider your own practice.

• One-page profile

Support plan

Transcript (.pdf, 60KB)

Name : Susan Reinfeld

Gender : Female

Ethnicity : White British

Download resource as a PDF file

First language : English

Religion : Humanist

Susan is 70 years old. She is primary carer for her partner, Grace, who is 82. In their younger days Susan and Grace travelled widely, they had a large network of friends and although they don’t have any children of their own, they have nieces and nephews. Susan is particularly close to her nephew Graham. Grace has generally taken the lead in decisions and in the relationship. Sometimes now she gets angry with Susan if she doesn’t do things the way Grace expects or if Susan makes a suggestion which Grace sees as ‘stupid.’ Grace’s family have at times struggled with her sexuality and while her relationship with her nieces and nephews is good, her relationship with her brother Clive has been more difficult.

Over recent years Grace has become increasingly frail and has relied on Susan to wash and dress her, support her to use the toilet, as well as maintain the home and cook meals. Two months ago, Grace had a fall and was admitted to hospital. She was discharged to a rehabilitation bed in a care home. Before the hospital admission Susan and Grace were not in contact with services. Whilst in hospital and the care home, Susan has visited every day and helped Grace with personal care. Grace frequently phones and texts Susan. After six weeks of rehabilitation, Grace continues to need support to walk and with all her personal care, including support at night. You have been involved in a multi-disciplinary assessment which has recommended that Grace needs 24-hour care. As part of this assessment, Susan talked about how exhausted she is, and said that she no longer feels able to support Grace at home because of the impact on her health. Grace has agreed to a trial three months in a care home.

Susan and Grace are not legal partners, as they have not entered into a civil partnership nor are they married. Susan has no power of attorney for Grace. Susan is worried about the costs of a home and how this will be paid for. She feels guilty about ‘letting Grace down’ and sad about the future she will no longer have with Grace. Susan is also worried about Clive’s reaction.

Susan has asked to speak to someone about her concerns. You meet with Susan and do an assessment and support plan.

Susan Reinfeld

What others like and admire about me

It depends on their politics! I am a human rights activist, a peace campaigner and environmentalist. My friends admire the strength of my life-long commitment to socialist principles.

What is important to me

Socialist feminism

Cinematography

Being outdoors

Walks and good food

How best to support me

Don’t make assumptions about me.

Read the notes before meetings or discussions so that I don’t have to repeat information.

Give me information and advice on how to find and finance the best possible care for my partner.

We need open-minded communities. Be aware and sensitive to us as a lesbian couple.

Recognise that I am still a carer even though Grace is in a care home.

Help me to carry on caring for Grace and to manage the impact for Grace and her family of her being in a care home.

Support me to understand the implications for our home, finances and future decisions as we are not civil partners or married.

Address : 69, Willow Crescent, Allpark, ZZ3 Z33

Telephone : 07856 765432

Email : [email protected]

Date of birth : 01.06.45 Age 70

GP : Dr Habeeb, Allpark Surgery

Chronology completed by

Organisation :

Date chronology completed : 08.03.16

Date shared with person : 08.03.16

Susan’s Ecogram

Date completed : 8 March 2016

Carers Assessment

Name: Susan Reinfeld

Address: 69, Willow Crescent, Allpark, ZZ3 Z33

Telephone: 07856 765432

Email: [email protected]

Gender: Female

Date of birth: 01.06.45 Age 70

Ethnicity: White British

First language: English

Religion: Humanist

GP: Dr Habeeb, Allpark Surgery

How would you like us to contact you?

Mobile or email

Do you need any support with communication?

About the person/ people I care for

My relationship to this person: Partner

Name: Grace Wilson

Telephone: 07878 123456

Date of birth: 18.01.34 Age 82

Ethnicity White British

First language English

Religion Humanist

GP Dr Habeeb, Allpark Surgery

Please tell us about any existing support the person you care for already has in place. This could be home care, visits or support from a community, district or community psychiatric nurse, attending any community groups or day centres, attending any training or adult learning courses, or support from friends and neighbours.

GP, Dr Habeeb.

Phone calls from nephews and nieces.

Grace is currently in a residential care home for rehabilitation after being in hospital.

Social Worker who organised the step-down bed

Multi-disciplinary reablement team

The things I do as a carer to give support

Please use the space below to tell us about the things you do as a carer (including the emotional and practical support you provide such as personal care, preparing meals, supporting the person you care for to stay safe, motivating and re-assuring them, dealing with their medication and / or their finances).

Before Grace went into hospital, I used to support her throughout the day and night. Now I go to the care home after breakfast and stay until Grace goes to bed. Grace often rings me when I am not at the home including in the night.

This is what I generally do:

• I launder Grace’s clothes and bring them in – Grace is meticulous about her appearance – very stylish.
• I take Grace to the toilet during the day – she needs support to be able to use the toilet and it is important to her that I do this.
• I remind Grace about her medication and help her to take the correct ones at the right times.
• I help Grace to go down to meals in the home – I bring in some food for her which I cook from her favourite recipes
• Grace likes us to watch films or TV recordings together, especially documentaries. We usually manage at least one programme a day together. She likes me to keep her informed about what’s going on in our political networks. I bring in books and local information, international news items, and read to Grace. I try to find things that interest her to bring in every day.
• I help Grace to get undressed and showered in the evening – she likes to feel fresh at the end of the day.
• When I get home, I sort things out there and get things ready for visiting the next day.

When Grace was at home I also:

• Helped Grace to get washed and dressed in the morning.
• Did all the shopping, meal preparation and cooking – Grace is a good chef and explained how things need to be done.
• Arranged Skype calls with friends for Grace.
• Helped Grace to have a bath each evening – we don’t have a shower.
• Helped Grace to the toilet in the night, usually a few times.
• Fetched things for Grace in the night if she wasn’t able to sleep.
• Arranged any medical appointments and collected medication.

How my caring role impacts on my life

Please use the space below to tell us about the impact your caring role has on your life.

The last year or so has been very difficult. I have done my best to support Grace and this has gradually made me more and more tired. I have been feeling unwell due to the lack of sleep and am always exhausted.

I worry about letting Grace down but I cannot do all that she needs me to do at home. Even with help coming in, there would be so much time when it was just me. Grace has said that she will try a care home and I think this is best. However, I feel guilty every time I leave her.

Even while Grace has been in hospital, and now in the reablement home, I seem to be as busy as ever. Grace is anxious about being in the home so I visit every day. The food is definitely not up to Grace’s standards – so I try to prepare something fresh to take in for her every day. Grace phones or texts me when I am not there and sometimes during the night. It is very stressful being ‘on call’. She forgets that I may be asleep or driving to see her.

I used to like going to the cinema and I wanted to get involved in a “University of the Third Age” group which I saw is exploring the history of film. I would like to travel and carry on with campaigns. At the moment I am too tired to do more than visit Grace and I don’t want to let Grace down by not being there for her.

It feels like my future is very bleak. We were planning to do so much more but all that has faded away along with Grace’s health. I feel like I have already lost her in a way. I miss the relationship that we had. Grace gets frustrated and she can lash out with her tongue. She gets quite angry if I don’t get it right. I know she doesn’t mean it but it does hurt and I don’t know who to turn to. Some of the staff in the home seem quite uncomfortable around us and some have made comments that I find quite oppressive.

My sister passed away last year and I miss her. Grace’s brother, Clive, is hard work – he’s very domineering. I’m concerned about his response if the decision is made for Grace to go into a care home for good. He has always expected me to cope no matter what – his attitude is that I’ve ‘made my bed and must lie in it’. He expects me to continue caring for his sister as “that’s what I would have to do if I was Grace’s husband”.

What supports me as a carer?

Please use the space below to tell us about what helps you in your caring role.

I have a very supportive network of friends, we phone and email a lot. The trouble is we are so spread out, and I don’t really like talking about Grace behind her back, certainly not about the more private side of our relationship. I used to relax by walking, watching films, reading, studying or visiting new places.

My nephew, Graham – he only lives 20 miles away – he and I used to enjoy long walks together and we’re very close. He phones often and we make plans but I am so busy trying to sort everything out I hardly see him now.

The GP is very good and comes when we need her, but there is not much she can do either now, it’s the staff at the home who are looking after Grace at the moment. Some of the staff are very supportive.

My feelings and choices about caring

Please use the space below to tell us about how you are feeling and if you would like to change anything about your caring role and your life. I know I can no longer provide the level of care that Grace needs and it is right for her to be in a care home. However, I can’t help feeling that I have failed her. There were so many things that we shared and we had plans for the future. I’m beginning to recognise that some of the feelings I have are bereavement – the life we once shared is coming to an end.

By the time evening comes I feel emotionally drained. I feel like I can’t ever switch off from thinking about Grace. My life is on hold and I miss the things that I had hoped to be doing now, being more active in the world. I have had to give up a lot to support Grace and it is affecting my health. I want to support Grace as much as I can and ensure that she is happy. I do need to make sure I can keep going and that I can still be me.

I would like us to have time together that is not just about caring. I’m now providing personal care to my partner- our relationship has shifted – I’m not sure we feel like equal partners in life – not only from my perspective but I think Grace finds it difficult too. I’d love us to just be partners again, to have the intimacy we used to have with each other. I don’t want that side of our relationship to disappear.

Grace’s brother doesn’t agree with the decisions that are being made. He has always found our relationship hard to accept, and he likes to be in charge. He has very traditional values. I want him to understand and to support us.

Information, advice and support

Let us know what advice or information you feel would help you and what sort of support you think would be beneficial to you in your caring role.

I’d like someone to discuss my concerns with and talk things through, so I feel reassured I am making the right choices, for both of us. I must get it right.

I’d like to not have to repeat my story and keep having to explain our relationship. I’d like to be able to stay over with Grace and feel free to visit when I and she want.

Good communication between all the professionals. An explanation of everyone’s roles, and one person to co-ordinate it all. I’d like to know who to contact and who there is to help me.

Grace needs looking after properly and professionally but I don’t know how I can pay for everything to keep our shared home going and sort out her care. Being clear about how the care home is going to be funded will help.

Confidence in the paid carers doing their job properly, that they know what equality actually means.

Grace to have access to the internet so that she can keep up with her interests when I am not there.

I need expert professional advice about looking after Grace’s affairs, our home – which belongs to her, and our finances.

Having someone to attend meetings with me, be my advocate.

I don’t know how to cope with her brother’s response. I’d like help with this, and support from the f amily with this.

To be used by social care assessors to consider and record measures which can be taken to assist the carer with their caring role to reduce the significant impact of any needs. This should include networks of support, community services and the persons own strengths. To be eligible the carer must have significant difficulty achieving 1 or more outcomes without support; it is the assessors’ professional judgement that unless this need is met there will be a significant impact on the carer’s wellbeing. Social care funding will only be made available to meet eligible outcomes that cannot be met in any other way, i.e. social care funding is only available to meet unmet eligible needs

Date assessment completed 08 March 2016

Social care assessor conclusion

Susan has been providing significant daily support to her partner, Grace aged 82, who has recently been hospitalised after a fall and had six weeks support in a reablement bed. At 70 years of age herself, Susan is struggling to cope with the physical and emotional demands of caring for her partner. Susan describes feeling exhausted and says that her health is deteriorating. Before the hospital admission Susan and Grace weren’t in contact with services. Following a six week reablement period, and during subsequent assessments, Susan and Grace have reluctantly come to the joint decision that a care home for Grace is needed due to the level of needs. Susan is determined to still be able to provide a high level of care for Grace, bringing her food and supporting her personal care, and activities during the day. Susan wants to maintain daily contact and be able to stop overnight with Grace. The impact of this decision and the pressures on Susan of trying to find a suitable residential home for Grace, sorting Grace’s affairs and their legal position, are considerable. Susan is also concerned about Grace’s brother’s response to her going into a care home. The situation is having a significant effect on Susan’s emotional wellbeing and she needs support in order to continue as a carer and maintain her relationship with Grace, and to engage in her own activities and maintain her home.

Eligibility decision Eligible for support

What’s happening next Create support plan

Completed by

Organisation

Signing this form (for carer)

Please ensure you read the statement below in bold, then sign and date the form.

I understand that completing this form will lead to a computer record being made which will be treated confidentially. The council will hold this information for the purpose of providing information, advice and support to meet my needs. To be able to do this the information may be shared with relevant NHS Agencies and providers of carers’ services. This will also help reduce the number of times I am asked for the same information.

If I have given details about someone else, I will make sure that they know about this.

I understand that the information I provide on this form will only be shared as allowed by the Data Protection Act.

My relationship to this person Partner

Name Grace Wilson

Address 69, Willow Crescent, Allpark, ZZ3 Z33

Telephone 07878 123456

Gender Female

Date of birth 18.01.34 Age 82

Support plan completed by

Date of support plan: 08 March 2016

This plan will be reviewed on: 08 May 2016

Signing this form

Susan has asked for this support plan to be considered as part of Grace’s care and support plan but for it not to be shared with Grace.

Transition into a care home

Evidence shows that hospital social work is reported as highly valued but with carers feeling that empowering and person-centred practice was sometimes undermined by the discharge and care management processes (McLaughlin 2016). Issues of information for carers, their expectations of a social worker who has to move on to the next patient and the difficulties of reconciling the role of carers and the rights of service users – which can be at odds at the point of discharge (Fowler 2009) – are raised. Guidance for health and social care professionals on the transition from hospital settings to the community or care homes (NICE 2015) stressed the importance of shared information (with carers if the patient consents), communication and multi-disciplinary care planning.

• NICE guidance on Transition between inpatient hospital settings and community or care home settings for adults with social care needs https://www.nice.org.uk/guidance/ng27
• NICE quality standards on Mental wellbeing of older people in care homes
• NIHR (2012) Understanding and improving transitions of older people: a user and carer centred approach
• SCIE Quality in social care: achieving excellence in care homes for older people

Integrated work

Research highlights three characteristics of social workers in hospital discharge settings – first that they managed unanticipated events, second they made good use of a broad and interconnected perspective of the health and care system plus third, relationship building between patient, caregiver and health and care providers was an effective component of that social work (Fabbre et al 2011).

• The College of Social Work and the Royal College of GPs (2014) GPs and Social Workers: Partners for Better Care Delivering health and social care integration together
• Research in Practice for Adults Frontline: Supporting successful integration – improving outcomes in social care and health https://www.ripfa.org.uk/resources/publications/frontline-resources/supporting-successful-integration–improving-outcomes-in-social-care-and-health-frontline-briefing-2015
• SCIE (2012) SCIE Research briefing 41: Factors that promote and hinder joint and integrated working between health and social care services
• Kings Fund (2014) Making our health and care systems fit for an ageing population http://www.kingsfund.org.uk/publications/making-our-health-and-care-systems-fit-ageing-population
• CarersUK (2016) Pressure Points: carers and the NHS

Transitions for carers

Research points to contributions of social workers to care transitions, specifically, informational continuity; patient-health care professional relational continuity; conflict resolution; mediation among family, patient, and health care professional (for example, doctors and nurses); collaboration with family caregivers and community supports; and relocation counselling.

• Carers Trust (2014) Improving health outcomes – older carers voices and stories
• Carers UK (2015) Need to know: transitions in and out of caring: the information challenge
• Carers UK (2012) In sickness and in health http://www.carersuk.org/for-professionals/policy/policy-library/in-sickness-and-in-health
• SCIE, The participation of adult service users , including older people and carers, in developing social care

Tool 1: Carer life transitions

Family complexity and conflict

Research shows that in situations of multiple and complex needs the distinction between client and carer blurred and could change circumstantially. The question of separate social workers for people in such relationships (Swetenham et al 2015) or the introduction of a carers advocate (SCIE, Care Act 2014) have received consideration. Family group conferencing, along with mediation as whole family approaches, were found to have particular applicability to adult safeguarding social work. (SCIE 2012).

• RiPfA Key Issue: Balancing need: the relationship between carers’ assessment and needs assessment
• SCIE (2012) Safeguarding adults: Mediation and family group conferences
• SCIE (2012) Safeguarding adults: mediation and family group conferences: Information for people who use services
• Skills for Care and Carers Trust (2014) Assessing carer’s needs: a short guide to taking account of everyone in the family who cares
• Carers UK (2014) Caring and family finances inquiry
• Tool 2: Mediation stages

Identity and sexuality

The significant potential of social work to ensure sustainable and effective support over the longer term, in forming relationships and undertaking comprehensive and sensitive assessments in partnership with (older) people and their carers has been documented. (Milne et al 2014 in making the case for gerontological social work).

• SCIE, Personalisation briefing: Working with lesbian, gay, bisexual and transgender people
• National LGB&T Partnership (2015) The Adult Social Care Outcomes Framework LGBT Companion Document
• Safe Aging No Discrimination (2015) Researching the hopes, fears, experiences, expectations  of health & social care by older – and old ‐ lesbian, gay,  bisexual and trans people in Shropshire
• Pugh S, McCartney W and Ryan J with the Older Lesbian, Gay Men, Bisexual and Transgendered People’s Network (2010) Moving forward: working with and for older lesbians, gay men, bisexuals and transgendered people: training and resource pack
• SCIE Working with lesbian, gay, bisexual and transgendered people: older people and residential care: Roger’s story
• Tool 3: Moving into a care home – checklist
• Tool 4: Moving into a care home – advice for lesbian, gay and bisexual people
• Tool 5: Top tips for including LGBT people – LGBT Health and Wellbeing (2014) Ten top tips for becoming more inclusive of lesbian, gay, bisexual and transgender people: a guide for services and organisations working with older people
• Tool 6: LGBT Checklist for social care providers – Age UK Camden and Opening Doors London (2011) Supporting older lesbian, gay, bisexual and transgender people: a checklist for social care providers

Download tool as a PDF file

You can use this tool to consider a transition point in someone’s life.

This tool is based on Transitions’ extract from Lynne Wealleans (2013) A Life Course Approach to Promoting Positive Ageing. Beth Johnson Foundation

The life course model outlined in this report comprises five core elements; place, transitions, catalyst for change, personal resilience and control and enhancing future life choices.

Back to Summary

Tool 2: Mediation Stages

This tool sets out the stages of a mediation process. You can use it to plan and deliver a mediation session.

Establish the arena

Set the agenda, prioritise and plan

Discuss the issues and explore options

Develop solutions and secure agreement

Mediation – The stages

Stage 1: establishing the arena.

The mediator manages introductions, clarifies the process, establishes ground rules and confirms their role. They will make sure that all participants have signed the Agreement to Mediate, which sets out the terms and conditions of mediation.

Stage 2: Defining and clarifying the issues

The mediator will ask each participant to explain why they have come to mediation, their concerns and what they hope to gain from mediation. The mediator will summarise this information after each participant has presented their view, to ensure that they have understood the issues correctly and to acknowledge the concerns and feelings of each participant.

Stage 3: Agenda setting, prioritising and planning

The mediator will ask each participant to help set an agenda for mediation. The issues will be drawn from each participant’s presentation in stage 1. The mediator will:

• ensure that the participants lead the development of the agenda
• include issues that are significant to the participants
• help the participants to link issues, which can make resolution easier in stages 4 and 5
• ensure that all issues that can be included are included.

The mediator will help the participants to prioritise the issues and agree an order in which to discuss them. It may be necessary for participants to be given the chance to resolve some issues before others can be discussed.

Stages 4 and 5: Discussing the issues and exploring options

The mediator will encourage participants to discuss each issue in the order set out in the agenda. They will listen carefully for agreement on certain issues and find ways to bring participants closer on issues they do not agree on. The mediator will also encourage participants to focus on interests – what each party needs – rather than positions – what each party wants. By establishing interests that are the same or similar, the mediator will encourage participants to be creative and explore options that meet everyone’s needs and interests.

Stages 6 and 7: Solutions and securing agreement

The mediator will encourage participants to build on the options discussed in stages 4 and 5 to develop solutions that meet everyone’s needs. Two important processes happen at this stage:

• Participants are empowered to find their own solutions that work.
• Participants work in partnership – collaborating to find solutions that are beneficial to everyone.
• The mediator plays an important role here: to help the participants test the achievability of the solutions they have developed.
• In appropriate cases, they will help the participants to focus on how their proposed agreement meets the needs of anyone – including those not present – affected by its outcome.

This information is based largely on: SCIE Mediation Stages

Download the tool as a PDF file

Care home checklist

Use our checklist to help you find out as much as you can about a care home and make an informed choice.

Where is the home?

Will visitors be able to get there easily?

Are there transport links near by?

Are facilities such as shops, pubs, parks and places of worship within easy reach?

How accessible is the home?

Will it be easy for you to enter and leave the building, and move between rooms and floors?

How good is the wheelchair access?

Is there a lift?

Does the home feel clean and inviting?

Are there any unpleasant smells?

Do the rooms feel hot and stuffy or cold and draughty?

Is there a relaxed and friendly atmosphere?

Will you feel comfortable chatting and socialising in the home’s public areas?

Are chairs arranged in groups or round the edges of the rooms?

Is there a quiet living room for reading, as well as one with a television?

Are the rooms a good size?

Will you have a room to yourself?

Is there any choice of rooms to accommodate preferences such as sun, shade or quiet?

Do the rooms have en suite facilities or basins?

Will you be able to bring your own possessions such as pictures, plants and furniture?

Does the home allow pets?

Will you be able to settle into the home?

Would you prefer a larger or smaller home?

Based on AgeUK’s care home checklist

Download the tool as a PDF

Moving into a care home – advice for lesbian, gay and bisexual people The Alzheimers’ Society

Making the decision to move into a care home is never easy, for the person with dementia, their partner or relatives – whatever the person’s sexual orientation. However, in spite of recent improvements in law to protect their rights, lesbian, gay and bisexual people can still find moving into a care home particularly difficult due to fears of homophobia or of not having their specific needs met. This factsheet provides some advice on choosing a suitable care home and suggests things to think about when the person moves in.

Ten Top TiPS for becoming more inclusive of lesbian, gay, bisexual and transgender people A guide for services and organisations working with older people LGBT Age

What does it mean to be inclusive of lesbian, gay, bisexual and transgender (LGBT) people? How can you make sure that LGBT people feel actively welcomed? Why is it important to go beyond ‘treating everyone the same’? How can your organisation provide the best service possible to older LGBT people?

Supporting older Lesbian, Gay, Bisexual and Transgender people A checklist for Social Care providers Age UK Camden, Opening Doors London

This checklist 4 aims to assist organisations to become LGBT friendly (i.e. to ‘come out’ to older LGBT clients as “gay friendly”) so that the organisations more readily meet their requirements under the Equalities Act and the older person feels able to “come out” to the organisation and be fully themselves.

• Equal opportunities
• Complaints procedure
• Terms and conditions
• Privacy policy
• Cookie policy
• Accessibility

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Case study ďavid health and social care

Birch View is a residential care home in Wales. It caters for older people, lots of whom have dementia. Many of the individuals living in Birch View speak Welsh and the home tries to employ care and support workers who speak both Welsh and English. Birch View aims to treat all individuals living in the home with dignity and respect and provide services that help them achieve their personal outcomes and what matters to them, for example knowing what time they like to get up and go to bed, when they like to eat their meals and the type of food that they enjoy, what their hobbies and interests are and how they would like to stay in touch with family and friends. The home is welcoming and has lots of different activities such as: • An art club • Singing for pleasure • Film and book clubs • A gardening group • Keep fit sessions e.g. chair-based exercises The home has an activities co-ordinator who organises the clubs and groups, she is always keen to hear from the individuals living at Birch View about their interests or what they would like to try. The activities co-ordinator has resources for the clubs and groups including computer tablets that can be used to watch films for the film club. Birch View involves the local community in the home including: • Visits from school children • Weekly hairdresser • Monthly visiting Chapel Service • Visits from people with their pets • Visits to events in the local town David has recently moved into Birch View, he is 88 years old and speaks Welsh as his first language. David has been diagnosed with dementia. Until recently, David lived at home with his wife Gwen who is 85 years old. He was supported by Gwen, health and social care services and their son and daughter who both live locally, have families of their own and work full time. David has become more confused recently, he is becoming muddled between night and day and Gwen has found him wandering outside in the middle of the night. He is struggling to access the bathroom in the house, is having difficulties with continence and has had a number of falls; after the last fall he was admitted to hospital where he was treated for minor injuries. Before he was discharged from hospital, an assessment was completed with David, Gwen, their son and daughter by social services and health professionals. This included a mental capacity and best-interest assessment. It was agreed that it was in David’s best interest for him to move into a residential care home as it was no longer safe for him to stay at home. Gwen, their children and grandchildren visit him regularly. 48 David has been given a walking frame to use at Birch View but forgets to use it. Since moving into Birch View, he has become more unstable, he has fallen twice and struggles to get in and out of bed. The care and support workers have reported that he seems agitated and confused, is not sleeping well, is trying to get out of bed in the night and has little appetite. David’s family and the care and support workers are worried that he is not settling in and is struggling more with his mobility. Nicole is one of the care and support workers at Birch View, she has noticed that David tends to be more confused in the mornings but is clearer in the afternoons. This information has been recorded in his personal plan to support his communication. Nicole is working with David and his family to find out more about his interests and background. Gwen tells her that before he became unwell, he was very active, walking the dog daily and gardening. She says that he loved growing vegetables and had been a vegetarian for the past 30 years. He was a history teacher and used to belong to the local history club at the library, he loved reading and enjoyed watching old war films. He spent a lot of time with the grandchildren as they were growing up, spending time with them in the garden, planting seeds and growing plants in their own little plots on his vegetable patch. Nicole explains to Gwen that even though David’s personal plan says that he is a vegetarian, he has been choosing the meat option from the lunch time menu and then not eating it. The care and support workers are offering David vegetarian food options but he is refusing these. Nicole asks Gwen for some ideas of the type of food that David enjoyed when he was living at home as she is worried that he is not eating enough and this may be affecting him. Nicole arranges for David to meet the activities co-ordinator in the afternoon when he is less confused and more able to express what he wants. Having spoken to Gwen and David, she thinks that he may enjoy the gardening group and film club and wonders whether they could arrange for one of his favourite war films to be shown to get him interested. Describe one method used by Birch View to meet David’s communication needs. The decline in David’s mobility has the potential to impact upon his well-being. a. State two potential impacts of this on his physical well-being. State two potential impacts on his mental well-being Explain how the principles of the Mental Capacity Act have been applied in supporting David’s health and well-being.

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Securing adolescent health and well-being today is vital for the health of future generations - WHO

Increased investment is urgently needed to address evolving health risks and meet the mental and sexual and reproductive health needs for the nearly 1.3 billion adolescents (aged 10-19 years) globally, according to a new scientific publication released by the World Health Organization (WHO).  Adolescence is a unique and critical stage of human development, involving major physical, emotional, and social transitions, and is a pivotal window for laying long-term foundations for good health.

“Promoting and protecting the health and rights of young people is essential to building a better future for our world,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “Conversely, failing to address the health threats that adolescents face – some longstanding, some emerging – will not only have serious and life-threatening consequences for young people themselves, but will create spiraling economic costs for societies. That makes investing in services and programmes for adolescent health both a moral imperative and an economic no-brainer.”

The publication was launched at an event on the margins of the United Nations’ Summit of the Future . It highlights a number of troubling trends in adolescent health observed over the last decade, pointing to the urgent need for action.

At least 1 in 7 adolescents globally now suffer from a mental disorder, for instance, with particularly high rates of depression and anxiety.  Anaemia among adolescent girls remains prevalent, at levels similar to those in 2010, while close to 1 in 10 adolescents are obese.  Sexually transmitted infections (STIs) including syphilis, chlamydia, trichomoniasis, and genital herpes that commonly occur among youth are rising, and if left untreated, can have lifelong implications for health.  

Meanwhile violence, including bullying, affects millions of young people worldwide each year, with devastating impacts on their physical and mental health.

Concerningly, attempts to roll-back adolescents’ access to sexual and reproductive health care and comprehensive sexuality education have escalated amidst a growing backlash against gender equality and human rights. Restrictive age of consent policies are limiting their access to STI and HIV services. Such measures can marginalize young people, reduce health-seeking behaviour, and lead to lasting negative health impacts.

The study emphasizes other broader fundamental challenges to the future of adolescents including climate change, conflict, and inequality.

The authors also highlight that gains are possible with the right investment and support.  For example, adolescent HIV infections have declined, due to coordinated and persistent efforts in this area. Adolescent pregnancy and harmful practices such as female genital mutilation and early marriage have reduced. In addition, many positive trends in health outcomes are linked to more time in school, especially for girls; since 2000, the number of secondary-school-age children out of school decreased by nearly 30%.

Against this backdrop, the findings make a strong case for investing in adolescent health and well-being, with attention to foundational elements including education, healthcare, and nutrition.  The authors call for enacting and implementing laws and policies that protect adolescent health and rights, for health systems and services to be more responsive to adolescents’ unique needs, and for the prioritization of youth engagement and empowerment across research, programming, and policymaking.

“Adolescents are powerful and incredibly creative forces for good when they are able to shape the agenda for their well-being and their future,” said Rajat Khosla, Executive Director of the Partnership for Maternal, Newborn and Child Health (PMNCH), which co-hosted the event where the publication as launched. “Leaders must listen to what young people want and ensure they are active partners and decision-makers. They are critical for the world’s future social, economic, and political stability, and if given the platform they need, they can help make a better and healthier world possible for everyone.”

Earlier this year, world leaders committed to accelerate efforts to improve maternal and child health , including adolescent health, at the World Health Assembly.  Implementing these commitments, as well as those reflected in the UN’s Pact for the Future, will be critical to protecting and promoting the health and well-being of current and future generations.

Notes for editors 

The publication was released at a high-level event convened on the margins of the UN General Assembly. It was hosted by the Governments of Chile, Colombia, and Ireland along with the UN’s Human Reproduction Programme, PMNCH and WHO in collaboration with: FP2030, Guttmacher, International Association for Adolescent Health (IAAH), Johns Hopkins Bloomberg School of Public Health (JHUSPH), Plan International, UNESCO, UNFPA, Women Deliver, and YieldHub.  

The Summit of the Future takes place on September 22 and 23, 2024, seeking new consensus around how the international system can evolve to better meet the needs of current and future generations. 

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Nhs seeks 30 suppliers for £3bn it framework.

The second iteration of the health service’s Digital Workplace Solutions procurement vehicle will allow NHS organisations to buy a range of computing infrastructure, as well as bespoke and off-the-shelf software

The NHS is seeking to appoint up to 30 suppliers to a multibillion-pound IT framework through which health-service bodies will be able to buy a wide range of hardware and software.

The publication of a contract notice by NHS Shared Business Services (NHS SBS) – a joint venture between the health service and supplier Sopra Steria – marks the opening of bidding on the Digital Workplace Solutions 2 deal. The buying vehicle will feature a single lot and is hoped to come into effect in May 2025.

This is three months before the existing Digital Workplace Solutions engagement expires after reaching the end of a five-year term that began in August 2020.

Its replacement comes with an estimated potential value of £3bn, once VAT is included – marking a fivefold increase on the £600m indicative price tag that was attached to the incumbent arrangement.

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Both frameworks are intended to connect NHS bodies – and any other public-sector buyers that wish to use the agreement – with suppliers of core computing hardware infrastructure, as well as both tailored and generic software tools.

The contract notice advises potential bidders that the deal “is proposed to include, without being limited to… commercial off the shelf software licensing, bespoke software development, infrastructure equipment supply, infrastructure support and maintenance, [and] infrastructure management services – [including] equipment [and] software”.

“NHS SBS are seeking to appoint a range of value-add resellers and original equipment manufacturers capable of providing hardware, software and services to approved organisations,” the notice adds. “As part of demonstrating capability, bidders will be required to evidence the accreditations they hold with vendors to ensure the framework delivers maximum value for money. “We are committed to working with suppliers who are dedicated to sustainability and social value and there will be a significant weighting on these elements in the tender.”

Bids for a spot on the framework are open until midday on 7 November. Once submissions have been assessed, NHS SBS will award deals to up to 30 of the highest-scoring suppliers – or potentially more if scores are tied. Procurement records indicate that 32 companies were awarded a spot on the original Digital Workplace Solutions deal in 2020 – although the number of providers appears to have reduced to 27 since then.

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CASE STUDY: Marjorie Frustrated with Spending Way too Much Time in the Kitchen?

[dropcap style=”font-size: 60px; color: #00adef;”] A[/dropcap] few weeks ago I got a lovely email from one of my meal planning members …

We made the pork and fennel burgers last week and they were incredibly flavorful and tasty, perhaps a good one for your app — looking forward to your app! The first time I used your Soupstones Meal Plan it was because our kids had both gone off to university and I could not stop myself from buying the amount of food needed for two kids and various friends. Sticking to the meal plan helped me realize how much food to buy for just two again! This time around, it’s helping me to keep meals simple during the week. I love to cook, but I kept deciding to make meals during the week that took too much time. The meals on your plan are fresh, delicious and fast, and the shopping list keeps me on track. Thank you again! Marjorie

So I setup some time to talk to Marjorie in more detail about her experience with Soupstones Meal Plans .

Here’s what we spoke about…

_________________________

JULES: What hesitations did you have about signing up for Soupstones Meal Plans?

MARJORIE: What initially stopped me from doing it was actually money.

At first I hesitated about spending money on something that I could do myself . And I could do all this myself but I wasn’t.

I’m a really good at food. I’m good at cooking. I’m really interested in it, so I should be able to do it.

But with the meal plans it’s all here. You’ve done it all.

It’s so easy.

My husband and I work together, and if we’re coming home and it’s late you think ‘oh lets just pick something up’… It’s so easy to use the meal plans. It keeps us from eating out when sometimes we would.

Then you realize if it keeps you from going out even once then that’s like $12. If you can afford to go out to dinner then you can afford to do this. Because it’s going to save you at least that amount of money.

Then there were the monthly payments. And that makes you stop but I realized pretty quickly the value.

At first I really doubted that we would like it . Or that it would taste good because of the limited amount of ingredients.

I’m used to putting garlic and onion into everything so it felt funny not to do that. But I followed it. And I was surprised that everything tasted good.

I was thinking ‘alright this is just going to be bare bones healthy meal on the table’

BUT it was delicious!

The other thing I hesitated about was seasonality . We live in an agricultural area we have very specific local things available at certain times. So not being able to shop specifically towards sales when they came up. Like ’spinach is on sale’ or ‘kale is on sale’ or whatever.

Then I also have a garden. So having the seasonal meal plans has been really helpful. Very much so.

And I realized that I can really modify the meal plans easily for what is hyper locally available.

JULES: What did you find as a result of using the meal plans?

MARJORIE: I really noticed the time saving aspect . Big time.

I like cooking and the meal plan stops me from going ‘oh that sounds really good’ when it’s the middle of the week and I’m working and I’m trying to work on my side hustle stuff. So I don’t want to spend a lot of time cooking like I used to when the kids were here and I was in the kitchen anyhow when they were doing their homework.

Now I just want to get ‘in and out’.

The plan keeps me honest. It keeps me focused .

And I really trust you a lot. Something important that sets you aside from a lot of people is your background as a food scientist. That brings a lot to the table.

When you say in your storage options that you can keep something this long. And to trust smelling and tasting things yourself. That made me hang onto things longer and avoid getting rid of food before I needed .

I also found I was able to cook on my own very easily rather than following recipes. Because I used to be a big recipe follower. Now I’m able to open up the fridge on the fly and go ‘I’ve got this, and this and this’ and I’m going to trust that it will taste good.

So that was a big result that was different from how I cooked before. I can trust myself to do my own thing .

Every so often my husband cooks. I forward the meal plan to him so he can see what’s going to be happening for the week. Sometimes he will cook one of them.

Now he’s buying into it.

Initially, when I first did this he had a lot of hesitations about liking it . He was worried we were going to change completely how we eat. But it really didn’t change a lot how we eat.

It just changed the amount of time I put into the meals.

So it was great. He liked it.

JULES: Which specific feature do you like best?

MARJORIE: It’s hard to choose one thing. Saving time. That’s what motivated me to pay for it again is the time saving.

However, I wouldn’t have done it if it wasn’t really healthy to begin with.

So it was really really important to tick both boxes.

Then I got diagnosed with pre-diabetes even though I’m eating so well. And when you also got diagnosed I knew you were very conscious with your recipes for the meal plans for that. Very helpful. We had done the Whole 30 and this just fits right into it.

I love to have a lot of vegetables. So I usually supplement the meal plans with a side. I often do some extra roast veg or a salad. Just something thats really easy so it’s not an issue.

The shopping list gets me in and out of the grocery store really fast. Because I’m really slow, I don’t know what happens when I go into the grocery store. So I just shop from Jules Clancy’s list. And I go in and just get whats on the list. And that’s it.

So the shopping list is a huge deal for me and it for sure saves me money.

Then even though I do like thinking about food and planning, it’s nice during the week not to have to. It’s really nice to have it all planned out for me. So I don’t have to make that decision when I’m tired.

JULES: What makes Soupstones Meal Plans unique?

MARJORIE: The limited amount of ingredients for sure.

And what you’ve done with the variations.

So you’ve got your meal and then you go ‘more veg’, ‘more carb’, ‘no dairy’. You’ve got all these options. It’s all there. It’s just really, crazily well thought out. I can’t imagine how much time it’s taken you over the years to get to this point but it is organised.

The flexibility, making it easy to adjust. It’s very unique.

The fact that you’re a food scientist and you know what you’re talking about. That is also unique. Because people don’t usually come from that background and I think that’s a big deal.

JULES: Would you recommend the meal plans?

MARJORIE: I would and I have. Because you really learn how to cook healthily without sacrificing the taste and the satisfaction.

Because we feel good.

Sometimes I think is that going to be enough of a meal? And it is enough. Because we add the vegetables, I’ll often divide it into 3 so my husband and I will have dinner and then he has lunch the next day.

And I tell people you save time and money by shopping for just what you need.

I have friends and relatives who use Blue Apron and this is way faster than that. And Blue Apron is expensive. And the packaging all those ice packs and all the stuff you have to throw away. I feel bad about that so I think ‘just do Soupstones Meal Plans’ .

Seriously, it’s faster, it’s way cheaper and better for the environment.

Want to enjoy all the benefits of meal planning?

Then check out my new FREE 5-day training!

It’s my simple 3-step process for meal planning.

In short daily bites.

I’ll walk you through my 3 simple steps.

To allow meal planning to work for you.

Enter your email below to receive the free 5-day training:

Have fun in the kitchen!

With love, Jules x

Thank you and Chocolate and Zucchini.

Welcome Jeannine :)

I was doing the meal plans but quick because it wasn’t accomadating enough for vegans many recipes had vegan options but not all. But I’m not writing this comment to complain – the meal plans didn’t work for me personally but for regular folks I think they would be great. I have a suggestion. A vegan cookbook I know you give vegan options for most of your recipes and I love that. But for someone like me who hates to cook. That can be hard over time. If you put together a vegan cookbook I wouldn’t need new recipes just the veganized variations. Especially the quick ones (seethe aforementioned hate to cook). I’m not doing anything that takes more than 10 minutes. Although I will do some meal prep.

Thanks for sharing Andrea! And you’re right there aren’t vegan options for every recipe. :)

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