Heaven and Hell Exercise 2 way – hospitals to work better with homes – recognised standard paperwork Hospital discharge to be improved Vanguard Care Home Champions Heaven and Hell Exercise GPs to have more time with residents Partnership to be improved “Secret Millionaire” type for owners/ managers to go back to the floor Training opportunities – regardless of care home type Clear communication with outside professionals Paperwork to be streamlined Apprenticeship levy Good staffing levels Achieve outstanding (CQC) Happy home/happy residents Need registered nurse – care practitioner – can’t do insulin/bloods as not nursing home Paperwork backs up work/care delivery – trying to streamline and avoid duplication Leadership – workforce – providers/ managers Reward staff/ recognition Terms and conditions for staff Choice for residents I’m satisficed that I do a good job at the end of my shift Paperwork – bed rails, observations and checks – food and fluid Dementia training for families and health professionals Valued – praise for hard work from management Electronic care plans and more charts Clean environment – dedicated cleaners Not knowing if I need to call GP or UCT very time consuming/Chasing all the time – pulled from pillar to post Families not fully understanding dementia Work with external health professionals – value care staff and knowledge they have Health and Safety Good managers / good leadership Employee of the month scheme – care staff feel valued Respect and partnership/ staff know residents well – lack of understanding from external professionals Families understand and involved Training – external open to learn something new eg. bloods UCT ask to speak to residents rather than the staff - even those with dementia Minimal paperwork - tablet Regular resident meetings ensure activities/outings are what they want Lack of respect from professionals – don’t value (poor under-standing dementia related) Waiting times once resident has been referred to dietician Lack of Discharge info from hospitals Change in legislation Dehydration, pressure sores Some families very involved/conflict with family Perceptions – because the patient is in a care home – think they will be okay (ambulance) More regulation No person centred care Our staff provide good person centred care – good training package for staff Late night discharge – especially with dementia patients – QE don’t understand Cuts in fees from commissioners Procedures not followed Family moves resident Staffing levels – sickness – causes stress Lack of skills No LA involvement Lack of involvement Poor training- knowledge Good teams within care home - apprenticeships sometimes lack motivation - culture/ values Restructure to care homes – lack of funding Increase in hospital admissions CURRENT THE ROAD TO HELL HELL HOW WE GET TO HEAVEN HEAVEN KEY Lack of choice for individual Neglected safeguarding – closed down Malnutrition Death not being able to deal with it