Collaborative building of resources to support carers in the home (family carers, paid support workers and home care providers) Julie Haggie, HCHA

Provider peak body – paid support workers and providers Peak body for family carers – Carer focus Funder: injury prevention and supporting carers

The government’s vision for carers in NZ is that Aotearoa is a society that values individuals, families, whanau or aiga who support others who need help with their everyday living. Vision, NZ Carers Strategy, 2013 Kaiāwhina Workforce Action Plan vison: A kaiāwhina workforce that adds value to the health and wellbeing of New Zealanders by being: competent adaptable an integral part of service provision

 Most likely one-on-one without direct supervision.  Who guides the support? Sometimes the carer, sometimes the person being assisted. Potential for injury - insufficient understanding or knowledge, and also potential for interdependence - person and their carer.  Less access to training in and use of equipment than in residential/hospital.  Changes of support workers can lead to the erosion of or gaps in technical knowledge.  Housing modifications and equipment may be approved but often a time delay.  Private homes offer challenges: confined spaces, uneven surfaces, stairs, insufficient light, and normal distractions such as pets, children and family life.  Change for both the carer and the person being assisted can increase safety risk (e.g. weight, strength and cognitive changes, injury, repetitive use, illness, and changes in other responsibilities).

 Unaided lifting or supporting weight.  Frequent and repetitive lifting with a bent and/or twisted back.  Pushing or pulling actions, particularly on slopes or surfaces that are uneven, or are resistant to wheels, for example, carpeted floors, or wheeled equipment that is not maintained.  Unexpected force or movement for example spasms or an unexpected shift of weight  Static working positions with the back bent, e.g. leaning over a bath whilst tending to a person.  Lowering in restricted spaces, for example, into a vehicle or onto a toilet.  Carers trying to catch a person who is falling.

University of Auckland longitudinal study of carers 663 family carers, 2014 (first year results) 21% indicated -" lifting and handling" in answer to the question: What areas of learning have been most important to you or, if you have not received training or education, what areas would you like to learn about? NZ Work Research Institute AUT Survey of Aged Care Workforce survey (2014) 574 responses (homecare). Preliminary results. Support workers are experiencing back injuries, sprains and strains and bruising, and a major cause is lifting, pushing, pulling and bending. AUT, anticipated publishing early Contact: Dr Katherine Ravenswood Also HCHA Workforce Survey 2011

Carers Strategy Action Plan Objective two: Protect the health and wellbeing of whānau, aiga, family and carers Action 2.2 Adapt Guidelines for Moving and Handling People, for integration into resources and information for family carers. HCHA Strategic Plan Vision: Quality home health and community support services: Quality and Safety Goal 2015: Guidelines for moving and handling completed.

Guide for employers Printed and online brochure for carers “Watch and learn” video resources for families Resources in different languages Increased expert training Increased access to and knowledge about equipment

Purpose: To develop resources that will improve the understanding about and skill in moving and handling of people in the home environment. These resources will be useful for anyone undertaking or assisting others with moving and handling activities in the home environment (including family carers). Aims:Reducing and limiting injuries to all carers, support workers and service users. Encouraging a culture of health and safety through the use of the resources. Providing a resource for training that can be adapted to suit the needs of specific clients, work environments and staff.

HCHA, Carers NZ, ACC Governance Service users, employers, ACC, allied health, nursing, funders, education trainers, MHANZ, unions, equipment suppliers, advocates, children’s support services, carers Project owners Working group Consultation network

Controlling risk

Understanding challenges and risks of the home environment Developing policy and procedures Undertaking risk assessments, Developing plans including client care planning Communication Equipment The brochure is also included, as a training resource

Introduction – purpose, safety, rehabilitative support. Look after your body – good posture, stance, what not to do. Communication for a successful move. Planning – risk assessment – thinking about you, the person, the place and the task. Techniques – walking, narrow spaces, stairs, standing and sitting, rolling over in bed, bathrooms, in and out of cars Supporting someone who has fallen. Equipment Do you want more information

It is helpful if you both understand the normal order of a move before you start. This will help you work together. It might be that you will coach the person in their movement. Or they may say what works for them. Then you can work together to make sure that the move goes well and is safe for both of you.

Late November 2015 – second consultation December-Jan – production and distribution

Injury rates – little research Training – not enough going on Access to expert training – family and paid carers need more Falls prevention – data from ACC – not well tracked in home environment despite being the place where more falls occur Focus on residential and hospital – in philosophy, ‘best practice’, equipment Workforce retention, recruitment and training Equipment – need more in the home Increasing demand

Collaboration between paid and informal workforce networks Collaboration between expert practitioners and the coalface isn't always easy It takes effort to speak a 'common language‘ It makes sense to do this for efficiency and cost savings where possible. We have identified other ways to work together having learned so much from this project with ACC.

Collaborative building of resources to support carers in the home (family carers, paid support workers and home care providers) Julie Haggie, HCHA