Symposium Report: Developing competencies amongst the health and social care staff within care homes
On Thursday 2nd May, over 50 people joined us for our online spring symposium. This eagerly-anticipated session focussed on how health and social care staff could increase their knowledge, skills, and understanding when providing care and support to care home residents.
Describing competencies for the medical care of residents, addressing challenges of training GPs and educating students.
In our first presentation, Dr Neil Chadborn and Lauren McCarthy from the University of Nottingham talked about care home competencies for GPs and other medical professionals. Neil described data showing that GPs may feel out of their comfort zone when working in care homes, and may be unprepared for organisational and logistical difficulties. The GPs also felt that, if the professional hierarchy between the GP and care assistants can be put aside, then good communication and team work can lead to good care.
Lauren then reported the results of a consensus study that she completed whilst a medical student, which described competencies for GPs and physicians when caring for residents. One way to enable GPs to develop such competencies is through offering care home placements during their medical education and training. However, Neil explained how challenging it had been to make this happen in his region. For instance, he described concerns that the care home environment may not be sufficiently ‘medical’, or that appropriate supervision might not be available to students. He reported though that Kelly Millington, Joanne Pattinson and Adam Gordon are starting to address these challenges through ongoing student projects within a local nursing home.
Gaining hands-on experience as a health care assistant
In our second presentation, Professor Susanne Lindqvist and Elizabeth Davison from the University of East Anglia (UEA) spoke about their experiences of short placements for medical students in care homes and community hospitals. In their model, which has been running since 2015, foundation year medical students spend three days being trained, and three days working as a Health Care Assistant (HCA) under the mentorship of an experienced HCA. Participating students report increased confidence, empathy and communication skills from these placements, as well as a greater understanding of what person-centred care really is. Many say this opportunity will make them better doctors in the future. Importantly, the HCA mentors also reported increased self-esteem and status from being able to showcase their skills and work to the medical students, thus helping them to feel and be part of the team.
Colleagues at UEA are now looking to roll this model out to all first-year medical students within the acute setting. Susanne and Elizabeth are also exploring the possibility of the students gaining further experience through bank work in care homes. They are also keen to expand their model to other healthcare professionals who would benefit from this inter-professional learning. For instance, medical and pharmacy students could visit care homes together to conduct medicines use reviews. Importantly, Susanne and Elizabeth emphasised the need to ensure that any such initiatives are done in a sustainable way, that do not add pressure or burden to participating care homes. They should also benefit the participating homes and their residents, as well as the students.
Nursing skills in care homes
In our final presentation, Pam Hodge (Middlesex University) and Louise Keane (Nurse Educator at North Central London (NCL) Training Hub and Social Care Advisory Council Lead for NCL Integrated Care System) described their involvement in two collaborative projects for increasing knowledge, skills, and understanding of nursing practice in care homes. The first of these projects enhanced existing relationships, and developed new relationships, with adult social care partners in the locality. These conversations have already led to better understanding of some of the barriers and facilitators to having nursing student placements in care homes. Bespoke preparation and support for the care home teams and enhanced student preparation in advance of these placements have also been successful. So far, this work has led to four new care home placements being established, which, combined, could host up to 60 students per year
Their second project involved the co-development of innovative training delivered at the Middlesex Clinical Skills labs. Here current and future nursing home staff can develop their nursing skills in simulated care home settings. The state-of-the-art labs, which use mannequins, actors, and virtual reality technology to provide a realistic training environment, allow participants to develop and refine the complex skills needed for their work. The training labs also allow existing care home staff an opportunity to connect with student nurses, and for students to better understand the complexity of the care home role.
Participants of both projects reported that their experiences had given them a greater understanding of, and respect for, the roles of nurses in care homes, and that they had been able to apply their learning into everyday practice. There is also evidence that these initiatives led to improved health outcomes for residents, as well as savings in health care costs.
A blueprint for the future
All three presentations highlighted the benefits of collaborative, inter-professional working and learning for developing a health and social care workforce that is skilled and knowledgeable about working within care home. They also show how such initiatives increase understanding of, and respect for, the roles of care home staff. Whilst there are clear challenges and obstacles to setting up these initiatives, the evident benefits to students, staff, and residents will hopefully help such practices to become more widespread in the near future.
