Adults with Autism: What we need to understand

[vc_row][vc_column width=”1/2″][vc_custom_heading text=”“There are around 700,000 autistic people in the UK“” font_container=”tag:h3|font_size:40|text_align:right|color:%23848685″ use_theme_fonts=”yes” css=”.vc_custom_1550578409212{padding-bottom: 10px !important;}” link=”url:https%3A%2F%2Fwww.independent.co.uk%2Farts-entertainment%2Ftv%2Fnews%2Fim-a-celebrity-anne-hegerty-autism-asperger-syndrome-charity-a8646296.html||target:%20_blank|”][/vc_column][vc_column width=”1/2″][vc_column_text]

Last week we examined the notion of opening up the conversation about autism, in order to adequately support children who are diagnosed with ASD (Autism Spectrum Disorder). While we do discuss the issues facing those with autism, there still exists a stigma within our society surrounding autism and those on the autism spectrum; and it’s important we continue to be open about it in order to normalise things more. By sharing stories and information, we can help to provide a more aware and structured support system for those with autism – helping them to feel less isolated simply due to their diagnosis. No-one should be made to feel alone or vulnerable because of how their brain works, so it’s up to us to break down the stigma about autistic people and show them that everyone is accepted, especially for the bits of them that makes them different. Part of this journey towards a stigma-less society means we have to shine a spotlight on a demographic that sometimes can be overlooked: autistic adults.

[/vc_column_text][vc_btn title=”Learn More About Autism in Adults” style=”flat” shape=”round” color=”warning” align=”center” link=”url:https%3A%2F%2Fwww.nhs.uk%2Fconditions%2Fautism%2Fadults%2F||target:%20_blank|”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]A large part of the conversation about autism is focussed on children. How they adapt in a school environment. The struggles they face when making friends. This is partially driven by the fact that many people start to show signs of ASD earlier in life and the UK getting better at recognising the symptoms sooner; however, there’s also just a natural assumption that autism is more problematic in younger people. Children “struggle” more because they’re still developing, whereas autistic adults have learnt to adapt. While that can be true for many adults with ASD, the issues they face should not be underestimated and we should work to ensure fair support is available for them too.

Recently the subject of autistic adults has become more prevalent, thanks to the frank honesty from The Chase star Anne Hegerty during her time on ‘I’m a Celeb’. She unashamedly shared how each trial affected her and how her autism came into play in her day-to-day life. She became a voice for autistic adults, using her public profile to raise awareness of how ASD continues to affect adults. From day one in the jungle, she was clear about how her Asperger’s diagnosis made social interactions difficult and the lack of a structure to her day was leaving her overwhelmed.

Many individuals can go through their whole childhood without an official ASD diagnosis, not understanding their unique approach to the world until later in life. Anne Hegerty wasn’t diagnosed with Asperger’s until she was 45 and opened up about how difficult it was to “grow up different”, not knowing why. While some autistic adults who were diagnosed as a child are able to develop coping mechanisms over time; for those who recognise their autism later in life, it can be a very emotionally trying time. After all, it can be a relief that there’s finally an explanation for why they’ve always viewed the world different to everyone else, but the stigma around ASD can be very isolating. The weight that comes with the autism label puts a lot of pressure on an individual, as a result increasing the separatism between those with ASD and those without.

Autism is a lifelong condition, so let’s make sure we’re showing autistic adults all the care and support we show children. Step 1 is understanding autism, so let’s be clear on how to recognise symptoms. Autism can manifest itself in different ways but can be centred around 3 key areas:

Autistic adults can vary from being very high functioning, showing only mild traits, to those who manage more extreme conditions, leaving some non-verbal and finding it very difficult to integrate in society. These symptoms can include:

  • Difficulty interpreting what others are thinking or feeling
  • Trouble interpreting facial expressions, body language, or social cues
  • Difficulty regulating emotion
  • Trouble keeping up a conversation
  • Inflection that does not reflect feelings
  • Difficulty maintaining the natural give-and-take of a conversation; prone to monologues on a favourite subject
  • Tendency to engage in repetitive or routine behaviours
  • Only participates in a restricted range of activities
  • Strict consistency to daily routines; outbursts when changes occur
  • Deep knowledge of one particular topic, such as a certain branch of science or industry

These symptoms may not dissipate as the individual grows up, and this can leave autistic adults facing a lot of pressure to act in a more “normal” way, when their brains are programmed differently. There’s an expectation for adults to act in a certain manner, meeting with societal norms; and while we’ll forgive children for showing symptoms of ASD, there sometimes seems to be less understanding for adults. This is an unacceptable state of affairs; and should motivate us all to do better.

Although there’s no direct “cure” for autism – as it’s essentially about how a person’s brain is wired – speech and language therapy, as well as occupational therapy, can help to manage the symptoms. Therefore, a key part in breaking down the stigma that autistic adults face is to make people aware of the fact that these treatments exist and can help. Adults who receive an ASD diagnosis should never feel like they’re alone because of their autism; since there are countless services and professionals around to build a personalised support system. Those not on the autistic spectrum should also work to understand the condition more, that way they can shape friendships and relationships to be more nurturing and supportive.[/vc_column_text][/vc_column][/vc_row][vc_row parallax=”content-moving” css=”.vc_custom_1550581273500{padding-top: 5px !important;padding-bottom: 10px !important;background-color: #848685 !important;background-position: center;background-repeat: no-repeat !important;background-size: cover !important;}”][vc_column][vc_custom_heading text=”While you’re here…” font_container=”tag:h2|font_size:30|text_align:center|color:%23ffffff” use_theme_fonts=”yes” link=”url:https%3A%2F%2Fwww.ossmembership.co.uk%2F||target:%20_blank|”][vc_empty_space height=”10px”][vc_column_text css=”.vc_custom_1550578842442{margin-bottom: 0px !important;}”]We want you to join our social work community and help us shape the future of social work. Our collective is involved in reviewing the standards of social work and you can use our platform to champion the causes close to your heart. We want to hear about your examples of good practice, and your suggestions for areas that need improvement. Join OSS Membership and have your voice heard . [/vc_column_text][vc_btn title=”OSS Membership” style=”outline” color=”white” align=”center” link=”url:https%3A%2F%2Fwww.ossmembership.co.uk%2F||target:%20_blank|”][/vc_column][/vc_row]

The Hidden Story of Eating Disorders During Pregnancy

[vc_row][vc_column][vc_column_text]An article in The Times recently commented on how midwives were calling for a return to the policy of “weigh-ins” for women during pregnancy, to monitor weight gain. While the focus was more geared towards the effects that excessive weight gain of pregnant women can have on their children, leading to higher levels of child obesity; it raises the spotlight on a related issue: eating disorders during pregnancy. Growing a human requires women to put on substantial amounts of weight to ensure the baby grows at a healthy rate; however, for some women it can distort the relationship you have with your body. Pregnancy can also be an incredibly trying time for women who have struggled with their body image and eating habits in the past.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]While in-depth research on this topic is scarce, studies show that around 1 in 20 pregnant women suffer from an eating disorder. One in *twenty*. So, why aren’t we talking about this more?[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Without wanting to sound too much like something out of “What to Expect When You’re Expecting”, pregnancy press is usually all about the traditional “glow”. There’s an emphasis on the positive experiences during pregnancy and the less than glamourous side-effects don’t really get talked about in much depth. Every tabloid in Britain is currently obsessed with what maternity wear Meghan Markle has or just how much she is “glowing” on every public outing; whereas that is not the day-to-day experience for many pregnant women. While it is exciting and enjoyable for countless mothers-to-be, around 5% have a much more complicated experience while pregnant with very serious risks. Women can experience a re-occurrence of a previous eating disorder due to the changes their body experiences, or pregnancy can act as a trigger for latent image and body issues. After all, pregnancy changes your body shape and size in a way that is, for the most part, out of your control – an issue which people in recovery from eating disorders find challenging.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Working through an eating disorder while also experiencing all the biological, psychological and emotional changes that come with pregnancy is no easy feat. Women face a great amount of psychological conflict if they need to eat more than usual for their health of their child, while their eating disorder twists the action to break down their body image. While many women are able to use the maternal drive as strength to defeat their eating disorder during pregnancy, those who do not run the risk of many complications. Irregular and disordered eating can cause pregnant women to suffer from consequences including the following:

• Dehydration
• Cardiac irregularities
• Gestational diabetes
• Severe depression
• Premature birth
• Labour complications
• Difficulties nursing
• Postpartum depression.

Additionally, due to the inherent nature of a mother’s nutrition affecting the human they are growing, eating disorders can seriously affect the foetus as it develops. Risks include:

• Poor development
• Premature birth
• Low birth weight
• Respiratory distress
• Feeding difficulties
• Other perinatal complications[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]The psychological turmoil pregnant women experience when battling an eating disorder can be heightened by the need to gain appropriate amounts of weight for the health of their child, so the notion of bringing back “weigh-ins” is a tricky one. Feeling like your weight is being monitored by external forces while internally battling an eating disorder can make it harder to stay healthy. On the other hand, as eating disorders are such a prominent issue, perhaps more structured guidelines and weight-related check-ups would allow healthcare professionals to notice changes quicker and provide support to expectant mothers sooner. Regular check-ups can give you the additional medical observation you and your growing baby needs, so don’t be afraid to ask for more. If you’re honest with your doctor, they can help you stay on a positive track. Tailor your pregnancy to suit your own body and your mind, so that you’re staying nourished and healthy, both physically and mentally.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]The key thing that we should all take from the fact that 1 in 20 women go through this experience, is that we need to talk to each other more. I for one was completely ignorant to any major prevalence of eating disorders during pregnancy and any possible consequences. We need to change this. We’re getting better about being more open in regard to mental health in general, so now it’s time to get into the nitty-gritty. Let’s have frank and honest discussions about what pregnant women go through physically and mentally if they’re battling an eating disorder. If we make it easier for women to talk about this complicated, negative side of pregnancy, we remove the stigma about needing to look a particular way when pregnant. As a result, we take away some of the power of the eating disorder. There are several blogs online where women share their stories about handling an eating disorder while expecting; but the lack of information, statistics and real understanding about the issue tells us this evidently isn’t enough. As with so many mental health problems, by sharing your feelings with someone and feeling like you have adequate support, it can become so much easier to overcome and stay healthy.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_cta h2=”Useful Resources” txt_align=”center” color=”grey”]While you’re here, why not take a look at some of our helpful resources around eating disorders, body image and pregnancy. They can help develop your practice and add new layers to your work with service users. Let us know what you think![/vc_cta][vc_btn title=”Body Image Toolkit” color=”warning” align=”center” link=”url:https%3A%2F%2Fwww.onestopsocial.co.uk%2Fsocial-work-social-care-resources%2Fresources-card%2F%3FdID%3D3490%26title%3DBody%2520Image%2520Tool%2520Kit||target:%20_blank|”][vc_btn title=”Pre-birth Child Protection” color=”warning” align=”center” link=”url:https%3A%2F%2Fwww.onestopsocial.co.uk%2Fsocial-work-social-care-resources%2Fresources-card%2F%3FdID%3D3785%26title%3DPre-birth%2520Child%2520Protection||target:%20_blank|”][vc_btn title=”Understanding Eating Problems Booklet” color=”warning” align=”center” link=”url:https%3A%2F%2Fwww.onestopsocial.co.uk%2Fsocial-work-social-care-resources%2Fresources-card%2F%3FdID%3D4633%26title%3DUnderstanding%2520eating%2520problems%2520booklet||target:%20_blank|”][vc_btn title=”Managing Depression: A Resource for Women Living With Depression During and After Pregnancy Workbook” color=”warning” align=”center” link=”url:https%3A%2F%2Fwww.onestopsocial.co.uk%2Fsocial-work-social-care-resources%2Fresources-card%2F%3FdID%3D4418%26title%3DManaging%2520Depression%3A%2520A%2520Resource%2520for%2520Women%2520Living%2520With%2520Depression%2520During%2520and%2520After%2520Pregnancy%2520Workbook||target:%20_blank|”][/vc_column][/vc_row]

The Strain, Stigma and Struggles of Life After Prison

As a society we have a strange obsession with crime. We binge watch tv shows dedicated to murderers and fill newspapers with stories of people committing terrible deeds or being dragged into criminal actions. We’re sympathetic in some cases, outraged in others; but all the while there’s an interest. We shape the narrative about the life of anyone convicted of a crime, influenced by popular culture and the misconceptions from films. However, how does this embedded perception of prison and people convicted of a crime affect their lives after they have served their time? What are we subliminally stereotyping anyone involved in crime to be?

If someone commits a crime and are convicted to serve a prison sentence because of it, there is an unspoken question about what their life will be like afterwards. Unless they’re given a life sentence, there will be a time after prison for them. Currently though, that time is affected by a stigma about the type of person who goes to prison or the impact prison has on your character. While we recognise that not every convicted criminal is the real-world embodiment of Sideshow Bob from The Simpsons, there’s stigma that everyone with a criminal record is less trustworthy and a less deserving participant in society. Families and friends find it difficult to forgive any level of offence sometimes, severing key relationships when the offender is most vulnerable. This psychological manipulation of the situation can make people feel like they can’t integrate with society after prison; only worsened by the fact that they’re trying to adapt from the strict structure of life behind bars. Such social isolation leading them to mental health issues like depression and poor anger management, which will increase their chances of re-offending. And the mission for everyone should be to reduce the number of people who are led to re-offend, as re-offending costs the economy somewhere in the region of £11 billion.

No matter what your thoughts are about the criminal justice
system and its sentencing laws, every human deserves a level of respect; and
this should extend to those who have served time in prison. After all, we don’t
know everyone’s story: we don’t know what circumstances led them to offend and
whether they have managed to escape negative influences. Therefore, we shouldn’t
immediately assume to understand about someone’s character or actions just
because of a criminal record. Within social work, we regularly see how children
and young people can be exploited into committing criminal acts, or vulnerable
adults manipulated into taking part in an activity that could lead them to
prison. Guilt is not set out by a criminal conviction but by the honest reality
of events.

Many people discover that after leaving prison they struggle
to find steady employment, putting them in a precarious financial position and more
at risk of becoming homeless or reoffending. Some of this is partly due to the
stigma associated with having spent time in prison. There seems to be an
unwillingness to accept the idea of rehabilitation or change; that someone who has
been sent to prison must have something in their DNA making them “a criminal”. Some
people commit atrocious acts and betray the laws of human decency; this is an
undeniable fact of life. Our true-crime show obsessions teach us that terrible
people do exist in this world. And many of those terrible people do end up in
prison. But does that intrinsically mean that every person who is sent to
prison is of the same character? Shouldn’t we stop ourselves from tarring everyone
with the same brush?

Stories have been shared that highlight how “the true sentence began” after leaving prison. People feel their opportunities are vastly restricted just by the fact they have any form of a criminal record, and there is no consideration to their individuality or circumstances. Surely this must make us think whether we’re making the post-prison life as fair as it could or should be? Some crimes can not be understood, forgiven or forgotten. But some, less serious offences that still involve prison-time must leave the person open to rehabilitation. And if someone is shown to be actively trying to change their ways and become a positive contribution to society; are we letting our prejudices stop them? Should we be working more actively to reduce the power of the stigma we have about life after prison?

Useful Resources

If you’re working with someone who has been through the criminal justice system, or a relative of someone sent to prison; there are some helpful tools for your practice on our website. If you can’t find what you’re looking for – get in touch and see if we can help!

Smart Works: Supporting Unemployed Women with a Royal Edge

After the Royal Wedding fever of 2018, the attention on Prince Harry and his new wife Meghan seems unstoppable. Tabloid writers feed of any hint of a story, whether it’s a potential rift between Meghan and Kate or what the young royals will be naming their new baby. Despite all the eyes watching her every move, Meghan Markle – now HRH The Duchess of Sussex – is using her new platform to champion some very positive causes. A lifelong advocate for female empowerment and gender equality (we’ve all heard about her childhood exploits campaigning against a sexist soap advert), the new Duchess has recently announced patronage of an organisation that works to support women trying to enter the world of work: Smart Works.

Who are Smart Works?

Smart Works are a charity who operate in seven locations across the UK to provide high quality clothes for unemployed women who are preparing for a job interview. They also give the women interview training in order to develop their confidence and increase their chances of succeeding at interview stage. Many of the women who come to Smart Works have been rejected for over 50 jobs, which can severely affect their belief in their own abilities. Therefore, to have the Smart Works team on hand to help them prepare and to have that extra boost to the self-esteem when it counts, can make a real difference.

Why support Smart Works?

It may seem frivolous to some people that this royal platform is being used to raise awareness for a charity which focuses on fashion; however, the significance of their work is so much more than just an outfit. The women who are referred to them are those who are struggling to find a job; which in our line of work, we know can be for a whole number of very serious reasons. Victims of domestic abuse can find it very difficult to succeed in interviews if their confidence has been manipulated and exploited by their abuser. Those recovering from substance abuse might not be in a financial position to be able to get the clothing needed to present a professional front to prospective employers. Women who have had their mental health affected by any one of all the issues social workers encounter on a daily basis can actually benefit greatly from the work of the Smart Works team. And these are the women who Smart Works help.

The recipients of these interview outfits are referred to Smart Works from places such as “job centres, work programmes, prisons, care homes, homeless shelters and mental health charities”. For women in these situations, an outfit means a lot more than just a matching set of clothes. It’s the ability to look at yourself in the mirror and feel like you are stronger than the causes of your unemployment. It’s the chance to present a version of yourself that external causes have kept hidden until now. It’s a step towards a job which can provide financial independence, stability and professional purpose. It’s a gateway to a more positive life.

Not just a personal shopper…

They recognise that the women who come to them need more than just new clothes to improve their interview chances. After all, presenting the right image might help first impressions from your potential new employers, but you still need the confidence and skills to succeed in the interview. Therefore, the Smart Works teams put great emphasis on developing appropriate skills and workshopping different scenarios with the women they work with, so that when it comes to the interview, they’re able to present the best version of themselves – both in appearance and capabilities.

The comments from women who have used Smart Works to prepare for an interview and succeeded in securing a job (as do over 60% of women through the Smart Works doors) are a real validation for this service. One case study, Letitia, comments Being unemployed for a long time and being unsuccessful in so many applications had really impacted negatively on my sense of self-worth and confidence.  I didn’t really believe in myself at interview which I am sure showed, and I know I wasn’t instilling confidence in the people interviewing me. However, after working with the team at Smart Works, she felt a “real confidence boost” and explained how their interview preparation session had helped her learn how to handle the difficult questions she encountered, and she went on to secure a job at Google.

Whether or not you’re in favour of the monarchy, or if disagree with the idea that any action they take is “news-worthy”; it’s undeniable that this is the state of play at the moment. A member of the UK royalty sneezes and it’s in every newspaper the next day. Any item of clothing either of the two Duchesses wears sells out within hours. So surely, it’s a positive sign that the Duchess of Sussex is using this unavoidable attention and analysis into her every fashion choice to highlight causes like Smart Works. This charity helps women who might find themselves in a vulnerable position to find their footing in the world of work: promoting empowerment and equality within employment.

In social work, we know there are multiple different avenues and channels towards facilitating change for a vulnerable person; so why shouldn’t fashion be one? We’re not saying an outfit can change everything, but the way we view our appearance has knock-on effects for our mental health and specifically our confidence; which can help build inner strength to succeed in a particular situation. Overall though, as Yves Saint Laurent put it: “What is more important in a dress is the woman who is wearing it”.

One LPA or Two LPAs? That is the question…

The mainstream media generally seems to place greater emphasis on the financial implications of not having a Lasting Power of Attorney (LPA) in place but should the “Health and Welfare” LPA really be the poor relation?

With two different LPAs available, which is more important to you, “Property and Finance” or “Health and Welfare”?  Many people now understand the advantages of making an LPA that helps to keep their Property and Financial Affairs in order but fewer people seem to fully appreciate the benefits of making a Health and Welfare LPA. Protecting yourself financially is important; but putting the right systems in place for your well-being and to look after your interests when you’re vulnerable should be just as much of a consideration. 

What if I lose mental capacity and don’t have a Health & Welfare LPA?

Your family members and loved ones are likely to
not have a say in how you live or are cared for, leading to:  

  • Social Services may have to take the lead in making decisions about
    where you should live and what care you will receive.
  • Only your legal next of kin would be consulted about decisions regarding
    resuscitation and life sustaining treatment. And even though they are talked
    to, it still does not mean they will have the final say.
  • Decisions may have to be made by the Court of Protection, rather than by
    the people you would choose. This will be an expensive and time-consuming
    process.

Looking at it like that, it is clear that it’s smart to prepare, just in case. While we recognise that social services across the country work to support vulnerable people and will do whatever they can to get the best outcome for you, they may not always know clearly what that best outcome is as they’ve not shared a lifetime with you. Your family, partner or beloved friend does. They know your little eccentricities and can use this caring knowledge to support you during this time. 

How can a Health and Welfare LPA be used if I have one?

Unlike a Property and Finance LPA, a Health and
Welfare LPA can only ever be used if you have lost the mental capacity to make
such decisions yourself.  With this LPA in place, your chosen attorneys
have the power to make decisions about things like:

  • your daily routine, for example washing, dressing, eating
  • medical care
  • moving into a care home
  • life-sustaining treatment

With a growing number of Britons suffering from dementia or Alzheimer’s, careful planning is needed to make sure that you would have the right people making decisions on your behalf if the need arises. In the absence of a Health and Welfare LPA, you run the risk of having strangers making decisions about your personal welfare, even if your friends or relations know far better what your choices would have been. Social services teams are here to support you, but they aren’t here to replace your loved ones so don’t feel like the people you care about and who care about you can’t have a say in looking after you, should you lose mental capacity.

To put it simply, only by having both LPAs in place can you make sure that your wishes in as many aspects of life as possible are always going to be taken into consideration. It’s important to understand the value of a Health and Welfare LPA and should form more of a discussion in our society. Rather than just the ever-popular plot device in films, the financial power of attorney.

For any additional information contact The Honey Group – Rachel Colbert – by calling us on 0800 847 7086 to arrange a free, no obligation consultation at a time convenient to you and your loved ones, in the comfort of your own home. Their experienced team can guide you through the process.

Contributed by Rachel Colbert, The Honey Group. 

Find out more..

Learn more about mental capacity with the resources available on our site, including the ‘Mental Capacity Law Guidance Note: A brief guide to carrying out capacity assessments’ from 39 Essex Chambers.

Caring at Christmas

[vc_row][vc_column][vc_column_text]For many, Christmas is a wonderful time of year. Friends and family come together, often over great distances or time apart, to celebrate with too much chocolate and turkey. We spend months preparing for Christmas day, exchange presents with those we love.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]For those living in care homes, this isn’t possible. More and more of our population is aging, and with the increased life spans comes more of those unable to live independently. Due to health issues, they have been forced to move out of their own homes, often away from their family or friends. For the patients, Christmas time can be fraught with memories of how they used to spend the festive season, traditions that are no longer viable in a community home. What is difficult for staff, therefore, is creating a festive environment by trying to cater to as many different patients’ traditions as possible.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]The key to bringing Christmas and those memories to the residents is through events. Gosmore Care Home in Hitchin organised for residents to decorate woollen snowmen alongside their relatives, allowing those that cannot be home for Christmas day to have some quality time together regardless. Similarly, Grove House Care Home in Prenton provided an event for residents to bake and decorate gingerbread, a traditional Christmas activity that many residents may have done before their time in a care home. Other care homes have recorded having choirs visit to perform to the residents, making stockings or crackers for the residents, and helping those less able to send cards to their loved ones, as they would have usually done.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Why is it important to do this? Studies have shown that there are many benefits to performing traditional Christmas practices with those in care homes. By recreating practices residents might have done themselves, reminiscence therapy as it is called, cognitive functions and overall mood of those suffering from dementia have been recorded to have improved significantly. By understanding not only their patients’ medical needs, but also their emotional, care home staff are able to greatly improve the residents’ quality of life.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]These studies are not new discoveries either. Many articles have been written, detailing the differences in health of those that are able to relive, or recreate, some of their old traditions. It all links back to staff, and their connection to their patients. An article written for The Guardian in 2014 links patient recovery to “it is the small touches – based again on a knowledge of residents and their personalities – that can make all the difference”. Balcombe Care Home published an article, stating “Some residents will enjoy reminiscing about past Christmases, and memories can be stimulated by smells, sounds or images of Christmas. Activities such as making their own Christmas cards, decorations or even mince pies can help people rekindle the Christmas spirit”, pinpointing how important again having the habits of the residents in mind when planning Christmas events is important to their enjoyment of the season.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Throughout all this, however, it is important to remember the staff, who give up their time over the festive season to care for those who need it, spending time away from their own loved ones. The Christmas period is as much about their enjoyment as well. Many care homes, alongside the Christmas dinners provided for their residents, will offer one for their staff as well. It allows them to rotate their own time on Christmas day, and be able to partake in their own traditions. Staff are also allowed to wear festive jumpers, so the day feels as just as much for them as the residents. By focussing on both staff and residents, care homes can guarantee a good, positive atmosphere to their Christmas celebrations.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Contributed by Katie Mountain, Salford University student. [/vc_column_text][/vc_column][/vc_row]

Startup Unlocks Solution to London’s Delayed Discharge Crisis

[vc_row][vc_column][vc_column_text]Just in time for Winter, joint research between One Stop Social and Care Sourcer highlights how social workers could find vital care in hours, not weeks.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]In September 2018 alone, there were 13,191 hospital bed days lost due to delayed discharge in London hospitals, costing the capital’s NHS a massive £4m and putting incredible pressure on social care services.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]MP Helen Hayes recently identified social services authorities as being at “breaking point” and said that the impact on patients is “creating misery”. However, Edinburgh-based startup, Care Sourcer, believe a solution exists – and it lies in their groundbreaking care matching technology. Care Sourcer provide an entirely free care matching service – searching all 27,000 registered UK care providers and delivering a tailored list of all available providers and their prices within 24 hours. With UK-wide recognition for already successfully reducing NHS delayed transfers of care, increasing patient safety and reducing costs, Care Sourcer are poised to challenge the status quo in London. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_text_separator title=”A problem on an unprecedented scale”][/vc_column][/vc_row][vc_row][vc_column width=”1/3″][vc_single_image image=”3642″ img_size=”medium” alignment=”center”][vc_column_text]St Mary’s Hospital in London during the bed shortage crisis in January 2018[/vc_column_text][/vc_column][vc_column width=”2/3″][vc_column_text]Delayed discharge has a devastating impact on patients. According to a 2017 report by Carnall Farrar, “patients can lose up to 5% of muscle strength per day and are at increased risk of acquiring infections.” Prolonged bed stays can also negatively impact the morale and independence of the patient and “increase the likelihood of them needing to go into a nursing or residential home after discharge.” This research highlights that it’s of course not just a strategic move for hospitals or social care services to rethink the discharge process, but it’s also very beneficial to the patients themselves[/vc_column_text][vc_column_text]The scale of the delayed discharge problem is nothing new to health and social care professionals, who are faced with systemic problems due to lack of funding, staff shortages and an ageing population every single day.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]While the crisis is country-wide, recent figures from London paint a particularly worrying picture. Research published by Care Sourcer shows the worst affected boroughs for average delayed discharge days per patient are Kensington and Chelsea (28.1 days), Barking and Dagenham (17.56 days) and the City of London (17.33 days.) Boroughs with the shortest delays per patient include Enfield (8.01 days), Brent (7.66 days) and Haringey (7.35 days.) While it is reassuring that not every Borough is working with delayed discharge rates of nearly a month, a week still feels like too long.  

Details on each borough’s delayed discharge rates can be found in Care Sourcer’s report: www.caresourcer.com/london[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_text_separator title=”Fixing a broken system”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Typically, council or CCG-commissioned care for patients is found through the brokerage network, which takes an average of 11 days per patient in London. By contrast, Care Sourcer can get a care offer for a patient in London in 1 hour and 18 minutes from a CQC-registered care provider. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]One of the reasons for these delays is a common misconception about commissioning care.  Belinda Schwehr, CEO of charity CASCAIDr, which provides advice on NHS Continuing Health Care and Care Act rights, explains:  “It is a common misconception amongst those working in the statutory social work sector that they are only able to use the “Preferred Provider” network that their borough has selected. But that just doesn’t have to be the case if direct payments or health budgets are made attractive and easy to use. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Personalisation within the care sector alongside the fundamentals of the Care Act enable care seekers, their proxies or their advocates to find and select any care provider they like, giving people far more choice and control of their lives.”[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Care Sourcer can help social workers find care for individuals who are eligible for funding as well as those who are paying for their care privately. On top of the free service provided at www.caresourcer.com, they also offer a bespoke service for NHS trusts and CCGs that offer additional insights and help with delayed hospital discharges.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]However the care is funded, Care Sourcer achieves a staggering reduction in wait time by directly connecting care providers with the people who need care and their advocates. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]NHS Transformation Programme Director, Catherine Holmes says “Care Sourcer is an essential part of any winter escalation plan. It is an enabler for improving patient flow, it puts the power of choice back into the hands of the patient and it minimises the impact on health and social care staff time.”[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Choice, cost and quality do not suffer at the expense of the speed of their offering. On average, a Care Sourcer care request in London can expect 10.06 offers back from providers, of which most are priced between £12.84 and £19.88, allowing the person looking for care to make an informed decision about what best suits them. Providers are all CQC-regulated and 59% of the providers offering in London are rated good or above, compared to 35% in the UK overall. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_text_separator title=”Proven 40% reduction in delayed discharges”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Having proven to reduce delayed discharge by an astonishing 40% in a Gloucester hospital pilot, Care Sourcer is currently rolling its service out to the Hammersmith & Fulham Clinical Commissioning Group[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]With winter approaching and an already strained system creaking under the pressure, this might be the solution that can solve the delayed discharge crisis once and for all. By embracing technology like the one offered by Care Sourcer, we can work to innovate our sector and develop better processes that keep the service user at the heart of the matter.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_cta h2=”Find out more…” txt_align=”center”]Care Sourcer’s free solution is available now at www.caresourcer.com. Their CCG and NHS trust product is also available now, with competitive pricing only payable once care is arranged.

Find out more about Care Sourcer’s work with the NHS: www.caresourcer.com/nhs-trusts

For more information on the statistics referenced in this article, visit: www.caresourcer.com/london[/vc_cta][/vc_column][/vc_row][vc_row][vc_column][vc_cta h2=”Further Resources for Your Practice” txt_align=”center”]If you’re interested in learning more about delayed discharges, then why not check out the resources available on One Stop Social? We upload new resources regularly on a variety of topics in order to support the social workers and care professionals within our community. These are just some on related topics that might inform your work or studies:

The Social Worker’s Guide to the Care Act 2014

Safeguarding Adults Under the Care Act 2014

Community Care (Delayed Discharges etc) Act 2003

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End of Life Care for People with Alcohol and Drug Problems

[vc_row][vc_column][vc_column_text]For the past two years, Professor Sarah Galvani has been leading a multidisciplinary research team at Manchester Metropolitan University, exploring end of life care (EoLC) for people with alcohol and other drug problems (with funding from the Big Lottery Fund). The research has examined the good practice and challenges experienced by health and social care practitioners, service users and families when life-shortening conditions co-exist with problematic substance use (SU).[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”2/3″][vc_single_image image=”3626″ img_size=”medium” alignment=”center”][/vc_column][vc_column width=”1/3″][vc_single_image image=”3625″ img_size=”medium” alignment=”center”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

It sought to answer the following questions:
1. What does the existing international research and wider literature tell us about current responses to end of life care for people with substance problems?
2. What practice or care pathways already exist to support adults with substance problems needing end of life care, and the families/carers of these people?
3. How many people with substance related chronic or terminal illness are receiving, or in need of, end of life care in the UK?
4. How do people with substance problems, past or present, experience end of life care?
5. How do family members, friends and carers (FMFCs), experience the care and support provided to their loved one? To what extent have services been responsive to FMFCs own support needs?
6. What are the challenges and opportunities professionals face supporting people with substance problems and chronic or terminal illness?

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]This is a very under-researched field, and our work has revealed particular knowledge gaps around the scale and prevalence of need for individuals and their families – that have resulted in this population remaining hidden from view. Yet, we know that the UK has an ageing population, with alcohol-related harm known to be escalating in older age groups. Combined with evidence of the cohort of ageing heroin users in treatment, urgent attention needs to be paid to the end of life needs of this growing group of people.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]From a policy perspective, despite recognition of the increasing importance of palliative care for an ageing population, little is known about how these services could best support people with substance use problems – many of whom do not access services and others whose social circumstances may not always fit with traditional medication or health / social care regimes. This population generally experiences multiple, long-term, and complex health and social care needs, combined with high levels of mental health difficulties and social isolation. This combination can leave them particularly vulnerable. Quite often, reluctance to engage with services means that they rely on costly emergency hospital and ‘blue light’ services for their healthcare needs. Both for these individuals directly, but also for their families and informal carers (who frequently have long-term healthcare needs of their own), community-based approaches need to be developed to provide effective support and to ensure that this group of people are able to die with dignity and care.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Unfortunately, current substance use policy does not account for the needs of this group and there is no way of monitoring the extent to which palliative care reaches people with substance problems. But we are finding small pockets of developing good practice across the country and we’re hoping that our research is the first step in helping to develop new policies and services that meet the needs of people with substance problems at the end of their lives, and also support their families/carers.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]We are now moving forward to examine what guidance is needed to help integrate health and social care policies that better support work across the substance use and palliative/end of life care sectors. We hope to further develop this work and have recently submitted an application for further research funding to examine the whether a new model of care could improve access to, and experience of, end of life care for people with problematic substance.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”2/3″][vc_column_text][/vc_column_text][vc_column_text]

For more information about our project or to share insights about your own work and experiences, please contact:
Dr Sam Wright sam.wright@mmu.ac.uk 07815 595609
Professor Sarah Galvani s.galvani@mmu.ac.uk 07775 680418

[/vc_column_text][vc_column_text]Contributed by Dr Sam Wright, Senior Research Associate at Manchester Metropolitan University[/vc_column_text][/vc_column][vc_column width=”1/3″][vc_single_image image=”3624″ img_size=”medium” alignment=”center”][/vc_column][/vc_row][vc_row][vc_column][vc_cta h2=”Interested in Finding Out More? ” txt_align=”center”]If this research from Manchester Metropolitan University has sparked your interest and you want to find out more about End of Life Care, or handling Alcohol and Drug problems in adults, then make sure to check out our Resources Page. We have a whole range of tools to support your practice, on a variety of topics.

And don’t forget, if you have a guide, book or resource you’d like to contribute to One Stop Social, get in touch with our team at central@onestopsocial.co.uk![/vc_cta][vc_btn title=”My Future & End of Life Care Plan” color=”warning” align=”center” link=”url:https%3A%2F%2Fwww.onestopsocial.co.uk%2Fsocial-work-social-care-resources%2Fresources-card%2F%3FdID%3D3562%26title%3DMy%2520future%2520%26%2520End%2520of%2520Life%2520Care%2520Plan||target:%20_blank|”][vc_btn title=”End of Life Care Common Core Principles for Social Care and Health Workers” color=”warning” align=”center” link=”url:https%3A%2F%2Fwww.onestopsocial.co.uk%2Fsocial-work-social-care-resources%2Fresources-card%2F%3FdID%3D3891%26title%3DEnd%2520of%2520Life%2520Care%2520Common%2520Core%2520Principles%2520for%2520Social%2520Care%2520and%2520Health%2520Workers||target:%20_blank|”][vc_btn title=”Understanding Substance: Use Policy and Practice” color=”warning” align=”center” link=”url:https%3A%2F%2Fwww.onestopsocial.co.uk%2Fsocial-work-social-care-resources%2Fresources-card%2F%3FdID%3D611%26title%3DUnderstanding%2520Substance%3A%2520Use%2520Policy%2520and%2520Practice||target:%20_blank|”][/vc_column][/vc_row]

Driven Forward: Getting our Elderly from A to B.

[vc_row][vc_column][vc_column_text]When it comes to travelling any form of distance, we all complain. About everything. Traffic is frustrating. Taxis are too expensive. There aren’t enough cycling lanes. Walking is tiring. Buses are infrequent. Trams or the tube are too busy. We are a nation of complainers and with transport, it can feel like there’s no pleasing us at times. However, most of us have multiple options. In the grand scheme of things, it’s not a complicated process to get from one place to another. However, for some elderly people, transport is a much bigger concern. Due to illness or social circumstances, it can be difficult for some people to leave the house for outings in their older age. Problems with their eyesight may prevent them from driving themselves, and an injury may make walking to a bus, tram or tube stop dangerous. There’s also a large confidence issue at play. After all, nowadays buying a ticket for public transport or booking a taxi relies more heavily on technological skills. It can end up that you need to know how to work an app, understand a touch screen and be able to deal with contactless payments just to be able to go to the shops. For many in their older age, this is simply not realistic. What happens then, when the ability to travel even short distances is restricted or completely taken away? Elderly people can find themselves more and more isolated, which negatively affects their mental health and can even weaken their immune systems, making them more susceptible to illnesses. Luckily, a charity in Berkshire (“Driven Forward”) is determined not to let that happen.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Driven Forward is a new initiative from Tiia Stephens as a way to provide vulnerable adults with transport across Windsor, Maidenhead and the wider Royal Borough area. Tiia is setting out to organise regular (wheelchair accessible) trips for local care home residents and other vulnerable adults, in order to combat the risk of loneliness and social isolation. With their first trip recently to Longacres Garden Centre in Bagshot for 10 residents from Bowes Lyon Close estate, it’s clear this could be the start of a great new social venture.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]A really positive part of Driven Forward is their commitment to vulnerable adults from all backgrounds. They’re not just looking at the stereotypical residents in care homes who are isolated, but also those who have recently left homelessness who may be finding it tough to maintain a healthy lifestyle. As Tiia says, “it’s more than just a taxi service, it is about rehabilitation into society and improving the mental wellbeing of people who are reluctant or unable to engage in activities alone or among the wider society.” She’s hoping that with adequate funding they’ll be able to grow into fortnightly trips to Asda as well as other social activities for groups of older adults. It’s a not-for-profit movement looking to improve the lives of the elderly, by focusing on a key problematic area: travel. Once it becomes easier for isolated adults to leave the house, it’s then just a hop skip and a jump away from reducing the risk of social isolation and the mental health problems the elderly can feel. With help from programmes like Driven Forward friendships can be made, gossiping sessions can be had, new creative outlets can be discovered and overall wellbeing can be improved.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]As a recent episode of Old People’s Home for Four Year Olds examined, there are excellent benefits (both physical and psychological) to be had from encouraging elderly people to be more active within the local community, whether it’s through going to a superstore or in Driven Forward’s case, having a wander around a garden centre. It can stimulate creativity and social skills which may not get as much use in isolated older age, as well as forcing adults into doing a level of physical activity that helps their blood pressure, heart rate and other key areas. So, if charities like Driven Forward can make it easier for adults to get out into the community, it could end up doing the world of good to our elders; inspiring more strategic efforts across the country. And who knows, maybe soon, everyone (no matter their age or situation in life) will be able to complain equally about having to deal with public transport systems.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”2/3″][vc_cta h2=”Adult Wellbeing” txt_align=”center” add_button=”bottom” btn_title=”Adult Wellbeing Scale – Adult Assessment ” btn_color=”warning” btn_align=”center” btn_link=”url:https%3A%2F%2Fwww.onestopsocial.co.uk%2Fsocial-work-social-care-resources%2Fresources-card%2F%3FdID%3D3159%26title%3DAdult%2520Wellbeing%2520Scale%2520%7C%2520Adult%2520Assessment||target:%20_blank|”]Driven Forward and other such services exist to help support the mental health and wellbeing of the elderly. If you’re concerned about the wellbeing of an adult you know then why not take a look at this resource with the Adult Wellbeing Scale.[/vc_cta][/vc_column][vc_column width=”1/3″][vc_single_image image=”3592″ img_size=”medium” alignment=”center” onclick=”custom_link” link=”https://www.onestopsocial.co.uk/social-work-social-care-resources/resources-card/?dID=3159&title=Adult%20Wellbeing%20Scale%20|%20Adult%20Assessment”][/vc_column][/vc_row]

The Complications of Finding Care

[vc_row][vc_column][vc_column_text]For professionals who need to refer service users to find care, it’s often a minefield to navigate your way through sourcing care in an efficient way. Referrals can take weeks or even months to process, which leaves the vulnerable adult in need of care waiting around until suitable care can be found. This can put pressure on family or friends who don’t have the skills to provide quality care, or on health services who must stay involved until the patient can be moved into the social care sector.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Finding care calls for different approaches, which does not help to keep things simple. If you’re not a specialist in the social care field, then it can be tricky to know which type of care solution is best. Sometimes what’s best is to keep a vulnerable adult at home but bring in a professional to support them in different areas of their lives. Home help can suit you if you need:

  • personal care, such as help with getting washed and dressed
  • housekeeping or domestic work, such as vacuuming, cleaning and doing laundry
  • help with cooking or preparing meals or “meals on wheels”
  • nursing and healthcare
  • companionship

On the other hand though, it may be impossible for an elderly person to stay in their own homes due to an illness or disability. But how then do you decide on which care home? In order to make an informed decision, it can be tough to weigh up the pros and cons of alternative settings for your service user or loved one. It seems like everywhere you turn, there are more choices but no easy way of finding an answer![/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]If you’re looking for residential care, then Age UK recommends going through the following steps when looking at choosing a care home:

  1. Make sure the home provides the level of care you need or could need in the future.
  2. Check if the home currently has any vacancies. If it doesn’t, find out how long the waiting list is.
  3. Read the home’s brochure or website before your visit, and call or email the home to speak to the staff or manager.
  4. Read the most recent inspection report for the home. You can ask the home for it, or look for it on the CQC website.

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]What happens though, if your case is time-sensitive and you simply don’t think you have the time to do the research into the different options? Do you settle for a ‘knee-jerk’ decision for the first offer you find? Not every offering is the same and as people are intrinsically different, not everyone will respond to the same offer positively. The best way to approach finding care is to have multiple choices where you can pick based on preference rather than desperation or time. Whether you’re looking for the right care home for an elderly relative or a social worker trying to find at-home care for an adult you’re working with; you shouldn’t be tied down by limited choices. Given the number of people actually working in social care who are dedicated to supported vulnerable adults, it seems an illogical situation that the process to actually connect them with people who need care appears so complicated.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Luckily for the social care sector, and all social workers who have to go through complex referrals, a new company has emerged with an innovation that could make picking the right care solution a whole lot simpler. Care Sourcer, a tech start-up from Edinburgh, have developed a care-matching service which does all the leg work for you. You tell them your client’s specific needs and they search all available providers and get back to you in 24 hours with prices and details of available providers. And as if that wasn’t enough, it’s entirely free. There’s a slight cost to care providers if theirs is the offer that is selected, but for all service users it’s free.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]One Stop Social like to keep an eye out for creative ideas that we feel will support our social work community, and from what it looks like Care Sourcer is just one of them. They are offering social workers a free way to compare thousands of care providers with barely any of the effort. From where we’re standing, it’ll make the lives of adult social workers a whole lot easier.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_cta h2=”Interested in finding out more? ” txt_align=”center”]If you’d like to find out more about Care Sourcer and their free care-matching service, click here. [/vc_cta][/vc_column][/vc_row][vc_row][vc_column][vc_cta h2=”Whilst you’re here…” txt_align=”center” color=”orange” add_button=”bottom” btn_title=”Find out about the Social Care Membership” btn_color=”warning” btn_align=”center” btn_link=”url:https%3A%2F%2Fwww.onestopsocial.co.uk%2Fsocial-care-membership%2F|||”]Have you heard about the new Social Care Membership from One Stop Social? We’re working hard to support our social care community so we’ve introduced a rewards scheme that could help you save over £1,000 a year, with discounts on holidays, travel, utilities, gym memberships and more! It’s our way of caring for the people who care so brilliantly for the vulnerable people in our society. Sign up today for just £2.99 a month![/vc_cta][/vc_column][/vc_row]