Six ‘Vanguard’ areas across England have been developing approaches to enable care homes to better support the increasingly complex health needs of their residents. These six, focusing on ‘Enhanced Health in Care Homes’, were among 50 Vanguard pilot areas (2015 to 2018) tasked with developing models of care that can be sustained and replicated across England, helping the health and social care system tackle financial pressures and rising demands.
A recent National Audit Office (NAO) report has examined the Vanguards’ impact so far, in terms of value for money, and concluded: ‘there are early signs of a positive impact on emergency admissions’. However, at this early stage it cautions that ‘the longterm impact and sustainability of Vanguards is still not proven’. (page 47)
Back in those six ‘Enhanced Health in Care Homes’ areas, care home staff have stories to share about the impact of the Vanguard: about the support they received and the expertise they have developed. King’s College London’s ‘Cameos of Care Homes’ film captures some of these stories within one area – East and North Hertfordshire – where staff in two care homes reflected on their experiences. Between them, these 12 staff have over 210 years of experience of working in social and health care. The King’s College London team behind this project believe that these are voices that should be heard.
In the film, staff describe the impact that taking part in the Vanguard had on improving how they support their care home residents. Not only did it increase the knowledge and confidence of the staff who undertook intensive training, but this was cascaded within the organisation to improve everyone’s care for their residents:
“The biggest success is the staff empowerment – if you empower staff, you build their morale and that has been the best thing that has come out of it. And also, for the residents … their needs have been met quicker, because carers are the front line and they are the ones that have the ‘one to one’ with the residents before they can even get to call the nurse, myself, or call the GP”
Staff talk about being better at preventing problems developing. The impact of this boost in staff confidence and skills was that in some cases they did not have to call out GPs, district nurses and ambulances:
“I would say the success is the lower hospital admissions, which is as a result of confidence of staff, because of the knowledge staff pick up the signs quicker, so that we take action before it escalates to become an emergency”
But participating in the Vanguard was resource intensive: for individual staff, who were away from work on training and taking coursework home, and for care home managers and owners who needed to make sure that residents still got the care they needed throughout. One care home director said:
“Being part of the Vanguard hasn’t always been easy. There is a large level of commitment that needs to come from senior management, to commit to releasing staff to training and to then implement the staff learning within the home. So there needs to be a strong ethos within the organisation and clear leadership”
The care home staff and managers we interviewed in making this film were keen to celebrate the successes of their participation in the Vanguard. They highlighted that ongoing support is needed to embed new knowledge and practice in care homes, and to refresh and update staff learning. These are lessons for the next phase, of sustaining and replicating Vanguard successes, and we hope that ‘Cameos of Care Homes’ will contribute to this.
Jess Harris is Research Fellow at the Social Care Workforce Research Unit, King’s College London.
‘Cameos of Care Homes’ took place 2017 – 2018 as a collaboration within King’s College London between the Social Care Workforce Research Unit, The Policy Institute at King’s and the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care. It was funded by NHS England.