Sally Boa, Head of Education, Strathcarron Hospice

Phase 1 story (Spring / Summer 2020)

How have you been able to keep a focus on what matters to people during COVID? 

As an organisation, we have a long history of supporting Care Homes by providing mostly face to face education and experiences to enhance skills and knowledge of palliative and end of life care. We have also developed a community of practice through our Project ECHO care home network. This is a global tele-mentoring model that joins communities (in this case, health and social care) together so they can learn with and from each other. The care homes come together (through Zoom) to agree a programme of learning and we facilitate  the sessions through presentations on the topic and anonymised case studies.  

During this pandemic, our Care Home ECHO network has grown and has provided a forum  for care home staff to share good practice, celebrate when things have gone well and  reflect on the more challenging aspects of supporting residents and families during this  difficult time. We have also been able to host larger information meetings, via zoom, for  health and social care partners to ensure they have the right information as they need it.

What have you had to do differently and what made this possible? 

We have worked with our health and social care partners in a really collaborative way.  The barriers of using technology have been removed and Care Home staff have been very  keen to share what’s important to them and how they want to be supported.

What have you noticed that has been better? 

Collaboration between partners has been better and there is more understanding of  different people’s/service roles. In spite of challenges with reports from the press, on the  whole, Care Home staff and the jobs they do appear to be more valued by others. One  participant told us:

Made me reflect that at the beginning of a shift we check everyone has what they need  physically (e.g. PPE) but don’t’ always check how people are managing psychologically.  Will include this going forward.

How did this make you feel?  

During the ECHO sessions in particular, I feel very humbled to hear how care home staff  are working to support their residents and families. I’m also excited that different  agencies and professional groups are working together, which makes me optimistic for  the future.

What have you learned through this?  

Relationships are key. Our support for care homes has brought positive outcomes for  people because we have worked hard at building relationships and trust. Rather than  going in and telling people what they need to know, we have asked them what would  help and tried to find solutions together.

Phase 2 story (Autumn 2020)

What has continued to help keep a focus on what matters for people during the  pandemic? 

We’ve continued to engage with care homes, using Zoom to provide a forum for different  care home to come together for discussions and learning. Because many have been  feeling isolated, they have valued a space to ‘meet’ each other which is supportive as well  as being an opportunity to learn and reflect.

Are there changes that seem to be lasting longer term and are there things that have  slid back to old ways of doing things?  

The way we deliver education has changed as we aren’t able to meet face to face. In  many ways, this has increased access for staff and as they’ve become more familiar with  using technology, they have participated more freely. We are now also using technology  much more to connect with people in our communities (for example, people who used to  attend Day Care). This is working really well for some, as it provides a forum for people to  meet, connect and support each other. Clinicians are also using NearMe and the phone to  provide clinical assessment, interventions and supports. 

Technology doesn’t work for everyone, and there is a worry that some people are left  feeling isolated. We are constantly trying to address this by thinking of creative ways to  connect people (an example from our Creative arts facilitators is the ‘dove project’: wooden doves and butterflies have been sent out to people normally attending day care  inviting them to decorate doves and fly them back to the hospice, while decorating and  keep the butterflies or passing them on to family and friends. Doves fly back to the  hospice with comments: “I have totally loved doing this and it made me feel part of  something really good” “It challenged me in a good way” 

We have shared this work with our Care Home community, who have adapted the project  to connect residents and families in their own settings.

What difference has this made to people? 

We now have much closer relationships with some care home staff, which means people  are more likely to phone for help if they need it – and this is reciprocal as we know where  to go for advice too. 

Staff in care homes have felt well supported: “Very reassuring – I get a lot out of these  sessions. Reassures me that we’re all in this together and it’s good to hear what others are  doing.”  

We are maintaining connections with those who used to attend our day services and  providing opportunities for peer support, which is an important element of the day care  experience

How did this make you feel?  

It’s always good to get positive feedback from those we are involved with. There is,  however, an element of frustration as we would like to meet people face to face, but  currently that isn’t an option. Thankfully, technology has really helped us during this  pandemic.

Reflecting on your experiences what have you learned? 

That people are resilient, creative and resourceful.

What difference has it made to you to tell your story as part of this project?  

It’s good to reflect on this journey and think about how far we have come, and think  about the things we have gained as well as the things we have lost.