9:00 a.m. at Sunderland's Adult Services.
Home to the eight teams providing services for older people.
for the city West Division the day starts with a diary share meeting
Heading today's meeting is Rachel Dorat who's acting up whilst her manager is on leave.
[Group are in discussion]
Rachael qualified as a social work in nine years ago and began her
career in the team at Sunderland royal hospital
she joined older people services three years ago and reached a senior level a year later.
Every team have a diary share once a week, the team managers attend SMT
which is a senior management meeting and they basically trickle down the
information and from a Directorate.
Also in the meeting is Lisa Galli whose
Social Work career began just 12 months ago
Lisa's colleague Bertha has an important issue to raise.
Over the weekend one of the members of the staff and the manager...
[voiceover] An unwell elderly man has assaulted a carer at his residential home and the home wants him
to leave. Rachel and the team are concerned that it could be a hasty reaction.
He's had one incident and it was a serious incident.
It's a difficult situation with potentially serious consequences for the elderly man.
As acting team manager it's now Rachael's job to speak directly to the home
[On the phone]
[Voiceover] the man was placed in the home just
three weeks ago after he was assessed as being unable to cope living independently
So Rachel already knows his case history. The gentleman unfortunately
lacks capacity to make his own choices about place of accommodation he
wasn't able to manage his insulin, he wasn't able to judge when he was having
a hypo we had a big case conference for me the feeling was in his best interests
it would be safer to be within a 24 hour care environment but after that one incident
the home manager has been quite quick to then want him out. I haven't really
investigated the cause of the the incident we haven't looked at getting
psychiatry involved and furthermore we haven't we looked at the challenging behaviour
team which is it's acceptable for you to directly refer to, to look at changing
the home now and him moving out after three weeks I think you know I think we
needs it's a bit hasty I feel. she's going to refer to challenging behaviour
team and homes can directly refer to them to get their input as to how to
manage someone's behaviour. I've also advised if any other incident
happens again she really needs to get on to look at a mental health assessment.
As Rachel writes up the case notes, Lisa is heading out to visit a woman who she
helped to retain her independence after a serious illness jeopardised it.
She had a brain aneurysm back in March which set her back about quite a long way, she spent
quite a lot of time in hospital she spent six weeks in Farmer Court which is
our intermediate care centre and then just had a couple of weeks of reablement and
actually in her own home and she's just recently finished that we're just gonna
go and see how she's doing.
Sixty six-year-old Olive was very poorly
when Lisa first met her it was Olive's best friend Kathleen who persuaded Lisa
that there was potential for recovery.
Lisa needs to be
sure Olive's getting all the support she needs
Ok, I've just popped in this morning just to see how the carers are
doing Olive because you've just changed over from from the girls who were coming previously
Lisa spent eight years as a senior care
worker in a residential home for elderly people before embarking on her Social
Work degree at Teesside University.
It was general social social work, we did
kind of things such a social policy, ethics and values and the counsellor modules I
found really helpful and therapeutic communication I found really good and I
find that they most have benefited us since I've come here.
I probably decided to do older people
because it's what I was comfortable with them for at least my first year of
practice I wanted something else familiar
[Speaking to Olive] Did she treat the home with respect Olive you happy?
And you feel that she's meeting your needs ok Olive? If you're happy with that yeah?
Because I've obviously worked with older people since I was 18 and all their
kind of values and things like that so that's helped but also because I'm now
reviewing care homes I've got an idea of how care plan should be devised
and stuff like that so I know what to look for.
[To Olive] So you'd be looking forward to
going to visit Catherine at her new house then yeah? How do you think you'll manage
a bus at the moment Olive? How confident would you feel? I don't know!
Maybe a couple of trips with Kathleen and then maybe - you never know.
We're focusing
a lot more on kind of community living now and personalization and stuff like
that we do get quite a few referrals in for 24-hour care but they are starting
to kind of fizzle out now that I think the mindset of a lot of older people
especially here, is that you know you get to a certain age and that's kind of where
you go but I think we are starting to change that now when people are
accepting support at home and the extra care scheme - that's where we went today
so that's really good as well.
I think it went really well it was it was a
positive review, I think Olive's really happy with
a new bungalow and her new surroundings.
If it wasn't for Lisa she wouldn't have
been where she is now, the doctors told me that she would be in a home all her
life, then Lisa came in and me and Lisa had a talk and then she got her another bungalow so
I'd rather be here, it's much better here!
I think it's been positive for Olive
but also for our family and friends to watch as well three months earlier and
we thought she was gonna have to go into a nursing home where
her potential wouldn't have been met because people would have been doing for
her rather than showing her what to do so it's been a really good experience.
Meanwhile Rachel's also out on the road.
She's on her way to check up on 94 year old Vera who she's recently placed into
Sunderland's newest extra care housing scheme.
Extra care is a sort of a home for life it's basically 40 fully furnished
apartment within a building, it's very much about independent living yet with the
support on hand so there's care staff available 24/7.
What happened is I received an assessment to assess Vera's needs on discharge from hospital and at
that point she felt very strongly about not returning back to her property.
She's been there about four weeks so we're going to do a review of how things are so far.
How are you? Fine. good! I've just come today just really to see how
things are since you've moved in to bramble. Wonderful! How have things been
since you actually moved in in terms of your flat? Yes, yes good thanks to you.
And what about the carers, what about the people who help you? First class!
I mean it's everything you said, I mean they helped me in every way all of them. Good!
I've always wanted to be a social worker since I was about 12 I think I
went from being wanting to be a firefighter to a social worker so
it's just like wanting to kind of contribute towards helping people and
trying to make things better for people.
Are the carers respectful when they're talking to you? Yes, very! They're very helpful.
I started at the hospital Social Work team
and that gave me excellent grounding and I was there for about six years. You deal
with anyone over 18 and it's all divisions and I think that gives you a
really wide range of knowledge and also understanding about what resources are
available for each of those client groups. Some people do tend to go from
the hospital to the older person services and I was at that point really
wanting to progress.
So has the move here sort of made you feel a bit
more secure about living by yourself?
Yes, it's...
it's given me more confidence. Good, that's good.
Vera is an amazing woman I
think and because she felt her life was over and this has given her a new lease
of life the way she describes it. So what we'll do now is Vera's case I'll
keep it open for another four weeks and then it'll go back into the
review system so in a year's time - it sounds like a long time to wait - we'll
review it again sometimes you don't realize how much you help people just
seeing how happy she is compared to how she was in the hospital just it is
really rewarding and it's part of my job that I absolutely love.
Rachel's duties don't stop with immediate service users. Her next call is about a much trickier case
She's on her way to Sunderland's carers centre to discuss how they might
be able to help a woman who's struggling to look after her sick husband.
So he's got quite high-level need, he lives with his wife and they have very minimal
support because John really is quite reluctant to accept a lot of support so
it really falls upon his wife, and she has her own health problem so she's
found it quite difficult. You say you've done a care assessment for her? - Yes.
when you in a situation where someone's really desperate and upset and if you can't
help them for whatever reason - for example the service user won't accept a
little bit more help which would just be amazing for his wife, he has the mental
capacity to refuse a service and that's difficult for her to understand that we
can't just overrule him.
Rachel and her team deal with situations like this
every day, based on assessments made under the Mental Capacity Act.
It's just part and parcel of everyday because we need to be looking up
people's mental capacity around the huge decisions like change of accommodation
we need to also look at the mental capacity around finances and that's
become more more prominent of late - part of that student personalisation looking
forward to direct payments in terms of people choosing what care they want and
where they want it and what we need to acknowledge is whether people have the
mental capacity to be able to manage a direct payment or their suitable person
who can act on their behalf.
Perhaps work with the carer to approach the
gentleman as to how it would benefit both of them to have respite.
It's the emotional side of things for me, you'd go home and you can't just switch off you
do you think about people, you go on leave and you think about what's happened.
Rachel will work with the carers centre to ensure that the man and his
wife receive as much support as possible.
Back at the office, social worker Bertha updates Rachel about the man who was at risk of being evicted
from his residential home. She's happy to keep the placement while she's waiting for the CPN's assessment.
It's good news - for now.
They were happy to retain this placement until the appropriate assessment was
done and then we can look at whether it is appropriate for him to
move on or not. So at the minute, things are ok.
it's now getting towards the end of
the day and a chance for Rachel to catch up on paperwork. As well as acting
manager, she's also practice teacher and on the out of hours rotor.
It can be stressful which is part of it that I really enjoy
and it's really enables you to use the skills that you've got in terms of
trying to juggle things.
I think challenges for anybody in Social Work is
probably always going to be resources it's always going to be money for all
you can know what people need and you can't always give it to them and
that's quite hard, it's quite hard, sometimes can take it quite personally
as well... but I do enjoy it yeah. I mean I've only been here a year but I do
enjoy it, and it's been a very quick year and I've learned a lot in a year.
I know it sounds really corny but absolutely, I love my job
I do enjoy coming to work, I enjoy working with people, I enjoy that there
are different challenges that are thrown at you sometimes it could be just simply
I come back and then someone's not very happy so they want to speak to manager
so that's that's, if my managers not around I would have to do that
somebody phones in sick then you have to run around trying to get cover for duty
or any appointments that they had, so I love my job in terms of the variety and
I'm busy and I like being busy and I like people and... I'd like to think
that we can make a difference and I'd like to be part of that, the success
stories like Vera.