Safe in a Care Home? A guest blog by George Coxon

After recently attending our Accelerated Patient Safety Officer Training Programme, George Coxon, a Devon based care home owner, guest blogs today sharing his insights and thoughts on safety in care homes. This is part 1 of a 2-part blog series.

As a Devon-based care home owner and chair of the popular provider-led Devon Care Kitemark with more than 60 care home members, as well as an active mental health clinician and recent NHS senior commissioner, now dealing with complexity in the care of older people which is almost as complex as the health and social care systems we operate in, life is never dull.

The invitation to attend the recent Accelerated Patient Safety Officer Training Programme run by the Institute for Healthcare Improvement (IHI)  and led by a team of facilitators made up of mainly Boston, USA- based experts was very exciting.  The course was attended by 80 predominantly health managers and clinicians and addressed using the tools and techniques formed around quality improvement and safety system thinking.

Being one of the only social care representatives involved in this, the 3rd South West Academic Health Science Network (AHSN) cohort, I felt my challenge was to ensure I adapted and extracted themes to apply not just to my care homes and those of the Devon Care Kitemark but also to reflect the greater need to promote more health and social care integration and involvement in sharing the methodology and approaches across this great divide.

In mapping out my plan and putting ideas into action, my efforts during the intensive week-long programme were to construct regular mind maps for onward use – sharing these via emails and texts with my staff and fellow ‘Kitemarkers’ – as well as using regular Twitter comments to draw on a far wider population of interested parties. (NB one of my mind maps shared on Twitter was commended by a fellow PSO lead in Minnesota, USA during day 3!)

My copious notes have also already led to several do–able actions that include:

  • Capturing key messages to share PDSA principles eg our care home consultation process on looking at what works in terms of an approach to residents’ activities at one of my care homes – see our most recent blog for more details
  • Addressing using staff huddles augmented with our current team briefings and shift handovers to create new language and thus a refreshed view of effective communications between staff
  • We are combining our ‘celebrating great staff week’ in July with themes derived from the session on psychological safety covered in the course too
  • The principles of Diffusion of Innovation (E Rogers 1962) have been often cited in our Care Kitemark work in terms of the leadership theory of our movement
  • I have also embarked upon a buddying plan with a previously unknown senior fellow course member to both share the impact of the programme in our respective work as well as help improve connections between our services – care homes and the local Ambulance service

Safety in care homes has orientated around prevention more than promotion to my mind. Care homes are, understandably, always vulnerable to adverse attention if something goes wrong and the fear of a full safeguarding investigation in what many feel to be a blame culture. This does impede dynamic and innovation in how we deal with the independence and fun aspects of looking after frail and older people. I will go into more detail in how we address this in part two of this two part exploration of safe in care homes.

Geoge Coxon

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