How a UK council is helping a remote Atlantic island deliver social care

The island associated with Napoleon’s exile has forged a relationship with a Scottish council to improve its social care. Natalie Valios reports

A job advert in Community Care has led to an unlikely relationship between Midlothian Council and St Helena, a remote British Overseas Territory in the South Atlantic where Napoleon spent his final days. In 2009, Penny Watson, then a care manager and practice teacher for the Scottish council, successfully applied to the advert for a one-year post as social worker and trainer to develop the island’s community service for older people and to train its two new care managers.

In a continuation of that process, in August care manager Sandi Francis left St Helena for the first time in her life to undertake the nine-day journey by ship, air force plane, London Underground and train to Edinburgh for a nine-week observational visit of Midlothian’s older people’s services. The trip is funded by the St Helena government which sends a small number of staff overseas each year for experience and training.

Access to quality training

Despite obvious differences between the two places, there is common ground. Like the UK, St Helena has an ageing population – 18% are older than 65 – and life expectancy is comparable. “The number of older people is rising steadily and the young often leave to work elsewhere, which is similar to here,” says Watson, now a hospital discharge social worker for Edinburgh Council. “A lot of older people return to St Helena to retire which adds to the demographic.”

Accessing high quality training is challenging because staff would have to travel thousands of miles for practice accreditation. As a result, no one on the island has any formal social work qualifications and Watson’s main role was to train the care managers to carry out comprehensive assessments and put together care packages. The older person’s service receives referrals for everyone over 65 who may need social care, including home support, sheltered accommodation and residential care.

Francis is enjoying seeing how Midlothian’s reablement service works as she feels the service in St Helena is similar, if smaller: “Here so many people get involved [with one client] and I’m not used to that; it’s just me, the client and my manager who need to know the information.”

Francis and her colleague, Ivy Thomas, manage a team of 70 care workers who provide support in people’s homes, including personal care, cooking meals and shopping. Some of the male care workers chop wood for clients’ stoves. Supporting people to remain at home is a key issue, but there are obstacles, says Francis, not least that an hour of care pays just £2.31. Most care workers are part-time and live near the person they support, but the terrain is hilly and some houses can be difficult to access, she adds.

Speaking to Community Care four weeks into her visit, Francis already has a couple of ideas she wants to take home to discuss with her manager. She would like training for the care workers, who are unqualified, and she is also interested in exploring using telecare more widely, for example incontinence sensors for people in their own homes.

Grant Dugdale, community care social worker at Midlothian, is overseeing her visit and says he too has learned something from the process: “You can take the service for granted, but when someone is shadowing you and asking questions about why you did this or that, it makes you think about what you did and why, and what you could do differently.”

Francis feels she is benefiting from seeing the bigger picture but is not tempted to leave St Helena. “I would rather stay there, it’s so safe. I’m proud of our care service and we go out of our way to look after our clients.”

Social services on St Helena

● Of a population of 4,000 on St Helena at the 2008 census, 26% are older than 60 and 18% older than 65.

● Within the island’s public health and social services department there is a social work team, with four staff who work with everyone under 65 who needs social care, and the older person’s service, which works with those older than 65 and consists of two care managers (Sandi Francis and Ivy Thomas) who manage a team of 70 care workers supporting people in their own homes.

● There is one care home on the island with 49 beds; one hospital; and three sheltered accommodation facilities.

● Although there is now child protection legislation, there is no adult protection legislation or community care act.

● There are no private sector services.

Picture caption: Sandi Francis (left) from St Helena takes tips from Penny Watson and Grant Dugdale

Community Care 13 October 2011: ‘Distance Learning’

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