The Croydon care support team was developed in response to reports of abuse within long-term care services several years ago. Set up in 2008, this multi-disciplinary team is a joint initiative between Croydon Council, NHS South West London, and South London & Maudsley NHS Foundation Trust.
Croydon has more care homes, nursing homes and private hospitals than any other London borough, and the team’s aim is to improve the quality of these services through training, advice and support, with an approach that places an equal emphasis on the social, mental health, and nursing needs of residents.
The team comprises the manager, Zowena Green, who is also the council’s Mental Capacity Act manager and Deprivation of Liberty Safeguards lead; a senior social worker; a community psychiatric nurse specialising in dementia; and a registered general nurse.
Training requested by care homes
They go into the homes to deliver training direct to staff. The team’s involvement is either as a result of a safeguarding investigation, where the chair of a serious case review may refer the home to the team for support in implementing safeguarding plans, or the home self-refers. The latter accounts for 70% of cases, says Green, because “they recognise they need help”.
“The first thing we do is carry out an audit with the care home manager to find out which areas need addressing. As part of this we look at things such as how they evidence practice, how they record risk assessments, and the support available to staff.”
Health and social work specialisms
Each practitioner from the team has their areas of expertise, for example, the senior social work practitioner leads on person-centred care planning; risk assessments; dignity in care; introduction to safeguarding; mental capacity and Deprivation of Liberty Safeguards. The psychiatric nurse leads on mental health awareness, dementia awareness, and understanding schizophrenia.
“There are several services that we signpost homes onto once we have worked with them, including a specialist community pharmacist, a local hospice, and a specialist falls nurse,” adds Green.
An independent evaluation of the team in 2010 found strong evidence of its effectiveness and impact, including reduced rates of readmissions to hospitals and fewer suspensions of placements at homes, increased awareness of safeguarding issues among care staff, improved communication between staff, and improved quality of care.
The knock-on effect is financial, says Green: “If standards rise in care homes then it is less likely that hospital will be thought of as an option because staff will have the skills [to continue to care for residents].”
For other agencies considering working together in a similar fashion, Green says: “You need buy-in from the local authority, mental health, community NHS and hospital services. Any strategic commissioner has to have the view that this is a project that will lead to enhancing and improving standards in care homes.”