The following reflection was written to client Operators attending the Target Round Table event, where we bring our Tenants together under Chatham House Rules, to discuss sector trends, concerns, and best practice. 

Dear friends,

I am so disappointed that I am not able to be with you this evening. You may have heard that I have had something of a health scare. I am now doing my best to behave and rest while my body heals, and I regain my stamina.

As some of you may know from personal experience, sometimes a hiccup in our health or that of a loved, one leads to a pause for reflection; or something deeper like a change of lifestyle, or a reordering of our priorities. This is possibly something we should be doing in a pre-emptive way rather than waiting for some life-changing event to force us into it!

During the last few weeks, I had the privilege (of sorts!) to analyse the deeper workings of NHS ‘Intensive Care’, spending 8 days in a Critical Care ward hooked up to all manner of contraptions, losing all sense of independence and feeling very vulnerable, especially once the opiates wore off!

As I became more aware of my surroundings and the teams caring for me, a lifetime immersed in care got my brain ticking, and, from this, the outcome of what I want to pass on to you today. Of course, I know I am likely teaching you to ‘suck eggs’ as the old saying goes, but sometimes it’s good, as previously said, to stop and reflect!

One event which will stay with me for a long time was waking up at 11pm in the ward. The lights were dimmed, I was wired up to numerous machines, and staff were busy elsewhere. Within minutes, I began developing an irrational (in hindsight) anxiety that quickly led to a feeling of terror like I have never experienced in my life. For the first time during my stay, I realised I had no nurse call alarm. The staff in intensive care, of course, rely on monitors to alert them to rising blood pressure or agitation and, because I was lying stock still, I didn’t register in a hurry. After what seemed an age, but was likely only a few minutes, a nurse came over and sat with me for some time, gently reassuring me. I drifted back to sleep, and thankfully awoke in the small hours with no further anxiety.

That event gave me a lot of food for thought: the nurse who reassuringly sat with me; her many colleagues who stopped by over 8 days to gently turn me, clean me, encourage me to help myself, to stand, to wash to walk, or just to talk.  It reminded me of the care likely given each and every day in your own homes. Yes, there were one or two who had lost the vocational spirit of caring, albeit still completely professional, but on the whole, this was the NHS at its best. I know in the Social Care Sector we sometimes have frustrations with the NHS, but the quality of care in this department was exceptional.

 As I improved, one thing that concerned me was that almost every one of the staff were obviously completely frustrated by the ‘system’, and seemingly most were frequently considering moving on.  I gathered that they often felt unappreciated, had restrictions on resources, and were constantly delayed from leaving work after long shifts due to staffing difficulties.  

It made me think, in respect of our own enterprises, how we must seek out staff who have a great ethos and a vocational spirit, and, once we have done that, resource them, encourage them, and reward them in a way that honours them! We must also root out those who treat residents with disinterest and indifference and have no place in care, unless we can inspire or reinvigorate them.

"We must seek out staff who have a great ethos and a vocational spirit, and, once we have done that, resource them, encourage them, and reward them in a way that honours them!"

When we walk your homes, we often see lovely interactions: hugs; and gentle, caring directions; and we love that. We realise that in the scheme of things, skilled, compassionate caring is so much more important than a frayed carpet or some boring maintenance issue. Albeit we will continue to nag you over those!

In light of my experience, I encourage you also to walk (or continue to walk) your homes and look for those great caring qualities on a regular basis. I appreciate those with larger enterprises cannot do this easily. But then perhaps you need to find a trusted ambassador to do that for you, someone who has direct access to you and your senior team. I am not convinced that area or regional managers work in this scenario, they are often too busy and bogged down in the pressing issues of the day. We all know that encouragement and resourcing our teams well bring with it loyalty and reduced turnover. But even more so, it should spill over into better support and comfort for the residents, whose lives are ultimately in our hands!

I hope you have a stimulating evening. The entities you run are complex and challenging (despite what the public think) and I wish I could be there to encourage you personally. What you do should be recognised as a more noble task than you are given credit for.

And remember- don’t be a ‘distant’ head office!

Andrew Brown, Head of Healthcare. Nov 2023