Life in a care home

We’re going to find out what it’s like to live and work in a care home. Chris Smith went to Walton-on-Thames - to the south-west of London - to meet Slawomir Janik who manages Adelaide House. Chris started by asking him what he sees as the biggest areas for improvement in his line of work…

Slaw - So I think one of the biggest issues is the miscommunication between different organisational governing bodies. We're talking about different services like the NHS, GP practices, pharmacies, hospitals, and then governing bodies like the CQC. The communication line with local authorities is such that each one of us is almost like an individual entity instead of being a joint one. So we have different processes, different systems. Because the other one uses a different system, we basically have to repeat the same information over and over again.

Chris - A big digital disconnect then?

Slaw - Extremely. I think there are currently around 15 to 20 different programmes used across almost the same services within the national system, so yes.

Chris - How, in your mind, does that affect the care that we're able to give to residents in a care home like this one?

Slaw - It takes up time. It's the time we’re supposed to spend on the floor with the residents, fulfilling their needs, that gets taken away or restricted because we also have the legal aspect which has to be shared with so many different organisations. It's time-consuming and not effective.

Chris - Let's think about a person's journey then. Say a person has a problem and they need to go to hospital. How readily can the information follow that person to hospital to inform what the doctors do while they're an inpatient?

Slaw - Within a care setting like mine, we use something called a passport or documentation package, which we provide to the hospital with all the information relevant to the resident. That data may or may not be used in the hospital, and on the way back, it may not be shared. So we require very specific information when somebody returns to us. Of course, we need to know their medical condition, medication changes, and what treatment is expected from us. If that information is not provided to us—because on some occasions it may be lost in transport, or the wrong information was given, or medication was given incorrectly or not at all— that will set us back to square one, where we have to contact everyone again and try to obtain the vital information. The residents will suffer delays, and unfortunately, in some situations, those delays may have a detrimental effect on their health.

Chris - Vivaldi aspires to try to change some of this, particularly with respect to infections first. How common is this as a problem? And how do you think having better data collection could enable you to act in a more agile way and manage infection problems better?

Slaw - Infections are quite common within a care setting, especially with the client group we are working with. The benefit of Vivaldi will be recognising common trends and pre-empting a certain level of incidence. One of the most common is urinary tract infections, which are simple infections that can be quickly resolved with antibiotics—or very often avoided altogether by having certain interventions in place. Vivaldi will be able to pinpoint these and share insights across services. It will stop a domino effect. Very often, something that starts as a simple infection leads to severe consequences.

Chris - What do your residents make of it? Are they aware that they're making history here and that, with this project, they're actually helping to improve the care sector?

Slaw - They see themselves as being interesting to others. I think that's the most important thing—that at this stage of their life, they’re contributing significantly to the future. Quite a lot of residents are aware of the programme. They may not know the exact name of it, but they know that this information is important. In some ways, it also brings additional meaning to their lives. People often see being in a care home as the final stage of life—and in some ways it is—but it's also still a stage where you can contribute for the benefit of those who are 20 today but will eventually reach this stage.

Chris - Shall we have a chat with some of them?

Slaw - Yes, let’s go and meet—let's start with Eric. Come with me. Chris - Hello Eric. How are you doing?

Eric - I'm okay.

Chris - How long have you been here?

Eric - This is my second year.

Chris - What do you make of being in a situation like this? Were you at home before and had to come into the care home?

Eric - I was independent, living on my own with my little dog. My son was worried about me because I couldn't cope on my own. So he suggested I come to a care home and I ended up here.

Chris - How old are you, Eric?

Eric - 85.

Chris - Really? I wouldn’t have thought so. When you had to make the transition from life at home to life here, what was that like?

Eric - Hard. Very hard. I've been independent all my life and I've got a good family around me, so they helped me transition to come here. I never thought I’d reach this age. At the start, I thought I'd be 70 and that would be it. But I joined the Royal Navy straight from school and that was a good step for the rest of my life. I've always been very positive.

Chris - Thank you very much, Eric.

Eric - You're welcome. Thank you.

Slaw - This is Linda.

Chris - Oh, hello Linda.

Linda - Hello.

Chris - How are you?

Linda - Very well, thank you.

Chris - How long have you been here?

Linda - A year last May.

Chris - And what was the reason for coming to live here?

Linda - To be close to my daughter's home in Brentford. I had a stroke, and if I’d stayed in accommodation in Leeds, it would have meant them having to travel all that distance just to visit—and I wasn’t having that. I made the decision to come and live down south.

Chris - What’s it like having to leave your own home and come into a setting like this? Was that hard?

Linda - Yes, it’s hard to start with. You have to move away from your friends and neighbours.

Chris - What’s made it easier, though? And how are you getting on now?

Linda - I’m getting on great at the moment. I've seen my daughter and she’s seen a difference in this place for me.

Chris - Have you been poorly at all while you’ve been here? Have you had to see the doctor?

Linda - Just small things, nothing major.

Chris - Was that a routine, easy thing to do—seeing the doctor?

Linda - No, it’s like getting blood from a stone.

Chris - Really? Was it just hard getting an appointment?

Linda - That’s how it is these days—getting the doctor to see you.

Chris - Do you know that the home here is taking part in a research study to try to build a better way of collecting and sharing information with other healthcare providers like hospitals? Are you positive about that sort of approach? Do you think it’s a good idea?

Linda - Yeah, definitely.

Chris - So you don’t mind being a guinea pig?

Linda - No.

Chris - You’re very future-looking. You’ve got an iPad on the table in front of you, so you’re obviously quite tech-savvy.

Linda - No, definitely not. I know what I need to do for what I want to do, but for the rest of it I need help.

Chris - I think we all need a bit of help, especially in this era. Linda, thanks very much for talking to me.