Caring for those who care
What Makes Us Different?
Dementia Training
There is a suspected 55,000 people currently living with dementia in Ireland. Despite these figures there is a vast educational deficit in the provision of dementia care.
Unlike most homecare providers North Dublin Home Care has a specialist dementia training team dedicated to ensuring that Home Care Workers have the required knowledge and skill-sets to deliver person-centred care.
All of the team have completed DCU’s ‘Person Centred Dementia Champions QQI Level 8’ training and successfully completed the ‘Train the Trainers’ course for “Understanding Dementia for Homecare Workers”, facilitated through Ireland’s National Dementia Office.
FOLD Telecare Responder Service
In partnership with the HSE and Trinity Community Care Clg, North Dublin Home Care provides an out of hour’s service for FOLD Telecare.
This involves the dispatch of Home Care Worker’s (Responders) for the purpose of on call, who will respond to any alerts from FOLD Telecare.
The emergency response service is to all (80+ Service Users) within the North Dublin catchment area who have signed up to FOLD.
FOLD provide an alarm unit and portable personal pendant etc., linked via the ordinary telephone line to FOLD’s 24/7 Telecare monitoring centre. By pressing the pendant or setting off an alarm (door exit, bed etc.), an emergency call is placed through to a FOLD TeleCare Call Advisor. The Advisor offers immediate reassurance and support; whilst arranging additional help were needed.
If a caller does not answer the phone when the Advisor calls back, the Advisor escalates this concern to a family member or alternative point of contact. In the event were the Advisor deems the Service Users emergency contacts to be unavailable, an emergency call-out is made to the Responders. Service Users in the Dublin North community can avail of this service through their local Public Health Nurse.
Lourdes Day Care Centre
Similarly to that of North Dublin Home Care, Lourdes Day Care Centre was founded in the 1970’s. As a like minded community based organisation, the HSE asked North Dublin Home Care for their assistance should Lourdes Day Care Centre require support with regards to their staffing levels.
North Dublin Home Care has always felt privileged to support such a strong established organisation, particularly given its reliance on volunteers. We therefore provide Home Care Workers to assist with the bus collection of visitors to the Centre and cover staff while the Centre’s Care Assistant’s are on annual leave, sickness etc.
Training
North Dublin Home Care recognises that unskilled workforces contribute to the delivery of sub-standard care. When Home Care Worker’s are more adequately trained, this reduces the high turnover of staff, reduces stress and brings about personal and professional job satisfaction.
As an organisation we recognise that Ireland’s current infrastructures do not capture the required person-centred approach to training delivery. Therefore we have made every effort to enhance the provision of training despite there being no state requirement to do so.
Care Collaborations
Likewise we recognise the sometimes overwhelming restraints felt by Family Carers. Congruent with our organisation’s mission, North Dublin Home Care reinvests profits into the company and community in which it serves.
Therefore, one of our investments can be seen in the delivery of free certified Manual Handling and Patient Moving and Handling training to our Service User’s family.
Many Home Care Worker’s assigned to Home Care Packages work directly alongside informal carers (Family Carer’s). Typically made up of family members, informal carers often act as the required second person in high dependency cases.
This practice is common when funding for more hours is not made available by the HSE, resulting in the two types of carers coming together for the provision of safe, quality care. This collaboration of working has helped to build working relationships, often missing in the private sector.
Home Support Worker/Mentor
Currently North Dublin Home Care have 9 Mentors assigned to support new Home Support Workers when they join our company. Our teams are passionate about the work they do and are dedicated to providing top quality help and care.
We have established a staff recognition and training platform to expand the skills of our staff. The role of Home Support Worker/Mentor was developed to encourage employee progression and for the purpose of shadowing new employees to allow them to feel comfortable and confident in carrying out their newly assigned duties.
We now have a recognised support infrastructure in place which encompasses community supervision, advisory assistants and care staff support.
Care To Move
Developed by an internationally recognised training company in the UK called Later Life Training and is informed by current research and policy, North Dublin Home Care are the first homecare company in Ireland to train their workforce in ‘Care to Move’ approaches.
The main aims of ‘Care to Move’ are to:
- Enhance interactions between Home Care Workers and Service Users
- Empower Service User’s to move more during packages of care and everyday living
- Up-skill Home Care Workers to become ‘Movement Motivators’ and increase movement opportunities during visits and between visits
- Improve communication skills, movement principles & prompts to empower long term adherence to physical activity.
Safe move approaches maximise independence, assist in the reduction of stiffness and increase mobility during everyday activities. Qualified Home Care Workers at North Dublin Home Care offer these approaches at each visit, allowing our Service Users to choose how much or how little they want to get involved.
The main message is movement! North Dublin Home Care recognises the importance of moving, reaching, twisting, stretching, sitting forward, walking and standing up regularly. Older people are often afraid of falls. But falls are not an inevitable part of growing older and can happen for many reasons.
You can have a fear of falling whether you’ve fallen before or not. This fear often increases with the memory of previous falls and many avoid activities ‘just in case’. However, prolonged sitting leads to loss of bone and muscle strength, slower balance reactions and feeling ‘wobbly’. It can also lead to a poorer quality of life, depression and loneliness.
The research is a feasibility study on ‘Care to Move’ approaches now being carried out by a research team to evaluate its impact on older people and their Home Care Workers. The feedback will help shape the delivery of future services.
Qualified Staff
As a non-for-profit organisation North Dublin Home Care has been in a position to reinvests all surplus finances gained from the new HSE tendering process back into the organisation, particularly in the area of training.
As an employer we pride ourselves on ensuring the highest quality of care to our Service Users by offering paid training (QQI Level 5) to potential employees which have suitable referees and approved Garda clearance.
To compliment and enhance the skills of our staff we also facilitate on-site training in our dedicated training facilities. We prioritise commitment to our long-standing staff members and each Home Care Worker has been supported to complete their required training, which is some cases required a duration of 1-3 years, were literacy was a determining factor.
This commitment can be reflected in the stability of our staff, some of which have been with the company for 35 years. As a mark of respect, once our Home Care Workers have completed their full QQI Level 5 course they are awarded with their silver qualification pin.
Research
With particular focus on older adult populations, we believe that by conducting research North Dublin Home Care can assist older people to live longer and more independent in their own home. Our strategic planning always incorporates the importance of establishing realistic and feasible strategies to support all older adults to live as independently as possible.
Thus we allocate an annual budget to employ a full-time researcher to investigate potential initiatives to improve current home care practices. We have demonstrated our continued commitment to the future of homecare services in Ireland resulting in 3 academic publications from our working research group. Our co-design approach to homecare services will ultimately inform future healthcare policy and potentially change the way homecare is delivered in Ireland.
Study 1, Title: Prevalence of frailty among community dwelling older adults in receipt of low level home-support: a cross-sectional analysis of the North Dublin Cohort (Kelly, O Brien, Smuts, O’Sullivan, & Warters, 2017).
This study aimed to profile a large cohort of older adults in receipt of low-level home-help (<5 hrs) in terms of their health and dependency status specifically, frailty (n= 1,312). Frailty is a chronic long-term condition related to ageing in which multiple body systems gradually loose their built-in reserves.
It is a significant risk factor for recurrent falls and disability among those aged over 65 years of age. The prevalence of frailty among this cohort was 41.5% with a further 38.4% classified as vulnerable.
This study highlighted a need for earlier intervention strategies targeting frailty for those already in contact with the health service, through their use of home-support services. This is the second largest studied carried out on the prevalence of frailty in Ireland and was cited in a European research review on frailty studies. This study was published in the BMC Geriatric Journal.
Study 2, Title: High prevalence of dementia among community dwelling older adults in receipt of state funded home care packages: implications for health care planning (O’Brien, Smuts, Fan, O’Sullivan, & Warters, 2019).
This study aimed to estimate the prevalence of dementia and related cognitive impairment among older adults in receipt of formal home-support in a defined health administrative area in North Dublin in 2016 (n= 935). The results of this study estimated the prevalence of dementia and suspected cognitive impairment to be 37% and 9%, respectively.
Furthermore, those with dementia and suspected cognitive impairment were found to have a higher dependency status, greater home-support hours, increased communication difficulties and the majority lived alone (51.6%). This study was the first in Ireland to estimate the prevalence of dementia amongst older adults in receipt of formal home-support services.
Importantly, this study highlighted a need for a multi-model approach to home-support, for example, introducing dementia-specific training for home-support staff in the community and developing cognitive-specific home care packages. This study was published in the Irish Journal of Psychological Medicine
Study 3, Title: Predicting admission to long‐term care and mortality among community‐based, dependent older people in Ireland (Aspell et al., 2019).
The aim of this study was to identify factors that predict admission to long-term care and mortality among a cohort of older adults in receipt of formal-home-support in 2017 (n= 1,597).
The prevalence of transition to long-term care and mortality was 8% and 9%, respectively. Physical dependency and advanced age were associated with an increased risk of mortality.
Furthermore, it was reported that cognitive dysfunction which included dementia and related cognitive impairment, and the intensity of home-support hours provided were independent predictors of transition to long-term care among this group.
This study highlighted a need for investment in cognitive-specific home support packages in order to avoid premature admission to long-term care services and support ageing in place. This study was published in the International Journal of Geriatric Psychiatry.
Dementia Research Projects
Our CEO, Debbie Rooney was invited to represent the community regarding the provision of dementia care pilot programme of work undertaken within the community catchment area of the Mater Hospital in the Dublin North Central area.
The pilot programme “Developing personalised supports that are integrated for people with dementia” was supported by the National Dementia Office and facilitated across eight sites in Ireland.
The Health Service Executive (HSE) commissioned Genio to work collaboratively with working groups comprising of representatives from health services in the hospital and community domains in each of these sites. Debbie represented the provision of homecare in the Dublin North Central area
NDHC’s response to the Covid-19 pandemic
Introduction of Covid-19 Officers with Specialised Training
In response to the Covid-19 pandemic, NDHC’s Health and Safety Advisory team completed specialised training to become designated Covid-19 Compliance Officers within our organisation. The Covid-19 Compliance Officers are responsible for implementing required protection and mitigation measures to ensure the safety of all staff.
The Health and Safety Advisory Team includes the following members:
- Debbie Rooney, CEO
- Lisa Murphy, Service Manager
- Debbie O’Shea, Quality Lead/ Safety, Health and Welfare at Work Officer
- Miriame Belusi, HR Officer
- Caroline McCann, Service User Care Manager
The Health and Safety Advisory team is the first point of contact for all information relating to suspect cases amongst service users or staff. This designated team monitor all suspected, confirmed, or close contact cases of Covid-19 related to the organisation. Each member of the Health and Safety Advisory Team has a pre-defined role and set of responsibilities. The responsibilities of the Covid-19 Compliance Officers are time-sensitive and clear protocols have been established within our organisation for all Covid-19-related cases. The formation of a Health and Advisory Team and the implementation of clear processes has successfully minimised the impact of the Covid-19 pandemic on our services.
Protecting All
NDHC is dedicated to protecting the safety, health, and wellbeing of our staff and service users throughout the Covid-19 pandemic. In line with government regulations and guidance, the protective measures implemented by our Health and Safety Advisory team are evident throughout the office and within the community. Perspex screens were installed at reception; this acts as a protective barrier between staff and visitors. Face masks are mandatory within the office building and hand sanitiser is provided at all entry and exit points. We have implemented daily cleaning schedules with designated office staff disinfecting all handles, light switches, and other frequently touched surfaces every hour. Importantly, Personal Protective Equipment (PPE) is continuously provided to all staff which includes face masks, gloves, aprons, and goggles.
NDHC understands the importance of reducing face-to-face contact in mitigating the impact of Covid-19. In-person meetings have been replaced, where possible, by video conferencing calls and the sharing of physical documents has been reduced by the implementation of upgraded IT systems. Additionally, NDHC has adapted to working from home practices where possible, with administrative staff split between office-based and working from home teams each week. While the way we work may have adapted throughout the pandemic e.g., all staff have access to the specific equipment and technology if required to work from home, ensuring that our commitment to delivering high quality care remains unchanged.
Recognising NDHC Home Support Workers’ Dedication to Service
NDHC has long championed the important role of Home Support Workers in supporting individuals to remain living independently within the community. The unwavering dedication of Home Support Workers to the individuals they provide care for became increasingly apparent throughout the Covid-19 pandemic. The demands placed on Home Support Workers have never been greater than in the last year. Throughout the initial stages of the pandemic, when fears and uncertainty reached an all-time high, our dedicated staff continued to provide essential services in the community, without hesitation. NDHC wished to acknowledge the immeasurable contribution and resilience of our staff throughout the Covid-19 pandemic. All staff who displayed dedication to their role were presented with certificates for outstanding contribution to service, commemoratory pins, and a bouquet of flowers. These tokens of appreciation aimed to acknowledge the increased efforts from all in providing person-centred care, in often challenging and uncertain times. NDHC feels privileged to work with such committed professionals who in our opinion, are the unsung heroes of the pandemic.
Learning from the pandemic
These uncertain and challenging times may have adapted the way we work, but not the quality of care we deliver. NDHC has invested in research, which captures the voice of service users to ensure our services continue to be led by the needs of the community. During the initial waves of the pandemic, we conducted telephone interviews with older adults in receipt of our care. This was to monitor any reported declines in physical function or quality of life. Secondly, we conducted surveys with our home support workers, to gather their suggestions on how best to deliver physical activity prompts while maintaining a social distance. Finally, as we begin to emerge from the pandemic, NDHC supported research examining the overall health status, specifically muscle strength, among our service users. The findings from this research will inform the delivery of our care and the development of proactive multimodal community interventions that support ageing at home.
