Carers live in a land called Upstream

Plitvic

“Treat the future well; it was not given to you by your parents, it was loaned to you by your children”    Adapted from a north American Indian saying

Any sensible review of care; how we provide it and the cost of providing it, will recognise that we need to intervene upstream. This blog takes a view on the lack of support for carers, those 6.5million unpaid friends and family members who day after day provide the care without which our health and social care system would be overrun.

Goldsborough Coaching & Consultancy

So what do we mean by upstream?
Looking for the causes of long term health e.g. educating and encouraging healthy eating and exercise helps prevent type 2 diabetes, cardiac disease and a 101 other ailments. Providing early intervention with mental health problems helps to prevent hospital admissions, sex education helps reduce unplanned pregnancies etc.

As Public Health notes, investing upstream in prevention rather than downstream in intervention is often wiser and more effective, or as grandma said “a stitch in time…”

Simple then, so why do we sell off playing fields whilst increasing a focus on the 3 R’s and then act surprised when surrounded by childhood obesity? Why when faced with savage local authority cuts is our attention immediately drawn from prevention to the pressing symptoms and expensive reactive interventions?

So in this extended period of austerity let’s talk about carers,  if carers stopped today the swamped system which would collapse tomorrow – simple. Nothing can be clearer than the upstream contribution carers make to the system.

You may say “well it was always thus” however the UK demographic is changing strikingly, some facts to ponder:

• One in five people aged 50-64 in the UK are carers to an older family member, yet the same number have no children of their own to fulfill this role for them, already one million over 65’s fit into this category and this is forecasted to double by 2030.

• Carers aged 75 and over have increased by 35% since 2001

• There are now more older people in need of care than there are adult children able to provide it.

The 2014 Care Act did provide recognition and provided some rights e.g. to have a carers assessment, but the harsh reality in these times of de-growth is that cash strapped local authorities fail to ‘advertise’ this, have created waiting lists and have then restricted the resources allocated post assessment.

Surely if we cannot get our act together to do anything else upstream, we should be providing much more meaningful resource to the unpaid workforce that lives there, because if they crumble its game over.

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A cruel irony

police#

“Do not make important what you can measure, measure what is important”

The CQC are officially part of the drive that causes the outcome they are not going to measure – read on!

Goldsborough Coaching & Consultancy

The CQC have just released a report – ‘The State of Mental Health Care’ & Michael Brown in his Mental Health Cop (highly recommended) blog notes from the report:

“There is national concern about the difficulty of finding a bed when a young person requires inpatient care. When a bed is found, it is often a long way from the young person’s home. We do not always detect this unmet need because our assessment focuses on the quality of the care provided to patients who are already on the ward, and not to those that require or are awaiting admission. However, we have received reports of the impact of the unavailability of inpatient care. This includes a letter from an assistant chief constable about a 17-year old who was kept in a police cell for 78 hours because no bed was available. The assistant chief constable commented that “the majority of this time in police custody was unlawful and it amounts to a human rights violation, given that Article 5 of the European Convention on Human Rights prevents detention by the state except in accordance with processes outlined by domestic law”.

He goes on to note that police forces have threatened and started action against the NHS over this issue. If this is not a clear indication of how bad things have got and how community mental health need is being mopped up by the police then I do not know what is!

But can we take this analysis one step further, namely that the source of the problem is the powerful Transforming Care Delivery Board’s (TCDB) overtly stated intention to sharply reduce inpatient beds (in which they are succeeding) it is this that has lead directly to this kind of suffering.

Now the idea that better designed services in the community will be forthcoming is a cruel farce. The scale of the cuts to local authority budgets over the last few years has meant that far from services moving up stream the only thing that has gone up is the threshold criteria to receive services.

However let us just consider a further cruel irony in the system; the CQC are extremely unlikely to drill down on this issue because they formally signed away their neutrality when they signed up as a core member to the TCDB – they are officially part of the drive that causes the outcome they are not going to measure!

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Wimbledon without rain

Wimbledon

“Everyone needs a coach. It doesn’t matter whether you are a basketball player, a tennis player, a gymnast or a bridge player”  Bill Gates

Goldsborough Coaching & Consultancy

Can you imagine a Wimbledon without strawberries & cream, the tournament without rain, the players without coaches?

It has been done……but very rarely indeed.

Players hire coaches to be the best they can, their performance is important to them, they desire to excel & to that end line up the best support they can find.

Business is fast catching on, taking decisive action & getting results “Recent studies show executive coaching to be the most effective means for achieving sustainable growth, change and development in the individual, group and organisation.” HR Monthly

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Theory & truth in the labyrinth

Theory

“No theory can be right because no theory can have all the answers & hold a monopoly on the truth”

Goldsborough Coaching & Consultancy

Earlier this year in Marrakech I was hunted down through a labyrinth of streets by a trader who had shut up shop to catch up with me. When he eventually did so he grabbed my arm & various scenarios flashed through my mind, none of which came close to the truth of what was about to transpire.

He duly informed me that I had mistakenly given him the equivalent of £100 too much & counted out the notes methodically before me! Needless to say we parted as friends.

I admit it did leave me a bit perplexed, not what I would have expected in theory & it took a while to adjust to this new truth.

I think it is rare that our experiences are this cut & dried & so the reality check an experience has the potential to provide us can get overlooked in favour of previously embraced theories. In many ways coaching should provide a space to challenge ourselves and our theories and test them in a safe space, to ensure that practice informs theory as well as the other way around.

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Coming alive

dav

“Don’t ask yourself what the world needs. Ask what makes you come alive. Because what the world needs are people who have come alive”   Harold Whitman

Goldsborough Coaching & Consultancy

In many ways this goes to the heart of coaching; getting in touch or reconnecting with our core self & ensuring our actions are congruent with this, enables a kind of coming alive or reawakening .

Skilled facilitation can help to remove the tarnish & rust from our best self, helping us to set aside our mind-forged manacles, towards improved vision & performance.

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By their fruits

lights

“The real test of a leader lies not in the personality or behaviour of the leader, but in the performance of the groups they lead. By their fruits we will know them”    Rosemary Stewart

Goldsborough Coaching & Consultancy

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Inside / Outside?

In out

“The answers aren’t out there, they’re in there”  Goldsborough Coaching & Consultancy

How often are we seduced by the notion that the answers we need are to be found outside of ourselves?

In a world of living by algorithms it can seem faintly ridiculous to validate our own resources.

When creating a strap line to capture the essence of my business coaching role I thought it important to nail my colours to the mast;

“The answers aren’t out there, they’re in there”

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