Views Voyage Care Voice – S2E7: Outstanding Prader-Willi Syndrome support
After a successful pilot season of Voyage Care’s first ever podcast, we are excited share our second season with everyone! Relaunching as Voyage Care Voice, our podcast will be showcasing real people with real insights.
In this season, we’ll be focusing on how important quality is in the social care sector. This week, we’re hearing from Loraine Swinburne, Service Manager of Redbank House and MorganJo Murray, Deputy Manager of Esmer House. Redbank House is one of our Prader-Willi syndrome specialist services and is rated Outstanding by the CQC! The staff team provided a great amount of support to Esmer House, a nearby Prader-Willi syndrome specialist service, when they first opened. This episode will explore how the two staff teams worked together to ensure excellent quality care is provided to the people we support at both services.
Since recording this episode, Esmer House has received an Outstanding rating from the CQC on their first ever CQC inspection!
Prader-Willi syndrome support
The staff in our specialist care homes and community support hubs are experts in providing the best possible care and support for people with Prader-Willi syndrome across the UK. To learn more about our specialist support, visit our dedicated webpage.
Catch-up on Voyage Care Voice
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Read the transcript of the podcast below.
Loraine Swinburne:
Hello, I’m Loraine Swinburne. Welcome to the Voyage Care podcast. I am the Manager of Redbank House, which is a Prader-Willi specific residential care service, and I’m here today with Morgan.
Morgan:
Hello everybody, I’m Morgan, I’m the Deputy Manager at Esmer House, the Prader-Willi specialist service.
Loraine Swinburne:
And today we’re going to be discussing quality at both of our services, Redbank and Esmer House and how we deliver high quality care and support.
Loraine Swinburne:
Morgan, can you tell me a little bit about Esmer House, when you opened and why?
Morgan:
Yeah, so we opened in January, 2020, just at the beginning of the pandemic. We opened because we were getting a lot of referrals through Nottinghamshire that were Prader-Willi and obviously we had only got Loraine at Redbank that was a Prader-Willi service. So, we were getting all these referrals with nowhere to go because Loraine’s full. So, Alex got approached to open Esmer House and that’s what we did. We went searching for houses what would be suitable. And then that was that. We went from there, we had all the worked on, we opened at the beginning of 2020. I had a lady move in straight away, who Alex had previously worked with at a previous job.
Morgan:
Then moving forward from that, we had a few open days where social workers and family members came and then we got another person that we support, from the open day and a family member and his social worker visited on that one. He moved in in the March, then we went through lockdown, came and then I had another young lad move in. He moved in around July time. Then from that, we were all back open and it was fine again. Then we had our last two move in. So, from next week, we will be full, just after 18 months.
Morgan:
When Esmer House opened, we did have Loraine that helped with a lot and Janine from Redbank and they helped us with ensuring that the high quality in care and support. So, Loraine, do you want to explain just some of the ways that you ensure that we are giving high quality care and support?
Loraine Swinburne:
Well, we were instrumental in delivering a lot of the training to the staff members around Prader-Willi syndrome. When I started at Redbank House 13 years ago, I hadn’t even heard of it. So, it is a very, very complex syndrome. When you first meet the guys, it’s very difficult to see what the issues are because they’re not at surface level, they’re much deeper.
Morgan:
I think for Loraine to come over and give us the training, it was much appreciated because even me as deputy manager, I had heard of Prader-Willi but I didn’t know all the complex situations and the things that come with it. Like Loraine says, it’s not surface level, there’s a lot deeper things. There’s a lot more mental health involved and being able to spot it. So, even interviewing staff that had never heard of Prader-Willi syndrome before, it was quite difficult to have even get going with a staff team. It’s not common. You could ask somebody, “Have you ever heard of Prader-Willi?” And they haven’t, they don’t know.
Loraine Swinburne:
And very often, you will come across people that say, “Oh yeah, I know about Prader-Willi syndrome,” and they just mentioned the eating side of things, which actually is probably the easier part to put measures in place to help them cope with their satiety response. But there is so much more than that. So, it’s very important that everybody gets to understand exactly what’s involved with a person with Prader-Willi syndrome and exactly what their complications and the things they find difficult, what they are.
Morgan:
I think it helped more that Loraine had got so many years’ experience because when she delivered that training, it wasn’t your standard set training, she could tell you … Any question that you asked, she’d already had that situation, or she already knew of the answer to tell you, because she’d already been there before, after 15, 20 years of working at Redbank. Whereas I was asking questions that probably sounded quite minimal and it isn’t now until a year later that I thought, “God, that’s what I thought was going to be the worst part,” and it wasn’t. I thought the fridge and a freezer being locked and things being put away was going to be the worst part and actually, that’s minimal compared to the rest that come with it.
Loraine Swinburne:
So, in terms of ensuring high quality care and support, I think you can’t break that down and do it justice because there’s so many layers to delivering high quality care and support and they all interlinked with one another. For us, I think it’s important to have a team on each shift, which incorporates age, experience knowledge, obviously all the care and support that you deliver is person-centred and it’s paramount to have good communication throughout the entire team because continuity of approach, in most services but especially with Prader-Willi syndrome, is absolutely essential. You really do all have to sing from the same hymn sheet.
Morgan:
Yeah, I agree with that. I think being new and opening, even a staff that may have been rung sick, just the little bit of changes like that, I didn’t pick up on how big that would be to somebody else’s day and the impact that that would have. So, just staff communication was a big one when we first opened, making sure that they all knew. Like Loraine said, a balanced team, not a big turnover for staff because they can’t cope, they can’t understand the reasons why.
Loraine Swinburne:
Yeah, managing change is a big thing because change is something that they do struggle with most of all. Changing routine, change in staff members, any disruption to the day can really make a massive difference. So, there always has to be a strategy in place and approach to that strategy is paramount.
Loraine Swinburne:
So, in terms of when we were working alongside you, all of us at Redbank House, and obviously we had staff coming over and shadowing. What do you think Morgan, that you learned from us as an outstanding service, that you’ve been able to take into your service moving forward?
Morgan:
I think from come over and shadowing your staff members on day-to-day and different times of the day as well, because I think that was important. It’s things just from like little paperwork that Loraine would have made, that’s not anything big but it’s just so stuff know. So, I can always remember that Loraine has got something in place that says about their morning snacks, their afternoon snacks and what they’re having and what they’re having on certain days. At first, I used to think, “Oh God, this is really scheduled. This is really intense.” And it isn’t until now, actually, that I have that same format for mine because they can’t know the difference between Monday they’re having one thing, Tuesday they’re having another and it has to be in black and white, it has to be on a sheet.
Morgan:
So, for me, I think it was the bits that you don’t think of for the staff to pick upon. So, coming over and looking at all the things that have made Loraine and Redbank outstanding, that we then can take away and use. I think when we last … We’ve just had asked CQC inspection and I think that they was very impressed with the support that Redbank had gave us and given the staff the quality training of what we needed before we’d even opened, because we’d been coming over there for a good three, four weeks before we had anyone even come and move into Esmer House. So, just general knowledge is a big one. Just helping, just think like when Redbank staff came over to Esmer before we’d opened, I’d got just a standard bin and it was just things where Loraine would say, “Oh, you know, Morgan, we could swap up for this reason and you might not want that for this reason.” So, just their time, the dedication to help us and just their compassion and kindness to get up and running the same level as them.”
Loraine Swinburne:
Yeah. I think one of the things I would say is that my availability is always there. So, very often when they have different scenarios and different things happening, they’re able to just get in touch with me and say, “Well, what would you do in this circumstance?” Usually I do have an answer.
Morgan:
I think that just knowing that Loraine’s just at the other end, that speaks volumes in itself because I can just pick up the phone and be like, “Oh my God, Loraine, please help me, what would you do?” And she’ll know the answer. There’s never been a time where I’ve rang her and it’s not been like, “Oh God, I’m going to have to get back to you on that one. Let me have a think that it.” She’ll give me the answer, she’ll tell me what to do. I’ll put the phone down, I’ll deal with whatever it was, and I think, “Oh, perfect. Sorted.”
Morgan:
So, Loraine, can you explain how you measure quality over at Redbank, that might be different to here as Esmer?
Loraine Swinburne:
Well, obviously you’ve got all your quality audits and I’m one of those very strange managers that actually loves an audit. It helps me experience and know that what I’m doing, I’ve got things in place, and obviously my quality scores, if they’re below 95, I’m not happy. So, that’s just one of those things. But in terms of measuring quality, the people we support, their quality of life, are they happy? Are they getting as much experience from life as they possibly can? They set their own goals, things they want to aspire to, and we do baby steps towards the bigger ones, and then obviously the ones that we can meet sooner, then obviously we make those happen.
Loraine Swinburne:
We have one young lady, who her entire family are in Australia. Before COVID hit, I needed to know how this young lady was going to cope with a long-haul flight, because it’s not just as straightforward as putting somebody on an airplane and seeing how they crack on. So, that will be hopefully April next year, we’ll be taking her to Mexico to see how she gets on. Obviously, I’ll be doing a lot of research and studying how she copes with changing time, weather, because all of these things can affect them. So, that’s one thing we do to ensure that they have quality of life, that they get the experiences they want from life.
Loraine Swinburne:
I think the other thing that I do like is feedback. I’m constantly in touch with external professionals, family members, and I persistently ask, “Is there something we can do better? Is there something you think we can improve on?” I always say, “I don’t mind negative comments if you’ve got any negative comments, just hit me with them.” Because I need to know where I can improve if I haven’t identified it myself.
Loraine Swinburne:
In terms of quality, obviously I think the quality assurance in Voyage Care is second to none. I’ve got a lot of friends in the health and social care sector that work for other companies, that just don’t have the set up that Voyage Care has. It really is second to none in terms of us always being able to measure what we have in place and what we deliver.
Morgan:
Yeah, I think I agree with Loraine with that. I mean, you can always refer back to consolidate and action plan when you’ve done your audits and that improves the quality that you’re given. You won’t know what you’re missing out on if you’ve not got them. So, I agree with Loraine, I do quite like a quality audit, and I think you’ve just got a look at your service, can your hear laughter, can you hear having fun? It’s all right saying, “Is all your office-based stuff done?” But also, this is somebody home. You’ve got to make sure that they’re living their best life, happy with what they’re doing, that they’re meeting their needs, they’re meeting their wishes. And definitely I agree with Loraine, family involvement, because they are such a big part of how you run and how you manage their family while living here.
Morgan:
I’ve got a young man who has got a really big family, he’s got four sisters and a brother. I just think he has got so many family telling him different things when they’re coming to visit, what they’re going to do, and that can be quite a lot for him because he’s got all this happening and I won’t even know because they’ll speak to him directly. So, a lot of the time we’ll have a monthly meeting with his mom, and we’ll be saying, “What’s happening? What are we going to do? What’s the steps going forward, please let me know if I can do anything this end, if you need any help that end.” So, definitely having good family involvement, and then it just works better for them because you all know that they’re on the same page. He’s not going to get anything more from his family that is not going to get from here. And he knows that when he goes home, I know what’s happening and what they’re doing.
Loraine Swinburne:
Yeah. I think going back to what Morgan said about laughter, that is probably the one comment that Redbank House gets the most, how much laughter there is. Admittedly, sometimes you have to laugh because otherwise you’d cry, but every day is a school day with our guys. If for whatever reason that laughter wasn’t happening, then I’d seriously question what was going wrong.
Morgan:
Yeah, I agree. I think that even though you have to be so serious all the time around most of their daily life decisions, you have got to make it as fun as possible for them because if not, they’re already cut short of what they can and can’t do, so taking away their daily laughter and daily fun and what they do, it’s quite sad really.
Morgan:
So, Loraine, obviously you’ve been at Redbank House for over 10 years. So, do you think that the quality has changed over the years and the approach to getting to that high standard of quality?
Loraine Swinburne:
Yeah. I mean, I don’t know when they were first introduced, because obviously I’ve been a manager, what three, four years? But I can remember as a senior and a deputy, quality began to be measured a lot more through quality auditing. So, when we first started doing those, it was a real eye-opener because I think you didn’t get to see what actually went into everything until you actually had to audit everything you do in all the different criteria sections to do with the key lines of inquiry and our quality audits, we do disseminate to other staff to also do, so that they can see exactly what is involved in the whole process to do with managing a service and delivering quality care. So, they also are instrumental in doing some of the quality audits to give them a better understanding, it widens their knowledge as well as our own.
Loraine Swinburne:
So yeah, I’ve found that over the years, we are audited a lot more, but I think that has been key in ensuring that we’re doing everything we should, and we’ve got everything in place. So yeah, that has changed a lot.
Morgan:
Yeah, I think I agree Loraine, I think when I first started at a young age, quality was seen as such a scary thing. When quality would turn up, you would panic. I think now as the deputy manager looking back, we’re all on the same page and quality just want the best for us and want us to get to a high standard. There’s no need to be scared, they’re not scary people. I think from years ago, you would panic, you’d think, “Oh my God, no, quality’s here.” Whereas now, you relax, and you think, “Well, if they pick up on something, at least you know before CQC come and then at least you can get them jobs done and sorted and you’re prepared.”
Morgan:
I enjoyed quality, I liked that they come, and I like that they come and look at everything because if not, it’s a fresh pair of eyes looking at everything that you’ve got. So, for me, I like it due to knowing what you’ve got and what you’ve not got.
Loraine Swinburne:
Yeah, it is one of those things that does go a long way to preparing you for your ultimate inspection from CQC. So, it does give you that peace of mind to know, “Well, I do my audits and I know what I’ve got in place and know what I need to do,” and yeah, it does, it prepares you for all of those things.
Loraine Swinburne:
I just want to say thanks, Morgan, for talking to me today about quality, about Prader-Willi syndrome, about our services. And if you’d like to learn more, visit our website
Morgan:
No, thanks Loraine. Thank you for having me. Thank you for all your help that you gave us for opening as Esmer House and we will forever be in your debt for that.
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