3 Spirit UK accredited for creating genuine social impact
Hertfordshire based 3 Spirit UK has been awarded the Social Enterprise Mark, which proves they are in business to benefit society, community and the environment.
The Social Enterprise Mark is only internationally available social enterprise accreditation, enabling credible social enterprises to prove that they are making a difference. Only organisations which can prove they operate as a social enterprise, with the central aim of using income and profits to maximise their positive social and/or environmental impact taking precedent over a requirement to maximise personal profits for owners and shareholders are awarded a licence to display the Social Enterprise Mark.
Applicants must meet robust qualification criteria in order to be awarded the Social Enterprise Mark, and are re-assessed each year to ensure they continue to meet the criteria. Subjected to an assessment process which is overseen by an independent Certification Panel, 3 Spirit UK’s governance documents and accounts were scrutinised. As a result, 3 Spirit UK has earned the Social Enterprise Mark guarantee that profits [or surpluses] are used to
to improve the quality of care for vulnerable people through education;
to support the rights of vulnerable groups through access to education;
to prevent and delay further deterioration in the health and wellbeing of a person living with dementia through access to education and/or tools.
3 Spirit UK joins other social enterprises that have been awarded the Social Enterprise Mark, such as the Age UK Enterprises, Eden Project, Big Issue, and the Phone Coop.
Government data estimates that there are 70,000 social enterprises across the UK, contributing over £24 billion to the economy and employing around 1 million people.
Social enterprises plough the majority of their profits back into activities that benefit people and planet, rather than just lining shareholders pockets. However, some businesses are taking advantage as there is no legal definition for them. The Social Enterprise Mark CIC is the guardian of genuine social enterprise principles, and it safeguards these through the independent accreditation process.
The 3 Spirit UK aim is to foster a collective responsibility in the social care sector to champion human rights, and to improve the wellbeing of the most vulnerable in our communities. Through education and collaboration, they aim to empower both front line services, and corporate strategists to maintain an ethical and moral ideology in every facet of their work. This is achieved in two different strands of their work:
by providing education to the health and social care workforce, and directly to vulnerable groups.
by providing services tools and/or consultancy to improve the impact of their work, to create efficiencies that improve wellbeing.
Over the last four years 3 Spirit UK has been dedicated to researching and developing innovative learning opportunities. This has involved engaging with a wide variety of stakeholders by utilising social media and other platforms to share ideas. In this process the aim has been to develop resources that engage the workforce, and work well in overstretched and underfunded services. In a very challenging social care market 3 Spirit UK has aimed to identify strategies and resources to help services balance competing priorities, focusing on what good care and support, and to determine how to meet individual outcomes for wellbeing.
Caroline Bartle said, “We’re really proud to have been awarded the Social Enterprise Mark. 3 Spirit UK is absolutely committed to supporting sustainable businesses and consequently helping local communities to thrive and prosper”. “Over the last two years 3 Spirit has been engaging with research that identifies factors that impact on the wellbeing of individuals living with dementia. This research shows that there are several lifestyle factors which may delay the onset and progression of dementia. A broader amount of research indicates that many people living with dementia in our communities are amongst the most loneliness, which is harmful to health. To improve outcomes, we have been reviewing the evidence base, and attempting to come up with a tool that provides solutions in practice; the Home Spirit Tool. We are hoping that the mark will demonstrate our commitment to meeting wider social goals through the application of this tool”
Lucy Findlay, Managing Director, Social Enterprise Mark CIC, advised:
“As the only way to independently assess and accredit genuine social enterprises, the Social Enterprise Mark guarantees businesses use profits for purpose not for the pockets of shareholders.”
Over the last few years, we have had the opportunity to work in a more integrated way with health services in our course development. Supported by health and social care practitioners we have been considering how health and social care interact; the cause and effect, the impact and outcomes on a practice level within specific domains. This interlocking enables us to develop new insights and tools. Within this we have been considering:
What are the individual and collective benefits to services of receiving more support for exercise for people living in with dementia?
What are the potential barriers to providing exercise in care homes and/or community settings?
What priority is given to this and what training is available to facilitate this?
Health and Wellbeing is identified in the Dementia Care Skills Education and Training Framework (section 6), as a key area for education and development for staff working with people with dementia both at tier one and tier two. Section 6 includes health as well as psychosocial activities as expected, and exercise is explicitly mentioned in the first outcome. We have interpreted the outcomes to a more meaningful and measurable course outcome, with exercise linking to many other aspects identified within this section, including but not limited to falls and pain management. Alongside my health colleagues we have debated and developed the merits and outcomes of this course which is set to be a very practical and holistic look at front line integrated interventions.
Over the last few years there has been some exciting research emerging about the impact of exercise on dementia. Alongside which we have started to see exercise offered in front line services as part of prevention strategies. In addition, policy and legislation changes such as the Care Act 2014 have outlined their vision for prevention, of which exercise must feature. Organisations like Age UK have offered chair based exercise, and exercise has been targeted by some authorities as an intervention to reduce the risk of falls and other health outcomes.
The emergence of more collaborative working between health and social care has stimulated the growth of such initiatives; pooling funding to improve health outcomes with prevention. However, what is emerging from the research is that exercise potentially has much wider benefits than reducing the risk of falls, particularly in terms of its application to dementia. Mental health services and local primary care services have offered exercise on prescription for many years as a valid form of treatment for depression, so exercise may potentially offer a valid treatment for some of the neuropsychiatric disorders which often are associated to dementia for example; depression, apathy, hyperactivity and agitation. Exercise may also enable improvements in cognition, and some research seems to suggest that exercise may act directly on the pathology of dementia. What is very clear however is that exercise has far reaching impacts both for physical and mental wellbeing.
Exercise is planned, structured and repetitive movement which aims to improve or maintain physical health. Physical activity is any movement which contracts skeletal muscles and increases energy expenditure. The main types of exercise are aerobic, strength, flexibility and balance. Aerobic exercise increases breathing and heart rate. Strength exercises make your muscles stronger. Balance exercises can help prevent falls and flexibility exercises help you to remain limber and improve the range of movement.
However, accessing and maintaining activity where comorbidity is present can be a challenge. If a person is older when they develop dementia they may also experience barriers to accessing and maintaining exercise. For example, pain, fear of falling, arthritis, sensory loss, or respiratory problems. A person may also have restricted movement and some rigidity and quite possibly not be mobile. Good assessment, including pain assessment should be completed to develop a plan that is appropriate to that individual alongside advice from the GP. However not all people developing dementia are older, so this could exercise may be an excellent targeted intervention for younger people with dementia? A study in the Netherlands is currently researching the impacts of exercise in early on set dementia (EXERCISE-ON study) the authors (Hooghiemstra et al 2012) suggest that certain dementia characteristics such as apathy may lead to sedentary and socially impoverished lifestyles, and by targeting these interventions in a timely fashion they can have far reaching impacts.
Together with co-morbidity barriers, we need to consider the challenges dementia brings in potentially engaging in exercise. For example, difficulties with coordination, motor skills, visual perceptual challenge and memory difficulties. These difficulties will require us to have a considered approach to the support systems needed to overcome these challenges.
There is such a wide variety of exercise available to us therefore it is about identifying strengths, and identifying suitable exercises that engage these strengths. This might include walking, dancing and/ or using music. Music can powerfully evoke memories, impact on motivation as well as provide rhythm and structure to support difficulties with memory. It is therefore an excellent method of exercise.
Exercise may improve thinking skills. A Chinese study (Lam et al 2012) found that mind-body exercises such as Thai Chi could improve cognition as well as have additional impacts such as improving balance and strength. Exercise is targeted as a potential primary prevention strategy to delay / reduce onset of dementia once someone has been diagnosed with mild cognitive impairment. The wider impacts of exercise on health outcomes are well documented, despite this many services fail to see the importance of it, and more specifically their role in supporting and enabling exercise.
Some studies have been completed to look at how effective exercise is in care homes at reducing the incidence of depression. Depression impacts on quality of life and pharmacologic treatments are not without their side effects. Some studies have found no evidence that moderate exercise in a care home had an impact on depression (Conradsson et al 2010). In contrast Edris et al (2009) had more success in providing a three week exercise plan, as found that it reduced levels of agitation. Agitation and depression are not directly comparable, and clearly variables will differ within this context. However, reducing incidences of agitation could have a direct impact on staff costs associated to working with challenge. Researching the impact of exercise on depression within a care home is a complex task, as the social environment, beyond the time of the exercise will potentially impact. Separating these variables in research is bound to be a challenge.
Despite the barriers, both in research and in delivery opportunities for people living in care homes to exercise must continue to be a priority. Factors to be considered include: building design, access to outdoors, effective pain assessment and management, and education on the benefits of exercise. There may be a wider impact on these enablers, including improved mood, better sleep and potentially improved nutritional intake.
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Aman, Edris et al.(2009) ‘Supervised Exercise to Reduce Agitation in Severely Cognitively Impaired Persons’, Journal of the American Medical Directors Association , Volume 10 , Issue 4 , 271 – 276
Baker, L.D., Frank, L.L., Foster-Schubert, K., Green, P.S., Wilkinson, C.W., McTiernan, A., Plymate, S.R., Fishel, M.A., Watson, S.G., Cholerton, B.A., Duncan, G.E., Mehta, P.D. and Craft, S. (2010) ‘Effects of aerobic exercise on mild cognitive ImpairmentA controlled trial’, Archives of Neurology, 67(1), pp. 71–79. doi:
Conradsson, M., Littbrand, H., Lindelöf, N., Gustafson, Y. and Rosendahl, E. (2010) ‘Effects of a high-intensity functional exercise programme on depressive symptoms and psychological well-being among older people living in residential care facilities: A cluster-randomized controlled trial’, Aging & Mental Health, 14(5), pp. 565–576
Duzel, E., van Praag, H. and Sendtner, M. (2016) ‘Can physical exercise in old age improve memory and hippocampal function?’, 139(3).
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Hooghiemstra, A.M., Eggermont, L.H., Scheltens, P., van der Flier, W.M., Bakker, J., de Greef, M.H., Koppe, P.A. and Scherder, E.J. (2012) ‘Study protocol: EXERcise and Cognition in sedentary adults with early-oNset dementia (EXERCISE-ON)’, BMC Neurology, 12(1), p. 75.
Littbrand, Hã., Lundin-Olsson, L., Gustafson, Y. and Rosendahl, E. (2009) ‘The effect of a high-intensity functional exercise program on activities of daily living: A Randomized controlled trial in residential care facilities’, Journal of the American Geriatrics Society, 57(10), pp. 1741–1749
Lam, Linda C.W. et al (2012) ‘A 1-Year Randomized Controlled Trial Comparing Mind Body Exercise (Tai Chi) With Stretching and Toning Exercise on Cognitive Function in Older Chinese Adults at Risk of Cognitive Decline’ Journal of the American Medical Directors Association , Volume 13 , Issue 6 , 568.e15 – 568.e20
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Tier 2 (Subject 6) Dementia Health and Well-being Training Course
This course outlines the importance of maintaining physical and mental health in relation to someone living with dementia. This course provides information on how to tackle: nutrition, hydration, pain, continence care and sleep. Participants will develop a basic understanding of holistic approaches to health, but are provided with some practical information in supporting activities of daily living. The course is mapped to tier 2 – Dementia Core Skills Education Framework (subject 6). This course is delivered in an engaging way, and participants get the opportunity to engage in experiential learning activities.
Explain why it is important to maintain good physical and mental health.
Describe how to identify a person’s heath needs including malnutrition, pain, dehydration, falls and fatigue
List the signs of delirium and the signs of dementia, recognising delirium is a medical emergency
Describe the possible impact, including psychological and social impact, of incontinence.
Describe the potential causes of, and impact of loneliness and the importance of maintaining social engagement
Describe possible ways to support ADL’s in a person centred manner.
Issued in 2014/15 identified a number of safety concerns in the Adult & Social Care sector i.e.
“A range of factors affect the safety of services, including a failure to investigate incidents properly and learn from them so they do not
happen again, ineffective safety and risk management systems and, in hospitals and adult social care, concerns with the adequacy of
staffing numbers and mix, alongside skills, training and support.”
In Adult Care Services specifically contributory factors were staffing levels, understanding and reporting safeguarding concerns, and poor medicines management. It was noted that “adult social care providers struggle to recruit the staff they need. Vacancies and turnover in the sector are high. For nurses, vacancy rates can be as high as 20% in domiciliary care and 11% in residential care.”
Additionally based upon an analysis of the inspections carried out 1 in 10 of adult social care services were rated as inadequate!
The CQC’s comments in relation to those inadequate ratings were “there were a range of governance issues that undermined the organisation’s quality and safety – from poor data quality (such as inaccurate care plans and medication records) or a lack of staff meetings, to little or no responsibility for complaints or mistakes.”
In relation to these concerns, of the inspections undertaken, there has been an increase in CQC enforcement actions to 7% in 2014/15 from 4% in 2013/14.
In contrast the observed outstanding services have management that ensure their staff receive continuous development and training. One inspector commented that
” It was how the people were supported. There were high levels of staff training; the training was just immense really, with staff doing refresher training throughout the year.”
These observations and data, particularly regarding vacancies and turnover, suggest that more effective risk management and quality training would be a substantial contribution to ensuring that care is always safe.
The HSE, following a review, have now recognised that there are aspects of health & safety training that can be covered by online training. Their guidelines are to be updated and will include advice to employers to ensure that the online training is fit for purpose. There are elements of Health & Safety training which must be classroom based i.e. first aid
My experience of training managers in the residential and domiciliary care sectors identifies, quite clearly, the challenge of developing effective risk assessments. Overcoming this challenge by using quality training companies not only assists these organisations in meeting their legal requirements but also minimises the risk of HSE sanctions and penalties that have been substantially increased in terms of fines and custodial sentences.