In your shoes: ExtraCare by night

Head of Marketing and Communications at The ExtraCare Charitable Trust, Richard Tower, stepped outside the comfort of the office to join an overnight shift at the organisation’s Brunswick Gardens Village, in Sheffield.

Here, Richard tells us how he found shadowing those who help put the ‘care’ in ExtraCare.

Delivering night care around a five-acre retirement village requires navigation skills, or as a taxi driver might put it, ‘the knowledge’. If you know every stairwell, lift, corridor, apartment number and bungalow you’ll save yourself both ‘time’ and ‘miles’. And it’s five miles if you’re Diane and Donna, both Resident Support Workers (RSW) working the ten-hour night shift at Brunswick Gardens Village.

I joined both carers to ‘shadow in the shadows’ at the 217-home village recently. Between them, they met 44 residents from 8.45pm to 6.45am, ensuring each doorstep arrival and departure took place on time and in line with a carefully planned schedule.

If this sounds more like logistics than care, there’s a reason. Both carers take the timely delivery of medication more seriously than compliance requires and are also keen to meet the expectations of their residents who welcome them, sometimes against the clock, for a variety of social and domestic duties. These include help going to bed, applying cream, changing clothing or pads, night time medication, preparing food, or help getting up (one lady says she likes a shower at 5am: “I got up early all my life!”).

As Diane or Donna softly say hello at each front door, their ability to sense and assess each resident’s ‘ups and downs’ in terms of health, mood or aspiration, is uncanny. And both staff know each person’s preferences by heart, whether it’s Shirley who likes her window “open a crack”, or Bill who “likes his curtains pulled”. Both meticulously record the details after each visit.

For all this there’s plenty of positive reaction. At bed time a lady called Margaret talks about Diane: “This lovely lady puts on my socks,” she says. “I thank her. I thank all of them.”

At 1am. we stop for a ‘night-time lunch’ and a cup of tea. I asked both carers how they deal with the difficult moments.

“In this job you have to find your strength to deal with upsetting circumstances,” says Donna who previously drove the Sheffield night buses before she came to the village. “Death can be distressing, especially if it’s unexpected and we’re usually first on the scene, but we can have counselling. You never stop caring but you have to let go, you need to find your resilience.”

Diane, previously from an army family who travelled from the Outer Hebrides to Germany, has been doing nights for 30 years and says providing good end of life care can be very special. “One gentleman asked if I would give him a shave and I met his wishes. Sadly, he died soon afterwards. His son was very grateful. He said ‘He’ll be joining mum – whenever he greeted her in the morning he was clean shaven – so thank you.’ ”

As the only people walking the village, night time carers are usually first to handle anything that comes their way including liaison with the 999 services. Both say the paramedics are under pressure but have good relationships with them and “pop in for a cuppa sometimes”. Once, a lady pulled her emergency call after she had a cut and was bleeding badly; Diane attended and called the ambulance, but it took two hours to arrive. “I think they knew I was on site, so we probably got put to the back of the queue,” she says. Another time she put a burning toaster on steel table on a balcony whilst the fire service made their way to the village, “they seemed happy with my actions.” They’ve also dealt with floods, managed evacuation and even looked after pets.

All jobs develop their vernacular and care is no exception. In the early hours between visits and an urgent catheter call, Donna and Diane talk about ‘two-handers’ (visits where both staff are needed to help with lifting), the ‘raizer’, which, despite its frightening name, is a remarkable chair that assembles on the floor and raises someone who’s fallen to sitting position (Diane ably demonstrated it with the team on the office floor). They also discuss ‘handovers’, which are vital catch up meetings between shifts reinforced through a prominent office notice which reads ‘Listen at Handovers – Don’t be loud and don’t be vocal!’

It’s dawn and we’ve just greeted Hannah, 99, who is serene, bright and generous in her praise for the staff: “They are simply wonderful, they really are,” she says.

Donna and Diane reflect on their roles and it’s clear their residents are at the centre of their experience at ExtraCare. Donna says: “Our relationships are mostly with the residents; in reality, we don’t see much of day to day life in the village. But if we walk through someone’s door and put a smile on their face – that means the world.”

In September, the GMB union warned of a ‘hole’ in social care staffing with more than 75,000 vacant roles. Vacancy rates for care workers are running at a staggering 9.1%.

At ExtraCare, turnover rates are lower than sector averages, and Diane says that whilst the role can be stressful during emergencies when time is pushed between calls, it’s better working at the village than other places. She adds: “You don’t get abused; the approach is more about the people than the care itself – we really get to talk to people. I love hearing about people’s histories and their stories.”

The delivery of care, by its very nature, is personal, private and regulated – this compassionate work is sometimes a song left unsung.

It’s worth remembering that our 750 care colleagues, the majority of our workforce, will be delivering care 24/7, while most of us are tucked up in bed, or spending time with our loved ones. So maybe, as we settle down for the latest box set, or tuck into a family meal, we can can all take a moment to think about the carers too.

For confidentiality reasons, the names of residents have been changed.