Dementia nurse wins RCNi Leadership Award: overcoming the stigma of a care home career
Winner of RCNi Leadership Award, sponsored by Nursing Management, Yvonne Manson ensures people with dementia, their families and carers have a voice
Innovative, strong, passionate, collaborative, inspiring, knowledgeable, impressive: just some of the words used to describe the leadership of dementia nurse consultant Yvonne Manson by colleagues, and the judges of RCNi Nurse Awards.
Ms Manson, who works for Balhousie Care Group, was declared winner of the Leadership Award category of the RCNi Nurse Awards for designing and implementing a dementia programme that has improved the lives of more than 700 people with dementia or cognitive decline.
‘Winning this award is amazing,’ says Ms Manson. ‘Choosing a career in care homes means facing a lot of stigma. People told me I wasted my career. So this award will help dispel the myth that you can’t have a successful career in care homes.’
‘Over the past 23 years, I have worked with a range of great nurses. This is a team win,' she adds.
Her strong leadership and engagement skills have enthused staff across Balhousie's 25 care homes, who are trained and supported to provide a high standard of dementia care and strive for excellence.
Watch: RCNi Nurse Awards 2018 Leadership winner Yvonne Manson describes her project
Giving a voice
Ms Manson's strategy ensures people with dementia, their families and carers have a voice. One focus is on education, and every home is working towards ensuring all staff complete a national programme to promote excellence in dementia care.
'People told me I wasted my career. So this award will help dispel the myth that you can’t have a successful career in care homes'
'Dementia ambassadors' share best practice in their care homes. They were introduced as part of Balhousie’s previous strategy, but under Ms Manson’s leadership they have grown in number from four to 100 including family members, with the group meeting every two months.
The biggest challenge has been getting staff to trust her, says Ms Manson.
‘They had seen it all before,’ she says. ‘They thought I would come out to see them but nothing would move forward, and that I would be just another voice in the distance.
‘It was not about preaching to people but getting them to understand that we are a team, that everyone’s voice is valued the same and there is no hierarchy; if they had an idea for how we could improve the life of our residents, we would explore it.’
Overcoming the engagement challenge
Yvonne Manson had a clear idea of how to design a dementia strategy that would work: engage every member of staff across 25 care homes and incorporate their views.
‘It is actually fairly simple,’ she says. ‘You go and visit all the homes and get the views of residents, families and staff about what they would like from the programme.
‘The care homes are spread across Scotland, from Aberdeen, Arbroath, Perth, Dundee, Fife, and Kinross, so gathering information from everyone took time.
‘It takes almost five weeks to visit every home for a full day, but I’m not shy of work.’
Knowing she would miss people on her visit, Ms Manson sent out surveys to service users and linked responses with the current national dementia strategy.
A draft was then sent to everyone and amendments made before it was published. It is available online, in all of Balhousie’s homes, and has been used to support strategies in other organisations.
The effort and long hours have been worth it. ‘After the programme was agreed, getting buy-in was easier because all the groups had been involved,’ says Ms Manson.
‘More people were willing to sign up and support the programme as it addressed things they had requested. This included staff who completed the training and became involved in projects but residents and family members also signed up.’
Building relationships with teams means visiting them as often as possible to grow the relationship and build trust.
‘It is still difficult,' she says. 'I cover 2,000 miles every month.'
‘But staff have my mobile number and email, and I am contacted regularly. I always tell them not to be shy and ask, and it might be a fantastic idea. We explore everything, whether it is suggested by a family member or staff.’
Staff were convinced once they saw how the strategy and training improved residents’ experience and that their suggestions were being taken up.
‘It’s all about collaboration,’ says Ms Manson. ‘Not stuff you read in a text book; really listening to people and putting things in place.’
Her commitment to staff development has also been important.
‘Ambassadors meet every two months, which has seen them develop to an enhanced level in dementia care and achieve their career goals.
‘It has been very much about empowering them to become leaders. Our role as leaders is to help individuals find their leadership skills.’
She gives the example of one of her team, Donna Sinclair. ‘She has gone from healthcare assistant to deputy manager of a care home, where she is excelling and following her passion.’
An answer to staff retention issues
The programme has also improved staff retention, a significant issue for care homes. ‘Once people get involved, they want to stay involved. One ambassador told me recently that the dementia programme stopped her leaving, as she feels valued and gets reward from her work.’
As well as a focus on staff development, there is regular evaluation of care and training. Dementia care mapping is carried out in all homes regularly and, since the programme has been implemented, mood and engagement scores have improved. Training sessions are evaluated by staff after every session and feedback acted on. In one example, it resulted in the framework being delivered in three different formats, online, workbooks and face to face, to support different learning styles.
'My winner every day of the week'
Donna Sinclair is deputy manager at Balhousie Stormont Lodge care home and a proud dementia ambassador.
‘I began my current role in February 2018, after 20 years at Balhousie Wheatlands. My responsibilities are to work alongside the care home manager and support our team to provide the highest standard of care.
'Yvonne has been my dementia lead nurse now for nearly three years and has given me extensive training and increased my knowledge in dementia care.
'I cannot begin to describe the impact she has made at Balhousie; she has completely changed the way our organisation looks at dementia.
'She has also had an enormous influence on me personally, inspiring me to continue working and learning to make our residents’ lives much better. Yvonne once told me we need to make sure our residents are living, not just existing. This is the thing I always work to on a day-to-day basis.
'Yvonne would be my Nurse Awards winner every day of the week; she has brought so much to Balhousie as an organisation, but also to each individual staff member.’
‘Moved and impressed’
The RCNi Nurse Awards judges were impressed by how Ms Manson has taken staff, patients, carers and communities with her in her drive to improve dementia care.
Consultant editor of Nursing Management Barry Quinn says: ‘A core part of Yvonne’s innovative leadership in this field has been her ability to engage with, and her learning from, people for whom dementia is part of their daily lives and using their insights to inform the programme of care.’
He was ‘moved and impressed’ by Ms Manson and her work.
‘Dementia is a field of nursing leadership and healthcare that deserves more recognition,’ he says. ‘Working with colleagues across Scotland in many care homes, Yvonne addressed the often hidden suffering and turmoil that dementia can bring to individuals and their families.
‘Through raising awareness, education, training, growing the role of dementia ambassadors and providing safe and comforting places, Yvonne and her colleagues have supported many families.’
RCN professional lead for its executive nurse network Christine McKenzie notes Ms Manson's passion for dementia care.
‘This energy has led to a comprehensive review of the experiences of patients, carers and staff across Balhousie Care group, resulting in some fantastic changes for people whose lives are affected by dementia,’ says Ms McKenzie.
‘Yvonne actively seeks ways to work with others to enhance the residents' lives, and the evidence of opportunities to listen and act on the request of families and carers was heartwarming.’
Ms McKenzie was impressed at the way Ms Manson has encouraged her staff to develop and supported requests from others to learn from the experiences of the work she has led.
Ms Manson’s own ambition is to share her work even more widely ‘to place care homes in a different light’.
‘But I hope to be able to do that with Balhousie and by highlighting what we are achieving here,’ she adds. ‘All these people have come along with me for the journey. It is my ideal job and I love what I do.
‘I am so proud of the dementia ambassadors. I cannot believe how much they have achieved in the past two years: improving care, speaking at conferences, winning awards. You can see in their faces how much it means to them and it is so rewarding to see them develop and see that come out of the programme.’
Meet the other finalists in the RCNi Leadership Award category, sponsored by Nursing Management
Andrea Hargreaves and the National Major Trauma Nursing Group
This nursing group strives to shape the future of trauma nursing as a recognised subspecialty area of expertise and practice. The group has developed a thorough ‘trauma measure’ detailing the education and competency standards, from junior nurse to advanced clinical practitioner, throughout trauma clinical settings.
Joann Morse and the RN Degree Apprenticeship team, University Hospitals of Morecambe Bay NHS Foundation Trust
This team aims to ensure the trust develops career progression for care staff and grows its own registered nurses. The scheme it uses, one of the first of its kind in the UK, enables recruits to combine vocational training with accredited qualifications on a journey to full-time roles as registered adult nurses.
Keith Anderson, NHS Fife
Clinical nurse specialist Keith Anderson has developed a specialist nurse service to assess, manage and support people with myalgic encephalopathy-chronic fatigue syndrome (ME-CFS), a controversial clinical area. Through educational meetings, webinars and clinician-to-clinician advice, he mentors and trains GPs and consultants.
Sandra Bennett, Barts Health NHS Trust, London
Sandra Bennett has empowered her diverse team of international nurses. When she became their manager, in-depth interviews revealed the team of sexual health nurses had worked through difficult times, with low morale, high sickness absence and a lack of senior support. Ms Bennett coordinated their learning and development to keeping them motivated.