POST COURSE REPORT
Heather Godfrey (B.Sc., P.G.C.E., M.I.F.A.)
(Published in the Aromatherapy Times, Journal of the International Federation of Aromatherapists: vol 1 no 71 2006)
The following report will provide an overview of training undertaken with care staff working at Lisieux Hall from the perspective of training provider. Commencing with the historical context, the author will present the underpinning supporting premise, will describe the process undertaken, then, will discuss the outcome (both actual and perceived). The ensuing text is divided under the following sub headings:
- Background History:
- Course Innovation and Development
- Learning Context:
- Learning Outcomes
1) Background History
Brothers of Charity – Lisieux Hall and ‘winds of change’
Lisieux Hall offers both residential and day care provision for people with profound learning disabilities. This service is provided by the Brothers of Charity Services and is funded by Social Services and the Primary Healthcare Trust. Care administered within large homes is generally considered an outdated and undesirable scenario, especially by those operating within this sector: institutionalisation, dependency and limited ability to exercise personal choice being the critic’s key argument, along with acknowledgement of the high costs involved in maintaining such environments (Smith, 2005 Hasset, 2003). Recognition that the service user has a right to reasonable autonomy, independence and choice regarding their care provision, also underpins this view (Smith, 2005; Kelly, 2005); reiterated within the recent Green Paper, ‘Independence, Wellbeing and Choice’ (March 2005). The key themes of this paper focus on ‘autonomy’ and ‘social integration / inclusion’. These positive values and good practices have been observed and proactively implemented by service providers for some time. The Brothers of Charity, for example, have been phasing their residential and day care service users into smaller supported environments for the last twenty years and anticipate that by the end of 2006 the number of people remaining in residence at Lisieux Hall will be minimal (Kelly, 2005; Hassett, 2004).
The vision and values contained in the green paper are very positive and based on what has started to happen for people with learning disabilities and their carers. Person centred approaches, individual budgets and the extension of direct payments will give greater support when they need it (Smith, 2005).
As a service we continue to change in response to the needs and wishes of the people we support. Over the last three years we have concentrated a great deal of time and energy in transforming our community based residential services from registered care to a supported model…..people are now tenants in their own homes with all the additional rights and responsibilities that entails (Kelly, 2005)
RADIUS, one of the remaining units housed within Lisieux Hall, supports people with multiple and profound learning disabilities; many of these service users require intensive 24 hour support. The roles and demands undertaken by the carer in this context are physically and emotionally challenging. Remuneration for care staff remains in the lower pay margins (Hassett, 2004). These connective factors appear to add pressure to staff morale, retention and recruitment. Brother Alfred Hassett (National Director) identifies this disparity in the Charity’s Annual Report (2002-2003):
“However, given the current rates of remuneration that can be provided in the sector, we expect to face a continuing challenge in attracting, inducting, training and retaining suitable additional staff for the immediate future.” (Hassett, 2003)
In counterbalance, and in recognition that “the quality of training provided has a direct link to the quality of service provided” (Hassett, 2004), staff development is one important and successful factor aimed at maintaining and improving good standards of practice; supporting care staff and service user. Team building also appears a significant focus:
“……it has also become increasingly clear that we need to redirect some of our efforts around training, especially into developing and supporting individual staff teams…..”
“Our Induction and Foundation training scheme has proved to be highly effective and is a model used by a number of our regional associates and partners………… ” (BoC Annual Report, www.brothersofcharity.org.uk retrieved 2005)
David Searle, Training Manager at Lisieux Hall, contacted this author in 2004, to enquire about delivery of training in Aromatherapy for members of care staff operating within RADIUS.
2) Course Innovation and Development
In light of the above circumstances and with careful deliberation regarding the context of special needs, the author synthesised her previous knowledge, experience and expertise in her field to create a course specifically tailored to the carers perceived remit (see appendix 2). Sandra Walton, Senior Support Worker, also invited the author to visit RADIUS, where discussion took place with regard to the context and relevant content of learning. Consequently, ‘Carers Aroma Wellness©’ was innovated: contra indication and safe practice being primary underpinning dual considerations against which the course content was interwoven. For example, certain essential oils (collectively known hereinafter as ‘Gem’ oils) were deliberately selected due to their appropriate qualities, but especially because they represent some of the least contra indicated essential oils all essential oils carry certain cautions in terms of their use). These oils presented potential for related complementary inclusion of other safe, subtle modalities, such as, for example, Bach Flower Remedies and colour therapy (among others): adding optional dynamic to the potential therapist’s tool box, or an alternative where the application of essential oils or massage was not appropriate. Holistic wellbeing was furthered through the inclusion of basic diet and nutrition, gentle exercise and relaxation methods. Basic Anatomy and Physiology were incorporated to support and practically underpin each dynamic – therapy and wellbeing.
The course was specifically designed to allow division of the content into component parts, or modules (Aroma and Wellness) that could be delivered separately, if necessary (especially pertinent when delivered ‘in-house’ where restraints on time or group size might exist – these modules, for example, could be presented simultaneously to a subdivided group – applying team teaching). It was envisaged that the knowledge and experience acquired could, potentially, be transferred and synthesised into the carers role and incorporated accordingly within the care plans of the service user. The need to create learning packages that would also link in with other training provisos, such as, for example, N.V.Q., and other subject specific ‘pathways for learning’, was also acknowledged and accommodated.
Although underpinned by accreditation and the required evidence of achievement, this course would also provide an opportunity for fun: team building / bonding; de-stressing. The tactile aspects would engender feelings of personal value, self worth and acceptance – improving self-esteem as well as practically supporting the immune system.
Curriculum development was set against certain principles underpinned within the Governments Green Paper, Our Healthier Nation (1998). This paper identifies the need for collaborative interaction in terms of improving and maintaining the ‘Nations Health’, dividing responsibility between ‘government and national players’, ‘communities and local players’ and ‘individual players’. Pertinent to the Aroma Wellness project*, for example, A Contract for Health (Our Healthier Nation, 1998: 3.9), states (or advises) that –
- Take responsibility for their own health and make healthier choices about their lifestyle.
- Ensure their own actions do not harm the health of others.
- Take opportunities to better their lives and their families lives, through education, training and employment”
“local players and communities can:
- Provide leadership for local health strategies by developing and implementing Health Improvement Programmes
- Work in partnership to improve the health of local people and tackle the root causes of ill health.”
Factors Affecting Health (Our Healthier Nation, 1998: 2.3) also lists under ‘Lifestyle’, diet and physical activity as areas to focus health advice (other areas under this title include smoking, alcohol, sexual behaviour and drugs). ‘Stress and insecurity at work’ are also cited in this document as areas where improvement might meet the Governments ‘Quality of Life’ agenda (Our Healthier Nation, 1998: 3.29-31)
Once the design of the ‘Carers Aroma Wellness© Course’ was complete, the content was presented to the International Federation of Aromatherapists (IFA) with a view to them accrediting the course.
“We would like to reiterate just how interesting, holistic and well written we find your course.” (Lotte Rose, IFA Council Chair 2005)
Applying the content and embracing the underpinning premise of the ‘Carers Aroma wellness Course’, the IFA subsequently developed Carers Aromatouch, their own a simplified version (omitting elements such as diet an nutrition, exercise and mobility and complementary subtle modalities – flower remedies, colour therapy – originally included to accommodate contra-indication to massage and essential oils)
3) Learning Context – Lisieux Hall
Carers Aroma Wellness©’ was delivered in-house at Lisieux Hall over a twelve week period (April to June 2005) as a pilot. Course delivery was adjusted to accommodate time constraints incurred through working ‘in-house; more emphasis was placed on placed on home-study (revision, research, completing work-packs and homework tasks. The learner was evaluated using formative (i.e. periodic tests, question and answer, homework completion) and summative (i.e. Care Plan) assessment measures (approved and endorsed by the IFA).
The course was divided into two factions:
- ‘Aroma’, exploring the use and safe delivery of ‘Gem’ essential oils and other pertinently related complementary therapies employed to enhance relaxation and health maintenance.
- ‘Wellness’, exploring basic nutrition and anatomy and physiology, gentle exercise, mobility and relaxation methods.
A team-teach approach was applied to accommodate contact teaching time availability while working in-house. Team teaching also facilitated and supported good practice through allowing constant feedback and assessment, cross marking, varied teaching styles, evaluation of process and practice and a broader teaching and learning knowledge base.
4) Learning Outcomes
As well as acquiring accredited skills and knowledge in terms of their working roles, the information gained, both official and osmotic through collective interaction, will enable the student to extend this awareness to enhance their personal decision making, as well as encourage proactive involvement in terms of their own lifestyles; for example, personal diet and eating habits, exercise methods and regimes, and certain health maintenance modalities and relaxation techniques (strengths and limitations). The knowledge and experience gained will also provide a foundation that may support the carers general training and continual professional development programme.
The course content provides the carer with transferable skills and knowledge that can be integrated into the service users care plan (adhering to ‘safe practice’), potentially broadening the scope for holistic support, and choice, in terms of care provision. The application of essential oils and massage (and other modalities) offer an opportunity for deliberate sanctioned tactile support, applied with the service users consent, potentially improving their self esteem, perception of body and personal image, and offering support in terms of immune and psycho-emotional support, especially through inspiration of the essential oils.
Team enhancement – Post delivery observation
Carers from various sites, as well as those working with in RADIUS (the host unit), were united for the teaching and learning sessions. This appeared to facilitate and encourage the perpetuation of collective and individual awareness in relation to the roles and responsibilities undertaken by each other and the various departments represented, which in turn presented an opportunity for the integration and exchange of skills, thoughts and ideas generally. Participation in the course enabled the opportunity for carers to support each other, as above, and also through the tactile application of massage during practical sessions. This proactive involvement appeared to assist the participant’s management of their stress levels while generally supporting their sense of wellbeing at work.
Inspired by a request to deliver an aromatherapy course for carers at Lisieux Hall, this author synthesised her previous knowledge and practical experience with research and deliberation in relation to the context in which the course would be delivered: thus, the appropriateness of the content was carefully considered and tailored accordingly. In retrospect, post course, the author is aware that some adjustment may be required in future. One consideration, for example, based on feedback from students, is that future courses be extended from twelve to fsixteen weeks, interspersing breaks (one or two staggered weeks), to allow more time for assimilation of knowledge, experiential practice and space for students to research, study and ‘catch up’.
The framework of the course allows the content to be adapted according to the learners remit. The content may be taught in house, or at another teaching and learning venue, to a range of people in various caring roles. This approach facilitates greater appeal and uptake for those learners who are keen to develop their skills and interest in this area of complementary health care, but who do not have the time or energy to attended college classes outside of their working roles.
‘In-house’ training allows for specialist adaptation, and cross-professional integration and collaboration. One outcome, for example, was the creation of a generic Care Plan Consultation Proforma, based on the carers input from a group review of the processes involved. Another was the proactive enlightenment for this author regarding the processes and complexities involved in relation to the support and care of the severely disabled, which led to greater awareness of special needs and contra indication when applying essential oils and massage in this context. Conversely, the author was able to share with the learner relevant experience gained from working with similar caring groups.
The course content is relevant for both carer and those they care for. For example, dietary awareness, exercise routines, and the appropriate safe application of complementary therapies to support emotional and physical wellbeing. A sound foundation for further deeper study was laid.
Innovation of this course has generated interest from other groups and institutions. The IFA, for example, have consequently created their own official course for carers. Other groups, such as, for example, Home Start, Stepping Stones (MIND), Open Doors (Galloway’s Blind Centre) and Well Women have expressed interest in this course and related workshops.
Delivery of this course as a pilot at Lisieux Hall allowed evaluation of (realistic) time scales and the usefulness of the content. Student’s feed back is valuable and much appreciated. Progressing the course from a concept to actuality served to consolidate theory into practice and provided scope to improve areas of oversight or weakness. The Carers Aroma Wellness© Certificate provides the receiver with legitimate and universally accepted recognition of knowledge and achievement and foundation on which to build and develop their knowledge and training..
The author wishes to thank Brian Kelly, David Searle, and Sandra Walton (for her enduring specialist guidance and enthusiasm throughout), for their support and feedback in preparing and presenting this report.
- Brothers of Charity Annual Report 2003-04: brothersofcharity.org
- Hassett , Brother Alfred, National Director: Brothers of Charity – Annual Reports (2002 – 2003 / 2003 – 2004): brothersofcharity.org
- HM Government Green Paper (1998) Our Healthier Nation – A Contract for Health: p 7-8, 12, 30, 31, 36, 50
- HM Government White Paper (2005)
- Kelly, Brian (2005) News from the Brothers of Charity: brothersofcharity.org
- Rose, Lotte (2005) Correspondence: International Federation of Aromatherapists: int-fed-aromatherapy.org.uk
- Smith, Keith (Chief Executive): (2005) Response prepared by the British Institutes of Learning Disabilities to HM Green Paper – Independence, Wellbeing and Choice: email@example.com.