Be Inspired! Shirley Ayres Consulting

The simple answer is yes. This conclusion was prompted by one of the many emails I receive asking for help and advice. With the writers consent and personal details changed I will be publishing our correspondence and the discussions I have with relevant care organisations over the next few weeks. Finding a specialist dementia care home which exemplifies best practice is a serious challenge which is being confronted by an ever increasing number of people who care for older relatives and friends. 

My parents belief in social justice has been a guiding force in my professional and personal life. The care they received at the end of their life was important to me, my family and our friends. With over thirty years experience in the care sector I was able to navigate and understand what often seem to be very complex systems and information. I hope that these  posts will help the many people confronting a similar dilemma about finding good quality residential care for people who have been affected by Dementia and Alzheimer’s.  

 I am currently developing the Click Guide to Personalisation which brings together online resources for professionals supporting adults receiving care services. For the benefit of carers, relatives and social entrepreneurs developing new services, the Guide will now include further information about how adult social care services work, and the roles of the various national, regional and local bodies.

Dear Shirley,

I am the sole carer of my mother who suffers from Dementia with Alzheimer’s.  After several years of caring for her in her own home I find myself physically and emotionally exhausted and in my forties I can see the rest of my life mapped out for me if I don’t take action now.  I am looking for an outstanding home to care, engage and love her. I have explored all publicly available sites for information but only two places have inspired me in their approach which are Spring Mount in Bradford and Merevale near Birmingham, both of which are full to capacity and have waiting lists.  Those homes that I have visited do not cut the mustard or are protectionist and will not signpost me to good practice elsewhere.  So I am hoping you can help.
My mother is in good physical health, is involved in daily tasks of life and living and is a creative, gentle spirit.  We live in London but ultimately I’m willing to place her outside London if this ensures she gets the best possible care and am willing to travel.
I do hope you can help to sign post me in the right direction. If you are unable to do so, perhaps you know of someone who can help me, with unbiased information that I can research further? Its a mine field and I’ve discovered that the CQC rating is a pile of crock.  In helping me you will go a long way to supporting my duty of care towards my mother, who you can imagine is the most precious person in my life and who deserves the best care possible.  She is Asian too so any culturally specific places could be worth exploring.  I’ve looked at a few in XXXXXXX which are very institutionalised.

Kind regards and in anticipation,
K

Dear K,
Thanks for your email and I understand the challenges you are facing. My mother had dementia, she was precious to us all and we loved her dearly. We fought long and hard to find the right home for her when she could no longer be cared for at home. In my experience the care provided is very dependent on the manager and we eventually found a place for my mother at XXXX (NB The name of the home has been deleted following my discussions with the Care Quality Commission which will be reported in the next post). A brilliant home with a committed manager and an excellent example of best practice. We did have to fight with the local authority who were more concerned about a single room being available and the cost rather than the philosophy and approach underpinning the care.
 
I believe that as our knowledge and expectations increase about what is appropriate care for people with dementia we, as a society, have to challenge inadequate and bad practice. But I also see the potential for conflict with the budget cuts being used as an excuse for justifying the lack of improvements which need to be addressed by strong leadership, staff training and supervision.
 
I would have recommended Spring Mount in Bradford and Merevale near Birmingham but since they were highlighted in TV programmes I guess it is understandable that they now have long waiting lists. Have you been in contact with the national charities representing people who have dementia and carers?
 
You may have picked up that I am a keen advocate of the potential of social networking to improve care standards. With your consent and without identifying you or your mother I would like to post the content of your email across a number of professional networking forums and on my website to highlight the issues you raise in your email and to see what homes would be recommended. Do let me know whether this is an idea you would be happy for me to pursue.
 
As a matter of professional curiosity can I ask why you contacted me?
 
With all good wishes
 
Shirley

I would really welcome feedback about the issues raised in this post, recommendations for care homes which provide “person centred” dementia care and thoughts about any websites which provide an “Amazon” style ratings system locally, regionally, nationally or internationally.

About Shirley Ayres Consulting

Tags: Alzheimer’s, care homes, care quality commission, choice and control, Click Guide to Personalisation, dementia, personalisation, social care, workforce development

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A very timely BBC 2 documentary in which businessman Gerry Robinson explores what can be done to help improve services within care homes dedicated to looking after people with dementia.  I have always found Gerry Robinson’s  approach thoughtful and probing and I am delighted he is exploring an area of care which both requires and deserves more scrutiny. If you work in this area or are faced with making a decision about finding care for a person with dementia I recommend that you watch this programme which is available for the next seven days on BBC iplayer.

The Alzheimer’s Society states that ‘In less than two generations one in three of us will either have dementia ourselves or be related to, or caring for, a person with dementia.’ The significance of this statistic and the implications for society require a transformation of perceptions and strategies. One of the biggest challenges facing society today is the funding and care of older people, a growing number of whom will have dementia. 

“We are in the dark ages of dementia care”, “Keeping people alive rather than helping them to live”, “dementia farms” and “granny warehousing” some of the terms used in the programme to describe current provision. Shameful comments about how we treat some of the most vulnerable people in society but does it have to be like this? One of the major challenges with ¼ million people in dementia care homes is that they are mostly paid for out of public funds but run by private companies. 

Should we be shocked that anyone can buy a care home provided they have the money, do not have a criminal record and can demonstrate that they are suitable to be a “registered person” with the Care Quality Commission?  Yes the services are regulated but there are no minimum standards in terms of the specialist dementia knowledge and skills required. It would appear that homes are judged on their capacity to manage risk rather than the fundamentals of care which can leave residents spending hours just staring at the walls.

“Life could be so much better” is the conclusion from the first programme. It is not that complicated to make a difference: staff who feel valued and have additional training in understanding dementia, one to one contact and encouraging the involvement of family and friends and involving residents in the running of the home all create a more positive and rich experience. 

When my mother had dementia we were fortunate in finding an excellent home. I would have no hesitation in recommending Lakeside Nursing Home  SE19 2DR. The manager is passionate about ensuring that dignity and respect underpin the quality of care provided. The ethos of the home centres on the recognition of the individuality of the resident and the importance of actively involving friends and families.

When looking for a residential care home I always advise people to start by reading the latest report and quality ratings from the Care Quality Commission which provides a number of useful indicators. There is a big question about whether any of us would want to place a vulnerable person in a dementia home with a rating of poor or adequate and should local authorities even be suggesting this as an option?
  
The Social Care Institute for Excellence has an excellent online resource in the Dementia Gateway if you work with people with dementia in nursing, residential or domiciliary settings. There are lots of practical tips, tools and activities in the sections below that will help you with your daily work. Each section has been written by a national dementia expert so you can be sure the information and guidance is up to date and reflects what we know about best practices in dementia care. Another section lists Useful Dementia Resources where you can find out more about dementia, research studies, reports and policies, resources for people with dementia, carers and professionals

What training is provided for staff is an important question to ask when considering a dementia care home placement. Encouragingly there are a lot of training programmes available to address the skills and knowledge gaps identified by Gerry Robinson.

The Open Dementia e-Learning Programme is aimed at anyone who comes into contact with someone with dementia and provides a general introduction to the disease and the experience of living with dementia. This programme is designed to be accessible to a wide audience and to make learning as enjoyable as possible and so allows users to fully interact with the content and includes video, audio and graphics to make the content come alive. In particular the programme includes a considerable amount of new video footage shot by both the Alzheimer’s Society and SCIE where people with dementia and their carers share their views and feelings on camera.

Skills for Care have developed a Knowledge Set for Dementia Care. Knowledge sets provide key learning outcomes for specific areas of work within adult social care. They are designed to improve consistency in the underpinning knowledge learnt by the adult social care workforce in England. In addition to the knowledge set documents, staff can download a ‘progress log’. Both documents are freely downloadable at  Skills for Care. The progress log will be required for each individual worker/learner for each knowledge set. Individuals can keep copies of their progress logs showing their ‘signed off’ progress for their NVQ portfolios.

The Alzheimer’s Society provide factsheets which cover a wide range of dementia-related topics. The online sheets can be saved as a PDF or emailed to a friend.

The Open University has produced a free leaflet, Dementia Care: Sustaining The Person Within, to accompany the programmes. It lists the help and support available when making decisions affecting the care of people with dementia. Centred on the life story of one woman with dementia, the leaflet explores challenges and opportunities for good practice, from a diverse range of perspectives of people involved in dementia care. The aim of the booklet is to encourage people to ask: What is good quality dementia care? How can it be provided? What resources are needed? What organisational cultures are needed to achieve this type of care?

I have always believed that how we care for the most vulnerable members is the mark of a civilised society.  It is in all of our interests to ask questions and challenge poor and inadequate care services on both a personal and a professional level. I would like to see exemplars of best practice promoted and published by the Department of Health. This would establish a benchmark of what we should be aspiring to now and in the future. Public funding is an important consideration but is it the only critical factor in delivering quality care? Research which explores the link between costs and quality care would be a useful starting point.

What will it take to sort out our care homes? An interview with Gerry Robinson in the Daily Telegraph

Tags: alzheimer's society, BBC documentary, care quality commission, dementia care, education and training, encouraging innovation, free on line learning, Gerry Robinson, leadership, mental health, residential care, safeguarding adults, scie, skills for care, Social Work, vulnerable people

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