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