Yesterday we had an excellent guest post from Mike Ewins, explaining the work that is being done by Birmingham City Council to improve quality and safety in residential care. Mike talked about the involvement of family, friends and the community. He explained Birmingham’s proposal to “identify the numbers of residents who have no external visitors or contacts” and this has attracted strong support as a useful safeguarding measure by our #dementiachallengers on Twitter.
So what can residential and care homes do to improve the experiences of residents living with dementia, whether or not they have these external links?
Is it possible to offer personalisation for all or do some residents just have to sit quietly and watch the four walls or the TV?
Should they play Bingo? – well, actually, YES… if that is what is important to them!
Here Gill Bailey – and Winifred – tell us how personalised ‘one page profiles’, unique to each individual, can make a huge difference to quality of life …
David Behan, the Department of Health’s Director General for Social Care, offered a challenge to *Helen Sanderson recently around developing Individual Service Funds, after he heard about the work she had been involved in with Dimensions via ‘Making it Personal for everyone – towards Individual Service Funds’.
His challenge was:
“You have done it with six people living in residential care – come back to me when you have done it with 40 people.”
We took that challenge very seriously, and in partnership with Stockport Council and Borough Care (Stockport’s leading provider of support to older people), we are working to see how far we can go with personalising residential care for forty three people living in Bruce Lodge (One of Borough Care’s residential services for people who have dementia) working under the banner ‘My Home, My Time, My Choice’
We know that in these times of financial constraint we have to do something different, or we will simply get more of the same. We are trying to work at two levels:
1. That people living in Bruce Lodge direct their own support on a day-to-day basis. We therefore need to know what matters to each person (what is important to them) and what good support looks like. We learn from the person and those who love and care most about them. This is recorded as a one-page profile.
2. That each person living at Bruce Lodge has an upfront resource allocation that they can determine how to use. Each person will have two hours of individual one-to-one staff time each month that they can spend however they want, doing something that is important to them, where they want (in home or community) and choose who they want to support them.
We have also developed a one page strategy exploring what success looks like for Bruce Lodge/ Borough Care, how we will deliver it and how we will measure it.
Winifred, who lives at Bruce Lodge has taken a real role in looking after her home, this is her story.
By learning what matters to Winifred (what is important to her) and what good support looks like to her and recording this on a One Page Profile we began to think with her and her family around how she would spend her upfront resource allocation of two hours of individual one-to-one staff time each month. This is happening for all the people living here.
Winifred is described as a wonderfully, loving personality who brightens the room with her smile. Winifred’s daughters and the team recognised she was feeling lost at times and so they focused on her gifts and when were the times her wellbeing was at it’s best – helping Beryl the housekeeper was the resounding answer and so it became more structured so that Winifred spent her individual time with Beryl.
It has now become simply the way Winifred spends each day carrying out the household chores with Beryl. She can be heard singing aloud as she polishes, mops, washes up and carries out the chores she did so routinely in her own home before she moved here. The increase in wellbeing is clear to see. Maureen and Bernie, Winifred’s daughters, have noticed the change this has made to Winifred, in that she is happier, chatting more, using fuller sentences, is sleeping better and generally ‘’more alive.’’
The people who live here are using their time in many different ways. Annie wants to go to Ashton market, have tea and cake or a meal whilst out. John is going out on a boat, Besse is going to make a scrapbook of her life and travels, which her daughter Barbara is helping us with, Doreen was an assistant verger at Norbury Church in Hazel Grove and wants to go to a church service there. Van has later stage dementia and after thinking with her and her family, our best guess is that she would enjoy going out to the park and sitting by the bowling green to have an ice cream or to have someone read aloud to her – Danielle Steele was always a favourite author.
Half of the 42 people living here now have an Individual Service Fund in place, the plan is that this will happen for everybody by the end of October 2012.
I have worked with *Helen Sanderson Associates for over ten years and one of my lead areas is exploring how we can use person-centred thinking skills with people experiencing dementia, and move away from traditional mechanisms of care, where services and professionals retain control, to a situation where people can have a say over how their lives and support looks, even in communal settings such as residential care homes. I also work with an external provider and spend time in an independent hospital for people living with dementia. _______________________________________________________________ Footnote
Good to see more good practice from Stockport! Hopefully approaches such as these will become the ‘norm’ as people become more aware of the need for people living with dementia, in all settings, to have a life rather than simply being “cared for”. http://www.nutshellcomms.co.uk