Positive Approaches

The following is a case study told by Rosaleen Charles, Care Home Manager at Bryn Haven.

We admitted a lady at Bryn Haven who has vascular dementia. When she first came to live at the home she was disorientated as to where she was and was unable to find her bedroom. This was distressing for her and she would walk the corridors getting very upset. She asked all the time how she could get back to her old address. I had attended a training course run by Age UK about managing challenging behaviour and one of the tips I had picked up from this was it is, sometimes  helpful  to put a picture  on a bedroom door of a residents previous house along with the address. I decided to try it with this lady, and printed it from Google. She instantly recognized the front door and address as being a place she was familiar with.  When her son next came to visit her he was surprised to see the picture and thought that it would upset her. When I explained the reason we had done it. Although he was not convinced that it would help he agreed to give it a try. At the end of his visit he came back to me to say that he had asked his Mum to take him to her room and let her lead the way. He was surprised that she stopped immediately at her bedroom door and said this is mine and read him the address. He was also surprised that she was more settled within the room and saw it as a place of comfort and safety, which she had not done on his previous visits.

We have since tried this again with other residents and whilst it doesn't work for all; on the whole it has been successful and is a positive way of helping people settle.

Personalisation in Care Homes

Stockport Council is working in partnership with Borough Care and Helen Sanderson Associates (HSA) to explore how much we can personalise support in care homes. We have started to explore this in Bruce Lodge, where 43 people who have dementia live.

What?

We want to do 2 things:

1. People living with dementia direct their own support on a day to day basis. We need to know what matters to each person (what is important to them) and what good support looks like. We record this as a one-page profile. Staff are coached and supported by managers to deliver this.
2. People having an upfront resource allocation that they can determine how it is used. Each person has 2 hours undivided time each month that they can spend however they want (2 hours together, 2 x 1 hour, 4 x ½ hour), doing something that is important to them, where they want (in home or community) and choose who they want to support them.

 We are working towards the standards for Individual Service Funds. 

How?

We started by evaluating what the service is like now, so we can measure what changes. We used two observational tools - Dementia Care Mapping, and the Quality of Interactions Schedule, along with Progress for Providers - Checking your progress in delivering personalised services. We will repeat each of these in 8 months time. We have a partnership leadership team facilitated by Helen Sanderson, with people from Stockport Council, Borough Care and Bruce Lodge. Here, commissioners and providers are working together to make changes. The only additional resource to Bruce Lodge is 10 days training and coaching from Gill Bailey, from HSA. We are using person-centred thinking tools to deliver more personalised services.

What next?

The leadership team meets for a whole day each month. Every staff member is developing their own one-page profile. In the first month we have started to deliver personalised 2 hours to three people. By the end of July, we will have done this with everyone living at Bruce Lodge.