Four Seasons Health Care

Dementia Care Framework

Presented by:Dr M Claire Royston

27th April 2016

Context Four Seasons Health Care

Round Numbers

Homes 350

Residents 18,000

Staff 20,000

% State funded 85%

Average Weekly Fee £590

Dementia units 290

Services

Residential care Learning Disability

Nursing Care Mental Health

Dementia Care Younger person

Palliative Care

Respite Care

Intermediate Care

The Four Seasons Dementia Care Framework has been developed using current standards and best practice guidelines

It all comes down to…

The individual Experience

Using technology to facilitate dementia care

• Quality of Life

• Live in 350 Homes

• Listening and responding to individual Residents and Families

• Supporting Staff to get it right

• Operational grip, quality assurance and governance

• Reporting

• experience and outcomes for individuals and the service

• quality improvement, contributing to the evidence base

Quality of Life - QoL

• Residents• Friends and families • Visiting professionals • Colleagues

Provide their feedback, comments and suggestions quickly and easily, via a static or mobile iPad

Feedback is also gathered from colleagues as we know happy and supported teams are vital to positive resident experiences

The system records these comments and makes them available immediately to the home and support teams

First Key Tool: Live Feedback

What does feedback look like from Residents?

25, 465

Quality of Life - QoL

Resident TRaCA (Thematic Resident and Care Audit)

• Based on the experience of that individual resident

• Starts with talking to the resident and asking for their input into the care they are receiving

• Completed by various members of the team on iPads

Our ‘system’ TRaCAs

These cover key aspects of our service:

– Daily and weekly medication TRaCAs

– Housekeeping, Health and Safety, weight loss, daily walk round etc.

– TRaCA for Regional Managers

Second Key Tool: Digital TRaCAs to enable a Find and Fix approach

Introducing………

TRaCAd –what is it?

• Evidenced based

• Specific to England, Scotland or Northern Ireland requirements

• Covers over 300 standards

• Focused on individual experience of care

• Find and Fix

• Based on personal accountability and action

• Supporting Colleagues to get it right

• Includes risk assessments and process

to review medication (incl antipsychotics)

• Reporting function

What is covered by TRaCAd?

Feedback Questions

Observation Tool

Care Documentati

on

Meaningful Activities

Rights Consent Capacity

Bed Rails Lap Belts DoLs Medication Pain

Mobility FallsDistress Reaction

Personal Risk

Assessment

Nutritional Needs

Choking Risk

Weight Loss ContinenceUse of Sensor

EquipmentCognition

End of Life Communication DeliriumPsychological and Sleep

Hygiene

Skin/Tissue Integrity

Pressure Ulcers

Minor Wounds

Recent Admission

Sensory

Resident and Family Perspective

• Starting point was to understand what is important to a Resident and their Family

• Co-produce a Charter and connect this directly to the way we support Staff to deliver care (TRaCAd)

• Linkage to the Resident experience statements (outcomes)

Co-production with Residents and their Family

• Feedback from Residents/Family via Quality of Life iPads

• Focus Groups

• ConclusionsOver 450 comments collected on all aspects of the Charters 95% liked the idea of having a resident and family charter – 100% from visiting professionals90% agree with headings

• Providing the Right Care• Making it work• Keeping me Informed• Respecting My Rights• End of Life Care

Resident Charter

“The People who look after me have taken the time to find out who I really am”

Providing the right care for me

I can trust you to:

• Continuously monitor my health and wellbeing and deliver the right care for me

• Understand how I want to be cared for and if you have to make decisions for me, you do your best to include me and support me in doing what is best for me

• Help me to remain as active as possible for as long as possible

• Care for me with team members who have the right skills to care for me and understand me as a person

• Support me to continue the hobbies and social activities I enjoy

• Support me to keep my links with my friends and community networks

Four Seasons will seek to understand and recognise the range of emotion that may be experienced when a relative is living with dementia. This Charter demonstrates the support I can expect to receive as a family member, how you will value our input, alongside providing special experiences for my relative.

Keeping me informedYou commit to:

• Inform me of changes to my relative’s health and wellbeing, following their consent

• Enable me to have the opportunity to regularly provide feedback

• Say sorry and put it right if you don’t get it right

Family Charter

Four Seasons Dementia Care Framework

A set of values and actions we follow to support

Special Resident Experiences