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Transcript of Clare Royston
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