Excelcare

We provide nursing and residential care in care homes throughout the South East of England. We also provide domiciliary care and continuing healthcare in the community.

Updated:
10 February 2016
Location:
National
Sectors:
Pharmaceutical, Health, Care

1. Action Plan

1. The National Dementia Declaration lists seven outcomes that the DAA are seeking to achieve for people with dementia and their carers. How would you describe your organisation’s role in delivering better outcomes for people with dementia and their carers?

We developed an initial two year plan (December 2010) for moving our dementia strategy forward. The Managers of each service developed their own strategy for delivering positive outcomes; in keeping with the wishes of the people who live in the homes. We are implementing our plan and have seen our residents with dementia ‘come alive’. Dementia champions have been appointed in each region and they form part of the dementia steering group. The steering group has led policy and practice by example. The environmental changes seem to have had the most positive effect on residents.

The changes included; improvements to lighting and décor, signage for key areas, themed corridors or areas ‘bringing the outside in’, rummage boxes and lots of ‘stuff’ in communal areas. Some homes have created a tea room/coffee bar, a laundry room or a kitchen. Home baking, ironing and daily chores are key activities that enable many of our residents to feel there is value to their day. Staff do not wear uniforms and act like ‘family’ spending the day with residents; including sharing mealtimes. We monitor the usage of antipsychotic medication and have seen a reduction in its use as the environments have improved.

2. What are the challenges to delivering these outcomes from the perspective of your organisation?

Our first challenge lay in changing the attitude of staff from a task orientated mind set to a person centred approach. In addition staff were fearful of the risks residents may be put at, for example the risk of scalding when making a cup of tea. 

Another challenge lay in helping visitors and relatives to understand what we are trying to achieve. For example many relatives tell us they are keeping a persons’ photographs at home for safekeeping. 

Changing environments is a challenge; older homes tend to be more ‘homely’ and improving the environment can be costly. New homes are ‘hotel’ like and can appear stark.

2. Actions

  • Training and Education

    Training and Education - 50 staff enrolled on the Dementia Care Matters Diploma in-house and have cascaded their knowledge; which is ‘feelings’ based, to other staff. Two Managers are currently completing the training to be able to deliver the diploma in house from 2013. Further dementia training is sourced, provided, and its effectiveness monitored, both in house and by outside organizations, to ensure we provide true care centred on the persons’ needs and wishes.

    50 Staff have completed the dementia care matters diploma and this continues as a rolling programme of training. In house training is also ongoing to educate and support staff in delivering feelings based person centred care. External training is sourced by individual services to meet the needs of the people who live and work there.

    Status:
    Delivered

    2012 - Third Quarter Update

    In progress.

    2012 - Second Quarter Update

    In progress.

    2012 - First Quarter Update

    In progress.

  • Therapies

    Therapies - we are using SONAS therapy in some homes which clearly demonstrates an improvement in the wellbeing and attention of people.  A new therapy to this country called NAMASTE is being pioneered in two homes. It is having positive effects in the later stages of dementia and at end of life. It reduces the incidents of repetitive crying out and people who have been unable to show their feelings usually have a positive reaction.

    Status:

    2012 - Third Quarter Update

    In progress.

    2012 - Second Quarter Update

    In progress.

    2012 - First Quarter Update

    In progress.

  • Observational audits

    Observational audits – the number of staff who are trained to be dementia care mappers will increase to ensure there is at least one person in each region. Currently we have several in some regions and none in others. Observational audits will continue to be used as a training tool for staff.

    Observational audits continue as part of the quality monitoring process and from these supportive actions are taken to maintain what is working well and to tackle what is not working well

    Status:
    Being implemented

    2012 - Third Quarter Update

    In progress.

    2012 - Second Quarter Update

    In progress.

    2012 - First Quarter Update

    In progress.

  • Technology

    Technology – A technology steering group meets quarterly to look at innovations that can improve the independence and care for residents. By 2014 we aim to have wireless internet in all our services to enable people to skype and e-mail their families and friends. To continue making My Life units available to residents, their friends and families and using them to improve life stories with the inclusion of photographs. Being part of a trial into the improvement of wellbeing when the units are used.

    Status:

    2012 - Third Quarter Update

    In progress.

    2012 - Second Quarter Update

    In progress.

    2012 - First Quarter Update

    In progress.

  • Environment

    Environment - Improvements to lighting, where needed, for completion 2013. Reduction in locked doors to only those that, if unlocked, would compromise the health and safety of residents. Decoration in homes to present as ‘homely’ and the introduction of themed areas – bringing the outside in

    All homes continue to develop themed areas to present a homely feel and stimulation for people. Some homes have been awarded financial grants and have developed areas such as themed gardens and people enjoy outside activities such as gardening clubs.

    Status:
    Completed

    2012 -Third Quarter Update

    In progress.

    2012 - Second Quarter Update

    In progress.

    2012 - First Quarter Update

    In progress.

  • Medication

    Medication - continued reduction in the use of Anti Psychotic medication. This is monitored on a monthly basis.

    The monitoring of use of antipshychotics contiues and close working relationships with GPs, families and community based professionals has demonstrated a measurable reduction in use.

    Status:
    Delivered

    2012 - Third Quarter Update

    In progress.

    2012 - Second Quarter Update

    In progress.

    2012 - First Quarter Update

    In progress.

  • Evaluation of our Dementia Strategy November 2012

    Evaluation of our Dementia Strategy November 2012. Care in the community, for people with dementia, is increasing. Our Domiciliary Care Services will develop strategies to improve lives for people they care for.

    The dementia steering group is to be relaunched to deliver the new 2015 strategy.

    Status:
    Initial Scoping

    2012 - Third Quarter Update

    In progress

    2012 - Second Quarter Update

    In progress

    2012 - First Quarter Update

    In progress