Four Seasons Health Care

FSHC are the leading independent healthcare provider in the UK. We own and operate over 500 care centres and nursing homes. Our homes are unique and we are proud to offer consistently high standards of service and care. We provide quality dementia care that is supported by a dedicated dementia team.

Updated:
10 February 2016
Location:
National
Sectors:
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?

Within Four Seasons Health Care (England Division) we have 140 units or homes that provide care for people living with dementia, equating to approximately 3,800 beds.

In January 2008 we developed our own accreditation scheme, comprising of 144 criteria to help homes develop into centres of excellence for people living with dementia. The PEARL (Positively Enriching And enhancing Residents Lives) programme consists of training, mentorship and support to work in collaboration with the home to help them achieve at least 65% of Score 5's (Bronze Award). Four Seasons Health Care have their own dedicated Dementia Care Team of 8 people who work across the UK to provide help and support to our residents who are living with dementia. We currently have 33 units within the Company that have achieved PEARL status. It takes approximately 12 months for each home to achieve PEARL and we estimate that we should have all homes through by the end of 2014.

The team have won 2 awards for the work we have been doing (Guy Rotherham and Excellence Network) as in the first phase of the project there was a 52% reduction in anti-psychotic medication on average across the care homes that were validated. We are now measuring other clinical indicators within Phase 2 of the project and have noted many successful outcomes for individuals including weight gain, reduction in both falls and distressed reactions.

 

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

  • Carers' understanding: We occasionally experience difficulties explaining the concept of person centred approaches to relatives or carers of people living within our homes. For example if a wife tell us that she would like her husband shaved every day but he becomes so distressed in a morning that we shave the gentleman in the afternoon when he is happy for us to do so. Also a critical part of our work is obtaining life story information but relatives or carers sometimes do not appreciate why this is important, despite explanation but as more organisations become more person centred (including general hospital, domiciliary care) hopefully this will reduce.
  • We occasionally experience difficulty also when we are trying to work with GP's/Consultants to titrate or discontinue anti-psychotic medication as the relative/carer becomes anxious that the person will become distressed, particularly if they have been on the medication for a number of years. Again, hopefully as public awareness is raised these encounters will become less frequent and also as we publish our own successful outcomes with PEARL, relative and carer confidence will increase

2. Actions

  • Increase in Pearl Homes

    Continue to implement PEARL and support those homes that have had awareness raised with PEARL.

    Status:
    Implementation

    2014 - Third Quarter Update

    We now have 75 homes accredited with the PEARL award and a further 65 homes are currently working towards the project.

    2013 - First Quarter Update

    We currently have 56 homes that are accredited with PEARL. Two homes are now accredited at a Platinum standard. We have developed a 12 month action plan to assist homes in achieving PEARL as well as developed 2 in house dementia development programmes for new Care staff and Nurses working within our dementia care homes that are aligned to the QFC dementia modules 52 homes are currently working towards PEARL. 29 homes will commence working towards PEARL from July.

    2015 - First Quarter Update

    We now have have 84 homes with PEARL accreditation with a further 76 homes working towards PEARL.

    2012 - Third Quarter Update 

    There are currently 51 homes accredited with PEARL.We have introduced a Platinum level for those homes who have achieved GoldWe have developed a 12 month action plan to assist homes in achieving PEARL as well as developed 2 in house dementia development programmes for new Care staff and Nurses working within our dementia care homes that are aligned to the QFC dementia modulesWe will commence the PEARL programmes with up to another 70 homes.

    2012 - Second Quarter Update

    There are currently 52 homes accredited with PEARLWe have introduced a Platinum level for those homes who have achieved GoldWe have developed a 12 month action plan to assist homes in achieving PEARL as well as developed an development pack for new employees working within our dementia care homes that are aligned to the Skills for QFC dementia modulesWe have devised and developed a PEARL pathway programme to assist homes in reaching a quality standard across the organisation in readiness for the full PEARL programmeWe have continued to roll out the PEARL project with another 40 homes joining in March 2012.

    2012 - First Quarter Update

    There are currently 50 homes accredited with PEARL. We have introduced a Platinum level for those homes who have achieved Gold. We have developed a 12 month action plan to assist homes in achieving PEARL as well as developed an induction pack for new employees working within our dementia care homes that are aligned to the Skills for Care dementia modules. We have devised and developed a PEARL pathway programme to assist homes in reaching a quality standard across the organisation in readiness for the full PEARL programme. We have continued to roll out the PEARL project with 60 homes joining in September 2011. We will continue with the PEARL roll out with 60 Care Homes joining in March 2012 and a further 60 will join in December 2012.

  • Dementia Care Mapping

    Continue to use DCM (Dementia Care Mapping - a specialised observational assessment tool) to establish the views of the person living with dementia and to help train our staff in person centred approaches

    Status:
    Delivery

    2015 - First Quarter Update

    We now have 784 staff trained in Dementia Care Mapping - a specialised observational assessment tool.

    2014 - Third Quarter Update

    Continue to use DCM (Dementia Care Mapping - a specialised observational assessment tool) to establish the views of people living with dementia.

    We have delivered 6 courses throughout 2014 to 180 staff.

    2013 - First Quarter Update

    Continue to use DCM (Dementia Care Mapping - a specialised observational assessment tool) to establish the views of the person living with dementia and to help train our staff in person centred approaches.

    We continued to use DCM (Dementia Care Mapping - a specialised observational assessment tool) to establish the views of the person living with dementia and to help train our staff in person centred approaches and most homes have a dedicated Dementia Care Mapper. DCM is being utilised within the PEARL homes particularly a minimum of every 3 months to help develop care plans and improve levels of wellbeing. We will continue to use Dementia Care Mapping and provide support and mentorship for existing Dementia Care Mappers.

    We have delivered 3 courses so far this year increasing the number of mappers FSHC employs and we have plans to deliver 3 more courses.

    2012 - Third Quarter Update

    We continued to use DCM (Dementia Care Mapping - a specialised observational assessment tool) to establish the views of the person living with dementia and to help train our staff in person centred approaches and most homes have a dedicated Dementia Care Mapper.DCM is being utilised within the PEARL homes particularly a minimum of every 3 months to help develop care plans and improve levels of wellbeing.We will continue to use Dementia Care Mapping and provide support and mentorship for existing Dementia Care Mappers.

    2012 - Second Quarter Update 

    We continued to use DCM (Dementia Care Mapping - a specialised observational assessment tool) to establish the views of the person living with dementia and to help train our staff in person centred approaches and most homes have a dedicated Dementia Care Mapper.DCM is being utilised within the PEARL homes particularly a minimum of every 3 months to help develop care plans and improve levels of wellbeing.

    2012 - First Quarter Update 

    We continued to use DCM (Dementia Care Mapping - a specialised observational assessment tool) to establish the views of the person living with dementia and to help train our staff in person centred approaches and most homes have a dedicated Dementia Care Mapper. DCM is being utilised within the PEARL homes particularly a minimum of every 3 months to help develop care plans and improve levels of wellbeing. We will continue to use Dementia Care mapping and provide support and mentorship for existing Dementia Care Mappers.

  • Provide Person Centred Care Training

    To continue to provide Person Centred Care training  and relevent Dementia realted topics to all our dementia care units/homes.

    Status:
    Delivery

    2015 - First Quarter Update

    We have trained 2500 staff in dementia related courses.

    2014 - Third Quarter Update

    We have trained 1800 staff in dementia related courses.

    2013 - First Quarter Update

    We have provided a 1 day ‘Caring for Residents Living with Dementia’ Course to 1325 staff members who work within our dementia care units during 2012 and this will continue to be delivered throughout 2013. We have delivered Resident Experience training on a ‘Roll Out’ programme to our homes and trained 65 staff to deliver this internally throughout 2012 and we will continue to roll this out throughout 2013. We have devised and continue to deliver be-spoke training sessions to our staff on different topics such as Mental Capacity Act, Activities, Communication, Person Cented Care Planning, Distressed Reactions and Nutrition etc. We have developed an e-learning package to cover most of the theoretical underpinning knowledge to care for a person living with dementia and this is now accessible to all staff and this is mandatory.During 2012 this had been completed by at least 80% of our staff across the Company.

    2012 - Third Quarter Update 

    We have provided a 1 day ‘Caring for Residents Living with Dementia’ Course to 2524 staff members who work within our dementia care units since 2011.We have delivered Resident Experience training on a ‘Roll Out’ programme to our homes and trained 165 staff to deliver this internally.We have devised and continue to deliver be-spoke training sessions to our staff on different topics such as Mental Capacity Act, Activities, Distressed Reactions and Nutrition etc.We have developed an e-learning package to cover most of the theoretical underpinning knowledge to care for a person living with dementia and this is now accessible to all staff and has been completed by at least 80% of our staff across the CompanyWe have delivered 12 Dementia Workshops throughout various locations to support homes.

    2012 - Second Quarter Update

    We have provided a 1 day ‘Caring for Residents Living with Dementia’ Course to nearly 2000 staff members who work within our dementia care units/homes this year.

    We have delivered Resident Experience training on a ‘Roll Out’ programme to our homes and trained 125 staff to deliver this internally.We have devised and delivered be-spoke training sessions to our staff on different topics such as Mental Capacity Act, Activities, and Nutrition etc.We have developed an e-learning package to cover most of the theoretical underpinning knowledge to care for a person living with dementia and this is now accessible to all staff and has been completed by at least 80% of our staff across the Company.

    2012 - First Quarter Update 

    We have provided a 1 day ‘Caring for Residents Living with Dementia’ Course to 1748 staff members who work within our dementia care units/homes this year. We have delivered Resident Experience training on a ‘Roll Out’ programme to our homes and trained 111 staff to deliver this internally. We have devised and delivered be-spoke training sessions to our staff on different topics such as Mental Capacity Act, Activities, and Nutrition etc. We have developed an e-learning package to cover most of the theoretical underpinning knowledge to care for a person living with dementia and this is now accessible to all staff and has been completed by at least 80% of our staff across the Company. We have held 8 dementia conferences throughout the UK for all our Care Homes to ensure quality standards are maintained. We will continue to deliver and review the training needs of our staff to ensure training is current and beneficial.

  • Review Pearl Criteria Annually

    To review the PEARL criteria each year to ensure that it is aligned to latest government recommendations i.e. National Dementia Strategy, NICE Guidelines and Outcomes and also that it contains recommendations in relation to very latest evidence/research based practice.

    Status:
    Implementation

    2015 - First Quarter Update

    We have done a full review of the PEARL criteria in January 2015.

    2013 - First Quarter Update

    We have reviewed the PEARL criteria in May 2013. This remains at 158 criterion and it has also been aligned to latest government recommendations i.e. National Dementia Strategy, the CQC outcomes as well as some criteria being specific to the relevant regions.(England, Scotland and Northern Ireland). This has ensured PEARL remains current and incorporates the most up to date best practices for each specific region within the United Kingdom. We continue to collate data to record the many benefits of PEARL which have included a reduction in anti-psychotic medication, falls and the number of distressed reactions. We will continue to review PEARL and the criteria to ensure it is current and reflects the needs of our residents and staff. We will continue to collect data to record the benefits of PEARL.

    A second FSHC report has been published highlighting the continuing benefits of PEARL to those homes that have been accredited.

    2012 - Third Quarter Update

    We have reviewed the PEARL criteria and it has now extended to 158 criterion and it has also been aligned to latest government recommendations i.e. National Dementia Strategy as well as the CQC/RQIA/CI outcomes. This has ensured PEARL remains current and incorporates the most up to date best practices for each specific region within the United Kingdom.

    We continue to collate data to record the many benefits of PEARL which have included a reduction in anti-psychotic medication, falls and the number of distressed reactions.We will continue to review PEARL and the criteria to ensure it is current and reflects the needs of our residents and staff.

    We will continue to collect data to record the benefits of PEARL

    2012 - Second Quarter Update 

    We have reviewed the PEARL criteria and it has now extended to 158 criterion and it has also been aligned to latest government recommendations i.e. National Dementia Strategy as well as the CQC/RQIA/CI outcomes. This has ensures PEARL remains current and incorporates the most up to date best practices.We have been collating data to record the many benefits of PEARL which have included a reduction in anti-psychotic medication, falls and the number of distressed reactions.

    2012 - First Quarter Update 

    We have reviewed the PEARL criteria and it has now extended to 152 criterion and it has also been aligned to latest government recommendations i.e. National Dementia Strategy as well as the CQC outcomes. We have been collating data to record the many benefits of PEARL which have included a reduction in anti-psychotic medication, falls and the number of distressed reactions. We will continue to review PEARL and the criteria to ensure it is current and reflects the needs of our residents and staff. We will be working in partnership with Boots to ensure all our residents who are prescribed anti- psychotic medication will receive a full medication audit and advice on the possible reduction or discontinuation of medication where it is deemed appropriate

  • Review Dementia Care Manual Annually

    To continue to review our Dementia Care Manual annually in line with the PEARL criteria review (as policies/guidance are aligned to the PEARL programme).

     

    Status:
    Completed

    2013 - First Quarter Update

    Polices and guidelines within our Dementia Care Manual have been reviewed in May 2013 and added to and these continue to support our care homes and are aligned to the PEARL criteria.

    2012 - Third Quarter Update 

    Polices and guidelines within our Dementia Care Manual have been reviewed and added to and these continue to support the PEARL criteria.

    2012 - Second Quarter Update 

    Polices and guidelines within our Dementia Care Manual have been reviewed and added to and these continue to support the PEARL criteria.

    2012 - First Quarter Update

    Polices and guidelines within our Dementia Care Manual have been reviewed and added to and these continue to support the PEARL criteria.

  • Listen to Others

    To continue to listen to our residents, our relatives and our staff and to act on suggestions for improvements.

    Status:
    Delivery

    2015 - First Quarter Update

    We continue to work with individual homes across the UK and listen to the views of people living with dementia.

    2014 - Third Quarter Update

    To continue to listen to the views of people living with dementia

    2013 - First Quarter Update

    We continually work with individual homes across the UK and interview staff and relatives listening to their comments and suggestions. As a company, we also conduct an annual Customer Survey.

    2012 - Third Quarter Update 

    We have worked with individual homes across the UK and interviewed staff and relatives listening to their comments and suggestions. As a company, we also conduct an annual Customer Survey.

    2012 - Second Quarter Update 

    We have worked with individual homes across the UK and interviewed staff and relatives listening to their comments and suggestions. As a company, we also conduct an annual Customer Survey.

    2012 - First Quarter Update 

    We have worked with individual homes across the UK and interviewed staff and relatives listening to their comments and suggestions. As a company, we also conduct an annual Customer Survey.

  • Update Knowledge of Dementia Care Team

    To continue to update the knowledge of the Dementia Care Team to enable our staff within the Company to share our knowledge.

    Status:
    Delivery

    2015 - First Quarter Update

    To continue to update the knowledge of the Dementia Care Team to enable our staff within the Company to share our knowledge.

    2014 - Third Quarter Update

    Continue to ensure best practice, up to date, dementia care is delivered

    2013 - First Quarter Update

    We continue to update the knowledge of the Dementia Care Team to enable our staff within the Company to share our knowledge. 3 hours every 6 weeks at our Dementia Services Team Meeting has been dedicated to new learning to help us to develop and enhance our knowledge in the field of Dementia. We have 2 members of the team who are approved DCM trainers.

    The team was awarded with a highly commended by the Nursing Times. The team has been restructured so now each region on the United Kingdom has its own dedicated Dementia Care Project Manager. We have introduced a new role of Senior Dementia Care Project Manager to support the Project Managers in their role. One member of the team presented at the International Alzheimers Confernace in Taipei in April 2013.

    The team has been shortlisted at this years Health Investors Awards for Specialist Care Provider of the year.

    Three members of the team will be attending the National Dementia Conference in November 2013.

    We have employed 3 Dementia Care Advisors to further support Dementia Care within the company.

    We will continue to deliver and review the training needs of our staff to ensure training is current and beneficial. Members of the Dementia Care Team will continue to expand on their knowledge and share this information.

    2012 - Third Quarter Update 

    We continue to update the knowledge of the Dementia Care Team to enable our staff within the Company to share our knowledge. 3 hours every 6 weeks at our Dementia Services Team Meeting has been dedicated to new learning to help us to develop and enhance our knowledge in the field of Dementia.

    We now another member of the team who is an approved DCM trainer.

    The team has been shortlisted for an award by the Nursing Times.

    The team has been restructured so now each region on the United Kingdom has its own dedicated Dementia Care Project Manager. We have introduced a new role of Senior Dementia Care Project Manager to support the Project Managers in their role.

    One member of the team has presented at the Royal Society of Medicine Conference.

    The team is attending an award ceremony as they have been shortlisted for an award by the Nursing Times.

    Three members of the team are attending the National Dementia Conference in October.

    A new Project Manager will join the team in September 2012.

    We will continue to deliver and review the training needs of our staff to ensure training is current and beneficial.

    Members of the Dementia Care Team will continue to expand on their knowledge and share this information.

    2012 - Second Quarter Update 

    We continue to update the knowledge of the Dementia Care Team to enable our staff within the Company to share our knowledge. 3 hours every 6 weeks at our Dementia Services Team Meeting has been dedicated to new learning to help us to develop and enhance our knowledge in the field of Dementia.

    One member of the team has presented at the International Alzheimer’s Conference in London.

    One member of the team has presented at the Community Care Conference.

    2012 – First Quarter Update 

    We continue to update the knowledge of the Dementia Care Team to enable our staff within the Company to share our knowledge. 3 hours every 6 weeks at our Dementia Services Team Meeting has been dedicated to new learning to help us to develop and enhance our knowledge in the field of Dementia.

    Two team members presented at the National Dementia Conference in Liverpool (2011).

    All team members attended the Dementia Care Congress in Liverpool October 2011.

    In January 2012 we expanded the Dementia Services team to include 1 extra Project Manager and 2 new Dementia Quality Advisors so we now have 10 Dementia Care Clinicians in the team

    One member of the team is presenting at the International Alzheimer’s Conference in London.

    One member of the team is presenting at the Community Care Conference

    One member of the team is presenting at the Royal Society of Medicine Conference.

    One of the Dementia Care Team is currently undertaking a Post Graduate course with Bradford Dementia Group.

  • Work towards Dementia Care Vision

    To continue to work towards our Dementia Care Vision and help all our staff working within our homes to recognise that each person living with dementia is unique.

    Status:
    Delivery

    2013 - First Quarter Update

    We continue to work towards our Dementia Care Vision and help all our staff working within our homes to recognise that each person living with dementia is unique.

    2012 - Third Quarter Update 

    We continue to work towards our Dementia Care Vision and help all our staff working within our homes to recognise that each person living with dementia is unique.

    2012 - Second Quarter Update 

    We continue to work towards our Dementia Care Vision and help all our staff working within our homes to recognise that each person living with dementia is unique.

    2012 - First Quarter Update 

    We continue to work towards our Dementia Care Vision and help all our staff working within our homes to recognise that each person living with dementia is unique.

  • Awards and Achievements

    To continue to work hard in our field to ensure people living with dementia are provided with the best practice dementia care.

    Winners of the Health Investors Award 2014 - Specialise Care Provider of the Year for the PEARL programme and specialised dementia care

    Status:
    Delivery

    2013 - First Quarter Update

    During 2012 we recieved a Highly Commeded award at the National Nursing Times Award.

    One of our Day Centres caring for people living with dementia won Best Dementia Team at the 2012 UK Dementia Congress awards.

    The Dementia Care Team have been shortlisted at this years Health Investors Award for Specialist Care Provider.

    2012 - Second Quarter Update

    Four Seasons has won 2 awards, Dementia Care Home of the year and Dementia Care Home Manager of the year in 2010 and we have been finalists for 4 awards to date this year within the team, along with several finalists within the Care Homes.

    2012 - First Quarter Update 

    Four Seasons has won 2 awards, Dementia Care Home of the year and Dementia Care Home Manager of the year in 2010 and we have been finalists for 4 awards to date this year within the team, along with several finalists within the Care Homes.