St Christopher's Trust
St Christopher’s Trust is a registered charity (number 527036). We have been providing care and support since 1954 to adults with learning disabilities, including dementia, living in High Peak. Offering residential, domiciliary and respite care and supported tenancies, we believe that of our all residents and service users should receive the care and support they need to enable them to reach their full potential and to lead as full a life as possible.
- 4 August 2021
- North West
- Care, Charity, Clinical Commissioning Group, Commissioners Sector, Domiciliary Care
- Local Alliances:
- Tameside and Glossop Dementia Action Alliance
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?
Our mission statement is MAXIMISING ABILITY, MINIMISING DISABILITY and our vision is to provide accommodation and person-centred support to adults with a learning disability,including dementia, enabling each individual to exercise choice, to actively participate in the community and to lead fulfilling lives.
Our core values are:
■ Encouraging independence
■ Enabling choice
■ Preserving dignity
■ Developing standards of excellence
■ Involving family and friends
2. What are the challenges to delivering these outcomes from the perspective of your organisation?
Providing appropriate and stimulating recreational activities for people with dementia.
Avoiding anxiety for the person with dementia.
Understanding the causes of and communicating issues to staff internally around all aspects of dementia and caring for people who have it.
Managing sleep, changes in sleep patterns and wakefulness of a person with dementia.
Communication problems between professional staff members providing care for people with dementia.
Medication management and ensuring person with dementia takes prescribed medications
Coping with secrecy, dishonesty and repetitive behaviours
Keeping staff person-centred planning and training and protocols up to date
Staying aligned to to best practice recommendations regarding dementia care environments design and layout etc.
1. Providing appropriate and stimulating recreational activities for people with dementia1. Providing appropriate and stimulating recreational activities for people with dementia Next steps: proactively guide our staff on all the latest best practice examples as to how to engage in constructive and stimulating activities with service users. For example, this might look at how to bring in a broader selection of options intended to bring back happy, comforting and empowering memories from the past. This means that people with dementia are not only able to reminisce about their life, but connect more closely with the people they are telling their recollections to, leaving them feeling proud and productive. Our priorities will therefore be to explore three new ways of encouraging our service users to engage with nature, try new and mindful hobbies and express themselves through a range of different • Animal therapy • Cooking and baking • Creative projects involving participating in art, craft-making and playing or listening to music
2. Avoiding anxiety for the person with dementia
1. Avoiding anxiety for the person with dementia
Next steps: as their condition progresses, people with dementia become more disorientated, forgetful and less able to think things through in a logical, systematic manner. For some people this struggle to make sense of the world can cause anxiety. But there can be a number of other contributory factors including pain, a sense of isolation, fear of sustaining a fall and so on. Reducing anxiety can involve a service user’s wider circle of family and friends as well as professionals, such as GPs, psychotherapists, occupational therapists, physiotherapists and social workers.
Our priorities will therefore be:
Working to understand what is triggering the anxiety.Exploring physical, pharmaceutical and/or psychological solutionsLiaising more closely with other professionals and family/friends
3. Managing sleep, changes in sleep patterns and wakefulness of a person with dementia3. Managing sleep, changes in sleep patterns and wakefulness of a person with dementia Next steps: introduce more strategic behavioural management interventions into the daily care routine. Our priorities will therefore to build into the daily routine new sleep-promoting actions such as: • Ensure service users get regular daily exercise and limit daytime naps and caffeine intake • Plan activities that use more energy early in the day (such as baths), setting a peaceful mood every evening and ensuring bed time is the same time every night – perhaps with reading aloud included. • Introduce the use of low lights or nightlights as an alternative to bright daytime lighting sources.
4. Communication problems between professional staff members providing care for people with dementia
4. Communication problems between professional staff members providing care for people with dementia
Next steps: we recognise that positive and supportive communication is essential to ensure good quality dementia care. As such, we take person-centred approach at all time focusing on supporting a person to use and retain their skills and abilities. Pivotal to this is seeing things from the perspective of the person living with dementia. A strong starting point is encouraging our carers to get to know their helpees inside out – ie: their life history, priorities, preferences and the names and details of all the people they have ever known and loved, both living and deceased. We will therefore now seek to:
Find out key information about a person's life before they developed dementia in the form of life story and reminiscenceTalking as often as possible about a person's past and bringing their history to life and into the present. Identifying strong social and cultural 'touchstones' or events from the past of great personal significance to forge a more powerful personal connection.
5. Ensuring service users diagnosed with dementia take their prescribed medications
Next steps: run training sessions with staff looking at modifications to the current routine which might help patients are as receptive as possible to taking medication, for example:
• Always creating a calm environment when it is time to give medications.
• Ensuring that no other issues (dental problems, other illness, anxiety or fear) are contributing to any sense of reluctance.
• Make investigations with the on-call pharmacist or GP to check whether any of the medications being given in a liquid, rather than a pill formula – or if the pills could be crushed (which not all can and retain their effect) and added to food to make them easier to consume.
6. Coping with secrecy, dishonesty and repetitive behavioursNext steps: People with dementia often repeat words or actions because of problems with short-term memory, which is a normal part of the condition. We plan to take steps to help our carers take more notice of the feelings and needs that are underpinning the repetition in order to be able to handle these behaviours with more understanding and empathy. Our actions will include: • Working with staff on a one-to-one basis to develop coping strategies for each of their more challenging patients. • Provide practical support to staff in the form of talking therapies, particularly CBT geared towards the needs of carers who have been under long term pressure. • Help our teams to network with a wider support circle of professional colleagues in order to develop and apply joint social strategies – such as engaging service users’ families more in the care process, joining new activity groups and seeking spiritual/pastoral support.
7. Delivering ongoing, updated staff dementia care training programmes
Next steps: plan and implement regular training days/programmes for our staff at all levels. Our actions will include: staying up-to-date with recommended prevailing best practice and legislation around dementia care. Our actions will include: • Ensuring staff are receiving the best dementia training • Include updated training on person centred care processes and practices • Ensuring robust, transparent managerial support for all line-managed staff working on the front line
8. Keeping staff Person-Centred Planning (PCP) training and protocols up to date
Next steps: in addition to maintaining up to date patient records for each service user, we will ensure that person centred plans (PCPs) are created by identifying details around how individual service users specifically need/should and like to be supported. Details recorded will cover a person’s likes/dislikes choices, preferences, dignity, respect, health conditions, behavioural plan (if needed) medication and interactions with friends and family, social and community activities. All these elements of care will be accompanied by risk assessments and guidelines. For example, there will be a tailored personal evacuation plan in place for each service user, a health action plan, a hospital passport, Herbert’s passport and family and friends contact details. Some of our service users already have a “This is me” in place, devised in conjunction with Derbyshire County Council. We will take steps to ensure that this is the case for all our service users, and train staff in all the necessary requirements.
9. Staying aligned to national best practice recommendations regarding dementia care environments design and layout
Next steps: in recognition of the fact that the design, decoration and overall physical environment of a care home or other setting for people with dementia has a significant effect on patients’ quality of life as well as improving symptoms of their condition, we will proactively seek to improve safety, security and a calm, relaxed atmosphere. Also, to assess current levels of compliance in our homes and associated care environments with specific regard to:
- Fixtures and fittings
- Entrances and exits
- Lighting, colour and contract
- Kitchens and bathrooms
- Ambient noise
- Outdoor spaces
Our actions will include: consulting with national guidelines (such as those issued by NICE and the Social Care Institute for Excellence) to consider how we might improve all aspects of our physical care environment(s), such as ensuring the use of distinguishing colours for residents’ doors and rooms, use of pictures as well as words on signage and decluttering as much as possible to reduce hazard levels. We will also take steps to ensure optimum maintenance of patients’ dignity by giving attention to bed areas and toileting, and bathing experiences. We will pro-actively seek to enhance the design of our communal settings by providing the stimuli, resources and opportunity to encourage service users to participate in fulfilling meaningful activities.
providing the stimuli, resources and opportunity to encourage service users to participate in fulfilling meaningful activities.