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?

Castletroy has been a registered provider of residential care for many years and is well known as such within the local community.  Our specialist dementia care services commenced in late 2015 with the opening of a small specialist dementia care unit.  This was in direct response of demand and requests for dementia care to be provided at Castletroy.  This small Unit gave us the opportunity to adjust the environment, train specialist staff and experience supporting people living with dementia to do so well, to have a good quality of life and to feel safe.  The great success of this initial service and ongoing increase in demand resulted in further developments and increased during 2016 with around half of the service now providing support and care for people with dementia.

We use a person centred system of assessment and care planning that seeks always to involve the individual in decision making.  We take account of the principles of the Mental Capacity Act and are compliant with its requirements.  We advocate for service user’s rights relating to decision making and train all our staff in MCA and DoLS ensuring that rights are protected.  Conversations are recorded that provide details of the persons wishes and viewpoints.  We actively promote personal choice and offer visual choices, signs and symbols, colour coordination, lighting and help from staff, family, friend and professionals to achieve this.  When we have to make decisions, because a person has lost the mental capacity to do so (MCA assessment would be undertaken), we would make decisions in their best interests and using the best interest checklist.

Restrictions on individual’s rights would only be used when appropriate, proportionate and lawful.  Some residents are being deprived of their liberty and are therefore subject to the Deprivation of Liberty Safeguards.  Whilst this maybe the case, we continue to support people to make their own decisions whenever they can and continue to offer choice and opportunity to have an active and satisfying life. 

Additionally, we take account of individual’s skills, life history, previous choices and lifestyle etc.  We collate this information with the individual, their family, friends and advocates and involve individual’s named advocates in decision making, particularly when the relevant person has lost capacity to make decisions for themselves.  Building trusting relationships and valuing people beyond living with dementia is a key to success.  We take account of each person’s apparent anxieties and emotions and provide care and support that decreases negative feeling and replaces this with feelings of happiness and safety.

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

The cost of providing best practice, person centred dementia care far exceeds the fee level paid by local authorities.  Overall, fees have decreased over recent years and care providers are now recognized for going out of business at a high rate.  Castletroy needs to provide the best care in the local market to stay competitive and to attract privately paying residents to mitigate the ‘losses’ relating to local authority contracts.  We will do this by:

·         Building our currently excellent reputation and extending this to our dementia services.

·         Letting the local community know that we now provide dementia services and what we provide by:  Publishing a brochure, including information on our website, inviting people in to attend Dementia Friend Information Sessions, letting Social Workers and commissioners know of our services.

·         Minimizing local authority contracts whenever possible.

·         Ensure increased fees levels are negotiated whenever a resident requires additional care.

·         Lobby for realistic fees.

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