Care Home Success or Failure – It’s all about culture and leadership
What a brilliant idea! The Henpower Project started in 2011 to help combat loneliness and depression.
This is a fabulous initiative – it reminds me of a great care home in Hindhead who have been planning to install their own sensory paths and Japanese water gardens in their grounds with golf buggies as well for those less mobile so all can benefit
Kings Park in Stirling, Scotland, has been transformed to allow those with dementia to have a stroll outdoors and still feel safe.
To create a welcoming outdoor space for people living with dementia, the park now has directional signage and more park benches. In addition, the park’s plants have been enhanced, the uneven paths have been repaired and there have been improvements to the visibility and the standard of the park facilities.
The dementia friendly park’s opening coincides with Dementia Awareness Week (4- 10 June) and is the result of efforts by Scotland’s walking charity Paths For All, which worked with the community to identify the best ways to make Kings Park dementia friendly.
“We want to create a welcoming environment to allow people with dementia and their carers to enjoy green space”, said a spokesman for the charity.
“There are many barriers for someone with dementia accessing the outdoors including a lack of information about accessible outdoor spaces, the services available (parking, paths, terrain, toilets, etc), required level of fitness, costs, safety concerns and transport issues.
“For someone living with dementia, getting out for a walk can reduce the feeling of isolation and help them maintain independence for longer.”
‘You forget any worries when you’re wandering’
It is estimated that Scotland has around 90,000 people with a dementia diagnosis who could benefit from more everyday walking opportunities.
People with dementia benefit from being outdoors and in contact with nature as it can help to relieve stress, increase self-esteem, produce vitamin D, and exercises the brain, helping with memory and cognitive functioning.
As part of its dementia friendly walking project, charity volunteers spoke to people living with dementia to ask how getting out for a stroll can benefit them.
One person with dementia told the charity: “It is getting you out. You sort of forget any worries when you are wandering around.”
The charity received £15,000 in 2017 from The William Grant Foundation in partnership with the Life Changes Trust to fund dementia friendly changes to the park. In March, an additional £6,000 was given by Stirling Council.
A leaflet with a map has also been created to assist with wayfinding and decision-making prior to visiting King’s Park.
Mental Health Minister Maureen Watt, who officially opened the park, said: “There has been a lot of work in recent years across Scotland to build dementia friendly and dementia enabled communities, through local partnerships and committed grass-roots work, and we want to see all communities becoming dementia friendly.
“The Kings Park project shows what can be done to help make our communities and green spaces more accessible and inclusive for people with dementia.”
This is fabulous – another example of a motto from one of my favourite managers who used to say “people come in here to live – not to die
A care home in Devon, that promotes positive risk taking such as skydiving and climbing trees, has been rated ‘outstanding’.
Malden House in Sidmouth, part of Hartford Care, has been given four ‘outstanding’ ratings for its effectiveness, quality of care, responsiveness and leadership by the Care Quality Commission.
Sean Gavin, chief executive officer of Hartford Care, said: “We’ve always been really proud of the team at Malden House because they ensure the residents receive the best possible care on a daily basis.
“We are delighted this has been recognised by the recent report by CQC and I would like to congratulate the team on this outstanding achievement. This is a first for the Hartford Care Group and I am confident that Malden House will be a shining example for the rest of our care homes in the family.”
The CQC report said “staff ‘go that extra mile’ to meet residents’ needs and wishes” and use opportunities to stimulate residents’ interests and learn new hobbies, including sky diving, climbing trees and learning to play the harp.
It added: “Residents were helped to make informed choices about risk taking to live life to the full. In a discussion about making a ‘bucket list’, two residents identified an ambition to try skydiving. Staff accompanied them to visit an airfield to progress their ambition.”
CQC inspectors also praised the care home for organising visits with its local nursery Tiny Feet to develop intergenerational relationships.
Similarly, staff and relatives bring their children and grandchildren to the home each week, which prompts memories and discussions about parenting and bringing up children.
One resident was seen lying in bed with a baby in one arm and a teddy in the other. According to the report, “their huge smile showed how much they enjoyed and benefitted from the experience.”
In the report, residents, relatives and staff spoke about the ‘exceptional quality of care’ provided at Malden House.
One resident said: “I can’t tell you how well cared for I feel living here. My life is wonderful now. There’s nothing I’d change, you can’t improve on perfection.”
A member of staff added: “There is a family atmosphere here and you can’t buy or install that. It comes from the top. It’s as near a home from home as you can get. Nothing is too much trouble and everyone is treated as one of the family. There isn’t anything we wouldn’t do.”
Registered manager, Agnieszka Orlowska, started her journey with Hartford Care in 2014. She said: “It has been my biggest dream and ambition to achieve this Outstanding rating. I am very proud of the whole team because they have all contributed to this achievement to provide care, comfort and companionship in an environment that is safe and happy for all.
“The Outstanding rating is proof that we provide a high level of person-centred care, so our residents can live their lives with purpose and full potential.”
The two-storey care home is registered to provide care for up to 19 older people, many of whom are living with dementia. Residents who wish to, can help around the home, such as with maintenance, repairs and with recruiting new staff.
Wow! This takes pet therapy to another level. Well done Hastings Court
An 85-year-old dementia resident with limited speech has been ‘brought alive’ by a lifelike children’s ‘robotic pony’, brought into the care home by the registered manager for a racing-themed open day.
The animatronic pony was purchased for a two-figure sum on eBay by the home manager of Hastings Court in Hastings. Georgina Gamble had bought the pony from an online auction site as she thought it would be a nice toy for her young grandchildren to play with. However, resident, Mary Long, who has advanced dementia, amazed staff and family by suddenly chattering away to the robot toy, often for ‘hours on end.’
‘The pony doesn’t demand anything of her’
Therapy pets have long been used in care home settings, and increasingly, care environments are seeing ‘robotic therapy pets’ manufactured especially for their market. These ‘therapy pets’ are specially designed for people who are unable to take care of real animals.
Recent studies have shown that they are particularly effective when treating residents with dementia, and those with speech problems.
Ms Gamble said: “When people like Mary lose the ability to verbally communicate they can find it more difficult to connect with others and as a result, they can feel more isolated.
“The pony doesn’t demand anything of her, but it responds to her touch by whinnying and she’s made a connection that she gets a huge amount of pleasure out of. And the effects of the interaction last – her mood is brighter for a while after spending time with the pony.”
Ms Long, a former dental nurse with dementia, lives at Oakland Care’s Hastings Court care home which offers residential, nursing, memory and respite care. Her daughter Sharon works there as a receptionist, and her husband and five other children call in regularly to visit.
Sharon can’t believe the difference the robot pony has made to her mother’s mood. She said: “Although Mum can’t say much to me these days I know she’s happy here. To see her come alive when she spends time with the pony just makes my day.”
‘Mum can literally spend hours chatting to the pony’
The realistic looking animatronic horse, which makes a whinnying sound and moves its head and legs, is not quite as big as a real pony but stands a good few feet off of the floor, being originally designed for young children to be able to sit on.
Although the robotic pony at the care home was initially designed for a child, previous studies have shown that robotic pets have similar benefits to real animals; they can increase feelings of wellbeing to counteract those of loneliness, as well as help to lower blood pressure.
Ms long has memory loss and mobility problems which are a direct result of Fragile X-associated tremor/ataxia syndrome (FXTAS). At the home, she likes to sit in reception with her daughter whilst she is working.
Sharon says her mum’s reaction to the pony was immediate. She said: “I went and brought my mum downstairs as I knew she loved animals and she literally sat talking to the pony for three hours and was trying to feed it and brush it.”
She believes the robotic ‘pet’ has really improved her mother’s quality of life. She says: “Mum can literally spend hours chatting to the pony, saying “come to Nanna” and feeding it carrots. She has always loved animals and as children we always had dogs and cats at home. To see her interacting with the pony, brushing it and laughing, is very, very special.”
Staff at Hastings Court found the pony robot had a similar effect on many of the other residents in the 80-bed home too. They also enjoy visits from a live pony and other therapy animals including sheep, dogs, ducks and rabbits.
Robotic toys for 4-8- year old girls being bought for ‘aging loved ones’
In December of last year, children’s toy manufacturer, Hasbro, launched a realistic robotic puppy aimed at ageing adults. This was in addition to their successful ‘pet cat’, aimed at the same market. The cat ‘purrs’ and moves when stroked and has tactile fur. Some older people think it’s a real animal, and others are aware that it’s purely robotic.
This ‘companion pet’ range, called Joy for All, is now made by a company called Ageless Innovation which is made up of former Hasbro employees; they set up shop in May 2018. Their CEO Ted Fischer said in an interview on YouTube channel, The Not Old Better Show”, that they had noticed a similar Hasbro toy was being bought for ‘unintended users’ a decade or so ago.
The CEO explained: “There was a product that was intended for 4-8-year-old girls and about 10 to 15 per cent of the reviews we got were from people not buying it for their daughters but buying it for an aging loved one.”
Interestingly, Hasbro were also the makers of the animatronic FurReal Butterscotch Pony which Ms Long took such a liking to at Hastings Court. When Ms Gamble realised the pony was such a hit with her care home residents, she immediately bought an identical one off the internet. This now lives permanently at the care home, and her happy grandchildren get to keep the original.
Love this initiative. Bravo Nicolas Kee Mew
Nicolas Kee Mew, who has been working in care homes for over a decade, says it is the “passion of the staff that make a good care home”.
Mr Kee Mew has just been appointed manager of Riverdale Court. Prior to that, he was manager of Barchester Wimbledon Beaumont Care Community where he introduced the silent disco, which has become a popular phenomenon at festivals.
He is originally from Mauritius and came to the UK to study accountancy. “I needed a part time job for the weekend and a friend of mine recommended I try working as a housekeeper in a care home.”
Mr Kee Mew, who was 19 at the time says: “We did not have any care homes at that time in my country but my grandfather had Alzheimer’s and I was always curious about this disease since I was very young.”
In his new role at Riverdale Court managing 56 members of staff, he hopes to introduce more technologies such as sensory equipment to prevent and reduce falls while still allowing residents to still be as independent as they can. He also wants to use music as he did at Barchester Wimbledon Beaumont Care Community to boost residents’ physical and mental wellbeing.
As manager of Arthur House in Wimbledon in 2017, Mr Kee Mew won the award for Dementia Care Inspiring Leader at the National Dementia Care Awards.
He received the award for being an inspiration to his team and developing morale.
Motivating staff is very important to Mr Kee Mew, as he sees that as integral to how the care home performs.
He sees the challenges of his job to “be for the care team to be recognised for their hard work and to feel appreciated.
“Unfortunately the labour turnover can be high in a care home and it is my role as the manager to motivate my team and show them there is a career in health and social work.
“It is vital for me as a manager to create a culture where my staff feels appreciated. I like to support and coach my team to get the best out of them so that one day they can become a manager too.”
Part of the appeal in working in a care home for Mr Kee Mew, is the variety and that every day is not the same.
He also enjoys the praise and recognition from the residents and their relatives when they are happy in the care home and feel well looked after.
“There are a lot of competitors around but what make us unique is about how we differentiate from our competitors in terms of person centred care, treating our residents with respect, dignity and also promoting their independence.”
Mr Kee Mew is also keen for the home to be fully inclusive and recently the care home held its first mini silver pride.
“I have been caring for a lot of LGBT residents and manage some LGBT staff. It is important to let them know that it’s okay to be who they are and to celebrate diversity.
“Unfortunately it is taboo in many care homes and it is more difficult for residents living with dementia.”
Mr Kee Mew believes that it won’t be long before care homes start caring for transgender residents, saying: “We will have to adapt to the changes and ensure that our staff understand how to meet the needs of LGBT+ older people.”
Care home bosses have dismissed fears Brexit could exacerbate the nursing workforce crisis, saying EU nurses are expensive to recruit, retention rates are low and they don’t want to live in the areas where shortages are.
Care homes in the UK have been struggling to attract nurses for some time, with the National Audit Office recently revealing that one in 11 nursing posts in the care sector in England is vacant, after the number of nurses fell by 8,000 to 43,000 over the last four years.
It is a similar picture in Scotland, where Scottish Care has said some care homes are being forced to pay up to £1,000 per shift for an agency nurse, with nearly a third of nursing posts vacant. In Wales, some care homes have been forced to close due to being unable to recruit nurses, according to Care Forum Wales.
Care England, Scottish Care and Care Forum Wales have voiced fears the situation could worsen post Brexit, with care homes losing their EU nurses.
Recruiting EU nurses is not a magic bullet
However bosses of large care home groups such as Barchester Healthcare and Hallmark Care Homes say they have given up recruiting nurses from the EU as they haven’t proved to be the magic bullet they had hoped.
Pete Calveley, chief executive of Barchester, spoke at the Future of Care conference, saying: “We spent quite a while recruiting lots of EU nurses. It was very expensive and very unrewarding. The average cost of recruiting a nurse was £8,000 and the average time they spent with us was six months.”
He revealed that one of the problems is “we struggle to recruit in certain rural areas in Scotland but these are also areas where EU nurses don’t want to live. They want to live in cities such as London or Edinburgh”.
Consequently he believes it is “important that care providers appeal to a wider group of nurses than those in the EU and we have to become more attractive as employers”.
“Nurses have to feel why would they want to go elsewhere,” he added.
‘Retention of EU nurses was poor’
Joan Elliot, general manager of UK Care Services, backed up Dr Calveley’s comments, saying: “We have found the same. We recruited from the EU and found retention of EU nurses was poor.”
However she was quick to point out that in terms of the EU nurses that Bupa does have, she would like more concrete reassurances from the Government over their rights to stay.
Avnish Goyal, managing director of Hallmark Care Homes, revealed that they too have “recruited from the EU and had a bad experience in terms of retention and we have had the same issue with costs.
“We have also found the settling in period for EU nurses is much longer than for UK nurses as they have to adjust to the language and the culture.”
He questioned why care homes are taking nurses from other countries, saying: “We need to be growing our own nurses and providing the funding to help people train to become nurses. You need to offer nurses good career progression then you can attract them into the sector”.
EU nurses are ‘still a valuable resource for care homes’
Despite these comments from leading care providers, Martin Green, chief executive of Care England believes EU nurses are still a valuable resource for care homes.
He said “The recruitment and retention of nurses, and indeed care staff, is one of the biggest challenges facing our sector. In a post Brexit world, we need the Government to streamline administration and bureaucracy and enable our sector to attract high quality nurses from across the globe.
“Brexit is already having an effect on nurse recruitment, though this is not only because of Brexit, but also because of the fall in the value of the pound which makes it less advantageous for European citizens to work in the UK.”
New data from Skills for Care shows that currently seven per cent (95,000) of the social care workforce in the UK are from the EU.
From today, people in Wales will be able to keep up to £40,000 of their savings before they need to start paying for their care home.
The Welsh Government has raised the capital limit from £24,000 up to £50,000 during the current Assembly term which runs till 2021. In April last year, the limit was raised to £30,000 and from today the limit will be £40,000.
This new capital limit in Wales is now the highest in the UK. In England, people with capital and savings above £23,250 have to fund all of their own residential care. In Scotland, the capital limit is £27,250.
Social Care Minister, Huw Irranca-Davies said: “This is the second step in delivering one of our top six “Taking Wales Forward” commitments to more than doubling the amount of capital a person in residential care can retain without having to use this to pay for their care.
“This is another firm example of this Welsh Government delivering its commitments to the people of Wales.”
There are up to 4,000 care home residents in Wales who pay for the full cost of their care. Around 450 care home residents have already benefitted from the increase last year, with a steady increase in this number expected.
Mario Kreft, chair of Care Forum Wales , welcomed the original announcement of the new capital limit. However he called for the policy to be properly funded, saying “otherwise local authorities or care homes themselves will be picking up the tab at a time when they are already being squeezed financially”.
A group of care homes in the New Forest have just received their third consecutive ‘Outstanding’ within a year from the Quality Care Commission (CQC).
The rating was awarded to the Woodpeckers care home in Brockenhurst, which is part of the Colten Care group. Inspectors praised the home for its ‘one-team’, approach, adding: “Staff understand the needs of people and support them in an exceptionally personalised way.”
Woodpeckers is a 39-bed care home with nursing for older people.The other homes that also received an outstanding accreditation, were Linden House in Lymington and Kingfishers in New Milton.
Dedication to high nursing standards and working with local health organisations was singled out in the CQC report. It said: “The service worked in partnership with other health organisations and were involved in a pilot with the local clinical commissioning group called ‘NEWS’ National Early Warning Score in care and nursing homes to identify a physical deterioration in people and to detect early warning signs.
“All senior nurses had attended a study day on how to use the tool in line with best practice. This meant nurses observation skills and responses times were improved resulting in decisions for emergency services being appropriate and working closely with the NHS to reduce inappropriate referrals.”
Mark Aitchison, Colten Care chief executive, responded to these comments, stating: “It’s particularly gratifying as we are achieving this independent recognition while investing in nursing at a time when others are turning away from it due to recruitment challenges and higher costs.”
In total, 15 per cent of Colton Care’s homes are rated outstanding against an industry average of less than two per cent and, three out of their five New Forest homes have now been rated as outstanding.
Mr Aitchison added: “Having three homes rated outstanding in successive inspections really does put us among the country’s very top providers registered for nursing care.
“With all 20 of our homes rated outstanding or good, we can justifiably lay claim to being in a different class from many other private sector operators.”
He praised staff for their hard work, and when receiving the outstanding certificate, said: “You should all be especially proud that Woodpeckers is the first Colten home to be rated outstanding across three separate lines of enquiry: being effective, responsive and well-led.
“That’s a huge triumph involving a great many people.”
Just one hour of social interaction combined with personalized care, can reduce anxiety and aggression in care home residents with dementia, according to a new study.