Dementia: Quality of Care 2016

1. Four Seasons
Health Care
Dementia Care
Framework
Presented by:
Dr M Claire Royston
27th April 2016

2. Context Four Seasons Health Care
Round Numbers
Homes 350
Residents 18,000
Staff 20,000
% State funded 85%
Average Weekly Fee £590
Dementia units 290
Services
Residential care Learning Disability
Nursing Care Mental Health
Dementia Care Younger person
Palliative Care
Respite Care
Intermediate Care

3. The Four Seasons Dementia Care Framework
has been developed using current standards
and best practice guidelines

4. It all comes down to…
The individual Experience

5. Using technology to
facilitate dementia care
• Quality of Life
• Live in 350 Homes
• Listening and responding to individual Residents and Families
• Supporting Staff to get it right
• Operational grip, quality assurance and governance
• Reporting
• experience and outcomes for individuals and the service
• quality improvement, contributing to the evidence base

6. Quality of Life - QoL
• Residents
• Friends and families
• Visiting professionals
• Colleagues
Provide their feedback, comments
and suggestions quickly and easily,
via a static or mobile iPad
Feedback is also gathered from
colleagues as we know happy and
supported teams are vital to positive
resident experiences
The system records these comments
and makes them available
immediately to the home and
support teams
First Key Tool: Live Feedback

9. What does feedback look
like from Residents?
25, 465

10. Quality of Life - QoL
Resident TRaCA (Thematic Resident and Care Audit)
• Based on the experience of that individual
resident
• Starts with talking to the resident and asking for
their input into the care they are receiving
• Completed by various members of the team on
iPads
Our ‘system’ TRaCAs
These cover key aspects of our service:
– Daily and weekly medication TRaCAs
– Housekeeping, Health and Safety, weight
loss, daily walk round etc.
– TRaCA for Regional Managers
Second Key Tool: Digital TRaCAs to enable a Find and Fix approach

11. Introducing………

12. TRaCAd –
what is it?
• Evidenced based
• Specific to England, Scotland or Northern Ireland requirements
• Covers over 300 standards
• Focused on individual experience of care
• Find and Fix
• Based on personal accountability and action
• Supporting Colleagues to get it right
• Includes risk assessments and process
to review medication (incl antipsychotics)
• Reporting function

13. What is covered by
TRaCAd?
Feedback
Questions
Observatio
n Tool
Care
Documentati
on
Meaningful
Activities
Rights
Consent
Capacity
Bed Rails Lap Belts DoLs Medication Pain
Mobility Falls
Distress
Reaction
Personal
Risk
Assessment
Nutritional
Needs
Choking
Risk
Weight Loss Continence
Use of
Sensor
Equipment
Cognition
End of Life Communication Delirium
Psychologic
al and Sleep
Hygiene
Skin/Tissue
Integrity
Pressure
Ulcers
Minor
Wounds
Recent
Admission
Sensory

14. Resident and Family
Perspective
• Starting point was to understand what is
important to a Resident and their Family
• Co-produce a Charter and connect this
directly to the way we support Staff to
deliver care (TRaCAd)
• Linkage to the Resident experience
statements (outcomes)

15. Co-production with Residents
and their Family
• Feedback from Residents/Family via Quality of
Life iPads
• Focus Groups
• Conclusions
Over 450 comments collected on all aspects
of the Charters
95% liked the idea of having a resident and
family charter – 100% from visiting
professionals
90% agree with headings
• Providing the Right Care
• Making it work
• Keeping me Informed
• Respecting My Rights
• End of Life Care

16. Resident Charter
“The People who look
after me have taken
the time to find out
who I really am”
Providing the right care for me
I can trust you to:
• Continuously monitor my health and
wellbeing and deliver the right care for me
• Understand how I want to be cared for and if
you have to make decisions for me, you do
your best to include me and support me in
doing what is best for me
• Help me to remain as active as possible for as
long as possible
• Care for me with team members who have
the right skills to care for me and understand
me as a person
• Support me to continue the hobbies and
social activities I enjoy
• Support me to keep my links with my friends
and community networks

17. Four Seasons will seek to
understand and recognise
the range of emotion that
may be experienced when
a relative is living with
dementia.
This Charter demonstrates
the support I can expect to
receive as a family
member, how you will
value our input, alongside
providing special
experiences for my
relative.
Keeping me informed
You commit to:
• Inform me of changes to my
relative’s health and wellbeing,
following their consent
• Enable me to have the opportunity
to regularly provide feedback
• Say sorry and put it right if you don’t
get it right
Family Charter

18. Four Seasons Dementia
Care Framework
A set of values and actions we follow to support
Special Resident Experiences