Application of the SPECAL appraoch in a home care environment E23

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Information about the SPECAL® approach used to promote individualised and consistent care and support for people living with dementia in their own home. Contributed by: The Good Care Group

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  • Dementia is different – a different approach is requiredExploring innovative solutionsSPECAL – similar value base and attracted to the ‘toolkit’The Good Care Group keen to investigate whether it really works in domiciliary care
  • So today’s page for us looks always like this on the leftWhilst for the person with dementia their today’s page looks like thisThe blanks start to sequence, ribbons of lost information
  • So today’s page for us looks always like this on the leftWhilst for the person with dementia their today’s page looks like thisThe blanks start to sequence, ribbons of lost information
  • And now in end stage dementia, two people, one with and oneWithout dementia, have albums like thisThe person on the left is referencing what has just happenedThe one on the right is running almost entirely on feelings without any factsThe old photographs from long before dementia are there, but we don’t use thoseIt is common sense not toBut common sense is no good for the person with dementiaThey need SPECAL sense and they need help from usFeelings are more important to them than factsWe need to look at feelings
  • Application of the SPECAL appraoch in a home care environment E23

    1. 1. Application of the SPECAL approach in a home care environment Zoë Elkins Head of Care – The Good Care Group
    2. 2. Our Company • Providers of award-winning, high quality home care services since 2009 • Registered in England and Scotland • Employs over 200 people • Founders/management team passionate about service ethos in care market – make a difference • Extensive board and management team expertise • Over 30 years’ care sector experience • Ambition to be market leading, set the standards, revitalise industry & professionalise care • Specialist in care of conditions – dementia, Parkinson’s • Fully compliant service inspected by CQC
    3. 3. Our Vision To be the leading provider of high quality care in the home that enables older people to enjoy staying safely and happily in their own homes and own community for as long as possible, whilst enhancing their well-being and lifestyle
    4. 4. Our Clients • Older individuals and couples that want a high quality service • Average age 82 – although serve those in their 50/60’s • Specialist care needs: • 75% with dementia • 5% with Parkinson’s • 20% mobility/frailty/falls • 25% are couples • 80% self funders/ 20% PCT funded • Client groups: • Client receiving care • Daughters – arranging care • Sons – financial/legal aspects
    5. 5. Our Services • Live In Care • High quality, 24 hour care at home • Flexible from 4-7 days per week • England and Scotland • £850-£1,250 per week – subject to assessment, rota, number of days • Day Care • London only • Minimum 7 hours a day, 3 days a week • £15-£20 per day, subject to assessment • Respite • Give family carers a much-needed break – build on-going relationship • Sample our quality service • Not a one off service - access our expertise and support between bookings • £1,200 per week – initial 2 weeks as a minimum, thereafter 3 days • Discounted weekly fee for repeat bookings after total of 4 weeks • England and Scotland
    6. 6. What is Live In Care – how does it work? • Provision of a professional trained carer who lives in your home • Directly employed or fully managed service provider vs. introduction agency • Carefully matched carer with client involvement in choice • Consistent team of two carers • Rota to suit the clients needs/requirements • Client provides – full board/room • 2 hour daily breaks required - ensure carers have sufficient rest time
    7. 7. Benefits of Live In Care • Live life the way you choose with independence • One-to-one, dedicated care – not achieved in a care home • Consistency and familiarity – critical for those living with dementia • Maintain lifestyle and interests • Couples can stay together as loving partners • Cost comparable solution to residential care • Maintain assets/capital appreciation
    8. 8. Our Difference – Supporting Families & Carers • Support family with decisions – including financing and funding • Comprehensive matching service – introductions ahead of service • Fully managed service from Regional Care Manager – small client portfolio • 24/7 helpline for carers providing out of hours support • Supporting, coaching and mentoring in placement to ensure service excellence • Access to internal condition based experts • Family education forums and webinar events
    9. 9. Our Difference – The Best Carers • Carers are employed – not an introduction agency • Market leading employment packages – attract talent and longevity of relationship with carer • Shares in our business • Flexible working and rota patterns – ensure carer rest time • Industry leading training • Professional development – treated as professionals • Support in placement and 24/7 helpline • Committed to communication and engagement • Ambition to be the employer of choice in UK
    10. 10. Our Difference – Training and Development • Carers trained to exceptionally high standard • Pioneering induction programme – 11 modules • 12 weeks e-learning in client placement • Specialist modules for conditions – dementia/Parkinson’s • Lifestyle training – communication, cookery, depression, nutrition • Professional Apprenticeship in Health & Social Care • Advanced training as part of development plan • Career development opportunities • Pay scales that reward performance
    11. 11. Our Difference – Reputation and Expertise • Shaping government policy on quality, accessibility and choice in social and dementia care • Independent Advisory Board – experts from charity, medical and social care • Work closely with leading doctors, PCTs, local authorities and other professional partners • External expertise into training programme • Recognised as industry leaders in dementia home care • Award winners – health and social care • Top 45 UK healthcare companies in industry poll • Collaborate with leading dementia and Parkinson’s charities
    12. 12. Challenges for in home care with people living with dementia • Carer understanding of dementia from the client’s perspective • Risk management outside of a formal care setting A solution is required – a sustainable economic and easily transferrable model
    13. 13. Collaborative Working • The Contented Dementia Trust, which incorporates the SPECAL® method, is a charitable organisation with the aim of promoting sustainable well-being for people with dementia • The SPECAL® method is underpinned by a particular explanation of memory, ageing and dementia, known as the SPECAL® Photograph Album
    14. 14. © CONTENTED DEMENTIA TRUST The SPECAL® Photograph Album – a metaphor
    15. 15. © CONTENTED DEMENTIA TRUST
    16. 16. feelings facts Normal photograph: facts-plus-feelings © CONTENTED DEMENTIA TRUST
    17. 17. Normal photograph: facts-plus-feelings Dementia photograph: a fact-free, feelings only ‘blank’ feelings feelings facts © CONTENTED DEMENTIA TRUST
    18. 18. Normal memory pages Dementia pages stage 1 (pre-diagnostic) © CONTENTED DEMENTIA TRUST
    19. 19. Normal memory pages Dementia pages stage 2 © CONTENTED DEMENTIA TRUST
    20. 20. Normal memory pages Dementia pages stage 3 © CONTENTED DEMENTIA TRUST
    21. 21. The person with dementia has not lost their reason, only their recent facts. They will, very reasonably, turn back to much older pages in their album, before dementia, to provide a context to what is currently happening in their life today. We need to listen and learn from them. © CONTENTED DEMENTIA TRUST
    22. 22. SPECAL’s three Golden Rules • Don’t ask direct questions • Listen to the expert – the person with dementia - the questions they ask us are highly significant • Don’t contradict © CONTENTED DEMENTIA TRUST
    23. 23. Collaborative Case Study • Mike was 88 and living with Alzheimer’s disease when his wife Angie approached TGCG • Would not leave wife for even a few seconds • Paranoia, delusions – accusations of abuse • Aggression and fearfulness • Refusal to accept help or medication
    24. 24. Personalised application of SPECAL’s three Golden Rules • Using old ‘photographs’ to provide factual information missing on today’s ‘page’ – bridging the gap between present and past • Rugby as a theme for promoting well-being • Finding acceptable explanations and answers to Mike’s questions
    25. 25. Our Results • Mike held in a contented state using continuously recycled acceptable experiences • Wife able to leave house for hours or days at a time – improvement in her quality of life • Carer able to give Mike medication and support him as required • Elimination of antipsychotic medication
    26. 26. Questions? • Zoe.Elkins@thegoodcaregroup.com • www.thegoodcaregroup.com More information on the SPECAL approach? • www.contenteddementiatrust.org • ‘Contented Dementia’ by Oliver James

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