By Louise Morris, Head of Care Quality
Having worked alongside dementia care services for several years, I understand the importance of supporting people living with dementia and their families, as well as how a provider should evidence outstanding outcomes regarding the CQC.
Dementia is not a single disease, but a collective term used to describe a decline in memory or brain function that impacts on the person’s daily life.
A person living with dementia may need specialist care, especially as their condition progresses. In many cases, the person might need to move into a care home where their needs will be met more efficiently. When choosing a care home, the latest CQC report is often referred to as an indicator of how well the home is performing and any other areas of concern, therefore it is critical for Care Home providers to showcase their work at inspection.
I started as a Care Assistant in a Residential Care Home when I was a student nurse from 1999-2002. Some of the clients I cared for were living with dementia and I started to learn how to provide outstanding care. Early in my career, it became clear to me how care home providers can influence the experience of living with dementia and how this in turn can affect outcomes and CQC ratings.
From 2015-2020, I supported specialised Dementia Care Homes with quality, compliance and training. This was a particularly important period of my career as I used my working knowledge to coach providers to showcase outstanding outcomes and care in relation to people living with dementia.
Personally, I find working with clients who are living with dementia to be both challenging and very rewarding, but it is not for everyone. Care Homes that use values-based recruitment processes and can evidence resident participation in the selection processes are more likely to achieve good or outstanding ratings.
Help with Daily Activities
Thankfully, gone are the days where care homes used to have a “bath book” and each resident was allotted a specific day for bathing. However, as a care home manager, the subject of assisting with personal hygiene for people living with dementia can be complex. How do you make sure you are meeting everyone’s needs while still offering choice and evidencing the support that you are providing?
A lot of the time, there is no one-size-fits-all response when it comes to care, however each person’s care plan should be reflective of how they are assessed, what support (if any) is needed, how this will be recorded and how often the care plan needs evaluating. Assisting with personal hygiene is a very private activity, so Care Assistants must be sensitive and respectful when carrying out any level of support, including just prompting. Some people living with dementia may choose not to carry out personal hygiene activities and that decision needs to be considered in line with their capacity. Any best interest decisions should be clearly documented, following the providers Consent policy.
Some people living with dementia will also require assistance at mealtimes, since they may not realise that they are thirsty or hungry on their own. Some may respond better to finger food or snacks than sitting down for a meal. Meal and snack choices should be evidenced in care documentation where there are issues with malnutrition, but every person within a care home does not require food monitoring charts.
If a change to the environment is made, people should be monitored carefully for any distress reactions, such as restlessness, agitation and/or irritability. Monitoring frequency and potential triggers is expected, and outcomes should be recorded in care plans.
In my time supporting in dementia care homes, I have witnessed outstanding activities such as miniature horses visiting the residents, cheese and wine tasting and some amazing talent competitions.
Creating opportunities for social engagements for people to enjoy is one of the most important things a care home can do. Activities such as outings, games or a special dining experience can help reduce loneliness and improve self-esteem.
Activities don’t always have to be in groups, however meaningful activities should always be based on the person’s preference. Some individual activities can include:
- Doll therapy
- Reminiscence work
- Pet therapy
Homes that achieve good or outstanding tend to have full activities calendars that evidence what is planned across the month. Any activities offered and engagement levels evidenced in each individuals’ care documentation is very good practice.
For more advice about achieving outstanding outcomes for your care home provider, contact us today.