Latest Blog posts from AveryHealthcare.co.uk

Reminiscence, a Touchstone with the Past

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Avery Healtthcare is proud to welcome The Daily Sparkle into its portfolio of homes. The Daily Sparkle is a reminiscence newspaper resource for elderly residents and is proving to be a great hit within our homes. Avery acknowledges the potency of historical stimuli to some of our residents who live with dementia.

The Daily Sparkle is a resource for people in residential care, or using day care facilities, including those with early signs of dementia. It's a daily 'newspaper' containing short articles that prompt reminiscence and discussion, and stimulate conversation between residents and visitors.

The format of The Daily Sparkle is large clear print, and short varied articles that can be enjoyed by people who have in the past enjoyed reading as a hobby, but who can no longer sustain the concentration to read books and newspapers. It can be read by individuals as well as used as the basis for group discussion. Each Daily Sparkle is accompanied by Carers' Notes, to help Activities Co-ordinators or Care Assistants (and whose culture and first language may not be from the UK), to be well-informed about the background to the articles. Carers' Notes also include suggested questions to prompt free-flowing discussion.

The articles and the way they are written stimulate reminiscence and conversation based on all five senses, plus movement. For example, an article about food rationing or war-time recipes would include reference to the taste, texture and smell of the food; items about 1950s fashion would include questions about what the fabrics felt like to touch or to wear.

The Daily Sparkle was the concept of a Psychotherapist with extensive experience designing and delivering activities for older people in residential care. Articles are written to ensure that although the majority of residents in care homes are women, the content is not too 'cosy and domestic' for male residents .

Palliative Care at The Cedars Care Home, Bourne in Lincolnshire

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The Cedars Nursing Home in Bourne has become a leader in Palliative, end of life care and is recognised nationally for its excellence in this area. Helen Brewster, the homes manager has been integral to this and has worked tirelessly across the community in helping to improve understanding in this critical area of care provision. Helen picks up the story.

In 2004, whilst conducting an audit of care practices within The Cedars Care Home, it became apparent that residents being admitted were frailer and life expectancy reduced. We were providing a good standard of care in many areas however, there were noticeable shortfalls in the service being afforded to those residents facing the end stages of their lives. We found:

Care was reactive
Multidisciplinary team care was uncoordinated
Symptom control was inadequate, causing high anxiety for residents, relatives and staff
Residents were being admitted to hospital to die, even though they expressed a wish to stay in the Home surrounded by people who knew them
Bereavement care for relatives was patchy, with no documented information to act as guidance

And so the search began to find initiatives that could help improve our performance in this area.

The Home worked closely with the Community Specialist Palliative Care Team and this is where we commenced our crusade, using their expertise, knowledge and guidance. The Liverpool Care Pathway and Gold Standards Framework for Care Homes were brought to my attention. Following a lot of research into both initiatives, ensuring their introduction was achievable and would benefit the residents and team, Deputy Matron and I presented their concepts to everyone involved with the Home. The general consensus was to go ahead with their implementation and so the Home was formally signed up for both in early 2005.

The Gold Standards Framework (GSF) is an enabling, flexible model that allows individual modification to meet the specific needs of residents. This is not a short term fix. It is an initiative that Care Home Teams need to take ownership of and embed into their everyday working ethos.

The aims we set ourselves were:

To improve the quality of care for residents nearing the end of their lives and ensure they and their significant others had more say in how this was to be achieved.
To improve collaboration between GP’s, hospitals, primary care teams and specialist care teams
To reduce the number of unnecessary admissions to hospital in the last stages of life enabling residents to die in their ‘home’

Introducing GSF, which incorporates Liverpool Care Pathway, into the Home brought about a number of changes. Some positive outcomes were achieved, all of which we have maintained over the years. The benefits for our residents and relatives have been significant in a number of areas:

Better coordinated care
Better symptom control with anticipatory prescribing
Fewer crises and unnecessary hospital admissions
A more dignified, individualised death, respecting the residents wishes and choices
Proactive care with advanced care planning
Greater family support
Better person centred care – physical, psychological, social and spiritual

There have been noticeable benefits for the team too:

Greater job satisfaction
Empowered to make improvements in care
Improved communication and working relationships with the multidisciplinary team and other professionals
Less stress
Improved skills, knowledge and awareness of residents needs.

When introducing change into any care environment it is inevitable that challenges will present themselves. For change to be effective you have to change people’s way of working and thinking – not an easy task!

Our first challenge was getting the GP’s on board. Without their leadership and input many aspects of GSF would not be achievable. Getting them to address key issues like anticipatory prescribing was essential. Building stronger relationships with all colleagues was important to ensure understanding of the aims we had set ourselves. Anticipating family needs and finding ways of addressing them. Implementing Advanced Care Planning in a sensitive but effective way and embedding GSF into the overall working culture of the Home. ‘Time’ is perhaps the biggest challenge of all. It is wonderful to want to implement something that you know will make a positive improvement to your residents’ lives but finding the time is sometimes hard. It truly takes team effort and commitment.

We only get one chance to get end of life care right for each resident and their loved ones. At such a highly emotional time people will remember every word, or lack of them, every expression or gesture. Good communication is essential between all parties for an open, trusting relationship to be achieved. Getting it wrong may leave a legacy of grief to a loving family and cause distress to staff. Getting it right makes us really proud to see the positive effect our care has on our residents and their families at such a difficult time

Avery Healthcare is committed to promoting quality in all aspects of our resident’s lives no matter what stage of life they are at or the level of care required. As a team we were proud to achieve a GSF Quality Hallmark, Beacon Status, in recognition of our hard work and commitment to our residents.

Helen Brewster is manager at The Cedars Care Home in Bourne, Lincolnshire and can be contacted on 01778 42155. She is more than happy to advise people on end of life issues .

Crabwall Hall Care Home Digs Deep

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Crabwall Hall residential care home near Chester celebrated Children in Need in fine fashion by dressing all our staff up in pyjamas for the day raising £249 in the process. Residents judged the staffs efforts and had much fun throughout the day.

Managers kept a vow of silence for an hour with staff and residents happily paying for the pleasure, while other activties included naming the bear, a raffle and treasure hunt!

Much fun was had by all and everyone was really pleased that they were able to raise such a large amount of money.

Crabwall Hall is a residential care home situated in Mollington near Chester and delivers residential care to 43 elderly residents. The home has been awarded 3-stars by the industry regulator for the quality of care provision.