Living well with dementia, EachStep of the way
23 August 2016
In this post, our Associate Gill Bailey talks about her hopes for EachStep Blackburn, a cutting-edge residential care home for people living with dementia. We have been working with EachStep since before they opened in May 2016, and continue to work with them to embed person-centred practices.
EachStep was planned in partnership with Community Integrated Care and Blackburn with Darwen Council. The EachStep approach aims to support people throughout their journey with dementia, providing support that adapts with changing needs each step of the way.
It provides personalised care and support to 64 people living with dementia, and it is their home. People live in small households and we are supporting an ordinary way of living life which includes pleasure and purpose, however that looks for each person, because we will get to know people. Beautiful new buildings only become home when we work at making them feel like home.
As Sarah Rochira, the Older Peoples Commissioner for Wales says “The word ‘home’ should mean something special, a place that we hope will be filled with friendship, love and laughter.”
She goes on to say that,
“Within the current social care system, there is no formal way to recognise or reinforce crucial values such as compassion, friendship and kindness, self-determination, choice and control. Yet these values are key to quality of life and must now be placed at the heart of the residential and nursing care sector.”
This is what we are seeking to place at the heart of EachStep Blackburn and ‘Progress for Providers’. The ‘EachStep Way’ is our operating system that we will measure our success against.
Our mantra is we cannot deliver personalised support unless we know what matters to people and how best to support them from their perspective – where people don’t use words to speak or communicate typically we will listen differently to what people are telling us in ways other than words – the quality of our listening is so important, and of course working proactively with family members to ensure we capture the rich contribution they have to make too.
What we have been doing - the highlights
As our partnership with Community Integrated Care got underway we wanted to build on the EachStep principles to fully embed not only person-centred practices with people who live there, but include person-centred teamwork and Community Circles, also going beyond excellent care and support to focus on choice and control through using the principles of Individual Service Funds.
Together we imagined what the most personalised process would look like for people and their families from moving into the home, living life and eventually through to end of life, what was the very best we could imagine, mapping it out and thinking about what would it take for us to implement this.
You can have a look at this film where Helen talks through the most personalised approach we could possibly imagine and how we are going to implement and embed it at EachStep Blackburn.
The process below explains what we have developed for the people that live there and their families.
I will share how the process works through the stories of people who live at EachStep, their families and colleagues who work there over the coming months.
Early May: colleagues were appointed
We met some of the new team members at EachStep Blackburn as they began their induction period with Community Integrated Care, Cath Barton (Community Connector) and I had opportunity to work with Julie York who is employed with the charity and was delivering some of the induction training and Phil Benson the home manager.
Of course if person-centred practice requires a different way of listening to people we support, then creating a person-centred culture means extending this to colleagues as well.
Together we introduced the new team to the concept of one page profiles. We shared our one page profiles and they began to develop their own one page profile for work, because personalisation starts with a one page profile. It has three sections – an appreciation section about your qualities, what’s important to you and what good support looks like to you.
The three questions, described, which form the one page profile look deceptively simple, but experience tells us that asking these questions directly rarely works.
Seeing a one-page profile as a new form to fill out and just asking people or their relatives ‘What is important to you?’ and ‘How do you want to be supported?’ is unlikely to lead to the rich information that we need.
This information has too be drawn out through conversation, learning about people in different ways, and a one-page profile is simply a way to structure how we record this information – so we emphasised that it’s the record of a conversation which will grow and evolve with the person not another service form to fill in – the new team members embraced this new way of working, many had come from traditional services, they were a joy to work with and expressed that this felt like the soul of their work and there was a feel of real congruence as we had a solid shared values base. Everybody who lives and works at EachStep Blackburn will develop a one page profile because personalisation is about a shift in power and that requires a shift in relationships, the quality of the relationship between people we support and the team member providing that support is the most important issue in quality of life and we can’t simply leave that to chance. So one-page profiles are used for matching people supported and direct support staff too.
Footnote: how did our partnership come about?
Last November Helen and I were driving together to Telford, where we were both speaking at Dementia Congress. We talked about Atul Gawande’s incredible book called ‘Being Mortal’ which had touched us both so deeply and our dream of having our own care home to demonstrate what could be possible. As we could never really afford our own care home we wondered who could help and Helen thought about Community Integrated Care, one of our customers, there and then in the car she emailed Neil Matthewman, the chief Executive, we were both so impressed with the solid values base of the leadership team and the organisation – it felt like a real possibility and of course the rest is history as we move into the most exciting part of this innovative work and welcome people as they move into their new home, encourage family members to see this as their relatives home where they visit as they always would and continue to be central in their loved ones life, we aspire to a true family feel in the home and a culture which welcomes all. I look forward to sharing the stories, the detours and the learning with you all.
Gill Bailey, May 18th 2016
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