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13 th & 14 th September 2006 EXTRA CARE HOUSING AND DEMENTIA COMMISSIONING FOR QUALITY

13 th & 14 th September 2006 EXTRA CARE HOUSING AND DEMENTIA COMMISSIONING FOR QUALITY. AN OVERVIEW OF THE ISSUES Sue Garwood. Why this Conference ? . Simplistic messages Salmon sheet – applies to all Extra Care Green sheet – dementia specific – no claim to comprehensiveness

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13 th & 14 th September 2006 EXTRA CARE HOUSING AND DEMENTIA COMMISSIONING FOR QUALITY

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  1. 13th & 14th September 2006EXTRA CARE HOUSING AND DEMENTIACOMMISSIONING FOR QUALITY AN OVERVIEW OF THE ISSUES Sue Garwood

  2. Why this Conference ? • Simplistic messages • Salmon sheet – applies to all Extra Care • Green sheet – dementia specific – no claim to comprehensiveness • Other presentations • Workshops to explore issues in greater depth

  3. Partnerships and Finance • Identifying additional stakeholders – OPMHTs and local Alzheimer’s Society, potential users • Capital – Any specialist sources? • Revenue – Attitude of your local Supporting People Administering Authority

  4. Range of Provision? • Range of provision – housing only or residential and other services • For each additional provision: • Source of capital • Source of revenue • Who will manage service? • Registration implications • Conformity to other regulations e.g HC

  5. Provisions Shaping Design • Facilities for staff • Facilities for other staff and organisations? • Amount of parking • Number and type of communal areas • Progressive privacy

  6. Target Groups Shaping Design • Scale of scheme • Number, size and specification of individual units • Lighting, field of vision, aiding orientation, homely feel etc • Security features and walkways • If separate dementia wing, design to minimise risk of ostracism Jon and Sylvia to cover

  7. Assistive Technology and Telecare • Infrastructure – future proofing • What will be applied universally? e.g. pendant and alarm • Which applications individually decided? e.g. flat or building exit detector; falls or gas detector • Developing guidelines and protocolsSee“Telecare and Ethics” Factsheet: http://www.cat.csip.org.uk/_library/Telecare/Factsheet-Telecare-Ethics19July2005.doc

  8. Tenure • For rent • For sale • Shared ownership • Mixed tenure Jane’s examples span a range

  9. Legal Aspects • Issues include: • Capacity in relation to signing tenancies • Capacity in relation to complying with agreement or refusing care • Validity of tenancies and security of tenure • Registration issues Belinda to cover

  10. Which Model? • Dementia specialist or dedicated? • Dementia friendly? If so, integrated or separate dementia “wing”? If a wing: • For all who have dementia or only some? • If all, will you move those in main scheme when they develop dementia? If so at what point? • If only some, eligibility criteria for wing? • Will wing differ in terms of design, AT and staffing – if so how? • Can it be seen as equivalent to an 80s EMI unit in terms of target group?

  11. Some Pros and Cons In favour of separation – • Can concentrate staffing resources in wing • Can tailor design and assistive technology • Other residents may be more tolerant Against separation – • Risk of ghetto • Where integration more mutual assistance • Criteria for entry and issue of blurring over time • If targeted at higher needs, risk of resemblance to residential care – does this matter? Does it still offer something better? Desperate need for research into costs and benefits of different models

  12. Point of Entry and Eligibility Criteria • Should Extra Care completely replace residential care? • Is there a point beyond which Extra Care is no longer suitable for someone with dementia to move to? • Have you developed jointly agreed eligibility criteria which suit the built environment and level of services likely to be available?

  13. Assessments and individual preparation • Who? Assessor(s) needs to understand dementia, eligibility criteria and the scheme’s services and limitations • Needs and risk assessment. Diagnosis? • Focus on personal history • Importance of individual engagement and preparation • Enduring/Lasting Power of Attorney

  14. On site service design • What management structure – integrated housing and care management or separate? • Who provides care? Supporting People services? Relationship between them. • Staffing levels • Person centred provision • Group work

  15. Staff training • Understanding dementia very important • Joint training if separate housing and care staff Beth to cover

  16. Home for life – guarantee or aspiration? • Reality for many, not for all • Dependent on many factors • Risk to individual and others • Staffing levels, flexibility and experience • Availability of peripatetic specialist services • Get ownership and support from specialist services during scheme development • Think in advance about moving-on criteria and processes

  17. Final Thoughts • Proper preparation and partnership working fundamental • Make sure that the following are properly aligned and compatible: • Scheme features - the physical environment, service specification and policies • Scheme eligibility criteria/target groups • Individual assessment and allocation of units

  18. Contact Details Sue Garwood– Extra Care Specialist Phone: 01763 838 179 Mobile: 07962 186 308 E-mail: Sue@suegarwood.co.uk Web: http://www.suegarwood.co.uk

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