In last year’s development plan, we set the following overall aim:

 

Our aim, by the end of 2010, is to be a ‘first choice’ care home with a reputation for expert dementia care, offering a physical and social environment that is far superior to what can be achieved at home. So placements become a positive and early choice.

 

To achieve this, we will provide substantially more person centred care, provide a more therapeutic environment for the residents of Rose Lodge, and communicate more effectively with existing and potential residents and their families. Through these initiatives, our reputation will extend beyond Exmouth to the wider Devon market.

 

We have achieved this aim, as evidenced by the following facts:

 

• In May 2010 we achieved a CQC ‘2-star’ award, recognising the progress we have made towards a person-centred dementia care model. In fact the inspector told us that we were in fact operating at a ‘3-star’ level but that award is only given after operating at that level for a number of years. CQC ratings are current effectively frozen as CQC have stopped their current rating scheme and have not yet announced a replacement (if any).
• Over the year, the demographic of our residents has been changing substantially. We are now admitting many more residents with surviving spouses, indicating they have made a positive choice to join Rose Lodge, rather than placements being made as a ‘last resort’. The presence of visiting spouses has, we believe, a beneficial impact on the well-being of those residents.
• Our home has been full since July 2010 and we have a healthy waiting list of people who have made an early and positive choice to join Rose Lodge and are prepared to wait so that they can join the home of their choice.
• We have attracted residents from areas such as Sidmouth, Ottery St Mary, and Exeter, where people have decided they prefer our home to homes that are more local to them.
• Our day care service has taken off, indicating Rose Lodge is an attractive home to spend a day at.
• We have become an active and social home with a relaxing atmosphere where residents have a great deal of freedom to go about their lives as they please. When asked where they are, many of our residents will describe something akin to ‘ a nice social club where you can stay the night’
• Accidents and falls have reduced dramatically, and levels of verbal and physical aggression are very low, indicating a high level of resident well-being through good person-centred care within a supportive physical environment.
• Our ‘Dementia Care Devon’ web-site is becoming a well-established resource for general information about dementia and dementia care in Devon, and this has resulted in people knowing about Rose Lodge well before they require residential dementia care.
• We are reported on regularly and favourably within the local press resulting in a much improved awareness of Rose Lodge within Exmouth and the surrounding areas.
• Visitors and professionals often comment on the high level of well-being of residents and the high quality of care that is observed.

 

In summary, we are now indeed a ‘first choice’ home for people living with dementia for the East Devon area, and we have gained recognition in the local press for our achievements. There is now a clear understanding of how Rose Lodge is different from other homes in the area:

 

• We provide a high quality specialist dementia care, treating residents as individuals and seeing the person before we see the dementia.
• We are an active and social home with an extensive activities programme. Many residents see us as a great social club where you can stay the night.
• We have extensive gardens, and residents use them for relaxing and purposeful activities
• We recruit staff from the local market. While more expensive we believe that this brings significant advantages to our resident in areas of communications and cultural understanding.
• We are actively engaged with the wider community.

 

We have achieved this by executing successfully on our 2010 development plan.

 

We have developed our care team and provided extensive training and ongoing development in person-centred dementia care:

 

• Our Manager Karen Bousher has extensive experience of dementia care, gained at local dementia homes.
• We have two Heads of Care with primary responsibility for medication and liaising with GPs and District Nurses, providing HoC cover 12 hours each day, seven days a week.
• We have two Senior Carers with primary responsibility for personal care, providing Senior Care cover 12 hours each day, seven days a week.
• We have two Senior Night carers, providing Senior Night care 12 hours each night, seven days a week.
• We employ a full complement of carers which means we do not require agency staff, except in exceptional circumstances. (in the period November 2010 to January 2011 we required an agency carer only once).
• We employ a dedicated activities coordinator who arranges a rich programme of occupational and relaxing activities.
• In the spring of 2011, our care team attended a four-day training course in person-centred dementia care, and we have incorporated key aspects of this training in our care planning and practices.

 

We have greatly enhanced the physical environment of Rose Lodge in a number of ways. The saying ‘we create our environment, and our environment creates us’ has particular meaning in  dementia care, where a therapeutic environment can help residents to achieve much higher levels of well-being.

• A new care office for the manager and care team, so that we can ‘keep the work out of the lounge’ recognising that our lounge is, first and foremost, for the benefit and use of our residents. Keeping the work out of the lounge makes the lounge much more homely for our residents. At the same time the care office looks out onto the lounge, enabling the manager to observe the lounge unobtrusively.
• A new book-case which is readily accessible by residents and care staff, and we have refreshed the contents of our book case so that resources are useful and enjoyable for our residents.
• A new quiet lounge, providing an opportunity for residents to enjoy some quiet time, and we have also used this as a space for our portrait and photo exhibitions to which we invite the Exmouth community.
• New specialist dementia carpets in the lounge, dining room, some of the halls, and a couple of our bedrooms. These carpets have been designed specifically to help orientation and navigation by people living with dementia.
• Improved signage (yellow on black) which aids resident’s navigation around the home.
• Raised beds outside the lounge, helping to provide interest for residents in the lounge, and drawing them into the garden.
• A vegetable garden, providing occupational activities and seasonal topics of conversation for residents.
• We converted our office into an additional bedroom, allowing one of our existing double rooms to be converted into an en-suite single room (planned for 2011/12).
• We optimised space for the staff team, with a new store room, medication room, and admin office.
• We redecorated and re-carpeted a number of bedrooms when they became available.
• We are re-redecorating our toilets and bathrooms to make them more domestic. Not only does this make them more enjoyable to use, it will also help some of our residents recognise the purpose of these rooms, and so encourage the residents to use them more independently. We expect most of this work to be completed by April 2011.
• We have decorated our quiet room and hall with pictures that are directly relevant to our residents, i.e portraits of some of our residents, and photo montages of life at Rose Lodge.

 

 

We have greatly enhanced our social environment at Rose Lodge:

 

• We recognise that boredom is one of the greatest risks for people with dementia and so we have an activity programme covering both occupational and relaxing activities, and which provide an opportunity for residents to socialise..
• We tend to focus the morning on occupational activities such as cooking, cleaning, folding laundry, setting the table, polishing shoes etc. These kinds of activities can give a great deal of meaning to people who may have forgotten that they have retired and so look for ways to be useful, and this can help them to be less frustrated and achieve a higher level of wellbeing.
• We tend to focus the afternoon on relaxing activities where residents can participate if they wish, including music, massage and manicures, a pub quiz, and drama.
• Activities follow a broad weekly pattern, so helping some of our residents to orient themselves around the week, and our activities schedule is displayed prominently together with a calendar clock to help residents work out when certain activities take place.

• We celebrate resident’s birthdays as well as national days such as VE day, fireworks night, remembrance day, and major holidays days such as Christmas and Easter.
• We encourage relatives to visit as often as they like and our activities programme acts as a focal point for many relatives to visit and participate.
• We provide a daily local and national paper as well as the weekly Exmouth Journal.
• We have organised a number of events to draw the wider community into Rose Lodge and to break down some of the stigma associated with dementia. In 2010 we organised a garden party, a portrait exhibition, and a photo exhibition of ‘a year at Rose Lodge’ and invited the Exmouth community to these events.
• We have organised a number of outings including two theatre trips, a trip to World of Country life, and an outing to see the Christmas lights.
• We have engaged the services of a local drama therapist who joins us twice a week, once for a drama club, and once for a pub quiz.
• We have retained the services of three entertainers, a pianist, a guitarist, and a couple of singers for ‘singalongs’
• We organised a Christmas show performed by residents, relatives and staff.
• We have invested in a wheelchair-adapted minibus which has enabled us to be more flexible in meeting resident’s transport needs and has helped to support day care customers.
• In 2010 we started to keep three chickens that provide a great deal of entertainment and are a regular topic of conversation, and encourage some grand-children to visit.