Importance of location when placing someone in residential care

The front of 2 Kingsthorpe Grove

Location is often one of the first considerations when placing someone in residential care – so that they can be close to friends and family – but it’s not necessarily the most important. It’s usually a combination of factors that contribute to the quality of the care provided that takes precedent over the location. This is especially true of specialist residential care and rehabilitation for adults with acquired brain injuries, learning disabilities, complex needs and behaviour that challenges – there simply aren’t the facilities available across the country to meet local needs.

The Richardson Partnership for Care is located in Northampton – we’re in the centre of the country and have good road and rail links, so easily accessible for families to visit. We welcome visits to our care homes but these are not always practical, especially if family members work full-time, have children to look after or are elderly. Or they may have a long way to travel – our service users come from all over the UK as well Ireland and Eastern Europe.

Supported home visits
We believe that family contact is very important for our service users’ well-being so we include regular supported home visits when devising each individual’s care plan. Our care support staff arrange their transport and accompany them on their journey (overseas if necessary) and often continue to support them in their family home during their stay. If it’s not practical for individuals to stay with their relatives, then we arrange accommodation for them. This provides valuable assistance to the families too, helping them to enjoy the time spent with their loved one.

Video calls
As well as phone calls, we also use online applications and video calls to help service users and their families keep in touch – this can enhance communication for people with speech and language difficulties, making them easier to understand. It also means that their families get to see them and become more involved and reassured about their care.

We also use video calls to enable family members to participate in the review process. Our service users have an external review every 12 months where their care team and case workers review their care plan and discuss their progress. The service user can choose whether or not they take part in the review, but under The Care Act 2014, reviews must be attended by a family member or advocate.

A video call enables family members to take part in a review when they may have otherwise been unable to perhaps due to other family or work commitments. They can contribute fully to all areas discussed, see and hear the review team and ask questions as well as providing their thoughts and feelings on the care package.

If the service user declines to take part in the review, they can still have a video call with their family afterwards and speak with their care manager and review coordinator about what happened in the review.

Local environment
The immediate local environment can have a greater impact on someone’s day to day wellbeing than where they are located in the country. For example, all of our homes are situated in areas within easy reach of the town centre, but with their own communities. This means that we can visit local shops, pubs, cafes and leisure facilities and benefit from the friendly and personal service that they provide. We have found that some service users with acquired brain injuries and/or complex needs, on arrival at The Richardson Partnership for Care, have not accessed local communities for years. We facilitate and actively encourage service users to access local facilities as it is an important part of their well-being, rehabilitation and progress towards independence.

Centre of excellence
Due to historical factors, Northampton has evolved to become a centre of excellence in brain injury rehabilitation. This draws neurological experts to Northampton, which means that we have a larger pool of talented and experienced professionals in the area enabling us to deliver high quality rehabilitation care and support. We work in partnership with other support services if crisis care is required, providing continuity and orientation for service users and improving outcomes.

So, although location may be a starting point when placing someone in residential care or for residential rehabilitation, geographical distances can be overcome. It’s the quality of care, well-being and outcomes for service users that should take priority. We also find that in some cases, after a period of specialist rehabilitation, service users require less intensive support and are therefore able to go and live closer to their families.

Bowls sessions provide a range of benefits

One of the most popular activities that we arrange in-house for our service users is the weekly bowling sessions that we hold in the main hall at The Mews each Monday.

We are fortunate to have Duggie Mitchell on our team, who is an experienced bowling instructor and has played competitive bowls for 35 years with success at Club, County and National levels. Duggie joined the board of Disability Bowls England in 2016 and continues to be inspired by the achievements of people with disabilities. His experience, skill and enthusiasm for the game as well as his empathy with the service users have contributed to the success of the sessions. Duggie is assisted by Lisa Hutchins, the Administrator at 144 Boughton Green Road, who helps with the organisation and keeps the score.

Bowling adapted to suit the players
The format of the game is Short Mat Bowling, which is very similar to Carpet Bowling. A mat 45 feet long and 6 feet wide is laid out in the main hall with guards at either end to stop the bowls running too far. A jack is placed at one end of the mat and each player uses weighted bowls to try and hit the jack. We have adapted the rules to meet the cognition needs and suit the various abilities of the players. They bowl eight balls each and Lisa records the number of ‘strikes’. People from all of our homes join in and we have a league in which around 20 players take part. One of our service users who is blind has mastered bowling very successfully. Other service users come along to watch and support, and it’s a lively, social occasion with lots of cheering.

Key benefits to individuals
What may just look like a leisure activity is actually an important element of our service users’ care. As well as being very enjoyable, the bowling sessions also help to improve:

Physical strength and dexterity
Co-ordination
Cognition and communication
Motivation and self-esteem
Social Skills

Duggie has been running the sessions for around two years and new players can join in at any time. He has noticed significant improvements in some of the participants and says: “I have seen so much change in many of the group since we started: going from little or no eye contact or verbal communication in the early days to total interaction and response. My partner and I went along to the Christmas party recently and it was lovely to have them recognise us and want us to join them dancing.”

Thank you to Duggie and Lisa for their help and commitment to these sessions. They have contributed to some significant improvement and much enjoyment for our service users.

Duggie Mitchell demonstrating short mat bowls

Duggie Mitchell demonstrating short mat bowls

Satisfaction survey: our care home residents

Adults with acquired brain injuries, learning disabilities and complex needs

In addition to surveying the families of service users in our care on an annual basis, we also complete a questionnaire with the individuals themselves, which asks specific questions about different aspects of their lives within the care home. They are asked to respond using a satisfaction rating of 0 – 4 where 4 is the most satisfied. All of our service users have complex needs and some are unable to answer the questions, so staff either help them to answer the questions or observe their behaviours to ascertain their needs.

The results from each individual are combined to give average scores, which are shown below. There are up to five questions in each section, so the totals show an indication of satisfaction in each area.

However, as every person is different, and has different needs, our approach is always individualised, person-centred care.

bar chart showing satisfaction survey results

Service user satisfaction survey results 2017

The following gives you more information about the specific areas covered in the satisfaction survey.

Know how to complain
This question assesses how well the individual knows what to do if they have a complaint. The average overall score across the homes was 3.63 out of 4. It excludes the individuals who were unable to understand the question.

People you live with
This is very important to all of our service users, and satisfaction ratings can vary according to the type of care home as stable populations with long term residents tend to have a higher satisfaction rating. The Mews, which focuses on short-term intensive rehabilitation for adults with acquired brain injuries, naturally has more of a changing population. This can affect the dynamics of relationships between the residents. We work hard to ensure that any incoming service users will not upset the balance in any care home and we continually review our admissions policy to ensure that we receive sufficient information in advance of a full assessment of any potential new residents.

There is very much a family environment within our care homes, and many strong friendships develop between individuals. However, like a family, it doesn’t mean that everyone gets on well with everyone else all the time. Therefore it is important that we focus on relationships between individuals and use mediation and psychology to manage any disagreements. As a last resort, we can move individuals into another of our homes but this is rarely necessary.

Decision making
These questions covered how involved people feel in decisions relating to their care plan and risk assessments as well as making choices in their everyday lives.

Staffing
These questions ascertain how well service users know the support staff in their home and how they feel that they are treated by them: whether the staff are approachable, as well as whether they would like to be involved in the interview process. Many service users said that they would not want to be involved, which has reduced the average score.

Food and drink
As well as being asked about their choice of food and their cultural needs, individuals were also asked about how involved they wanted to be in menu planning and food preparation.

Activities
Many of these questions were qualitative: describing current activities undertaken or potential new ones, so a numerical score was not given. The activities that we provide are very much tailored to the individual and if something is requested but not achievable or affordable then we explore alternatives.

Environment
These questions simply asked how satisfied service users are with the communal areas of the home, the garden and their room.

Homes gain high scores in independent assessments

Headway Approved Providers
Two of our residential care homes for adults with acquired brain injuries – The Mews and 144 Boughton Green Road – have been recently re-assessed by Headway, the brain injury charity. The assessment process requires the home to demonstrate the provision of appropriate specialist care for people with complex, physical and/or cognitive impairment due to acquired brain injury. Headway has identified six key themes, or domains, against which it assesses the level of care provided, as well as issues such choice and dignity of service users. The domains are; Communication, Culture, Development, Governance, Quality, Environment (psychological/emotional) and Environment (physical).

We are pleased to report that both The Mews and 144 Boughton Green Road scored well in all of the domains to retain their Approved Provider Status for a further two years. This is subject to passing unannounced visits from Headway assessors during this time.

Headway Approved Provider

Quality Checkers
2&8 Kingsthorpe Grove, our homes for adults with learning disabilities, were recently assessed by Northamptonshire Quality Checkers. This is an independent assessment by an ‘expert by experience’ who meets residents in the home and performs a standardised quality check from the service users’ perspective. They are then supported by a co-ordinator to produce a report of their visit.

The Quality Checker on this occasion was Paul, who was visiting the homes for the first time. He met two service users with learning disabilities who live in the homes. One of them answered a series of questions and Paul used their answers to form the basis of his report. He gave the homes a top rating of ‘Very Good’ for all of the categories assessed, which were; home and bedroom, support staff, activities, food and drink, friends and people in the service user’s life, the service user’s health and what it’s like to live there.

Paul then asked the support staff and manager questions about procedures and safeguarding. As he was so pleased with the home, he made no recommendations for improvements to be made.

Information about other independent inspections of our care homes click here

Families’ survey results 2017

We encourage feedback from the families of the service users in our care on a regular basis, but once a year we formalise this process by sending them a short questionnaire to complete. It is sent to both the families of service users who have learning disabilities and those who have an acquired brain injury. We ask all families whether they strongly agree, agree, don’t know or disagree with the following statements:

1. I am happy with the care provided for my relative
2. The home has a warm, non-institutional feeling
3. The home provides an inclusive or family environment
4. Staff are friendly and approachable
5. I am regularly updated with information
6. I feel that my relative is treated with dignity and respect
7. I feel that their quality of life has improved since they arrived at The Richardson Partnership for Care
8. I feel that my relative takes part in meaningful and/or enjoyable activities
9. Would you recommend The Richardson Partnership for Care?

We are very pleased that:
100% of respondents strongly agreed or agreed with the statements: “I am happy with the care provided” and “The home has a warm, non-institutional feeling.”

And 100% of those who answered said that they would recommend The Richardson Partnership for Care to others.

We take note of all the feedback and we’re not complacent, making sure that we address any concerns raised. The responses to each question are show below:

graph showing 2017 survey results

2017 Survey results

We would like to thank all of the family members who took the time to complete our annual survey, and we are delighted with some of the comments that we have received. Some of them are shown below with the names removed to protect the identity of the service users.

Comments from families of service users with learning disabilities:

“He has been there over 20 years. Quality of life could not be better.”

“The home is friendly and welcoming, the other residents are pleasant and friendly… They know her so well and it is her second family, and when we visit we are welcomed… She gets help and support from all and she is treated with respect and love… I have no problem recommending your services, they are outstanding.”

“He has progressed so much this year, being able to go on holiday and attend social events… He realises he is cared for well and that he is valued within his community… He is like a new man, he was very dependent on drug therapy when he arrived at Richardson’s. Your care has enabled him to flourish and grow… the social and psychological stimulation helps him make progress. We would like to thank you for all your highly skilled and sensitive work with him.”

Comments from families of service users with acquired brain injury:

“Excellent care that has made a positive difference to my husband and his demeanour… Importantly staff display a warmth, empathy and understanding towards my husband…Thank you. Your care of my husband has made a big difference to his quality of life.”

“I have always been very happy with the care my sister has… Although she is not much of a mixer, there is a good family atmosphere… She has very challenging behaviour but I think she has the best quality of life possible… As long as she has been with the Richardson Partnership, she has only ever got the best care possible.”

 

Olivia and Jo join the psychology team

Assistant Psychologists Olivia Shepherd and Jovita Valuckaite have joined Julita Frackowska in the psychology team, which is headed up by Consultant Clinical Psychologist Dr Pedro Areias Grilo.

The Assistant Psychologists are assigned to specific service users depending on their needs and the homes in which they live. Julita supports service users in 2 & 8 Kingsthorpe Grove who have learning disabilities, autism spectrum disorders and mental health needs. Olivia works with service users at 144 Boughton Green Road and The Mews, providing psychological and practical support for people with acquired brain injuries and mental health needs, and Jo works with service users at 23 Duston Road and The Mews, supporting people with acquired brain injuries, dual diagnosis, mental health needs and behaviour that challenges.

The Assistant Psychologists perform an important role, completing psychometric assessments for service users to monitor cognition, mood, mental state and behaviour. They provide psychological reports for each individual, which include a functional analysis of their risk behaviours which is used to inform their individualised treatment plan. They also offer advice, psychological support (including cognitive behavioural therapy, cognitive stimulation therapy, substance misuse work and relaxation) as well as providing practical support such as budgeting and functional living skills.

Consultant Clinical Psychologist Dr Pedro Areias Grilo heads the psychology team. He is an inspiration to his colleagues due to his work ethic and methodical approach but most of all, he is immensely passionate about making a difference to service users. He works closely with other members of our multi-disciplinary clinical team, especially Consultant Neuropsychiatrist Dr Seth Mensah, to develop individualised treatment plans for service users. He also works directly with the service users to provide therapy, supporting them and monitoring their progress. In addition, Pedro oversees the work of the Assistant Psychologists, both supporting them in their role to deliver therapy and complete standard assessments but also challenging them academically to find better ways of working.

Olivia Shepherd and Jovita Valuckaite

From left to right: Assistant Psychologists Olivia Shepherd and Jovita Valuckaite

Dawn is finalist in Learning Disabilities Awards

Dawn BriggsWe’re delighted to report that Dawn Briggs reached the final of the National Learning Disabilities and Autism Awards 2017 in the Support Worker of the Year Award.

Dawn started work at The Richardson Partnership for Care in 1995 as an Administrator and Co-ordinator/ Activity Support Worker, soon becoming an integral part of the home, developing relationships with service users.

To care means genuine concern for others, to listen, empower, be adaptable, dedicated and have integrity. Dawn has all of these attributes, most of all she is sociable, compassionate and good natured. She is dependable and responsive to people’s needs, wants and aspirations.

An essential part of Dawn’s ethos is her interpersonal skills, enabling her to relate to service users and understand individual’s differences. On many occasions Dawn has gone the extra mile to help service users, which demonstrate her strengths as a carer.

Here is just one example of Dawn’s supportive and compassionate nature and we are very proud to have her as part of our team.

Denise’s story
In the early years, one service user in particular, named Denise, started becoming close to Dawn. In 1998, Dawn invited her into the office for coffee. When Denise showed an interest in photocopying, Dawn was patient and took time to show Denise how it worked. After a couple of months Denise felt confident to start using the photocopier.

Denise has now been working in the office with Dawn for 19 years and Dawn has become an integral part of her care. She has supported Denise with her personal care, medical appointments and shopping trips, as well as making her feel valued in her role in the office. Dawn is never phased by Denise’s, at times, ‘colourful’ behaviour, and calmly, verbally de-escalates any anxiety that Denise feels, which has enabled her to live a more fulfilling life.

Dawn is now the most significant person in Denise’s life, which can be illustrated by a situation recently when Denise became critically ill with a life threatening condition. After being admitted to the local hospital, she was transferred to an ICU ward in an induced coma, in a specialist neurological hospital in another county.

Dawn took time out of her day to travel to the unit, where she spent time talking and reassuring Denise’s family: her mother, sister and brother.

Dawn also sat with Denise, talking quietly about their 19 years. In fact, Dawn was the first person that Denise asked for when she woke from her coma, and Dawn was there.

Thank you letter
And this is the letter that Denise’s sister wrote to Jackie Mann, Registered Manager at Denise’s home:

“I wanted to drop you a line to tell you again what wonderful people you all are for looking after my beloved sister Denise, and I would like to personally thank Dawn who is like a second mum to my sister. She has given her the time and patience to learn new skills while working in the office with her and helps Denise with all her personal needs, which is a difficult task with Denise. And recently, with Denise’s stay in hospital, Dawn went above and beyond for Denise. I could see the bond they have, which was wonderful to see. The first person Denise asked for when she woke up from her coma was Dawn. Please pass on my thanks to her for caring for my sister, which she does flawlessly, and to you and all your wonderful team.”

My warmest regards,
Mrs Karen Bence

 

Celebrating The Queen’s Birthday in Style

Last month, we held a garden party at The Mews in honour of HM The Queen’s 90th Birthday. Service users from all of our homes were invited along with their families and all of our staff.

The Mayor of Northampton, Councillor Christopher Malpas, and the Mayoress were also invited. They enjoyed meeting some of our service users with learning disabilities and acquired brain injuries, learning about our services and experiencing what it’s like in our care homes.

The garden and the main hall were decorated with Union Jack bunting and balloons, as well as artworks which had been created by service users in their arts & crafts sessions in preparation for the event.  Fortunately, the weather was kind to us and everyone had a lovely day. There was a wide range of activities for everyone to enjoy including a Punch and Judy show, magician and live music from Martin the Music Man. We even had a cut-out of the Queen so you could be photographed next to her!

We also had a visit from Sarah’s Animal Adventures, where we had the opportunity to get up close and personal and learn about all sorts of amazing animals. And there was an impressive display of birds of prey. We played outdoor games and competitions and held a raffle in aid of Headway Northampton. All in all it was a very successful day and a great opportunity for everyone to catch up and celebrate the occasion.

RPC Garden Party sign and stall

RPC Garden Party

For more photos of the day, have a look at our album on Facebook.

Structured skills development for adults with learning difficulties

In May 2012, The Richardson Partnership for Care became an officially-recognised accreditation centre with ASDAN – the Awards Scheme Development Accreditation Network. The organisation provides courses to thousands of training providers, which offer flexible ways to accredit skills development and enrichment activities.

For service users with learning difficulties, ASDAN offers the flexibility to complete modules in different ways according to each individual’s abilities, preferences and concentration levels. It also means that service users can gain accredited qualifications in a familiar environment, working with people that they know and trust.  Receiving a certificate for their efforts also provides a sense of achievement and fulfilment, which often encourages them to progress to further learning and qualifications.

As Arts & Crafts is a popular activity within our homes for adults with learning difficulties, we started the ASDAN programme with the Creativity module. This has led onto modules in Independent Living (Introduction and Progression levels) and Numeracy Skills (Introduction and Progression levels). Sallie Maris, our ASDAN Co-ordinator finds creative ways to encourage the service users to participate in the modules and gain new skills. For example, learning numeracy skills may involve baking a cake, dividing it into segments and sharing it with others. We are now starting modules called ‘Myself and Others’ and ‘Personal Care Routines’.

Evidence must be provided for each task and assessments for each module are independently verified. Each individual is awarded a ‘grade’ for their module as follows: Experience recorded, Sensory experience, Physical help, Spoken help, No help. These ‘grades’ ensure that people with disabilities can still be treated fairly and their qualifications properly accredited.

The scatter diagram below shows the ASDAN qualifications obtained by service users with learning difficulties in Creativity and Independent Living, where 1 represents ‘Experience Recorded’ and 5 represents ‘No Help’.

ASDAN awards for adults with learning difficulties

The power of music to improve well-being

Music is a powerful medium and can have a profound effect on emotions. It can create a calming, tranquil environment or drive energy and motivation, depending on the style and tempo.

In addition to weekly music sessions in one of our homes, once a month on a Saturday, Simon Moxham, a professional Saxophonist comes to play at The Mews. Service users from all of our homes are encouraged to come along for a tea party in the main hall and Simon provides the entertainment, playing either his or Alto Sax or his Tenor Sax.  He starts with slower songs, which create an exceptionally calm and relaxed atmosphere when everyone is milling around and having their drinks and snacks. Then he gradually increases the tempo, so by the end service users and staff are clapping, singing, moving to the music in their chairs, or dancing and leaping around!

Simon plays a range of pop music from the 60s, 70s, 80s and 90s, which helps our service users with the acquired brain injuries with reminiscing. But it’s also a chance to celebrate being alive – it’s a really joyous and uplifting atmosphere that is enjoyed by everyone and enhances their well-being.

Watch a video of Simon playing his Alto Sax at The Mews

Simon’s website: www.simonthesax.co.uk

 

Simon Moxhan with his saxophone

Simon Moxham, Saxophonist