Improving Care in Care Homes

1
Improving Care in Care Homes

• Application of the Newcastle Model in Dementia
  Care
• Ann Scott
• Practice Development Facilitator
• Homefirst Community Trust

2
Current standard of care is poor

• 17 homes surveyed in the North of England all
  rated as requiring much or radical improvement
  (Ballard et al, 2001)

Why?
challenging behaviour beyond scope of care staff
3
Impact of Challenging Behaviour
Admission to the dementia assessment unit
Move to another facility
problem is moved on - staff miss opportunity to
learn
High mortality rate within first year of
move (Aneshenel, 2000)
4
Practice Development
CPNs shared vision to develop efficient service
new ways of working (DHSSPS, 2006)
The Newcastle Team
The Martha McMenamen Memorial Scholarship
5
The Newcastle Model
Mental Status
Pre-Morbid Personality
Life Story
Environment
Cognitive Status
Medication
Physical Health
Thoughts
Need
Behaviour
Appearance
6
Neuropsychiatric InventoryCaregiver Distress
(NPI D)
7
Cost Benefit Analysis
Cost of G grade CPN for 5 months
Cost of hospital stay (4 patients x average
length of stay x daily bed cost)
Cost of hospital stay x 1 patient over a one year
period
Does not include cost of retaining bed in care
home or transportation costs Number of admissions
prevented 4 patients.
8
Stakeholder Analysis
Claims Concerns Issues
Meeting needs decrease in behavioural difficulties Reduction in use of medication Unnecessary moves avoided Increased quality of life Carers job satisfaction increased Workload will increase for staff in homes Can service be implemented throughout the trust Will care homes still have access to Tardree House if required Can model be used in wards Funding required to secure service 3 Behavioural Sciences nurses