Birmingham Dementia Services Scrutiny Inquiry

23rd July 2014

Angela Bradford

Shirley Hall

Michael Spellman

The Enriched Opportunities Programme®

The Enriched Opportunities Programme® (EOP) was developed

by The ExtraCare Charitable Trust to support residents experiencing dementia to live independent, healthy, and active lifestyles.

The service began as a research project with the University of Bradford which involved:

• A 2 year cluster randomised controlled trial of a new approach to living with dementia and other mental health issues in ExtraCare

• Development of a specialist staff role the “Locksmith” who unpicks impairments and unlocks a persons potential.

+ =

EOP Research Outcomes

Residents supported by a Locksmith were…

• 50% less likely to move out of ExtraCare into a care home

• Spending less time in hospital as an in-patient

• More likely to have their mental health condition diagnosed

• Had improved access to Health services

Residents also…

• Rated their quality of life more positively

• Experienced decreased symptoms of depression

• Experienced greater feelings of social support and inclusion

(As detailed in the 2009 Bradford dementia group report, available on the ExtraCare website)

The Enriched Model of Dementia Care

The programme is based on Tom Kitwood’s Enriched Model of Dementia Care. Developed from person centred psychotherapy it is a caring and effective way to establish a person’s unique experience of their condition.

D = NI + H + B + P + SP• Neurological impairment

• Health

• Biography

• Personality

• Social Psychology

Helps to understand and ‘connect the dots’ in a maze of misunderstanding.

Its holistic, and reduces the ‘failure to listen’ which can lead to a person being labelled as ‘challenging’.

EOP in practice

It’s the difference between seeing

A Person with Dementiaor

APerson with Dementia

‘The Uncle’

‘The Sports

Person’

‘The

Gardener’

‘The Baker’

‘The

Brother’

‘The

Student’

‘The Film

Lover’

EOP in practice

The EOP achieves this through five major elements working together:

Specialist Expertise• The right Locksmith – found through unique recruitment

• A senior role, influencing and teaching everyone to think ‘person centred’

• Skilled empathic communicators that create therapeutic relationships

Individual Assessment and case work• One to one ‘quality time’ with residents, understanding their individual

experience of dementia or other mental health condition

• Development of an ‘Enriched Profile’ & ‘Resident Story’

• Use knowledge to improve the way we care and support

EOP in practice

Activity and Occupation• Understanding a person leads to activity that is meaningful

• Create opportunities to learn new skills and retain abilities

Staff Training• Specific Locksmith Training through the University of Worcester

• Locksmith CPD – creating a Locksmith Curriculum

• All staff training – mental health awareness and understanding of the EOP

Management and Leadership• Requires Scheme / Village Managers full participation

• Organisational support, EOP Services Coordinator

• Requires an enabling Policy, with commitment to quality and improvement

The Enriched Opportunities Programme® today…

• Over 900 residents in ExtraCare live with a mental health

condition

• Over 390 experience dementia

• 66% have been supported by their Locksmith to receive a

dementia diagnosis.

• The average hospital stay for a resident receiving Locksmith

support is 11 days

The Enriched Opportunities Programme® is a big part of achieving our vision to create

Birmingham

Birmingham

The EOP currently supports 157 residents in

Birmingham

• 29% have a diagnosis of dementia

• 42% have a diagnosis of depression

• 29% receive Locksmith support for other EOP

needs e.g. Risk of social isolation or other

mental health condition.

Birmingham – next steps

• Dementia friendly communities

• Intergenerational work - schools

• Memory assessment clinic – Pannel Croft

• Working with other organisations

• Prevention (well-being), early identification – the

EOP model

• Helping to keep residents at home

• Partnership working

Outweigh the challenge

The Dementia

Challenge:• 800,000 people with

dementia in the UK

• £23 billion cost per year

to the NHS

• Many people feel they

are not living well with

dementia

• Many people feel a loss

of choice and control

Alzheimer's Society

Dementia 2012 Report

Hopeful and

Positive:

• Better care &

approaches

• Better lives

• Supporting

health services

More!

Contributing factors to the ‘experience of dementia’

Dementia

Drugs &

AlcoholDepression

Learning

disabilities

Physical

Health

Other MH

conditions

Each of these can

affect the

experience of

dementia

Unpicking issues and Unlocking potential

“Why?” is normally the

starting point…

The role of the Locksmith

is to use their knowledge

to unpick the mystery, and

provide an answer.

Understand a person’s

weaknesses but focus on

their strengths to achieve

living well with dementia

Living well with dementia for longer

Development of

Dementia

End of life

EOP and external

service intervention

Higher independence

Reduced reliance on care

Good quality of life

Risks to independence

Increased care needs

Risks to quality of life