our vision - chartered institute of housing folder/health and... · key facts •there is a...
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Our Vision
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Our Mission
To give older people an independent,
safe and secure future in a network of
inspirational communities
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About Us
• Charity formed in 1988
• 14 retirement villages / 17 housing schemes
• Over 4,000 residents
• 5,000 older people in the community supported
• Over 60 charity shops
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Key Factors
• Flexible care, assessed to meet your needs and
delivered in your own home by qualified staff
• Dedicated 24-hour on-site team - available to
support you in the event of an emergency
• Proactive health screening and well-being
services providing help and advice to stay fit
and well
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Key Factors
• Stimulating activities, social and leisure
interests, helping residents stay healthy, active
and independent for longer
• Active encouragement of participation in
community life through volunteering
• Highly-trained staff, fostering a can-do culture,
supporting personal achievement and growth
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Our Well-being Programme
• Prior to the introduction of the Well-being service a
survey found that 75% of residents living independently
had not visited their GP
• A pilot service was produced with the recruitment of
Registered Nurses back in 1990’s
• Annual Well-being Assessments, health action plans,
and health interest groups were implemented
• The pilot found 122 previous undetected and untreated
conditions amongst a population of 135
• Residents assumed the symptoms they were
experiencing were just part of an ageing life
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Funding?
Past -
• Charitable income
• Supporting people
• Grants and awards
Future -
• Local Authority
• CCG
• Grants and awards
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What do we do?
• Baseline and annual assessments
• Drop-in clinics
• Monthly special interest talks
• Develop community champions - volunteers
• Signpost to services
• Connect people
• Training – continence
• Keep our residents healthy and well and retaining
independence
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Some Key Facts
• Our award winning Well-being service is
recognised as a national example of best
practice
• Residents use drop in clinics on average twice a
year – some are frequent flyers
• Common issues detected through the Well-being
Programme include high blood pressure, high
cholesterol, osteoporosis risk, urinary tract
infections and diabetes indicators
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Key Facts
• There is a Wellbeing Advisor in every ExtraCare
location – some work across 2 or 3 sites
• The cost of the project is £500,000 per year
• Links with other ExtraCare services such as the
gym, the Enriched Opportunities Programme
and the care service
• Residents want more health services on site –
nurse practitioner
• GPs and other community services see the WB
service as vital to their work too
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Outcomes – Drop in’s
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Outcomes
Condition Diagnosed/Treated Showing Symptoms/At risk
Hypertension 51% 6%
Arthritis (Osteo) 38% 3%
Coronary Heart Disease 21% 0%
Diabetes 21% 36%
Osteoporosis 21% 12%
Cancer 14% 0%
Depression 13% 3%
Asthma 10% 0%
Stroke 9% 0%
Dementia 8% 1%
Chronic Obstructive Pulmonary Disease (COPD)
7% 1%
TIAs 5% 0%
Arthritis (Rheumatoid) 5% 0%
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Outcomes
• Out of 560 assessments last quarter, only 34
residents did not have any diagnosed conditions
• Confusion and memory loss was identified with
5% and 14% identified respectively
• Reduction in unplanned hospital admissions
• Improved appropriate access to other health
services
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Cost savings
• There were 5,604 drop in visits last quarter –
potential saving to the NHS of c£168k
• Savings to health services through reduced
planned admissions
• Savings through appropriate use of health
services
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Future plans
• Expansion of WB role – Nurse Practitioner
• WB HCAs alongside WBAs
• Student nurse placements
• Leg clubs
• Step down services
• ‘Dying Well’ communities and charter
• Community Locksmiths expansion
• LGBT support
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Case study
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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.
+ =
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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)
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The Enriched Model of
Dementia
D = NI + H + B + P + SP • Neurological impairment
• Health
• Biography
• Personality
• Social Psychology
Helps us ‘connect the dots’ and ‘unravel the mystery’
“Don’t correct me connect with me”
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EOP in Practice
It’s the difference between seeing
A Person with Dementia
or
A Person with Dementia
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5 Key Facets of the EOP
• Specialist Expertise
• Individual Assessment and case work
• Activity and Occupation
• Staff Training
• Management and Leadership
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EOP in practice
“He’s aggressive and agitated”
“He wont drink or eat properly, just cake and crisps”
“He hides things, everyday” “He accuses people
of stealing”
The starting point for a Locksmith…
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EOP in practice
“He’s aggressive and agitated”
Mr K had been through a big change, he’s lived alone and lived independently. He now had at least 4 ‘strangers’ visit each day, which often left him feeling vulnerable and as if he had lost control. This often left him feeling threatened or frustrated We focussed on educating everyone – family and professionals about why Mr K may feel anxious when they visited. Everyone involved in Mr K’s wellbeing needed to understand their part in
contributing to Mr K feeling threatened… and understand his perspective
“Don’t correct me
connect with me”
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EOP in practice
“He wont drink or eat properly, just cake and crisps”
Mr K would eat what was easy, introducing some healthy ‘grazing boxes’ around the house meant he
could snack easily and more healthily Drinking prompts in key
areas help increase fluid levels
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EOP in practice
“He hides things, everyday”
What + Where = Why
Mr K only hid things that carers used on a daily basis – tea bags, coffee jars, and cutlery.
Mr K could not see what people were doing in his kitchen, or see items had been put back.
People needed to explain what they were doing, and stand with Mr K so he could see and get involved
Introducing some visual containers helped as Mr K could see where his belongings were whenever he liked
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The Enriched Opportunities
Programme® today…
• Over 4,400 residents in ExtraCare live with a diagnosed
dementia
• Over 1000 live with an EOP need
• 72% Diagnosis rate within ExtraCare schemes and Villages
The Enriched Opportunities Programme® is a big part of
achieving our vision to create