Drive to raise standards of dementia care in care homes

This month the Alzheimer’s Society is launching both its Quality Dementia Care Standards for Care Homes and its Care Homes Forum. It has long been recognised that improving care for users is the single most important reason for looking at service quality.

Almost half a million people in the UK receive long-term care in residential and nursing homes and in hospitals, according to the 1999 Royal Commission on Long-Term Care, and around half of this number are likely to be affected by dementia (Medical Research Council, 1999).

Government policy such as the National Service Framework for Older People (DoH, 2001) and the enactment of the Care Standards Act next year aim to drive quality upward, increase protection of older people and encourage consistently high-quality care in care homes. Yet effective dementia care in the NHS and nursing homes is often neglected and needs radical improvement.

The rights of people with dementia living in care homes are often curtailed, usually for the best of motives, but the anxieties of staff and managers can lead to over-restrictive practices. People’s rights may also be overlooked because staff are not aware of them and may lack training in dementia care.

The project

In 1998 the Alzheimer’s Society commissioned the RCN Gerontological Nursing Programme to manage a project to develop person-centred standards for care homes to bring together:

- The society’s knowledge of high-quality dementia care developed through its quality assurance project, the Care Consortium

- The views, experiences and wishes of people with dementia and their carers about life in a care home

- Current good practice in dementia care

- The views of care staff in care homes.

Person-centred standards

The standards offer new ways of providing care for people with dementia. They are based on the person-centred approaches developed by pioneers such as Kitwood (1997).

These approaches challenge the established ways of caring for people with dementia, which have tended to focus on physical care and managing symptoms. The emphasis has now switched to considering the person as an individual rather than a collection of symptoms, and discovering ways to work with, and alongside, the person to enhance their quality of life.

The society’s care standards will be essential to anyone involved in the provision of dementia care in a care-home setting. They will also be relevant and useful to organisations such as registration and inspection units, local authority purchasing departments, as well as families and carers of people with dementia.

The Care Homes Forum

Care-home managers and owners are crucial to the provision of high-quality care, as they have a major influence on the setting of standards and the philosophy of their establishments.

Many managers are concerned about the delivery of high-quality care and may want to enhance their knowledge of and skills in dementia care and, in turn, provide support and development for staff.

The Alzheimer’s Society aims to provide access to information, training and ideas, as well as offer support from the society through membership of its Dementia Care Homes Forum.

On registration, care homes will be provided with the following:

- The society’s dementia care standards and a support pack, including information and advice sheets

- Access to local, regional and national events organised by the society, its publications and training materials

- A twice-yearly forum newsletter, plus the society’s newsletter

- Access to the annual forum conference

- Access to a specialist section of the society’s website, with links to training, useful organisations, useful articles, discussion groups and so on.

Membership of the Care Homes Forum is a unique opportunity to exchange information and ideas on effective high-quality dementia care with other managers and owners nationwide.

Guidelines for the registration and inspection bodies for care homes, which complement the Quality Dementia Care Standards, are due to be published next year.

- The Alzheimer’s Society’s Quality Care Dementia Standards costs £50, plus postage and packing. Membership of the society’s Care Homes Forum (including a copy of the standards) costs £100. Tel: 01904-633581

- Next month we will examine an initiative on diabetes for care homes.

Medical Research Council Cognitive Function and Ageing Study and Resource Implications Study. (1999)Profile of disability in elderly people: estimates from a longitudinal population study. British Medical Journal 318: 1108-1111.

Department of Health. (2001)National Service Frameworks. Modern Standards and Service Models: Older people. London: DoH.

Kitwood, T. (1997)Dementia Reconsidered: The person comes first. Buckingham: Open University Press.

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