Is this the future of residential care for people with dementia?

A new care home for people with dementia has the air of a luxury hotel and the latest in dementia-specific design. But, says its manager, it also has challenging ambitions of delivering truly person-centred care.

Photo credit: Gary Brigden

A tour of West Hall, Anchor’s latest care home, leaves me feeling I’m visiting a luxury hotel I couldn’t possibly afford to stay at.

The home, designed for people with dementia, cost £30m to build, is set in 10 acres – five of which are landscaped and the other half developed, and communal facilities are housed in the original 18th century manor house. Here residents can make use of a library, hair salon, treatment room, activity room, a bistro dining room complete with five-star chef, and a private dining room for when friends and family visit. Wherever residents decide to eat, all food is cooked on site fresh every day.

Three specially designed buildings or ‘clusters’ each house 39 bedrooms, all with flatscreen TV and fridge, as well as ensuite bathroom. There are three sizes of room, with some big enough for couples; ground floor rooms have patios and some upstairs rooms have balconies. There are communal dining and living areas on each floor.

“This is about people choosing a lifestyle,” says Anchor chief executive Jane Ashcroft. “We are trying to achieve happy living here and encourage a feeling of people living in a small community with access to fantastic facilities.”

 

Dementia design features

 Distinct colour schemes on each floor of the clusters help residents recognise the floor their room is on;

 Display cabinets called ‘memory boxes’ have been built into the walls next to every bedroom door. These are lit up and can be filled with personal items such as photos or mementos to help those with dementia recognise their room;

 A unique patterned tactile panel outside every bedroom door again help residents identify when they have reached their room;

 Some bedroom drawers and wardrobes have transparent panels to reduce frustration and anxiety when people cannot remember where they have put something;

 A light comes on when a resident gets out of bed at night to help them find their way to the bathroom;

 Sensors have been built into bed frames which can be programmed individually – if they are needed at all – to monitor individuals’ sleep patterns and bedtime bathroom routines, and alert staff to abnormalities that could indicate a fall.

 

Ashcroft says prices charged by the not-for-profit provider are comparable to other private care homes in the area, but at between £1,400-£1,600 per week depending on care needs it will require people to have an asset or investment to draw on, she says. However, she is keen to take the learning from West Hall, particularly around design, and apply this to Anchor’s other services when refurbishing.

Anchor’s dementia consultant, Victoria Metcalfe, has been heavily involved in the design at West Hall. “In the past, architects and designers have used pale and pastel colours because they felt they were the least offensive for older people but that is a flawed concept.

“As dementia advances people need to connect sensorily to their world, so where we want to highlight an area we use a brighter colour. Everything is designed to help maintain as much independence as possible because that makes them feel more confident, which makes them feel happier.”

Unusually for a care home catering for people with dementia, the outside space is seen as important a resource as the internal facilities. Unlike the many homes that lock their doors, West Hall actively encourages residents to go outside and use the grounds. If they can’t walk around there are even buggies to drive them around. The communal building has French doors leading out of all rooms so the outside is easily accessible; there are circular walkways between buildings so that residents can walk around without getting lost; and there are allotments so that residents can grow what they want; a herb garden; a greenhouse; raised beds; and a croquet lawn.
 
But delivering person-centred care is seen as just as important as the design or facilities.

“Whether someone has dementia, complex or challenging needs these are always secondary to the person,” says West Hall’s general manager, Vishul Seewoolall. “We are not putting people into boxes here although it will be a challenging time.”

The challenging aspect he refers to comes from the fact that residents will have a say in their care provision and lifestyle choices. Care staff will support a maximum of five residents each and they will be expected to respond to the desires and routines of residents.

Residents will have a say over who works with them, which will involve matching personalities and interests of residents with those of care staff. The person-centred care expected at West Hall has meant the recruitment process has differed from normal too, he says. “Rather than just relying on qualifications and experience we have picked people whose personalities demonstrate that they will be able to build a rapport with residents,” says Seewoolall.

“Because we have such a robust dementia training programme I’m confident of taking anyone from any walk of life.”

Claire Humphries is an example of this new approach. She had cared for her grandmother when she had dementia and had worked for a private domiciliary care agency, but had no care qualifications or other relevant experience. She has now completed Anchor’s specialist dementia training programme and is set to do an NVQ3 in health and social care.

“Looking after my nan made me want to work with people with dementia. When I came for the interview I liked Anchor’s criteria about values and behaviours and I feel really privileged to work here.”

Just over 60 residents are expected in the first month and when West Hall is at full capacity there will be about 250 staff on site. All, from the handyman to the receptionist, gardener to kitchen staff, will have dementia awareness training.

“I know people with dementia can live well here and that makes me so proud,” says Metcalfe.

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