Interview conducted by April Cashin-Garbutt, BA Hons (Cantab)
Please could you give a brief introduction to dementia?
The term 'dementia' is used to describe symptoms that occur when the brain is affected by specific diseases and conditions, such as Alzheimer’s disease, vascular dementia, Lewy Bodies or Korsakoff’s syndrome.
Dementia affects a person's ability to remember, understand, communicate and reason. As a progressive condition, dementia will gradually get worse over time, although how fast it progresses will depend upon the individual, as people experience it in their own way.
What types of care do dementia patients require?
People with dementia want the same things that we all do: to have a sense of identity, to live with comfort, to feel loved and to enjoy a purposeful life, filled with meaningful activity - good dementia care should support these aspirations to be realised.
The specific care and support that people with dementia require depends upon the needs of the individual, and may include supporting their physical, psychological, emotional and spiritual needs. ‘Person-centered care’, which focuses on achieving an understanding of the person being supported, their cognitive abilities, as well as their life history, can often bring out the best in people with dementia.
What is the main problem with current dementia care services?
There are a lot of positive things about many dementia care services in the UK – we have many dedicated carers, there has been some great innovation in the design of dementia care facilities and research is driving higher standards of care. However, there is a lot more that needs to be done.
We need to achieve better stability for people with the condition by creating integrated dementia care services; these reduce the need for people to move between care providers when their support needs change.
The insight gained from research into building design and assistive technologies should be seized, to create appropriate living environments which maximize independence and enhance comfort and safety.
We need to change the all-too prevalent culture of support which sees staff in dementia care services doing things for individuals with dementia rather than with them; services need to be more focused on supporting people to be as independent as possible. We can achieve this with staff training that inspires these values and gives carers a stronger understanding of dementia and its complexities.
Finally, there needs to be greater recognition that that dementia is immensely stressful, not just to the person with dementia but also to their loved ones. Family carers save the UK public purse £8 billion every year and we need to better respect and support their contribution, offering them advice and respite.
Please can you explain what the EachStep model is?
EachStep is a new model of integrated dementia care developed by Community Integrated Care. At its core are a set of seemingly simple ambitions brought together in a genuinely innovative way: that people with dementia and their loved ones need stability in their lives; that they should be supported by expertly trained, caring staff in facilities that truly meet their needs; and that people with dementia should lead fulfilled and active lifestyles, where their personality and interests are recognised and promoted.
We launched our first service under the EachStep model in July 2012 – EachStep Blackley, a pioneering £5 million dementia service in Manchester. EachStep Blackley delivers a complete range of specialist dementia care from one location – home care, day care, respite care, and residential and nursing support, and in doing so, we are able to support people from their initial diagnosis through each step of their journey with dementia.
EachStep draws upon the latest research in dementia care, the insight of our academic and carer group partners, and our charity’s own in-depth understanding of the condition and the care sector - gained through our 25 years of delivering progressive care services, to create a service that fulfils the aspirations of the National Dementia Strategy.
How does this model overcome the main problem of current dementia care?
EachStep is about supporting people with dementia through any challenge they face and in short, this is our greatest benefit. By providing a genuinely integrated dementia care service, we are able to tailor the support we provide whenever needed and ensure that people will always be supported by a team of staff who know them and their needs, in an environment that they are familiar with and comfortable in.
Moreover, the EachStep ethos of supporting people to live fulfilled lives, underpinned by our excellent staff training and state-of-the-art facilities, results in genuinely life enhancing support. Although we are only half a year since launch, we’ve already seen some tremendous outcomes for the people we support.
Do you have plans to open more EachStep facilities?
Absolutely, we are currently reviewing the areas that will benefit most from having EachStep services in the future. We believe that we have a developed an exceptional service model that can solve many of the issues created by the rapid rise in dementia and are very excited about sharing these benefits in communities across the UK.
What sort of interest has EachStep received?
The reception from the Manchester community has been overwhelmingly positive and EachStep is rapidly gaining a reputation as being an incredible asset for the local area. Because of this, the service has been inundated with people enquiring about how they or their loved ones can access our support.
As such a new and progressive service, we’ve also received some fantastic national interest too. Professor Alistair Burns, the Government’s Dementia Tsar, praised EachStep Blackley when he formally opened the service; we’ve had fact-finding visits from the likes of the Joseph Rowntree Foundation and The National Care Forum; and we even welcomed a delegation from the Singapore Government, who wanted to find out more about the latest innovations in UK social care. As a charity, we are driven by providing public benefit, so we have really relished exchanging insight with these groups.
How do you think the future of dementia care services will develop?
The need for serious improvements in UK dementia care system has been recognized in the recent ‘Prime Minister’s Challenge on Dementia’, a programme of work which aims to deliver major improvements in dementia care and research by 2015, and new funding from the Department of Health to develop fresh innovations in the field of dementia. Dementia issues have also really captured public attention recently and this has led to a raised profile of both best practice and deficiencies in dementia care services.
It is our hope that this will spur the development of new tools that can keep people with dementia living independently for longer, greater integration of dementia care services, more research into improving dementia medication and support services, and a better understanding amongst carers of how to deliver support that is truly life enhancing.
What plans do Community Integrated Care have for the future?
Community Integrated Care has recently set itself the ambition of becoming the ‘UK’s leading Health and Social care charity’. This means that we will be growing our organisation significantly to offer our support to many more people, investing extensively in quality and innovation in our services, and pioneering best practice in care – as we have done in creating EachStep.
Our organisation is one of the UK’s largest charities and we support thousands of people with learning disabilities, mental health conditions and age related needs across England and Scotland. We have a quarter century history of supporting people with care needs to live full and happy lives and are hugely excited about furthering this legacy over the years ahead.
Where can readers find more information?
For more information on Community Integrated Care and the range of services we provide across the UK, visit: www.c-i-c.co.uk
More information about EachStep Blackley can be found at www.each-step.co.uk
About Sue McLean
Sue McLean led the development of Community Integrated Care’s ground-breaking ‘EachStep Blackley’ dementia care service in Manchester.
Sue is a qualified nurse with over two decades experience in the care of older people, working in a variety of senior, strategic roles in both the not-for-profit and private sectors.
Having overseen Community Integrated Care’s wide portfolio of services for older people since June 2009, holding the role of Director for Senior Care, Sue has recently taken a new direction in her career to become the charity’s Director of Quality and Standards. In this position she takes overall strategic responsibility for the delivery of quality standards, compliance and safeguarding in the charity.
Sue is passionate about using her operational and strategic experience to ensure that high standards of quality are realised in care services, not just in Community Integrated Care but across the care sector. Sue has supported published academic research projects and regularly works alongside local and national care sector bodies to share best practice.