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Dementia service

The service is a specialist home care service, providing what is known as person centred support for people with dementia and their carers. A person centred approach is one that supports people with dementia to lead as fulfilling life as possible in all areas of daily living.

Aims of the service

Are as follows:

  • To provide services which will maintain and support people with dementia and their carers who are identified as being at particular risk of breakdown within the community and prevent their admission to institutional care.
  • To offer more flexible, person centred services which are responsive to the individual and changing needs of service users.
  • Develop effective discharge and aftercare arrangements for service users with moderate/severe dementia following a period of hospitalisation.
  • Keep to an absolute minimum the number of care staff providing a service to any one individual.
  • Services will be outcome focussed rather than service centred.

Accessing the service

To access the service service users must meet the social care FAC's criteria plus:

  • Service users will (usually) be over the age of 65, and will be assessed as having high or medium dependency needs.
  • Service user living alone, or where care arrangements are under severe pressure and are in danger of breaking down.
  • There is significant risk due to behaviour, functional problems, abuse, neglect or self-harm.
  • Potential for serious disruption to living arrangements.
  • The care plan requires a high level of monitoring, adjustment, or coordination.
  • There is difficulty in engaging or in maintaining contact with the service user.

Service ethos

The service strives to be a learning organisation that is proactively seeking to improve the service offered and its knowledge and its understanding in all areas of dementia.To achieve this there are four key areas:

1 Working with service users

  • All service users are involved in the development of their own operational service user plan.
  • The service provided is centred around the service user, and focuses on enhancing their quality of life.
  • This can best be achieved through positive and sustaining relationships formed between staff and their service users and their carers.

2 Working with carers

  • Carers will be fully involved in the operational service user planning process if they and the service user so wish.
  • The service will offer on going support to carers, and endeavour to enhance their well being.

3 Supporting staff

  • The service will ensure that all staff are well trained and supported.
  • Staff share in the responsibility for their own development, and will be encouraged and supported in doing this.
  • It is acknowledged that everyone in the organisation plays a vital role in providing care for people with dementia, and everybody's views will be respected.

4 The management vision

  • Aim to be positive leaders of the service.
  • Seek excellence in service provision.
  • Understand that we should seek to continually develop our services, and proactively find opportunities to do this.

Staffing

The service is operationally managed by a dedicated senior care officer and the team is staffed by dedicated and trained home care assistants who will liase closely with members of the Community Mental Health Teams for Older People, keyworkers with overall CPA responsibility, and commissioning social workers from community based Area teams.

Commissioning and provider arrangements

  • Commissioners will commission services over a full week period-eg.6 hours over 7 days. Commissioners will continue to specify any individual tasks which need to be carried out on specific days.
  • Home care staff will be responsible for day to day decisions on the allocation of time based on an ongoing assessment of the individuals needs whilst ensuring any essential tasks commissioned are always carried out on the specified day.
  • Home carers will maintain effective links with other key services which the service user may access-eg. Day Care, Day Hospital, Respite care, GP, etc.

Charges for the service

Social Services are obliged by law to charge for their services. This charge only represents a contribution towards the full costs of the service.Your care manager will advise you of the current charging regime and a copy of the appropriate leaflet will also be available in the service users file that will be kept in your home.

Referral point

Referrals in this service should be made by care managers to their local home care team.