So you want to meet Elvis?
Eden House care home in County Durham, part of Helen McArdle Care, was rated ‘outstanding’ by the Care Quality Commission after one of its new unannounced inspections. Residents have a nail bar and hair salon and are served restaurant-style meals at the home. Set amid landscaped gardens, it prides itself on meeting the expectations of its 53 residents.
‘She knew it wasn’t possible because he was dead, but she said how much she would have liked it,’ explains Kelly Watt, who manages the residential care home in County Durham. ‘We organised an Elvis impersonator to visit. She was thrilled.’
Going the extra mile is why Ms Watt believes the Care Quality Commission (CQC) rated the home as outstanding in a report last August, following an unannounced inspection.
Eden House is one of the first social care services in the north east to receive this exemplary recognition under the new CQC approach to inspection. Services are rated according to whether they are safe, effective, caring, responsive and well-led.
‘It’s amazing,’ says Ms Watt. ‘Everyone has done so much to get here. The staff are overwhelmed and so glad to be recognised.
Clockwise from left: Claire Liddy leads the music session at Eden House, staff raise a glass to those in their care, Leanda Bushbye gives one of the residents a manicure, Doreen Redfern receives an award for her service to the Red Cross, and the table set for dinner
‘A lot of our visitors have been asking about the inspection, as they were interviewed by the CQC, so they’ve been keen to know the results. We had a little party for the residents, their families and staff to celebrate the good news.’
The purpose-built home in the market town of Bishop Auckland opened in October 2013 and provides care for up to 53 older people. Features include en-suite bedrooms, spacious communal areas, landscaped gardens with walkways and seating, a hairdressing salon and a nail bar.
The home is part of Helen McArdle Care, which runs 17 homes in north east England. Eden House has a residential unit on the ground floor, with a dementia care unit for 26 residents on the first floor.
It was created using guidance from the Alzheimer’s Society, the National Institute for Health and Care Excellence, and the Online Virtual Care Home resource, developed by the University of Stirling’s dementia centre.
Although Ms Watt only joined the company in 2013, she worked in care for 24 years, starting as a junior care assistant and progressing upwards. Dementia care is one of her special interests.
‘My years of experience are important,’ she says. ‘The staff appreciate that I know what they’re talking about because I’ve been there. People with dementia have a right to be properly looked after and lead a fulfilled life,’ says Ms Watt, who has a dementia care diploma.
‘We look at their past interests and see what kinds of activities we can develop around those. Knowing more about their backgrounds also helps us to understand why they might become agitated sometimes too.’
The home uses rummage boxes, filled with everyday items such as clothes pegs and wooden spoons, to spark recollections.
‘Picking them up helps to develop lots of conversations,’ says Ms Watt. ‘A person might spend an hour or two talking or doing something as a result and, although they cannot remember it afterwards, the important thing is they enjoyed it at the time.’
Every year, just after Christmas, all the residents are asked to choose three wishes – things that are important to them and that they would like to achieve in the year ahead. ‘Sometimes they are just about continuing to have a happy life, but often they are about places they would like to visit, perhaps from their past,’ says Ms Watt.
In one instance, a resident asked to walk on the beach in bare feet one more time.
‘We try our best to meet their wishes whenever we can. And if it’s just not possible, then we find other ways to do it – including Elvis impersonators!’ says Ms Watt.
Mealtimes are an important event at Eden House. Every evening, tables are dressed with cloths and napkins to recreate the feeling of a restaurant, with wine offered at weekends and music to create a relaxing atmosphere.
‘We want the residents to have a fine dining experience,’ says Ms Watt. ‘They get excited.’
Three choices are offered at every meal, all made by trained chefs in the home’s state-of-the-art kitchen, from fresh and locally sourced ingredients.
Alongside more traditional options, there is a chef’s special, which may be something the residents have suggested. They can also choose their portion size and discuss their preferences, which are recorded by the chef, alongside any allergies and an updated record of their weight.
The company says it is the first UK healthcare provider to use a new puréed food technique to help residents experiencing dysphagia.
Developed in Germany, the Smoothfood technique uses special thickening and gelling agents, rather than starch-based products. This means that when food sets it has the right texture, but can be broken down easily, helping those who have problems swallowing solid food.
The food is shaped and moulded to look attractive and similar to an ordinary meal, whether a full English breakfast, a gammon and pineapple lunch, or a chicken curry dinner are being served. The crucial point is that each component tastes as it should.
‘You can use a knife and fork to eat it, just like everyone else,’ says Ms Watt. ‘For me, it’s all about maintaining people’s dignity – you see it on the plate and you wouldn’t know it was any different.’
As a result, there has been an increase in appetite from those who no longer enjoyed food because of their illness, with a marked improvement in weight gain.
Although Eden House does not employ qualified nurses, the CQC found its 34 staff were caring, motivated and well-trained.
‘Our training is so good that staff feel supported to handle any health issues that may arise,’ says Ms Watt.
From the outset, the home fostered close relationships with community nurses, GP surgeries and the nearby district general hospital, with an open day for healthcare professionals. Passing district nurses also have an open invitation to call in for a cup of tea or a bite to eat.
When residents need nursing interventions, Eden House staff are on hand with in-depth knowledge about the patient.
Medicines are stored at the home and detailed medication records are audited each week. Two staff who have completed medication training are on duty every shift and controlled drugs are checked and administered by two members of staff. Another key issue is staff retention.
Research shows that reducing staff turnover can also play a crucial role in improving safety.
The CQC’s 2013 annual report found a statistical link between care homes with increased rates of staff turnover and death notifications, particularly in homes with no nursing provision.
A well-developed training programme is one of the ways in which staff are encouraged to progress within Helen McArdle Care, according to its training manager Stephanie Callaghan, pictured.
‘Staff are your biggest asset and it’s about making them feel they are valued,’ she says.
‘When you invest as much as we do in staff training, you get loyalty – and with that comes staff retention.
‘This can only be a good thing for the residents, as a more stable workforce means a more settled life for them. It’s upsetting when people leave and residents want to see constant and familiar faces.’
Demonstrating its commitment to training, the company opened its own purpose-built training academy at its Gateshead headquarters in January 2015. It includes two training rooms, a multimedia suite for online learning and a kitchen to train new chefs and develop the current catering team.
All new staff have a 12-week induction programme, supported by a mentor, learning the company’s values, ethos and expected standards of care, encompassing core issues such as safeguarding and dignity.
‘It’s a robust programme that goes far and above what some might consider mandatory,’ says Ms Callaghan.
‘My view is that you can never overtrain your staff. The more skilled they are, the higher quality of service they provide, so better care is delivered for residents.
‘Training is their toolkit. You wouldn’t send a plumber out to put in a new sink without their wrench.’
Career progression is encouraged from the outset.
‘I tell them that some of our care home managers started where they are now,’ says Ms Callaghan.
‘They know it’s possible to progress with us from the beginning.’
At the end of the induction, the carers are awarded a certificate and are expected to be proficient at their job.
With all training done in working hours, staff and managers agree on subsequent courses through annual personal development plans, taking into account the needs of the residents and the home.
‘We want the staff to stay and the residents to get to know them,’ says Ms Watt. ‘That’s important to us.’
Jason Parkinson joined Eden House when it first opened two years ago as a senior care assistant, but was promoted to senior lead 14 months ago.
‘I’ve been able to develop through the company’s training and the support of my manager,’ he says.
‘One day I’d like to manage my own care home and I’ll achieve that through the support I’ve had here. The company sees the potential in me. It promotes from within and they want you to progress.’
After working in the NHS as an auxiliary nurse and in mental health, he enjoys the caring atmosphere of Eden House.
‘The people we care for are not just residents here, they are an extended family to me,’ he says.
‘When I come to work, it’s like going from one home to another home.’
As one resident told the CQC inspectors: ‘I am 105 years old and I love living here; there are always lots of activities that I enjoy. Staff are the kindest people I have ever come across – and I should know because I have lived a very long time’.