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Innovation in care homes: Removing stigma and embracing technology

27 September 2023
By Kathryn Smith, SCIE Chief Executive

SCIE is always looking for new and innovative ways of providing the best social care and support to people to enable them to live their best lives. With this in mind my colleague Vikrant and I recently visited a dementia care home in Leeds, a part of Orchard Care Homes, where they are using Artificial Intelligence (AI) to support a new way of providing dementia care in a number of their new homes.

Paisley Lodge in Armley, Leeds, is one of these care homes. Here they have transformed the downstairs section of the care home into what they call a ‘reconnect community’. Housing between 18 and 20 residents who have typically been hard to place due to their so called ‘challenging behaviour’ – a term banned in Orchard Care Homes, along with many other terms they consider to be degrading, labelling or de-humanising, such as toileting. Such particularly offensive words seem reserved to the care sector, so I was very pleased to see them removed from this care home. Crucially, the behaviours referred to are in general not presenting anymore. The residents are treated with dignity and respect both in the language being used and the care they are receiving.

One of the ways they are achieving success in reducing such behaviour and improved residents’ expeirence is by using an application supported by artificial intelligence to assess a persons level of pain (Paincheck). This application that all staff are trained in uses facial recognition to identify where someone who is unable to communicate may be in pain, in order to get the right medication or treatment for their pain. At the same time, they have managed to reduce reliance on psychotropic medication, typically used in care homes or hospitals for people living with dementia to counteract behaviours such as ‘wandering’, frustration or aggression.

Image of SCIE CEO Kathryn Smith

The Reconnect Communities, modelled on care usually provided for people with autism, have a significantly higher staff ratio and a higher standard of training than a traditional dementia care home. The effects of their whole approach are immediately evident, every single person was meaningfully occupied, either with social activities or a ‘job’ that they had selected for themselves. For example, the laundry is not a locked room, residents are welcome to come in and put their washing in, hang the washing out or fold some laundry. There’s a workshop, unlocked, where residents can go in and do some painting, woodwork or something else that interests them. The garden is open for gardening, growing fruit and veg when the weather allows. All these activities safe in the knowledge that there are always staff around with time to support.

Paisley Lodge has an upstairs care home run on the traditional model of care with a separate pricing and referral process (albeit still using Paincheck). I asked one of the staff what the differences were from her perspective. She was very animated in the difference telling me she didn’t like working upstairs, she gave me an example of a lady who was prone to wandering and could be aggressive, upstairs she had to be ‘managed’, sat back down or maybe even ignored if staff were busy; downstairs a lady with similar needs was observed quietly and different staff would intervene to distract, look out for any problems, help the person to communicate their needs and become occupied more usefully – meaning this kind of behaviour was rarely a problem.

I felt quite uncomfortable at this ‘upstairs/ downstairs’ model and feel that to juxtapose the two care options within one building is especially unfair as many residents ‘upstairs’ would benefit from a Reconnect model but might not have been adequately referred or are unable to afford the fees. It is worth noting, though, that the ‘upstairs’ traditional dementia care model is providing a high standard version of the regular dementia care home model. Orchard Care homes have persuaded commissioners across the country to pay double the usual care home fee to place people in the reconnect communities, providing evidence and statistics to show the savings achieved reducing costs across the system in places such as frequent hospital visits, placement breakdown and medication. Not to mention the impact on the persons wellbeing and happiness which was the crucial takeaway for me.

I have long felt that we have age discrimination built into our care and commissioning model with younger people receiving exponentially larger care packages than older people. In my view, this is because we don’t value the emotional and social wellbeing of older people, the need for them to be meaningfully occupied in just the same way as younger adults. If the Orchard Care Home model was rolled out across all older people requiring care and support, it would come at a cost, but what might the savings be to other parts of the system, and isn’t this the kind of care we would all want for ourselves and our loved ones in older age? Taking a people-first approach to care homes and prioritising an experience for older people with dignity and respect is the standard social care should uphold.

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