Building homes for people with complex needs

9 July 2018

Complex needs care at Exemplar

Building homes for people with complex needs requires consideration at every juncture to ensure that the environment is suitable for each stage of an individual’s care – whether it be for degenerative conditions such as dementia and Huntington’s Disease, or conditions where an immediate decline in health has been experienced through a brain injury or stroke.

At the preliminary design stages, the Equality Act is a piece of legislation at the forefront of our considerations in terms of making reasonable adjustments to the living spaces for our service users. In addition to the Equality Act, the Care Quality Commissions Regulations are also imperative to ensuring we deliver care that is not just satisfactory but outstanding.

Regulation 10, Dignity and Respect includes the provision of privacy for when service users need and want it, alongside giving them support to allow them to be autonomous, independent and involved in their local community. This regulation is an area we’ve focused significant efforts across both our existing and new care homes and as such, as well as providing suitable personal care facilities for our service users, we have increasingly developed spaces such as The Hub. 

The Hub is a space within a selection of our homes that charities and community groups can hire for free. A space of this nature dovetails Regulation 10 in so much as it gives our service users an opportunity to be more involved with the local community, yet there are also the safeguarding considerations which are involved in accommodating groups of people that have a level of access to our service users.

As well as having vital spaces to integrate community groups into our home settings, we do of course have several rooms to support the rehabilitation of our service users. We have spaces where a variety of entertainment takes place, as arranged by our care staff, and designated sensory rooms which are adorned with special lighting, have music provision and objects to facilitate recovery. 

Alongside provision that you would expect, such as sensory and entertainment rooms, our aim to make every day better than the last for our service users has led to us utilising existing spaces in care homes in new ways. These were ways in which we had never anticipated when we first build or acquired the building, and have the required support and understanding at all levels of the business to make it possible.

At Quarryfields in Doncaster a pop-up shop has been developed for service users with learning disabilities to gain volunteering opportunities. Service users are involved in all elements of the shop, from handling finances under supervision to meeting coffee suppliers and making the uniforms. Elsewhere, following feedback he provided to his home team a service user was accommodated with a new room with the relevant facilities and processes so that his son could stay overnight.

In both examples above, the ability for change empowered not just the service users but the wider organisation to highlight how our physical buildings can be remodelled to provide facilities that not just let our service users survive but thrive.

In addition to our traditional care home settings we have developed a service called OneCare which provides accommodation for service users that allows them to have a greater sense of independence. The development of this service has led to an acquisition of existing properties and the development of new buildings on or near land we already own.

OneCare services are unique to the service user’s needs, so each of the flats and homes are developed separately to cater for individual requirements. Examples include a home developed for Simon*, a sufferer of autism who has severe sensory triggers and requires a home which has no skirting boards, radiators or wallpaper. Alongside reducing triggering textures, his flat has been developed so that there is a living space upstairs for when he is suffering from intense anxiety as well as the facility for care workers to stop access to the kitchen area for his own safety.

While the space and its facilities are of significant importance, especially in relation to Simon’s triggers, it is the hard work of staff and their role in supporting Simon’s family in the process of transitioning his care to an Exemplar Health Care home which is key to his quality of life. Without the understanding and desire from the team to not only cater to his needs but also to allow him the opportunity to develop independence through cooking for himself and keeping him safe, the wider structure and technology would not suffice.

It is important for us to remember the development role when considering how care provision is being developed for people with complex needs - it is the right environment and technology combined with the relevant specialist care which can make a difference to service users’ lives.

Case Study – brain injury rehabilitation

For several months, Ingrid had been suffering from intense headaches which continued for days without a break. When Ingrid became unable to carry out her day to day tasks she was rushed to A&E by her husband and scans carried out in hospital highlighted an aneurism on the brain. 

Unfortunately, the aneurism burst before surgery could be carried out and due to the size and impact of the aneurism, Ingrid suffered severe stroke type symptoms, which significantly changed her life.

When Ingrid was admitted to an Exemplar Health Care home she was immobile, suffered with poor speech, severe short-term memory loss, and very poor cognition and coordination. 

The experienced staff in charge of supporting Ingrid worked with family, friends and community therapists to develop a care plan to increase her functional abilities.

The sensory room at the home encouraged Ingrid and paved the way for her recovery in developing her senses using special lighting, music and objects. 

Due to her short-term memory loss, Ingrid had initially struggled to come to terms with physio and cognitive therapies. Staff recognised this and worked on a regime of short periods of regular therapy and slowly she blossomed.

As time progressed, Ingrid began reaching her goals. She regained movement, speech and most importantly, her independence. 

Just 18 months after arriving at Exemplar Health Care, Ingrid was able to go home to her beloved family – fully mobile.

Almost back to her old self, Ingrid is now completely independent and doesn’t require any further care packages to support her recovery.