John Noble Home 97 MOUNT PLEASANT STREET BRANTFORD, ONTARIO N3T 1T5 TELEPHONE: (519) FAX: (519)

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1 John Noble Home 97 MOUNT PLEASANT STREET BRANTFORD, ONTARIO N3T 1T5 TELEPHONE: (519) FAX: (519) DATE: February 3, 2016 REPORT NO. PHSSS TO: FROM: Chair and Members John Noble Home Committee of Management Erin Denton, Acting Administrator John Noble Home 1.0 TYPE OF REPORT CONSENT ITEM [ ] ITEM FOR CONSIDERATION [ x ] 2.0 TOPIC Noble Project Report [Financial Impact- None] (PHSSS ) 3.0 RECOMMENDATION A. THAT the Noble Project Report PHSSS from the John Noble Home BE RECEIVED; and B. THAT Committee of Management DIRECT staff to further investigate the opportunities available to become a pilot Dementia Care Home in Ontario. 4.0 PURPOSE To provide information along with a presentation to the Committee of Management about a current quality improvement project in long-term care that focuses on culture change in dementia care. 5.0 BACKGROUND The Administrator and Director of Care attended an education session at the Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS) annual conference in April 2015 on Dementia Care Matters, a model of care first introduced in the United Kingdom. Dementia Care Matters focuses on the best practice of client centered care in a home like setting. The John Noble Home developed a team in the summer of 2015 at the request of the Administrator to look at ways of implementing parts of the Dementia Care

2 REPORT No. PHSSS Date: January 13, 2016 Page 2 Matters philosophy. The team has been meeting every two weeks and has been exploring ways to change the culture of the home to a more resident centered space utilizing client centered care best practices and change ideas from the Dementia Care Matters, Butterfly Household philosophy. The home did purchase some educational materials from Dementia Care Matters but was unable to become a pilot Butterfly Care Home in Ontario due to the cost of around $100,000 which includes 50,000 English pounds plus capital dollars. A presentation was requested by the Committee of Management at the December meeting to explain the project. 6.0 CORPORATE POLICY CONTEXT High Quality of Life and Caring for all Citizens 7.0 INPUT FROM OTHER SOURCES Dementia Care Matters 8.0 ANALYSIS The Noble Project Team that includes staff, management, volunteers and members of the Family Council continue to meet every two weeks to discuss change ideas and implement ideas as appropriate. 9.0 FINANCIAL IMPLICATIONS N/A 9.0 CONCLUSION John Noble Home continues to look for opportunities to be a leader in providing an environment that supports its residents, engages them and enhances their quality of life. Erin Denton, Acting Administrator John Noble Home

3 REPORT No. PHSSS Date: January 13, 2016 Page 3 Attachments: The Noble Project Presentation Copy to: N/A In adopting this report, is a by-law or agreement required? If so, it should be referenced in the recommendation section. By-law required [ ] yes [ x ] no Agreement(s) or other documents to be signed by Mayor and/or City Clerk [ ] yes [ x ] no Is the necessary by-law or agreement being sent concurrently to Council? [ ] yes [ x ] no

4 AN APPROACH TO HOLISTIC CARE

5 Dementia Care Matters Dementia Care Matters is a philosophy of care that focuses on the resident as a person Implemented in the UK by Dr. David Sheard-65 homes in the UK and Canada are designated as Butterfly Care Homes There are opportunities to become a pilot Butterfly home at a cost The philosophy is that by moving away from a medical based model towards a more social model we are able to provide an environment that better supports our residents Has shown positive outcomes such as decreased behaviours and decreased falls and increased social interaction

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7 Butterfly Household Model Four Key Components: Person Centered Care Philosophy Feelings Matter Most -enabling residents to be alive Developing Staff Emotional Intelligence Physical Changes in the Environment to reflect a Home Source: Dementia Care Matters

8 Butterfly Household Method Culture Non-hospital practices Expert Nursing Care within a household model No them and us between staff and residents Rights to life rather than: protection from life Qualitative Observation vs. Mechanistic Audits Source: Real Culture Change: The Butterfly Care Homes experience, Australian Journal of Dementia Care April/May 2015

9 Butterfly Household Method Leadership is committed to principles Environments suit the needs of those with dementia rather than what professionals view of what the home should look like Disorder and creativity is valued thereby mirroring the lives of those with dementia Teaching regulators the new culture of dementia care Cohesion in Senior management team Emotional intelligence and emotional labour Source: Real Culture Change: The Butterfly Care Homes experience, Australian Journal of Dementia Care April/May 2015

10 Dementia Care Matters- Butterfly Care Homes Looking for Ontario Long Term Care homes to pilot the project in Ontario Cost is about $ ( plus capital costs)

11 Butterfly Care Home Project Outline 1 year project timeline 4 site visits - two of them with Dr. David Sheard Includes Qualitative Audit of the Home- 2 days Launch meetings with staff, regulators, residents, family- 2 days On site training 3 half-day per month mentoring sessions- Skype Supply and license to use all Dementia Care manuals, materials, DVD s etc. Unannounced Audit

12 Best Practice Culture Shift to: Health Care Consent Act as the core of all care Client Centered Care- Best Practice Client Directed Care Residents Rights (Long Term Care Homes Act 2007) Nothing about me without me

13 The Noble Project Overview Staff, residents and the Family Council were very interested in the concept of dementia matters and decided to incorporate parts of Dementia Care Matters into a Quality Improvement Project called the Noble Project A team that includes staff, management and family members is meeting regularly and adopting some of the concepts of Dementia Care Matters and tailoring them to our Home There is no budget for this project We hope to transform one of our home areas to a place where moments of connection between our residents and staff has as much value as the care we provide for them.

14 Reminiscing Kits

15 Progress We started the project by engaging staff and families We held a contest to make Reminiscing Kits Around 40 kits were received, many of which were very creative. Topics included fishing, tools, letter writing, baking, jewelry etc. We added interesting interactive areas within the home such as an Elvis corner, A doll therapy corner etc.

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17 Goals We have been looking for volunteers to create murals in the Resident Home Areas (RHAs) Plan to fill up the Resident Home Areas to make them more home like and interactive Educate staff to spend time with residents outside of performing tasks Encourage staff and managers to touch residents, call them by name and have small chats with them

18 Butterfly Moments

19 Goals Continued Work through the Dementia Care Matters 50 point checklist to identify areas where we can make changes, checklist includes items like: Removing uniforms for staff Staff sharing meals with residents Limited use of psychotropic medication Sensory items are available to residents Residents involved in domestic activities such as sweeping, gardening, washing dishes

20 Challenges Balancing this philosophy of care with the expectation of our numerous governing bodies: Ministry of Health, LHIN, Public Health, local Municipalities and the Fire Department Changing the culture of the Home and obtaining buy in from the staff, management, families etc. Sustaining the project Educating everyone involved to come to an understanding of the goals

21 Opportunities To provide an environment that supports our residents, engages them and gives quality to their days Our goal is to see quantitative improvement in some of our quality improvement indicators : such as responsive behaviours and falls To become a leader in changing the way we deliver care in Long Term Care

22 Financial Implications At this time there is no budgeted dollars specifically for this project We would be interested in further investigating costs to move forward with this project in a more formalized way.

23 Future Plans Expand the Noble Project Home Wide Continue to use Best Practice change ideas to provide Client Centred Care Continue to look for opportunities to be a leader in Dementia Care Propose a Specialized Resident Home Area to the LHIN for residents with Responsive Behaviours based on the Philosophy of Dementia Care Matters

24 Thank You!