AQW 12943/17-22


Ms Paula Bradshaw
Alliance Party
South Belfast


Tabled Date: 19/01/2021
Answered On Date: 10/02/2021
Priority Written: No


Question:
To ask the Minister of Health what specific support is being given to people with dementia living in care homes, given their particular circumstances, including with reference to care partners.


Answer:
All individuals with or without a dementia residing in care homes have individual care and support plans in place which continue to be reviewed on a regular basis to ensure it meets individual assessed need.
Residents living with a dementia in care homes are a particularly vulnerable population given the impact of the pandemic on their routine.
There are a number of regional supports available to care homes with dementia units. These include staffing and financial support where enhanced staffing assists with maintaining residents’ social distancing, regular hand hygiene and provision of individual activity and meaningful occupation. The Northern Trust for example has provided additional bespoke one to one care for those residents with dementia who have been required to self-isolate as per covid regulations and who could not do so by themselves due to cognitive impairment.
Extra training and education sessions related to supporting dementia residents and care staff to understand and respond to changes in behaviour in people with dementia during the COVID-19 pandemic have been provided on a regional and Trust basis. This includes sessions on the importance of activity and meaningful occupation.
Additional written information and handouts relating to managing and communicating with residents during the covid pandemic have also been forwarded to care homes by each Trust.
There are also a number of ongoing initiatives by individual Trusts. These include:
The NHSCT commencing to pilot a service into 3 care homes in the East Antrim locality from 18/02/21 until 31/03/21. This service will utilise a multi-disciplinary approach to unwell residents and assess for early detection of frailty and decline in their residents. An element of this service will be psychological care and assessment provided by a clinical psychologist who will review residents exhibiting distressed behaviours. They will also be reviewed alongside the associated AHP’s to provide a comprehensive clinical care plan and interventions for these identified residents, including a medication review by the Pharmacist.
The NHSCT Responsive Education and Anticipatory Care for Care Homes team (REaCH) in conjunction with the East Antrim GP Federation have 2 Clinical Nurse Specialists appointed and aligned to the East Antrim locality to undertake Nurse Led Community Anticipatory Care Plans (NLCACP) in care homes. They will review residents within the care home setting with a focus on residents and families wishes and plans for future care needs. This will include the discussion and support required for those residents who have palliative care needs.
Since the beginning of the COVID-19 pandemic, the SHSCT have facilitated a regular virtual Care Home Managers Meeting, as well as an Extension of Community Healthcare Outcomes (ECHO) Education programme. Both of these forums have afforded the opportunity for ongoing support and education to Care Home Managers and their staff in relation to the care of people living with dementia.
The impact of restrictions on visiting and contact with families has been recognised and the Trusts are working in partnership with families and care homes to ensure contact is being maintained between residents and relative in line with regional visiting guidance.
It remains my position that care home visiting and the subsequent implementation of the care partner role is of critical importance to the health and wellbeing of care home residents and in particular those with a dementia.
Care partner contact is in addition to visits to a resident which are organised according to the care home’s visiting policy and the DoH Covid-19 regional principles for visiting.
The increase to Level 5 visiting restrictions will not prevent care partners from being permitted access to care homes. Care homes are being actively encouraged to adhere to all aspects of the revised visiting guidelines, including the introduction of care partners, and care partner contact can continue providing that visits are aligned with infection prevention and control measures. In addition, my Department is currently undertaking work to facilitate the testing of care partners as part of the care homes staff testing programme.
Trusts will continue to engage with care homes to reinforce the Care Partner message. Key workers are also ensuring in family communications that they are aware of this role and offering support to families to help them set up the role when they identify a need.
The Care Home Manager is still responsible for permitting visitors into a home on a day to day basis and there may be, of course, circumstances where visiting may be restricted further. In such cases the full visiting guidance should be referred to. As well as Trusts, the HSCB and PHA are working with those homes who are finding implementation more challenging – identifying and sharing good practice.
We continue to live and work with the threat of Covid-19. While we wait as the vaccination programme is rolled out, it is still important to take measures to minimize risks of spread of infection alongside providing safely managed but meaningful visits for residents with their loved ones.