Treating dementia with dignity: The Orchard Centre
At Care UK, more than two thirds of the people in our care homes and day centres have dementia, and we are dedicated to helping each one of them to enjoy lives that are as independent, active and fulfilled as possible. Ensuring people still feel valued is critical – and an innovative model has been developed to achieve this goal.
Located in Epsom, Surrey, The Orchard Centre, is a community-based day and night care centre. It provides a welcoming and supportive environment for those aged 50 and over with dementia or memory impairment, from those in early onset to people with more advanced cases.
As service users can spend between four and twelve hours at The Orchard Centre within any 24 hour period, it presents a flexible resource where those with dementia can benefit from dedicated care while still retaining the independence of living in their own homes. It also enables their carers to continue with their daily lives, knowing their friend or relative is receiving the best possible care while they run errands or enjoy some all-important respite.
This approach also offers significant cost savings and efficiencies when compared to often costly hospital or care home placements. Prices are set at £9 per hour (or £10 per hour after 6pm), which includes freshly prepared meals. These costs tend to be met either from the service user’s personal budget or via direct payments from local Social Services.
Referrals to The Orchard Centre come from a variety of sources, including Social Services and GPs. The Centre also works with the wider health and social care community including charities such as the Alzheimer’s Society who have first-hand knowledge of the service. In addition, many service users and their carers contact the centre direct, after hearing positive reviews of the service from other clients.
Empowerment through activity-based care
While there are many community-based day care centres across the country, what sets The Orchard Centre apart is its unique approach to activity based care. Service users are made to feel part of the centre, and are encouraged to help with daily tasks, such as laying the table, or looking after people with more advanced dementia. This helps to maintain their sense of ‘usefulness’ and ensures that clients don’t feel that they’ve been sent to the service just to be looked after.
The night service is a special strength. As many service users can be prone to restlessness, or simply may not sleep at night, there is a full programme of activities available 24 hours a day to keep people entertained and safe, and allowing their carers to take a break or enjoy an evening out, for example.
The centre has places for 25 people during the day, and ten at night, with staffing levels adjusted according to occupancy.
Elaine Carruthers is the Centre Manager, and leads an eight-strong team which includes a deputy manager, general carers and two drivers, who transport service users between the centre and their homes.
All members of the Orchard Centre team are fully trained in working with people with dementia or memory impairment. They can administer medication for service users if required and can also manage those clients with other needs and conditions, such as incontinence.
But beyond formal training and qualifications, staff at The Orchard Centre are chosen for their compassion, caring natures, patience and understanding. Each service user is assigned their own dedicated carer, to make sure personal preferences and needs are always considered and placed at the forefront of care.
Elaine said: “One of our key benefits is our flexibility. As we are open 24 hours a day, seven days a week, we know how important it is to ensure everybody’s care needs are met. Many of our users book their time to visit us in advance, but often we will receive a call in the morning with a request for care that day, and we pride ourselves on always being responsive and accommodating.
“This peace of mind is particularly important for families, who know that if an emergency crops up, they can still secure care for their loved ones in a cost effective way and at short notice.”
A personalised approach
Assessment of each service user’s requirements is also flexible, depending on their needs. A typical assessment process may involve arranging a brief visit to the centre and time for a cup of coffee with other clients. On a second visit the person may then spend a bit longer at the centre, enjoying some lunch and joining in one of the activities. By gradually introducing them to centre and the staff, while assessing their requirements, staff can ensure each client receives the care that they require.
Elaine said: “We think it is unfair to assess or judge someone on the basis of a single observation visit over the space of an hour or two. We spend time to properly assess our clients, catering for them and their wants and requirements. People are more than just their diagnosis, they are individuals and we make sure we always treat them as such.”
A range of activities are offered by the centre, including quizzes or reminiscence sessions where service users are encouraged to remember and discuss events from their past. Discussions on current affairs and reviews of the newspapers also take place, with service users encouraged to lead sessions and play an active role in the centre’s activities. Weather permitting, clients can enjoy the centre’s extensive outdoor area, either relaxing in the sun or helping with gardening.
Purpose-built with users in mind
Constructed in 2006, The Orchard Centre is purpose-designed to ensure that service users do not become lost or feel trapped. It is built as a circle, meaning that all rooms and corridors lead into each other and an easy through-flow is maintained throughout the building. There is a dedicated quiet area, as well as a dining room and activity areas.
Elaine said: “We are always mindful that our service users are adults, and should be treated as such. No area of the building is off limits – our clients can use the kitchen to make tea or help with the washing up for example, and this activity based care helps in retaining independence and a feeling of contribution and usefulness.
“Rather than a day and night care centre, we almost think of ourselves as a club. Our service users, or club members, get to come and enjoy activities relevant to them in a comfortable and inviting environment. Their carers also benefit from vital respite, while still enjoying peace of mind that their loved ones are being well looked after.”
