A Revolution in caring for the elderly is taking place creating agonising choices across Cheshire. The number of people over 65 has doubled in the last 70 years and continues to grow with the cost of running nursing homes escalating year by year.
BARRY ELLAMS highlights the conflict of emotions taking place in one care home where elderly residents are being relocated to create a specialist unit for dementia patients.
A NUMBER of elderly residents are to be moved from Sherwood Court residential care home in Helsby under plans by owner group CLS to convert the home into a specialist unit for dementia patients.
Twenty four existing patients have been offered the option of relocating to neighbouring Loxley Hall on Robin Hood Lane. Residents were informed during consultation with families and Cheshire Social Services that alternative accommodation would be sought for them if they didn't wish to relocate.
Up to now the home has provided accommodation for low to medium dependency residents, who have been able to enjoy an independent and active lifestyle.
However, the demand from these residents has decreased, with five to six vacancies existing at Sherwood Court at any one time over the last 10 months - putting extra-financial pressure on the services they provide.
CLS, which is a charitable not-for-profit organisation, is currently undergoing a county-wide programme to provide places for dementia care in Cheshire, with more than £600,000 being spent on upgrading facilities.
As provider, it has acted on a County Council policy of taking on more residents suffering from dementia to plug the yawning gap of increasing demand becoming a prominent Cheshire-wide problem.
The number of referrals for Dementia residents in recent months has increased and CLS took a number of sufferers on at Sherwood Court, which has caused problems for existing residents. Pensioners who have been long-standing residents at Sherwood Court lodged objections as they were very unhappy at being mixed with residents who needed increased supervision.
This led to CLS creating two separate care service units. A specialist unit at Sherwood Court for Dementia sufferers and Loxley Hall, which will accommodate residents with low to medium dependency.
Theresa Lundy, Home Manager at Sherwood Court, explained that the move would be done in a sensitive manner as places became available.
She said: 'Our residents obviously develop friendships over the years so we will be moving friends together - and we are transferring some of our own staff to Loxley so there will be plenty of familiar faces around when they are settling in.
'There is a lot of work to be done at Sherwood, including colour-coding all the doors and changing the decor, as even having the right sort of pattern on a carpet can make the living area more recognisable for people with this condition'.
In both selection and training, CLS was seeking to ensure that staff could demonstrate a real understanding of the effects of the dementia process on the person.
'Staff can display their support for a person with dementia in a huge variety of ways - holding a person's hand, reassuring someone, having a conversation about a person's past, dancing to a tune on the radio,' she said.
'Natural warmth and the ability to 'stand in the shoes' of the person with dementia are the qualities we seek in the appointment of staff, for it is this that lies at the heart of person-centred care
'Moreover, the training programme we have developed is designed to help staff express their natural warmth and concern in ways that will be of specif ic benefit to the person with dementia.'
The Helsby development will create 24 places but much more capacity needs to be created across the county to cope with demand, according to CLS Operations Manager Kerry Fisher.
'Such provision represents a new departure towards caring for people with dementia,' she said.
'Although our services for people with dementia are based around the same principles as all our care services - person-centred care - our approach to dementia care has been advanced in a number of ways.'
However, a question mark remains over those patients who don't want to move to Loxley Hall. CLS has conceded that a number of patients are unwilling to move and discussions are under way between residents, families and CLS to seek alternative accommodation.
Helsby Parish Council has been contacted by a number of concerned relatives who fear that there are few alternative residential care options in Cheshire to locate them.
The Council is drafting a letter to CLS querying the options left open to those residents who don't want to move.
Cllr Frank Thomas said: 'I have been inundated with calls from people concerned with the proposal. Because of government policy, the referrals of core market residents are not coming through, there is now this phasing in of dementia residents so that nursing homes are more viable financially.
Cllr Betty Williams, who attended a meeting with CLS, explained that she was concerned that elderly residents were frightened of being uprooted.
She said: 'Communication with the elderly residents could have been more open to start with. A lot of the residents were very upset, they thought they had a home for life. I know that CLS are looking to create a specialised unit at Sherwood Court solely for dementia residents. There is a mixture of dementia and other residents, which is not ideal.
Cllr Michael Bellairs said: 'The letter I am drafting seeks clarif ication on a number of issues, namely the consultation of residents.
'I understand that CLS are a business and need to consider new options of providing a viable service but we feel that patients and families have not been properly accomplished. We have received a letter informing us of the changes expected, but to us it feels like a fait accompli rather than a consultation.
'Whilst there is provision for those residents that want to stay at Loxley Hall what about those who want to move to alternative premises? Where will they go. My concern is that there is a shortage of accommodation in Cheshire and elderly residents may have to uproot to an area outside the county.'
Cllr Terry O Neill added: 'There is a suggestion that patients will have to move to other nursing homes which we want to look into.'
Cheshire County council is aware of the dilemma of the increasing dis-proportion of elderly residents referred to nursing homes needing up to moderate care, to the rising referrals of dementia residents requiring supervision.
A Spokesman for Cheshire County council explained: 'There is a need for the further development of high quality services in Cheshire for elderly residents suffering from dementia.
People are living longer, there is a higher proportion of people in Cheshire requiring residence in residential and nursing homes.
He explained that Social Services had no option but to address the dilemma by saying: 'Our latest contract with providers has been designed to provide increasing facilities for elderly people suffering from dementia, this is an issue facing local authorities across the UK.
'Currently, demand exceeds supply, but because of our latest contract it is already producing results.
'The level of specialist care and supervision for dementia patients requires that local authorities pay more money to providers offering these facilities.'
CLS provide care for older people in residential, nursing, dementia and intermediate care They also provide respite and day care at selected locations. They have many homes across Cheshire. Over 2,000 CLS staff look after the welfare of approximately 1,600 older people. The Nantwich-based provider has already completed schemes in Crewe, Chester and Winsford.
The next scheme has now started in Helsby with the gradual phasing-in of specialist care places at Sherwood Court in Helsby. Further developments may take place in Warrington and Wigan. CLS has already:
* Set up a special dementia care unit at West View in Underwood Lane, Crewe.
* Added a 10-bedded wing at Florence Grogan House in Blacon, Chester.
* Built another 10-bed wing at The Laurels in Winsford.
* One in 20 people in the UK aged between 70 to 80 has dementia which mainly affects older people. It currently affects some 700,000 people in the country who experience problems with memory, speech and perception.