Making the right choice Specialist nursing care - a guide for families

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It can be a very emotional and stressful time when you or a family member decides to move into a care home. Often this is totally new territory and the decisions required can feel daunting and overwhelming.

These emotions are totally understandable. We hope this guide will help to make the process a little easier and provide you with the information you need to make an informed decision.

Welcome

In this guide:Welcome 03About us 04What’s involved in choosing a home? 06Funding 07Respite care 09Personal stories 10Why choose an Exemplar home? 16What’s life like in an Exemplar home? 18Frequently asked questions 20

About usOur care homes provide highly specialist nursing care for

adults with complex needs. This could include people with

neuro-disabilities, brain and spinal injuries, stroke, mental

ill-health, complex dementia, autism and learning disabilities.

When you choose an Exemplar home,

you’re choosing one of the leading

providers of specialist nursing care in

the UK. We have a reputation for

delivering truly person-centred care

built around an individual and their

unique needs and goals.

Our mission, to make every day better for everyone we care for, sits at the heart of everything we do. We enhance the lives of our residents, families and care home teams by providing everyone with the opportunity to develop, grow and reach their potential – irrespective of health or ability.

Exemplar currently has 26 care homes across Yorkshire

and the Humber, the Midlands, and the North West, and

plans to open several new homes in 2019 and beyond.

“My sister has a long-standing acquired brain injury and has complex needs. Havenmere is by far the best residential home in which she has lived, particularly in respect of the understanding of her needs and the way in which she is supported. She has thrived under the care of the team at Havenmere and has achieved so much more than in other settings. The team there really do go ‘the extra mile’.” David, brother of resident at Havenmere.

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What’s involved in choosing a home?First of all, it is important to establish what type of care you or your loved one requires. If you are considering an Exemplar home, it’s likely that this will be highly specialised nursing care to meet specific needs.

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FundingBefore a decision can be made as to whether a person can be placed in a care home,

it needs to be clear how the care will be paid for. In the UK, most people have to pay

something towards the care they receive. However, people with ongoing significant

health needs, which are complex or particularly severe, may be eligible to have their

care paid for through a scheme called NHS continuing healthcare.

What is NHS continuing healthcare?NHS continuing healthcare is a package of care for people

who have been assessed as either:

• Havingongoingsignificanthealthneeds,or

• Requiring care primarily because of the nature of their health needs.

HowdoIfindoutifIqualifyforassistance?The first step is to speak to either your GP or your local social services team. A nurse

or social worker will then complete a checklist, identifying your needs and deciding

whether you need to have a full NHS continuing healthcare assessment. If you are

referred for a full assessment, information will be gathered from all relevant health and

social care professionals about your physical, mental health and social care needs.

All of this information will be given to the Clinical Commissioning Group (CCG) who may

be responsible for funding your care. The CCG will confirm their decision to you in writing

and will discuss the suggested package of care and support with you and your family.

We receive funding from a number of places including CCG’s, local authorities,

special injury specialists and private funders.

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Your right to chooseYour CCG should always involve individuals and families in the assessment process, and take your views into consideration when agreeing any care and support package and how and where it will be provided. Carers and family members should also be included and consulted as appropriate.

If it is agreed that a care home is the best option, you should be provided with a choice of homes that have the suitable experience and specialist teams to offer the correct support and care to meet your or your loved one’s needs. It is important to remember that, even if you are granted financial assistance, you do not have to choose the care home that is suggested.

You have the right to ask and challenge any decision made regarding your or your loved one’s welfare. Any decision made should be justified and that decision cannot be based on costs alone.

Considering a trial stayBefore making your decision, if possible you should try and visit at least three care homes. Whether you are visiting for yourself or a loved one, it can help to take someone with you for moral support and a second opinion.

To ensure you are completely happy with your choice, Exemplar homes offer a trial stay for up to two nights plus five additional visits to your chosen care home. This allows you or your loved one to meet and talk to other people living in the home, take part in daily life and get a real feel for what life would be like in the home.

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Respite careYou may also consider respite care for yourself or a loved one if:· the person you’re caring for wants

a change of scenery· you’re planning a holiday· you need additional support· your loved one needs help to recover

from an illness or operation· you are waiting for an adaptation to be

made to your home or a care package to be put in place

· you or a loved one would like a trial visit before considering a more permanent move.

As with every care package, our respite care is built around the requirements of each individual who will be assessed to ensure we can meet all their needs including social activities and interests. 09

Exemplar’s OneCare services

At Exemplar, we know that for many reasons, a care home environment may not be the right fit for some individuals living with complex needs. For this reason,

we have developed a range of OneCare services, which are specially adapted houses and flats in the local community, in close proximity to our care homes. In this way we can support individuals with complex needs in a less formal and enabling environment but with the continued support of a professional team that is close by.

“Mark’s OneCare flat allows us to meet his nursing and care needs, providing a high level of support in an environment designed specifically to help.”Cath,homemanager,Quarryfields.

Personal stories

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In 2005 my husband John had a series of severe strokes which left him unable to communicate, walk and swallow food. He now lives with complex needs and I care for him full time at home.

I approached Exemplar about them providing some specialist respite care and support. The assessment and clinical teams worked with both John and myself to create a tailored care package that would meet all of his needs. This covered the types of high-quality specialist care needed and his individual care goals, as well as getting to know his likes and dislikes and chosen ways of communication.

Exemplar has provided John with fantastic care over the last couple of years and are able to give him the support needed in a specialist environment and make sure his care is of the highest quality, even to the point of undertaking additional training in order to beabletoaccommodateallofJohn’sspecificmedicalneeds,someofwhichcanbelifethreatening. Having that additional support has made a huge difference to our lives.

For me, John’s respite care means that I can go and run errands more easily and have some time to myself – but all with the peace of mind that he is being looked after in a high-quality environment. It is also convenient for us as we live locally. As John visits the home on week-long respite care, I am also able to go on holiday or visit my daughter. I am so grateful to the team for all of their help and support in John’s care – I know that he is happy with the care he receives and I wouldn’t want him to go anywhere else for this treatment.Joanne, wife of John.

Respite care with peace of mind: Joanne and John’s story

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Personal stories

Finding that special place: A family’s personal experience

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When our dad became ill, we went through some very difficult and emotional times as a family and finding a trusted care home for our loved one was one of the most stressful. Having the right place for him to be cared for was paramount in our minds, so that we could make his life as comfortable and settled as possible.

Havenmere has that special feeling of ‘home’ as soon as you arrive and all the staff ensure they extend the same kind welcome every time. They take a genuine interest in the lives of the people who live there and are enormously attentive to their needs, both physical and emotional. The place has a fantastic social aspect to it for the residents but still greatly respects those who wish to live a less involved, quieter lifestyle.

Havenmere have helped us keep our dad’s quality of life the very best it can be which is so important to him and to us, whether this was through his regular trips to the beachfront, personalising his room to his own tastes or assisting us with the serious challenges that dad’s condition regularly throws at us all.

We could not recommend Exemplar more for their professionalism, but it’s the personal aspect which really makes the difference and provides us much needed peace of mind. There is always someone on hand to ensure that our dad receives excellent individual care for his condition and is treated with the dignity he deserves.

Claire and James Manship and family.

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After two years of hospital visits and tests, my wife, Barbara, was finally diagnosed with Huntington’s disease in 2007. The news changed our lives - Barbara had to give up her job as a teaching aide working with children with learning disabilities and I reduced my hours at work in order to look after her at home with the help of part-time carers.

As her condition progressed I reluctantly had to place Barbara into care with respite visits at home over the weekend, however even this had to stop as her condition worsened to the point where she had to leave the care home and was sectioned in a mental health unit until her medication could be stabilized.

This was an extremely stressful time. The home where Barbara had been previously refused to readmit her and I felt alone and distraught. None of the homes suggested to me seemed suitable and it was only when the Huntington’s Disease Association mentioned Exemplar that I saw some possibility, but the home suggested was 70 miles away. Desperate to find somewhere, I visited and was immediately impressed by the home, the care offered and the residents who seemed happy and settled. I was then told that there was a home nearer to where I lived and a place might be available in the near future. Fortunately, this was the case and I made my mind up on the spot, although still 30 miles from my home, I knew this was the place for Barbara.

I visit Barbara four times a week, take her out and accompany her on trips and outings. Until our dog passed away, I was able to bring him into the home to visit – whilst only a small thing, this made a huge difference to Barbara’s happiness.

The news that changed our lives: John and Barbara’s story

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If I were to offer any advice to others it would be the following:o Listen to the advice offered by the professionals but also do your own homework.

o Don’t be afraid to question and make your own suggestions.o Visit the homes yourself and talk to the people living there.o Although you might be under stress, take the time to find somewhere you are happy with and find out what is on offer. Getting the right placement is so critical. Without the quality of care here at Exemplar I would be lost. The reassurance of a good placement is an amazing thing.John, husband of Barbara.

Personal stories

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Excellent care is a given, what makes us different is our commitment to maximising the quality of life of every person we care for.Our purpose-built, welcoming homes offer a caring and supportive environment where the needs and aspirations of each individual are central to our approach to care. At Exemplar, the person, not their illness or condition, is our priority. This person-centred approach means that we really listen to our residents, finding out what they want and need and involve them in every decision about their life. We ensure all the right support and services are in place from nursing care, observation, nutrition and medication to occupational therapy and physical therapy.

Warm, kind and caring staffExemplar is committed to constantly improving the quality of care we provide and invest in our people and training to ensure our services always reflect best practice. Everyone working in an Exemplar home completes an intensive training course aligned to recognised standards within the care sector.

Our dedicated and highly skilled teams are passionate about what they do and we continue to develop our people both personally and professionally throughout their career to enable them to deliver outstanding personally tailored care.

Why choose an Exemplar home?

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A commitment to quality and excellenceWe are proud of our services and our commitment to quality is recognised and reflected in the ratings we receive from external bodies including the Care Quality Commission (CQC), the independent regulator of adult health and social care services in England; health and social care professionals and support organisations; and of course families, friends and residents.

Working in partnershipTo ensure we can provide the right level of care and support for everyone living with us, our multi-disciplinary team of nurses, physiotherapists, occupational therapists and speech and language therapists work closely with consultants, GP’s, specialist nurses, psychiatrists, psychologists and mental health teams in the community. In addition, we recognise and value the significant role that family and friends play in the recovery and well-being of residents and encourage them to visit their loved ones and be involved in their care planning as much as possible.

Truly person-centred careAll of our homes offer nurse-led care for adults with complex needs. We deliver truly person-centred care, working collaboratively with individuals to understand their unique needs and personal goals. We develop individual care plans to help each person achieve their desired outcomes including independent living where this is possible.

Warm, kind and very caring, carers are more like friends, ensuring my partner is well looked after in every aspect. The management team are brilliant, nothing is too much trouble, any queries are dealt with on the spot or as near as. Nurses are impeccable. I trust them 100%. No worries for me as my partner has excellent care. Win-win situation. Most of all my partner is happy.” Lynn, partner of resident at Bridgewood Mews.

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What’s life like in an Exemplar home?

Managers, carers and nurses selected for their skill, compassion and commitment to providing the highest quality care

Bright and spacious accommodation, either purpose-built or adapted to best accommodate the needs of residents

Fully furnished en-suite rooms with TV points, which can be decorated to individual taste

Comfortable lounges to socialise and dedicated quiet spaces

Recreational activity programmes and regular trips and outings

Dining rooms where residents can enjoy fresh, varied menus focused on providing a healthy and balanced diet

Quiet areas to enjoy time with friends and family

Access to WiFi.

Exemplar care homes provide highly individualised care, excellent facilities and expertly trained staff within a safe, warm and inviting environment. At all of our homes you can expect:

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Excellent care home, very understanding and helpful staff who do genuinely care for the residents; it’s not just their job, they really treat residents like their own family members. The home feels like a home from home. Residents (and their families) are encouraged to decorate bedrooms to personal taste to make them feel more at home. Residents have days out and are entertained during the day. An all-around excellent care home, nothing to fault.”

Kelly, daughter of resident at Kavanagh Place.

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Q: How is Exemplar different to an older person’s care home?A: Our homes differ from the traditional care home in the type of care that we provide. All Exemplar care homes provide highly specialised nursing care for individuals with complex needs arising from mental ill-health, neuro-disability, brain, stroke and spinal injury, complex dementia, autism and learning disabilities.

Q: How do you assess whether you can care for me or my relative?A: You must contact your GP or social worker in the first instance who will assess your individual case and identify if funding can be provided.

Q:IfI’mreceivingfinancialassistance,canIhaveasayinthechoiceofcareprovider?A: Yes, under the Government Care Act 2014, the local authority must carry out an assessment based on a person’s individual needs, taking into account their well-being and desired outcomes. This gives you more control over the type of care and support you receive and means that you do not have to choose the care home suggested if you feel your needs, or the needs of a family member would be better met elsewhere.

Q: What if I am paying for care myself? A: We are happy to accept private funders, please contact us via our enquiry line - details can be found on the back page.

Q: Can I contact Exemplar directly? A: Yes, you can contact us and arrange to visit any of our homes to look around.

Q: Can visitors stay overnight?A: Some of our homes have a guest room where visitors may stay overnight should they wish.

Frequently asked questions

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Q:WherecanIfindahome’sCQCreport?A: The Care Quality Commission undertake regular inspections of all care homes to ensure they meet government standards.

Their reports can be found on their website alongside reviews provided by members of the public. Visit the CQC website www.cqc.org.uk. Alternatively, visit www.exemplarhc.com, where all our homes have a direct link to the CQC website on their individual home pages.

Q: Can friends/family visit whenever they choose?A: Yes, Exemplar homes have an open door policy. This means friends and family are

welcome any time, though we would suggest that you make an appointment if you would like to speak to a member of the management team to ensure

they are available. We also encourage family members to be involved in care planning and our homes hold regular resident and relative meetings

where loved ones can share their suggestions and feedback.

Q: Is an increased level of care available should it be required in the future?

A: At Exemplar we review each person’s needs regularly to ensure we have the correct care and support in place. We manage a range of complex disabilities and conditions including those requiring high dependency nursing

(including enteral feeding regimes and airway management through tracheostomy care).

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Q: What is the ratio of support staff to each resident?A: Each person is assessed individually and the package of care and staffing levels reflect the care and support required to deliver truly person-centred care.

Q: Are residents involved in decisions about life in the home?

A: Yes, we put residents at the heart of everything we do and by listening and acting on what they say we ensure they have

a real say in the running of our homes. Our resident council has a direct link to our board of directors and is involved in all aspects of

managing a home including addressing decisions that directly affect them such as recruiting and interviewing our care home teams.

Q: Does each resident have their own personal care plan?A: Everyone is different and Exemplar’s approach begins with person-centred planning which includes an individual’s goals, beliefs and aspirations. By really listening to people and finding out what they want and need, we can then make sure our care plans and services are tailored to individual needs.

Q: Are special diets catered for?A: All our menus offer freshly cooked, appetising and nutritionally balanced meals, which take into account personal preferences, condition-specific and religious dietary requirements.

Q: Can residents personalise their rooms?A: Yes, we encourage residents to decorate their bedrooms to suit personal tastes to help them feel more at home.

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Q: Can residents continue to do the things they love?A: Our homes support residents to make choices about how they live their lives, their hobbies and interests and every home organises activities, trips and outings which reflect the interests and wishes of residents. We also support people back into work or full-time education where appropriate.

Q: Can residents still be part of the community?A: Residents are encouraged to access local community facilities and are supported as necessary to continue to live as independent a life as possible.

Q: Do the staff give residents the opportunity to help with activities within the care home, e.g. gardening or cooking?A: Yes, residents can help with day-to-day activities, from making a cup of tea to cooking, doing laundry and gardening and in this way develop their independence, confidence and life-skills in a home from home environment.

Q: Can I or my loved one leave the care home should my/their condition improve?A: Our specialist nurses and life-skills teams support residents to live their lives as they choose and to progress their journey to rehabilitation and independence and where possible, a return to life within the community.

Some of our homes offer OneCare services (see page 9), which are specially adapted individual houses and flats in the community for service users who do not require the full-time care of a home, but still require support. Individuals can further progress their journey towards independence as part of their recovery pathway, whilst still having the support of the main home as and when they require it.

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If you would like to find out more about Exemplar care homes:

Call 01709 565777

Email enquiries@exemplarhc.com

www.exemplarhc.com