Involvement in my care plan - “I can change

Involvement in
my care plan “I can change
things”
Jack*, service user, March 2014
Ranaich House
Residential Care Home with Nursing
01786 823 694 | danshell.co.uk
Ranaich House
Residential Care Home with Nursing
Ranaich House situated in Dunblane, is a residential care home with
nursing which supports up to 12 people who are living with a
learning disability and complex needs. The service also supports
people who have additional mental or physical health needs
including behaviours which are perceived to be challenging.
People may come to
Ranaich House for different
reasons. They may come
following a stay at an NHS
or other specialist hospital
or may be people who need
more support than a
residential care home can
provide. They may also be
people who are on a
journey towards a place of
their own in a supported
living arrangement.
At Ranaich House we
believe that everyone
should be treated as a full
and valued member of their
community with the same
rights as everyone else.
Therefore, our focus is
rehabilitation and the health
and well-being of our
service users, developing
trusting relationships and
attaining positive outcomes.
Service users are
encouraged to identify and
achieve their own personal
aspirations using person
centred thinking and
approaches.
Get in touch
Ranaich House Residential Care Home with Nursing, Leewood Road, Dunblane, FK15 0DR
01786 823 694 | info@danshell.co.uk | www.danshell.co.uk
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Ranaich House 2 3
Service User Pr
ofile
and Admission C
riteria
Adults 18+
mixed gend
er.
Primary diag
nosis – learn
disability wit
in
h complex n g
eeds.
Diagnosis m
ay include: p
who have ad
e
ditional men ople
and physica
tal
l needs.
May have an
spectrum co autistic
ndition.
We believe that everyone should
be treated as a full and valued
member of their community
with the same rights as everyone else.
Ranaich House
Residential Care Home with Nursing
About Ranaich House
Ranaich House is a large
period detached property
which has good sized
living areas, a dining
room, and a well-stocked
activity room.
Everyone at Ranaich
House has their own
bedroom and people are
supported to personalise
their own space in a way
that they would like.
There are two Activities of
Daily Living (ADL) kitchen
where individuals can
menu plan and prepare
their own drinks, snacks
and meals. Externally
there is a spacious and
private garden which
hosts seating and picnic
areas for relaxing or
enjoying time with friends.
Ranaich House is within
walking distance of the
small cathedral town
of Dunblane which
has a good choice of
recreational and leisure
facilities including parks,
a library, cafes and shops
for people to access.
Individuals can enjoy
walks in the outstanding
surrounding countryside.
When a person comes
to Ranaich House we
like to find out what
they like to do and what
interests them. People are
supported to plan menus,
shop and prepare food
with support to increase
their daily living skills
in readiness for moving
on. Many people are
supported in education at
local colleges and some
have paid or voluntary
work placements which
also promotes skill
development.
Our goal is to enable
people to structure their
time; build relationships
and establish a balance
between therapy, selfcare, work and leisure
as appropriate to
their individual needs.
Community based
activities give people
opportunities to meet
others, experience new
activities, participate
in leisure activities and
practice social skills.
Activities depend on
individual preferences
and can include a variety
of community based and
educational choices.
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Ranaich House 4 5
Ranaich House
Care pathway
Monroe House
If in crisis or needing
extra support from
home, supported
living or residential
care
Residential
care
Trinity
House
Supported/
Independent living
Independent
or NHS
hospital
Staff team
The service is staffed 24
hours a day, seven days a
week with a registered nurse
on duty at all times. The team
is made up of a registered
service manager, nurses,
support workers, an activities
coordinator and ancillary
staff, along with support from
psychiatrists, psychologists,
occupational therapists
and speech and language
therapists. Staff undergo
training in order to help
support people to manage
long term health conditions
such as diabetes, epilepsy
and dementia. We are
committed to the learning
and development of our
staff as stated in our Quality
Strategy and Personal PATHS
model of care.
We have also created a
Training and Development
Strategy which reflects the
importance of increasing
people’s confidence,
knowledge and expertise.
Ranaich House
Model of care - Personal PATHS
At Danshell we believe that we must be fully accountable to those we serve,
their families and to those who commission services on their behalf. In order to do
this we have described what we do in a straightforward and transparent manner
based on 5 key principles.
These 5 key principles form the foundation stone of our model of care and are:
Positive
Behaviour
Support
Appreciative Therapeutic
Inquiry
Outcomes
Positive behaviour
support
Many of the people we
serve at Ranaich House
have behaviours that
challenge services. We
believe that we have
to make a long term
commitment to providing
the right support for each
individual to improve
their quality of life.
This does not mean that
people need to remain in
the same place but rather
we continue to support
them in a person centred
way along their care
pathway and ensure that
Healthy
Lifestyles
what we learn about
the person and the best
way to work with them,
is respected, applied
and built on.
Importantly, our way of
working supports people
to be included in their own
communities and promotes
choice and control, the
development of skills and
alternative strategies for
coping with challenging
situations.
To enable this to happen
we implement a range of
interventions including:
Functional Assessment
of Behaviour.
Safe
Services
Personal Positive
Behavioural Support
Plans.
Individualised activity
and skill acquisition
programmes.
Education and
employment
opportunities.
Specialist assessments
of need and risk e.g.
HCR-20.
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Ranaich House 6 7
Discover
Appreciative inquiry
At Danshell we are clear
that our values and beliefs
are the foundation on
which our work is founded.
If our foundations are
strong our care and
support will be strong.
We believe that we take a
strength based approach
to the people we serve and
the staff that support them.
To enable us to do this we
have taken an appreciative
approach to care delivery
and organisational
development.
How we do this for
individual service users and
families is through a range
of measures that include:
Involving the service
user in the design,
development and
evaluation of our services
using appreciative summit
meetings.
Using person centred
approaches in our
assessment and care planning processes e.g.
Deliver
The
appreciative
cycle
Design
what makes a good
day/ bad day for the
individual.
Employing person
centred tools to capture
what we like and admire
about them, their
strengths and talents
and how best we can
support them e.g.
One Page Profiles.
Listening to the individual
and their families and
using tools to capture
their compelling
vision for the future
e.g. MY CPA,
Person Centred
Care Plans
and Life
Story books.
Dream
Ranaich House
Residential Care Home with Nursing
Therapeutic outcomes
A core belief of our
organisation is that we are
accountable for everything
we do with the service
user, their family and
those who commission on
their behalf. To do this we
must demonstrate good
outcomes and measure
them in ways that are
valid and inclusive.
The Outcomes Star™ using relevant version
depending on age
and needs.
The Health Equality
Framework (HEF).
Clinical outcome
measures such as
HoNOS.
These tools place the
person and their family
At Danshell we use a
central to the process
range of clinical and risk
assessments depending on and enable us to support
need but most important to and measure change with
this methodology is the use each individual.
of comprehensive outcome
tools, these are:
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Ranaich House 8 9
Healthy lifestyles
We know there is a solid
body of evidence about
the positive effects that
diet and exercise can
have on mental health
and also that people with
learning disabilities and
mental health problems are
more likely to experience
ill health and premature
death.
At Danshell we want to
ensure that the people we
serve have the best chance
of living a healthy life and
that we do all we can to
enable this by providing:
Robust individualised
activity programmes
for everyone.
Health Action Plans
and Hospital Passports.
Healthy lifestyles groups
and health improvement
interventions such as
smoking cessation,
relaxation classes,
anger management,
weight reduction
programmes etc.
Implementation of
the Health Equality
Framework (HEF).
Access to national
initiatives to promote
sport and exercise e.g.
Special Olympics.
Ranaich House
Residential Care Home with Nursing
Safe services
We serve many vulnerable
people who need to
feel and experience care
that is safe, sound and
supportive. We take this
need very seriously and
have developed a quality
assurance and governance
system that provides us
with the measures and
tools to ensure we can
monitor, improve and
check our services robustly.
By setting targets and
working directly with
service users and families
we are clear about
‘what good care and
support looks like’ and
strive to deliver to their
expectations. We check
and support this goal by:
Applying a robust Quality
Assurance System
(QDR’s) and annual
audit programme.
Training and working with
service users and families
to check the quality of
our services.
Measuring and
monitoring different
aspects of clinical care
e.g. reducing the use
of restrictive physical
interventions, incidents.
Providing an extensive
library of accessible
information for service
users.
Service user and family
carer feedback systems.
Our organisation is
committed to delivering
care and support in a safe,
dignified and respectful
manner. We have an
extensive governance
system called ‘Safe, Sound
and Supportive’ that
monitors individual and
organisational performance
against a range of safety
and outcome indicators.
Using electronic reporting
systems we are able to
monitor and act swiftly
in response to incidents
or untoward events. Our
systems and structures
provide what we believe
to be a ‘gold standard’
approach to securing
service user safety.
Across all services there
is an independent and
confidential whistle
blowing policy and service
for all staff to use if they are
worried about service user
safety, care and wellbeing.
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Ranaich House 10 11
Family matters
At Ranaich House we know
that the people we serve
are part of a wider circle of
family, friends and networks
that are important to them
and therefore, important to
us. We work in partnership
with them to ensure we
provide the right service
for their relative but also
to support them in their
own right as a family carer.
Family carers and important
others are encouraged
to develop good contact
arrangements with staff at
Ranaich House. We look
forward to receiving visitors
and family carer and friend
updates are welcome too,
either by email, phone
or Skype.
The Danshell Family
Carer Forum is run
independently by a group
of family carers and there
are representatives from
This image shows
the first family carer
newsletter, produced by
the Family Carer Forum
every region of the UK.
The forum facilitates family
carers to ask questions,
discuss worries and support
one another. It produces
a quarterly newsletter
which helps families share
experiences as well as
keeping people up to date
with benefit information,
legislative changes
and relevant Danshell
developments. Your
service manager can give
you details of how to get
in touch or contact them
through the on line forum
on the Danshell website.
Ranaich House
Residential Care Home with Nursing
Service user involvement
We encourage people to say
how they feel about all
aspects of the service they
receive and we give them the
tools and support to do this.
This includes their views
about how we deliver
support to them, their care
plans and the activities they
want to do. At Ranaich House
we support people to be part
of the service user forum.
Here, they can tell us what
matters to them, their points
and actions are noted. This is
then created in an accessible
format and fed back to the
manager to act on and
feedback is given to the
group. We also support
people to attend the regular
regional service user forums
which are a great way for
people to meet new people
from other services and
exchange ideas.
A number of service users
have been trained as Experts
by Experience or Quality
Checkers, their role is part
of the Quality Development
Review Team who inspect
services to make sure they
are good. We also train and
support people to be a
valued member of the
recruitment and interview
process in many of our
services. We have devised
policies, communication and
measuring tools to enable
this to happen across all
of our services.
Feedback from the people
we serve is vital to making
sure we are doing things well.
We have post CPA and
service user exit
questionnaires which are used
to support people to do that.
Adapted questionnaires are
used for people who need
support in communication
and that way we can be sure
all voices are heard and acted
upon. All feedback is collated
and fed back to the board.
The advocacy group working
at Ranaich House is called
Central Advocacy Partnership
and everyone we serve has
access to an independent
advocate.
Danshell is committed to
developing services that
reflect what the people who
use our services and their
families tell us is important.
This includes ensuring they,
their family and carers are fully
involved in processes such
as the Care Programme
Approach (CPA) and in
evaluating the service we
provide.
These images are posters
which service users, families,
staff and commissioners
made at one of the recent
Quality Roadshows. These
posters told us what people
thought “good” looked like
and they were used in
devising the Danshell
Quality Strategy.
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Ranaich House 12 13
Louise –
Ranaich House Activities Co-ordinator
As activities co-ordinator I
support service users to have
individual person-centred
plans. I spend time each
week supporting people
on a 1:1 basis using their
own preferred method of
communication to develop
their own individualised easy
read weekly activity planner.
At Ranaich House, we support
each service user in a minimum
of 30 hours of meaningful
activities every week. Activities
are tailored to reflect a
combination of an individual’s
likes, wants, needs, personal
goals and ambitions as well
as any therapeutic goals set
out within their care plans.
Some individuals prefer to
develop their independence
and life skills including
shopping, cooking, laundry,
using public transport,
budgeting and personal
safety. Others like activities
that support individual choices
including sports or hobbies
such as football, bowling,
crafts, movies, archaeology,
and music concerts. Many
activities are community based
including opportunities for
education and training.
“We support each service
user in a minimum of
30 hours of meaningful
activities every week.”
Archie* moves on
When Archie* first came to Ranaich House he was a
shy man who struggled to express himself. His life
experiences were limited to what his small home-town
could provide. His only aspiration was to live with his
family who were 100 miles away.
Whilst at Ranaich House many opportunities opened
up for Archie*.
He wanted to learn to read; the team at Ranaich House
assisted him to attend literacy classes.
He wanted to lose weight; Archie* was supported to
join the gym.
He asked for a programme of care which promoted his
independence; the team at Ranaich House worked hard
to make this happen.
He needed to be with his family; Archie* was supported
to maintain these important relationships.
Through hard work, a person centred approach and
positive attitude Ranaich House helped Archie* to
get the things he wanted in life with great humour
and personality. After a successful transition period
Archie* moved into his own flat with support, which was
importantly, only a 45 minute bus journey from his family.
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“I enjoy cycling,
football and walk
ing
to the shops”
Sam*, service user
, March 14
About the Danshell Group
Danshell is a provider of health and social care in the UK,
caring and supporting young people and adults through
specialist hospitals and residential services.
Our locations
SCOTLAND AND
NORTHUMBERLAND
LEARNING DISABILITIES
AND COMPLEX NEEDS
independent hospitals
KEY:
A Inverclyde
B West Dunbartonshire
C East Dunbartonshire
D North Lanarkshire
E Glasgow City
F Renfrewshire
G East Renfrewshire
H Clackmananshire
I Dundee City
J Aberdeen City
Moray
Highland
2 Chesterholme
Hexham, Northumberland
Aberdeenshire
J
7 Monroe House
Dundee, Angus
residential services
with nursing
Angus
7 14
8 Oaklands
Hexham, Northumberland
Perth and Kinross
I
14 Ellen Mhor
Dundee, Angus
15 Ranaich House
Dunblane, Perthshire
18 Trinity House
Lockerbie, Dumfries & Galloway
Ranaich House
Argyll
and Bute
Fife
Stirling
B
C
A
E
F
North
Ayrshire
15
H
Falkirk
D
City of
West Edinburgh
Lothian
Midlothian
East
Lothian
G
South
Lanarkshire
Scottish Borders
East
Ayrshire
Northumberland
South
Ayrshire
18
Dumfries and Galloway
2
8
Get in touch
Manager - Heather Brown
heather.brown@danshell.co.uk
Ranaich House Residential Care Home with Nursing,
Leewood Road, Dunblane, FK15 0DR
Lincolnshire
01786 823 694
Cheshire
Nottinghamshire
Derbyshire
For referral or to organise a visit to Trinity House
please contact Colin Beattie on 07875 409833
colin.beattie@danshell.co.uk
Staffordshire
*service user names in this brochure have been anonymised
Leicestershire
Shropshire
Rutland
Norfolk
Huntingdonshire
Northamptonshire
Worcestershire
Warwickshire
All literature featured in this brochure is available on request
Suffolk
www.danshell.co.uk
Cambridgeshire
Bedfordshire
Herefordshire
Essex