HC-One Scotland recognises success of dementia project with Care InspectorateHC-One Scotland, in collaboration with the Care Inspectorate, has achieved significant success in a project aimed at reducing inappropriate psychoactive medication for individuals living with dementia.
Conducted across eight HC-One Scotland care homes over nine months, the initiative resulted in improved outcomes for residents. Care teams demonstrated a commitment to learning and sharing best practices, contributing to a collective effort to address common challenges in dementia care.
It resulted in improved resident outcomes, better quality of life, and empowered colleagues across eight participating care homes – and will be featured in the Scottish Government’s new Dementia Strategy.

The challenge

Recognising challenges in medication management within the social care sector, the project stemmed from a collaboration between Katy Jenks, Dementia Care Manager at HC-One, and Dr. David Marshall, Senior Improvement Adviser (Pharmacy) at the Health and Social Care Improvement Team in the Care Inspectorate.
HC-One Scotland wanted to support the health and social care system and achieve better outcomes for people living with dementia, and for care home teams to be more confident to call for change and challenge the status quo.

The approach

The project focused on minimising the reliance on routine and as-needed psychoactive medication for managing stress and distress behaviours among people living with dementia.
Through the implementation of Antecedent (Action), Behaviour, and Consequence (ABC) chart completion for all medication administrations and peer reviews, the team prioritised understanding the underlying causes of behaviours, ensuring medication was utilised as a last resort.
Katy Jenks, Dementia Care Manager (Nursing) at HC-One said:
“It was a very inspirational project to cohost with the Care Inspectorate, watching frontline staff embrace a new way of working that had positive impacts on people in our care and wanting to share this with others reminded why I wanted to be a nurse and work in dementia care. They embraced finding the “why” for behaviours and adapt care so that medication was only ever a last resort resulting in better quality of life outcomes for people in our care and improved job satisfaction for colleagues who work in these homes.” 

Key findings

Residents who had their medication reviewed experienced increased engagement, mobility, and independence. 

Quality of life improvements included increased happiness, activity levels, and participation in meaningful activities.

Colleagues also gained confidence in advocating for residents and finding non-pharmaceutical solutions. 

Success stories

Hillside View Care Home: Colleagues recognised that the height of care assistants  contributed to a resident’s stress. By identifying this, colleagues were able to provide better personal care for a resident living with dementia – who has since become more accepting of personal care without becoming stressed, as well as gaining weight and becoming more engaged in activities following a reduction in medication. This personal care story will be included in the delivery plan for the Scottish Government’s ten-year Dementia Strategy.

Fullarton Care Home: By identifying residents with changing needs requiring a review of medication – and understanding why each person was prescribed – the team worked with a GP and managed to achieve a 65% reduction in unnecessary psychoactive medication doses. Residents were notably more engaged and active, with one relative commenting: “The feisty wee woman I knew is back!”

Charlotte Beaumont, Home Manager at Fullarton Care Home, said:
“The team are now asking questions as to why people are on certain medication and if it needs reviewed. This has been a big change as before I would have had to have started these conversations.”

Project expansion

HC-One Scotland aims to expand the ‘Reducing Inappropriate Psychoactive Medication For People Living with Dementia’ initiative to additional care homes, with plans to roll out the program from March 2024.
The success of this collaboration with the Care Inspectorate serves as a testament to the transformative potential of person-centred care in dementia management - paving the way for improved quality of life and well-being for people living with dementia.
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