Information about the SPECAL® approach used to promote individualised and consistent care and support for people living with dementia in their own home. Contributed by: The Good Care Group

1. Application of the
SPECAL approach
in a home care environment
Zoë Elkins
Head of Care – The Good Care Group

2. Our Company
• Providers of award-winning, high quality home care
services since 2009
• Registered in England and Scotland
• Employs over 200 people
• Founders/management team passionate about service
ethos in care market – make a difference
• Extensive board and management team expertise
• Over 30 years’ care sector experience
• Ambition to be market leading, set the
standards, revitalise industry & professionalise care
• Specialist in care of conditions – dementia, Parkinson’s
• Fully compliant service inspected by CQC

3. Our Vision
To be the leading provider of high quality
care in the home that enables older
people to enjoy staying safely and happily
in their own homes and own community
for as long as possible, whilst enhancing
their well-being and lifestyle

4. Our Clients
• Older individuals and couples that want a high quality
service
• Average age 82 – although serve those in their 50/60’s
• Specialist care needs:
• 75% with dementia
• 5% with Parkinson’s
• 20% mobility/frailty/falls
• 25% are couples
• 80% self funders/ 20% PCT funded
• Client groups:
• Client receiving care
• Daughters – arranging care
• Sons – financial/legal aspects

5. Our Services
• Live In Care
• High quality, 24 hour care at home
• Flexible from 4-7 days per week
• England and Scotland
• £850-£1,250 per week – subject to assessment, rota, number of days
• Day Care
• London only
• Minimum 7 hours a day, 3 days a week
• £15-£20 per day, subject to assessment
• Respite
• Give family carers a much-needed break – build on-going relationship
• Sample our quality service
• Not a one off service - access our expertise and support between
bookings
• £1,200 per week – initial 2 weeks as a minimum, thereafter 3 days
• Discounted weekly fee for repeat bookings after total of 4 weeks
• England and Scotland

6. What is Live In Care –
how does it work?
• Provision of a professional trained carer who
lives in your home
• Directly employed or fully managed service
provider vs. introduction agency
• Carefully matched carer with client
involvement in choice
• Consistent team of two carers
• Rota to suit the clients needs/requirements
• Client provides – full board/room
• 2 hour daily breaks required - ensure carers
have sufficient rest time

7. Benefits of Live In Care
• Live life the way you choose with
independence
• One-to-one, dedicated care – not achieved
in a care home
• Consistency and familiarity – critical for
those living with dementia
• Maintain lifestyle and interests
• Couples can stay together as loving
partners
• Cost comparable solution to residential care
• Maintain assets/capital appreciation

8. Our Difference
– Supporting Families & Carers
• Support family with decisions – including financing
and funding
• Comprehensive matching service – introductions
ahead of service
• Fully managed service from Regional Care Manager
– small client portfolio
• 24/7 helpline for carers providing out of hours
support
• Supporting, coaching and mentoring in placement to
ensure service excellence
• Access to internal condition based experts
• Family education forums and webinar events

9. Our Difference
– The Best Carers
• Carers are employed – not an introduction agency
• Market leading employment packages – attract
talent and longevity of relationship with carer
• Shares in our business
• Flexible working and rota patterns – ensure carer
rest time
• Industry leading training
• Professional development – treated as professionals
• Support in placement and 24/7 helpline
• Committed to communication and engagement
• Ambition to be the employer of choice in UK

10. Our Difference
– Training and Development
• Carers trained to exceptionally high standard
• Pioneering induction programme – 11 modules
• 12 weeks e-learning in client placement
• Specialist modules for conditions –
dementia/Parkinson’s
• Lifestyle training –
communication, cookery, depression, nutrition
• Professional Apprenticeship in Health & Social Care
• Advanced training as part of development plan
• Career development opportunities
• Pay scales that reward performance

11. Our Difference
– Reputation and Expertise
• Shaping government policy on quality, accessibility and
choice in social and dementia care
• Independent Advisory Board – experts from charity, medical
and social care
• Work closely with leading doctors, PCTs, local authorities
and other professional partners
• External expertise into training programme
• Recognised as industry leaders in dementia home care
• Award winners – health and social care
• Top 45 UK healthcare companies in industry poll
• Collaborate with leading dementia and Parkinson’s charities

12. Challenges for in home care with
people living with dementia
• Carer understanding of dementia from the
client’s perspective
• Risk management outside of a formal care
setting
A solution is required – a sustainable
economic and easily transferrable model

13. Collaborative Working
• The Contented Dementia Trust, which
incorporates the SPECAL® method, is a
charitable organisation with the aim of promoting
sustainable well-being for people with dementia
• The SPECAL® method is underpinned by a
particular explanation of memory, ageing and
dementia, known as the SPECAL® Photograph
Album

14. © CONTENTED DEMENTIA TRUST
The SPECAL® Photograph Album –
a metaphor

15. © CONTENTED DEMENTIA TRUST

16. feelings
facts
Normal photograph: facts-plus-feelings
© CONTENTED DEMENTIA TRUST

17. Normal photograph:
facts-plus-feelings
Dementia photograph:
a fact-free, feelings only
‘blank’
feelings
feelings
facts
© CONTENTED DEMENTIA TRUST

18. Normal memory pages
Dementia pages
stage 1 (pre-diagnostic)
© CONTENTED DEMENTIA TRUST

19. Normal memory pages
Dementia pages
stage 2
© CONTENTED DEMENTIA TRUST

20. Normal memory pages Dementia pages
stage 3
© CONTENTED DEMENTIA TRUST

21. The person with dementia has not lost their
reason, only their recent facts.
They will, very reasonably, turn back to much
older pages in their album, before dementia, to
provide a context to what is currently happening
in their life today.
We need to listen and learn from them.
© CONTENTED DEMENTIA TRUST

22. SPECAL’s three Golden Rules
• Don’t ask direct questions
• Listen to the expert – the person with
dementia - the questions they ask us are
highly significant
• Don’t contradict
© CONTENTED DEMENTIA TRUST

23. Collaborative Case Study
• Mike was 88 and living with Alzheimer’s
disease when his wife Angie approached
TGCG
• Would not leave wife for even a few seconds
• Paranoia, delusions – accusations of abuse
• Aggression and fearfulness
• Refusal to accept help or medication

24. Personalised application of
SPECAL’s three Golden Rules
• Using old ‘photographs’ to provide factual
information missing on today’s ‘page’ –
bridging the gap between present and past
• Rugby as a theme for promoting well-being
• Finding acceptable explanations and
answers to Mike’s questions

25. Our Results
• Mike held in a contented state using
continuously recycled acceptable
experiences
• Wife able to leave house for hours or days
at a time – improvement in her quality of life
• Carer able to give Mike medication and
support him as required
• Elimination of antipsychotic medication

26. Questions?
• Zoe.Elkins@thegoodcaregroup.com
• www.thegoodcaregroup.com
More information on the SPECAL approach?
• www.contenteddementiatrust.org
• ‘Contented Dementia’ by Oliver James