FREQUENTLY ASKED QUESTIONS

We set out below some of the questions most frequently asked by prospective residents or their families and representatives and the answers we give to such enquiries.  However, if you have any questions which are not answered here or elsewhere in our Statement of Purpose, Residents Guide, or you wish to discuss something further, please feel free to ask us.  Additional information, including a copy of our most recent inspection report, can be viewed in the Information File in the entrance Hall.

 

What sort of facilities can Aranlaw House offer?

Accommodation is spread over three floors served by stairs or two passenger lifts to aid access. We have a total of 46 single bedrooms, all of which exceed the National Minimum Standard of 12 square metres.  On the ground floor we have eleven bedrooms and there are twenty bedrooms on the first floor and fourteen on the second floor.  Each floor has its own dining and lounge facilities, toilets and assisted bathing facilities.

All of our bedrooms have en-suite toilet and shower facilities.  Bedrooms are equipped with under-floor heating to ensure adequate warmth at all times and also air-conditioning if the weather makes the room too hot.  Bedrooms are also equipped with high quality furniture and furnishings, wall-mounted LCD/Plasma televisions, (with Freeview) and an alarm call system to summon staff assistance if needed.

We also have a wide selection of equipment to assist people with a range of needs.  This includes hoists, profiling beds, pressure relieving equipment, grab rails, assisted baths and walk-in showers.

 

You are registered DE (OP) but what does this mean?

Aranlaw House is a care home that provides personal care and accommodation for 46 older people (OP) who have dementia (DE). 

At Aranlaw House our approach to meeting the needs of older people who have dementia is possibly quite different to that taken in many care homes.  We work to a model of care that is known as a ‘behavioural staging model’.  This helps us to identify where in the course of their illness the person with dementia is, so that we can understand the specific difficulties they are having.  We can then use the helping strategies that are most appropriate to the particular stage the person has reached to help them to live as full and enriched a life as possible. The model also helps us to anticipate what we can expect to see as the person’s illness progresses through the different stages and to identify when changes might be about general ill health or those associated with old age rather than the person’s dementia.

Our staff recognise the different stages of dementia and are trained to implement helping strategies. 

As far as possible, residents associate with other residents within the same behavioural stage as themselves.  Residents in Stage One are accommodated on the ground floor, those in Stage Two on the first (middle) floor and Stages Three and Four on the second (top) floor. 

Environmentally each floor provides communal facilities including lounge space, dining space and bathing facilities to enable this separation.

 

Why separate floors for different stages?

Research in this field indicates that this model works much better if different stages are accommodated separately. For example, those in Stage One benefit from being with the well elderly and with staff. They often appreciate receiving the special recognition that comes from having a particular role or responsibility that can emphasise their competence.  Those in Stage One are frightened of losing control and independence  and can feel very threatened if confronted with residents in Stages Two or Three.

There are times when a resident may need to move bedrooms as they progress through from one stage to another. During these transitional stages or if there are practical difficulties regarding appropriate rooms, a resident may be given a bedroom on one floor but spend their time on another floor. For example, a resident who is in transition from Stage One to Stage Two, may continue to be accommodated on the ground floor but spend their time using the communal facilities with residents on the first (middle) floor which is intended to manage those in Stage Two.  If a move is considered to be in the best interests of the resident, the resident and/or their relative or representative will be fully consulted in the decision making process.

 

Can you explain a bit more about the different behavioural stages?

We set out below a brief overview of the four stages. 

Stage One – Malorientation, mild confusion

In this stage the person can still maintain a good social facade to hide short-term memory losses.  They appear to be orientated, but their attention span is reduced.  People in Stage One are aware of ‘mistakes’ such as misplacing or forgetting things and try to hide them.  They are often frightened of becoming ‘crazy’, of losing control and their independence. They will often exaggerate their independence to mask their own fears and are frightened by other people in the more advanced stages of dementia.  They will experience difficulty in finding some words and may lose the ‘thread’ of a conversation.  They may appear frustrated and sometimes become angry, defensive, blaming, tense or anxious.

Stage Two – Time Confusion, moderate confusion

In this stage, people become visibly disorientated and lose their sense of chronological time.  They are not always aware of the season or the time of day and may refer to deceased persons, e.g. parents, as being still alive.  They start to become disinhibited, losing their sense of social etiquette and starting to say what they are thinking. Language starts to become more obviously affected and people may lose the ‘thread’ of a sentence.  They will often invent new words to substitute for lost ones. Attention span is very limited and they will keep misplacing things.  However, people in Stage Two are less aware of their memory deficits and ‘mistakes’ so are less tense and anxious. They will often retreat to memories of happier times and are more relaxed than in Stage One.

Stage Three – Repetitive motion, severe confusion

In this stage, verbal ability is limited.  Speech is usually in short phrases and sometimes may be just whistling or singing.

Phrases such as ‘Nurse, nurse’ or ‘help, help’ are often repeated throughout the day and efforts to initiate verbal contact are minimal.  People in Stage Three often experience severe sensory deficits, especially visual.  They will make repeated movements, such as rocking, tapping, patting, polishing or rolling up their dress.  They will often sit or lie down for much of the day.  They may recognise family members as being familiar, but usually cannot retrieve their names or their relationship to them.

Stage Four – Vegetation

In this stage, people appear to be sleeping for most of the day.

Their muscles are loose, with almost no body movements. They do not appear to recognise family members. They seem to withdraw from the outside world for most of the time.

People in Stage Four are still able to respond to loud noises and unusual stimuli, but mostly to music, a friendly voice tone, favourite foods or a massage.

Notes about staging.

Within any of the four stages there can be a range of severity, through low to medium and high level functioning.  People in transition between the different stages may exhibit behavioural characteristics of both stages simultaneously for some time, usually a number of months.  During lucid moments, it is possible for a person to function at a stage higher than their normal level of functioning.  It is not possible to predict how long a person will be in any given stage as this depends not only on how quickly the dementia is progressing, but on physical health, motivation, stimulation, perception, life experience and personality.

 

Is the care you provide any different to other homes?

We use the ‘Validation’ method, a practical approach based on knowledge about and empathy for the progressively isolating experience of people with dementia.  This emphasises communication techniques based upon whichever stage the person with dementia has reached.

Our belief is that older people with dementia need to feel secure and comfortable if they are to get the most out of their lives and this is central to the way that we care for the people who use our service.  We work closely with residents, their families and friends and the various professional’s who may also be involved in supporting them, to gather as much information as we can about the person’s personality their likes, dislikes, life history, experiences and influences as we believe that this information will help us to better understand the person’s behaviour and build relationships with them.

For many people who have dementia their behaviour is influenced strongly by fear that is created by them having a deep sense that something is not right with their thinking and memory. It is this fear that often creates behaviour that can be hard to understand in a person who has dementia. As the person has reduced logical thinking ability and their ability to memorise and verbalise feelings and thoughts is often affected, attempts to try and explain how they feel are impossible.  At Aranlaw House our staff are trained to recognise and allay fear in the residents we care for so that their personality is more readily visible and we can identify those abilities that have been least affected by the person’s dementia and work to maintain these, whilst supporting the person in the areas that  are the weakest. 

 

Is the environment at Aranlaw House fully suited to caring for people with dementia?

It’s not just the care that we provide for residents that is a bit different; we have made numerous changes to the house and gardens to ensure that these areas provide the best possible environment for the people who use our service. These changes are in response to research material that evidences how certain design and environmental features can result in significant improvements in the quality of life for people with dementia living in residential care homes. 

As we get older our vision deteriorates as the result of normal age related changes;  these include reduced night vision, less acuity, some colours being more difficult to see, reduced peripheral vision and being less able to detect the differences between objects that do not have strong colour contrasts.  In older people with dementia these normal changes and other sensory changes cannot be understood or communicated in the same way as thinking ability and the ability to problem solve are affected by dementia. This can often result in the person with dementia making ‘visual mistakes’ as they try to make sense of what it is they are seeing.  This can lead to the person feeling disorientated and frightened and their behaviour will change accordingly.

As well as the person needing input from skilled staff to help to reduce their fear there are numerous design features that can help to reduce these visual misperceptions; we have prioritised lighting, signposting, use of colour and other visual cues when making changes to the environment at Aranlaw so that the people who use our service feel a sense of wellbeing and reassurance in an environment that encourages familiarity and feels ‘homelike’

We use special signage to assist recognition where needed; specially commissioned bedroom door plaques are in place, these contain  the occupants name and a picture or visual image that may help the resident to locate their room.  Brightly coloured images portray different themes on each of our corridors, such as a street, garden or beach themed corridors. The different scenes and brightly coloured familiar images stimulate the visual senses of the person with dementia and greatly assist in helping residents recognise where they are and to find their way around more easily.  Our handrails are all topped with a brightly coloured band that helps residents to locate the handrail and increases their safety and independence when walking.  Probably most striking of all are the brightly coloured bedroom and toilet doors which can be more easily seen by those people who have visual loss or problems with identifying contrast. 

Outside our gardens are secured by a wall and wooden gates that can only be opened via a coded key pad.  Many of our residents like to sit at the front of the building and watch people and traffic as it goes up and down Tower road.  We also have a sheltered decked area outside of the ground floor lounge that is often used for activities. Our rear garden is fully enclosed and specifically designed to be a space that older people with dementia will benefit from using.  There is a continuous walkway that allows for residents to walk safely around the sensory garden, using the handrail to support them and feeling the sense of well-being that comes from the sight, smells and memories they might have of certain plants or trees whilst getting fresh air and exercise in a secure environment.  There is also a patio area and a fully accessible raised flower bed as a focal point.

The information given in this summary of the model of care used at Aranlaw is provided purely as an overview of our service provision; we are always happy to explain our care ethos in more detail and for visitors to spend time with us finding out more about Aranlaw House and the care we provide here. 

 

What is the process for admission to Aranlaw House?

When you first make an enquiry about Aranlaw House, we will send you some written information, which will include our Residents Guide.  You are always welcome to visit and look around the home.  You can come at any time and do not have to make an appointment.  However, if you wish to spend some time speaking with the manager or deputy manager, it is best to telephone beforehand to ensure they do not have previous appointments.

We understand that making a decision about residential care is a very difficult one.  That is why we say you are welcome to visit as often as you like to help you in making the decision about whether or not Aranlaw House is right for you.  We are very proud of our home and the facilities it has to offer, but don’t just take our word for it, come and meet us, sample a meal or join in with an activities session.  Talk with our staff and meet the residents.  We will be very happy to show you around and answer any questions you may have. 

Before any admissions can be considered, we always complete a pre-admission assessment of needs.  Either the manager or her deputy will meet with the prospective resident to undertake this assessment.  This is a very detailed process where we gather information about all aspects of the care needed, including health, psychological and social care needs.  With the prospective resident’s agreement, we also like to gather information from other sources, such as relevant professionals (E.g., doctors and nurses where applicable) and family members.  This will help us to form a detailed picture of all aspects of the prospective resident’s care needs.  We will then have a meeting to decide whether we can meet those needs.  You will be informed of the outcome and this will confirmed in writing.

 

What happens on admission?

Once you have decided to make Aranlaw your home, we will ask you about the colour scheme you prefer for your room.  Prior to any new admission, we always offer to decorate the room to the colour of your choice.

We will draw up a care plan, based upon the information obtained during the pre-admission assessment and any subsequent information obtained after admission.  Such information will help to inform our staff about all aspects of the care needed and how these needs will be met.

All residents are admitted into Aranlaw House for a trial period of two calendar months.  At the end of this time, a decision will be made with the resident and/or their relatives or representatives as to whether they wish to stay and become a permanent resident.  If during this trial period it is decided by either party that Aranlaw House may not be the most appropriate placement, then a notice period of only one week is required.

 

Can relatives be involved with developing the care plan?

We recognise that every person with dementia is unique.  Their lives have been shaped by a number of experiences such as relationships, hobbies and interests, friendships and work employment experiences.  Often, by the time this person needs to consider residential care, their ability to communicate may be impaired.  This can make it more difficult for our staff to get to know the person, their background, likes and dislikes etc.

Families and friends are often good sources of information.  Usually it is families that have been providing care prior to considering admission to Aranlaw House, often over several years and 24 hours a day.  They therefore have a wealth of knowledge and experience to share with us to help make the admission process run as smoothly as possible.  We like to work in partnership with previous carers.  Our staff are very well trained, but those who have been caring already know of useful strategies for helping someone to get dressed, distract their attention elsewhere or when best to intervene if a particular situation may cause distress.  Such information will help us to write a much better care plan and help our staff to meet each resident’s needs.

 

Will relatives still be able to participate in the provision of care?

We welcome and encourage continued participation in the provision of care.  Relatives are most welcome to be involved in providing care and support for as long as they wish or feel able.  If you have any time to spare, (even if only for an hour or two) we also welcome relatives and friends to assist as volunteers within the home.  You could perhaps help with group activities or provide one-to-one support, such as reading a book or newspaper to a resident.  Please speak with any member of the management team if you are interested and would like more information.

 

How are relatives kept informed and updated about any changes in residents’ care needs?

For those relatives with access to the internet, we will regularly send information, including photographs where appropriate.  We will always telephone and notify relatives if a resident is unwell or there has been any change in their health or wellbeing.  We also have a monthly newsletter, the Aranlaw Argos, to keep everyone in touch with what is happening within the home.  This will be made available to all relatives visiting the home, but will be posted to those unable to come very often.                 

 

Can residents bring their own furniture with them to Aranlaw House?

Residents are welcome to bring as many items of their own furniture with them as will safely fit into their bedroom.  However, we ask that you agree this with us beforehand as all our rooms are usually supplied fully furnished.  We may ask to inspect furniture to ensure that it is safe to use.

 

What else can residents bring with them?

Residents are also most welcome to bring other items, such as pictures, photographs, bedding, a favourite teddy or soft toy, or ornaments to personalise their room and make it feel as much like home as possible.  Should any help be needed in putting up pictures etc, we will be happy to provide this.

 

When can residents have visitors?

We want all of our residents to think of Aranlaw House as their home, so there are no restrictions or set visiting times.  Residents can receive visitors whenever they wish, but we ask that meal times are avoided if at all possible.  Of course, visitors are welcome to join residents for a meal if they wish.  We supply beverages to visitors , but we ask for a contribution of £5 if a visitor is staying for the three course lunch or supper meal and £3.50 for breakfast.

We just ask that all visitors sign themselves in and out, using the Visitors Book in the entrance hall.

 

Are staff always available to provide help if needed?

We provide 24 hour care, so there will always be someone available to provide assistance whenever required.  All bedrooms, bathrooms and toilets etc are equipped with a call bell system to summon help if needed.

 

Is smoking permitted?

For the health, safety and comfort of everyone at Aranlaw House, we do not permit smoking within the care home. 

 

Can residents bring a pet with them?

We recognise the positive addition a much loved pet can make to the quality of a resident’s life.   Aranlaw is a pet-friendly home and we are registered with The Cinnamon Trust.  The home has a resident cat named Felix.

We encourage prospective residents to keep their pets on admission.  If you wish to bring a small pet with you please discuss this with our manager beforehand as we will need to ensure that your pet will fit in with any other pets already on the premises and will not cause a nuisance to other residents.  We also need to discuss any necessary arrangements for your pet, but we will do our best to offer help with feeding, exercise etc., if this is required.

 

What is the food like?

All of our meals are cooked on the premises, with careful thought to variety, nutrition and presentation.  We use fresh and locally sourced ingredients wherever possible.  We offer a choice of menu including a cooked breakfast, but alternatives are always available to suit individual taste and preference.

We always ask if there are particular foods that a resident does not like and will make sure these items are not served to them.  We can also cater for any special dietary needs.  Staff are always available to provide assistance with eating meals whenever required.

We like to involve our residents in deciding what goes onto the weekly menus, incorporating their favourite meals.  For example, at lunch time there is always a choice of starter such as soup of the day or melon ball cocktail.  Meals such as roast lamb with mint sauce, fish and chips, roast beef and Yorkshire pudding, toad-in-the-hole or gammon and pineapple are also great favourites.  Our residents enjoy a wide variety of puddings, such as treacle tart, rhubarb crumble, bread and butter pudding, egg custard, jam roly-poly and rice pudding. (You will find sample weekly menus with the Residents Guide.) 

We regularly ask our residents if there is something different that they would like to try and we will always do our best to provide this.   We also serve drinks and snacks throughout the day.

 

Can residents have meals in their own rooms if they prefer?

Residents are welcome to have meals served wherever they wish at Aranlaw House.  This might be in their bedroom, the lounge or dining room, on the terrace or in the garden when weather permits.  Fruit squash is always available in all communal areas and jugs of fresh water are supplied in all bedrooms and changed twice daily.

 

At what times are meals served?

Early morning tea/coffee                     As required.

Breakfast                                          As required.

(Including cooked breakfast, choice of cereals, toast etc)

Mid-morning drinks                            10.30am

(Choice of fresh fruit, yogurts, cake or biscuits)

Lunch                                               12.30pm

(Choice of three course lunch, with tea/coffee etc afterwards.)

Afternoon tea                                     3.15pm

(Choice of cake, fresh fruit and biscuits.)

Supper meal                                      5.15pm

(Extensive menu choice, including salads, jacket potatoes, sandwiches, anything on toast, pastries etc.)

 Evening drinks/snacks                         As required.

(Wide choice of drinks, e.g., hot chocolate, Ovaltine, Horlicks and a variety of finger foods.)

The above times are intended as a guide only and can be flexible to fit in with the needs and wishes of our residents.

Our kitchen is always open twenty-four hours a day and every day of the week, so snacks and drinks are always available.

Should you have an appointment, for example at the hospital, that means you will be late back for lunch, we will keep your meal and serve it on your return.  If you prefer to have your main meal of the day served in the evening rather than at lunchtime, this can be easily arranged for you.

 

Can residents access a garden?

Residents are able to use all of the facilities that the home has to offer, including the garden, whenever they choose.  Our attractive rear garden is secure and offers a secluded paved patio area with garden tables and chairs and a summer house. Residents are welcome to sit and relax and enjoy a cup of tea or coffee and refreshments at any time.  The large lawn area has a path around it which passes by the sensory garden, offering something of interest all year round.  Seating is available, so you can sit and enjoy the garden before finishing your walk.

 

Is there a telephone for residents to use?

There is a telephone installed in all bedrooms so residents can make and receive calls and keep in touch with family and friends.  Reasonable usage is free of charge.

 

Can residents still have their own doctor to visit them?

If you previously lived locally we will approach your GP to see if he/she is prepared to continue visiting you at Aranlaw House.  However, if your previous GP is based further away and unable to visit, we will make arrangements to register you with a local GP practice of your choice.  (Details about local surgeries can be found in the Information File in the entrance hall.)

 

What about services such as hairdressing and chiropody etc?

We have a visiting hairdresser and chiropodist and can also call upon the services of a visiting dentist, optician and audiologist.  However, if you have your own hairdresser, or wish to continue seeing your own chiropodist etc, we will happily encourage and provide assistance in contacting them if necessary and help in making arrangements for you to visit them.  If you prefer, we will see if it is possible for them to visit you at Aranlaw House. 

 

What are the laundry arrangements?

We have our own laundry facilities at Aranlaw House and our staff will be responsible for washing and ironing your personal clothing.  We will label your clothing for you on admission if necessary, to help ensure clothing does not get mislaid.   We will also carry out minor repairs, such as sewing on buttons.  We are not able to provide a dry cleaning service but can arrange this for you if necessary (at your expense.)

 

Will residents still be able to vote in elections?

If residents wish to vote in person, either in local or general elections, we will do our best to make arrangements for this. 

Alternatively, residents may prefer to have a postal or proxy vote and we will help to arrange this if necessary. 

 

Can residents receive newspapers and magazines?

The home orders a daily newspaper for residents to look at. We will also happily arrange to order any newspaper or magazine of your choice and this will be delivered to your room.  However, the resident (or their representative) will be responsible for the cost for such items.

 

Can residents follow their spiritual beliefs or religion?

We recognise that residents’ religious and spiritual beliefs are very important to them and must be respected and supported at all times.  We will use our best endeavours to support and facilitate residents in achieving spiritual fulfilment at whatever level they choose. 

We hold an interdenominational Christian service with Holy Communion at Aranlaw House on the first Friday of every month.  There are also additional services in between without Communion.  We will do our best to make arrangements for you to continue attending your own place of worship if you wish or request clergy to visit you at Aranlaw House if preferred.