industry & policy
What are some of the fundamental principles of the Butterfly Household Care model? [ Above all, it’ s that ] feelings matter most. The model is about replicating a household model, as the term describes, but in a way we hadn’ t thought about before. It’ s very much based on enablement, not dependence. It means working with residents to enable them to do things they would have done at home, but possibly didn’ t when they came into residential care.
It’ s also about creating small spaces – small, homey spaces that are quite busy. We look at a focus on things from the past being all around, whether they be from a person’ s activities, particular interests, an industry they worked in, or just in general from their past. [ This helps provide ] good opportunities for the staff to relate to the residents and for the residents to be more engaged than they have previously been.
The other principle is your staff. Sheard would talk about the social factors. Staff have to be of a mindset that they are there to help enable things with the residents. They’ re not there to be task focused, to make beds at a particular time, to feed residents at a particular time. This model is resident-led.
The model is live across two of your centres, what went into the implementation of the model across these two sites? The model takes one full year [ to implement, which ended for us in July ] so relatively recently. It takes a year of training, review and assessment. Dementia Care Matters likes to come and they do a baseline. They observe the centre and formulate a training plan for us about the areas that need to be focused on, particularly in the training.
It’ s about individualising not just the care for the residents but also the physical environment. So from the initial reviews comes a training plan.
One of the key factors Sheard was looking for when he was out in Australia with us and doing his assessment was making sure the leader and the person who was going to drive implementation was absolutely right for the role, and that needs to be someone with lots of energy, lots of passion, and great leadership skills, whom people will be inspired to follow. If we didn’ t have all of those fundamental drives, it would be challenging for us or any organisation to implement the model fully.
I’ m in the UK with a group of managers from our Aged Care Plus Centre in Australia [ on a study trip ]. We are looking at the Dementia Care model where it’ s fully implemented in homes. Each of the homes [ we’ ve visited ] was different, but they all shared some important principles. Staff were all totally engaged and committed, with a great leader; environments were all like small, busy homes, with small areas. It’ s been phenomenal. Those homes have had the model for some years now. The home we were at yesterday met the gold standard for Dementia Care Matters in terms of effective implementation. It was a real privilege to be there and observe the care the residents were being provided with, and see what we believe will happen for us fully implemented already.
What are some of the big differences you expect the intervention will bring about for residents and staff? The big thing is how unstructured it is. One of the centre managers said to me:“ It needs to be very unstructured and it needs to be very much resident [ focused ]. From when we come in, we’ re orchestrating things all day so residents will be interested and engaged.”
In the past, a staff member or the team would come on and they’ d think they need to do particular things at set times. Residents [ would be led to think ]‘ This is the meal time, it’ s either now or you’ re going to miss out until lunch time.’
Of the activities and things we were able to see going on [ under this model ], the biggest thing for me is [ the contrast with stories you hear of residents in facilities ] who aren’ t well cared for, who are very bored, who are sitting in chairs doing nothing with a TV blaring behind them. There was none of that. There was engagement, there were residents who had allegedly come from other providers who had difficult and severe expressive behaviours – aggressive physically, loud verbally, swearing, all of those things. They had been able to find a way to help engage those residents so they were not expressing those physical behaviours.
The model is a better quality of life. We were seeing that in action yesterday.
What lessons have you already learned and how will this inform the ongoing implementation of the model? The lessons we’ ve learned by seeing it in action here [ demonstrate that ] it’ s not a model you can quickly [ determine you’ re going to use ].
This is quite an intensive model. It requires good leadership and great skills from the team, and ongoing commitment. At times it is tough because we are challenging the way that it has been for so long in many areas. [ The UK staff ] did say to us that it is quite time consuming, all-encompassing and energy-sapping – but the results speak for themselves. Residents are engaged; they have a better quality of life.
For the business people out there as well, the homes are always full. They have long waiting lists. It’ s such a great culture and environment for the team to work in as well, with all the effort they put in, they’ re seeing the rewards right across the board.
From what you’ ve seen in the UK, what impact does the model have on staff? It’ s so obvious when you walk into one of these homes, the staff culture is positive, it’ s engaged. You can feel when you walk into a room that people want to be there. They feel that they are making a difference to the residents’ lives. You can just tell that all comes from culture.
We did much preparation and training for our tour over here, and we had a couple of DVDs. There’ s one that I can recommend. It’ s a [ BBC production ] called Can Gerry Robinson Fix Dementia Care Homes? We watched that twopart series, and it was very sad, but it was representative of a home where management and staff don’ t care and where the residents are the ones who are paying the price for that. You can see the staff culture and poor leadership and the profound impact that has on the quality of life for residents.
If you look at that, and then you look at a home where the Butterfly Household Care model has been implemented, it is absolutely a stark contrast. The culture, particularly for staff and their engagement – they’ re empowered to lead residents, they’ re empowered to make decisions. They’ re not sitting around waiting for management to make decisions on little things. All of that has a great impact on staff culture, and it’ s phenomenal for the residents.
The model has many benefits. As one of only two providers in Australia being selected to implement this, we are excited about the opportunities that it’ s bringing for us. Obviously for our residents and staff, but potentially for the whole aged-care industry back in Australia, where we could start to see some meaningful changes in the way we care for people. ■
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