Optimising dementia care in care homes: The TRaCAd

Introduction:
Approximately 500,000 people live in 20,000 care homes in the UK. With an increasing proportion of people living with dementia residing in care homes it is paramount that health care workers can deliver specialist dementia care.
Service Development:
The development of an audit tool known as TRaCAd (Thematic Resident and Care Audit for dementia), underpinned by over 320 externally recognised standards, was developed by Four Seasons Health Care. This audit tool is available on internal IPads which care staff complete. The system then produces a report of actions that the member of staff (and care home unit) must complete to optimise the care that resident living with dementia receives. The TRaCAd is made up of almost 300 questions and focuses on a variety of areas relating to the person’s holistic care including: washing and dressing, elimination, end-of-life care, activities, nutrition, cognition, capacity and mobility.
Sample:
20 care homes throughout the UK. 13 care homes were recruited from England, 4 from Scotland and 3 from Northern Ireland. 451 residents living with dementia lived across these 20 care homes.
Results:
The TRaCAd helped care teams identify 8,176 areas that could be improved within their dementia care units. Of these 8,176 areas that required action, 2,118 of these were fixed and resolved immediately once identified (25.91%). The remaining 6,084 actions were resolved before a care home became accredited (which was a maximum of 18 weeks later). Specifically, improvements were noted in the domains of spiritual care (47.89%), psychological care (43.68%) and social care (43.02%).
Discussion:
The TRaCAd audit helped care staff to improve quality of life for people living with dementia in care homes. The tool enabled care staff to facilitate care experiences which focused on broader aspects of holistic care such as a person’s psychological, social and spiritual needs.