Chelsea Court Place describes itself as the UK’s first luxury purpose-built and designed residential and daycare home for people with Alzheimer’s and dementia. Inside the building on the exclusive King’s Road in London, it feels more like a private members’ club or a five-star hotel than a care home, with its thick carpets, tasteful paintings and wall hangings.
There are none of the familiar smells of toilets, disinfectant or overcooked food that often rudely greet visitors to such establishments. Here, there is a private cinema, luxury spa and treatment rooms, and a library stocked with sumptuous coffee-table volumes. Its 15 elegantly furnished en suite “apartments” are set in a horseshoe shape around the central dining area, where a restaurant and 24-hour cafe for residents and visitors offer tailored food choices to suit individual nutritional needs.
Chelsea Court, which opened last month, also offers bridge evenings and outings to opera, tennis, golf and local attractions. The nursing team are all dementia specialists assisted by the latest technology. Each resident is tracked by “person-centred software”, which monitors progress through the day and offers staff an insight into why and when extra care or attention should be given if patients become agitated or confused. Dementia care mapping, an innovative observational technique, takes a complete history of each resident, offering insights into situations that can lead to mood changes.
Mwaya Siwale, the head of memory care, gives an example of a resident who gets “fidgety and anxious around 5pm”. “Relatives told us this was the time when she used to lock her shop. So at around five we have created a plan to reduce that anxiety. We also learned she is really attached to a particular carpet and does not like light-coloured curtains – so that carpet will be in her room and she will have dark curtains.”
Chelsea Court is the brainchild of hotelier and philanthropist Laurence Geller. His experience of seeing the impact of dementia on a relative drove his interest in improving care and treatment. Geller is co-chair of the Alzheimer’s Society appeal board, which aims to raise £100m a year for dementia research, and chancellor of the University of West London. Chelsea Court aims to champion research and innovation in partnership with the university, which is “spearheading new attitudes to dementia care, tailored medication and investing in research to help find a cure for dementia”.
Last week the Office for National Statistics announced that dementia has replaced heart disease as the leading cause of death in England and Wales. There are thought to be 850,000 people with dementia in the UK at an estimated cost to the economy of £26bn a year. With better diagnosis and rising life expectancy rates, numbers are set to reach two million by 2051, when one in three people over the age of 65 will have the disease and costs may treble.
People living in the elegant streets off the King’s Road have the highest life expectancy in the UK. It is one of the UK’s most affluent neighbourhoods where women can expect to live until 89 and men 85. But longevity has a price. The Royal Borough of Kensington and Chelsea is projected to have one of the biggest rises in new dementia diagnoses in London over the next 20 years – up 54% – equating to 700 people. This is in addition to the 1,335 residents already diagnosed. Yet the borough has one of the lowest numbers of dementia beds per resident in England.
Geller may have seen a gap in the market for the kind of bespoke dementia care on offer at Chelsea Court, but it does not come cheap. Rooms cost between £2,000 and £3,000 a week, putting it way out of the reach of the majority of people paying for their care, and of cash-strapped councils whose adult social care budgets have been slashed. The average care home cost paid by inner-London councils is £649 a week. But round-the-clock private home care in the capital can cost around £2,400 a week, and 24-hour nursing care £3,500 alone – before the cost of food, rent, and bills – whereas Chelsea Court guarantees a fixed-rate, all-inclusive pricing model, regardless of whether the level of care required increases. Its managing director, James Cook, says families come to him complaining that their parents get very little from home care. “We have a lot of older people in Kensington and Chelsea getting private or NHS home care who are getting almost no stimulation or activities, not even getting out of the house,” says Cook.
Lack of stimulation brings on problems such as depression, which adds to the toll on patients and families, says the general manager, Christine Bunce, a psychologist who has worked in mental health and elderly care. “Ensuring people are stimulated and engaged means that we can reduce the need for anti-depressants,” she points out.
Sadly such accommodation will be out of reach for the vast majority of families who struggle to afford appropriate care
New research by the Alzheimer’s Society reveals that only four in 10 home care workers have specialist dementia training in spite of government promises that all staff would be specialist trained by 2018. More than 400,000 people with dementia are believed to receive care in their own homes. The research found that poor-quality home care is leaving many people spending the day in soiled clothing, going without food or water, and ending up in hospital.
But inadequate care is not confined to home care. According to another new survey of UK local authorities by the Family and Childcare Trust, four in five UK local authorities have insufficient care for older people, particularly those with dementia, either in their own homes or in residential care homes. And only a third of councils said they had enough nursing homes with specialist dementia support. The findings come as horrific neglect exposed in two Cornwall nursing homes by an undercover investigation by BBC Panorama was broadcast on 21 November, where a resident with dementia was found to have a leg wound that had gone untreated. Less than 40% of care home staff in the the UK are trained to deal with the challenging behaviour often displayed by residents with dementia.
About 280,000 people with dementia are living in care homes. Bunce feels Chelsea Court can do much to improve dementia services and aims to produce a case study charting its course “from conception to capacity” to be used as an industry model of best practice for dementia care . “Our objective is to inspire other providers, including NHS and private, to adopt the concept and provide similar, much-needed services in the UK.” She adds that it would be happy to take residents whose payments could be topped up from their NHS personal budgets. Yet according to the Alzheimer’s Society, fewer than a third of people aged over 65 receiving care for memory and cognition problems have a personal budget that allows them greater choice over their state-funded care and support. West London clinical commissioning group, which runs the integrated dementia service for health and local authority social care in Kensington and Chelsea, says any personal budget it allocates for an individual’s care would take account of the market rates for care in the area. It describes its own MyCare, My Way service as bringing a “full range of physical, mental health and social support together in one [home] care package with support for carers, activities, physiotherapy and occupational therapy”.
Experts agree that without a public funding system that truly meets the cost of care, it is almost impossible to match Chelsea Court levels of care.
Martina Kane, senior policy officer at the Alzheimer’s Society, says there is more choice than ever for people who can afford it. “While this is welcome because it raises the bar in terms of what the care sector should strive for, sadly the reality is that such accommodation will always be out of reach for the vast majority of families who struggle to afford appropriate care. We hear stories every day of people being asked for top-up fees for what should be council-funded care. Some loving relatives are now faced with borrowing money to pay for food in order to meet these fees.”
She says Chelsea Court levels of care and accommodation “should be a right, not a privilege, but to make this a reality we need a properly funded system. Additional funding for social care needs to be made an absolute priority in the forthcoming autumn spending review.”
A luxury care home for people with dementia – but at what price?
