Caring for People in Specialised Homes

What is NZCare Group Limited ?  It is a subsidiary of Healthcare of New Zealand Limited – a major provider of healthcare services in New Zealand.  NZCare Group cares for people with disabilities, either physical or intellectual.  We are funded through contracts with the Ministry of Health and ACC.   Current contracts total $16.4 million and approximately 560 staff are employed.

Where does NZCare have its services?  Physical disability services are provided in Upper Hutt (Spring Lodge),  Porirua (Emmerson House),  Greytown (Noel Hamilton House),  Fielding (Kimbolton Road) and a new service is about to be developed in Hawkes Bay.  Intellectual disability services are provided in Te Awamutu, Nelson and Christchurch.

We care for a number of people with Huntington’s Disease now.  We are strongly committed to the care of these people and have developed considerable expertise.  We are keen to introduce a new model of care based on feedback from families, from our clinical experience, and from the “Disability Strategy” philosophy introduced by the government in April 2001.

We believe in community based care. We believe in the importance of caring for people in small home community settings as a fundamental human right of all people with a disability.  Everyone has the right to live as normal a life as possible.  In this way people can maintain maximum day to day independence and choice.   They can maintain personal control over their life and life style without the need to fit into an “institutional” model of care.

We believe in the principles of normal living.  Some examples include: to live in a place that has the look and feel of a home; to have private space; to have the opportunity to maintain all aspects of personal care for as long as possible; to have the opportunity to continue with such things as personal washing for as long as possible; to have choice in activities and living spaces; to have the opportunity to entertain family and friends; to have access to transport to maintain independence and to have the opportunity to continue living as an individual in all phases of the disease.

We believe a range of care options must be provided.  These include the following. Home Support to live independently with a family in the person’s own home with help and physical assistance as required. Supported Independent Living to live independently but with help and support to maintain this independence. Community Residential Support to maintain twenty four hour support in a community residential home setting. All three are of equal importance and all have their place in the range of care options.

We believe it is essential to involve families.  We want families to feel at home at our place so that it becomes their place too.  We want to work with families to achieve what is important to each family and we want the input of families into the establishment and running of the home.

We believe the right staff is crucial to success.  They must be well selected with caring attitudes and the right background experience.  They must be well trained with extensive on the job training in core skills, philosophy and practice.   They must also be well supported with personal and clinical advice and support.

We believe the home must be in keeping with the philosophy of care.  It must be homelike, creating an individual life style.  It must be warm and safe and comfortable.  It must be able to meet the changing needs of the person as the disease changes.

All the above factors need to be combined to develop a list of key elements in the design of a home.  For example the lounge/dining/kitchen needs to be the centre of the home. It needs to be spacious, open plan and just like the lounge/dining/kitchen in a normal home.  Individual bedrooms need to be spacious and personal with separate room temperature control and with light and sun. Ensuite access is important to maintain individual, private space.  To maintain the small home feel individual bedrooms need to be grouped into units or flats for 4 to 5 people with a shared lounge and kitchenette plus.  A specialised large bathroom and shared storage and cupboards are also required.

Consultation with the Huntington’s Association has been crucial.   NZCare has consulted throughout this project with individuals and with the wider Huntingtons Association interest group.  Both the philosophical concepts and the concepts plans have received input and now the draft and final plans are under review.  Consultation has been a very important part of the project.  It has taken time but it has also contributed significantly to the final result.

NZCare is no almost ready to proceed and we have made a definite commitment to proceed with a contract with the Ministry of Health to provide a residential home for 14 people.  This will be in Lower Hutt` on the corner of Cambridge Terrace and Rodney Street opposite the Woburn Railway Station. The site is an excellent one.  It is close to town and readily accessible. The present buildings will be demolished and a purpose built home is planed for completion in late April 2003.  Planning has taken a long time but the end result will be at the international forefront of building designs for the care of people with Huntington’s Disease.  NZCare feels proud and privileged to have this opportunity to provide this facility.  The first of its kind!

 Graeme Taylor   General Manager NZCare Group Limited