Our vision is to continue to improve as a dementia-friendly hospital where people living with dementia and their families feel safe, supported, and respected. To achieve our vision, we will focus on the objectives set out within our strategy.
As a trust we work in partnership with local mental health teams from Tees, ESK and Wear Valley who provide liaison psychiatry and the mental health frailty and older persons team.
We have weekly vulnerable adult group weekly meetings to discuss patients with complex needs, through a multidisciplinary approach, inclusive of mental health, learning disability, safeguarding, mental capacity Act/deprivation of liberty safeguards, tissue viability, nutrition, and therapeutic care.
National context
Dementia is a growing challenge. As the population ages and people live for longer, it has become one of the most important health and care issues facing the world. In England it is estimated that around 676,000 people have dementia. In the whole of the UK, the number of people with dementia is estimated at 850,000.
Dementia mainly affects older people, and after the age of 65, the likelihood of developing dementia roughly doubles every five years. However, for some dementia can develop earlier, presenting different issues for the person affected, their carer and their family.
There are around 540,000 carers of people with dementia in England. It is estimated that one in three people will care for a person with dementia in their lifetime. Half are employed and it’s thought that some 66,000 people have already cut their working hours to care for a family member, whilst 50,000 people have left work altogether.
There is a considerable economic cost associated with the disease estimated at £23 billion a year, which is predicted to triple by 2040. This is more than the cost of cancer, heart disease and stroke.
We are making progress
Here’s how far we have come
- CQC rated Good 2023
- Appointment of Lead Nurse for Dementia
- Dementia awareness training is now mandatory for all staff irrespective of role
- Tier 2 dementia training is mandatory for clinical staff caring for patients living with dementia
Our objectives
- Assessment
- Person-centred care
- Structured quality governance framework to provide safe exceptional care.
- Skilled workforce
- Dementia friendly hospital/environments
- Care/family involvement in personalised care
- End of life care
- Research and innovation
Objective one – Assessment
- We will identify and assess people with a known dementia, cognitive impairment and /or delirium when they access any of our services.
- We will ensure all patients are screened for dementia / delirium / cognitive impairment in accordance with NICE guidelines.
- Patients with cognitive impairment with be assessed for pain using an appropriate pain assessment tool.
- Patients can be referred to specialist teams such as the mental health liaison team.
- We will provide holistic care with input from Allied Health Professionals such as physiotherapists, occupational therapists, dietitians and
- speech and language therapists.
- Each patient will have a MUST score and an assessment regarding eating and drinking on admission.
- Discharge planning will be integral to the admission assessment process.
Objective two – Person-centred care
- We will provide excellent person-centred care in every interaction.
- We will ensure we have recorded each individual patient’s needs and plan care accordingly.
- We will continue to embed the implementation of personal life stories and information such as the ‘Forget me not’ card for patients with dementia and across all areas. Staff will be familiar with these using them to aid communication and to assist as a non-pharmaceutical approach to providing care.
- We will work closely with the patient’s relatives and carers will be integral to their experience.
- We will continue to embrace and support Johns Campaign using the carer’s passport scheme.
- We will ensure reasonable adjustments to support patients through their hospital stay or outpatient visit.
- We recognise it is essential to maintain links with families and carers.
- We will embrace use of technology to enhance care and evaluate the care we deliver.
Objective three – Structured quality governance framework to provide safe exceptional care
- We will have outstanding leadership in dementia care by aligning with the CQC fundamentals of care standards.
- We will ensure that we learn from experience using quality information and data utilising datix
- The Trust endorses a just and restorative culture that seeks feedback and implements learning to improve and develop services.
- Each collaborate has a safe and effective care lead that proactively participates in the wider governance structures of the Trust reporting to the safe and effective care group.
- The Dementia Strategy Group will work to a dementia action plan with accountability to the Site Director of nursing and safe and effective care group.
Objective four – Workforce: We will have an informed, confident and competent workforce
- We will ensure every member of staff has up to date training relevant to their role.
- We will ensure there are Dementia champions or link nurses in every area, and they have access to appropriate training and education in best practice in dementia care.
- We will continue to recruit and develop Volunteers to support our patients and support meaningful activities.
- This will include working collaboratively with the therapeutic care team to support vulnerable patients within the acute trust.
- We will plan and develop dementia training and support for volunteers and the therapeutic care team.
- Training will be monitored, recorded and reported to the Dementia Strategy Group.
Objective five – Dementia Friendly Hospital/Environments
- We will ensure there is standardisation of ward and outpatient environments to ensure that all areas of the Trust are dementia friendly.
- We will use patient and carer feedback to improve areas of the hospital that have more people with dementia.
- We are committed to our participation in the PLACE (Patient Led Assessment of the Care Environment) to assess our compliance against the dementia friendly design recommendations included in the audit process.
- We will ensure that the environment is welcoming for relatives and carers.
- We will develop a sense of community for people with dementia, relatives, and their carers.
- We will continue to forge links with community groups and dementia friendly hospital initiatives.
- We will work in partnership with specialist teams ensuring joined up working with the patient at the centre of everything we do. Including learning disability specialist nurse, safeguarding team, therapeutic care team, frailty team, OPM team, patient experience, and psychiatry liaison teams.
Objective six – Carer/family involvement in personalised care
- We will recognise the importance of the Carer and their expertise in the delivery of person centred care.
- We will maintain the hospital Carers passport scheme and support John’s Campaign.
- We will develop care that is developed in the context of life, family, friends, and community in which they live.
- We will work in partnership with community partners to facilitate safe transition from hospital and onwards care and support.
- We will work closely with services and care providers to develop collaborative working.
Objective seven – End of life care
- We will ensure that patients with dementia receive dignified outstanding ‘end of life’ care.
- We will ensure that advanced care planning and is referred to or completed in a sensitive and timely way.
- We will ensure personalised care plans for ‘end of life’ care for people living with dementia.
Objective eight – Research and innovation
- We will work to be recognised as providing dementia care using best available evidence, research and continuous quality improvement.
- We will promote research and innovation in dementia care and support all professions to do so.
- We will use quality improvement methodology to drive change.
- We will embrace the development and expansion of the use of digital and assistive technology.
How we will measure and improve our dementia care
Through the Dementia Strategy Group we will develop a work plan related to the objectives and Trust values driven by:
Assessment
- Review the National Institute for Health and Care Excellence (NICE) guidance around dementia and delirium.
- Annual participation in the National Audit of Dementia.
Person-centred
- Audit the completion of patients ‘Forget me not’ documentation to support personalising care to individual needs.
Quality/Governance
- Report implement and monitor actions from audits carried out with regard to dementia care to and from the Dementia Strategy Group.
- Collaborate with the falls lead, frailty team, OPM, end of life group, carers and patient experience team.
- Work with future developments and implementation of the National Audit for Dementia.
- Dementia strategy meetings run bimonthly. Dementia report presented to Safe and Effective Care Group quarterly.
- Develop and update an overarching improvement action plan annually.
Workforce
- Develop and maintain the dementia champions.
- Ensure training is accessible to all staff groups within the trust.
- The Dementia Team to celebrate local or individual quality projects that have been undertaken across the trust.
Environment
- Complete the annual Patient-Led Assessments of the Care Environment (PLACE).
Carer/family involvement
- Collaborate and work in partnerships with carers feedback and views.
- Continue to network and work in partnership with local community groups and patient experience.
End of Life Care
- Work collaboratively with palliative care team and promote gold standards in ‘end of life’ care for patients with dementia.
Research and Innovation
Inform and communicate through the senior nurses, matrons and managers, senior professional forum, frailty board and OPM directorate monthly meetings and Dementia Strategy Group new developments relating to the care of patients with dementia.
This strategy will require us to continue to build on the achievements and the commitment and energy of staff, volunteers, partner organisations and patient and carer representatives to ensure delivery.
Acknowledgements
- John’s Campaign
- Alzheimer’s Society
- Dementia Action Teesside
- Dementia UK
- NICE guidelines