Maidstone & Tunbridge Wells NHS Trust

Maidstone and Tunbridge Wells NHS Trust is a large acute hospital trust. We provide a full range of general hospital services to around 500,000 people living in the south of west Kent and parts of north east Sussex.

Updated:
1 December 2014
Location:
South East
Sectors:
Care, Communication, Health, Medical, Hospitals & Hospital Trusts
Local Alliances:
Kent Dementia Action Alliance

1. Action Plan

1. The National Dementia Declaration lists seven outcomes that the DAA are seeking to achieve for people with dementia and their carers. How would you describe your organisation’s role in delivering better outcomes for people with dementia and their carers?

1. The National Dementia Declaration lists seven outcomes that the DAA are seeking to achieve for people with dementia and their carers. How would you describe your organisation’s role in delivering better outcomes for people with dementia and their carers? 

Maidstone & Tunbridge Wells NHS Trust is fully committed to achieving the seven outcomes laid down by the Dementia Action Alliance (DAA).  Our role is pivotal in working within our own teams to:   

  • To promote safety and ensure the privacy and dignity of people with dementia. 
  • To reduce the prescription of antipsychotic drugs whilst the patients are with the acute care setting 
  • To ensure that people with dementia receive adequate nutrition and fluids 
  • To promote the independence of people with dementia, encourage social interaction and support their abilities to undertake activities of daily living 
  • To increase staff awareness of dementia and increased awareness of services available in the community 
  • To promote the contribution of volunteers 

We also believe our role is to work closely with others outside of the acute care setting to achieve the standards in the declaration.  We are fully committed to working closely with carers, family and friends of people living with dementia to ensure they are equipped and supported both practically and from an information perspective so that people with dementia are properly cared for in their own homes, wherever that may be.  This involves working in partnership with external agencies such as our social work colleagues, community liaison teams, charitable and voluntary organisations. To ensure that all of us work towards shared goals that are person-centred.  This is evidenced through the membership and activities of the Dementia Strategy Steering Group. 

The Trust has an active Dementia Strategy Steering Group to deliver this strategy and meet the seven standards set out by the DAA.  Challenges for the organisation include: 

  • Seeking adequate funding – both capital and revenue funding is a limited resource within the Trust with departments also required to make savings year on year.  Funding for dementia care can therefore be a challenge.
  • The practicalities of delivering changes in the environment – major building works are required in some areas to deliver the improvements.  Available space to provide some of the planned initiatives is limited and is therefore considered in ‘competition’ with other bids.  Limitations exist within the PFI arrangements that potentially can hinder initiatives. 
  • Releasing staff – to release staff from the clinical areas for an adequate amount of time to deliver the improvements is a potential challenge.  This includes allowing and rostering people time away from their work place for education and training activities.  Balancing this whilst continuing to deliver our core operational business can also be challenging. 

2. What are the challenges to delivering these outcomes from the perspective of your organisation?

The Trust has an active Dementia Strategy Steering Group to deliver this strategy and meet the seven standards set out by the DAA.  Challenges for the organisation include: 

  • Seeking adequate funding – both capital and revenue funding is a limited resource within the Trust with departments also required to make savings year on year.  Funding for dementia care can therefore be a challenge.
  • The practicalities of delivering changes in the environment – major building works are required in some areas to deliver the improvements.  Available space to provide some of the planned initiatives is limited and is therefore considered in ‘competition’ with other bids.  Limitations exist within the PFI arrangements that potentially can hinder initiatives. 
  • Releasing staff – to release staff from the clinical areas for an adequate amount of time to deliver the improvements is a potential challenge.  This includes allowing and rostering people time away from their work place for education and training activities.  Balancing this whilst continuing to deliver our core operational business can also be challenging. 

2. Actions

  • Practicalities of delivering changes

    The practicalities of delivering changes in the environment – many of the initiatives to improve the environment are easy to implement once procured, such as signage, and adjuncts in, for example, bathroom areas for patients with dementia.  The Trust is currently implementing a refurbishment programme which actively considers and undertakes dementia friendly building works and decoration.  An example is the recently opened Urgent Medical Assessment Unit which has adhered to dementia friendly guidance in its signage, flooring, and colour scheme.  This programme is scheduled to be completed by 2017.

    Status:
    Being implemented

    Update - First Quarter

    In Progress

    Update - Second Quarter

    In Progress

    Update - Third Quarter 

    In Progress

    Signage on all en-suite bathroom doors at TWH (pictorial and written) has been provided. Day room area has been developed at Maidstone Hospital and a Dementia activities co-ordinator post has also been developed for this area. A further day room is planned for use by the dementia buddy volunteers to use between two wards at maidstone Hospital. These areas provide a sociiable and stimulating area for dementia patients and have a non-clinical feel. An area outside one of the wards at TWH has also been developed as a cafe area and dementia patients have their lunch here in a sociable environment, there are plans to roll out the dementia activities co-ordinator role here to assist with providing more socialble and stimulating activities for this area as well. Other day rooms at TWH have also been developed for patients with dementia, and provide a less clinical feel. When the refurbishment work begins at Maidstone it is on the agenda to try and provide a dayroom for each ward to ensure a communal area for patients and relatives, and this will assist in providing a sociable and stimulating environment.
  • Releasing staff

    Releasing staff – Training days are advertised well in advance of the date.  A flexible approach has been taken to deliver the training such as e-learning and trainers attending the clinical areas. 

    Status:
    Delivery

    Update - First Quarter

    In Progress

    Update - Second Quarter

    In Progress

    Update - Third Quarter 

    In Progress

    A dementia training strategy and training needs analysis has been developed. An educational programme is well established in the organisation and this includes basic dementia awareness, intermediate dementia awareness and person-centred dementia care. All of these are available through attending training sessions, and there is also an e-learning programme available for staff. All staff in the organisation have received a basic dementia awareness leaflet that has been developed and meets the Tier 1 requirements from HEE, all new starters in the organisation are also issued with this leaflet at Induction. Further training is currently being planned for staff to include experiential dementia training and there are also plans to develop a carers study day for staff, to raise awareness of the needs of carers of people with dementia, and aid support and signposting.
  • Supporting Carers of people with dementia

    Undertaking Triangle of Care: Carers Included audit to ascertain what further actions are required to develop carers support in the organisation. To develop a carers information booklet for all carers of people with dementia that will compliment the current Trust Core Information Leaflet, but also be a resource for carers. To continue to work in partnership with the carers support agencies commissioned to the Trust. to continue to develop the carers survey, to ensure actions are taken and implemented on feedback received from this.
    Status:
    Implementation
  • Raising Staff awareness with regards end of life care and dementia

    To work with the palliative care team with regards providing support to staff on end of life care for dementia patients. Increasing their awareness through training and education and also confidence in conversations with patients and carers. Ensuring staff are aware of the various tools available, including advanced care plans, advanced directives, power of attorney etc.
    Status:
    Initial Scoping