Mid Cheshire Hospitals NHS Foundation Trust

Mid Cheshire Hospitals NHS Foundation Trust is the organisation which manages Leighton Hospital, Crewe; the Victoria Infirmary, Northwich and Elmhurst Intermediate Care Centre, Winsford. The Trust was originally established as an NHS Trust in April 1991 and became a Foundation Trust in April 2008. It employs approximately 3,200 members of staff and has around 540 hospital beds. A range of services, including A&E, maternity, outpatients, therapies and children's health are provided for people predominantly from the Crewe, Nantwich, Congleton, Middlewich and Northwich areas, although patients from other areas are also cared for.

Updated:
16 July 2015
Location:
North West
Sectors:
Medical, Health, Care, Hospitals and Hospital Trusts
Local Alliances:
Cheshire East Dementia Action Alliance, West Cheshire 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?

Mid Cheshire Hospitals NHS Foundation Trust (MCHFT) is committed to improving outcomes for people with dementia and their carers. Our local demographics and the prospect of an aging population means we must ensure our estate, care and services are able to meet the challenges ahead.

Examples of how we intend to improve the lives of people with dementia and their carers are:

  • Promoting early detection of memory problems via screening and referral for specialist assessment as required.
  • Ensuring that our workforce have knowledge of the normal ageing process and are able to recognise memory impairment.
  • Equipping staff to be able to make decision specific capacity assessments.
  • Involving people with dementia and their carers in decision making and choices about their care and treatment.
  • Ensuring that carers feel supported by providing appropriate information and asking for their feedback.
  • Enabling partnership working by encouraging open visiting for carers of people living with dementia.
  • Enabling people with dementia and their carers to be actively involved in service redesign.
  • Working in collaboration with our partners to ensure people with dementia and their carers know where to get help and support, at a time that is right for them.
  • Implementing additional support in hospital via a joint project with the Royal Voluntary Service.
  • Ensuring that staff understand and value the contribution people with dementia and their carers make to our society.
  • Helping support the dementia friendly community agenda.
  • Contributing to research that has a meaningful and positive outcome for people with dementia.
  • Striving to ensure that all patients with a diagnosis of dementia have a personal support plan/passport.
  • Developing person centred care pathways for patients with dementia.
  • Improving the quality of patient care from diagnosis to death.
  • Encouraging staff to become Dementia Friends.

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

The challenges we face in delivering these outcomes include:

  • Operational pressures and competing priorities.
  • Practical issues such as release from clinical work for training and education..
  • Ensuring people with dementia and their carers are truly involved in decision making.
  • Working collaboratively with the Commissioners and the third sector to ensure people get the right care, at the right time, in the right place.
  • Ensuring that care delivered is person-centred and understanding what that really means for people with dementia and their carers.
  • Contributing to research into dementia.
  • Reducing the stigma around mental health
  • Ensuring staff experience and understand what “living well” with dementia really means, interacting with people and carers in a positive way.
  • Working with local care homes to reduce unnecessary admissions to hospital for people living with dementia.
  • Managing the complex needs of the increasing number of people  with dementia who require treatment in hospital.

Member website

www.mchft.nhs.uk

2. Actions

  • Set up a Strategic Dementia Group

    To set up a Strategic Dementia Group including Primary Care, Commissioners and the third sector to drive dementia care forward.

    Status:
    Being implemented

    2014 - Fourth Quarter Update

    Within MCHFT a Dementia Care Strategic Committee has been implemented to look at policy implementation and explore issues escalated from the Dementia Care Pathway group.

    MCHFT are involved in the local CCG "Connecting Dementia Care" group and the local authority "Dementia Steering Committee".

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    New member.No action reported

  • Prioritise end of life care

    To prioritise end of life care for people with dementia, working closely with our local hospice.

    Status:
    Planning

    2014 - Fourth Quarter Update

    The End Of Life Partnership are in the process of recruiting to a new team,specialising in facilitation of excellent end of life care for people with dementia.

    MCHFT will link in with this team to ensure best practice is achieved and staff,carers and the person feel well supported.

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    Nothing to report - new DAA member

  • Implement Advanced Care Planning

    To implement Advanced Care Planning across the organisation.

    Status:
    Investigating

    2014 - Fourth Quarter Update

    MCHFT will work closely with the new  Dementia End of Life practice facilitators to explore,plan and implement Advanced Care Planning within the Trust.

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    Nothing to report - new DAA member

  • Permanent venue for the activity lounge

    To identify a permanent venue for the activity lounge and ensure it is appropriately equipped.

    Status:
    Initial Scoping

    2014 - Fourth Quarter Update

    MCHFT currently do not have an active Activity Lounge.However,there are plans to relocate the Care of the Elderly ward early next year and it is hoped to revitalise the Activity Lounge at that time.

    Presently MCHFT and the RVS are running a scheme of volunteer befriending on a couple of the inpatient wards.This has received much positive feedback and will form a good foundation from which to reestablish planned activities.

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    Nothing to report - new DAA member

  • Raise awareness of dementia via training and education

    To continue to raise awareness of dementia through training and education.

    Status:
    Implementation

    2014 - Fourth Quarter Update

    Following a training needs analysis MCHFT now have a mandatory training plan in place for dementia. Staff have the option of workbook or eLearning courses.

    This is supplemented by in house dementia awareness sessions and practice updates.

    Dementia Friends sessions have also been provided by our partners from The Alzheimer's Society.

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    Nothing to report - new DAA member

  • Promote safe and early discharge

    To promote safe and early discharge, with improved community support.

    Status:
    Being implemented

    2014 - Fourth Quarter Update

    MCHFT have an Integrated Discharge Team who work alongside ward staff,specialist nurses,the person and their carers to plan safe and supported discharge from hospital.

    The RVS are exploring ways to deliver an effective "Home from Hospital" befriending scheme.This is currently in the scoping phase.

    MCHFT have forged good links with local CMHT's, The Alzheimers Society and Age UK to support seamless care provision.

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    Nothing to report - new DAA member

  • RAID project and other initiatives

    To implement initiatives that improve outcomes for people with dementia and carers such as the RAID project.

    Status:
    Uncompleted

    2014 - Fourth Quarter Update

    The RAID project is currently on hold.However other options for support are being discussed within the CCG currently.

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    Nothing to report - new DAA member

  • WRVS to implement a befriending scheme

    To work with the WRVS to implement a befriending scheme for people with dementia whilst they are in hospital.

    Status:
    Implementation

    2014 - Fourth Quarter Update

    The RVS befriending scheme is being impolemented on two wards currently and feedback has been positive.It is hoped that this befriending service will develop and grow so that more wards can benefit from their support.

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    Nothing to report - new DAA member

  • Work collaboratively with Dementia Advisors

    To work collaboratively with the Dementia Advisors to enable them to in-reach into the Trust and offer advice and support for people with dementia and their carers.

    Status:
    Being implemented

    2014 - Fourth Quarter Update

    Good links have been established with the local Dementia Advisors.

    MCHFT are able to refer and signpost people to them as needed.

    The Alzheimers Society have an information display stand within the main out-patient department.

    MCHFT staff have benefitted from Dementia Friends sessions provided by The Society.

    Both local dementia advisors are involved in the Dementia Pathway group.

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    Nothing to report - new DAA member

  • Share good practice

    To learn lessons and share good practice.

    Status:
    Being implemented

    2014 - Fourth Quarter Update

    MCHFT have developed and are currently implementing a new Dementia Care Bundle which is aimed at delivering best practice in dementia care in a consistent way.Implementation has been very recent and early evaluation is due in the new year.

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    Nothing to report - new DAA member

  • Recognise early signs of dementia

    To recognise the early signs of dementia and refer to the appropriate services in a sensitive and supportive way.

    Status:
    Being implemented

    2014 - Fourth Quarter Update

    MCHFT screen all people over the age of 75 years to identify any concerns re:memory.If indicated a screening referral will be sent to the persons GP asking them to review the person after discharge and decide if a specialist memory asssessment is required.

    The Trust is consistently acheiving the National Dementia CQUIN target in this area.

    Update - FIrst Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    Nothing to report - new DAA members

  • Work closely with liaison psychiatry

    To continue to work closely with liaison psychiatry.

    Status:
    Implementation

    2014 - Fourth Quarter Update

    MCHFT have established good working relationships with the local OPCMHT's and the liaison team (based within the hospital).

    MCHFT now have access to CWP Carenotes,to assist holistic care planning.

    CWP practitioners continue to support MCHFT with training to support identified learning needs.

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    Nothing to report - new DAA member

  • Elderly care services

    To support the continuous development of elderly care services, working with partners to improve outcomes for people with dementia and their carers.

    Status:
    Implementation

    2014 - Fourth Quarter Update

    See all prevoius Quarter 4 updates

    Update - First Quarter

    N/A

    Update -Second Quarter

    N/A

    Update - Third Quarter

    Nothing to report - new DAA member