Royal Surrey County Hospital
The Royal Surrey County Hospital is a leading General Hospital and specialist tertiary centre for cancer, Oral and Maxillo-facial surgery and pathology. The hospital serves a population of 320,000 for emergency and general hospital services and is the lead specialist centre for cancer patients in Surrey, West Sussex and Hampshire, serving a population of 1.2 million.
- Updated:
- 12 February 2019
- Location:
- South East
- Sectors:
- Health, Hospitals and Hospital Trusts
- Local Alliances:
- Hampshire 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?
The Royal Surrey County Hospital is committed to providing and delivering a compassionate and dignified approach to caring for dementia patients and their carers throughout their stay/visit to our hospital. The work that is being undertaken in the hospital around dementia overlaps with the objectives outlined by the National Dementia Strategy in 2009 and the Quality outcomes for people with dementia in 2010.
The Royal Surrey County Hospital has an internal work-plan that identifies key initiatives that we are currently working on to improve / enhance the experience of the person living with dementia and their carer. A few examples of our key initiatives are:-
Working towards becoming a dementia friendly hospital. We are constantly updating and changing our hospital environment to make it dementia friendly. Any changes made are in line with PLACE requirements and the Kings fund enhancing the healing environment recommendations. Over the past couple of years three of our ward areas have also gained the Quality Mark.
Education and training of our patient facing staff.
A variety of dementia training is available to all staff (clinical and non clinical) working within the hospital. The training across the trust has been key to reduce stigma and empower staff working within the clinical areas to provide good quality evidence-based dementia care. The dementia training provided across the trust has also been recognised by the Alzheimer’s society as meeting the requirements for the dementia friends training and thus all staff if they so wish they can become a dementia friend
Type of training
Tier 1 dementia training – foundation level - Held monthly on clinical induction
Dementia virtual Tour - Experiential training - sessions held regularly during the month.
Tier 2 Dementia Training - 2 days (includes the dementia virtual tour) - Held quarterly
Carer support. Caring for and supporting carers has played a crucial role in improving the experience of the hospital stay for not only the person living with dementia and their carer but all carers across the hospital. As a hospital we have signed up to the Carers Charter and posters highlighting the aims and objectives of the carer charter are displayed across the hospital.
In 2016 our hospital signed up to John’s campaign. John’s campaign added the cement to all the work that we as a hospital have been undertaking around caring for and supporting carers.
A few of our carer support initiatives accross the hospital are outlined below:-
Carer passport for family members - The RSCH implemented a Carer Passport for Family members in 2013 and is in use accross the hospital. The carer passport for family members is an initiative that aims to support carers whilst their loved one is staying in hospital.
Carer support worker - We have two carer support workers working in the RSCH. The carer support worker provides advice and support not only to carers but also staff accross the hospital.
Carer prescription - During 2015 the RSCH has worked closely with the CCG to implement the carer prescription accross the hospital (The carer prescription enables staff to support carers they come into contact with by referring them electronically to a range of support services accross Surrey).
Carer cafe- A dementia carer cafe is held on the first Wednesday of every month. The cafe is informal and provides carers with advice and support. The cafe also signposts people so that they can access on-going support and services in the community
Ensuring that the care provided is patient centred. The RSCH uses a forget me not symbol to identify patients with dementia / delirium and confusion. The document "This is me, my care passport" is also used accross the hospital and supports staff in providing care that is individualised and patient centred.
2. What are the challenges to delivering these outcomes from the perspective of your organisation?
Patients with dementia often present to the acute hospital with complex medical and social care needs. Some examples of the challenges we face as an organisation can be attributed to internal and external priorities / constraints placed on the hospital for example financial, staffing levels and releasing staff for training and patient activity and volume (including seasonal volume).
Member website
www.royalsurrey.nhs.uk/2. Actions
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Staff Education and training
Training for all staff within the Royal Surrey County Hospital (both patient and non patient facing)
- Status:
- Being implemented
2019 - First Quarter Update
Current training available 01/2019
Tier 1 - foundation training - 1 hour
Tier 2 dementia training - two day training
Dementia virtual tour - Experiential training - 1.5 hour
2018 - First Quarter Update
In Sept 2017 the dementia Nurse Specialist and two colleagues undertook dementia virtual tour facilitator training. The dementia virtual tour is an experiential training which takes away people's primary senses, to let them experience the fear and frustration that people living with dementia go through on a daily basis”.
In January 2018 we implemented the dementia virtual tour training accross the hospital. The training is available to all clinical and non-clinical staff employed in the hospital.
2015 - Fourth Quarter Update
The RSCH provides a variety of tiered dementia training to staff (both patient facing and non patient facing) accross the hospital on a regular basis.
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Delirium - recognising, diagnosing and treating patients with Delirium
Develop a Multidisciplinary Delirium Management Tool and poster to raise awareness and consequently diagnosis and treatment of patients with a delirium accross the hospital
- Status:
- Being implemented
2019 - First Quarter Update
MDT Delirium management tool and poster devised and awaiting ratification.
Aiming to launch in March 2019
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Supporting carers
Supporting and signposting carers to the correct services (both internal and community) during their stay in hospital
- Status:
- Being implemented
2019 - First Quarter Update
Current carer initiatives 01/2019
Carer Passport for family members - embedded accross the hospital. the carer passport for family members support and values the role of carers during the hospitilisation of the person for whom they care.
Carer prescription - An online tool whereby carers can be quickly referred to a variety of organisations for ongoing community support / advice.
Signed upto and actvely support and endorse the principles the Acute Hospitals Carer Charter (2017). We utilise a carer support symbol accross the trust.
Dementia Carer cafe - held the first wednesday of the month
NHS Staff Carer friendly organisation - Occupational health and HR have worked together and rewritten numerous HR policies to identify and support members of staff who are carers.
2015 - Fourth Quarter Update
The RSCH has signed upto and embraces the principles underpinning Johns Campaign (2015). The RSCH implemented a Carer Passport for Family members in 2013 and this document is in use accross the hospital. The carer passport for family members is an initiative that aims to support carers whilst their loved one is staying in hospital. In September 2015 we welcomed a carer support worker to our team on the Older persons unit. The carer support worker provides advice and support not only to carers but also staff accross the hospital. During 2015 the RSCH has worked closely with the CCG to implement the carer prescription accross the hospital (The carer prescription enables staff to support carers they come into contact with by referring them electronically to a range of support services accross Surrey). The Dementia Specialist Nurse also provides carer support to carers and obtains feedback regarding the person living with dementia and their carers experience of their stay in our hospital. This information is then fedback to our hospital board on a quarterly basis. In 2016 we are planning on instigating a carer cafe in the RSCH.
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Patient centred care
Ensuring all care is compassionate, dignified and patient centred
- Status:
- Being implemented
2019 - First Quarter Update
Work is constantly on going around promoting the importance of patient centred, embedding the document This is me, My care passport and the use of the forget me not symbol.
All dementia training accross the trust incorporates the above concepts.
2015 - Fourth Quarter Update
The RSCH uses a forget me not symbol to identify patients with dementia / delirium and confusion. The document "This is me my care passport" is also used accross the hospital and supports staff in providing care that is individualised and patient centred.
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Becoming a dementia friendly hospital
Looking at environmental changes to improve the patient and carer experience.
- Status:
- Being implemented
2019 - First Quarter Update
Any environmental changes that occur accross the hospital incorporate the principles of the Kings fund and the dementia Friendly hospital.
Lots of work has been undertaken accross the hospital since 2015 and we are continuously making changes and improvements. A few examples of some of the environmental changes that have taken place are below
Quiet areas away from the ward baysSeating areas in the corridors (including Bus / train station areas)Communial areas at the end of the bays in Ewhurst & OPU where people are able to socialise, undertake activities and have mealsThrough use of colours making defined areas Using contrasting colours to promote rehabilitation ( for example in toilets and shower areas)Using pictures / images and signs on the ward to create a welcoming, friendly, orientating environment.
2015 - Fourth Quarter Update
We are constantly updating and changing our hospital environment to make it dementia friendly. Any changes made are in line with PLACE requirements and the Kings fund enhancing the healing environment recommendations. Over the past couple of years three of our ward areas have also gained the Quality Mark.
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The provision of a variety of age appropriate activities for patients on the ward.
The provision of age appropriate activities for patients to use during their stay in hospital.
- Status:
- Completed
2019 - First Quarter Update
All areas have age appropriate activity boxes at the RSCH and three areas have activity trolleys. We are currently in the process of purchasing other equipment which will enable and support staff to undertake further activities with patients.
2015 - Second Quarter Update
In May 2015 the Dementia Specialist Nurse distributed twenty five activity boxes to wards and departments accross the RSCH. The activity boxes contain a variety of age appropriate activities for patients to use during their stay in hospital.
In May 2015 numerous activity volunteers, started volunteering on a regular basis on two elderly care wards and an orthopaedic ward at the RSCH. The activity volunteers enhance the patients experience by engaging with patients therapeutically and undertaking a variety of activities that are patient centred.