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:
29 November 2017
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:
    Completed

    2017 - Fourth Quarter Update

    Dementia Care Group now fully implemented and meet bi-monthly.

    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

  • Partnership working with the Advanced Dementia Support Team

    To enable equitable access to palliative care for people with dementia,by educating and supporting carers and staff carers.

    To highlight the importance of Advance Care Planning.

    Status:
    Being implemented

    2017 - Fourth Quarter Update

    Ongoing partnership working with the End of Life Partnership Advanced Dementia Support Team including improving education and training for staff around dementia and palliative care issues.This also includes work around helping the person with dementia to plan for future care (Advance Care 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

  • Raise awareness of dementia via training and education

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

    Status:
    Implementation

    2017 - 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.

    Admiral nurse service now in place to offer bespoke training to carers and staff carers as needed.

    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 and reduce readmission rates

    To promote safe and early discharge back to usual place of residence, with improved community support via Admiral nurse team.

    Status:
    Being implemented

    2017 - 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 MCHFT Dementia Strategy aims  to reduce the number of emergency readmissions to the hospital and improve rates of people returning back to their usual residence by 25% by March 2018.

    The RVS are focussing on the ward befriending service currently.

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

    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

  • RVS to implement a befriending scheme

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

    Status:
    Being implemented

    2017 - Fourth Quarter Update

    RVS scheme now active on four wards.Hoping to roll out further depending on recruitment or additional volunteers.

    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 Alzheimer's Society

    To work collaboratively with the Alzheimer's Society to enable them to in-reach into the Trust and offer advice and support for people with dementia and their carers.

    Status:
    Being implemented

    2017 - Fourth Quarter Update

    Good links have been established with the local Alzheimer's Society.

    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.

    The Alzheimer's Society are involved in the Dementia Care group.

    Partnership working to provide a support group within the hospital for staff that care for family members  with  dementia.

    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

  • 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

    2017 - 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  their target of over 90%.

    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:
    Being implemented

    2017 - 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.

    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

  • Enhanced healing environment

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

    Status:
    Being implemented

    2017 - Fourth Quarter Update

    The Trust has developed a number of initiatives to become more dementia friendly and contribute to better outcomes for people with dementia.

    Within the Dementia Strategy certain areas have been identified to focus on enhancing the persons experience and the healing environment of the hospital:

    Creating a dementia friendly ward

    Improving way finding and signage

    Working towards becoming a Dementia Friendly Hospital

    Creating an outside garden area.

    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

  • Develop Admiral nurse service

    Develop service to provide support to carers of people with dementia -both family  and staff carers.Recruitment of Admiral nurses to support education of the MDT and encourage GP practices to facilitate early diagnoses of dementia to enable timely support.

    Additionally to look at ways to reduce/prevent hospital admissions and conversely facilitating a timely discharge bsck to usual residence.

    Status:
    Being implemented