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Gloucestershire Hospitals NHS Foundation Trust

Gloucestershire Hospitals NHS Foundation Trust is responsible for the two largest acute hospitals in the county, Cheltenham General and Gloucestershire Royal Hospitals. These specialist hospitals provide emergency care, specialist inpatient care and outpatient appointments to our urban and rural communities within Gloucestershire and further afield

Updated:
21 March 2018
Location:
South West
Sectors:
Medical, Health, Hospitals and Hospital Trusts, Emergency Services Sector

1. Action Plan

1. The National Dementia Declaration lists a number of outcomes that we 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?

Supporting continued improvements for the Care of patients with Dementia and their/family/Carers is a high priority for our Trust.

Our Trust Dementia Steering Group was established in 2010 with responsibility for development of and implementation of actions to support care of the patient with Dementia and support for family/Carers. We have a clinical lead, Executive Lead and also a team of senior clinical champions. Gloucestershire Alzheimer’s Society are core members of this Group and support our Dementia Care training programme. We are committed to partnership working within Gloucestershire as part of the Countywide Dementia Strategy

A Dementia Champion is in every care Team; 3 Trust wide Champion Events are held every year. We have implemented a comprehensive Dementia Care Training Programme, 5839 staff have completed level 1 training.  Improving assessment, investigation and referral to support access to timely diagnosis of Dementia in Hospital is a core Trust Objective. We have implemented a best practice clinical pathway which promotes increased awareness of the needs of patients with Dementia. Person centred care and improved communication. The pathway includes, care plan, carers leaflets, feedback from carers also a carer survey and an audit programme. A visual identifier symbol has been implemented to promote reasonable adjustments 

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

Potentially 1 in 3 patients will be aged 65 or above, potentially 1 in 4 experience symptoms of confusion or are known to have Dementia. Acute Hospital admission can be disorientating, hospital environments can present challenges.

Enhancing the healing environment presents a challenge; we are exploring action planning, in relation to environment enhancements, developments which seek to promote social interaction, use of art. to enhance wellbeing for patient and family/carers.

Ensuring services to support the person and carer within the community and at discharge may also present a challenge. Additional work is in progress within Gloucestershire, as part of the Dementia Challenge programme to ensure systems and services to support the person and to support carers.

2. Actions

  • Dementia Care Training Programme and Strategy

    During 2012/13 the Trust’s Dementia Training Strategy focused on implementations of actions to support patient assessment, launch of the Trust’s best practice clinical pathway and increased awareness of the needs of patients with Dementia within an Acute Hospital setting. Person centred care and improved communication; it also focused upon increased knowledge of Dementia Care and End of Life Care. During 2012/13 the role of the Dementia Champion was embedded with development events held. Sessions included a series of change management sessions. A comprehensive Dementia Care Training Programme is in place for 2013, with 4 levels of Dementia care training defined, dependent upon the role of the member of staff. The 2013 Training programme and Champion development programme will reflect learning for patient and Carer experience. We are developing closer connections and working in partnership with Carers as part of this programme. We are committed to listening to and learning from Carer experiences and using these to underpin our Training programme. We are developing a training DVD in supporting Carers in partnership with Gloucestershire’s Alzheimer’s Society and Carers. A Trust Acute Hospital bespoke Dementia Care Study day has been developed and will commence in May 13

    Status:
    Initial Scoping

    Update - First Quarter

    Nothing to report - new DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Role of Trust Volunteers

    We are committed to the positive contribution made by Trust Volunteers in promoting a positive experience for patients and enhancing wellbeing. The ward volunteer role had been extended to include a befriending role and a nutritional support role. Dementia Care Training is mandatory for Ward Volunteers. 70 Trust volunteers have attended training sessions on Dementia Care, Communication and Person Centred approach.

    Status:
    Implementation

    Update - First Quarter

    Nothing to report - new DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Supporting patient nutrition, person centred care and patient wellbeing

    Use of coloured glasses, jugs and crockery was implemented and evaluated on two General and Old Age Medicine Wards. The feedback and evaluation has been used to establish the preferred products. Crockery with an orange rim, opaque orange glasses and jugs have been identified as the preferred option this is to be rolled out Trust wide in 2013. The use of finger foods for patients with altered cognition has also been identified by the Alzheimer’s Society and within best practice guidance from the South West Dementia Partnership as a further means of supporting patient nutrition, person centred care and patient wellbeing. Tasting and evaluation of the use of ‘finger foods’ was undertaken and this is to be implemented and evaluated within practice. A Patient Photograph menu has been developed and implemented in March 13

    Status:
    Implementation

    Update - First Quarter

    Nothing to report - New DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Dementia information on Trust website

    In addition to the Staff Safeguarding Intranet site and Dementia Page, the Trust Home Page internet site has been developed and now hosts information on Dementia and links to carers support and patient /Carer held documents.

    Status:
    Delivery

    Update - First Quarter

    Nothing to report - New DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Trust patient / Carer Delirium

    Trust bespoke e-learning on recognition and care of the patient with Delirium has been developed and is planned to launch May 2013. A Trust Patient/Carer Delirium information leaflet was developed and launched in November 2012. 

    Status:
    Delivery, Implementation

    Update - First Quarter

    Nothing to report - New DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Cognitive stimulation sessions

    Cognitive stimulation Sessions are held led by Trust Health Psychology Team

    Status:
    Implementation

    Update - First Quarter

    Nothing to report - New DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Clinical resources to support patient assessment, care and treatment plans

    As part of the clinical pathway a range of clinical resources and documentation has been implemented to support patient assessment, care and treatment plans and to promote appropriate referrals to Mental Health Liaison Team. We proactively promote the This is me document. A Trust leaflet for carers of patients with Dementia has been developed and launches Trust wide in April 13, this gives information on support available and also signposts to services in community.

    Status:
    Implementation

    Update - First Quarter

    Nothing to report - New DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Adjustment Clinic checklist

    Reasonable Adjustment Clinic checklist developed and implemented to support patients and carers within the Out Patient setting. We proactively promote the This is me document. Trust wide and is integral to the in-patient care plan for the patient with known Dementia. An adapted ‘This is me’ Patient /Carer document, has been developed by the Trust  - for use by any patient/Carer - for the person who does not have known Dementia -  prompted within Out Patient setting and Emergency Department. This will be  launched Trust Wide April 2013

    Status:
    Implementation

    Update - First Quarter

    Nothing to report - New DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Trust Dementia Care Audit

     A Trust Dementia Care audit is undertaken three times a year this incorporated key questions of the Royal College of Psychiatrist National Audit of Dementia and NICE guidance: Dementia.

    Status:
    Implementation

    Update - First Quarter

    Nothing to report - New DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Trust participation in Reviews

    We have participated in the 2010 and 2012 Royal College of Psychiatrist National Audit of Dementia and in 3 South West Dementia Partnerships Dementia Peer Reviews, our Trust was last reviewed in January 2013, we have also participated as Dementia Peer Review team members.

    Status:
    Implementation

    Update - First Quarter

    Nothing to report - New DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Action plan for 2015

    During March 2015 we are updating our action plan and our new action plan will be posted – April 2015. 

    Status:
    Planning