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Shropshire Community Health NHS Trust

Shropshire Community Health NHS Trust provides community-based health services for adults and children in Shropshire, Telford and Wrekin, and some services in surrounding areas too. These range from district nursing, health visiting and running four community hospitals through to providing very specialist community care through talented and dedicated staff.

Updated:
22 May 2019
Location:
West Midlands
Sectors:
Care, Health, Hospitals and Hospital Trusts, Medical
Local Alliances:
Shropshire, Telford & Wrekin 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?

Ensure our approach to the care of patients with dementia is modern, evidence based and standardized throughout services.

Become a dementia friendly organisation with appropriate environments, skills and processes to reduce harm, and provide safe, effective care.

Deliver individualized care that supports the person with dementia and their carer.

Develop partnerships to improve collaborative working and improved pathways of care

Develop a skilled and effective workforce that will champion compassionate care for patients with dementia.

S.P.A.C.E.  – supporting good dementia care

Staff who are skilled and have time to care.

Partnership working with carers.

Assessment and early identification.

Care that is individualised.

Environments that are dementia friendly.

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

The Trust has difficulty with ensuring that agency staff are dementia aware.

Uptake of Dementia training is variable due to time, geographical distance, and reliance on local champions.

2. Actions

  • Supporting staff need to be informed, skilled and have enough time to care

    All SCHT staff to undergo dementia friends training by the end of 2019

     Identification of Dementia Champions in each service who will have support to undergo higher level or bespoke training e.g. Dementia and end of life.

    TNA against HEE dementia awarensss core skills

    We will seek opportunities to work collaboratively with local universities and staff undertaking academic research and clinical audit

    We will endeavour to ensure as part of our assurance that agency staff are dementia aware

    Status:
    Implementation

    2019 - First Quarter Update

    Need to get update list on Dementia Training from ESR. Already doing this as part of a HEE data request. Check that M&WB workers are lining up sessions. When they do them they send Attendance list to OD / ESR administrsator ESR update so we can keep a check on numbers

    HEE competency framework Needs to be discussed as part of RSET training group. 

    Dementia related research in in the research plans as we have secondment for 1 year so far on of a research delivery nurse from MPFT 

    Central bank to identify what framework agencies are supposed to provide in terms of dementia awareness? Could we invite our ‘ regular’ agency to a dementia friends session 

  • Family, carers and friends are seen as partners in care

    We will provide a dementia specific welcome pack for patients and carers both in hospital and community

    The continued and wider use of John’s Campaign in all 4 hospitals and the community setting. To be embedded in every day practice in care plans

    Dementia Cafes to be rolled out at Ludlow and Bishops Castle

    Re-launch of Reach out to me/This is me document for all patients that require it

    We will promote that patients and carers are represented in the planning and design of estate Décor, bathrooms, signage changes or improvements

    Status:
    Planning

    2019 - First Quarter Update

    Possible need to engage with capital and estates group and LCMs to ensure relevant expert groups are involved in new developments

    Our two lead RMNs to meet with local groups and discuss how better we can work together to support our patients at home and in hospital and to ensure the wider implementation of Johns Campaign

    Dementia welcome pack needs development

  • Assessment patients should be assessed using a standardised tool to facilitate prompt, early dementia identification and management of delirium and underlying aetiology

    Assessment therefore will be supported by:

    The development of identified Dementia Champions in our Community Hospitals Community Services and Prison.

    Use of agreed screening and assessment tools (FAIR) Skilled knowledgeable practitioners

    Clear delirium protocols and dementia pathways

    Clinical review of medication to support the appropriate use of antipsychotic medication

    Health education and preventing risks of dementia onset within the prison population at Stoke Heath

    Enhance our application of the principles of the Mental Capacity Act and Covert Medicines Policy

    Status:
    Delivery

    2019 - First Quarter Update

    An audit of MCA / DOLS knowledge and practice is underway – . Audit due to complete mid-June and Adult Safeguarding Lead will look at findings – link in with Anthony to ensure action plans are shares with this group and champions

    RMN  ensuring the right screening tools are in place

    RMN to work with Rio Config team

    Scoping prison health for identified champion to support early screening programme and risk factor health education

     Probable re launch / re education programme

  • Care plans will be person-centred, responsive to individual needs and support nutrition, dignity, comfort, continence, rehabilitation, activity and palliative care

    This will be supported by:

    Routine gathering of personal life story information making including the use of Who I Am, this is Me  or the Butterfly carers sheetInvolvement of family and friends in care planning with documented evidence of their involvementUse of mental capacity assessments, advance care planning, nutritional tools, pain assessments and safety tools

    Provision of appropriate activity to encourage social engagement, maintenance of function and recoveryAvailability of dementia champions / leadsAccess to and availability of palliative care specialists

    We will endeavour to provide snack boxes for patients living with dementia in our wards and explore the greater use of high water content foods and droplets.       

      We will provide a dementia specific welcome pack for patients and carers both in hospital and community    

    We will continue to invest in all hospital sites using Digital reminiscence Therapy (MY LIFE) – Re launch and improve its use 

    The continued and wider use of John’s Campaign in all 4 hospitals and the community setting. To be embedded in every day practice in care plans

    Embedded use of Abbey pain score

    Patient equipment crockery and uniforms are standardised for the trust as appropriate using evidence base and /or patient input in design

    We will promote that patients and carers are represented in the planning and design of estate Décor, bathrooms, signage changes or improvements

    Status:
    Delivery

    2019 - First Quarter Update

    RMNs to source and search for any relevant assistive technology we currently don’t use. ? Support them on national assistive technology conferences. Involve therapy leads 

    Need to engage with capital and estates group and LCMs to ensure relevant expert groups are involved in new developments

    Abbey Pain _ We have done some  training but it needs to go trust wide and be embedded in Rio as a pain assessment tool

  • Environments will be dementia friendly and support independence and wellbeing

    Minimal moves around the ward to avoid unnecessary distress and disorientation.

    Appropriate décor, lighting and floor coverings plus aids to support orientation and visual stimulation.

    Decorative schemes will be aligned to the scheme piloted at Whitchurch Community Hospital based on evidence from other dementia specialist ward sites. Signage will be also aligned to Whitchurch and Bridgnorth current schemes; an example is below and is based on the principles of colour contrast, numerical and pictorial display.

    In addition individual, pictorial bed identifications will be used. Signage should be in alignment with the language that is recommended in the Dementia Engagement and /empowerment Project ‘Words Matter Campaign’.

    Adequate space and resources to support activity and stimulation including a reminiscence communal area to sit and undertake activity which may incorporate ‘retro’ design and / or the use of Rempods (www.rempods.co.uk). The area should contain reminiscence objects. Infection control advice should be sought on minimising the risk of cross infection from communal reminiscence equipment.

    We will encourage use of the outdoor therapy environment

    We will continue to invest in all hospital sites using Digital reminiscence Therapy (MY LIFE) – Re launch and improve its use 

    Status:
    Delivery

    2019 - First Quarter Update

    Digital therapy - Need to take stock of what we have and whats already in place. RMNs to source and search for any relevant assistive technology we currently don’t use. ? Support them on national assistive technology conferences. Involve therapy leads 

    need to engage with capital and estates group and LCMs to ensure relevant expert groups are involved in new developments