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Darent Valley Hospital, Dartford & Gravesham NHS Trust

Darent Valley is a modern hospital in Kent offering professional care, exceptional quality. We provide patients with the latest technology for their treatment in safe, comfortable and clean surroundings. The hospital's team of around 2000 professional and friendly staff provide care for patients across a full range of day-patient, in-patient and out-patient care. We work closely with our local community to improve the standards of our services and welcome all patients both locally or further afield. Dartford and Gravesham NHS Trust (the Trust) was legally established on 1st November 1993, and is based at Darent Valley Hospital, in Dartford, Kent. It offers a comprehensive range of acute hospital based services to around 270,000 people in Dartford, Gravesham, Swanley and Bexley. The hospital opened in September 2000 and now has around 463 inpatient beds and specialties that include day-care surgery, general surgery, trauma, orthopaedics, cardiology, maternity and general medicine.

Updated:
26 November 2015
Location:
South East
Sectors:
Health, Medical, Hospitals and Hospital Trusts, Emergency Services Sector
Local Alliances:
Dartford, Gravesham and Swanley 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?

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?  

 Work closely with local NHS and Council, in the delivery of local action plans intended to meet the objectives within the Dementia Strategy.A Trust multi-agency Dementia Care Steering Group is responsible for delivering the objective related to acute hospital care. Areas for development form part of a work plan detailing how the experiences of patients will be improved in hospital.(including Dementia Buddy Service, Sensory Garden, improving environment)Develop a Dementia Challenge Action Committee which has created an action plan specifically with plans to improve the environment within the Trust for patients with Dementia.Provide dementia specific expertise within the Trust to educate and support multidisciplinary staff, patients and carers.Ensure staff are appropriately trained in dementia care to enable an informed and effective workforce.Develop an explicit care pathway for the management and care of people with dementia and cognitive impairment.Improve the quality of patient care and outcome.Developed a Dementia Buddy Volunteer Service to provide support to in-patients with dementia and improve the patient experienceImprove the end of life care for patients with dementia.Patients diagnosed will receive written and verbal information about their condition, treatment and the support options in their local area.Ensure that patients with suspected or known dementia have access to a liaison service that specialises in the diagnosis and management of dementia and older people’s mental health.Positive about providing integrated healthcare services.Continually audit and evaluate services which impact upon the care we provide patients with dementia and strive to continually improve our services and our patient, service user and carer experience, as well as reducing the stigma associated with mental illness and learning disability.

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

Infection control, patient activity and volume Encouraging others to prioritise implementation of the local Dementia Strategy as well as the Department of Health’s strategy. Ensuring dementia is a key local priority. Ensuring patient profiles are completed with adequate information to deliver person-centred care. Addressing nutritional issues for patients in the most acceptable way for catering and dietetic services. Improving services and meeting the increasing demand. Competing priorities – internally and externally.. Disparity of expectations from stakeholders. Keeping the profile high in an atmosphere of uncertainty and transition. Continue to work collaboratively with local GPs and other health team members on early diagnosis, the reduction in use of anti-psychotic drugs. Improving the commissioning of services for people with dementia. Encourage and support localities to prioritise implementation of the National Dementia Strategy. Attitudes of staff/patients and carers towards Dementia. The stigma attached to Dementia. Resources (staff/ expertise/facilities/ finances)

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

Work closely with local NHS and Council, in the delivery of local action plans intended to meet the objectives within the Dementia Strategy.A Trust multi-agency Dementia Care Steering Group is responsible for delivering the objective related to acute hospital care. Areas for development form part of a work plan detailing how the experiences of patients will be improved in hospital.(including Dementia Buddy Service, Sensory Garden, improving environment)Develop a Dementia Challenge Action Committee which has created an action plan specifically with plans to improve the environment within the Trust for patients with Dementia.Provide dementia specific expertise within the Trust to educate and support multidisciplinary staff, patients and carers.Ensure staff are appropriately trained in dementia care to enable an informed and effective workforce.Develop an explicit care pathway for the management and care of people with dementia and cognitive impairment.Improve the quality of patient care and outcome.Developed a Dementia Buddy Volunteer Service to provide support to in-patients with dementia and improve the patient experienceImprove the end of life care for patients with dementia.Patients diagnosed will receive written and verbal information about their condition, treatment and the support options in their local area.Ensure that patients with suspected or known dementia have access to a liaison service that specialises in the diagnosis and management of dementia and older people’s mental health.Positive about providing integrated healthcare services.Continually audit and evaluate services which impact upon the care we provide patients with dementia and strive to continually improve our services and our patient, service user and carer experience, as well as reducing the stigma associated with mental illness and learning disability.

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

Infection control, patient activity and volume Encouraging others to prioritise implementation of the local Dementia Strategy as well as the Department of Health’s strategy. Ensuring dementia is a key local priority. Ensuring patient profiles are completed with adequate information to deliver person-centred care. Addressing nutritional issues for patients in the most acceptable way for catering and dietetic services. Improving services and meeting the increasing demand. Competing priorities – internally and externally.. Disparity of expectations from stakeholders. Keeping the profile high in an atmosphere of uncertainty and transition. Continue to work collaboratively with local GPs and other health team members on early diagnosis, the reduction in use of anti-psychotic drugs. Improving the commissioning of services for people with dementia. Encourage and support localities to prioritise implementation of the National Dementia Strategy. Attitudes of staff/patients and carers towards Dementia. The stigma attached to Dementia. Resources (staff/ expertise/facilities/ finances)

Member contacts

http://www.dvh.nhs.uk/

Member website

www.dvh.nhs.uk

2. Actions

  • The environment in which care is given:

    Via the Dementia Challenge  and Charitable funding  :

    Improve the physical environment within the Hospital including pictorial signage and dementia friendly colour and font. Provide colour identifiable bays /curtains pictures within elderly care ward. Change the colour of the tolilet seats to provide clear distinction between seat and bowl to help prevent falls Introduce activity,  memory boxes and MP3 players Introduce picture books for reminiscence therapy Expand the Dementia Buddy Service to all wards/departments within the hospital Develop a reminiscence corridor within the hospital Develop a Sensory Garden within the hospital Introduce the Forget - Me – Not Scheme .  Provide dementia friendly cutlery and protected meal times with red tray system for vulnerable adults

    Status:
    Delivery

    2015 - Third Quarter Update

    The physical environment within the Hospital has been improved in areas where patientd with dementia are largely located, including the new assessment area in A&E.  This includes pictorial signage and dementia friendly colour and font.  Colour identifiable bays /curtains pictures within the elderly care ward and Ortho-Geriatric bay have been provided.  The colour of the tolilet seats has been changed to provide black on white to provide clear distinction between seat and bowl to help prevent falls on the eldlery Care Ward. Activities, memory boxes and music have been provided to wards. Picture books for reminiscence therapyhave been provided Trustwide. The Dementia Buddy Service is available as,resources allow, to all wards/departments within the hospital. A  reminiscence corridor within the hospital has not been developed due to challenges with space, but a dementia cafe is in situ on the ~Eldlery Care Ward.  The development of a Sensory Garden within the hospital has been delayed due to space issues. The  the Forget - Me – Not Scheme has been introduced but needs further work to embed in practice. Dementia friendly cutlery are being provided and and protected meal times with red tray system for vulnerable adults has been implemented.

  • The knowledge, skills and attitudes of the workforce:

    Continue to provide Dementia Awareness training for all staff. Explore alternative providers of Dementia Training to involve the voluntary sector. Inform staff about mental illness and mental health promotion. Ensure Dignity Champions are available to access in all wards/departments. Recruit a Band 7 Dementia Practitioner with education as a key part of the role Expand and recruit the Dementia Buddy Co-ordinator post to work bedside with volunteers and staff to provide coaching and role modelling. Ensure that the Lead Clinician for Dementia provides regular junior doctor training. Ensure all FY1 junior doctors Spend 1 month within the local Mental Health Unit. Ensure our PFI partners provide any necessary training for security, portering and domicillary staff and assist if required. Continue to implement the Dementia Observation Audit Schedule for each Ward within the Trust, providing feedback to the ward staff and developing action plans(which are evaluated quarterly) to improve care.

    Status:
    Delivered

    2015 - Third Quarter Update

    The Trust continues to provide Dementia Awareness training for all staff. Level 1 training is provided via an internally developed film, with level 2 training provided via a study day. Dementia is not yet part of medical or nursing induction but the team continue to endeavour to obtain a formal slot. The team take every opportunity to  Inform staff about mental illness and mental health promotion and have utilesed stals in the hospital foyer during Dementia Awareness weeks.    Dignity Champions are available to access in all wards/departments.  A Band 7 Dementia Practitioner with education as a key part of the role is in post, supported by a new Ageing and Health Matron. A second Dementia Buddy Co-ordinator is now in post to cover 7 days per week to work bedside with volunteers and staff to provide coaching and role modelling. A new Lead Clinician for Dementia has recently been identified and aims to provide regular junior doctor training which is currently adhoc.   FY1 junior doctors spend 1 month within the local Mental Health Unit. Our PFI partners provide any necessary training for security, portering and domicillary staff and assist if required. The initial observational audits and follow up schedule was completed on all relevant wards/departments and action plans agreed with each ward sister.

    2013 - Second Quarter Update

    New Member

  • The ability to identify and assess cognitive impairment:

    Promote early diagnosis of dementia by continuing to develop pathways for dementia/delirium care. To continue to develop improved assessment processes and care planning involving the person with dementia, their relatives/carers. Introduce guidelines on the completion of the mini mental test on patients admitted over the age of 75. Ensure Cquin targets are met. Continue to provide MCA training for relevant staff Work in partnership with mental health, community and social colleagues to provide an integrated approach

    Status:
    Delivery

    2015 - Third Quarter Update

    Pathways for dementia/delirium care have been developed and are available via the hospital intranet site to promote early diagnosis of dementia. Work continues to develop improved assessment processes and care planning involving the person with dementia, their relatives/carers, by using a patient centred approach.   Guidelines on the completion of the mini mental test on patients admitted over the age of 75 have been developed but need to be embedded in practice, particularly on discharge- new Clinical lead for dementia to take forward.    Cquin targets have been met to date.  Admin support to assist in data collection has recently been improved and recruitment process commenced. We continue to provide MCA training for relevant staff Work in partnership with mental health, community and social colleagues to provide an integrated approach

    2013 - Second Quarter Update

    New Member

  • The ability to support people with dementia to be discharged back home:

    To continue to work closely with voluntary services within the hospital and other local voluntary bodies. Work with commissioners to ensure that adequate intermediate care facilities for assessment and rehabilitation are provided for patients with dementia to give them the opportunity of returning to their own homes. Promote safe and early discharge with improved personal and community support. Develop information for clinical areas regarding services available in the community. Have access to alternative accommodation when they can not remain at home. Ensure that people are not inappropriately admitted and are supported to return home as quickly as possible. Work with Commissioners to influence the development of services in line with the recommendations of the National Dementia Strategy Provide consistent signposting to patients and carers regarding support services available in the community upon discharge. Develop a form of follow up service on discharge to ensure that patients/carers are receiving the support that they need to enable them to cope at home. Continue to work closely with the Carer’s First Project Worker to provide support to carers of patients admitted to hospital.

    Status:
    Delivery

    2015 - Third Quarter Update

    The Trust continues to work closely with voluntary services within the hospital and other local voluntary bodies., such as ADSS and Carer's First. Work with commissioners to ensure that adequate intermediate care facilities for assessment and rehabilitation are provided for patients with dementia to give them the opportunity of returning to their own homes is ongoing. Promotion of  safe and early discharge with improved personal and community support continues with the introduction of a 'Discharge to Assess' approach via the Hospital at Home and Integrated Discharge Teams. These teams with the new Ambulatory Care Service ensure that people are not inappropriately admitted and are supported to return home as quickly as possible.  Information for clinical areas regarding services available in the community via the hospital website and carer's clinics.  . Work is ongoing with Commissioners to influence the development of services in line with the recommendations of the National Dementia Strategy Provide consistent signposting to patients and carers regarding support services available in the community upon discharge. A form of follow up service on discharge to ensure that patients/carers are receiving the support that they need to enable them to cope at home has been implemented via the Carer's First Charity and the Trust continues to work closely with the Carer’s First Project Worker to provide support to carers of patients admitted to hospital.

    2013 - Second Quarter Update

    New Member

  • The use of a person-centred care plan which involves families and carers:

    Continue to raise awareness regarding the recently launched ‘Forget-Me- Not Scheme’. Continue to raise awareness regarding the ‘This is Me’ document. Continue to ensure that the cognitive impairment specific care plan is used appropriately by staff. Introduce a carer/patient/staff communication  tool to share experiences or issues Working with the Dementia Buddy Co-ordinator and Volunteer Manager to increase the number of volunteers supporting patients with dementia. Ensure people experience equality of service regardless of ethnic, religious, or demographic profile. Introduce tea afternoons for carers/staff/patients to share experiences and provide feedback.

    Status:
    Being implemented

    2015 - Third Quarter Update

    Carers First hold a 1-1 support clinic in the hospital twice a week which is problem-focussed.  The  ‘Forget-Me- Not Scheme’has been launched but still requires work to mainatin momentum and embed in practice.. Awareness continues to be raised regarding patient centred care planning using tools such as the ‘This is Me’ document. The Team continue to ensure that the cognitive impairment specific care plan is used appropriately by staff. Work also continues with the Dementia Buddy Co-ordinator and Volunteer Manager to increase the number of volunteers supporting patients with dementia. . 'Tea with Matron'  afternoons for carers/staff/patients to share experiences and provide feedback have been established in some departments.

    2013 - Second Quarter Update

    New Member

  • Underpinning actions:

    Having a board level commitment to becoming dementia friendly Dementia lead within the organisation Network of dementia/dignity champions Continue to implement Dementia Observation Audits across the Trust To commence a Discharge Outreach Dementia Liaison Service within the Trust. To continue to develop central resources via intranet. Working with wards at protected meal times, visiting times, coloured trays etc. To network locally, regionally and nationally to share good practice

    Status:
    Delivered

    2015 - Third Quarter Update

    The Trust has a board level commitment to becoming dementia friendly led by the Director of Nursing.  The Dementia lead within the organisation has been identified and works closely with the Dementia Specialist Practitioner who has been appointed since the last update.  There is a  Network of dementia/dignity champions who meet quarterly. Initial  Dementia Observation Audits and follow up have been carried out across the Trust and actions agreed with the ward sisters.  The Trust still wishes to introduce a Discharge Outreach Dementia Liaison Service within the Trust but has been unable to within the current resource.  The Dementia Team  attend  Dementia friendly meetings locally and national conferences  to share good practice

    2013 - Second Quarterly Update

    New Member