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Heatherwood and Wexham Park Hospitals NHS Foundation Trust

Heatherwood and Wexham Park Hospitals NHS Foundation Trust provides hospital services to a large and diverse population of more than 450,000 which includes Ascot, Bracknell, Maidenhead, Slough, south Buckinghamshire and Windsor.

Updated:
9 February 2016
Location:
South East
Sectors:
Pharmaceutical, Health, Care, Hospitals and Hospital Trusts
Local Alliances:
Buckinghamshire 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 Trust has Registered Mental Health Nurses who work within the general areas to support the clinicians and ward teams to ensure timely assessments, access to services, and provision of support for both patients and carers. There is close working with the social care team who complete capacity assessments relating to social care needs. There is a dedicated palliative care team who work closely with the wards and we are currently piloting the AMBER project. 

‘This is me’ documentation has been introduced. There is monthly training for staff (1 day), this includes a talk by a carer as well as addressing the psychological and physiological care needs. There is a 1950’s reminiscence room for use by patients and carers and toilets and rails are being fitted in contrasting colours to promote safety. The Trust has a Privacy and Dignity (P&D) Practice Development Nurse and each ward has P&D Champions. 

The Trust has regular strategy meetings which includes hospital and community staff, the Alzheimer’s society as well as carer representation to addressing acute hospital care. The Mental Health Team provide information and networking opportunities and have access to the community data case regarding patient diagnosis. 

There are on site assigned social workers to each ward who attend the wards on a daily basis, staff complete notifications (section 2) the social work department of any possibility of care needs or support required on discharge. The Trust uses the Independent Mental Capacity Advocacy service. 

The dementia SD provides staff with skills to recognise and manage challenging behaviours, the mental health team ensure staff follow a person-centred care plan regarding management of individual patient behaviours. We are working with the community teams to facilitate use of assistive technologies.

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

High numbers of patients admitted who although presenting with symptoms have not been diagnosed.  This creates challenges to ensure patients and carers are given sufficient support and that the persons discharge is not delayed due to it being considered unsafe for the person to return to their own home. As it is a challenge to maintain the persons independence and try to prevent them from losing skills whilst in hospital. 

Maintaining dementia as a key priority against other Trust priorities 

The hospital environment is challenging and to address this there are a number of initiatives being taken forward. Recently this has included a ‘walk about’ of part of the hospital by a disabled person which demonstrated the limitations of the current signage available for patients and visitors. 

Currently the wards do not use colours to contrast different areas of the ward and aid visual access to the toilets. There are limited areas where patients and carers can meet together, the recently opened reminiscence room has provided greater opportunity for this and the Trust bid successfully from the recent South of England Dementia challenge money to purchase further reminiscence equipment. 

Nutritional issues – personal likes / dislikes, sufficient calorific intake, maintaining social interaction with meal time experience

2. Actions

  • Continue training for all staff

    Continue training for all staff to ensure fully skilled and knowledgeable workforce which will inform identification, assessment and treatment of cognitive impairment 

    Status:

    Update – First Quarter

    In progress

    Update – Second Quarter

    In progress

    Update – Third Quarter

    In progress 

  • Collaborative working with care homes

    Collaborative working with care homes to assist in supporting patients who have unplanned admissions

    Status:

    Update – First Quarter

    In progress

    Update – Second Quarter

    In progress

    Update – Third Quarter

    In progress 

  • Environmental changes

    Environmental changes: development of signage, colours, lighting, music. Development of area in A&E specifically for people who have dementia. Development of garden areas to make safe areas for patients to walk. Development of facilities for carers and relatives to be able to stay in the hospital 

    Status:

    Update – First Quarter

    In progress

    Update – Second Quarter

    In progress

    Update – Third Quarter

    In progress 

  • Development of reminiscence areas

    Development of reminiscence areas using rempods and my life soft ware which takes into account the ethnic diversity of the population which the Trust serves 

    Status:

    Update – First Quarter

    In progress

    Update – Second Quarter

    In progress

    Update – Third Quarter

    In progress 

  • Development of resource areas for relatives and carers

    Development of resource areas for relatives and carers

    Status:

    Update – First Quarter

    In progress

    Update – Second Quarter

    In progress

    Update – Third Quarter

    In progress

  • Further collaborative

    Further collaborative working with the community to prevent delayed discharge 

    Status:

    Update – First Quarter

    In progress

    Update – Second Quarter

    In progress

    Update – Third Quarter

    In progress

  • Development of easy read information

    Development of easy read information 

    Status:

    Update – First Quarter

    In progress

    Update – Second Quarter

    In progress

    Update – Third Quarter

    In progress

  • Participation in research projects

    Participation in research projects 

    Status:

    Update – First Quarter

    In progress

    Update – Second Quarter

    In progress

    Update – Third Quarter

    In progress

  • Development of befriending service

    Development of befriending service for patients and carers

    Status:

    Update – First Quarter

    In progress

    Update – Second Quarter

    In progress

    Update – Third Quarter

    In progress