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Liverpool Heart and Chest Hospital Foundation Trust

As a tertiary hospital, Liverpool Heart and Chest Hospital provides heart and chest services for the North West of England, including North Wales and the Isle of Man.

Updated:
13 March 2014
Location:
North West
Sectors:
Health, Hospitals and Hospital Trusts
Local Alliances:
Liverpool Dementia Action Alliance

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?

LHCH is pleased to declare its commitment to delivering better outcomes for patients with dementia. Managing the care of people with dementia is a significant part of the work of our staff.    Literature suggests that people aged 65 and over occupy two-thirds of beds in acute hospitals, and of these up to 40% have dementia.  Therefore In order to ensure that these patients and their care partners receive good quality care we need to:

  • Recognize which patients may be affected by dementia by ensuring that we assess all relevant patients on admission.  We do this via FAIR (Find, Assess, Investigate, Refer) assessment which was introduced in 2012. This will enable us to focus on continually improving the standards of care for patients with dementia, promoting care partners and recognizing the improvement in early patient carer and family involvement.
  • Ensure that staff are appropriately trained to manage those patients who are affected.  We have already trained over 30 staff, and have plans to roll this out further. This will  improve the Trust’s awareness and understanding of dementia and create a skilled and effective workforce- Involvement of the Alzheimer’s Society to support training and the creation of a staff information leaflet
  • Have mechanisms in place to support staff caring for patients with dementia, for example using this “care contract ” and “care partner”  document to ensure that staff have access to key information with regard to the individual, and further developing this with the new patient and family electronic portal.
  • Demonstrate our commitment within our Annual Plan to improving the care & service offered for people with Dementia & their families and also within the Patient and Family Experience Strategy.
  • To improve contacts with the wider community via health watch to enable safe discharge by providing easy access to care, support and advice
  • Provide good quality information for patients and carers diagnosed with dementia- development of an information leaflet
  • Delivery of the CQUIN dementia standards to drive quality improvement and innovation- Screening, assessment and referral
  • Development of Ward based information folders which include information on nutrition and hydration, challenging behavior and Delirium
  • Development of dementia friendly ward areas in the line with the trust enhancing the healing environment work
  • Review of LHCH discharge policy to include patients with dementia- minimal ward moves, timely discharge

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

The key challenges to our ability to deliver patient and family centered care for patients with dementia are:

  • Failure to diagnose early, embedding strong performance in screening & diagnosis of Dementia.
    Recruitment of volunteers to support ward based activities
  • Ensure timely and safe discharge
  • Ensure all staff receive dementia awareness training
  • Our volunteers come, at the moment, mainly from our former service users and are experts by experience and therefore crucial to our services and we will work to inspire younger volunteers to support our befriending work for the future.
  • Activity levels – this impacts on both the quality of care we are able to deliver for our patients, particularly recognizing that patients with dementia may require additional support, and our ability to release staff to attend training.
  • Assessment and recognition – willingness of medical staff to complete the assessments and take appropriate action, as their focus is on treating the acute illness which has led to the admission.
  • Flexibility of services – we need to recognize that the needs of dementia patients do not always “fit” within our Organisational policies and structures and have an adaptable approach that is individualized.

Member contacts

http://www.lhch.nhs.uk/

2. Actions

  • To ensure continued roll-out of dementia awareness

    Develop a robust training plan to ensure continued roll-out of dementia awareness and more in-depth training for staff of all levels.

    Status:
    Implementation

    2013 - Third Quarter Update

    • New member
    • In development
  • Appoint a clinical lead for dementia

    To raise awareness with staff of the need to complete the dementia assessment.

    Status:
    Delivery

    2013 - Third Quarter . We are currently hitting the targets for the CQUIN.

  • Improve the physical environment within the hospital to ensure it is “dementia friendly”.

    Improve the physical environment within the hospital to ensure it is “dementia friendly”.

    Status:
    Delivery

    2013 - Third Quarter Update

    We have undertaken a full scoping to look at the dementia friendly ward environment

  • Complete the national dementia audit

    Complete the national dementia audit.

    Status:

    2013 - Third Quarter Update

    New member

  • Develop a Care Partner policy

    Develop a Care Partner policy and introduce a survey for carers of people with dementia to assess their experience of hospital services.

    Status:
    Initial Scoping

    2013 - Third Quarter Update

    New member