More information:
Overview of the findings of Peer review stage 1, 2011
Good progress with implementing the South West Standards for Dementia Care in Hospital was demonstrated across the majority of general hospitals, and there was evidence of excellent practice in a number of areas.
The peer review teams noted, in particular, strong engagement from hospital senior teams and trust Board members, and that hospitals that had achieved greater progress in delivering their implementation plans appeared to have had better engagement at Board level. Leaders, innovators and enthusiasts were evident in all hospitals; these individuals were in the most senior positions, and the most junior. Where Dementia Champion roles had been well defined, established and supported with opportunities for continuing professional development, greater levels of awareness about dementia and ‘dementia friendly’ environments were more in evidence.
Whilst the review focused on dementia care in general hospitals, there was evidence in some localities that system wide developments involving primary and intermediate care were being established and were also having a positive impact.
Peer review teams observed that those organisations that had developed a comprehensive dementia training plan and were delivering this trust-wide to all staff groups, including to medical and ancillary staff, demonstrated greater awareness of and knowledge about the needs of people with dementia. Similarly, this appeared to be reflected in the way that care was delivered and the environment organised.
The peer review process highlighted a significant shortfall in mental health liaison services in the majority of hospitals in the region. Whilst there were pockets of positive practice, a number of hospitals did not provide mental health liaison services seven days a week and out of hours, and staff numbers or capacity were low.
There were fewer examples of positive practice in outpatient and day surgery units. In a proportion of units, staff were of the view that they did not see many patients who had dementia, including in those areas where there are a high proportion of older people in the population.
In a number of hospitals, efforts to make the environment more ‘dementia friendly’ had been left largely to the initiative and efforts of a small number of committed staff. An organisation-wide approach to ensuring that the environment meets the needs of the frail older person was in evidence in only a small proportion of hospitals.
The Dementia Champion role had been promoted in the majority of hospitals. However, a proportion of hospitals were not able to demonstrate sustained support and development for this group.
Opportunities for improvement in screening for memory problems, documentation, record keeping, the use of symbols to alert staff to people with specific needs, and the use of a patient held record such as the ‘This is Me’ documentation (Alzheimer’s Society, 2010)6 were identified in a number of sites.
Further information
Kate Schneider, Programme Lead, Dementia, Mental Health, Autism, NHS South of England (West) [email protected]