This project aims to ensure that staff working in University Hospital Southampton are dementia aware and have the appropriate skills to meet the needs of people with dementia.

Dementia currently affects 800,000 people in the UK. In Southampton city alone that equates to over 3000 people. With the predicted increase by 2050 this will equate to 6500 people in Southampton. University Hospital Southampton (UHS) has 1100 beds and employs a workforce of 10,000 people who live mainly within the Southampton area. With our partners within this project, we are passionate about having a whole system approach to developing a Dementia Friendly Community within Southampton and ensure the dementia friendly vision and message cascades from the hospital to the community where people live and work.

We want to improve the experience of people with dementia throughout the community and recognize that one of the biggest stumbling blocks causing deterioration and stress to people with dementia and their carers is physical illness exacerbated by admission to acute hospital settings. A diagnosis of dementia can increase the risk of falls within the acute hospital environment which can cause further deterioration in health and prolong hospital admissions. Complaints regarding the care of people with dementia is common and a significant concern is that people with dementia often lose weight in an acute hospital setting. There is clear evidence of a need for partnership working to develop excellence in our care of this client group, to enable them to “live well” with dementia (National Dementia Strategy DoH 2009, Report of the National Audit of Dementia Care in General Hospitals 2011). We need to deliver on three key themes as discussed within the paper Equity and Excellence, Liberating the NHS (2010) of “putting patients first”, “High Quality care for all” and “Nothing about me without me”.<

Deliverables

To meet our challenge we are seeking to transform the environment of care in our community. Specifically we will

• Begin a programme to ensure that all staff in the trust receive dementia awareness training.
• Give enhanced training and education to those delivering care.
• Identify and train “dementia Champions” in all relevant clinical areas.
• Develop carer support and information groups.
• Make the hospitals physical environment more “dementia Friendly”.
• Introduce “This is me” – a tool designed to introduce the person with dementia to care staff across services in order to support person centered care.

We will provide a robust face to face training and coaching package to up skill staff led by the Admiral Nurse Specialist, and also to utilize e learning packages such as the open learning programme on dementia from SCIE to support and embed staff knowledge. We have recognized the benefit of experiential work in enhancing practical skills and building confidence of staff in their interactions and aim to use actors to enable staff to develop this.

Learning from elsewhere

There are examples of good practice in other areas of the country, notably at Newcross Hospital, Wolverhampton who have a dementia ward within their acute hospital and a robust learning and development programme that is delivered across the trust. We wish to adopt and adapt this approach to our community. However following our evaluation of this model we believe that all areas within the acute hospital should be dementia friendly rather than developing just one ward. Kings College Hospital in London has developed a dementia friendly environment as part of the Kings Fund Enhancing Healing Environment Programme. (Kings Fund 2009 updated 2012) We aim to emulate their lead in innovation but also to take it a step further so that all wards are dementia friendly and refurbished to the same standard.

“This is me” is an Alzheimers Society version of patients passports that helps to improve the care of people who may be vulnerable within mainstream services. And it has proved successful in Humber Mental Health Teaching NHS Trust. The Patient Passport is a simple communication tool that articulates the normal everyday needs of a person. It helps mainstream services deliver person centred care and understand their individual needs. The Patient Passport initially focused on people with learning disabilities but has now developed for people with dementia, end of life and long term conditions. In Southampton we want to adopt ‘this is me’ as a communication tool for everyone with Dementia coming in and out of the acute hospital setting.

>Overall UHS recognises the pockets of good practice through out the country and we have the drive and passion to review, adapt and deliver this to fit with the needs of people with Dementia and their carers in our own local community.

Anticipated outcomes

This project seeks to improve the acute hospital experience for people with dementia and their family. This will be achieved by

• Increasing the understanding of dementia across the workforce to ensure that they are able to understand the complexities.
• Improving the quality of the physical environment so that disorientation and disability induced by the environment is reduced.
• Introductions of tools and training to support person centered care across the hospital, ensuring their care is directed to their individual needs, creating a culture of empathy, quality and continuity of care.
• Introduction of ‘THIS IS ME’ as standard, both within the community and the acute hospital, to enable staff to understand the person behind the dementia/confusion which will lead to a person centered approach to care.
• A Reduction of the use of antipsychotics.
• Improved patient and family carer experience.
• Improved patient pathways through reduction in length of stay and readmissions
• Strengthening of the health community through effective communication and improved interface between health and social care.