This is an innovative new service which draws on best evidence to improve the quality of life of people with dementia through the development of a care home learning community.

The South Devon and Torbay Clinical Commissioning Group and Devon Partnership NHS Trust were jointly named Dementia Team of the Year at the British Medical Journal awards 2015 in recognition of this project. Read more about the Dementia Team of the Year award.

Background

In 2009, Sir Jerry Robison appeared in two programmes for BBC 2 called ‘Can Jerry Robinson fix dementia care homes?’ The programme highlighted the best and worst of dementia care in care homes. The latter was illustrated by a psychiatric care home in Torbay. In 2010, around 1 in 8 care homes in Torbay were rated as poor by the CQC. In response to these concerns and the recent publication of the National Dementia Strategy the Torbay Older Peoples Mental Health Local Implementation Group which includes carers, GPs, care home owners, secondary care clinicians and managers reviewed best practice and evidence and developed an innovative and cost-effective solution to support the very large number of local care homes (225 care homes for a population > 65 of 65,149) to improve the quality of life of people with dementia and address the learning and development needs of staff. The local care home industry is a key part of the local economy and major employer in South Devon and Torbay.

The project group realised many of the recognised models to support practice development in care homes would not be transferrable or sustainable due to the very high number of care homes in the locality and have worked closely with carers and care homes to adapt the consultative, collaborative and psychosocial interventions which have been shown to improve the quality of life for residents and staff, reduce challenging behaviour, acute admissions and also prescription of antipsychotics to local circumstances. Some members have also visited Gloucestershire which has developed a now fully funded multidisciplinary care home support team which has helped to shape the model. This service has recruited 80 dementia link workers in care homes across the county and has collected evidence of a substantial impact in improving the quality of life and care for people with dementia in care homes.

This project will utilise a team of Dementia Learning Facilitators hosted by Devon Partnership NHS Trust to work with care homes to identify, train and support a care worker to be a Dementia Champion in their work place. They will be networked with other care home Dementia Champions to share learning with facilitated monthly meetings/teleconferences. There will also be a monthly team award and newsletter highlighting successful practice and an annual conference showcasing successful improvements made in the quality of care for people with dementia in local care homes participating in the scheme. The training and facilitation would be free for care homes.

Over 6 weeks the Learning Facilitators will work alongside the Dementia Champions in a consultative way to help them develop leadership skills, develop clarity of staff roles and align their attitudes, behaviours and skills to best practice, improve person centred care and care planning and improve environments (all factors identified as key to the quality of care in research conducted by the SW Dementia Partnership in 2009, and in key research). The Learning Facilitator will use an educational programme, simple audit, change management theory and improvement and spread methodology e.g. ‘Plan, Do, Study, Act’ cycles to help introduce, embed and sustain positive changes in dementia care and support the Dementia Champions throughout the project. The facilitated network meetings will help to sustain improvements and support the work of the Dementia Champions.

Objectives

• To establish a cost effective and sustainable solution to improve the quality of life for people with dementia living in the large numbers of care homes in South Devon and Torbay
• To improve the job satisfaction, confidence and knowledge of care home staff working with people with dementia and hence staff retention
• To reduce antipsychotic prescribing for people with dementia living in care homes – National target
• To reduce acute hospital admission for people with dementia living in care homes – CCG QIPP target (to reduce acute admissions from care homes by 10%)

Anticipated outcomes

• Improved quality of life for people with dementia living in care homes – use dementia care mapping
• Improved carer/family feedback – carer satisfaction questionnaire, semi-structured interviews/focus group
• Improved satisfaction, confidence and knowledge of care home staff working with people with dementia – Improved staff retention rates, staff survey
• Reduced safeguarding incidents and falls
• Reduced antipsychotic prescribing for people with dementia living in care homes – quarterly audit following initial baseline audit
• Increased diagnosis rates – QOF/prevalence data
• To reduce hospital admission rates for people with dementia living in care homes –
• Reduction in referrals to Older People Mental Health Team from care homes

Progress update

• Staff for the project have been recruited and have started. They are being trained in Appreciative Inquiry, PRINCE 2 project management and Kings Fund Enhancing the Healing Environment.
• The model of care home training and support has been finalised and is due to commence with 6 identified phase 1 homes in November 2013.
• A launch event has been held with 25 local care homes in attendance. We have made links with similar projects to share learning.
• Evaluation is being commissioned at present and is due to start at the commencement of the phase 1 intervention.
• We are running a first phase to test the model of intervention and then will scale up with learning in phase 2.

Dementia Team of the Year 2015

The South Devon and Torbay Clinical Commissioning Group and Devon Partnership NHS Trust were jointly named Dementia Team of the Year at the British Medical Journal awards 2015.

The award is in recognition of the work undertaken in care homes, where dementia champions are placed to improve knowledge, leadership skills and confidence among staff.

Read more about the Dementia Team of the Year award.