The Powys Dementia Plan

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1 The Powys Dementia Plan Achievements to date and next steps

2 Pledge 1 To raise public awareness in relation to dementia, improving the lived experience Over 85 people attended the First Powys Dementia Network meeting facilitated on September 26th, in Knighton. Powys Association of Voluntary Organisation (PAVO) has commissioned, through the Intermediate Care Fund, Alzheimers Society and Dementia Matters to develop Dementia Friendly Communities (DFC s) across Powys and share/develop Innovative practice. Five new DFC s in 2016 so far and new Social Enterprise developed, Dementia Matters. PAVO has recruited a Third, Third Sector Broker who has the lead in knowing what community services exist in Powys relating to Dementia. She will also help identify gaps. The Broker was recruited mid September Befriending Network initiated and has met twice in 2016 to share best practice and who delivers befriending services to people with Dementia. PAVO is currently developing a specific Dementia Information web page, which should go live very shortly (December 2016). This page will be linked with the Powys Teaching Health Board (PTHB) and Powys County Council (PCC) webpages. To support the initiative Dementia Matters in Powys to share good practice, develop partnerships, network and provide a platform for the voice of people with dementia in Powys. PAVO will facilitate two Dementia Network meetings per calendar year, next in March PAVO will continue to support DFC development in new areas in Powys and the sharing of best practice and innovation in these communities. PAVO to spearhead development of a Patient Story, (carer or person with Dementia), through working jointly with PTHB and Powys Council and local communities. Third Sector Broker to build on knowledge of local Dementia community groups/services and identify gaps. This will then be shared with the community development team in PAVO. Build on identifying needs and local community resources for Befriending Services in relation to Dementia. This will include volunteering in hospital settings/wards for people with Dementia. Initiate PAVO s process in Working Towards becoming a Dementia Friendly Organisation

3 Pledge 2 To reduce risk, ensure timely diagnosis and improve dementia diagnosis rate PTHB has taken part in the second National (Wales) Memory Assessment Service audit and has received the results. The audit shows that Powys Memory Assessment Service is under resourced compared to other Health Boards in Wales particularly in relation to the range of disciplines involved. A business case for the development of memory assessment services is currently being drafted. An application has been submitted to the Royal College of Psychiatrists to become an affiliate member of the National Memory Services Accreditation Programme. This will help PTHB identify the standards and work towards full accreditation. Review training has been delivered on the Butterfly Scheme including Delirium and Dementia to all community hospitals. This will help general hospital staff identify people with Dementia and Delirium, communicate more effectively and engage with carers. Focus on raising awareness of dementia diagnosis in Primary Care. Support Care Homes in identifying people who may have dementia and ensuring appropriate and timely referral for diagnosis. Improve diagnosis rates to 50% in 2017 and 75% in 2018.

4 Pledge 3 To ensure appropriate post diagnostic interventions are in place Two Dementia Support workers have recently been appointed following Welsh Government funding. The new post holders will act as a point of contact in the memory assessment service to those newly diagnosed with dementia. They will help signpost people to information and support depending on the person s need at the time. A programme of carer s information and support (CrISP) training is currently being delivered across Powys by the Alzheimer s Society funded through PTHB. This will initially be aimed at carers of people who have been recently diagnosed with dementia, but the Alzheimer s Society will also deliver a limited number of sessions for carers of people with moderate dementia who will have had their diagnosis for a while. Fixed term Psychology Assistants have been appointed to reduce waiting times at memory assessment services following short term Welsh Government funding. This initiative will see the introduction of a consistent, improved quality, cognitive assessment process, which will help reduce the time that someone will have to spend face to face with the Psychiatrist. Extra Psychiatrist sessions are also being commissioned to reduce the waiting times in clinics where the wait is longest. Improve signposting within Primary Care and Care Homes for people newly diagnosed with dementia. A post diagnostic pathway will be introduced to ensure that all people and their carers receive appropriate information and support following a diagnosis of dementia. Increase the numbers of Carers assessment completed. Ensure Cognitive Stimulation Therapy is provided consistently across all areas of Powys, particularly for those newly diagnosed with dementia.

5 Pledge 4 To ensure people with dementia are treated with dignity and respect by staff who are skilled and competent Work has been undertaken in establishing what is commissioned in contracts with Social Services A copy of the Local Authority Domiciliary Care Service specification has been received and will help to identify what improvements could be suggested in the training of staff as a basic requirement. Contact made with leads in Social Services to establish what training staff have during induction. This will be reviewed and best practice between Powys Teaching Health Board and Local Authority will be shared. Copy of TRENT report obtained to look at numbers of staff achieving training. Contact made with Workforce and Development to establish the numbers of staff who have achieved the Dementia Module and how this will be achieved in the future. The target of 75% of frontline staff to be trained in dementia awareness is the first goal. Identified E-learning made available for staff to access. Identify strategies for Social Services staff to develop a train the trainer programme to facilitate staff achieving training minimising costs to the service. Monitor & facilitate numbers of staff attending Dementia degree module. Provide figures on the number of staff achieving e-learning & other group training. To review the number and availability of trained Dementia Care Mappers and seek to train new mappers if required. Dementia Care Mappers can assess interventions and communication delivered by staff to people with dementia and recommend improvements in practice.

6 Pledge 5 To improve the care of people with dementia in general hospital settings The Butterfly Scheme update training has been delivered across all of the general Wards in Powys equating to 64% of staff who have received training to help meet the needs of patients with Dementia during an admission. HIW have undertaken unannounced visit to PTHB and have identified the Butterfly Scheme is not well embeeded in some Hospitals. The John s Campaign is currently being initiated to offer carers a passport to enable them to visit outside of normal visiting hours to assist in their relative s well-being. Posters are also going to be displayed welcoming carers and highlighting the scheme. Community Hospitals have access to specialist advice through the Older People s Community Mental Health Teams, the Dementia Coordinator in the north and Liaison Nurse in South Powys. PTHB contributes towards funding RAID schemes in the DGHs that Powys patients are admitted to. Training on dementia care and audits have taken place across all Community Hospitals. This is Me or About Me documents in use to provide staff with a brief life history of the person with dementia, their likes, dislikes and key points of interest for communication. Butterfly Champions have been identified on all wards. Patient s activities Knitting / Crocheting twiddle muffs in use in Claerwen ward WRVS commissioned activities for Brecon Hospital Carers clinics commenced on all ward areas in the south, with the initiative being reviewed for wider roll out. Embed Johns Campaign in practice across all hospital wards in Powys Embed Hello my name is across all hospital wards in Powys Evaluate activities from a patient s perspective & produce a patient story. Review with works and estates all identified Dementia Friendly Environment work and report on progress Embed the Butterfly Scheme in all Wards. Secure funding for the MyDementia software to be purchased across all Wards.

7 Pledge 6 Support care homes in Powys to deliver person centred care for people with dementia Five dementia awareness sessions have been delivered in each of the care homes in Powys. This was funded through the ICF and coordinated by Powys Teaching Health Board. The medicine management team has been undertaking regular audits of anti-psychotic prescribing for people with dementia in care homes. The result has been a steady and significant reduction in prescribing this type of drug in these settings. To promote the Kings Fund Audit for creating Dementia Friendly Care Homes. Encourage Care homes to embrace meaningful person centred activities for people with dementia including using life stories such as This is Me and using technology such as mydementia for reminiscence and stimulation