hertfordshire county council developing the workforce to improve outcomes for people with dementia

Hertfordshire County Councilwww.hertsdirect.org

DEVELOPING THE WORKFORCE TO IMPROVE OUTCOMES FOR PEOPLE

WITH DEMENTIA


Adult Care & Health Panel

• Introduction

Team

• Steve Malusky – JCT

• Suzanne Potts – HPFT

• Breege Helbert-Jacob – HPFT

• Julie Edwards – ACS

• Sharon Davies - HCPA


Adult Care and Health Panel

• For Dementia, HPFT are responsible for providing both health care and social care assessments

• Through the social care assessments the needs of individuals are identified

• HCC then commission and ensure the identified needs are met


Dementia Care Pathway

GP Memory Service Community Services A&T Day services Inpatient Srvs

Info / advice Homecare Telecare Housing Support Residential care

Health

Social Care

Day opportunities

Short breaks


Adult Care & Health Panel

• Dementia has 3 stages of severity– Mild– Moderate – Severe

• Post diagnosis, mild stage generally managed in the community

• Moderate and Severe stage present greater challenges and service users access NHS and ACS services


Dementia Care

Fair Access to Care

Specialist CareCommunity Support, Vol

Orgs

ACS

MHSOPHealth & Well Being

High Level Needs

Low Level Needs

Hertfordshire PartnershipNHS Foundation Trust

Memory Clinic – OT Pilot Study

• Introduction

• Why OT?

• The Journey so far …….

• Future ……..


Introduction• Dementia Strategy “Living well with

Dementia” (DOH 2009).

• Hertfordshire Partnership Foundation NHS Trust (HPFT) has commissioned a year’s pilot study to enable occupational therapy (OT) provision within two established memory clinics in Hertfordshire.


Why Occupational Therapy?

• The OT role can provide an alternative approach in the assessment and treatment of individuals.

• With the unique skills and philosophy OT embraces it can complement the more traditional prescribing approach ensuring the service users are assessed holistically and with a recovery focused approach.


The OT RoleAssessment:

• All OT assessments are completed in the service user’s home environment, therefore providing a realistic measure of how they function when completing their ADLs.

OT Intervention:

• The OT interventions are to facilitate service users to maximise their independence and mental well being in meaningful and purposeful occupations.

• To provide guidance and support to carers/family members to encourage them to enable and not disable the service user with their daily occupations.

• All interventions are graded and adapted appropriately to fulfill the needs of either or both service user and carer. All interventions are reviewed and evaluated and where necessary amended.


Coping strategies & new techniques for completing their ADL’s

Education

Sign posting of services and organisations

CARERSCoping strategies & new techniques

Sign posting of services and organisations

Graded programmes

SERVICE USER

Education

Equipment Provision• Memory Aid

• ADL Aids


The Journey So Far…Evaluation of the pilot study remains ongoing; however the data retrieved currently demonstrate that the pilot

study has been effective and very beneficial.

Service Users:

• “OT was a life line”• “Listened to whatever problems I had”• “Made my life easier”• “I could not have asked for better”

Carers:

• “This support is greatly needed”• “Was flexible and offered visits during the evening”• “When needed we have always known we could contact her”• “Her role needs to be continued and others recruited”

Team Members:

• “The service has been transformed”• “Memory clinic did not just feel like a drug prescribing clinic”• “Quick effective home assessments”• “Positive immediate approach to holistic care”


The Future …..• Complete a comprehensive audit report.

• The recommendations at this stage would be that every memory clinic will benefit from OT provision, therefore continuing to provide a high level of service delivery which encompasses the National Dementia Strategy.

Contact Details:0208 236 7474Suzanne PottsSpecialist Occupational Therapist


Recovery Project at Logandene

• Logandene Inpatient Unit

• Recovery Project

• What is Recovery in Dementia?

• Meaningful Activities

• Future ……..


What is Recovery in Dementia?

• The principles of recovery represents a move away from pathology, illness and symptoms to health, strength and wellness.

• Recovery is seen as having at least three different meanings: As a spontaneous and natural process As a response to effective treatments As a way of growing with or despite continuing disability

Hertfordshire PartnershipNHS Foundation TrustLife Stories

• Life stories enable and assist with understanding the “essence and uniqueness of the person”.

• Working closely with service users and their families.

• A life story can preserve a sense of personhood and enable family members to see past the dementia.


Breakfast Club

• Over the last several months the Breakfast Group has been very successful and is now running every morning 7 days a week.

• The main aim of this group is to enable service users to maintain and increase their skills during breakfast.

• Overall this group facilitates the service users to be able to enjoy breakfast at their own pace and in a relaxed atmosphere, including having the social interaction if they so desire.


Gardening Group• With the new sensory garden in

progress a gardening group has been established.

• This group enables the service users to enjoy all aspect of the garden from going out to choose and purchase plants/flowers and vegetables, to planting and potting them. To just enjoying the sensory aspect of the garden, by walking or sitting in the garden.

• Through the relatives group, the service user’s relatives have volunteered to assist with this group, which encompasses the recovery approach within the unit.


Future ………

• Sharing good practice.

• Commitment from HPFT to roll out this approach in all inpatient units, therefore providing essential training, mentoring, education and supervision ensuring a knowledgeable and skilled workforce are able to provide high quality recovery focused services.

Contact Details : 01442 215060Breege Helbert-Jacob Suzanne PottsUnit Manager Specialist Occupational Therapist

ACTIVITIES PROJECT funded by Hertfordshire County Council Adult Care Services

December 2007-

December 2011

Sharon Davies MIfL, MCIPD – Workforce Development

Manager

Hertfordshire ProjectHertfordshire Project Memorandum of

Understanding between HCC and HCPA signed in 2007

November 2008 Application for funding to HCC ACS – Martin Wigg, Chair of HCPA had a vision

The Need... “Beyond the dominoes...” Little in the way of

inspection requirements regarding Activities

There was no emphasis at all on person centred activities

HCC Funding for Activities HCC Funding for Activities TrainingTrainingHCPA put in successful bids in 2008 -2011 Total of £175,000 NAPA Accredited Distance Learning Course ‘Provision of Activities in a

Care Setting’ was provided for 90 Activities Organisers.The Aim1. To impress upon Service Providers and Managers the importance of the Social

Life of individuals living in a care setting2. To have at least 1 Activities Organiser per care home trained in the delivery

of person centred stimulation in activities to Service Users3. To train Care Workers in the importance of their role in the delivery of

activities

OutcomesOutcomes

234 Activities Organisers have also been through HCPA’s own training programme

84 Care Workers have undergone the training workshops

National RecognitionNational Recognition

2008 – Caring Times Award (Pocklington House) – one of 6 finalists in the country

2009 – NAPA Breath of Fresh Air Competition (Willowthorpe) – Highly Commended

2010 – Great British Care Awards (Westbourne) – Eastern Region Care Home Activity Organiser....nominated for national awards on 5th June

Hertfordshire Activities Hertfordshire Activities CoordinatorCoordinator

Linda Whittaker RGN

Jean Clayton was nominated for the Great British Care Awards Activities Organiser. In 2007, she took part in the HCPA training programme

Westbourne recently had an excellent CQC inspection report, with the exceptional

quality of activities strongly featured. Inspectors wrote,”Jean takes time to focus on people’s individual needs and preferences. She encourages everybody to participate, but nobody has to.“

She noticed that some people had difficulty maintaining contact with friends and

relatives, so she introduced a laptop and taught people to use the internet and e-mail. This led on to the purchase of a Wii to enable a number of interactive activities. Other activities include:

coffee mornings at church, shopping trips, garden centre visits, quiz nights, calendar and holiday celebration events and cheese and wine evenings.

Jean’s manager said, “…nobody is left out. At Christmastime, Jean organised a carol

concert with the local school. The children went from room to room singing to people who were not able to join us centrally. They joined in the singing. Jean loves her job and has motivated us all. Residents are now themselves giving her new ideas for activities”.

Westbourne Story…Westbourne Story…

Personal HistoryPersonal HistoryWhen a person lacks capacity knowing about

their past lives will enable Activities Organisers and Care Workers to engage more meaningfully with each individual

Meeting the Core Needs of Meeting the Core Needs of Individual LivesIndividual Lives

1. Creative2. Cultural3. Physical4. Sensory5. Emotional6. Spiritual7. Intellectual8. Learning & Development9. Social

10.Self Esteem

The Importance of NostalgiaThe Importance of Nostalgia

Communicating with people with Dementia

Memory BoxesPhoto AlbumsPrompt CardsHistory BooksThemed EventsHistorical Props

Example of a Reminiscence BoxExample of a Reminiscence Box

Links to Making MemoriesLinks to Making Memories‘Making Memories’ is a Heritage Lottery Funded

project which aims to help develop community archive websites

Activities Organisers are encouraged to use the ‘Making Memories’ website to search achieved photographs and share memories

CQCCQC

A meeting was held with Helen Pettingell, Hertfordshire lead inspector in November 2009. She was impressed with the training and in particular with the documentation of personal life histories and care plans. She has copies of all the documents and intended to speak to all the inspectors about the importance of concentrating on activities provision in homes.

Inspection reportsInspection reports Some homes have received good feedback in their reports from

the inspectors on activities provision.

HCPA is aware of at least two homes that have achieved an enhanced star rating...the more that inspectors understand about the importance of Person Centred Activities, the more we will see a rise in star ratings in Hertfordshire.

Memory Wall - Famous FacesMemory Wall - Famous Faces

Future AimsFuture AimsTo maintain a person centred Activities Organiser in

every care home in Hertfordshire

To provide each care home with the resources and training to carry out motivational sessions with dementia service users

SummarySummaryThe Activities Project has... Enhanced the social lives of the individuals who receive

care in Hertfordshire by creating a bank of trained professionals who deliver person centred activities.

Increased public awareness of the importance of choosing a care home where their lives of their relatives are stimulated

Been the forerunner of the Personalisation Agenda

hertfordshire county council developing the workforce to improve outcomes for people with dementia

Documents

ot assessments

ot interventions

health care

philosophy ot

social care assessments

service users access

service users home environment

needs of individuals