MIDLOTHIAN
COMMUNITY CARE
PARTNERSHIP
Auditing the
Standards of Care for
Dementia in Scotland
Jane Fairnie and Janice Flockhart
The Standards
• Standards of Care for Dementia in Scotland
• Action to support the change programme, Scotland’s
National Dementia Strategy
• Development of the Standards co-ordinated for the
Scottish Government by the Mental Welfare
Commission
• Underpinned by The Charter of Rights for People with
Dementia and their Carers in Scotland and what people
with dementia and their carers have identified as
important to them and what they want from services
• Officially launched on 6th June 2011
6 Key Standards
1. I have the right to a diagnosis
2. I have the right to be regarded as a unique individual
and to be treated with dignity and respect
3. I have the right to access a range of treatment, care
and supports
4. I have the right to be as independent as possible and
be included in my community
5. I have the right to have carers who are well supported
and educated about dementia
6. I have the right to end of life care that respects my
wishes
How do we know how the Standards
are applied in practice?
• As providers and commissioners of services we
need to be sure that service providers are
meeting the Standards
• We need a tool which allows us to measure
Provider performance against the Standards
• Providers need to have a working knowledge of
the Standards and where their own service
delivery falls short of those Standards
• Providers need to plan for how they will meet
shortfalls in practice / service delivery
Process
• Selected SWOT as a tool which would simply and effectively
enable organisations to audit their service against the
Standards
• Numbered the Standards for ease of reference
• Contacted all 28 service Providers in Midlothian to
introduce the SWOT and engage them to participate
• Also contacted NHS and LA teams – this process is ongoing
• All Providers visited personally and all but 4 completed the
SWOT with input from Project Manager
• Providers included Care Homes, Day Services, Care at
Home, RSLs and Specialist Services
• 98% of Providers participated
SWOT ANALYSIS
STANDARD 2. I HAVE THE RIGHT TO BE REGARDED AS A UNIQUE INDIVIDUAL AND TO BE TREATED WITH
DIGNITY AND RESPECT
2.1 SERVICE USERS WILL ENSURE THAT THE ACTIONS OF THEIR STAFF AND THEIR POLICIES AND PROCEDURES
DEMONSTRATE:
2.1.1 An awareness of what the person with dementia and their family may be experiencing.
SCORE
STRENGTHS
What does your team do well?
What unique resources can you draw on?
What do others see as your strengths ?
Weaknesses
What could your team do to improve?
Where do you have fewer resources than
others?
What are others likely to see as weaknesses?
Opportunities
What opportunities are open to you?
What trends could you take advantage of?
How can you turn your strengths into
opportunities?
Threats
What threatens your team or creates barriers to
your team meeting this standard?
What are others doing?
What threats do your weaknesses expose you
to?
Results
STANDARD 2. I HAVE THE RIGHT TO BE
REGARDED AS A UNIQUE INDIVIDUAL AND TO
BE TREATED WITH DIGNITY AND RESPECT
2.1 SERVICE USERS WILL ENSURE THAT THE
ACTIONS OF THEIR STAFF AND THEIR POLICIES
AND PROCEDURES DEMONSTRATE:
2.1.1 An awareness of what the person with
dementia and their family may be experiencing.
Expected Outcome for
Standard 2.1.1
People who live with dementia and their carers
will experience increased understanding of the
impact that a diagnosis of dementia has had on
them both individually and as a family
Service areas for development for
Standard 2.1.1.
• Could improve links with Community Dementia
and Care of the Elderly Teams
• Need to raise staff awareness and family support
• Lack of any recent training for staff in dementia
• Need to research dementia further to provide
more information for staff
• Occasionally some staff recall negative past family
history which can sometimes impinge on working
relationship
• Staff may not always have coping strategies
Service areas for development for
Standard 2.1.1. cont:d
•
Need to re-train team carers in recording
• Have more regular support and supervision
• Lack of training for new staff.
• Staff lone working means that managers
cannot guarantee individual practice
• Volume of business – staff busy and managers
not monitoring as much as they could
• Could have more regular meetings with
family/carers
• Improve individualised care plans
Opportunities Identified to meet service gaps
for Standard 2.1.1
•
•
•
•
Establish better links with Health Teams
Include Health in In-service training
Create a Dementia Resources Folder
Big Lottery application submitted to focus on
staff training and awareness raising for
tenants
• Include dementia in SVQ assessment
• Increase management support of staff
Opportunities Identified to meet service gaps for
Standard 2.1.1 cont:d
• Access information and advice through Alzheimer
Scotland
• Open the Home to the local community through
the Dementia Support Group so that people with
dementia and their carers in Loanhead can be
included
• Reminding staff to recognise their need to work
within professional boundaries
• Training programme linked to Stirling University
“Improving Dementia Care” +“Transitions in
Dementia”
Opportunities Identified to meet service
gaps for Standard 2.1.1 cont:d
•
•
•
•
Create a Quality Assurance system
Development of Dementia Strategy
Training for staff in the residents’ experience
Training up a core group of managers to
cascade the DSDC training
• Extend the training to evenings or times that
accommodate staff availability
Threats/Barriers to implementing
opportunities to develop services to meet 2.1.1
• Limited resources and time
• Framework (local client database system) doesn’t always
show who is involved from Health
• Other agencies not having an understanding of what
people with dementia and their carers are experiencing
• There is not always a formal diagnosis of dementia
• Local communities don’t always understand dementia
• Lack of funding if Big Lottery application fails
• Some older staff not keen to undertake SVQ assessment
• Staff being motivated to come in for training in their own
time
• Use of locum/agency staff
How these findings may influence
service redesign in Midlothian
• Joined up working, building on successful Mental
Health service redesign – co-located team
• Programme of staff development in dementia
awareness delivered across all sectors to include
time management
• Public Awareness raising programme in
partnership with all providers
• Providers Forum for dementia to share best
practice, problem solve and share resources
• Set up a local Communities of Practice on
internet