1. Dr Yvonne Collins & Lesley Carver
Dementia Crisis Respite Service Initial Findings October 2013 – October 2014
Dr Yvonne Collins & Lesley Carver
Date Thursday 26 February 2015

2. Dementia Crisis Support
In October 2013, North West Surrey CCG launched a new service designed to better support people with dementia and their family carers at a time of crisis.
The Aim of the Service is to:
To prevent the breakdown of a caring situation that would normally have led to hospital admission or admission to a care home.
To enable people to remain in their own homes with appropriate support, including night sitting where necessary, during a crisis period.

3. Dementia Crisis Respite Service
Funded through Prime Ministers Challenge £234,200 for 1 year
24/7 Emergency respite service for people with dementia and their carers
2 hour response time from the initial referral to intervention being in place
6 week short intervention
Patients supported to remain in their own homes.
Aims
200 NEL admissions over a 12 month period
Avoid appropriate admissions to urgent short term acute care
Reduce A&E attendance

4. Dementia Crisis Respite Service
Aims
200 NEL admissions over a 12 month period
Avoid appropriate admissions to urgent short term acute care
Reduce A&E attendance

5. Service Commissioning & Procurement
The service was commissioned by North West Surrey CCG
Abicare was commissioned to provide the service

6. Eligibility Criteria The person has a known or suspected dementia.
The individual is registered with a North West Surrey CCG practice.
The sudden onset of an acute episode has created a crisis situation where ordinarily a placement in a hospital or care home setting would have been sought.
The carer is suddenly incapacitated and the individual requires support in the community where ordinarily a placement in a hospital or care home setting would have previously been sought.

7. Service Provision
Practical hands on support provided in the home by specialist home care workers including 24hr care/night sits were necessary.
A 2 hour rapid response time – only basic assessment information required – provider assesses need.
It is SHORT TERM service designed only to cover a period of crisis or an acute episode for up to a maximum 6 weeks.
Whilst receiving the service patient’s ongoing care needs will be assessed and where necessary alternative care and support arranged.

8. The boundary of the area lies within Surrey County Council and includes all or part of four Surrey boroughs – Runnymede, Elmbridge, Spelthorne and Woking. A very small number of the population also reside within the Guildford and Surrey Heath areas. As shown on the map, the service operated across three geographical localities of North West Surrey:
Stanwell, Ashford, Staines, Shepperton, Egham (known as “SASSE”)
Thames Medical
Woking
The service was most commonly used in Woking but referrals have stretched across the whole geographical region

9. Patterns of Usage
65 referrals during 1st year. The oldest person to access the service was 99. The youngest was 68. The age group with the largest number of referrals were years. 58% of referrals coming from Surrey Adult Services.

10. Referred from

11. Referral by Area
The highest number of referrals to the service were made in Woking. The lowest number of referrals to the service were made in Virginia Water.

12. When Referred

13. Why was it used?
The most common reason for referral followed a breakdown of the caring situation. There were 38 referrals attributed to the needs of the carer. Whilst 27 were directly attributable to the needs of the person with dementia. 29% or 19 of those using the service lived alone. For these people it is extremely likely that a hospital or care home admissions would have signalled the end of independent living.

14. Household Status

15. Referral Reason Carer Called away emergency situation 10
Carer emotionally/psychologically distressed in home 14
Carer physically unwell absent from home 20
Carer physically unwell in home 2
Person with dementia acute mental health episode 5
Person with dementia physically unwell 7
End of life care
Person with dementia found wandering
Admitted to hospital/nursing home 6
Total 65

16. Response Times

17. Monitoring the service
Provider held spreadsheets.
Monthly monitoring meetings:
Problem solve.
Performance manage.
Review and refine pathways.
Respond to trends and need.

18. Learning from the Pilot
The positive lessons The challenges Overview, lessons of living with dementia