1. A View from the Bedside. Getting it Right for Vulnerable Patients Ms E Childs Director of Nursing and Governance Executive Lead for Safeguarding Adults Dr G. Kendall Consultant Care of the Elderly Clinical Lead for Dementia

2. About Us Medium sized District General Hospital with world class aspirations. Positive benchmarked performance Work positively with partners – Torbay and South Devon NHS Trust, Local Authorities, 3 rd Sector We Serve Diverse area, coastal and moor = 300+sq miles Large % of older people, 23% over 65 and highest number of over 85’s Significant deprivation in many parts of local population

3. Our Key Priorities: Safest care, No Delay, Best Patient Experience Continuing to improve safety, reducing overall hospital mortality Eliminating unnecessary waits for patients in all aspects of their care Aspiring to achieve a ‘positive and ??’ experience for all parents / carers Improving quality through greater partnership working CQUIN Scheme 2010/11

4. Dementia - Improving Care at the Bedside Who:- Executive Lead: Director of Nursing linking into local Safeguarding Adults Board Executive Lead: Director of Nursing linking into local Safeguarding Adults Board Operational Lead: Associate Director of Nursing member of Torbay Learning Disability Partnership Board Medical Champion: Consultant Physician Care of the Elderly Clinical Nurse Specialist Dementia Care Mental Capacity Act/ Safeguarding Adults post Supported by increasing ‘dementia champions’

5. Dementia – Improving Care at the Bedside What have we implemented? Board to Ward awareness – patient stories told ahead of each meeting Dementia Policy – underpinned by principles which include minimizing ward moves. Use of ‘forget me not’ symbol (flagging PAS) Development of local ‘dementia champions’ underpinned with education / coaching Embedding patient profiles for dementia and learning disabilities (similar to ‘this is me’). Mealtime companions (Wards) Dementia befriender (A&E) Laminated card – prompts for staff – fits into ID badge holder Observations of care Multi disciplinary ‘Board Rounds’

6. Dementia - Improving Care at the Bedside Observations of care – replacing ‘real time’ patient feedback questionnaires o Weekly process o Trained staff (all disciplines) and external – presently Foundation Trust member ‘Working With Us Panel’ Immediate feedback to staff observed in delivery of care Record then filed with actions for evidence (CQC) 30 minutes observation o What do I see? o What do I hear? o What do I smell? o What do I feel?

7. Dementia – Improving Care at the Bedside Each patient discussed – ‘forget me not’ icon for dementia / special needs Outcomes – daily update on care plan, involvement of carer, improved communication, speedier discharge home/transfer increasingly nurse led Multidisciplinary Board Rounds Swift Plus – Interactive White Board (Linked to PAS) Led by consultant Involving – Junior Medical Staff, Ward Nursing Staff, OT, Physio, Discharge Co- ordinator, EoL Co-ordinator

8. Dementia – Improving Care at the Bedside

9. Safety risk factors Ill patients Infection control issues Improved Communication Whole team involvement Plan updated daily Discharge Planning Day 1 Destination and EDD Paperwork Nurse led Discharge Dementia – Improving Care at the Bedside The Board Round – Benefits:-

10. Dementia – Improving Care at the Bedside

11. The Board Round – Pros and Cons - Daily - MDT - Improved communication - Training - Safety - Drives discharge planning - Time - Timing - Confidentiality - Attendance

12. Motto – “if we get it right for patients with Dementia – we get it right for everyone!” Thank you!