1. Accessibility of information relating to capacity within records at Torry Medical Practice Dr Gordon Guthrie, Torry Medical Practice, Aberdeen 2014 Rationale During the first few weeks of the course and within my role within the practice as lead for the Nursing Homes and QOF lead for Dementia I had become aware that information regarding capacity was not always easy to find within the records. I thought it would be a worthwhile exercise to quantify this and hopefully improve the situation. Method Torry is an inner city practice of just under 7000 patients serving a deprived population. It covers a nursing home with EMI unit, a care home and 2 sheltered housing units. A search was run to identify the number of patients that the practice had and these were broken down into 4 categories, Nursing home residents ( Banks O Dee), Care home residents ( Balnagask House ), Sheltered Accommodation (Provost Hogg Court and St Peter’s Court) and those living at home ResidenceNursing home Care Home Sheltered Housing Own Home Total Number431181375 The record of all 75 patients were examined and the following information was taken o Adults with incapacity (AWI) form in place? o Power of Attorney in place? o Guardianship in place? o Contact details for next of kin in place? o Resuscitation status documented? o PoA Discussed if not in place Following on from this an ongoing process is being undertaken to keep this information up to date and make it easily accessible. Nursing home (43) Care Home (11) Sheltered Housing (8) Own Home (13) AWI in place43744 PoA in Place24343 Guardianship6000 Contact Details126310 Resuscitation Status 27535 PoA Discussed0023 Results of Audit There were some differences in the results between the groups which is most likely a consequence of the differences in degree of dementia within the groups. In relation to Guardianship and Power of Attorney it was not easy to gain this information from the records. There was no specific place this was being recorded and no specific code being used. The situation has been improving through the use of Anticipatory Care Plans and new patients coming into the cared for settings are now having this information documented in a consistent fashion. Nursing home (41) Care Home (11) Sheltered Housing (8) Own Home (13) AWI in place41844 PoA in Place24543 Guardianship6100 Contact Details4111813 Resuscitation Status 41855 PoA Discussed11126 Results of re-Audit Discussion These results show a significant improvement on all fronts. Reviewing the records was time consuming but worthwhile. Relatives do appear to find communication and discussion regarding their relatives useful and reassuring. The contact details of all demented patients are now easily identified within the record. Whether there is an AWI in place or not is now easily gleaned from the records as is resuscitation status and the presence or absence of statutory powers. Further improvement will hopefully be achieved over the following few months and also be part of the post diagnostic support received by newly diagnosed patients in the future. Summary The quality of the records of the patients with dementia under the care of Tory Medical practice have been improved which will hopefully result in better communication between the practice and their relatives resulting in better quality of care. It will be important to try and keep the information as up to date as possible which as ever will be a challenge. Acknowledgement This project was undertaken as part of the Dementia Scholarship. Attendance at the meetings and the associated job shadowing has improved my confidence in relation to managing dementia patients and helped with future communication with secondary care through an increased understanding of their role. As expected these figures were disappointing on a number of fronts. On a positive note all of the patients within the Nursing Home had an in date AWI form. Although individual care plans were absent for many of these forms although not perfect were fit for purpose. However they are being updated on a rolling basis to include specific care-plans.