National Dementia Strategy Action Plan

A Local Action Plan for Gateshead

September 2012 – September 2013

1 The Local Action Plan The National Dementia Strategy requires each local area to develop a local action plan for dementia to address the strategy objectives. Together with NHS South of Tyne an action plan has been produced for Gateshead in order to address the National Dementia Strategy requirements. The plan covers the period 2012/13 and will be reviewed and refreshed during this time. The plan is split up into the four key areas from the dementia commissioning pack, all underpinned by the need for ‘improved support for carers’: - Early diagnosis and intervention - Better care at home and or care home - Better care in hospital - Appropriate use of antipsychotic medication

Setting the scene: A national and local context

National There are now 800,000 people and 17,000 younger people with dementia in the UK and there are estimated to be 670,000 family and friends acting as primary carers. It is estimated that there will be over a million people with dementia by 2021.The current financial cost of dementia is £23 billion a year to the NHS, local authorities and families and the cost will grow to £27 billion by 2018.

The National Dementia Strategy, Published three years ago, sets the standard for improving the lives of people with dementia, their families and their carers through raising awareness, encouraging earlier diagnosis and providing high quality treatment and care.

Local The action plan contributes to the following plans and strategies:

- Vision 2030 – Gateshead’s Sustainable Community Strategy which includes Gateshead residents have the longest and healthiest lives in Britain and that vulnerable and older residents lead fulfilling lives with support of their choice. - Corporate Plan – The Council’s statement of intent and priorities, incorporating priorities and actions to deliver Vision 2030. - NHS SOTW Strategic Plan and the Gateshead PCT Integrated and Strategic Operation Plan 2011 – 2015 – Key priorities relevant to older people include reducing CVD and cancers, identifying people with long term illnesses, providing high quality intermediate and rehabilitative service, providing high quality care nearer to home, changing the way mental health services are provided and providing those at the end of life with good care.

2 - The vision for Adult Social Care – This addresses improved health and emotional well-being, making a positive contribution, increased choice and control, freedom from discrimination and harassment, maintaining personal dignity and respect and economic wellbeing. - The Older Persons Strategy 2011 – 2014 – Key themes making a positive contribution, being informed, living well and keeping healthy and active. - Gateshead Carers Strategy 2011 – 2014 – Key themes providing information, access and support, health and wellbeing, a life of your own, young carers, carers assessments, involvement and consultation, identifying carers and support for BME carers. - Gateshead Emotional Health and Wellbeing Action Plan – Key actions include exploring the use of social prescribing to address social isolation, particularly in relation to older people, people with dementia and carers. - South of Tyne and Wear Mental Health Model of Care – The work programme includes a review of primary care mental health services and the development of a memory service for dementia. - Strategy for Telecare in Gateshead – aims to reduce acute hospital admissions, increase support for hospital discharge and intermediate care services, contribute to the development of a range of preventative services and help those who wish to die at home to do so with dignity. - End of Life Strategy 2010 – 2015 – describes what patients and carers can expect from local provision, defines the standards expected across all care settings, defines a pathway of care for end of life service and describes a model of service that will improve the quality of care. - Safeguarding Adults Business Plan – improves joint planning and capability. Aims to prevent abuse and neglect in the community by improving awareness and improving the response to abuse and neglect. - Adult Social Care Commissioning Strategy – Sets out how the council plans to commission services that help people to gain their independence (reablement), provide better support to people who have chronic and long term illnesses such as dementia. Work with the NHS to reduce the number of people being admitted to hospital in an emergency and provide better support for people with in a crisis, recue the number of people going into residential and nursing homes, make more use of technology to help people stay in their own homes and develop more services for people with dementia while ensuring they can access the same services that other people do.

Local information Increasing life expectancy, and a larger number of older people among the population in future years, will mean that the number of people with dementia living in Gateshead will rise. Between 2007 and 2010 the number of people diagnosed with dementia in Gateshead has risen from 1,000 to 1,200. An aging population means that this trend is likely to continue as the risk of dementia increases with age. The number predicted to have early onset dementia in Gateshead from 2008 to 2025 is an increase of 4%. The number predicted to have late onset dementia in Gateshead from 2008 to 2025 is an increase of 36%.

3 Number and percentage of people with dementia among people all ages

Gateshead S Tyneside Sunderland number on Gateshead number on S Tyneside number on Sunderland SHA England disease Prevalence disease Prevalence disease Prevalence Prevalence Prevalence Year register (%) register (%) register (%) (%) (%) 06/07 1,023 0.50 837 0.54 1,393 0.49 0.46 0.40 07/08 1,090 0.53 908 0.58 1,377 0.48 0.47 0.41 08/09 1,164 0.57 983 0.63 1,436 0.50 0.50 0.43 09/10 1,181 0.58 1,047 0.68 1,472 0.52 0.53 0.45 10/11 1,238 0.60 1,122 0.73 1,574 0.55 0.56 0.48 Source: NHS Information Centre at www.ic.nhs.uk, data from the Quality and Outcomes Framework (QOF). Data for 2011/12 will be published Sept. 2012. Figures in bold indicate that these are significantly higher or lower than the comparative England prevalence at 95% confidence Prevalence of dementia by Gateshead GP Practice population, 2010/11

4 Source: Quality and Outcomes Framework, NHS Information Centre at www.ic.nhs.uk/qof

5 Proportion of GP Practice populations all ages in Gateshead that are diagnosed with dementia in 2010/11 Dementia Dementia Dementia Practice Prevalence Prevalence Register No. Code Practice Name 09/10 10/11 10/11 1 A85001 DR SCHUMM & PARTNERS 0.4% 0.5% 33 2 A85002 DR ROBERTS & PARTNERS 0.6% 0.4% 20 3 A85003 DR LIDDLE & PARTNERS 0.5% 0.7% 52 4 A85004 DR BRUMBY & PARTNERS 0.6% 0.7% 76 5 A85005 DR MORRIS & PARTNERS 0.7% 0.6% 68 6 A85006 DR TASKER AND PARTNERS 0.4% 0.4% 34 7 A85007 DR BRYSON & PARTNERS 0.6% 0.7% 58 8 A85008 DR STEELE & PARTNERS 0.8% 0.9% 126 9 A85009 DR RUTENBERG & PARTNERS 0.6% 0.6% 47 10 A85010 DR MATHESON & PARTNERS 0.5% 0.6% 69 11 A85011 DR SCOTT & PARTNERS 0.8% 0.8% 65 12 A85012 DR S M IMAM 0.3% 0.3% 15 13 A85013 DR ILYAS & PARTNER 0.5% 0.4% 14 14 A85014 DR CHAPMAN & PARTNERS 0.4% 0.7% 49 15 A85015 DR ROONEY & PARTNERS 0.5% 0.5% 11 16 A85016 DR ROONEY & PARTNERS 0.9% 0.8% 61 17 A85017 DR COPE & PARTNERS 0.3% 0.3% 18 18 A85018 DR JOHNSON & PARTNERS 0.4% 0.4% 19 19 A85019 DR KENNAN & PARTNERS 0.3% 0.3% 34 20 A85020 DR MCNULTY AND PARTNERS 0.4% 0.4% 71 21 A85021 DR KUMAR 0.2% * <6 22 A85023 DR SHERRATT & PARTNERS 0.4% 0.3% 16 23 A85024 DR M S HASSAN 0.1% * <6 24 A85025 DR ORRITT & PARTNER 0.3% 0.4% 14 25 A85026 DR PENRICE & PARTNER 0.8% 0.6% 27 26 A85601 DR MANDAL 0.4% * <6 27 A85605 DR HILTON 0.7% 0.7% 17 28 A85609 DR MUTHU KRISHNAN 0.9% 1.1% 21 29 A85611 DR SUCHDEV & PARTNERS 0.2% 0.2% 12 30 A85614 BRIDGES MEDICAL PRACTICE 0.5% 0.4% 15 31 A85616 DR DUGGAL 0.4% 0.4% 10 32 A85617 DR HUNT 0.4% 0.3% 10 33 A85620 GRANGE ROAD MEDICAL PRACTICE 1.4% 1.4% 47 34 Y02658 BLAYDON GP LED HEALTH CENTRE - * <6 35 Y02712 MEDICUS FAMILY PRACTICE - 32.2% 95 GATESHEAD 0.6% 0.6% 1,238 Point to note: number 35 prevalence rate is higher than the rest, however this particular practice only provides a service to nursing homes. Source: NHS Information Centre, Quality and Outcomes Framework, 2010/11, data for 2011/12 will be published in Sept. 2012 6 Projected increase in the number of people with dementia in Gateshead 2011 2015 2020 2025 2030 Total males aged 30 – 64 predicted to have early onset dementia 29 29 30 30 28 Total females aged 30 – 64 predicted to have early onset dementia 21 21 22 22 21 Total males aged 65 and over predicted to have dementia 859 930 1081 1228 1411 Total females aged 65 and over predicted to have dementia 1533 1586 1709 1884 2060

The most recent relevant source of UK data is Dementia UK: A report into the prevalence and cost of dementia prepared by the Personal Social Services Research Unit (PSSRU) at the London School of Economics and the Institute of Psychiatry at King’s College London, for the Alzheimer’s Society, 2007. The prevalence rates have been applied to ONS population projections of the 65 and over population to give estimated numbers of people predicted to have dementia to 2030.

7 Achievements

Training A comprehensive training programme is in place for Local Authority staff, delivering at a range of levels, including: Level 1 - Dementia Care – Person Centred (Trains on average 100 people per year) - Supporting the Dementia Journey – The end of life pathway (Trains on average 50 people per year)

Level 2 - Connecting with People with Dementia (Trains on average 25 people per year) - Meaningful Activities in Dementia Care (Trains on average 25 people per year) - Understanding Behaviour we find Challenging (Trains on average 50 people per year) - Certificate in Dementia Awareness (Trains on average 100 people per year) - Dementia Training for Adult Provider Services (Aimed at all promoting independence centres 3 employees from each centre) - Dementia Care Training for Dom Care (Trains on average 60 staff per year) - Dementia Care Person-Centre (Housing Services) (Trains on average 45 people per year)

Level 3 - Best Practice in Dementia Care (Trains on average 80 staff per year)

A one off course was also run on Dementia and Spirituality by Deacon Peter Lavery attended by 15 people.

Commissioned Services Our commissioned services take dementia training into account. All service specifications include a requirement for dementia awareness training; this is included in the contract monitoring process. New Domiciliary contracts include the requirement for providers to provide specialist training including dementia care.

Memory Protection Service The Memory Protection Service aims to improve earlier and more “timely” diagnosis of dementia in line with the government’s National Dementia Strategy. It aims to build onto existing services to engage with the 50-60% of Dementia sufferers not currently being picked up; doing so by working more actively in Primary Care / Community settings, more actively with Primary Care staff, in a user/carer friendly way. Evidence suggests that patients with an earlier diagnosis benefit from: - quicker access to pharmacological interventions which are effective in earlier disease. - psychological interventions in early disease can improve cognition, independence and quality of life.

8 - there is a strong economic argument. Early diagnosis could yield net saving of £7000 per patient. - carer benefits include support and counselling which can improve mood, reduce strain and delay institutionalisation of patients with dementia. - patients are carers are able to plan future care needs whilst patients with dementia have capacity to consent. Since the 2nd April there have been 34 referrals to the service from Gateshead all bar one from GPs.

Short Break Service The short break plan 11/12 – a range of extra services have been commissioned along the carers pathway from providing information and advice to provision of breaks. £440,000 was invested. In relation to dementia specifically the befriending service in the Alzheimers Society is funded. Over 400 carers benefited from the carers short breaks. A new plan has been developed for 12/13 with investment of a further £440,000.

Living with Dementia Group This group follows through from an eight week information programme and addresses many of the issues people newly diagnosed with dementia and their families face. It is run by the Alzheimer’s Society alongside health and social care professionals. The aims of the group are to help people who have dementia: - Gather and exchange information - Share experiences - Support each other and feel less isolated - Enjoy the company of other people who have dementia in a relaxed and friendly setting As at August 2012 the group meets on a monthly basis with a membership of six people

Carers Group The Alzheimers Society runs an established group specifically for people who are carers for those with dementia. Two groups in different areas run once a month with on average 20 people attending each group at all times.

Dementia Café The first Dementia Cafe in Gateshead launched on Monday 21 May 2012. It runs on a monthly basis providing a friendly, supportive and informative monthly meeting place for people with any type of dementia, their family and friends. It is facilitated by Alzheimer's Society Gateshead Dementia Support Service and is supported by a wide range of professionals in health, social care and the voluntary sector. The cafe has run three times to date, with a total of 13 attendances by carers, 7 attendances by people with dementia and 36 attendances by 21 individual workers from the health, social care and voluntary sector.

Community Dementia Forum The Alzheimer's Society in Gateshead runs Community Dementia Forums on a quarterly basis. The aim of the forum is to bring together a wide range of people from across the Gateshead community including people with dementia, their families and carers,

9 statutory services, voluntary organisations, businesses, to learn from each other and work together to improve the lives of people living with dementia and work towards achieving a dementia friendly community. The forum feeds back issues to the Dementia Action Alliance which is made up of members from the charity, public and private sector who are working to radically improve the lives of people with dementia and are united behind the National Dementia Declaration, a set of seven outcomes developed by people with dementia and their family carers.

The Gateshead Community Dementia Forum currently has a membership of more than 50 individuals and organisations and up to 29 people attending the forum meetings.

The Dementia Liaison and Coordination Champion (DLCC) Programme The DLCC Programme is a partnership between South of Tyne and Wear NHS and the Tyne and Wear Care Alliance. Tyne and Wear Care Alliance assembled and managed the programme which was designed to ensure that Health and Social Care Providers have dementia champions who are trained to help their staff achieve an effective level of dementia awareness and the ability to provide best practice person-centred dementia care. 75 staff were recruited from a broad range of dementia settings, specialist units, domiciliary care agencies and residential homes across Gateshead, South Tyneside and Sunderland. In Gateshead, of the 32 care homes or care with nursing, 14 homes engaged in the pilot, and now with further funding secured the remaining 18 will be approached for the next cohort of DLCC’s who will commence training in September.

Outcome Star Alzheimer's Society Advocacy Service has completed participation in a project overseen by Gateshead Advocacy Information Network (GAIN) to investigate the value of applying outcome star methodology to assessing outcomes for people using advocacy services. Results from the project indicate that this methodology has limited value for assessing outcomes for people with memory problems and/or fluctuating or limited capacity. The service will continue to review its use.

Memory Groups The 6 weekly memory groups focus on supporting people with dementia and their informal carers to preserve their memory and structure in their daily lives with a session being held each week on the following topics: 1. What is memory? (Educating people in a fun way about the 5 different types of memory and how memory works) 2. Problem solving (Taking people through a 5 step process of solving problems) 3. Simplifying the home environment (Adapting the environment and using memory aids to provide confidence and security) 4. Mnemonics and visual imagery (Using such tools to ‘jog memory’ for remembering facts, names, procedures or routines 5. Thinking exercises (Using a wide array of memory exercises for the mind to sustain attentiveness and encourage innovation) 6. Relaxation techniques (Encouraging people to look after themselves through sleeping well and anxiety management)

10 The groups possess connectivity to some of the themes which are embedded in the existing weekly Cognitive stimulation group at Shadon House and such memory groups could be accessed by those using Provider Services and individuals (perhaps not known to health / social care) who have themselves or their carer has, begun to have concerns about their forgetfulness. With such a specification, the memory groups would then be able to meet the aims of providing advice and information about local care and support services, provide peer support and an opportunity to assess carers’ needs and offer support on planning for the future.

Short Term Assessment and Reablement Team The START Team contact people who have been in Promoting Independence Centres 72 hours after discharge to check that everything is still ok, and then undertake weekly checks every 4 weeks along with long term domiciliary care users. This approach is to ensure that the well being of both the service user and informal carer is preserved and any issues that impinge upon the service user’s independence can be effectively responded to.

Laugh Out Loud Shadon House have been monitoring a new therapy introduced in April, it is a structured session based upon the benefits of laughter therapy. The purpose of this was because staff at Shadon House felt that healthy, non-ridiculing and connecting laughter provides physiological, psychological and spiritual benefits are born with the gift of laughter -it's being serious that we learn. ‘So, learn to laugh, and live, all over again!’ The sessions have been proven to increase wellbeing in those who have taken part: Ill being indicators show a reduction in Anger from April-July during the sessions going from 1.5-1.1 Signs of being withdrawn reducing from 1.2- 0.8 on average from Aril – July Signs of boredom started in April 2 reducing to 0.3 during the sessions in July Visual signs of bodily tension started at 2 on average for April’s sessions reducing to 1.5 in July’s sessions.

Hen therapy Gateshead based Equal Arts have provided half a dozen hens for an 18 month pilot scheme within Shadon House helping to brighten the lives of residents as well as providing a link with their previous lives. The hens are proving to be a therapeutic focus for residents, helping to take away some of their stress and anxieties. The people who come in to Shadon House are motivated and enthusiastic about getting up to feed the hens and check for daily eggs. Based on the success of the Birtley venture, Equal Arts have secured £164,000 in Big Lottery funding for an 18-month expanded scheme, introducing hens to another eight care homes and helping staff and residents to care for them.

Challenging behaviour Since October Gateshead Health NHS FT has had a dedicated Community Challenging Behaviour Team working into all care homes across the borough. The aim is to work collaboratively supporting staff in providing non-pharmacological strategies for managing challenging behaviour in dementia thus reducing distress for people with dementia and their carers. Additional aims are reducing the need for use of medication especially antipsychotics, reducing hospital admissions and moves of care home. The team comprises a full time senior nurse plus input from a consultant psychiatrist and a psychologist. Since October, the team has

11 worked with 108 people with dementia of whom only 5 have required hospital admission, 10 have had antipsychotic medication discontinued and 2 have required antipsychotic medication starting for severe psychotic symptoms.

Better Care in Care Homes Consultant Old Age Psychiatrists have been co-working on a monthly basis with GPs and care home staff in two of the seven dementia (EMI) nursing homes in the borough with this being extended to a further three in the near future. Primary and secondary care staff have been working more proactively into these homes aiding future planning for residents and their families and preventing unnecessary admissions to hospital. People with dementia form a high proportion of the care home population and this closer working is enabling their dementia to be managed more holistically as part of their overall health needs.

Reducing antipsychotic use in dementia Recent audits have shown that Gateshead has a low level of antipsychotic use in dementia compared to national rates but we still need to look at minimising this use to being only when necessary and being closely monitored. The developments above regarding non-pharmacological management strategies for challenging behaviour and better care in care homes are all part of the measures to reduce the overall use of antipsychotics and eliminate unnecessary use. Within the general hospital, particularly led by the liaison old age psychiatry team, alternatives are recommended, necessary prescribing is closely monitored and ongoing education of all staff teams looking after those with dementia is maintained.

Liaison Old Age Psychiatry at QEH Our well established team continues to see increasing numbers of referrals. The team have been doing a lot of work during this past year to get people with dementia referred much earlier in their admission to hospital, thus aiming to improve their overall care and avoid unnecessary prolonged stays in hospital due to their dementia not being appropriately factored into their discharge planning.

Younger People with Dementia Recent achievements within the Woodside team include more carers groups and closer working between community and day care provisions.

Inpatient Units The Old Age Psychiatry inpatient assessment wards for people with dementia at Gateshead Health NHS FT have moved into their newly refurbished building at Cragside on the QEH site. There are now 12 beds for men and 12 for women. The building has been refurbished to give more space, better facilities and more privacy and dignity for this group of patients.

12 Where do we want to be by 2014? - An improved awareness of dementia both among the general public and health and social care professionals through information and education - Arrangements are in place to diagnose dementia as early as possible enabling early intervention and delivery of high quality care and support for both people with dementia and their carers. - A Dementia care pathway has been compiled to ensure all feel supported throughout the journey - All cases of dementia are offered an early diagnosis & interventions - All have information at the right time - All feel supported throughout the journey - People with dementia can access all services within the community - People with dementia can stay at home for as long as possible making use of new technology - Carers accessing more carers assessments - People with dementia have access to personal budgets and are able to access the range of support they need. - All carers and families of people with dementia will be aware of safeguarding issues. - Training programmes are in place for everyone who will come into contact with someone with dementia - Access to Independent Advocacy is available for all people diagnosed, or undergoing diagnosis, with dementia

Governance arrangements The Action Plan will be a standing item on the agenda for Gateshead Senior Officer Group for Older Peoples Mental Health, with a full review taking place 6 months into the plan in February 2013. There will be a number of project/ task and finish groups set up to take the actions forward which will be centred around the following key areas; information/awareness raising, Advocacy, Personalisation, Dementia Friendly Communities, Reablement, Housing, Workforce Development, Better care in home/ care homes.

13 ACTION PLAN

Early diagnosis and intervention Objective: Case find all cases of dementia in Gateshead between 2012 – 2017 and ensure that this is tracked throughout all service areas. Support and information is given at all stages from early diagnosis. Target Proposed actions Lead Support Status updates comments date 1 Support case finding & NTW LA To be To OPMH group via referral to MPS and/or Bob Graham/ reviewed in contracts meeting at GHFT OPMH services for Alison February PCT diagnosis & interventions Griniezakis 2013 through all agencies

2 Develop a range of Leanne Douglas Wendy Kaiser To be To be monitored information and awareness Alzheimers reviewed in through dementia raising initiatives both to Society February communications staff and the public Steve Morgan 2013 strategy. 3 Train staff delivering meals Keith Hogan Daphne Patel December Staff development/ on wheels/ shopping service 2012 Communications to identify people with Strategy for dementia. dementia and encourage to Included in IDAP visit GP 4 Raise awareness to Wendy Kaiser Leanne Douglas To be Part of pharmacists, opticians, reviewed in Communications dentists on dementia and February Strategy actions they should take 2013 should they suspect someone has dementia. 5 Increase awareness and Melanie GAIN To be Linked into Advocacy promotion of the need and Stephenson reviewed in Strategy for Council. value of advocacy for February Gain Draft 2013 Commissioning people with dementia Strategy throughout their journey encompassing diagnosis to

14 residential care.

6 Commission adequate Melanie GAIN To be Identify needs and advocacy resources to meet Stephenson reviewed in resources need. February 2013 7 Ensure appropriate Darren Wilson/ Gateshead To be Linked into Carers provision is provided to Leanne Carers reviewed in Strategy and Action carers of people with Douglas/ Association/ February Plan. dementia at the earliest Alzheimers Crossroads/ Age 2013 Performance will be opportunity to enable good Society UK managed through the information, advice and carers partnership. support networks are identified. (Linked in with priority 1 – Carers Action Plan) 8 Develop a Communications Leanne Douglas Elaine Barclay, December Detail will include who plan for dementia to engage Communications 2012 we are communicating with people with dementia, with, the messages we the public, health and social want to get across and care professionals and the how we will third sector. communicate. It will also include details of any consultations undertaken in relation to dementia. Consideration should be given to awareness raising in schools, BME Groups etc.

15 Better care at home or care home Objective: To ensure inclusion of people with dementia in mainstream services, improve the support services for people with dementia, whether living at home or in care homes, and provide specialist dementia services where appropriate. Target Proposed actions Lead Support Status updates comments date Peer support 9 Increase opportunities for Margaret Barrett/ Alzheimers To be Project to map peer support networks, for Wendy Kaiser Society reviewed services/ resources people with dementia and in and identify gaps. their carers, to offer February emotional support, 2013 information and practical advice. Personalisation 10 Encourage people with Wendy Kaiser/ Leanne To be Joint work around dementia to take up Margaret Barrett Douglas/ Darren reviewed Alzheimers Society/ personal budgets to enable Personalisation Wilson in Carers Association to them to purchase personal Partnership February look at barriers/ more services tailored to their Board 2013 creative ways to needs. increase take up of personal budgets. Look into the work of A4E/ Peer Mentor Service. 11 Undertake pilot with Margaret Barrett/ Michael Brown To be residential/ domiciliary care Louise Rule reviewed and independent supported February living providers, providing 2013 individual service funds. Community support services 12 Ensure community support Leanne Douglas/ Alzheimers To be Scope project and services have sufficient Wendy Kaiser Society/ reviewed develop action plan. capacity & skills to address Neighbourhood in August Continue work re: the needs of people with Management/ 2013 Dementia Friendly dementia now and in the Community Communities. 16 future. Work towards Network/ Carers Dementia Friendly Association Communities. Intermediate care & reablement 13 Align the Reablement/ Keith Hogan Leanne Douglas December The Reablement intermediate care 2012 Framework will be Framework with complete by developments for people December; however with dementia. taking the actions Ensure reablement & forward will be intermediate care services ongoing to ensure are inclusive & address both areas of work are mental health needs aligned. alongside physical health To be monitored needs. through the Gateshead Intermediate Care and Reablement Steering Group. 14 Improve access to current Keith Hogan Reablement To be To be monitored reablement services for Development reviewed through the people with dementia. Officer in Gateshead February Intermediate Care and 2013 Reablement Steering Group. Carers 15 Commission support to Penny Davison/ Crossroads/ Review To be monitored carers through range of Carers Darren Wilson February through Carers interventions such as: short Partnership 2013 Partnership. breaks, respite care, peer support groups; support and information; training courses, access to psychological therapies. 16 Improve access to Gateshead Gateshead March 17 psychological therapies for Primary Care Primary Care 2013 people with dementia and Mental Health and Gateshead their carers through joint Sarah Grainger, Health work between Gateshead Gateshead Psychology Primary Care Mental Health Health Claire Service Services and Gateshead Martin Health Clinical Psychology Services. 17 Ensure dementia carers are Gateshead Alzheimers Ongoing Linked to priorities provided with adequate Carers Society monitored through information and support to Partnership Carers Action Plan. fulfil their caring role, including signposting to sport and leisure services and short break schemes. (Linked in to priorities 1 and 6 of the carers action plan) Housing 18 Explore options for housing Graham Leanne Douglas August By August 2013 a plan & housing support. Woodford/ Lisa 2013 should be in place Philiskirk around housing and dementia. To be monitored through the Mental Health and Housing Sub Group 19 Commence discussions Graham Mental Health December Discussions to have around mixed schemes and Woodford/ Lisa and Housing 2012 started by December their suitability for people Philiskirk Meeting (Sub with an idea if it is with dementia – rented group to possible by August housing/ housing available Gateshead 2013. to buy Vulnerable To be monitored Persons through the Mental Housing Group) Health and Housing Sub Group. 20 Consult on what people Lisa Philiskirk/ Mental Health January To be monitored

18 with dementia would like to Leanne Douglas and Housing 2012 through the Mental see available in relation to Meeting (Sub Health and Housing housing both now and in group to Sub Group the future Gateshead Vulnerable Persons Housing Group) Telecare 21 Make Assistive Technology Lorinda Russell Assessment and March accessible to all people Personalisation 2013 with dementia by increasing Teams. /ongoing awareness and publicising Keith Hogan process as benefits of the equipment to Telecare/health new enable people with co-ordindators technology dementia to stay at home. Voluntary Sector develops Corporate communications Team 22 Trial new software to Lorinda Russell Mental health To be support carers of clients Assessment and reviewed with cognitive impairment. Personalisation in October (RIEP Project) Teams 2012 Voluntary Sector Middlesbrough Council Telehealthcare co-ordinators

23 Promote the use of GPS Lorinda Russell Assessment and Ongoing tracking device for people Personalisation with dementia Teams Keith Hogan 24 Encourage assessment Lorinda Russell Assessment and staff to facilitate the use of Personalisation the ‘Just Checking’ system. Teams Keith Hogan

19 Telehealthcare Co-ordinators 25 Encourage the team within Lorinda Russell Jackie Ongoing Angel Court to facilitate the Woodward use of lifestyle monitoring Assessement which is integrated within and the building. Personalisation Teams 26 Consider the development Lorinda Russell Leanne April 2013 Part of of a professional newsletter Douglas/ Communications promoting new technology Communications Strategy. to carers, people with dementia and professionals. Quality of care/ Commissioning 27 Ensure that the needs of Michael Brown Ken Youngman/ From New Specifications to people with dementia are Julie Wade October include dementia met through the tender 2012 needs process. 28 Develop and measure Michael Brown Ken Youngman/ From Include in assessment better residential and Julie Wade October process and tools domiciliary care services for 2012 people with dementia. Measure through contract review. 29 Work with care homes to Michael Brown Ken Youngman From Include in assessment help them provide good October process and tools quality care for people with 2012 dementia 30 Develop providers so they Michael Brown Ken Youngman From Nov Follows needs are more specialist to 2012 assessment exercise deliver dementia services. 31 Redesign services to Michael Brown Ken Youngman/ From Nov Follows needs provide value for money Julie Wade 2012 assessment exercise options to support more 20 people to be independent in Link to new domiciliary their community for longer. care reprovision and new residential and nursing care contracts 32 Identify areas where joint Michael Brown/ Leanne Douglas From Nov Link to integrated commissioning is key to Margaret Barrett/ 2012 commissioning pilot delivering improvements in Wendy Kaiser services and providing value for money. 33 Work with partners to Wendy Kaiser/ Alzheimers Plan in Project commenced. support development of a Scott Vigurs Society place by community challenging March behaviour service 2013. supporting those living in care with challenging behaviour. End of life care 34 Continue with the work of Margaret Barrett Claire Downes/ Review - How we can work the End of Life Steering Leanne Douglas February together to make Group for Gateshead 2013/ ‘deciding right’ ongoing work process - Advanced care planning for people with dementia Workforce development 35 Continue development of Tyne and Wear Leanne Douglas Measure staff employed by care Care Alliance impact home & home care (Sally Riding) August providers through Tyne and 2013 Wear Care Alliance Training and measure impact this has had. 36 Review the benefits of the Tyne and Wear Leanne Douglas Review Creation and ‘Room for the Imagination’ Care Alliance August development of Project ran by Tyne and (Sally Riding)/ 2013 ‘Activities Wear Care Alliance and Equal Arts Coordinators’ centred 21 Equal Arts. around three areas: - Music and dance workshops - Visual arts - Timeslips storytelling Will take place in 3 of Gateshead’s Care Homes. 37 Provide awareness training Michael Brown/ Leanne Douglas Review to all local Authority Steve Morgan February employed staff. 2013/ Ensure contracts include ongoing expectation that all relevant process commissioned services will be provided by staff with appropriate training. 38 Provide training for staff in Lorinda Russell Steve Morgan Review benefits of telecare. February 2013 (complete by 2013) 39 Ensure Deprivation of Cathryn Meredith Steve Morgan Review Liberties is fully understood February in care homes/ hospitals 2013/ through training. ongoing process Health 40 Challenging Behaviour Steven Common Karen Franks October Hospital CB outreach Outreach team working into Kate Andrews 2012 Team targeting care care homes within homes within Gateshead Gateshead – C.B. advice and information as well as assessing individual residents via referral 22 41 Challenging Behaviour Challenging Ongoing Staff training Workbook for staff Behaviour Team programme available – Steven for all care staff in Common Gateshead to access on the workbook 42 Challenging Behaviour Challenging Dec 2012 Draft carers/relatives handbook for Behaviour Team handbook on CB carers/relatives – Steven produced with in put Common from the carers support group at Alzheimer’s society as well as other professionals

Better care in hospital Objective: Improving quality care for people with dementia in general hospitals Target Proposed actions Lead Support Status updates comments date 4 Develop & deliver GHFT Judith Gibson/ Gillian McArthur Ongoing Regular monthly 3 action plan for general Richard updates via the hospital care of people with Harrison Dementia Dementia steering dementia, including Steering Group Group and the screening all admissions Managing Outcomes over 75 years with memory CQINN meetings problems.

44 Undertake dementia Judith Gibson Dementia November X2 audits to be environmental audits on x4 Environmental 2012 undertaken in Sept wards/depts within Sub Group 2012 and x2 audits in Gateshead Health October 2012 Foundation Trust. .

45 Roll out the 3Ds (Dementia, Alison Dementia Dec 2012 4 stages of roll out Delirium and Depression) Griniezakis/ Steering Group programme identified 23 Pathway to wards/depts. Claire Downes and linked to within the acute hospital timescales 46 Roll out and review the new Elaine Judith Gibson Sept 2012 New information ‘Medway Information MacDonald system is being System’ including the implemented flagging system for people throughout the Trust with dementia and memory problems. 47 Audit readmission rates Lindsey Surtees Dementia Oct 2012 Readmissions within including those patients with Steering Group 30 days are being dementia audited every three months which also includes patients with dementia 48 Produce a dementia training Emma Dementia Current training programme for staff Prendergast/ Steering Group Dec 2012 programme now being consisting of two levels of Claire Downes updated to include x2 training based on need. levels 49 Raise Dementia awareness Judith Gibson MH Liaison X2 Roadshows held at within the general hospital. Alison Team QEH Griniezakis/ Dementia Publicity information Claire Downes Champions distributed around all wards/depts. Dementia Evening Forum held

50 Roll out ‘space’ programme Judith Gibson Dementia Sept 2012 As above Steering Group 51 Roll out of ‘This is me’ Judith Gibson Hospital Dec 2012 Included as part of the Matrons 3Ds roll out 52 Place dementia friendly Judith Gibson Dementia Ongoing ward/dept areas signage within the hospital Environmental identified and signage sub group agreed 53 Undertake second National Judith Gibson Claire Downes Oct 2012 Both the Audit of Dementia (NAD) Organisational within general hospital checklist and the Core 24 audit have been completed 54 Ensure Dementia Treatment Judith Gibson Sandie Dickson July 2012 Satisfaction Team compile a Patient/ Joyce Stratford questionnaire has User satisfaction been evaluated and questionnaire for people reviewed and will be with dementia and their rolled out to other carers. dementia services within the Trust 55 Continue with Gateshead Judith Gibson SHA Dementia Ongoing SHA Link meetings Trust representation Task Steering held every three attending the Strategic Group months for N.E.acute Health Authority Dementia Dementia Trusts Task Steering Group for the Steering Group North East. 56 Ensure that Claire Downes Alison Ongoing MCA/DoLs training is MCA/Deprivation of Liberty Griniezakis available to trust staff training is available to staff Judith Gibson access via OD & within the Trust Training Dept and staff prospectus 57 Ensure dementia referrals Alison MH Liaison Ongoing Those emergency to MH liaison Team are Griniezakis Team referrals will see within responded to within 48 24 hrs including during hours the night shift 58 Provide Dementia Training Catherine MH Liaison ongoing Mental health liaison medical staff within the Kirkley Team have a dedicated Trust (Training provided by training slot in the F1 & MHLT) F2 training programme 59 Undertake yearly mental Catherine MH Liaison Nov 2012 Audit Undertaken in health audit regarding Kirkley Team November of each respond times to MHLT year. Report available including those patients with in Dec 2012 dementia 60 National CQUIN for Lucy Quarterly Q1 objectives Monitored through identifying dementia after 72 Topping/Wendy review achieved. PCT Quality meetings hours hospital admission. Kaiser with GHNHSFT. 25 Appropriate use of antipsychotic medication Objective: All antipsychotics for people with dementia are prescribed according to best practice Target Proposed actions Lead Support Status updates comments date 6 Share community Marie Thompkins June 12 0 pharmacy review of all those on the QoF registers for dementia also prescribed anti psychotics. Identify practices with high levels of prescribing. 6 Take forward discussion Marie 12/13 1 with practices to implement Thompkins/Anne best practice in Marie Bailey. Ola prescribing. Dafe 6 Consider outcome of pilot Wendy Kaiser 13/14 2 to develop anti psychotic patient passport.