To receive the above case study presented by the Dementia Care Advisor.

Jeanette Bailey, Team Manager for the Short Term Support and Rehabilitation Service gave a brief presentation on Dementia Care Advisers. Members note the following key points:

Ø  The role was originally established in 2014 to provide supportive advice and signposting for all newly diagnosed residents. This was linked to Memory Clinics and third sector dementia support services.

Ø  The role was well established and valued by all stakeholders over two years.

Ø  2014-2016 saw a period of growth and change such as:

o   As dementia diagnosis rates increased, there was an increased demand for services.

o   The profile of dementia raised as a specific condition and as part of complex needs with other long term needs.

o   Care Act implementation – there was more focus on carers needs.

o   Additional network of supportive services and liaison – through older person as Mental Health Sub-Group.

o   Launch of Each Step Together programme.

Ø  Maternity leave offered an opportunity to take stock, review and absorb learning from other models of DCA support – nationally and across Berkshire.

Ø  Activities from September 2016 – to date have included:

o   Increased staffing to 1.2 WTE – two DCAs with complementary and different skills and experience to widen scope of the role.

o   One nurse and one specialist in Cognitive Stimulation therapy

o   136 new referrals in seven months with a wide spectrum of neurological conditions.

o   Refresh all promotional information and proactive engagement with all contact points across wider H&SC systems i.e. practice nurses, public Daily Living Made Easy event in October 2016.

o   Speedy response and onward referral to targeted community support – EST approach.

o   Proactive relationship with the Memory Clinic – DCAs involved in last week of introductory course for better client/carer face to face contact.

o   Holistic and sustained support to dementia patient and family – better carer identification and support.

o   Targeted advice on acquisition of relevant equipment and use of assistive technology (with demonstrable impact on falls related NEL admissions), telephone triaging to identify those near crisis and offer immediate pre-emptive support with immediate access to other health and social care specialist advice.

Ø  Impact – Resident stories:

o   More joined up information sharing – reinforces the ‘tell your story once’ objectives for residents and targeted support without repeating historical information.

o   More timely and creative interventions to promote independence and reduce risk of crisis.

o   Tailored support for different types of dementia diagnosis – and links to other long term conditions.

o   Shorter waiting times for referral implementation e.g. reduced six week waiting time for Day Centre referrals to one week – EST

o   Whole person – lifelong support – not just at initial diagnosis – gateway to ongoing advice and support throughout patient journey.

o   Patient and carer – supported individually and together – multigenerational households.

o   Better/increased use of other dementia related services.

Ø  Dementia Care Advisors tried to personalise the service based on need

Ø  DCAs acted as key workers; they tried to avoid unnecessary hospital admissions and establish any longer term support requirements.