1. South West Dementia Partnership South West Hospital Standards in Dementia Care Rising to the challenge Rising to the challenge 05 July 2011

2. South West Dementia Partnership South West Hospital Standards in Dementia Care Care and compassion  behaviours; attitudes; expectations  person-centred; relationship  how care is organised  protective factors

3. South West Dementia Partnership South West Hospital Standards in Dementia Care Behaviours, attitudes, expectations  dignity; human rights  stigma of old age; invisibility – Western culture?  safety in the impersonal – ‘managing’ di/stress; keeping it at arm’s length  ‘defensive practice’; the burden of care  the risk of caring; of entering into relationship

4. South West Dementia Partnership South West Hospital Standards in Dementia Care Person-centred  recognising and respecting unique history, and individuality  valuing, appreciating and acknowledging  promoting independence  encouraging and helping  enabling a person to continue to be part of the community  valuing a person’s contribution

5. South West Dementia Partnership South West Hospital Standards in Dementia Care How care is organised responding to the context: vulnerable people with complex needs respecting realities practical challenges enabling people to fulfil, and realise their caring capacity remaining sighted on dignity; respect engaged and involved; working with compassion building and sustaining personal resilience

6. South West Dementia Partnership South West Hospital Standards in Dementia Care Protective factors  everyone’s responsibility  using our eyes, ears, voice  courage, aspiration, ambition  creating effective systems  recognising excellence  supporting people when improvement is needed  zero tolerance: acting, and acting fast

7. South West Dementia Partnership South West Hospital Standards in Dementia Care Doing it better; getting it right

8. South West Dementia Partnership South West Hospital Standards in Dementia Care 1. Respect, dignity and appropriate care 5. Nutrition and hydration needs are well met 7. Ensure quality of care at the end of life 6. Promote the contribution of volunteers 4. A dementia friendly hospital environment; minimising moves 2. Agreed assessment, admission and discharge processes with a needs specific care plan 3. Access to a specialist older people’s mental health liaison service 8. Appropriate training and workforce development

9. South West Dementia Partnership South West Hospital Standards in Dementia Care Peer Review: a paper chase? Enquiry; learning Positive practice Focus for leadership Accountability Driving up quality Commissioner-led Teams Data; observation; engagement Environment Distance travelled; plans Feedback

10. South West Dementia Partnership South West Hospital Standards in Dementia Care Radical change: what works?  Individual  Ward  Hospital  Organisation  Local systems  Community  Individual  Ward  Hospital  Organisation  Local systems  Community What the evidence tells us : environmental pressure visionary key people good relations organisational culture quality and coherence of policy, and data networks simplicity and clarity of goals and priorities ‘fit’ with the organisation and system (Bate et al. 2002) What the evidence tells us : environmental pressure visionary key people good relations organisational culture quality and coherence of policy, and data networks simplicity and clarity of goals and priorities ‘fit’ with the organisation and system (Bate et al. 2002)

11. South West Dementia Partnership South West Hospital Standards in Dementia Care Real and sustainable transformation? Context; systems Levers Joined-up commissioning Pooled budgets Pathways delivering outcomes Advance planning Personalised care Better care at home More support in the community Better data (diagnosis) Acute care tariff Acute care contract CQUINs Performance Governance – quality, safety Resources

12. South West Dementia Partnership South West Hospital Standards in Dementia Care Making it real? Knowledge and skills Care delivery Priority Core values Work-based learning Multi-professional Evidence; best practice Reflexive Expert patients/carers Mainstreaming ‘ Dementia proofing’ pathways; protocols Cognitive assessment; discharge planning A&E Mental health liaison Environment

13. South West Dementia Partnership South West Hospital Standards in Dementia Care Sustained? Leadership Culture Trust Board Clinical leads ++ Dementia champions ++ Partnerships Accountability Transparency Zero tolerance Person-centred Safeguarding Vigilance Quality, safety Responsiveness Reward & recognition Visibility

14. South West Dementia Partnership South West Hospital Standards in Dementia Care Priming change; sustaining improvement What will give this ‘traction’? Building on positive practice; what’s working well; learning Aligned with governance, organisational development, commissioning priorities Locally driven and accountable; transparency Involvement and ownership – new world ‘Zero tolerance’ – but with protective and enabling factors Investing in the future; leading the future

15. South West Dementia Partnership South West Hospital Standards in Dementia Care Doing it better; getting it right