Improving Care in Care Homes Application of the Newcastle Model in Dementia Care Ann Scott Practice Development Facilitator Homefirst Community Trust

Improving Patient Experience and Care through Practice and Quality Improvement NIPEC Conference, 27 th March 2007 Hilton Templepatrick Hotel Current standard of care is poor 17 homes surveyed in the North of England all rated as requiring much or radical improvement (Ballard et al, 2001) Why? challenging behaviour beyond scope of care staff

Improving Patient Experience and Care through Practice and Quality Improvement NIPEC Conference, 27 th March 2007 Hilton Templepatrick Hotel Impact of Challenging Behaviour Admission to the dementia assessment unit Move to another facility ‘problem’ is moved on - staff miss opportunity to learn High mortality rate within first year of move (Aneshenel, 2000)

Improving Patient Experience and Care through Practice and Quality Improvement NIPEC Conference, 27 th March 2007 Hilton Templepatrick Hotel Practice Development CPN’s shared vision to develop efficient service ‘new ways of working’ (DHSSPS, 2006) ‘The Newcastle Team’ The Martha McMenamen Memorial Scholarship

Improving Patient Experience and Care through Practice and Quality Improvement NIPEC Conference, 27 th March 2007 Hilton Templepatrick Hotel Thoughts Behaviour Appearance Need ‘The Newcastle Model’ Pre-Morbid Personality Mental Status Life Story Environment Medication Cognitive Status Physical Health

Improving Patient Experience and Care through Practice and Quality Improvement NIPEC Conference, 27 th March 2007 Hilton Templepatrick Hotel Neuropsychiatric Inventory Caregiver Distress (NPI – D)

Improving Patient Experience and Care through Practice and Quality Improvement NIPEC Conference, 27 th March 2007 Hilton Templepatrick Hotel Cost of G grade CPN for 5 months Cost of hospital stay (4 patients x average length of stay x daily bed cost)* *Does not include cost of retaining bed in care home or transportation costs Number of admissions prevented = 4 patients. Cost of hospital stay x 1 patient over a one year period Cost Benefit Analysis

Improving Patient Experience and Care through Practice and Quality Improvement NIPEC Conference, 27 th March 2007 Hilton Templepatrick Hotel Stakeholder Analysis ClaimsConcernsIssues Meeting needs = decrease in behavioural difficulties Reduction in use of medication Unnecessary moves avoided Increased quality of life Carers job satisfaction increased Workload will increase for staff in homes Can service be implemented throughout the trust Will care homes still have access to Tardree House if required Can model be used in wards Funding required to secure service 3 Behavioural Sciences nurses