1. Learning to Lead Excellent Practice in Dementia Care: Reflections from 1000 days teaching
Professor Dawn Brooker
Association for Dementia Studies
Presentation HEE Conference
Dawn Brooker Oxford Dementia Centre

2. The Association for Dementia Studies
Established as a university research centre aligned with the National Dementia Strategy
Multi-professional group of educationalists, researchers and practitioners
Cutting edge contribution to developing evidence-based practical ways of working with people living with dementia, their families, friends and carers that enable them to live well.
Using this evidence we deliver education programmes that empower people to provide skilled, competent and compassionate care
University of Worcester Association for Dementia Studies 2

3. Association for Dementia Studies Director - Professor Dawn Brooker
Early interventions and Primary Care
Lead on Timely Diagnosis Recommendations for EU ALCOVE programme
Development of Primary Care Dementia competencies
In-depth evaluation of the Worcestershire Early Intervention Dementia Service & the Dementia Adviser Service
Specialist Education Modules in Early interventions & primary care
PhD research on Early Cognitive Change
ADS is a multi-professional group of educationalists, researchers and practitioners with many years of experience in the field of person-centred dementia care and support. The perspective of people living with dementia, their families and their carers are intrinsic to the work of ADS at all stages.
We make a cutting edge contribution to developing evidence-based practical ways of working with people living with dementia, their families, friends and carers that enable them to live well.
We do this primarily through research, education, scholarship and policy advice. We draw on and contribute to the international evidence base for person-centred dementia care. Using this evidence we deliver education programmes that empower people  to provide skilled, competent and compassionate care
Excellence in person-centred care in care homes
PIECE-dem observational framework for advanced dementia
CHOICE – organisational culture and care experiences in care homes
‘Care Fit for VIPS’ free web-based toolkit for care homes
Specialist education modules in care home leadership and dementia specialists
FITS – Focussed Interventions in Training and Support to reduce anti-psychotic prescribing; funded by the Alzheimer’s Society
Living well with dementia
Supporting people from all communities to live well with dementia
ESRC Seminar Series: Age, Race and Ethnicity
Connecting Communities Programme evaluation
Innovative interventions to support people and their families, including new service model for RSAS.
Development and evaluation of MEETING DEM in UK, Italy & Poland JPND/ESRC funded
Research network and conferences in creative therapies and dementia.
Understanding Dementia and sight loss:
Dementia-friendly hospital care
Development and evaluation of a suite of interventions including a care bundle approach with the Royal Wolverhampton Hospitals Trust
Steering group membership of the National Audit of Dementia
Partners in NIHR Delirium Programme and PIE observation tool
Dementia Leadership and Specialist education modules in acute and community hospital dementia care.
End of life care evaluation
Supporting choice and control at home and in supported housing
The Enriched Opportunities Programme
The ASSET project – adult social care in housing with care schemes
PhDs on direct payments in rural areas and on home-based support in Israel
For more information please contact: call us on or visit our website at

4. Association for Dementia Studies Core Team June 2013

5. University of Worcester Association for Dementia Studies
The experience of people living with dementia and their families inform the work of ADS at all stages.
University of Worcester Association for Dementia Studies

6. Bespoke courses – early adopters?
Type of Commissioning Organisation
Number of organisations (approx days)
Types of providers covered
Local authorities, city councils, county councils 8
(550)
Care homes, dom care, extra care housing, mental health, acute hospitals
NHS Trusts 10
(70)
Acute hospitals, community hospitals, community health teams, early intervention team
Care Providers (charitable, not for profit) 5
(140)
Care homes, extra care & dom care
Others: FITS programme
30 (100 plus 90)
100 care homes to reduce anti-psychotic prescribing

7. Number of participants
Dates
Specialist
Managers
Acute
Primary care
Other
Total
01/09/12 – 31/08/13
307
193 58 41 48
647
01/09/13 – 10/01/14
234 85 17 - 15
351
541
278 75 63
998
This shows the number of participants completing a pre-course questionnaire
© The Association for Dementia Studies

8. © The Association for Dementia Studies
Job roles (3)
1187 responses from 998 participants.
© The Association for Dementia Studies

9. Time spent working with people with dementia
© The Association for Dementia Studies

10. © The Association for Dementia Studies
Age information
© The Association for Dementia Studies

11. The Challenge for existing workforce
Overwhelmed
Lacking knowledge about dementia
Lacking skills to help
The way services are set up work against people with dementia and their families getting the best help
Delivering brief sessions that raise awareness of short-fall may actually make the situation worse
University of Worcester
Association for Dementia Studies

12. Leadership Historically education in dementia care has:
Focused on training those at the ‘coal face’ of health and social care.
Inspired staff to make changes only to be faced with barriers when returning to the work place
One of those barriers is that the ‘leaders’ of the service do not recognise their crucial role in culture change.
University of Worcester
Association for Dementia Studies

13. Tiered Educational model
The Association for Dementia Studies education programme is based on research that has considered ways of increasing the likelihood of services improving, and more importantly maintaining this improvement.
University of Worcester
Association for Dementia Studies

14. ADS TIERED MODEL OF DEMENTIA Leadership
Managing
Dementia Care
Services
(Leadership for managers)
Dementia Specialist Practitioner (Leadership at the individual service user level)
Fundamentals in Dementia Care (all staff)
Start the education programme with the Managers
Managers choose specialists to act as a co-partners in leading and embedding change
Who are the Awareness sessions for? ADS mirrors the concepts presented in the PM’s Challenge i.e. that everyone should be ‘dementia aware’ including the general public.

15. Managing Dementia Care: leading the team (4-8 days)
Senior staff / managers
Provide clear vision, using VIPS framework.
Ensure know what “good” looks like.
Identifying priorities for change, who, what, when, how and identify barriers
Person centred management style
Increased confidence and competence to lead others and find solutions.
Working across service boundaries.
University of Worcester
Association for Dementia Studies

16. Leading by example Dementia Specialists (5-10 days)
Managers cannot make the change alone. This is where the second part of the model comes into action– the specialists.
These are motivated staff members who are supported through the education programme to be specialists in their area in working directly with people with dementia and families.
Chosen by managers to be part of the change in practice.
University of Worcester
Association for Dementia Studies

17. Specialist’s role Role model person centred care.
Expert up-to date knowledge & tool-kit in their specific area
Offer support and guidance to other staff.
Develop other staff through a coaching model.
Act as a link between leaders and other staff members.
University of Worcester
Association for Dementia Studies

18. 4 key elements of learning1
Interactive Workshops; hearts & minds 2
Self Learning / Inquiry relating to specific work setting 3 4
Putting into Practice –Trying out new ways of working
completed project (university module 20 credits)
University of Worcester
Association for Dementia Studies

19. Reflections on knowledge
The lack of knowledge and confidence, even at senior levels, is serious
There is an active dynamic between attitude change and knowledge acquisition
Aim to support staff to operate with clarity, creativity, and resilience and rather than with insecurity and doubt. 

20. Reflections on People
This is an experienced and intelligent work-force
Need to equip staff to make good decisions not to think there is an instruction to follow
Recognise changing the culture of care is about people’s hearts and minds. This is a people service; tools need to be well cared for, staff need to feel valued for a job well done.

21. Reflections on change
Research consistently points to  the high failure rate of change initiatives - not because of poor strategies or funding but rather a result of poor attitudes and behaviours.
The combination of empowering leadership at management and specialist level is powerful
Once these are unlocked the potential for change is great

22. Reflection on whole system working
By having leaders who can remove the grit that is blocking  the system  we can support sustainable change within and across organisations.
Dementia is complex – all staff need to know who to call on when they are out of their depth
Competence needed across the whole system – eg If GPs or mental health services are not competent/ accessible even the best skilled care services struggle.

23. Care Fit for VIPS website
Dementia Pledge

24. Thank you for listening!
Professor Dawn Brooker
University of Worcester
Association for Dementia Studies
Photographs of people living with dementia taking part in
ExtraCare Charitable Trust Enriched Opportunities Programme
University of Worcester Association for Dementia Studies