Embed Size (px)
Citation preview
Learning to Lead Excellent Practice in Dementia Care:
REFLECTIONS FROM 1000 DAYS TEACHING
Professor Dawn BrookerAssociation for Dementia Studies
Presentation HEE Conference
• Established 2009 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
The Association for Dementia Studies
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
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:
For more information please contact: [email protected], call us on 01905 542531 or visit our website at http://www.worcester.ac.uk/discover/association-for-dementia-studies.html
Association for Dementia StudiesDirector - Professor Dawn Brooker
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 www.carefitforvips.co.uk • 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
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
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
Association for Dementia StudiesCore Team June 2013
• 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
Bespoke courses – early adopters?Type of Commissioning Organisation
Number of organisations (approx days) 2011-14
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
Number of participants
© The Association for Dementia Studies
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
Total 541 278 75 41 63 998
This shows the number of participants completing a pre-course questionnaire
Job roles (3)• 1187 responses from 998 participants.
© The Association for Dementia Studies
Job roles overall AdministratorCare Home ManagerCare workerCateringCommissionerCounsellorDeputy ManagerEducator/trainerFamily carerGeneral NurseGeneral PhysicianGeneral PractitionerHealth Care AssistantHealth VisitorManagerMental Health NurseOccupational TherapistPatientPersonal AssistantPhysiotherapistPsychiatristSocial WorkerSpeech & language therapistStudentSupport servicesOther
Time spent working with people with dementia
© The Association for Dementia Studies
01/09/12 - 31/08/13 01/09/13 - 10/01/14 Overall0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Time spent working with people with dementia
More than 20 years10-19 years5-9 years1-4 yearsLess than 1 yearNever
Age information
© The Association for Dementia Studies
01/09/12 - 31/08/13 01/09/13 - 10/01/14 Overall0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Age of participants
65 and over50-6431-4920-30Less than 20
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
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
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
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)
Managers choose specialists to act
as a co-partners in leading and embedding
change
Start the education programme with the Managers
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
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
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
Interactive Workshops;
hearts & minds
Putting into Practice –Trying out new ways of
working
Self Learning / Inquiry relating to specific work
setting
completed project (university module 20 credits)
1 2
3 4
4 key elements of learning
University of Worcester Association for Dementia Studies
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.
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.
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
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.
Care Fit for VIPS websitewww.carefitforvips.co.uk
Dementia Pledge
Thank you for listening!
Professor Dawn BrookerUniversity of Worcester Association for Dementia [email protected]
http://www.worc.ac.uk/discover/association-for-dementia-studies.html
Photographs of people living with dementia taking part in ExtraCare Charitable Trust Enriched Opportunities Programme
