St Giles Hospice works in partnership to support dementia care in care homes

St Giles Hospice, in the West Midlands of England, provides palliative care for people with advanced cancer, motor neurone disease, and other terminal illnesses. With a long tradition of working in partnership with other like-minded organisations to provide supportive care, community engagement activities and education, the hospice is now gaining a reputation for its collaborative work in dementia care. Last week we published a post from St Giles Hospice, CEO, Dr Emma Hodges.

This week, Emily Pardoe-Billings, formerly Dementia Advisor for St Giles Hospice, describes her experience of working with care homes in Walsall to provide a partnership support service.

Left to right: Pat Roberts (Pathways 4 Life), Emily Pardoe-Billings (St Giles Hospice) receiving the 2018 Great People Award for their work.

I joined the Care Improvement and End of Life service in 2016. The service was originally commissioned as a pilot project in 2015 with funding from Walsall Clinical Commissioning Group (the National Health Service body responsible for the planning and commissioning of health care services in our local area) and Walsall Council. St Giles, with their experience in end-of-life care, partnered with Pathways 4 Life (part of the social care organisation, Age Matters – Accord Care and Support, focusing on dementia) in order to meet the challenge of people with dementia dying in hospital.

Walsall has historically been above the national average in respect of the number of people with dementia who are dying in hospital, as illustrated by the graphs below.

Figure 1 – Place of death – care home.

To reduce unnecessary hospital admissions from care homes, St Giles and Pathways 4 Life each provide a Dementia Support Worker who works closely with the care homes to improve their understanding of dementia through observations and tailored training.

Figure 2 Place of death – hospital.

At times, the role has been incredibly difficult. Care homes face many challenges of their own, such as staffing levels which means training is cancelled at short notice. At other times, the manager leaves and you have to start over from the beginning to rebuild that relationship. And there has been a degree of snobbery that because we are not nurses our thoughts are sometimesdismissed.

Care homes are under scrutiny from the public eye and from Care Quality Commission – CQC – (the independent regulator of all health and social care services in England).Often, we are initially greeted with a low level of wariness when we first reach out. Spending time simply observing life in a home grants you a privileged and unique insight into their world: a glimpse of their pressures, the beauty of small interaction between a resident and a carer. Investing this time allows you to truly understand the home holistically, thus we can tailor the support to meet their needs. We are not there to make them feel inadequate, but to provide a listening ear and gentle direction. The staff know we have walked in their shoes and we appreciate their struggles. The reward for this is the trust the staff place in us.

One care home had been in difficulty for some time – between our support and the hard work from the staff, they were able to turn themselves around. The manager said the true turning point for them was our involvement by improving the confidence of the staff to work with the residents. For me, that is priceless.

Partnership working has been the life force of this service. No one service is the expert on dementia. Everyone has something to bring to the table. We have strived for a two-way relationship with the homes, problem-solving together. We are fortunate to have a passionate commissioner who is always willing to share his knowledge. And I could not do my job without my wonderful counterpart from Pathways 4 Life. Together, we can achieve heights that we would not surpass alone. It has been an honour to learn from each other as we continuously develop our own skills. I hope to see more examples of partnership working as we look to the future of dementia support.






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