Rehab Centre

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Good Practice

Supporting carers of people with dementia in black, Asian and minority ethnic communities

A good practice example of working with carers of people with dementia from diverse communities by the Dementia Information and Support for Carers (DISC) service hosted by Sandwell Crossroads Birmingham
Area of Care: 
Mental HealthPhysical illnessSpecial education needsSpecialist servicesDay centreRehab CentreHospitalCare homesDementia care
Outcomes: 
Carer awarenessIdentifying carers
I work in: 
Health carePrimary careHospitalsMental health careHealth and wellbeingPharmacy ServicesCarers servicesCarers involvementCarers breaksInformation and adviceCommissioning for carersCommissioning
I work with: 
Adult carersFamilies
Caring for: 
AdultsOlder adults
Location: 
Whole UK
Date Revised: 
Monday, April 30, 2018 - 13:45
Body: 

DISC Dementia information and support for carers

The Disc Service was launched 11 years ago, it is hosted by Sandwell Crossroads and funded by Sandwell and West Birmingham, Cross City, South Central CCG’s, and Birmingham City Council through the Birmingham Bettercare Fund

The service originally operated in West Birmingham, but had funding extended to cover the entire Birmingham City Council area.

The service is focused on supporting carers from the diverse communities in the Birmingham area. The DISC service prides itself on being proactive in recruiting staff from local black, Asian and minority ethnic (BAME) communities who have both the language skills and understand the cultural sensitivities.

The service supports over 400 carers and offers Iiformation, advocacy and support for carers, though one-to-one contact and successful weekly information and support groups.

It also offers a signposting and referral service into other local statutory and voluntary sector services.

Examples of the type of help and support carers have receive:

  • Accessing respite
  • Liaising with district nurses, occupational therapists and social workers.
  • Continence advice and support.
  • Advice in managing changing and unusual behaviours.
  • Finding the right care such as day centres, care homes and care agencies.
  • Talking to the wider family.
  • Advice on benefits and carers' rights.
  • Information on the Mental Capacity Act.
  • Information on lasting power of attorney

DISC's strengths

  • Building relationships with carers over a long period of time.
  • Stepping in to offer support before a crisis develops.
  • Bridging the gap between clinical diagnosis and families coping alone.
  • Making carers feel welcome – 14 of them formally volunteer in supporting other carers.
  • Being led by carers, listening to carers and developing services to meet need.
  • Feeling passionate about the service.

Further information

For more information on the service contact Jo.Moon@sandwellcrossroads.org or visit the Sandwell Crossroads website.

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Research

A Road Less Rocky Supporting Carers of People with Dementia

A Road Less Rocky is a report from Carers Trust that found that carers of people with dementia are not getting the support and advice they often desperately need.
Area of Care: 
Mental HealthDay centreRehab CentreHospitalCare homesPrimary CareSecondary CareAcute CareDementia care
Outcomes: 
PreventionWellbeingCarer awarenessIdentifying carers
I work in: 
Health carePrimary careHospitalsMental health careHealth and wellbeingPharmacy ServicesCarers servicesInformation and adviceCommissioning for carersSocial careCommissioning
I work with: 
Adult carersYoung adult carers
Caring for: 
AdultsOlder adults
Location: 
Whole UK
Date Revised: 
Friday, April 27, 2018 - 14:00
Body: 

The report found that there were a number of critical points along a carer’s journey where they would most value information and support. These critical points include:

  1. When dementia is diagnosed.
  2. When the carer takes on an 'active' caring role.
  3. When the capacity of the person with dementia declines.
  4. When the carer needs emotional support and/or a break from caring.
  5. When the person with dementia loses their mobility.
  6. When the person with dementia has other health problems.
  7. When the carer has to cope with behavioural problems.
  8. When the carer's own circumstances change.
  9. When the person with dementia becomes incontinent.
  10. When decisions about residential care and end of life care have to be made

We have designed a toolkit around these ten points,the issues carers face at these points and what will make a positive difference. It has been produced to sit alongside A Road Less Rocky and gives guidance to professionals who come in contact with carers. The toolkit is useful for anyone who works with or treats patients with dementia and is therefore likely to come into contact with carers. 

A Road Less Rocky – Supporting Carers of People with Dementia complements the Triangle of Care Carers included: A Guide to best Practice for Dementia Care. This document describes how meaningful involvement and inclusion of carers can lead to better care for people with dementia, identifying six key standards required to achieve better collaboration and partnership with carers.

Although the terminology and legislation referred to in this toolkit applies to England the standards and rationale are applicable across the whole of the UK.

Further information

Find further information and download the full report A Road Less Rocky – Supporting Carers of People with Dementia (PDF, 962KB).

Download the toolkit PDF iconA Road Less Rocky: Making the Road Less Rocky for Carers, A Guide on how to Support Carers of People with dementia

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Guidance

Triangle of Care for Dementia

The Triangle of Care for Dementia was developed in partnership with the Royal College of Nursing and in consultation with carers, people with dementia and professionals. It is based on the original Triangle of Care and is aimed at acute care hospitals.
Area of Care: 
Mental HealthSpecialist servicesDay centreRehab CentreHospitalCare homesSecondary CareAcute CareDementia care
Outcomes: 
PreventionWellbeingHealth inequalitiesCarer awarenessIdentifying carers
I work in: 
Health careHospitalsMental health careHealth and wellbeingCarers servicesCommissioning for carersCommissioning
I work with: 
Adult carers
Caring for: 
AdultsOlder adults
Location: 
England
Date Revised: 
Tuesday, June 9, 2015 - 09:30
Body: 

The Triangle of Care Carers Included: a Guide to Best Practice for Dementia Care

In 2013 Carers Trust worked with the Royal College of Nursing (RCN) to adapt the Triangle of Care to meet the needs of carers of people with dementia when the person they cared for was adapted to a general hospital. A stakeholder day was held where carers, people with dementia and professionals were consulted and provided feedback on the Triangle of Care. 

Carers Trust and the RCN worked together in 2016 to update the guide.

The new guide and self assessment tool were launched in November 2016, this is specifically aimed at acute hospital wards and services where a person with dementia may be admitted but their dementia is not the reason for their admission.

The guide is to enable professionals to look at how they can identify and support carers ensuring that the person with dementia is included and receives the best care outcomes as well as positive outcomes for the carer.

PDF iconThe Triangle of Care Carers Included a Guide to Best Practice in Dementia Care.pdf

FileTriangle of Care for Dementia Self-Assessment Tool (Word Version)

The Triangle of Care Carers Included: a Guide to Best Practice for Dementia Care in Scotland

To reflect the Scottish context, the Triangle of Care has been adapted to suit the Scottish legislation, initiatives and policies around dementia. The Scottish version has been a collaborative effort between Carers Trust Scotland, Royal College of Nursing Scotland, NHS Greater Glasgow & Clyde, University of
Stirling Dementia Services Research and Dementia Carers Voices.

 PDF iconThe Triangle of Care Carers Included a Guide to Best Practice for Dementia Care in Scotland.pdf.

The Triangle of Care Carers Included: a Guide to Best Practice for Dementia Care, Wales Edition

In Wales, the Triangle of Care has been adapted to reflect Welsh legislation, good practice examples and policies around dementia in secondary care. The Wales edition has been funded by the Royal Collage of Nursing and adapted for use in Wales by Carers Trust Wales.

 

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Guidance

Triangle of Care Membership Scheme

As the number of mental health providers working to embed the Triangle of Care standards in their organisation continues to grow, Carers Trust felt it was important to offer some recognition of this work and developed the Triangle of Care membership scheme.
Area of Care: 
Mental HealthPhysical illnessAlcohol MisuseSubstance MisuseDay centreRehab CentreHospitalPrimary CareSecondary CareAcute CareDementia care
Outcomes: 
PreventionWellbeingIntegrationCarer awarenessIdentifying carers
I work in: 
Health carePrimary careHospitalsMental health careHealth and wellbeingSocial careCommissioning
I work with: 
Adult carersYoung adult carersYoung carersFamilies
Caring for: 
AdultsOlder adultsYoung peopleChildren
Location: 
England
Date Revised: 
Tuesday, November 22, 2016 - 16:15
Body: 

Triangle of Care Membership Scheme (England only)

As the number of mental health providers working to embed the Triangle of Care standards in their organisation continues to grow, Carers Trust felt it was important to offer some recognition of this work and developed the Triangle of Care membership scheme. A three stage recognition process for services who commit to self-assessing their existing services and action planning to ensure the Triangle of Care standards are achieved. The membership scheme is not a "kitemark" scheme that shows work has ended but is to recognise long term commitment from mental health providers who are working towards cultural change.

Carers Trust has developed a simple membership scheme and application process. 

What does being a member mean?

When a Mental Health Trust joins the Triangle of Care membership scheme, they are basically committing to changing the culture of their organisation to one that is carer inclusive and supportive. They do this by completing self-assessment for all their services in partnership with carers and then work on what needs to change to ensure carers are part of the core business of their Trust.

What do the stars mean?

Trusts who join the membership scheme and complete the appropriate stages for their organisation receive an award to recognise their commitment. For Mental Health Trusts this is up to two stars and for Trusts that are integrated there is a third star. They receive the first for completing stage one (self-assessing all inpatient and crisis teams) and then committing to improve. The second star is for completing self-assessments for all of their community services. This is all mental health, learning disability, older people and dementia and substance misuse services. Trusts who are integrated (provide community physical health services), they receive a third star if they complete self-assessment in all of their physical health services.

The stars do not signify that member trusts are fully carer inclusive. They are awarded when the trust has demonstrated a commitment to becoming more carer inclusive, has shown honesty about where they are now and planned where they need to be to ensure carers are better identified and supported.

The documents you will need to join the membership scheme are:

A number of organisations provide services that the existing Triangle of Care self-assessment would not be suitable for. These services fall into two categories: limited contact services (for example Liaison Psychiatry) and Community Health Services (for example district nursing). As such we have developed some additional guidance to help these services implement the Triangle of Care as well as a "universal" self-assessment tool.

Mental health providers are recommended to use the Triangle of Care Implementation Toolkit to ensure all elements required for successful implementation are in place, you can find full information on the toolkit here: Triangle of Care Toolkit - A Resource for Mental Health Service Providers.

As a requirement of membership, mental health providers must have carer partners who will act as critical friends to the process. Carers Trust has developed guidance to support carers and carer organisations to act as critical friends and the process to be as successful and positive as possible. You can download the Carer Toolkit here: PDF iconTriangle of Care Toolkit for Carers & Carer Organisations

You can download the documents here:

PDF iconTriangle of Care Guidance for Limited Contact Services

PDF iconTriangle of Care Guidance for Community Health Services

Microsoft Office document iconTriangle of Care Self -Assessment Tool for Community Health Services

Mental Health Trusts who have joined the Triangle of Care Membership Scheme (updated March 2018) are:

New members undertaking Stage One:

  • Camden and Islington NHS Foundation Trust
  • Coventry and Warwickshire Partnership NHS Trust
  • Cumbria Partnership NHS Foundation Trust
  • Lancashire Care NHS Foundation Trust
  • Sussex Partnership NHS Trust
  • West London Mental Health NHS Trust

Members who have completed Stage One and are currently undertaking Stage Two:

  • Birmingham & Solihull Mental Health NHS Foundation Trust
  • Bradford District Care Foundation Trust
  • Cornwall Partnership NHS Foundation Trust
  • Devon Partnership NHS Trust
  • Dorset Healthcare University NHS Foundation Trust
  • Dudley and Walsall Mental Health Partnership NHS Trust
  • Kent and Medway NHS and Social Care Partnership Trust
  • Leeds & York Partnership NHS Foundation Trust
  • Lincolnshire Partnership NHS Foundation Trust
  • Livewell South West
  • Pennine Care NHS Foundation Trust
  • South Staffordshire & Shropshire Healthcare NHS Foundation Trust
  • South West London and St George’s Mental Health NHS Trust
  • Tees, Esk and Wear Valley NHS Foundation Trust

Trusts who have completed Stages One and Two:

  • 2gether NHS Foundation Trust
  • Avon & Wiltshire Mental Health Partnership NHS Trust
  • Berkshire Healthcare NHS Foundation Trust
  • Cheshire and Wirral Partnership NHS Foundation Trust
  • Derbyshire Healthcare NHS Foundation Trust
  • Greater Manchester Mental Health NHS Foundation Trust
  • Hertfordshire Partnership University NHS Foundation Trust
  • Mersey Care NHS Trust
  • Norfolk & Suffolk NHS Foundation Trust
  • Northumberland, Tyne and Wear NHS Foundation Trust
  • Nottinghamshire Healthcare NHS Foundation Trust
  • Oxford Health NHS Foundation Trust
  • Somerset Partnership NHS Foundation Trust
  • Surrey and Borders Partnership NHS Foundation Trust

Trusts who completed Stages One, Two and Three:

  • Cambridgeshire & Peterborough NHS Foundation Trust
  • Rotherham, Doncaster and South Humber Mental Health NHS Foundation Trust
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