Welcome

1. Welcome

2. Housekeeping

3. FAST CAMPAIGN

4. Take Immediate Action! Transient Ischaemic Attack A STROKE waiting to happen If the symptoms are still there→ 999 If within last 24 hours→ A&E urgently If within last 7 days→ make urgent GP appointment TIA Campaign OCT ‘11

5. STROKE COMPETENCIES FOR CARE HOME WORKERS • Aims for the morning: • What is a stroke? • National/local drivers for quality of stroke care • Stroke Association and SA training • Why, how and when of stroke training • Plan until April 2012 • Long term sustainability applicable to care homes – what are the barriers and how are we going to overcome them? • Questions and answers

6. Card game • True/false

7. Care Home TrainingA guide to stroke

8. What is a stroke? A stroke is a brain attack. A stroke is what happens when the blood supply to part of the brain is cut off. Blood carries essential nutrients and oxygen to the brain. Without a blood supply, brain cells can be damaged or destroyed.

9. How does this happen? Ischaemic (69% - 80%) Death of tissue (infarction) because of blockage by: Thrombosis – a solid clot of blood in artery supplying brain or Embolism – a clot or other substance (fat, cholesterol, blood platelets) carried from elsewhere in circulation

10. How does this happen? Haemorrhage (15% - 20%) Bleeding in the brain Burst blood vessel e.g. artery High blood pressure can weaken artery Bursts and damages tissue Brain damage is the result

11. AGE HIGH BLOOD PRESSURE INACTIVITY FAMILY HISTORY & ETHNICITY HEART DISEASE BINGE DRINKING & SUBSTANCE ABUSE RISK FACTORS DIABETES SMOKING PREVIOUS STROKES & TIAs ORAL CONTRACEPTION & HRT OBESITY: UNHEALTHY EATING

12. Stroke facts In the UK Every five minutes someone is having a stroke Stroke is the third largest cause of death Approximately a third of people will die within the first 10 days At any one time there are over a quarter of a million people disabled by stroke

13. National and local drivers for stroke improvement in care home provision

14. Local drivers for stroke care home improvement • CQC Review Herts NHS and Herts CC • Consequent re-design of stroke care pathway in Herts • ‘The times they are a changing’, CCG’s and all the things we love…. • ASI program implementation Herts • County council savings/commissioning • JSNA Hertfordshire

15. The Stroke Association • What do they already do in Herts and who are they?

16. Stroke Association Services in Hertfordshire Communication Support • Pat Storey (West Herts) • Rebecca Byrne (Hertsmere) Information, Advice and Support • Alan Kerby (West Herts) • Judy Smyth (North & East Herts) • Joanna Clark (North & East Herts)

17. The Stroke Association • Professional training tailored to your needs • Web site – www.stroke.org.uk • National Stroke Helpline – 0303 30 33 100 • Free quarterly Stroke News magazine • Information leaflets and factsheets • Life After Stroke Services • Welfare Support • Stroke Clubs • Research • Fundraising • Campaigning

18. Why Have Stroke Training? More efficient practice would save £20 million annually, avoid 550 deaths and over 1,700 patients would fully recover from their strokes, who would not have done so otherwise

19. What you get… A dedicated trainer delivering the course Well produced course materials – no need for notes! ‘Practice Card’ for QCF, NVQ and PREP reflective learning Up-to-the-minute information about stroke and stroke care Training which involves participants and uses their skills and experience

20. ‘Caring for people affected by stroke’ mapped against knowledge relevant to QCF Level 2 and 3 in Health and Social Care Programmes mapped against Skills for Health National Occupational Standards for Stroke Flexible in delivery according to levels of knowledge and expertise Informative to all staff; meeting, supporting and communicating with people with disability

21. Who should attend? A wide range of staff caring for those affected by stroke at home and in the community: Nursing staff Care workers Social Care staff Informal Carers Primary Care teams First aid providers and trainers Commercial service providers…

22. Training Programmes Include: Caring for People Affected by Stroke – Day 1 Caring for People Affected by Stroke – “What next” – Day 2 Stroke is a Medical Emergency – Face to face training and e-learning Informal Carers’ Training Active Listening Active Communication Stroke - The sight effects Blood Pressure Training

23. Caring for people affected by stroke ‘Thoughts and Feelings’ psychological effects ‘All About Strokes’ a general introduction and overview ‘It’s Good to Talk?’ stroke and communication ‘Hard to Swallow’ swallowing and nutrition ‘Family and Friends’ the needs of those closest Physical needs- movement, mobility, and continence

24. Unit Statistics From April 2010 – March 2011 we delivered: • A total of 501 courses • To over 6,084 people across the UK

25. Plan until April 2012 • Start with short form course of 3 hours specifically for home care workers to increase stroke awareness. • Support this with educational materials available on-line, DVD, competency framework and possibly learning portal. • Delivery in clusters of care homes in Hertfordshire which have registered interest by SA funded by Herts CC/BHHSN

26. Long term sustainability applicable to care homes • What are the barriers and how are we going to overcome them? • What are your homes’ specific need? • How can we make things more accessible to you? • What has worked in the past eg dementia? • What didn’t work in the past?

27. Many thanks to: • Hertfordshire County Council training department • HCPA (Hertfordshire Care Providers Association) • The Stroke Association Training department • Beds and Herts Heart and Stroke Network