Bringing About Positive and Safe Cultural Change Through The Carer Engagement Project

1. Bringing About Positive and Safe Cultural Change Through The Carer Engagement Project John’s Campaign: The Carer and Family Engagement Project on Westerdale Wards

2. Activity: • If your loved one with dementia was admitted to a hospital ward, what support would you want to be offered? • Consider: • Communication • Information • Visiting times • Emotional support • Practical support

3. Aims of the Project • To increase awareness of the flexible visiting hours on the ward. • To offer the opportunity for carers to be able to stay overnight with their loved one in a comfortable and safe environment. • To help carers and family members to feel more welcome on the ward. • To work collaboratively with carers and family members in the planning of their loved ones care. • To support carer’s wellbeing by assessing their needs and offering support and/or signposting to other services where necessary. • To assess the effectiveness of the project and measure outcomes.

4. What we did…

5. What we did… • The project was officially launched on Monday 12th June, with tea, coffee, cakes and biscuits at the entrance to Westerdale South. This was advertised on The Trust’s InTouch page, Facebook and Twitter accounts and a photo of the event was shared on Facebook. • Carer Packs were designed and used alongside carer passports. • A carer assessment and support plan was designed and used to assess the needs of carers. • Westerdale South was officially signed up to John’s Campaign and has a pledge on the Blog and the Observer site along with a photo from the launch.

6. What we did… • Push from all staff to encourage carers and family to be on the ward when they wished e.g. meal tokens introduced etc. • Carer and family events took place on the ward every 2-3 weeks. Events were supported in the planning and delivery by OT and Housekeeping. • Three Volunteer drivers were sourced to support carers who have difficulty accessing the ward to help with transport to and from the ward for visiting, events and meetings. • A fold-away bed was purchased for carers to use when staying over on the ward with loved ones.

7. Carer Events

8. Carer Events

9. How does this map on to your answers?

10. Outcomes

11. Outcomes: PACE Quality Audit • Patient and Carer Experience Audit routinely conducted to explore good practice standards. • The WesterdaleSouth Ward’s PACE Quality RAG rating improved from 4 out of 18 (May 17), to 14 out of 18 (August 17) and finally 18 out of 18 as of February 2018 and was rated as green. • Fig 1: PACE quality audit RAG Rating

12. Outcomes: FFT Carer feedback improved! Prior to the project carer feedback was not being routinely recorded on Westerdale South. Following the recruitment of a designated Carer and Family Worker, scores were obtained from August 2017 onwards. The scores remained above 90% throughout the life of the project with a mean average of 95.50%. Fig 2: Carer Overall Satisfaction Scores for WesterdaleSouth Oct 17– May 18

13. Outcomes: Staff and Carer Feedback Questionnaires • The results of the staff feedback questionnaires showed a positive increase in mean averages of 348% - moving from ‘mild’ to ‘strongly’ agree across all areas of carer support. All questions received a positive response post project, in terms of staff confidence and ability to support carers. • The results of the carer feedback questionnaires showed a positive increase in mean averages of 58.24% (0.91 to 1.44) moving from agreement to strong agreement across most areas. All questions resulted in a positive response post project, with the majority closer to ‘strongly agree’. • Staff and carer responses were more closely aligned post project which showed an increase in agreement between carers and staff of the level of support offered to carers.

14. Outcomes: Carer Feedback There is an ‘open house’ which welcomes visitors, giving a pleasant atmosphere for visitors, patients and staff. Visiting and transport are brilliant.

15. Outcomes: Staff Feedback The impact that protected time for carer engagement has had on our patient and carer experience has been invaluable. It has improved the quality of our care plans and provided a voice for carers that can sometimes be lost in day to day care delivery. It’s made a massive difference as it’s given staff, patients and relatives a different focus. It is improving our relationship with relatives by providing the opportunity for carers to spend time with staff and their loved one in an informal environment and a nice atmosphere.

16. Outcomes: Staff Sickness Levels • Throughout the duration of the project run on Westerdale South, staff sickness levels reduced. The average sickness rate for the previous 12 months was 5.85%, this reduced to 3.84% over the 12 months of the project. Although this cannot be causally linked as a project outcome, it is felt by the senior management team that the change in culture on the ward contributed positively to staff wellbeing.

17. Outcomes • How did the project create a cultural shift on the ward? • Role of carers in care planning. • Carers are present / can be present at any time. • Advocate for the patient who may not be able to express their views. • Forging closer and better relationships between staff and family. • Better knowledge of the person = more person-centred care planning. • Helping to see the person - not a set of behaviours. • Less ‘fear’ of family members. • Problems resolved at an earlier stage – carers have a ‘mediator’. • Carers becoming more familiar and supporting each other. • Better MDT collaboration.

18. Activity What could you do in your service?

19. What could you do in your service? • Thinking about how you currently engage, support and collaborate with carers in your service,rate your service in each area on its current level of provision for carers: • Meals / Refreshments • Transport • Information Packs • Support • Events • Groups • Communication • Visiting Arrangements • Rate each area out of 5 for your service • Where 5 = ready and 1 = not considered

20. Barriers • What barriers are there to engaging carers and families? • What fears or concerns do you have?

21. Action Planning What can you do in your area?

22. Dr Graeme Flaherty-Jones (Consultant Psychologist) • graeme.flaherty-jones@nhs.net • Tom Hurst (Modern Matron) • thomas.hurst@nhs.net • Emma Thornton (Assistant Psychologist) • emma.thornton1@nhs.net Contacts