A big Star-Wardsy well done to Castleside ward for achieving the Full Monty Award!
Castleside is an inpatient unit for older people with mental health problems arising from organic disorders such as dementia.
On my visit to the ward, staff told me that it was encouraging to see that many of the 75 ideas were already in place, while some were in the germination stage, and others sparked ideas of how the ward team could adopt and adapt the examples. While working through the 75 over about 18 months, they used Northumberland Tyne and Wear NHS Foundation Trust’s (NTW) ‘Talk 1st’ initiative as a driver to introduce new strategies and ideas onto the ward. Project lead and Occupational Therapist Kristi Pearson writes:
It has been gratifying to know that a lot of what we are doing is seen as a benchmark to good practice. It has been a great way of involving the team in reviewing what we provide and come up with other ways to improve service provision.
Due to our patient group, we rely heavily on the patient’s carers for support in getting to know the patient. We hold 72 hour meetings which follow a more psycho-social approach, gathering information about a person’s likes/dislikes, routine, activities of daily living. Within this meeting we hand out a personal profile which gathers information about a patient’s life, significant memories, identify what can make them relaxed, what can make them sad or angry etc. All of this information helps us to understand a patient, why they behave in a certain way, what their needs are and look at appropriate interventions. We use all of this information within our newly set up formulation sessions using the Newcastle model. This model has been used within the ward for over 4 years by our behaviour support service nurse, but is now to be implemented by our staff nurses and MDT and be part of the ward processes. We are currently in development of ensuring the outcomes from the model are implemented into care plans which is presently working well.
The ‘personal profile’ helps the Occupational Therapy team to complete a patient activity care plan. This care plan highlights some interesting information about their past, their level of function and activities that are meaningful to them. These are used to implement meaningful activities on the ward by all ward staff, but especially the activity co-ordinator. We can also use this information to identify any similar interests that we could use to organise a new group e.g. collective interests in walking, the Sunderland Area, mining careers.
There are other developments which are currently in the pipeline including more carer support groups including a dementia friends session, to provide further education on dementia to families and an opportunity for family support, information giving and receiving, complete points of you etc. Our carers sessions have previously not been well attended, but feedback has been that families are kept well informed via the 72 hour meeting and progress meetings. Also there are times when many patients are out of area so it may be difficult for families to attend or patients are transferred to their local area before the meeting has taken place.
The ward staff have all recently been given training on sensory awareness which should be implemented at all times, but to also provides staff with a better understanding of how to use the chill out room effectively once it has been set up. These techniques will help to identify what activities will help a patient relax when they are distressed or provide them with stimulation when they are under-stimulated. These techniques are reviewed during MDT and formulations regularly.
Other processes which are to be implemented in the future are the use of the Pool Activity Levels for staff to understand a patient’s level of function. We are also planned for staff to receive Communication and Interaction Training (CAIT) in February which helps their understanding of how best to engage with patients with dementia throughout the day during various activities. The Occupational Therapy team plan to provide further education on the importance and the use of activity for patients with dementia using activity care plans as a guide.
The Occupational Therapy team work closely with the ward manager, Trish Whittle to maintain continual development of staff, ward processes, and review patient engagement in meaningful activity. Trish is supportive of meaningful activity and open to trying various activities depending on patient interests. Some more unusual activities have included pony therapy, virtual reality reminiscence and a trip to Beamish Orchard Cottage (1950’s cottage). We do have weekly visits from our pat dogs which are thoroughly enjoyed by most patients each week.
Our Star Wards project has us helped to think about what we have in place, and identify areas that could be developed all with patient experience at the heart of the planning and implementation. We were surprised to see how much we do already!! Very encouraging.
Kristi Pearson, Occupational Therapist, Castleside ward