South West Dementia Partnership

The review team found lots of examples of good and innovative practice, with many highly motivated and committed staff doing their best to support people with dementia and their carers. However the overriding finding was that services were not joined up. This was because they have not been planned in a way that provides a range of reliable care options as a person’s condition deteriorates. The review concluded that agencies needed to be clearer and bolder in the way they planned and commissioned services.

The review noted that there was potential to support people to remain at home and improve their quality of life by diverting expenditure from emergency, residential and hospital care.

General findings

• Leadership to drive forward the National Dementia Strategy is variable. In some areas this needs to be strengthened.
• There is huge variation across the region and there are particular difficulties in providing support in rural areas.
• Services are based on historical practice rather than future needs.
• Services are often disjointed. Health and social care services need to be streamlined so that they are more efficient and deliver a consistent, joined-up service.
• The contribution from voluntary services varies from excellent to non-existent. Some voluntary services are heavily reliant on fund raising which makes them vulnerable.
• Data collection about the amount, range and costs of existing services is weak. This is partly because it is hard to separate out services supporting people with dementia from generic and mental health services. This makes planning difficult.
• Some areas have some good services for younger people with dementia but in many areas the needs of this group are overlooked. As a result they sometimes receive inappropriate services alongside older people.

More specific findings

1. Most places do not have a well-planned programme to raise public or professional awareness. Low awareness amongst GPs and frontline staff is a significant problem.
2. There are varied and sometimes confusing arrangements for providing memory assessments and follow-up advice.
3. In general there is a lack of reliable information available for people.
4. There is a range of peer support networks with some examples of highly valued memory cafes.
5. There is little use of direct payments for people with dementia.
6. Specialist home care is being used in some areas although this can be expensive.
7. Hospitals tend to provide unsuitable care and environments for people with dementia and there are delays in moving people back into the community.
8. Support to keep people at home or leave hospital quickly (intermediate care) does not seem to meet the needs of people with dementia.
9. Very limited use is being made of assistive technology to support people living in the community.
10. Care in care homes is variable. In some areas dementia link workers or champions have helped to drive up standards of care.
11. There is little specific end of life support for people with dementia although a number of areas have adopted the general Gold Standard Framework.
12. Workforce planning and development is generally weak across the South West.