Integrating Physical and Mental Health staff in a care home in reach team: Evaluation of a redesigned service

Abstract

There are 35 million people with dementia worldwide, many of whom live in care homes. For example, in the UK one third of people with dementia live in care home facilites, and a large proportion of these individuals have moderate or severe dementia and have highly complex care needs resulting from a combination of cognitive, functional and communication impairments, neuropsychiatric symptoms and medical comorbidity. The aim of the redesigned care home in-reach service in Oxfordshire is to improve the quality of care and health outcomes for people with dementia and enable family and paid carers to feel better supported to deliver their caring role. The model of care combines new ways of working which incorporates a biopsychosocial approach which has been effective in large scale research trials (Fossey, 2006;. Ballard, 2009) and to evaluate the effectiveness of the implementation in a routine NHS setting in the UK. The redesigned service integrates an established Care Home Support Service (physical health/ falls prevention team) with a mental health service which can work with all 102 care homes in the county in a responsive and preventative manner. The evaluation of this service uses the RE-AIM framework (Glasgow 1999) to determine the impact on - Reach of the service for indiivudals and services in the county - Effectiveness in terms of : o Health and well-being for people with dementia who receive the service using routine service outcome data for individuals . o County- wide Service use data – diagnosis rates for dementia, referrals to other services,admissions and length of stay o Family/carer satisfaction - Implementation , Adoption and maintenance factors o By thematic analysis of focus groups of staffs’ perception of benefits and difficulties of new model o Service quality data - Economic impact of this model of care This presentation will outline to key elements of the service redesign and initial findings arising from this 12 month study.