March 11, 2012

First National Audit of Dementia Care in General Hospitals

A recent report into the findings of the first National Audit of Dementia Care in General Hospitals was published and identified a need for more training for hospital staff in order to improve the level of care recieved by people with dementia.

The collaborators in the project included:

  • Royal College of Psychiatrists
  • British Geriatrics Society
  • Royal College of Nursing
  • Royal College of Physicians (London)
  • Royal College of General Practitioners
  • The Alzheimer’s Society

The aim of the audit was to "examine the quality of care received by people with dementia in the general hospital". 89% of hospitals eligible for audit submitted data. The report notes the high participation rate and says it "shows that care of people with dementia has been recognised by hospitals as a highly important area for quality improvement".

Primary conclusions

The primary conclusions from the audit are summarised in the report as follows:

  • "Most staff from all job roles agreed that further training would be beneficial and would improve the level of care received by people with dementia.The number of staff agreeing on the need for further training in relation to awareness of dementia was striking. The data and comments on training received in particular aspects of care reveal that further training is needed across all job roles for a range of competencies related to the care of people with dementia"
  • "A person-centred approach benefits all patients, as the emphasis is on inclusion in care decisions and on making sure that the care is delivered to each patient in the way which is most suitable to them, which is the underlying principle of essential care. While no approach will avert all possible problems and distress, the approach should support staff to provide the best care within their ability"
  • "The ability of staff members to engage with people with dementia, to provide clear information and understand how to deliver care in the way most suited to the person with dementia, can ensure that care is provided consistently and can lead to a qualitatively different experience of care"
  • "Awareness and understanding of dementia shown by the frontline staff providing daily care was identified as a priority for patients and carers"
  • "The organisational checklist audit found that training frameworks and strategies to address essential skills were not generally in place, and staff responses also pointed to deficiencies in training"
  • "The audit findings as a whole echo the statement of the NICE Dementia Quality StandardAn integrated approach to provision of services is fundamental to the delivery of high quality care to people with dementia"

Facts and figures

  • "Only 5% of hospitals had mandatory training in awareness of dementia for all staff, and 23% of hospitals had a training and knowledge framework or strategy identifying the necessary skill development in working with and caring for people with dementia.
  • 32% of staff said they had sufficient training/learning and development in dementia care, including awareness training and skills based training.
  • 26% of hospitals had a training strategy specifying that staff working with people with dementia are trained to anticipate challenging behaviour and are taught how to manage violence, aggression and extreme agitation, including de-escalation techniques and methods of physical restraint.
  • Less than half the staff surveyed said they had sufficient learning and development/training in these areas.
  • 23% of hospitals had a training strategy specifying that staff of all grades and disciplines have access to communication skills training involving older service users. Half the staff surveyed said they had sufficient learning and development/training in this area.
  • Training in person-centred care was felt to be sufficient by 67% of staff, and about one half of staff said training in involving people with dementia and their carers in decisions on care and treatment was sufficient.
  • 66% of staff said they had sufficient training/learning and development in introduction to adult protection policy and procedures. However, less than half the staff said they had sufficient training or learning and development in the Mental Capacity Act and in how to assess capacity"

Read the full report