Success story of an NHS Tier 2 dementia training programme

Clinicians from the Dementia & Frailty Division within Birmingham Solihull Mental Health Foundation Trust (BSMHFT) delivered the first two-day Dementia Tier 2 Training Programme on 19-20 September 2023 for staff working with people living with dementia. The training was developed and delivered by a multidisciplinary team for a multidisciplinary audience, from inpatient and community services, including Health Care Assistants (HCA's), occupational therapists (OT), nurses, physiotherapists, medics, administrators, and psychologists. 

This fantastic training stemmed from the senior leadership team identifying that there was no routine dementia training being delivered within the trust. It also was developed on the backbone of CQC recommendations, which highlighted a need for staff training. The programme content was developed by using Health Education England's (HEE) Skills for Health Dementia Standards Framework as benchmarking standards (Skills for Health, Health Education England and Skills for Care, Dementia training standards framework - skills for health 2018). A committee of clinicians who volunteered their time to drive the programme agreed on what training should include, who was best to deliver it, and how we would evaluate its success. 

Day one

On day one, delegates were offered the opportunity to grab a hot drink and some biscuits before starting the day with an 'Overview of Dementia and Dementia Assessment'. After a break, there was a session on 'Communication in Early and Advanced Dementia'. Delegates were then offered a rare complimentary lunch! The second half of the day included sessions that invited delegates to consider 'Living well with Dementia', and 'Culture and Ethnicity', before ending the day with 'Psychosocial Interventions'. 

Day two

Day two followed a similar structure to day one. There were topics focusing on the importance of person-centred care (with Tom Kitwood's seminal work at the heart of this); 'Behaviour, stress and distress', 'Pharmacological Interventions'; and 'Environmental Modifications'. Following lunch, sessions centred on 'Physical Health and Pain'; 'Legal Considerations'; and ending the day and programme with a powerfully emotive session delivered by an expert-by-experience speaking about their experience of 'Caring in Dementia'. 

Three case studies were weaved throughout the two-day training programme, where delegates were asked to discuss each case study in a small group and consider how they might work with that person and/or family. Each session included an element of psychoeducation, with some more interactive sessions, and some that invited group-based discussion. 

Evaluation

Delegates were asked to complete anonymised pre- and post-evaluation forms to monitor the effectiveness of the training being delivered. We found that there was a significant improvement - attendees felt more confident in having a good understanding of dementia, understanding the importance of looking after themselves when caring for people with dementia, confident in helping a person with dementia to feel listened to and understood, understanding how the quality of our interactions with people with dementia can impact on their well-being, and confident in administering cognitive assessment (e.g. ACE-III, mini ACE) to better understand a person's cognitive impairments.

In addition to this, attendees felt more confident working with people with a dementia who are from BAME communities, understood how pain and physical illness may impact upon a person with dementia, understood how to take a person's life story and use it in their work with people with dementia and finding out about a person's history/life story can be helpful in identifying causes and reduce behaviours caused by stress and distress. 

The feedback also showed us that the attendees understood the rationale for using ABC charts to record instances of behaviours caused by stress and distress in people with dementia, and how to use ABC charts when a person with dementia shows behaviour caused by stress and distress. They felt confident in implementing strategies, other than clinical holding-based strategies, in response to behaviours cause by stress and distress in people with dementia. They mentioned that they understood the role that cognitive impairment may play in the development of behaviours caused by stress and distress in people with dementia. These were just some of the improvements we noticed from pre and post questionnaires of staff's understanding of the different aspects of dementia. 

Feedback from the first round of training was overwhelming with the amount of positive feedback! Some of the topics which had most interactions in the feedback included understanding dementia, culture and ethnicity, psycho-social interventions, person-centred care, and caring, amongst the rest of the sessions, which were also well received. I have included a graph below summarising the results! Delegates were asked to rate how useful they found each session and invited to feedback one key strength and area for improvement.

Overall, all sessions were well received, and staff found the sessions to be useful, well organised relevant and well taught, with some sessions being scored high on being interactive, particularly the life-story, culture and ethnicity and caring sessions. The most recent round of training was held in November, and we are in the process of evaluating that too. 

We hope that if there are any members within the Trust and would like to join this training for the next round, which is in February, please get in contact with myself via email: [email protected] so I can support you in getting a place (whilst places last!)

Well done to all the facilitators who delivered their sessions and to the first cohort of participants for contributing to the discussion and completing feedback for the team, which was presented nicely by Mohammed! 

We plan to continue running the training on a quarterly basis, with up to 25 delegates per round, and will continue to monitor its effectiveness. The programme's ultimate aim is to improve the quality of person-centred care delivered to people living with dementia within Birmingham and Solihull. Our plan is to publish results from a year-long evaluation in the Faculty of Psychology of Older People (FPOP) division of the British Psychological Society (BPS).

Author Bio

Mohammed Tayib is an assistant psychologist, working within the dementia and frailty division of the NHS. Mohammed graduated from Coventry University in 2019 and is currently in the process of applying for the clinical doctorate programme. He has over ten years of experience working within the clinical field of psychology, including working with LD, forensic, functional, and organic presentations, including dementia and frailty.

Mohammed has recently obtained an accreditation in positive behaviour support, which is an evidence-based intervention, commonly used with 'behaviours that challenge, presentations'.