Dementia Post Diagnosis Support

Examples of Practice

Supporting people with a new diagnosis of dementia and their relatives/carers to be better informed about the condition, to understand the support available to them, and to plan for their future care.

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Intermediate Care – Fife

Examples of Practice

The aim of establishing ICASS in Fife was to transform community services by bringing together uni-disciplinary teams to utilise fully resources available in line with demand, and to coordinate care through a single point of access (SPOA). It contributes to our commitment to ensure the closer integration of the range of community services under one system.

It aims to improve quality of care and outcomes for older people whilst allowing them to remain independent within their own homes or communities, provides alternatives to hospital admission, reduces the number requiring long term institutional care, reduces length of stay for those who require a hospital admission.  It aims to address the following:

  • Moving from an inpatient model of care to a robust community based model of care involving older people and their carers and families in care planning
  • Bringing together teams to make more efficient use of resources to meet the needs/demands of the increasingly elderly population
  • To provide a single point of access
  • To provide alternatives to hospital admission
  • To reduce length of stay if an admission is necessary
  • To provide assessment and care in the person’s own home or a homely setting
  • To achieve and sustain maximum potential and independence; and
  • To reduce numbers going into long term institutional care.

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Community Engagement Team

Examples of Practice

The establishment of the Community Engagement Team supports the need to develop new models to support service delivery and community engagement to rural and remote-rural areas and proposed to test ideas that:

  • Older people could contribute to providing community-based services for other older people.
  • Older people could be maintained living in their own homes and communities for as long as possible if communities developed the capacity to provide basic services in ‘co-production’ with statutory public service providers.
  • Social organisations of various types established in and by communities, could be sustainable and could provide ‘value-added’ benefits (social participation, health, community involvement etc.).
  • Communities could be supported to engage in meaningful and sustainable dialogue with key statutory public service providers to ensure transparency and co-production.

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Closer Working with the Independent Sector

Examples of Practice

West Dunbartonshire CHCP recognised that the RCOP agenda offered both opportunities and risks to providers of care.  In developing a cohort of managers involved in My Home Life we are attempting to support our Managers to embrace the changes which RCOP will bring and also support them to engage with key decision makers in order that they can help direct the future provision of care in order that it better meets the needs of those receiving care.  Whilst promoting the delivery of high quality care.

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