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Tuesday 26 March 2019
Derbyshire Healthcare NHS Foundation Trust
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Dementia Rapid Response Team - south Derbyshire

Two older ladies walking

The Dementia Rapid Response Team (DRRT) for the south of Derbyshire and Derby city is a community-based service that was launched by the Trust in March 2015.

The team is multi-disciplinary and includes mental health nurses, psychiatrists, occupational therapists and health care assistants, supported by others specialising in physiotherapy, psychology and pharmacy.    

How does the service work?

The service is delivered in an individual’s home, wherever that home may be. The team is flexible and highly responsive, providing a same-day response. The service is available Monday to Friday between the hours of 8am - 8pm and also between 9am - 5pm on Saturday and Sunday.     

The service starts with a specialist assessment. From there, an individual person-centred plan of care is developed, in collaboration with the service receiver and their carers. Where home treatment is part of the plan, intensive support will be provided. This can be up to four times a day and for seven days a week. Although the majority of individuals receive two intervention calls per day for six weeks, this is very much led by the individual's needs. 

The assessments, interventions and treatments offered by the team are informed by evidence-based best practice (from research and associated guidance including that provided by the National Institute for Clinical Excellence – NICE).     

What kind of support does the team offer?

Specific interventions, or actions, the team may offer include:

  • Focusing on the immediate crisis, identifying the source and treating it – for example through behavior mapping, psychotherapeutic intervention and medication review

  • Identifying and intervening to meet an individual's needs in challenging situations – for example by ensuring daily activities are maintained

  • Building on the steps above to enable carers to meet these needs through modelling (learning through observation and imitation), support and education

  • Collaborating to develop a care plan including the use of advance statements (written statements setting down an individual's preferences, wishes, beliefs and values regarding their future care)

  • Working with caring relationships to build resilience – such as through cognitive reframing (looking at your thoughts from a different point of view) 

  • Offering education, advice and support to enable resilience and reablement

  • Exploring factors which might cause stress and ways to prevent and manage relapse

  • Encouraging individuals to develop a range of coping strategies and ways to keep safe

  • Enabling  individuals and carers to access other support services which may be of help.

The team is a key part of the dementia care pathway, working closely with community mental health teams (the triage and access point), and in an integrated way with key partners – including adult social care, integrated care services, GPs and primary care, and the voluntary sector.

The team also has a strong role in enabling people who are admitted to hospital to return home as soon as possible, to reduce the impact of negative outcomes that can result from being in hospital. Consequently the team works closely with inpatient services. 

Who does the team support?

Individuals requiring the service will be experiencing a breakdown to the point of crisis as a result of their having dementia, or suspected dementia. Other community services will be unable to support them safely at home and hospital admission is a likely pathway for their care.

Others who will benefit from the service include individuals who are in hospital but who could be discharged sooner with a short period of intensive support.  The team will help to ensure a rapid discharge back home.

How does an individual get referred into the service?

Referrals into the service are through the neighbourhood mental health teams and old age consultant psychiatrists. The service is for people with a diagnosis of dementia or symptoms consistent with a diagnosis of dementia.
If you are concerned about someone with dementia, please speak to your GP. Your GP will then be able to contact the relevant neighbourhood mental health team, where the duty triage system will determine the best pathway of care for an individual.