We provide a range of services to support people experiencing crisis as a result of dementia, or suspected dementia. These include our Dementia Rapid Response Teams, our inpatient (hospital) services and our memory assessment service. We also hold regular dementia information sessions.
The Dementia Rapid Response Teams (DRRT) provide a community-based service which is an alternative to hospital care during times of crisis. There are three separate teams providing a comprehensive service to all areas within Derbyshire.
The primary aim of both DRRTs is to improve the well-being of people with dementia at times of crisis, by delivering rapid assessment and intensive support. In the process, the team aims to reduce the need for admission into specialist dementia hospital beds. Evidence suggests that people with dementia are best supported within their home environment where possible. Admission to hospital can be confusing and have a detrimental effect.
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 user 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 service users 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 guidance including that provided by the National Institute for Clinical Excellence – NICE).
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.
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.
Referrals into the service are through the community 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.
Sometimes individuals with an acute organic mental illness, such as acute dementia, cannot be safely supported in the community or at home. These individuals may be referred to our inpatient unit, Cubley Court.
Cubley Court is a modern 36-bed assessment and treatment unit at Kingsway Hospital in Derby. It serves both men and women with an acute organic illness who require a period of assessment within an acute mental health setting.
The unit provides single-sex accommodation. It is split into two sections, a male side and female side. It has a shared lounge that links the two sections together.
While in hospital, individuals can expect a comprehensive assessment from a team of health professionals. They will assess the individual’s needs from a social, physical and mental health perspective.
The team work within the principles of the Care Programme Approach and focus on person-centred care. In this way, they provide a detailed assessment and a range of treatment options to help each individual achieve their best possible level of functioning.
Cubley Court Female: normally individuals over the age of 65, suffering from a dementia-type illness, who cannot be safely maintained in the community. Ladies under the age of 65 may be admitted if they are suffering from a dementia-type illness, on a needs-led basis.
Monday - Friday:
2.00pm - 4.00pm
6.00pm - 8.00pm
Saturday and Sunday:
10.00am - 12.00pm
2.00pm - 4.00pm
6.00pm - 8.00pm
The Memory Assessment Service (MAS) assesses people in Derbyshire who have memory and other cognitive difficulties that might relate to a form of dementia. Diagnosing dementia accurately and early helps to ensure that people can access the treatment, support and advice they need to stay well and live independently for as long as possible.
The service is run by two teams – one in the north of the county and one in the south. The aim of both teams is to provide high-quality and timely diagnostic assessment. The service is becoming more nurse led with nurses delivering the diagnosis majority of the time with consultant and speciality doctor supervision.
The teams link with the dementia support services currently provided by Making Space (for Derby city) and the Alzheimer's Society (for Derbyshire county). The teams also refer people to the ‘Living Well Programme’ run through our specialist day services following a diagnosis of dementia. The teams in the North and Derby City are currently engaged in a GP event which involves staff meeting regularly with GP's to discuss the referral criteria, the assessment and diagnosis process, treatment options and driving with dementia.
The initial assessment will be completed by a Memory Assessment Nurse. It normally takes place in a clinic. The nurse will take a personal and medical history together with a number of assessments in order to gain a better understanding of your memory problems. A dementia screening tool will also be completed.
At this appointment you will be provided with a care and contingency plan. Your capacity to consent to assessment and treatment will also be assessed.
You will be asked to bring a list of your medications with you and you are encouraged to attend with a friend or family member.
If not already completed, the nurse will request that a scan is completed. An appointment for this will be arranged and a letter informing you of the date for the scan will be sent to you.
If not already completed, the nurse will request an ECG (electrocardiogram) is completed. Information on where to have this test will be given at the initial assessment as arrangements vary from area to area.
If you are diagnosed with dementia, a further appointment with a nurse and a doctor will be arranged. Details of this appointment will be sent in the post and it usually takes up to 12 weeks to be seen.
The nurse and doctor will discuss with you the scan and ECG results, as well as other information that has been used to formulate the diagnosis. If it is appropriate, you may commence treatment or medication right away.
You will also be introduced to the dementia support services currently provided by Making Space in Derby and Derbyshire and the Living Well with Dementia edcation programme.
If you do not receive a diagnosis of dementia after assessment, the MAS team will try to help you learn more about cognitive problems. They will provide advice and signposting to other relevant sources of support and suggestions for referrals to other services.
Neuropsychology assessments which are carried out by clinical psychologists or neuropsychologists can be requested where there is not a clear diagnosis. This assessment is requested where more information is needed to help understand your individual difficulties or where the situation appears more complex.
The MAS teams accept referrals from GPs and other health care specialists including hospital consultants, staff from the Falls Clinic and neurologists. The following information should be included for all referrals into MAS:
- History and nature of presenting memory or cognitive complaint – this should be more than “experiencing memory difficulties”.
- Medical information (case summary) to include:
- Past medical history and current medical problems
- List of current medication
- Results of any cognitive screening assessment undertaken (although scores will not be used to determine whether to accept a referral to MAS)
- Routine blood test results, including FBC, CRP, IP, B12, Folate, TFTs
- Patient consent for referral should be documented and whether carer/family are aware of referral.
If the referral is from a source other than your GP, we will inform your GP about the referral and request a case summary and medication list.
We hold a number of dementia Q&A (question and answer) sessions each year across Derby and Derbyshire. These events are usually held in the evening and are free to attend. A team of dementia specialists from the Trust and other local organisations attend to answer your questions.
For upcoming sessions, view our events calendar.