Dementia and building design

The request was successful.

Darius van Niekerk

Dear Care Quality Commission,

I would be grateful if you could provide the following:

*A copy of any checklists/guidance used when assessing whether the design of hospitals meet the needs of dementia patients.

* A list of the best and worst performing hospitals in regards to the care of dementia patients.

Yours faithfully,

Darius van Niekerk

Information Access, Care Quality Commission

Our Ref: CQC IAT 1920 0415

 

Dear Mr van Niekerk

 

I acknowledge receipt of your correspondence dated Saturday10 August 2019,
in which you made a request for information. Your correspondence was
received by CQC on Monday 12 August 2019.

 

Your request is as follows:

 

“I would be grateful if you could provide the following:

 

*A copy of any checklists/guidance used when assessing whether the design
of hospitals meet the needs of dementia patients.

 

* A list of the best and worst performing hospitals in regards to the care
of dementia patients.”

 

CQC will consider your request in accordance with the Freedom of
Information Act 2000 (FOIA).

 

Our statutory deadline for response is 06 September 2019, but we will in
any event endeavour to respond as soon as possible.

 

We will write to you if we are unable to meet this deadline.

 

The information you have requested may be subject to an exemption from the
right to know. Should this occur, we will explain the reasons why when we
respond.

 

Kind regards

 

 

 

Information Access Team

Governance and Legal Services

Customer & Corporate Services Directorate

Care Quality Commission

Citygate

Gallowgate

Newcastle upon Tyne

NE1 4PA

 

Email: [CQC request email]

 

**************************************************************

The Care Quality Commission is the independent regulator of all health and
adult social care in England. www.cqc.org.uk. For general enquiries, call
the National Customer Service Centre (NCSC) on 03000 616161 or email
[email address].

 

Personal data is processed in accordance with the General Data Protection
Regulation (GDPR) and relevant data protection law. Information on the
processing of personal data by CQC can be found at
http://www.cqc.org.uk/about-us/our-polic...

 

Statutory requests for information made under access to information
legislation such as the GDPR and the Freedom of Information Act 2000
should be sent to: [CQC request email].

 

 

 

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Information Access, Care Quality Commission

2 Attachments

  • Attachment

    2 20180326 Mental health service framework Memory Services V1 FOR PUBLICATION.pdf

    306K Download View as HTML

  • Attachment

    1 Mental health Core Service Framework Wards for Older People with mental health problems.pdf

    382K Download View as HTML

Dear Mr van Niekerk

 

Our Ref: CQC IAT 1920 0415

 

I write in response to your correspondence of 12 August 2019 in which you
asked for the following information:

 

“I would be grateful if you could provide the following:

 

*A copy of any checklists/guidance used when assessing whether the design
of hospitals meet the needs of dementia patients.

 

* A list of the best and worst performing hospitals in regards to the care
of dementia patients.”

 

The Information Access team has now coordinated a response to your
request.

 

CQC has considered your request in accordance with the Freedom of
Information Act 2000 (FOIA).

 

Our main obligation under the legislation is to confirm whether we do or
do not hold the requested information.

 

In accordance with section 1(1) of FOIA we are able to confirm that CQC
does hold some recorded information in relation to this matter.  We have
addressed each of your questions in turn, but first it may be of
assistance to provide some information in relation to NHS core services as
they relate to the information you have requested:

 

Core NHS Services

 

Core services are the ones that most trusts provide. They are typically
services that people use the most, or in some cases, the ones that may
carry the greatest risk.

 

We will not always inspect every ward or part of a core service in a
single inspection. To help us select and prioritise the specific areas to
visit, we may either:

 

o select a random sample of some wards or parts of the service
o select others according to various factors about risk, quality and the
context of the services.

 

You can find out more about each of the core services via the link below:

 

[1]https://www.cqc.org.uk/guidance-provider...

 

Information requested

 

“A copy of any checklists/guidance used when assessing whether the design
of hospitals meet the needs of dementia patients.”

 

CQC provides guidance to inspectors to support their inspections of mental
health and acute trusts and includes how the environment meets the needs
of people with dementia.

 

Mental health trusts

 

Our core service framework ‘Wards for Older People with mental health
problems’ (please see attached doc 1) sets out and references checklists
and applicable NICE quality standards.

 

For example, a ‘Responsive’ ward “Has clear and simple signs at a visible
height that include symbols as well as words, where possible” (R2, R1) or
“Has staff who undertake assessment and care planning and who have
received training in dementia awareness” (E1, E3).

 

Additionally, our guidance for inspectors on ‘memory services’ (please see
attached doc 2) reflects care for people with dementia in hospital
environments and includes checklists/prompts relating to the physical
environment, e.g. “Are there safety features specific for a
dementia-friendly environment (hand rails, clear signage, lighting,
monitored egress, etc.)?“  Please note that ‘memory services’ is not a
core service that we inspect and is therefore not rated in its own right,
but contributes to the rating of core services, such as ‘Wards for older
people with mental health problems’ that we inspect.

 

You may also find these two CQC reports useful:

 

CQC Report: Cracks in the pathway:

[2]https://www.cqc.org.uk/sites/default/fil...

 

People with dementia: a different ending:

[3]https://www.cqc.org.uk/sites/default/fil...

 

Acute trusts

 

CQC’s regulatory approach for hospitals includes assessing how acute
trusts meet the needs of patients with mental health needs, which is set
out on this page of our Provider Handbook. In preparation for this work,
we held a ‘Parity of Esteem’ event in 2017, which brought together
external stakeholders and experts by experience.  This led to our core
service frameworks for acute inspections being strengthened to include
prompts relating to mental health care, including dementia care. Our
frameworks inform our inspections at core service level and are all
available via our website:

 

[4]https://www.cqc.org.uk/guidance-provider...

 

As an example, the core service framework for the Medical care (including
older people’s care) framework makes regular reference to dementia
including:

 

o In the safe key question under mandatory training (S1) and
documentation in patient records (S3)
o In the effective key question under effective care and practice (E1 -
referencing the NICE Clinical Guideline 42 – Dementia), assessing pain
relief for patients with dementia (E1) , patient outcomes (E2 - the
National Dementia Audit), staff competence (E3), and health promotion
(E6)
o In the caring key question in relation to compassionate care (C1)
o In the responsive key question under Service delivery and meeting
people’s needs (R1)

o It is this last one where a prompt specifically around the
environment have been added:

 

"How well do they care for people living with dementia? Is there a
dementia-friendly ward/area? How many staff have dementia training? Is
dementia assessed on admission?

 

Since September 2017, MH inspectors have joined our acute inspections to
provide specialist support to acute inspectors in carrying out this work,
and we carry out regular drop in calls with inspectors to provide ongoing
support and listen to feedback about findings.

 

“A list of the best and worst performing hospitals in regards to the care
of dementia patients.”

 

We do not have a way to quantify this information as we don’t have a core
service specifically related to dementia; and elements of dementia care
could be covered under several different core services as people are
admitted through pathways. 

 

Other information that may be of use to you

 

Our ‘Care directory – with filters’ contains the current published overall
rating for registered Locations and allows you to filter by ‘Dementia’ as
service user band.  Please note however, a location may have multiple
service user bands.

 

You can identify this information for NHS organisations using the
following filter options:

 

o Column J ‘Location type/sector’ – NHS Healthcare Organisation
o Column AN ‘Provider primary inspection category’ – Acute hospital –
specialised & non-specialised
o Column CZ ‘Service user band – dementia’

 

CQC Complaints and Internal Review procedure

 

If you are not satisfied with our handling of your request, then you may
request an internal review.

 

Please clearly indicate that you wish for a review to be conducted and
state the reason(s) for requesting the review.

 

Please note that it is usual practice to accept a request for an internal
review within 40 working days from the date of this response. The FOIA
code of practice advises that public authorities are not obliged to accept
internal reviews after this date.

 

Please be aware that the review process will focus upon our handling of
your request and whether CQC have complied with the requirements of the
Freedom of Information Act 2000. The internal review process should not be
used to raise concerns about the provision of care or the internal
processes of other CQC functions.

 

If you are unhappy with other aspects of the CQC's actions, or of the
actions of registered providers, please see our website for information on
how to raise a concern or complaint:

 

[5]www.cqc.org.uk/contact-us

 

To request a review please contact:

 

Information Access

Care Quality Commission

Citygate

Gallowgate

Newcastle upon Tyne

NE1 4PA

 

E-mail: [6][CQC request email]

 

Further rights of appeal exist to the Information Commissioner’s Office
under section 50 of the Freedom of Information Act 2000 once the internal
appeals process has been exhausted.

 

The contact details are:

 

Information Commissioner's Office

Wycliffe House

Water Lane

Wilmslow

SK9 5AF

 

Telephone: 0303 123 1113

Website: [7]www.ico.org.uk

 

Feedback

 

CQC will always endeavour to provide high quality responses to requests
for information and seek to be as helpful as possible. We would therefore
appreciate if you can take some time to complete our online feedback form
by visiting the following link:

[8]https://webdataforms.cqc.org.uk/Checkbox...

 

Any information you provide will be held securely and only used for the
purposes of improving the Information Rights service that CQC provides.

 

Kind regards

 

 

 

Sylvia Blakeley

Information Access Officer

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References

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1. https://www.cqc.org.uk/guidance-provider...
2. https://www.cqc.org.uk/sites/default/fil...
3. https://www.cqc.org.uk/sites/default/fil...
4. https://www.cqc.org.uk/guidance-provider...
5. http://www.cqc.org.uk/contact-us
6. mailto:[CQC request email]
7. http://www.ico.org.uk/
8. https://webdataforms.cqc.org.uk/Checkbox...