Dementia (health and wellbeing needs in South Tyneside)

South Tyneside Council has a statutory duty relating to the 2014 Care Act to assess local people's needs and their eligibility for publicly funded care and support. 

This is delivered by Adult Social Care Strategy via the 'Living Better Lives' (2022-2026) which outlines the approach adopted locally. Services are delivered in the context of:

• Being able to access support which builds on their strengths, friendships, and aspirations.
• Live safely and well.
• Live independently as much as this is possible.
• Have an equal voice in coordinating their care and support.
• Tell their story only once.
• Have their rights protected.
• Be included and treated as equal citizens.

"A better U" has been designed to help the people of South Tyneside improve their health and wellbeing through self-care, which ultimately supports improved overall health and wellbeing in the borough.

It helps local people to:

• Have more control over their health and the services they receive.
• Know how and when to seek support with a health concern.
• Being able to better manage a health concern or condition at home.
• Know what groups and support are available in the community.

Encouraging people to lead healthier lifestyles and to know how and when to seek support with a health concern is essential in helping to prevent dementia and encourage them to come forward with concerns relating to their memory.

The North East and North Cumbria Integrated Care Board (or ICB) is a statutory NHS organisation which is responsible for developing a plan for meeting the health needs of the population, managing the NHS budget locally and arranging for the provision of health services in a geographical area, locally this being South Tyneside.

ICB's will:

• Improve outcomes in population health and healthcare.
• Tackle inequalities in outcomes, experience, and access.
• Enhance productivity and value for money.
• Help the NHS support broader social and economic development.

A Dementia Services Map has been produced, which outlines the organisations that provide services to people with the condition in South Tyneside.

A copy of the chart can be accessed from the Commissioning Unit at South Tyneside Council, see Section 12. Details of selected services are provided below.

Cumbria, Northumberland and Tyne and Wear Foundation Trust

South Tyneside Cognitively and Functionally Frail team, provide assessment and treatment services to the older population who present with mental health problems.

This is on a 1:1 or small group basis and includes assessment and diagnostics, alongside the provision of community mental health nurses for longer term therapeutic and educational work with people and families, access to medication and consultation with a consultant psychiatrist and access to psychology and psychological therapies.

CNTW also deliver Carer Education groups at ACTS.

Following a successful pilot in 2021, CNTW now provides a Care Home Early Response Service working both in care homes and the local community to provide training and support.

A Delirium Support Service links with acute services to help reduce the impact of delirium on the individual, developing a better understanding of non-clinical staff and in turn reducing hospital admissions.

South Tyneside and Sunderland Foundation Trust 

In addition to providing personalised care for people living with dementia, tailored support is provided to relatives and carers.

The Dementia and Delirium Outreach Team (DDOT) which is operational in Sunderland, is currently being rolled out in the borough.

Clinics are now being held in South Tyneside, with other provision due to begin shortly. The service supports people with, or at risk of, cognitive difficulties such as dementia and delirium. It aims to assess all older people admitted to the Trust with or at risk of cognitive problems. Referrals can only be made from within the Trust.

The service also supports carers and staff from within the Trust by providing information, education, and specialist input to the wards.

People with dementia can be admitted to hospital due to many reasons such as infections, heart failure, falls or social issues. These people have complex needs and require specialist support. An outpatient follow up clinic is provided for people who have had delirium. See Case Study A for recent changes in Older People and dementia support at STSFT.

Haven Court - South Tyneside's Integrated Care Services Hub

Haven Court provides an 80-bed residential and nursing home, intermediate care, short break, and respite care facility and reablement to help rebuild the skills needed to live independently and reduce the need for ongoing support.

Based within the grounds of South Tyneside District Hospital, Haven Court is also the base for the Dementia Day Opportunities Service that is run by Age Concern Tyneside South (ACTS).

Care homes

South Tyneside Council currently commissions 23 independent and private sector care homes for older people.

• 14 are residential care homes that provide residential care (RES) and residential care with extra mental health intervention (EMI/RES).
• 9 are dual registered care homes that provides RES, RES / EMI as well as general nursing and nursing EMI care.

The bed statement (which include reablement beds not included below) outlines homes currently have a total of 1112 beds, split as follows:

• Residential only (RES and RES / EMI): 624
• Dual Registered (RES, RES EMI, general nursing and nursing EMI): 450

There are 5 Extra Care schemes in South Tyneside, providing housing solutions for adults over 55 with care needs.

Of these, two are in the private / independent sector, two are provided by the Council, whilst the most recent, which is run by South Tyneside Homes as a joint venture with the NHS, consists of a both a reablement and extra care service has 25 reablement flats and ten extra care flats. These schemes have an onsite care team which provides support and enables the resident to retain their independence for longer.

Plans are currently in development for new build extra care schemes within the borough, which include accommodation that will specifically support people with dementia.

The Alzheimer's Society

The Society provides support services to people with any form of dementia, their carers, and families.

In addition to leisure opportunities, including Dementia Café's and Singing for the Brain sessions, which provide links with support workers and volunteers, the Society also offers peer to peer support groups and carers meetings.

Dementia Support Workers offer information and practical guidance to help understand dementia, cope with day-to-day challenges, and prepare for the future.

The Society also offers information to people who are worried about their memory, and ongoing support to people affected by dementia face to face, over the phone or in writing.

Age Concern Tyneside South  

ACTS supports people over the age of 50, with the aim to support and empower older people to live fulfilling lives. Older people can access a range of services including information and advice, falls assessments, a home from hospital reablement programme, a home support service, community activities, an in-house gym, and volunteering opportunities.

As outlined above, ACTS is the provider for the Day Opportunities Service based at Haven Court.

Provision is available on a seven day per week basis for morning and afternoon sessions, offering a range of activities and social support and carer breaks.

ACTS works with people referred to find the right activity, which could be attending day opportunities at Haven Court or an Activity Support Worker to support attending a community activity, outdoor activity, or activity within the home.

It also offers carers workshops and support for community groups to become dementia friendly.

It is also developing other more personalised services for people with dementia to help meet their needs, and the needs of carers. A range of mental health support is available, with ACTS working in partnership with South Tyneside and Sunderland Foundation Trust (STSFT) to offer the Older Peoples Talking Therapies Service.

ACTS also provides support as part of the Home from Hospital Service. This can be practical or emotional support and includes providing transport home from hospital, or meeting the individual at home, week by week support with practical day to day tasks such as shopping.

Admiral Nurses - Dementia UK

Admiral Nurses are specialist dementia nurses have been working in South Tyneside since 2022.

They help families manage complex needs, including helping to consider the needs of the individual and their carers and loved ones.

This could be from pre diagnosis through to end-of-life care and support.

The Admiral Nurse team cover all patients registered with a South Tyneside GP and collaborate closely with all partners supporting people living and working with dementia. This includes the social work teams and the third sector teams in South Tyneside.

Nurturing Dementia - Churches Together in South Tyneside

The Nurturing Dementia project is part of Churches Together in South Tyneside, it runs Dementia Friends sessions which are information meetings to raise awareness of dementia, so that people can respond confidently to people experiencing dementia.

It also supports churches to become dementia friendly places of worship. It offers training sessions in schools and organises community events to enable a better understanding and response to dementia.

Carers Support 

A new carer support contract has recently been awarded, covering a three-year period from April 2024. The objectives of the service are outlined below and support the implementation of the South Tyneside Carers Strategy:

• To ensure adult carers are given the tools and support needed to maintain their own health and wellbeing to continue in their caring role, which will be bespoke to their needs and is centred around what matters to them.
• To promote social connectedness and prevent isolation.
• To promote access to services and maintain living skills.
• To ensure opportunities for access to employment, education, and training.
• To ensure there are links to other services, particularly mental health support.
• To provide support, advice, and information.
• Develop and provide a Sitting Support Service, which will give carers the opportunity to take a break and will be available to anyone with a need for it, whether they qualify for assistance from social care services or fund their own care.
• Work with young carers service to ensure they are supported during the transition to adult services.

Third Sector - Dementia Support

There are an extensive range of third sector organisations that provide social activities for people with dementia and their carers, where attendees can share experiences of dementia with others.

These sessions also provide practical and emotional support and can help carers address issues relating to their caring responsibilities, for example access to benefits advice.

These sessions are held on different days of the month, in venues such as church halls, libraries and community venues across the borough, with some people attending multiple meetings of different organisations. Feedback from the 2024 Memory Loss Survey highlighted the high regard these organisations are held in high regard by those that attend.