Development and training of healthcare assistants to join the Care Crew: supporting patients with challenging behaviour in a hospital setting.

Background Healthcare assistants (HCAs) provide care for people with dementia in acute hospital settings; current training focuses on QCF qualifications and dementia awareness. Specialist roles for HCAs are beginning to emerge. The ‘Care Crew’ at Royal Berkshire Hospital is a team of HCAs lead by a band 4 assistant practitioner. The structure of the Care Crew involves the development of HCAs to become recognised and valued members of a team, working independently to provide support and care for people with challenging behaviours, including those with dementia. Methods Care Crew members receive a programme of training and support from the Practice Educator in Dementia. Patients are referred to the Care Crew by nurses from 8 wards including elderly care, renal and bone fragility unit. The Care Crew provide one-to-one support and group activities. One-to-one support can be provided for any patient who is distressed, confused, unsettled, presents with challenging or aggressive behaviours, risk of causing harm to themselves or others, or are at risk of leaving the ward without being discharged. The Care Crew also supplements ward teams at key times of the day to support patients’ activities of living. Results Regular contact provides consistent and continuity of care for people with dementia, formal evaluation of the care crew is ongoing, but anecdotal evidence suggests a reduction in falls due to closer supervision of patients, reduction in use of anti-psychotics and improved uptake of food and drink by providing one-to-one support at mealtimes. Discussion On completion of a formal evaluation of the Care Crew, expansion of the model across Royal Berkshire Hospital will be discussed. Further expansion of the role and training of the Care Crew is currently occurring for example expanding opportunities to take patients off the wards, such as having a designated gardening area within the hospital grounds