[P3–481]: DEVELOPING A CARE PARTNER‐ASSISTED INTERVENTION TO IMPROVE ORAL HEALTH FOR PERSONS WITH MILD DEMENTIA

Commission inspection of Rotherham, Doncaster and South Humber NHS Foundation Trust wards for older people with mental health problems highlighted deficiencies in the application of the MCA. This service evaluation and improvement project was carried out to help address this. The clinical records of a sample of patients were scrutinised for documentation of capacity assessments which were rated by the authors. Patients’ diagnosis, treatment and discharge destination were also noted. 79% of all MCA assessment documentation was found to be insufficient. Documentation rarely described what information had been given to the patient, what had been done to assist the patient in making the decision and what options had been discussed. Capacity was rarely documented for significant decisions such as discharge to a care home. 67% of patients with a diagnosis of dementia had at least 1 assessment of capacity documented compared to 36% of patients without a diagnosis of dementia indicating that staff are more likely to document capacity for a patient with dementia. The majority of MCA assessment documentation for these patients was for decisions regarding treatment; however none of the documentation was specific about what the exact treatment was. Most MCA documentation stated the diagnosis of dementia as the reason for an impairment of mind or brain, without a description of how their dementia was affecting their ability to make the specified decision. This information is being used to tailor an educational package for staff and a new trust policy. We are developing guidance on what information should be provided to the patient and what can be done to maximise decision making ability for patients with dementia. We are developing a strategy to improve the quality of documentation of MCA assessments.