Social care assessments ‘must include dementia checks’

Social workers must ask questions designed to detect dementia where they suspect a person is at risk and know where to refer them for a formal diagnosis, says report by MPs and peers.

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Social workers must ask questions designed to detect dementia during assessments and refer people for diagnostic tests if there is a risk that they might have the condition.

That was a key message from a report published today by the all-party parliamentary group on dementia following an inquiry into how the low rates of dementia diagnosis can be raised. Currently diagnosis rates are estimated to be 43% across the UK but vary widely, from 37.4% in Wales and 41% in England to 61.5% in Northern Ireland and 64.5% in Scotland.

The inquiry, which received written responses from 1,075 professionals, users and carers, heard that people who are already in the social care system with undiagnosed dementia may be overlooked for diagnostic tests. This is despite the higher risk of dementia among people with social care needs, such as those with Down’s syndrome, learning disabilities or Parkinson’s disease, or stroke survivors.

In evidence to the inquiry English Community Care Association chief executive Martin Green said: “It is my view that if somebody has an assessment for domiciliary care, or indeed a residential care placement, one of the first things that should happen is that they should have a medical diagnosis around why they are having to have those services.”

The report called for people with conditions that signalled a higher risk of dementia – such as learning disabilities, Parkinson’s or a stroke – to have regular dementia tests. The government has already committed to providing such tests for people aged over 65.

“Professionals who are conducting social care assessments who suspect the person has undiagnosed dementia should routinely ask questions that will help detect this, and have avenues to check and refer to,” it added.

The report said all health and social care professionals should receive training in dementia detection and referral, and stressed the particular importance of training for care home staff on the process they should follow if they suspect someone has dementia.

Care home managers should commit time for training in dementia and diagnosis, it added, while the report also called for a central point of information for training in dementia to be established.

However, it also raised concerns about access to specialist diagnostic services. Waiting times for diagnostic appointments at memory services ranged from a few weeks to more than a year, said professionals who responded to the inquiry.

The report said health and social care commissioners needed to prioritise investment in memory services to ensure they are able to meet population needs. The report also called for mandatory accreditation of all memory services by 2015 to drive up standards. This would be with the Royal College of Psychiatrists’ memory services national accreditation programme, which the all-party group said should be resourced to collect regular data on the quality of memory services.

Mithran Samuel is Community Care’s adults’ editor.

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