What is the challenge your project is going to address and how does it connect to the theme of 'How can we improve across system boundaries?​

Deafness is the largest modifiable risk factor for dementia. However, identification and support for sensory care requirements feature low on the hierarchy of health and social care needs. As such, Deafness/Deafblindness are misdiagnosed or underdiagnosed in people with Dementia, with both presenting similarly – for example, difficulties following conversations, or memory problems.

Dementia assessments rely on hearing or seeing questions accurately. However, these are routinely performed without sensory assessments, leading to inaccuracies. For BSL users, Dementia assessments based on spoken language are inappropriate, and BSL cognitive screening tests are not used systematically. Health and social care staff are not systematically given sensory awareness training.

This project will provide a systematic, evidence-based framework for health and social care professionals across audiology, ophthalmology, and social care to assess (and be assessed on) how well they support people with Dementia and Deafness/Deafblindness. These interventions could substantially improve support and outcomes for people with Dementia.

What does your project aim to achieve?

The UK has an aging population, with growing numbers affected by Deafness/Deafblindness – including most care home residents (White, 2019; Monaco, 2021). People with sensory loss experience inequalities in access to health and social care. We must support preventative measures and interventions to improve the management of Deafness, Deafblindness, and Dementia. This project will develop standards for good sensory care and pilot a test of change in care homes and care at home. It aims to enable people to live well and have equal access to health and social care.

We will develop proposals for best practice, working with partners across the Care Inspectorate, audiology, ophthalmology, and care providers within the third and independent sectors. We will work closely with partners across health and social care to pilot a test for change. Our reports will reflect on wider UK and Ireland contexts, to inform wider practice in good sensory care.

How will the project be delivered?

We will develop and pilot a framework of sensory care standards, drawing on the expertise of the Scottish Sensory Hub (SSH) and our extensive range of partners in health and social care across Scotland.

The SSH is a forum for cross-sensory input into policy and practice, with a strategic connection between people with lived experience, the sensory sector, Government, and other stakeholders. Key people include Drs Amy White and Hannah Tweed, whose research specialisms centre on dementia and sensory care in care homes and people’s experiences of social care in Scotland.

The project will:

• Recruit a project advisory board (risk management).
• Gather and interpret data on sensory care and dementia, using mixed methods approaches.
• Publish a report and recommendations to improve the provision of sensory care.
• Develop and test a framework of sensory care standards (including an impact assessment).
• Share recommendations with Local Authority and Government partners and wider stakeholders.

How is your project going to share learning?

Project learning will be shared via a report and summary document (which will be translated into subtitled BSL) and shared with Q members and interested stakeholders. We will work with the ALLIANCE’s communications team to share findings widely, via blogs, filmed interviews, and presentations.

We will work with partners in the Care Inspectorate, Scottish Social Services Council, audiology, ophthalmology, and care providers within the third and independent sectors to implement the framework for sensory care standards, following testing, an impact assessment, and any revisions. This work will also be shared with partners in Local Authorities, Scottish Government, Health and Social Care Partnerships, and Integrated Joint Boards.

While the pilot and launch of the framework will be tailored to Scottish health and social care contexts, our literature review, report, and recommendations will draw on data from across the UK and internationally, to usefully inform wider systems change and improve sensory care.