ASC161 Sandwell Community Dementia Service

Our Community Dementia Support Service is designed to embed stronger integration across neighbourhood and frailty models of care, ensuring people living with dementia receive coordinated, person-centred support close to home. Working collaboratively with primary care networks, community health teams, social care, voluntary organisations, and local partners, the service promotes proactive identification, shared care planning, and seamless communication across disciplines.

By aligning with frailty pathways and neighbourhood-based multidisciplinary teams, we enable earlier intervention, reduce avoidable crises, and support individuals and their carers to maintain independence, wellbeing, and quality of life within their own communities. In response to the unique characteristics of Sandwell the service is to be provided through a "Provider Collaborative Model".

A Lead Provider is required to have sub-contracting arrangements in place with other community groups/ organisations across Sandwell who collectively are representative of the local communities' and diverse population mix that are to be served. The Service will provide a single point of access to support the health, wellbeing, and independence of those accessing the Service in community settings, including care homes and hospital settings.

The service will provide information, advice, and referrals to other services to promote independence. The service will develop integrated care and support plans to enable people to be self-managing.

The Service will deliver training for people living with the effects of dementia including carers and those with a memory concern to enable them to become self-managing. Training will be provided to professionals to address any identified Service deficits and ensure services are being provided by appropriately trained and skilled people. Training will also be provided for local communities and businesses in support of delivering "Dementia Friendly Sandwell" and schools and colleges to support destigmatisation.