JIP e-bulletin No 29 April 2012

Welcome

We are now well into Spring, the season in which the White Paper for social care reform is supposed to be released. Speculation is rife about when it will actually be published and if the issue of funding will be tackled head on.

Recent announcements by the Care Services minister, Paul Burstow, suggest the most we can expect is a White Paper outlining proposals for reform based on responses to the Caring for our future consultation, and a progress report responding to recommendations made in the Dilnot Commission report.

If this is the case, the issue of how we pay for elderly care will remain unresolved for the foreseeable future, and responsibility for making an inadequate system work in the best interest of elderly and vulnerable people, will remain solely with health and social care services.

Alongside this, is the new Health and Social Care Act, which promotes greater integration between the NHS and social care.

Collaboration and integration in commissioning will be required, and it is gratifying to see examples throughout the West Midlands of where health and social care services are ahead of the game. ADASS will continue to support these initiatives and engage with NHS colleagues.


Peter Hay
Strategic Director
Adults and Communities
Birmingham City Council

Falls detection – a user led approach

A report from the West Midland’s fall detector dissemination event held in December 2011, is now available.    

One third of older people who fall lie undetected for at least one hour.

Fall detectors can provide an early alert to a fall, and ensure a timely and appropriate response, but their use varies across the region.

The Health Design & Technology Institute (HDTI), Coventry University in partnership with the West Midlands Region Telehealthcare Network and Warwickshire PCT, were funded by NHS West Midlands to evaluate the use of detectors within the West Midlands Region.

The project captured and analysed users’ experience, and will use the information to improve the way fall detectors are deployed in the region.

The first phase of the project is now complete. The report including presentations from the dissemination event can be found on Coventry University’s website. 

The second phase of the fall detector project is now underway. This will involve spreading best practice and information, as well as evaluating falls prevention and falls response services across the region.

For further information or if you would like to get involved please contact swilliams@westmidlandsiep.gov.uk

Detailed information about fall detectors currently available on the market can be found at the Gadget gateway.





 

Assistive Technology degree courses

Coventry University is inviting applications to take up places on two degree course, designed to improve technical knowledge and expertise in products, service management and research skills.  

The courses – a Foundation Degree in Assistive Technology, and an MSc in Assistive Technology start in September 2012.

See site for details

Local Healthwatch free master classes

Free master classes will be held by the LGA to equip key officers with the tools and techniques needed to set up robust and credible local Healthwatch organisations, the bodies that will hold commissioners and providers of services to account, under the new Health and Social Care Act 2012.

Topics to be covered include:

• Options for procuring Healthwatch
• Working with elected members to deliver success
• Good governance
• Working with local stakeholders
• Developing sound transition plans and ensuring sustainability
• Working productively with Healthwatch England (the national consumer champion)
• Options for developing Healthwarch as a social enterprise.

A free masterclass will be held in Birmingham on Thursday 24 May. See details.

Promoting good practice in caring for carers - Case Study

Successful implementation of Worcestershire’s Supporting Carers Better action plan, has led to improved awareness among mental health teams of carers’ needs, and improved the support they provide.  

The action plan came from a workshop for the under 65s community mental health teams, in April 2011.

The workshop focused on how the teams could support carers, families and friends of people with mental health problems more effectively.

 The resulting action plan sought to give more prominence to carers’ issues, and to ensure they felt valued by offering carer assessments, appropriate support and relevant information.

A key action in the plan was to allocate a Carers Lead to each team. This has been rolled out across Community Mental Health, Early Intervention, and Home Treatment teams, as well as the Recovery Team.

The leads now meet regularly with the Carers Unit to help develop policies, procedures and services, and to inform colleagues of relevant issues. They also keep carers, their families and friends informed by maintaining notice boards and providing leaflets.

Other action plan achievements include:

• a carers information folder and e-folder for staff
• two training sessions for staff on carer assessments and support plans attended by 25 members of staff
• a session on carers and confidentiality for Carers Leads
• information on services given to carers at the point of referral to secondary services
• guidance on the carers legislative framework developed for staff
• step by step guidance on computer processes
• a specific carer's bulletin developed for employees
• a notice board competition - teams took the opportunity to update boards resulting in two new boards created
• dedicated pages in the staff induction workbook for the new mental health trust including a link for Carer Aware e-learning.

With implementation of the action plan completed, the unit is planning a Carer’s Lead workshop to coincide with Carers Week 2012, to identify further actions needed to improve services.

Contact: Amanda Blackton, Carer Development Officer, telephone: 01905 728824.

UK aims to be best in dementia care

Funding for research into dementia is to more than double to £66m by 2015, following a recent announcement by the Prime Minister.

The announcement was made along with a challenge to make the UK a world leader in the field.

The Prime Minister has urged the wider society, medical professions, business and government, to increase diagnosis rates, raise awareness, increase understanding, and to strengthen research efforts to help people living with dementia live a better quality of life.

Read more
 

Telephone call landmark for Dudley Access team

Dudley Access to Adult Social Care team recently reached the landmark figure of 25,000 telephone calls, from people enquiring about social care services.

Set up in June 2010, the team is the first point of contact for people in the city wanting advice, support and care services.

The team deals with 600 to 700 enquiries a week, half of these are resolved by giving advice, guidance, and referring callers to other bodies.  

The service is based in Brierley Hill Health and Social Care Centre.

Contact: dawn.fazey@dudley.gov.uk

 

Top status for Dudley telecare service

Dudley Telecare service has recently been awarded premium status, the highest level of accreditation possible, by the Telecare Services Association (TSA).

The award means the council has gained accreditation in all the following areas:

• referral
• telecare plan
•  installation
• response
• service user profiling
• service tailoring
• monitoring.

There are currently 8,500 people in Dudley who have telecare in their homes helping them to live independently. 

A recent survey found 100% of people using Dudley Telecare Service said the equipment provided them with reassurance and security. 

Contact: marie.spittle@dudley.gov.uk

Managing falls in care homes

Staff from Staffordshire County Council, Stoke-on-Trent City Council, Stoke-on-Trent Clinical Commissioning Group and the North Staffordshire Clinical Commissioning Group, have pooled resources to reduce the risk and incidence of falls among vulnerable people living in nursing homes.

Falls related injuries are among the most serious and common medical problems experienced by older adults, often resulting in loss of confidence and independence, fractures, head injuries and occasionally death.

Preventing falls, their frequency and impact is a key task for the health and social care organisations.

Work with care home providers entails identifying the potential for falls in their homes, and introducing assistive technology to help manage risk.

This includes the Wireless Alarm Kit with Large Bed Leaving Sensor Mat, which immediately alerts carers via a portable wireless pager as soon as the person has left their bed.

Equipment has been installed in the homes free of charge    

Contact: Sharon Finney, Commissioning Manager, North Staffordshire Clinical Commissioning Group, telephone: 0845 6026772 ext 1639, email: Sharon.finney@northstaffordshire.nhs.uk .

Learning from colleagues in Coventry

Coventry’s reorganisation of adult social care by merging all services into one is having the desired effect of staff learning from each other and sharing best practice. 

Reorganisation took place last year.  Examples of how the change is benefitting staff and the service include:

The five principles of the MCA
Staff in the Learning Disability Home Support Service struggled to recall the five principles of the Mental Capacity Act (MCA).  They worked together to produce an easy reminder of the principles in the form of a poster based on the acronym ASUME which stand for:

A – assume I have capacity
S – support me to make decisions
U – unwise decisions are my right
M – make decisions in my best interest
E – every decision must be the least restrictive option. 

An electronic copy of the poster is available, contact Andrew Reece, Head of Internally Provided Services, email: andrew.reece@coventry.gov.uk

Communicating CQC essential standards of quality and safety
Service managers have worked together to develop a pocket sized staff handbook as a workplace prompt for the Care Quality Commission (CQC) Essential Standards of Quality and Safety. Staff and managers have found this useful as a quick reference and reminder of the standards and outcomes services are expected to achieve.

Putting enablement into action

Birmingham City Council’s Visual Impaired Rehabilitation Team provides training in practical living skill for people with sight loss, helping them to live safely and as independently as possible. 

The number of people in the UK who have lost their sight is set to increase dramatically.  It is predicted by 2020 the number of people with visual impairment will rise to over 2,250,000, and this will increase to nearly four million by 2050.

Age related Macular Degeneration is the leading cause of blindness in adults.  Other significant causes are glaucoma, cataracts and diabetic retinopathy. 

Older people with sight loss are almost three times more likely to experience depression than people with good vision.

Skills training such as kitchen safety, independent mobility, and communication skills, are delivered in people’s homes or in a specialist training suite situated at the Southside Business Centre in Birmingham.

The rehabilitation team has discovered many older people are misdiagnosed as suffering from memory loss because they fail to recognise the person they are talking to, whereas the real issue is sight loss.  The team has sought to combat this problem by raising awareness around the council of visual impairment and how it affects older people. 

Life skills training reduces the need for support, while increasing independence and wellbeing for individuals. 

Contact: Andrew Sheehan, Service Manager, Visual Impairment Rehabilitation Service, telephone: 0121 464 4951, mobile: 07917643450.

Pill dispenser saves £400k plus

A region wide trial testing the impact of automated pill dispensers on reducing levels of hospital readmissions and helping patients to take medication properly, has resulted in savings of £431k for social care and the NHS.  
The dispenser is a battery operated device which is loaded with medication by pharmacists, and programmed to release the pills at set times.

Over 250 people took part in the trial which concluded on 31 March 2012.

The savings break down to approximately £1,700 per person over a six month period; most of which came from a reduction in the number of home visits required to remind people to take their medication, and a drop in hospital admissions. 

Of the dispenser users questioned, 96% overwhelming agreed it was effective in reminding them to take their medication, and as a result improved their health and made them more independent.

They were also unanimous in their support for continuing to use the device with 88% saying it improved the quality of their lives. 

Matt Bowsher, Head of Adult Social Care, Communications and Strategy at Improvement and Efficiency West Midlands (IEWM), said: “The pilot proves the pill dispenser is highly effective in helping vulnerable adults remember to take their medication.  Failure to take medication properly costs the NHS and social services heavily and more importantly eradicates quality of life.”

“The majority of local authorities and Primary Care Trusts that took part in the scheme have secured funding to mainstream the Project. We hope the findings will encourage others to follow their example.”

Full details of the pilot and the results can be found on the IEWM website.

NHS transition arrangements

NHS Chief Executive Sir David Nicholson has written to NHS staff about transition arrangements, following the passing of the Health and Social Care Act 2012.

Sir David says the Act provides clarity and certainty about future direction, and that ‘the onus now switches to the health and care system and the complex and challenging task of implementing the changes on the ground’.

He outlines the ‘important progress’ already made in laying the groundwork for transition and emphasises the strong platform on which the NHS can build.

He also sets out the overall approach to the movement of staff between the old and new systems, saying that how this is managed is critical to the success of the transition.

The Bill proposes to:

• set up an independent NHS Board that will allocate resources and provide commissioning guidance
• increase GPs’ powers to commission services on behalf of their patients
• strengthen the role of the Care Quality Commission
• develop Monitor, the body that currently regulates NHS foundation trusts, into an economic regulator to oversee aspects of access and competition in the NHS.

Read Sir David’s letter







 

Pressure to reform grows

Over 40 representatives of leading charities, care homes and housing providers are urging the government to honour its commitment to reform the social care system, and to act now.

In a letter to The Guardian, the directors, chief executives and chairs of some of the country’s most prominent organisations, have called for an end to ‘the crisis in our social care system’ saying the millions of individuals and families they represent ‘cannot wait any longer’.

 A White Paper on social care reform is due to be published this spring following the Caring for our Futures public consultation, which ended in December last year.
The organisations are asking the government to introduce legal reforms needed to give everyone confidence they will have access to quality care, when they need it, wherever they liveand to provide additional funding.

In response, Care Services Minister Paul Burstow said: "We have to get this right, that is why we have been engaging with a wide range of stakeholders, people who use services and carers on the priorities for social care reform.

"We will publish our white paper on care and support and a progress report on funding reform in the spring."

See full letter and signatories here.

Outgoing ADASS chief explains support for Dilnot

Former President of ADASS, Peter Hay, has warned against letting the fear of ‘failure to achieve perfection’, get in the way of change.

In his final blog published to coincide with the end of his presidential term, Peter explains why ADASS has consistently, but not unconditionally, supported implementation of the Dilnot Commission recommendations. He highlights five points as underpinning the organisation’s position:

Universal support – personal spending on care is growing each year, with people in some areas buying 80 per cent of residential care, and receiving no support from the state. Under Dilnot’s proposals all citizens will be treated equally and fairly, which is consistent with the ADASS aim of universal care and well-being for all.  

Freedom from fear – 25 per cent of people face care costs greater than £50k. Dilnot’s recommendations are about taking away the fear of costs that can lead to people losing their homes and other assets - an approach that resonates with the origins of the welfare state, but is placed in a modern context.

Prevention – ADASS recently revisited work it did a decade ago on creating a system based on prevention, community capacity and maintaining wellbeing. Dilnot presents the opportunity of setting up a legally binding system that has preventative care at its core, an approach that is consistent with ADASS’s aspirations.

Funding – Dilnot’s appraisal of insurance schemes to pay for care finds they are inadequate; likewise, finance experts say insurance products do not offer the kind of protection the population needs. ADASS believes this expert advice has to be taken seriously.

Capped system – ADASS is persuaded that a capped system has the best chance of providing protection against astronomical care costs to the greatest percentage of the population.

Peter confirms that change will not be without risk and says: “We are also clear that there are downsides to some of the consequences of Dilnot and reform no major change comes without some potential adverse impact.

“However, no system like Dilnot has been tried anywhere, and like any system it won’t be perfect. We can’t talk ourselves into failure to design perfection as a basis for no change, when the proposals are such a step forward from where we are now.”

See full blog  

Reform White Paper expected soon

A White Paper outlining proposals for reforming the adult social care system and a progress report responding to the Dilnot Commission recommendations, will be published soon according to Care Services Minister, Paul Burstow. 

The paper was due to be issued this spring, following the Caring for our future consultation, which ran from September to December last year.

Speaking at a cross party Backbench Business Committee debate held last month, the minister said he was anxious to publish the White Paper as soon as he could, and that this was dependent on a cross party agreement on funding.

Findings from the consultation show people do not understand the current care system; there is a lack of information, advice and support; people experience different quality of care depending on where they live in the country; there is a focus on short term results rather than planning for the long term and intervening earlier; people don’t feel they receive the care and support they really want and there is a lack of choice; older people are not given the support they need to keep them independent in their own homes, and younger adults are not getting the support they need to help them into jobs and housing; and services are not joined up.

Consultation findings will be addressed in the White Paper.

Read the transcript or watch the debate

Hundreds helped by carer support workers

Two carer support workers in Worcestershire have assisted over 200 carers in their first year of operation.
Based in the emergency admission wards at the Worcestershire Royal Hospital and Alexandra Hospital in Redditch, the support workers were put in place at the end of November 2010, to help carers of people with a cognitive impairment or dementia. 

Funded by Worcestershire City Council as part of the Dementia Strategy, their role is to ensure carers feel supported and informed by referring them for assessments, and giving them information about other voluntary and statutory services as well as ensuring they have someone to turn to during the hospital process and when the person being cared for goes home. 

Contact: Superna Makwana, Carers Development Officer, telephone: 01905 728 824, mobile: 07733 304 038.