Agenda item
Telford and Wrekin Council: Health and Social Care Update - Continued
To continue to receive a presentation on Health and Social Care in Telford and Wrekin from Liz Noakes, Director of Public Health, Telford & Wrekin Council and Sarah Dillon, Director: Adult Social Care, Telford & Wrekin Council.
Minutes:
The Committee
received a continuation of the presentation from the previous
meeting, relating to an all-encompassing update on health and
social care in Telford and Wrekin, with reference to changes made
as a result of the COVID-19 pandemic. The presentation was
introduced by The Director: Adult Social Care, Telford & Wrekin
Council, and included information on all things digital, supporting
carers, market management and planning for the
future.
All things digital.
The Committee were informed of the
digital offer that was available for adult social care in Telford
and Wrekin, digital projects that were being developed and Live
Well Telford. The Committee heard how many of the digital projects
implemented over the last year were already planned but were
escalated as a result of the COVID-19 pandemic. Some examples of
digital transformation projects that had been implemented
included:
- Microsoft Teams meetings for virtual hubs, assessments, reviews for residents with care and support needs, Making It Real virtual board meetings, adult learning disability strategy development engagement sessions and wider multi-disciplinary meetings across agencies and departments.
- Tech Enabled Care (Assistive Technology)
- Kindle Kindness in care homes
- App aiding mental health professionals with Section 12 and booking Doctors (in partnership with the CCG).
- Fully integrated case and financial management recording system.
Some examples of digital projects in development
included:
- Online professional referrals into Family Connect
- Independent Living Centre in partnership with CVS, including development of virtual tour of a house with Tech Enabled Care options.
- End stages of Gov Roam scheme, which enabled health and social care workers across Shropshire, Telford and Wrekin Sustainability and Transformation Partnership (STW STP) to work in any partner building.
- STW STP – Health and Social Care Integrated Care Record.
- Adult Learning Disability App called AutonoMe to support independence and preparing for work.
- Piloted “speech to text” software to record directly into case management systems while working mobile.
- Online self-service – access to information and advice, care accounts and financial assessments.
The Service
Delivery Manager: Service Improvement and Efficiency advised
that Live Well Telford was the Council’s one-stop-shop
website for providing advice for residents to live healthy
independent lives, as an all aged community resource directory for
information on access to early help, improving wellbeing through
connections in their community and enabling them to contact the
relevant professionals and organisations. The website received over
4,600 hits a month with over 1,500 services listed.
Members asked the following questions:
Members asked what assurance there was
that vulnerable individuals actually received the right care that
was being paid for.
The Director: Adult Social Care stated that when arranging care and
support for individuals, a support plan was drawn up based on their
individual needs and requirements. The Director: Adult Social Care
advised that the procurement team monitored the care provided by
the external sector.
Members welcomed the use of technology to
help improve independency of their residents, but wondered if the
recipients of the assistive technology would receive training on
how to use it.
The Service Delivery
Manager: Service Improvement and Efficiency stated that that was
part of the digital inclusion strategy to ensure that officers at
the Council could use the new technology and provide support.
Would the Health and Social Care Integrated Care Record
would be part of a national scheme which “talked” to
other systems, or would it be region specific?
The Service Delivery
Manager: Service Improvement and Efficiency advised that it was
currently a local solution for Shropshire, Telford and Wrekin but
the long term goal as part of the Government’s plan was for
it to feed into a national system to create a fully integrated care
record system.
Members welcomed the idea of an integrated care record
system, but were concerned over the potential for data to be lost
or stolen.
The Service Delivery
Manager: Service Improvement and Efficiency stated that all
information was backed up to ensure business continuity, and that
individuals accessing the information do not download it, but
rather access it in real time.
Members asked what we can do to encourage people to use
devices such as Amazon Echo and Alexa devices which can support
individuals in their homes.
The Director: Adult Social Care agreed that these type of devices
can provide support to individuals, and that is the Council was
signposting individuals on how to best use these type of assisted
living devices to have a healthier and independent lives, such as
settings reminder to take medication.
Supporting Carers.
The Committee received an update on the offer and support available
by the Council and its partner organisations to support carers in
Telford and Wrekin. The Council worked
closely with the Wellbeing Independence Partnership, and
specifically the Telford and Wrekin All Age Carers Centre to
undertake carer assessments and support planning for carers as part
of a Joint Carers Peer Review which ensured carer’s needs are
met in a holistic way. Specialist commissioned services had been
implemented, which were dedicated to supporting carers, such as the
emergency response team, a sit-on service and counselling for
carers.
In response to COVID-19, a special winter planning session had been
organised with the Carers Centre and partner organisations, which
resulted in the development of a carer’s winter wellbeing
booklet which included information on local guidance, support,
networks, contacts and groups, this would be sent to all carers
known to Adult Social Care and the Carers Centre.
Members asked the following questions:
How often carers were assessed, as there was a concern
that many did not reach for support when it was needed.
The Service Delivery Manager: Principal Social Worker stated that
this was a reason why the Carers Centre played such an important
role in providing support and key issues could be escalated in the
fortnightly calls, so that the right care and support can be put in
place.
Many of the usual methods for carers gaining respite
were currently closed due to COVID-19 social distancing
regulations, was there still an offer of respite.
The offer had changed for people with learning disabilities due to
the closure of days services, instead they were offered an online
platform for individuals and carers to get peer support as well as
creating smaller social bubbles within the community. In terms of
support for carers looking after individuals with Dementia, a
carers assessment could be undertaken and which may result in some
1-2-1 support respite for the carer and there was a specifically
commissioned service for crisis support if a carer is rushed to
hospital, which included where a carer had tested positive with
COVID-19.
Members were concerned about the COVID-19 impact on the
mental health of carers and those they cared for.
The All Age Carers Centre had undertaken wellbeing calls with known
carers in Telford and Wrekin, and the service had not been
overwhelmed.
Were carers were tested for
COVID-19.
Where respite care was provided, individuals were tested.
Market Management.
In respect of market management and the Council’s
responsibilities for supporting the care sector in Telford and
Wrekin, The Committee heard how the Council was instructed to
create a Care Sector Support Plan, in collaboration with Shropshire
Council, the Shropshire, Telford & Wrekin Clinical
Commissioning Groups and the various providers of care, to create
the STP Care Sector Task & Finish Group.
The Council supported hospitals in getting patients back home with
the care that they need and where they need it and note that the
Kindle Kindness campaign had been established by the Council to
allow families to interact with their loved ones in care homes,
which had helped improve the mental health and wellbeing of
residents.
In respect of the financial support the Council provided to the
care market, at the onset of the pandemic Members were advised that
providers were paid on commissioned care, not actual care, and
provided 10% extra on the contracts to cover setting up
organisational response to COVID-19, such as expenses for Personal
Protective Equipment, managing isolation with their staff and
covering sick leave for staff. The Committee heard how this was
replaced by Infection Prevention Control Grant that came out in
June 2020, and then again in October 2020 which went directly to
care homes, domiciliary care providers, supported living and extra
care.
Members heard that the key issues faced in market management
related to the impact of COVID-19 and the provider struggled with
capacity, recruitment, and retention as well as with staff off on
sick leave. Members also heard how some care homes were beginning
to struggle financially as some were at 80% capacity, which
highlighted a wider problem of sustainability.
Members asked the following questions:
Members were concerned about the financial
sustainability of the care homes given the additional funding that
they had received from the Government was due to end in March 2021.
Were any care homes in Telford and Wrekin were at risk of
closing.
There were no care homes currently at risk of closure.
Was the two hour discharge policy from hospital was
safe and that patients had the correct support at home and
medication available.
The two hour discharge policy required the patient to be
medically fit with the correct medication available to take home to
ensure the care home was ready to receive the patient.
Were members of the patient’s family and carers
involved in the discharge policy to ensure that the patients were
going to the right place and the right time, to ensure their needs
are met and that they are not re-admitted.
The Fact Finding Assessment (FFA) was very important as part of the
discharge process, Council worked closely with NHS colleagues
within hospitals in Telford and Wrekin, and if there were occasions
that discharges not working as smoothly as possible, then there
were daily calls with partners to raise those issues. The
integrated discharge team was discussed, where Council staff are in
continual conversations with partnered organisations regarding the
correct care for patients which relied on partnerships, close
connection and discharge planning to ensure a smooth pathway to the
correct home.
Was there concern with respect to the upcoming
Christmas period and temporary lifting of COVID-19 restrictions,
and if there were any plans to mitigate any potential problems that
could arise from this.
It was important to keep the mental health of cared for individuals
positive and advised against families taking their relatives out of
care homes around the festive period. The Care Home Support Plan
was in place as well as a redeployment group whereby health and
social care staff were mobilised to support a care home in crisis
and constant communication with care agencies that provide
domiciliary care.
Individuals living in care homes had not seen their family since
March 2020, and was there a way which utilised pre-visit COVID-19
testing to visit family in care homes.
Every care home in Telford and Wrekin had received
information from the Director for Public Health on advice and
guidance for risk assessments to facilitate visiting in a safe
manner which is tailored to the individual resident. Lateral Flow
Tests were being trialled in three locations across the United
Kingdom, however they were an extremely complicated administrative
burden in terms of managing and recorded. These were to be used
alongside risk assessments to facilitate visiting as seen fit,
along with the use of Personal Protective Equipment and isolated
areas for visits.
Planning for the Future
The
Committee heard about planning for the future of adult social care
in Telford and Wrekin, that it was important that the offer for
adult social care in Telford and Wrekin was developed; that it was
co-produced by people with lived experiences and their carers and
used population data to inform decision making. It was highlighted
the population in Telford and Wrekin was aging, and that
information needed to be included in the forward planning in order
to properly manage resource to meet the demand. Involvement from
external groups and internal audits would help improve the delivery
of services, by acting as the critical friend.
Members asked the following questions.
Where carers should go if the situation regarding the
cared for has changed, and they now required additional
support.
Either All Ages Carers Centre or via the Council and the Family
Connect team, as both organisations worked closely with one another
and could escalate queries.