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.

T
he 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.