Meeting: Communities Scrutiny Sub-Committee (County Hall, Durham - Committee Room 1a - 07/03/2005 10:00:00 AM)
Item: A6 Review Report from the Aids and Adaptations Scrutiny Working Group
Scrutiny Sub-Committee for Promoting Strong, Healthy and Safe Communities
7 March 2005
Aids and Adaptations: Review Report
| Report of Head of Overview and Scrutiny |
Purpose of Report
1. To up-date the Sub-Committee about the latest review of the Aids and Adaptations Service in the County.
Background
2. A Scrutiny Group, in December 2000, made recommendations about improvements in the Aids and Adaptations Service in relation to the following areas:-
- Overall co-ordination - One Stop Shop
- Joint Working, improved tracking of equipment, clarification of eligibility criteria and standards
- Pooled budgets and One Stop packages for Occupational Therapy Services
- Regular reviews of waiting times and dissemination of good practice
- Building up effective networks for users
3. A number of review meetings have taken place with representatives of the Service Users and Carers who assisted Members with the original investigation.
4. The latest meeting took place on 31 January 2005 and was attended by four representatives of the Service Users and Carers, fifteen Council Members, one Co-opted Member, one Town and Parish Council representative and one District Council Officer.
5. John Thornberry, Head of Adult Commissioning in the Social Care and Health Service gave a progress report. He explained that, through the Community Equipment Board, significant achievements had been made in delivering equipment, with:
- Improved performance against the national performance indicators (even when the new delivery requirements of 7 days were taken into account - remaining in the green domain)
- Expanded partnership working
- New models of provision such as the Home Independence Service
- More efficient commissioning of equipment and recycling of items
- Better administration with an electronic ordering system with the Home Equipment Loans Service.
6. John outlined the background against which the Aids and Adaptations Service was operating, with demand for services growing due to an expected 33% rise in the numbers of older people and an 18% increase in hospital discharge activity. We also heard about the following issues:
- Projected minor reductions in OT assessments and items of equipment issued (against the background of Fair Access to Care eligibility criteria and the Home Independence Service)
- A current full establishment of OTs due to a rolling recruitment programme
- Assessment backlogs reducing, but still issues to be tackled in Sedgefield (225 outstanding assessments in September and 171 by December 2004) and in Easington (240 in September and 185 by December 2004). Proposals for a peripatetic team to tackle some of the backlogs had not been able to be progressed due to funding issues
- Home equipment loans service performing well with an increasing number of items being delivered
- Improved performance and better arrangements for servicing of hoists and bath lifts
7. Jane Hartley (Chief Executive, Home Independence Service) provided details about the Service, which had been operating since the official launch in September 2004. There were five locality Home Independence Shops based at Stanley, Pity Me, Newton Aycliffe, Peterlee and Bishop Auckland. In addition, there were two Specialist Centres at Durham and Newton Aycliffe and two Sensory Impairment Resource Centres, which were being developed in Durham and Spennymoor.
8. In the first six months of operation nearly 3000 people had used the Service, far surpassing the expected 2000 people per annum. User satisfaction levels with the HIS were also high at 97% and work was underway to promote the Service and raise awareness amongst professionals. An events programme had been organised with sessions organised around issues such as scooters, motor neurone disease, Huntington’s disease and manual handling for OTs. Most of these sessions had been commissioned (i.e. by Social Care and Health) and were all well attended by professional staff. In the case of those seminars about specific medical conditions, representatives from relevant associations had also usually been invited to attend.
9. John advised that there were some issues of concern which needed to be considered in relation to the following:
- The increase in provision of stairlifts was placing ever greater demands upon the Community Equipment budget for maintenance, which had risen by £70,000 in the last two years
- The projected moves towards practice based commissioning by GPs were likely to have a significant impact on Aids and Adaptations. Of particular concern was the potential for fragmentation of services and the loss of any strategic management and delivery of services. The Community Equipment Board had indicated that it wished to see the strategic approach to commissioning and provision retained
- Local Authority changes relating to Managing the Future
Views from Service Users and Carers and Working Group Members 10. In the discussion which ensued, the following issues were raised by Members of the Working Group and Users/Carers:
- Provision of showers - Councillor Cordon referred to the difficulties encountered by a constituent in obtaining a shower. Although the assessment had been carried out over three months previously, the Disability Facilities Grant Officer at the District Council had still not received it for consideration. In any event the officer only worked two days per week. Mike Smith (Team Manager Social Care and Health) explained that there were still issues with delays in provision of showers, which in some areas of the County could take up to 18 months. John Thornberry advised that there were challenges around working jointly with the District Councils in the provision of Aids and Adaptations (although we noted the excellent position in Durham City which had its own OT). The Community Equipment board would be addressing this issue over the coming year with a view to improving services.
- Ken Ibbitson (Users and Carers) referred to the anecdotal evidence he had heard about aids and adaptations issues in Easington District. Mike Smith explained that there were issues, but backlogs were being tackled and he hoped these would be cleared by the end of the financial year. John Thornberry referred to the need for closer working between the Community Equipment Board and Easington District Council. Councillor Tennant also believed there was a need for improvements in partnership working in Easington District.
- Sheila Grant (Users and Carers) commented on the training events organised by the Home Independence Service. Whilst it was accepted that the majority of these were for professional staff, there may be occasions when carers or users might be interested and it would be helpful if they could be informed when such courses were held.
to County, District and Town/Parish Councillors. Jane Hartley advised that this would be done.
- Councillor Hogan referred to the need to eliminate the waiting lists for assessments identified in the report. John Thornberry explained that, whilst the proposals for a peripatetic team to tackle these issues had not received funding approval, he would examine the other means by which the backlogs could be tackled.
- In relation to stairlifts, Councillor Cordon referred to those cases where chairlifts were required in private homes. Due to the difficulties in getting funding, it was often the children of elderly or disabled parents who had to purchase stairlifts privately. Mike Smith referred to the complex issues around assessments and provision of stairlifts. There were some stairlifts which were being maintained when they should be re-assessed and replaced. A report on these issues would be submitted to Cabinet shortly. John Thornberry said that a report had also been submitted to the Leadership Group (of PCT Chief Executives). There were differences between the District Councils in relation to purchase and provision of stairlifts and it was being suggested that a move towards pooled budgets might help. One Carer explained that she had purchased a stairlift for her husband privately, but there were insurance costs of £150 each year which had to be borne.
- The Chairman (Councillor Nicholls) referred to an issue mentioned at a previous meeting about the need to keep customers up to date about progress following assessments.
- The Society for the Blind and Partially Sighted reiterated views previously submitted about concerns relating to their members having to pay for services which previously were provided free of charge. However, they did appreciate why the changes in the charging regime had been necessary. The Society’s view was that they were working well with Social Care and Health.
Summary of issues raised for further Action/Investigation 11. Members of the Working Group and Users and Carers felt that good progress was being made towards provision of an improved Aids and Adaptations Service, but that more could still be done. We agreed that a further review be undertaken in six month’s time and that the report to our next meeting should (amongst any other issues) include details of progress in relation to the following specific matters:
- The issues around joint working with District Councils which are to be addressed by the Community Equipment Board
- Provision of information to Users and Carers about courses/seminars being operated by the Home Independence Service
- How improved partnership working between Social Care and Health Service and the Health Sector is being addressed
- How the work of the Home Independence Service is being better publicised
- How reduced waiting times for assessments, particularly in Sedgefield and Easington, are being achieved
- Improvements in communication with customers about progress following assessments
- Progress towards consistency in relation to the supply of stairlifts across all District Councils (including single commissioning and pooled budgets)
- The position about the maintenance of hoists and provision of readily available parts
- Actions taken to address the long waiting lists for installation of showers and delays in transmission of assessments.
Recommendation 12. The meeting with Service Users and Carers proved extremely worthwhile and positive. However, Members felt there would be merit in revisiting this service again in approximately six months’ time . This would provide the opportunity to assess progress against the vision explained by the officers and the issues raised in paragraph 11 above.
Background Papers
Report from the officers to the Scrutiny Group and presentation by Jane Hartley.
| Contact: Tom Bolton Tel: 0191 383 3149 |
ATTENDANCE LIST - 31 January 2005
Present
COUNCILLOR NICHOLLS in the Chair
Durham County Council
Councillors Blenkinsopp, Cordon, Cox, Dormer, Douthwaite, Forster, Hogan, Howarth, E Hunter, Magee, Ord, Pye, Quigley and Tennant.
Durham City Council
Barbara Gow
Parish and Town Councils
V Chapman
Parent Governor Representative
Mrs A M Tallentire
Service User Carer Forum
Service User Carer Forum
M Edwards, Sheila Grant, B Hall and K Ibbotson
Apologies for absence were received from Councillors O Brown and Lethbridge, Linda Curtis, Michael White and Di Crosby.
Attachments
Aids and adaptations review 31jan2005.doc