Agenda and minutes

The Chairman welcomed everyone to the meeting, including the HOSC members who were attending in particular for the agenda item on  'Preventing Loneliness and Isolation'.

Apologies had been received from Councillor Andy Fry.

None.

Members of the public wishing to take part should notify the Head of Legal and Democratic Services, in writing or by email indicating the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 20 March 2018). Enquiries can be made through the telephone number/email address below.

None.

Previously circulated

The Minutes of the meetings on 10 and 22 January 2018 were agreed as a correct record and signed by the Chairman.

In attendance for this item were the Director of Public Health and the Cabinet Member for Health and Well-being.

The Director had prepared a presentation (available on the Council's website), and highlighted the main points for preventing loneliness and isolation, which included the context and approach, key facts about the effects on mental and physical health, potential answers, Worcestershire Health and Well-being Board's Loneliness Plan 2015-2018, examples of progess and the Reconnections Service.

As a county, Worcestershire was generally healthy but with a big demograph of older people, who were living longer but spending more years in poor health, especially in socially disadvantaged areas. A great deal of work was being done but this situation was not yet changing. Reducing loneliness was a key factor in addressing the health challenges facing Worcestershire's older population.

In 2014 the Health and Well-being Board held a loneliness event, which formed the basis for the Loneliness Plan 2015-2018 (included in the agenda). The work being done looked at triggers, how to identify and tackle loneliness; preventing loneliness in the first place was not yet included.

Research showed that a lack of social connections was bad for people's mental and physical health, and that loneliness increased the likelihood of premature mortality by 26%. Lonely individuals were more likely to visit their GP, go into residential care and use accident and emergency services.

One answer lay in looking at communities and focusing on what mattered to an individual rather than 'what is the matter with you?'. The three aims of the Plan included empowering residents and communities to maintain their connections, improving access to activities and services and raising awareness of isolation, identification, risk factors and local opportunities for prevention and intervention.

All approaches to tackling loneliness relied on having active communities and

the Director set out areas of progress relating to:

Reconnections - a new service run by Age UK Herefordshire and Worcestershire, this was an example of progress which the Panel may want to look at further. The service used innovative social impact bond funding and was progressing well. The model involved a core team which recruited and attracted volunteers to reach lonely people and reconnect them with their communities, building on their personal strengths, and was measured against scores from the University of California, Los Angeles (UCLA).

So far, Reconnections had supported over 1000 older people with needs and severity of loneliness higher than had been anticipated, but referral levels had been lower than expected. Reconnections appeared to provide value for money, but more thinking may be needed and it was resource intensive.

Social prescribing – for a pilot period paid social prescribers were being recruited, who would be based in GP surgeries to support people who needed social intervention.

Rural communities programme – led by Wychavon District Council, this work was routed very much within communities, with a project to identify and train the 'go to' people, who could spread the word about local services and assets.

Volunteer roles – this involved  ...  view the full minutes text for item 274.

In attendance for this item were the:

Interim Director of Adult Services

Strategic Commissioner of Adult Services and Health

Interim Lead Commissioning Manager for Adult Services

The Lead Commissioning Manager explained that Replacement Care, sometimes referred to as respite, was support provided to carers of someone with learning disabilities so that they could have a break. A report had been presented to Cabinet in February, and the engagement planned on how learning disability replacement care services should be delivered in the future, would be ahead of going out to consultation – an approach modelled on the recent engagement on Learning Disability (LD) Day Services. The engagement timetable would be made available to members shortly and was due to start the following week.

A presentation had been circulated to the Panel in advance of the meeting, which would also form the basis for the engagement meetings planned. The Interim Lead Commissioning Manager highlighted the key points.

LD Replacement Care was being looked at because of the need to get the best value for money from the Council's budget and initial analysis showed that because of block contract arrangements, 1,800 nights per year were not used, at a cost of approximately £450k. More detailed analysis would look at whether this stemmed from reducing demand or whether a different type of care was needed for people's needs. The Council needed to plan for changing future needs which included supported living options, increasing complexity of need and changing expectations from families.

Engagement was taking place during March and April which included staff, carers, wider meetings and with service users with assistance from Speak Easy N.O.W.

The total budget 2017/18 budget for LD Replacement Care was £2.6million, which included block contracted provision plus a small amount of 'spot purchased' provision in external care homes. Around 175 individuals received regular replacement care funded by the Council. Additionally some people also received emergency replacement care. The Panel was shown an overview of the 5 locations, which varied in size. Average occupancy ranged from 74% to 95% and officers advised the aim should be for 90%; 100% would never be aimed for because of the type of service involved.

Main discussion points

·         It was confirmed that members were being invited to the engagement meetings with carers, although it should not be a problem if a member wanted to attend one of the meetings with staff.

·         A member pointed out that smaller centres would always be more expensive, such as the Pershore Short Breaks with 4 beds

·         The process for arranging emergency care was explained, which would also form part of the engagement. In-house provision gave a degree of flexibility and was time efficient.

·         Officers were asked what was being targeted and the Director explained the need to be as efficient as possible given the financial pressures, and to have a better used service, and at this stage the engagement exercise was open minded and very much about talking to people. There may be an opportunity for co-production.

·         It  ...  view the full minutes text for item 275.