Learning Disability Partnership Board

Agenda Tuesday 13th September 2011, 10am – 1pm

Committee Room 1, Borough Hall, Cauldwell Street, Bedford, MK42 9AP

Time Item Lead Worker 10.00am Welcome & Apologies 10.05 Hot Topics 10.10 JSNA Update Dzifa Agbenu 10.20 Bedford LINk

Enter and view arrangements Arthur Dennis

10.40 Leadership

Peter Loose / Ronnie Franklin

Work & Day Opportunities

Kate Walker

Housing & Residential / Supported Living Developments

Marek Zamborskey

Health

Michelle Bradley

Having A Life

Maria Scozzari

Carers & Respite Care Review

Transition

Hugh Shriane

12.40 Any Other Business - Budget Consultation (phase 1) 2012- Telecare Strategy Consultation

Peter Loose

12.45 Dates for future meetings 29th November 2011  31st January 2012 20th March 2012 

1.00pm Close Meeting

Contact Information: To book a place (seats are limited), please contact Claire Minney on 01234 228204 or claire.minney@bedford.gov.uk 

Bedford Borough Learning Disability Partnership Board

Minutes 13th September 2011

1 Welcome: Peter welcomed everyone to the meeting and explained that Ronnie and others were unable to attend today as the meeting clashed with a Regional Learning Disability meeting. Peter read out the names of the people who were unable to attend today.

2 Hot Topics There were no hot topics from service users or carers at this meeting. Peter explained that John Bruynseels is now the Assistant Director for all care groups and he will be responsible for the Partnership Board in future. John will come to the next Partnership Board meeting to see how we organise ourselves. Peter will continue to work for the council until March 2012 and is managing some important projects in learning disability – the day services modernisation programme, a review of housing and support services and the reconfiguration of respite care services and shared lives.

3 Keeping Our Promises Minutes of the July meeting were not available. Peter apologised for this and said he would make sure that we have proper minutes for next time.

4. Joint Strategic Needs Assessment Dzifa Agbenu from NHS Bedfordshire explained to us that the Joint Strategic Needs Assessment is a publication with information about the local community and its needs. The JSNA was written in 2009 and is now being updated. She explained what the JSNA says about learning disability and invited members of the board to make comments about the needs of people with a learning disability. We agreed that the Partnership Board has said a lot about what we need and want and that she should refer to the minutes of the partnership board and in particular minutes of the April meeting when we agreed our priorities. The current JSNA is on the internet at www.bedfordshire.nhs.uk/publications/jsna.php and we will put the learning disability pages on the partnership board website so that members can make their comments. Dzifa agreed to come to the January partnership board meeting with the new version and we will still have a little time to comment before the final version is agreed in March.

http://www.bedfordshire.nhs.uk/publications/jsna.php

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5. Bedford LINk Arthur Dennis introduced himself as the chairman of Bedford LINk. He explained that the aim of the LINk is to find out what people want from their health and social care service and then work with the providers of these services to bring about positive change. The LINk is one of 150 around the country and they have the power to “enter and view” which means they can go and see what things are really like if people are unhappy about a service, but their aim is to work with providers for improvement, not to inspect and blame. Arthur explained that the LINk was hosted by Age Concern but from 1st October would be hosted by POhWER as this role was part of the tender they have recently won. This means they will move into offices with POhWER very soon. People can find out more about Bedford LINk on www.bedfordlink.org.uk or by writing to them at 21 – 23 Mill Street Bedford MK40 3EU or by calling 01234 347709. Members of the Partnership Board were told that they (and any other people interested in health and social care services in Bedford) can become members of the LINk. At the moment none of the LINk board are people with a learning disability or carers of people with a learning disability but this can change and Arthur said that people could put themselves forward. Anne Bustin has represented the LINk at the Partnership Board but the LINk rep will now be Tracey Brimmell. Anne will continue to attend meetings as a provider of LD services.

6. Leadership Peter explained that the council is about to begin a consultation on a lot of budget options for the next three years during which time the council has to save £28 million. This includes the proposals which were discussed by the council Executive in July. Details will be publicised on the Council website. Peter will ensure that members of the Partnership Board are given an opportunity to comment during the consultation period and will call a special meeting if necessary.

7. Day Services and Work Peter informed the Partnership Board that we have obtained premises at 21 – 23 Gadsby Street for the new Town Centre “hub”. This is one of the few places in the town centre with a safe route to the bus station which you can also get to by are and where it is possible to park a large minibus. The premises used to be the base for Trading Standards and the building at the front was once a police station. It is near to the Advocacy Alliance and POhWER offices and opposite the Lurke Street car park. The council will need to make some alterations, build a conservatory, knock down the internal walls, put in a lift and install disabled toilets and a changing places toilet which can be accessed 24 hours a day 365 days a year. The site will also house a disability equipment exhibition and provide a base for the Supported Employment Team. Peter showed pictures of the building, a map of the two centre showing the site and a plan for how he expects to adapt the building. The Day Services reference Group will look at the design in detail and users and carers will be included in that group so that they can have their say. Some members of the Board expressed concern that people should not be left to walk unsupervised around the town. Peter said that it is our intention to enable people to have as much independence as possible but everybody will have an individual assessment to ensure that they have the skills and support they need.

http://www.bedfordlink.org.uk/

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Kate said that the Meet and Greet service and car wash project would start operating in October, the catering group have a few orders and “Thumbs Up” cards are doing well. Ian McKenzie told the partnership about the work he and his team have been doing since April when the Borough took over the service. Everybody has now been seen by a worker and new referrals have been taken. The service is now working with 69 people.

8. Housing, Residential Care and Supported Living An organisation called Alder Associated is helping the council to review the residential and supported living services it buys. They are mainly being paid for by Regional Improvement Funds. All the service providers have been asked to provide information for a “market mapping” exercise. Peter said that this shows there were over 66 vacancies in Bedford Borough in August. A member of the board asked what would happen to the long stay residents of George Beal House. Peter said that the council will carry out an individual assessment for each person and the proposals would depend on the outcome of those assessments. The council needs at least 4 people to move by March to enable the respite care proposals to happen but the council intends to move all ten people eventually. People asked what will happen to the Orchard House site. Peter said the council intends to sell it to a Housing Association who will develop supported living for epopel with a lernign disability.

9. Health Michelle said that there will be a consultation on changes to the specialist learning disability service. It was always intended to review these services when SEPT took over from BLPT and this is what will now happen. Michelle promised to keep the partnership board informed. Michelle also told the Partnership Board about the new Community Health Facilitators which are now being recruited. This is the service the Board had discussed earlier in the year and will replace The Willows. There will also be an extra “acute liaison nurse” at Bedford Hospital to work with Nikki Keer. Peter informed the Board that following the consultation earlier in the year, he has now been asked by NHS Bedfordshire to inform the Board that the changes had been made to the Community Dental services. They are pleased to confirm that the dentist, Steve, is continuing to work in the service. The clinic in Kempston will not provide specialist dental services any more, but there is no change to the other services on this site such as the chiropody service and there are also no changes to the mobile dentist service which visits Kempston Day Centre.

10. Transition Abbey Woolgar is the Interim Transitions Co-ordinator. She came to the meeting and told the Board about the new protocol for transition, which says who should do what, how they should do it and when it must happen. She also told the Board about the new Transition Information Folders which will be given to young people between the ages of 14 and 19. There will also be a new Multi Agency Assessment for Transition (MAAT) which people will be able to fill in online. This will provide information to support individuals and will also give all agencies planning information to achieve better transitions to adulthood. There will be a transitions fair at The Addison Centre in

Kempston on 19th October. Information abut transition will be available soon on a special website at www.bedfordboroughpartnership.org.uk/transition

11. Any Other Business Members asked about changes to the Blue Badge service. Peter agreed to find out about this and report to the next meeting. Maria told people that the next Living It Up Event (stay up late) will take place on 29th September. Peter agreed to ask Councillor Roger Rigby if he could attend the next meeting.

12.

Date of Next Meeting Tuesday 29th November at 10am – 1pm in Committee Room 1 at Borough Hall. To book a place at the partnership board, please contact Claire Minney on 01234 228204 or email claire.minney@bedford.gov.uk.

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http://www.bedfordboroughpartnership.org.uk/transition

Leadership

• Peter Loose’s new role as Strategic

Projects Manager

– Day Services modernisation

– Improvements to residential services and

housing options

– Respite care reprovision

• The Borough Council budget 2012/15

policy options

The new Town Centre

hub will be here

This is what it looks like on Google Streetview. The “interface” sign has gone.

Supported Employment

Voluntary - 28 people at 32 positions

(+ 5 people Since July)

Team - Ian, Beverley, Carol & Stella

Paid Work - 24 people in 24 positions

(Same as July with 1 person returning from Long Term Sick)

Referrals - 17 people 5 Active Position being Pursued

(8 New Referrals since July)

We know in total of 94 Individuals

I want to talk about 3 things today.

1. We are talking to all people who provide

services in Bedford Borough for people

with learning disabilities to find out about

their services.

We did not have too many returns – 5.

Talked to them again, now – 21.

We need to look at the answers.

3. Mencap – decided to change

their 2 homes from residential into

supported living.

2. We had the first meeting with company

called ALDER. They will look at what is the

best way for people with LD to move their

homes.

HOUSING

Health

Learning Disability Forum at Bedford Hospital

continues to meet on every three months. Next

Meeting is on the 7th July from 12-2pm in the

Committee Room at Bedford Hospital.

Bedford hospital is currently

developing a DVD about coming

into Bedford Hospital for people with

Learning Disabilities

Lansdowne Care have reached

an agreement with the hospital

about supporting their service

users when they come into

hospital. Other providers have

now shown an interest in doing

similar agreements.

Contents Glossary 3

Foreword 5

Executive Summary 6

Introduction 8

Chapter 1 Carers in Bedford Borough 12

Chapter 2 Current Context 17

Chapter 3 Strategic Intentions for Carers 21

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CONTENTS

Page

1. Executive Summary 1

2. Introduction 2

3. Bedford Borough Context 3

4. National Policy and Local Drivers 8

5. Conclusion and Strategic Action Plan 11

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1. Executive Summary

1.1 This is the first commissioning strategy for telecare and assistive technology from Bedford Borough Council. It demonstrates the importance of the contribution to be made by telecare and assistive technology in enabling vulnerable adults to have maximum choice, independence and control in how they live their lives.

1.2 Assistive technology is:

“… any item, piece of equipment, product or system that is used to increase, maintain or improve the functional capabilities and independence of people with cognitive, physical or communication difficulties.” (Technology: Independence and Well-being, Audit Commission, 2004)

1.3 Telecare takes the support a step further by using technology to monitor a

person's well-being and summon help if required. Usually this means the telecare equipment is linked to a call centre. If an incident occurs, a message is sent using the person’s phone line and help is called quickly. The simplest form of telecare that most people are familiar with is the pendant alarm which is pressed to call for help.

1.4 The largest single service user group who can significantly benefit from

assistive technology and telecare is older people and this strategy will bring benefits to them. However they are not the only group who can benefit and this strategy is written for all adults who can benefit including those with disabilities and other vulnerabilities.

1.5 We have identified three strategic priorities with associated objectives which

can be found in the action plan at the end of the document. Strategic Priority 1. Ensure Bedford Borough Council’s design of

personalised social services includes easy access to assistive technology and telecare.

Strategic Priority 2. Ensure people experience assistive technology and

telecare as an integrated arrangement with other services so its use is as straightforward as possible.

Strategic Priority 3. Ensure people have access to information, advice and

support to use up to date technology as it develops. 1.6 This strategy sets our direction for the next three years and develops the

foundations needed to fully exploit the expected technological advances over the next decade such as intelligent monitoring and virtual presence (using video communications between users and professionals via broadband).

1.7 We remain committed to service user and carer engagement and during the

life of the strategy will continue to consult and invite feedback to ensure the annual action plans reflect any changes to local or national priorities.

2. Introduction

2.1 This is the first commissioning strategy for telecare and assistive technology from Bedford Borough Council. It demonstrates the importance of the contribution to be made by telecare and assistive technology in enabling vulnerable adults to have maximum choice, independence and control in how they live their lives.

2.2 The aim is to increase the number of older and other vulnerable people

benefiting from assistive technology and telecare in Bedford Borough. Implementing the strategy is central to our plans for personalisation and other key initiatives such as preventing hospital and care home admissions and facilitating hospital transfers of care. It is anticipated that improving the use of telecare and assistive technology will deliver savings in social, residential and health care costs.

2.3 The technology is improving and costs are expected to reduce. The

opportunity is here to extend the range of technologies used and the support they make possible. This applies to everybody in the community whether they are eligible for social care support or not. People with the means to fund their own needs for assistive technology and telecare are entitled to benefit from local information, advice and excellent providers.

2.4 What is assistive technology and telecare?

Assistive technology is:

“… any item, piece of equipment, product or system that is used to increase, maintain or improve the functional capabilities and independence of people with cognitive, physical or communication difficulties.” (Technology: Independence and Well-being, Audit Commission, 2004)

Assistive technology helps people maintain their independence. Some examples are:

specially designed plugs to stop the bath overflowing. talking reminders when someone walks past, eg ‘It’s night time,

best go back to bed’. a simple mobile phone with only seven buttons. bed occupancy sensors - can help prevent falls by switching on a

light when someone gets out of bed. programmable automatic pill dispensers. fall detectors – the person wears it, if they fall it sounds an alarm fire, smoke and carbon monoxide detectors.

Assistive technology usually works in the person’s immediate environment but not beyond it.

Telecare takes the support a step further by using technology to monitor a person's well-being and summon help if required. Usually this means the telecare equipment is linked to a call centre. If an incident occurs, a message is sent using the person’s phone line and help is called quickly. The simplest

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form of telecare that most people are familiar with is the pendant alarm which is pressed to call for help.

2.5 Assistive technology and telecare services in Bedford Borough need to be

better integrated with the social care and health assessment processes. Equipment to support a package of care or help a person maintain independence needs to be sourced and installed as quickly as possible for the full benefits to be realised, both to the person and the public purse.

2.6 The largest single service user group who can significantly benefit from

assistive technology and telecare is older people but they are not the only group that this strategy is written for.

2.7 Assistive technology and telecare can support many people in many

circumstances including:

Patients recently discharged from hospital Older people living alone People with a dementia People with learning disability People with physical disabilities People with increased frailty safety Chronic disease or long term condition sufferers People with mental health problems People with sensory impairments Tenants in sheltered housing schemes Extracare housing tenants Hostel dwellers with history of substance abuse People with complex support needs Unpaid carers of any of the above groups People at risk of domestic violence People at risk of abuse from bogus callers

2.8 This strategy sets out plans for the next three years and develops the

foundations needed to fully exploit the expected technological advances over the next decade. Assistive technology and telecare will become mainstream and we expect more advanced assistive solutions to be available such as intelligent monitoring and virtual presence (using video communications between users and professionals via broadband).

2.9 The strategy will be delivered through annual action plans. We are committed

to service user and carer engagement and during the life of the strategy we will continue to consult and invite feedback to ensure the annual action plans reflect any changes to local or national priorities.

3. Bedford Borough Context

3.1 General Demography

Bedford Borough covers an area of 476 sq. km and is home to approximately 156,000 people living in approximately 64,000 households. Just under two-thirds live in the urban areas of Bedford and Kempston, with almost 36% in the surrounding rural areas. Significant new residential development is

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planned in the Borough with the population forecast to rise to more than 172,000 by 2021.

On most social and economic measures the Borough is broadly similar to national averages including major growth in the numbers of older people.

The ageing of the local population is accelerating with the 75-84 population forecast to rise by 31% and the 85+ population by 61% between 2008 and 2021.

3.2 Diversity

The major difference between the Borough and national or regional profiles is in the ethnic makeup. Bedford has one of the most ethnically diverse communities in the region and is home to people from an estimated 60 countries, including large Italian and Asian populations. Black and ethnic minority (BME) groups formed 19% of the Borough’s population in 2001 and the figure is estimated to be 22% now. Nearly two thirds of this BME population growth has arisen from migration from EU Accession countries, especially Poland and Lithuania.

The BME population is concentrated in the urban areas, 58% of Queens Park and 44% of Cauldwell residents are from BME groups.

3.3 Health

3.3.1 Health in Bedford Borough is generally close to the England average. Average life expectancy is 80.2 years but life expectancy for men in the most deprived parts of Bedford is estimated to be 11 years less than in the most affluent wards. The urban areas of the borough have a greater proportion of people suffering a limiting long term illness or disability.

3.3.2 Using 2007 deprivation measures, Bedford Borough is in the mid-

range of English local authorities, but parts of Bedford and Kempston experience considerable deprivation where a higher proportion of people from minority ethnic groups live. Areas in Castle, Harpur and Cauldwell wards are amongst the 10% most deprived areas in England.

3.3.3 Pensioners living in Bedford and Kempston are twice as likely to be

income deprived as rural pensioners, with levels reaching 57% in the most deprived parts of Castle ward in central Bedford.

3.3.4 Approximately 15% of older people are in regular contact with care

services. Older people make up 16% of the population, but occupy almost two thirds of general and acute hospital beds and account for 50% of recent growth in emergency admissions.

3.3.5 The main reasons for people being admitted to residential and nursing

care are:

Dementia Stroke

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Frailty Arthritis Family/social reasons Unmet needs due to gaps in service provision

Assistive technology and telecare can contribute to well being in all these areas and help prevent admissions.

3.4 Living Alone

One effect of increasing life expectancy (and the difference in life expectancy between males and females) is that increasing numbers of older people are living alone. Living alone can lead to loneliness and isolation, depressed morale and other effects on health and wellbeing. The numbers of older people living alone is predicted to increase. This will probably increase demand for assistive technology and telecare services because of the absence of unpaid carers. Alerts or alarm systems will be required more often to maintain independence. Using technology to communicate with friends and family will also help combat loneliness and keep its depressing effects at bay.

3.5 Falls

3.5.1 About a third of people over 65 are likely to fall at least once per year. This rises to 50% in the 80+ age group. 5% of falls result in a fracture and 95% of hip fractures are as a result of a fall. The estimated cost of a hip fracture is £21,500 per person.

Although most falls do not result in serious injury, the consequences of falling, or of not being able to get up after a fall, can be devastating.

3.5.2 The major risk factors for falling include poor balance, muscle

weakness, medication, dementia and environmental hazards. The risk of falling increases with the number of risk factors. Using assistive technology and telecare to address some risk factors will make a major contribution to reducing the impact of falls on the overall health and well-being of the population.

3.6 Dementia

3.6.1 Dementia is used to describe a collection of symptoms, including a decline in memory, reasoning and communication skills, and a gradual loss of skills needed to carry out daily activities.

3.6.2 The prevalence of dementia increases markedly with age. Therefore,

as the number of older people is going to increase significantly, there will be a substantial increase in cases of dementia. The number of people aged 65+ in Bedford Borough with dementia that results in severe cognitive impairment and functional disability is projected to increase by 80% between 2008 and 2028.

3.6.3 Dementia is such an important factor that it has its own strategy.

Increasing the effective use of assistive technology and telecare to support people with dementia and their carers is a key goal towards

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achieving maximum independence for people throughout the course of their illness.

3.7 Current Services

3.7.1 We are part-way through reshaping adult social services for personalisation and when people ask for help our first response is becoming an offer of re-enablement with appropriate assistive technology and telecare support.

3.7.2 Assistive technology and telecare services are currently

commissioned through Aragon Housing Association. Social workers or other health and social care professionals identify a need for telecare services and then refer the person to Aragon Housing Association. Aragon employs a telecare worker for Bedford Borough and this worker is responsible for:

Assessment and review Ordering, installation and checking equipment Liaising with North Herts Careline (delivered by North Herts

District Council, based in Hitchin) to connect the alarm unit to the call centre.

A number of issues have been identified regarding the current configuration.

3.7.3 Assessment and review of people’s telecare needs are undertaken by

the service provider. The Council and PCT provider services currently undertake other assessment and review functions, such as community care assessments, carers’ assessments, assessments for community equipment, and assessments for wheelchairs. People are then referred to appropriate service providers, who deliver services according to assessed needs.

3.7.4 There is no mobile warden response if an alarm is triggered. The call

centre will contact a relative or neighbour from their support network. This means that people who do not have a support network, and are therefore among the most vulnerable, are not able to have a telecare service.

3.7.5 Quality assurance relating to response - responses are provided by

family or neighbours. There is no way of guaranteeing that the response is speedy, appropriate or effective. There is also no way of knowing what happened as a result of the alarm being triggered. There is no mechanism for demonstrating that telecare has helped to reduce inappropriate A&E attendances or ambulance calls.

3.7.6 Waiting times for assessment have been rising. This is partly due to

capacity issues within the service and partly due to process issues. Changes are required to make best use of all capacity in the service to undertake outstanding assessments and installations.

3.7.7 Process for sourcing and invoicing equipment: Aragon source the

equipment through North Herts Careline, who in turn source the

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equipment from Tunstall. Aragon then installs the equipment. The invoices for equipment are sent to Bedford Borough Council. The route from sourcing to invoicing must be more streamlined and transparent.

3.7.8 Lack of ability to “bolt on” telecare services to people’s existing

service: If someone living in Bedford Borough is using bpha’s local Carelink service then their needs change and they require an Aragon-provided telecare service, their existing service is disconnected, their alarm removed, and they are connected to the call centre in Hitchin instead. People using the bpha Carelink service can access a mobile warden service as part of their package, so switching to telecare not only means the loss of a local response, it can also mean the loss of a mobile warden service.

3.7.9 The service has been commissioned on a pilot basis for five years. Council’s are required to tender services on a regular basis and five years of pilot activity is far too long. The Assistive Technology and Telecare contract must be put to the market as soon as possible.

3.8 Proposed Future Services

Subject to further consultation, it is proposed that:

Assistive technology and telecare assessment and review should be undertaken by social care staff in future. Assessment will primarily be located in the ‘enablement team’ and ‘first point of contact’ for people new to social care services. As needs change over time, the review team would also provide an assessment and review function for telecare.

Tendering should take place for equipment procurement, installation,

checking and demonstration, a call centre and mobile response service to be delivered across the entire borough of Bedford by 1 April 2012.

Assistive technology and telecare is considered a community care service

and charged for under ‘Fair Access to Care Services’ (FACS) in the same way as other community care services. The pros and cons of doing this will need to be weighed up and justified recommendations made to the relevant Council committee.

People who do not meet eligibility criteria for social care but could benefit

from telecare services can purchase privately from the council’s commissioned provider. The provider would have an entry in the Directory of Services that is currently being developed, which will be available to self funders as well as direct payment users and people who refer to services or broker support packages on behalf of clients.

3.9 Workforce Development & Training

3.9.1 Assistive technology and telecare is not a substitute for properly staffed services – alerts need someone to respond to them in an appropriate manner. Making better use of assistive technology and telecare will support the best use of staff time. By providing technology

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based solutions for prevention and self-care, staff can be directed to personal care, long- term condition case management and rehabilitation programmes.

3.9.2 A comprehensive training programme will be implemented to raise

awareness among all staff about the range of assistive technology and telehealth services available and how referral and assessment processes need to identify where more technology is more appropriate than more service. ‘Hands-on’ staff will need to acquire new skills to ensure they are able to support service users to manage assistive technology and telehealth in their own homes.

3.10 Funding

3.10.1 It is assumed that the substantial cost savings demonstrated in UK

assistive technology and telecare projects will be replicated in Bedford Borough. Therefore future costs of assistive technology and telecare services and equipment will be met through the diversion of mainstream funding away from traditional forms of care.

3.10.2 Potential clients will be assessed under FACS and Fairer Charging

criteria and a service charge levied according to their status under the criteria. Where a client does not meet FACS criteria, a private pay assistive technology and telecare service will be offered at a non-subsidised rate.

4. National Policy and Local Drivers

4.1 National Policy

4.1.1 This strategy supports a number of national public policies for improving the health, well-being and quality of life of older and vulnerable people, and their carers, in the borough.

4.1.2 Independence, Well-Being and Choice (2005). “Assistive

technology telecare and telehealth has huge potential to support individuals at home, and to complement traditional care. It can give carers more personal freedom and more time to concentrate on the human aspects of care and support and will make a contribution to meeting potential shortfalls in the workforce”.

4.1.3 Building Telecare in England (2005), “Telecare is as much about the

philosophy of dignity and independence as it is about equipment and services. Equipment is provided to support the individual in their home and tailored to meet their needs. It can be as simple as the basic community alarm service, able to respond in an emergency and provide regular contact by telephone. It can include detectors or monitors such as motion or falls and fire and gas that trigger a warning to a response centre”.

4.1.4 Our Health, Our Care, Our Say (2006) Assistive technology and

telecare has a key role in achieving the 6 overall aims of -

1. More services in the community.

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2. Greater prevention. 3. Enhanced access to general practice and community services. 4. Better support to people with long-term conditions. 5. Integrating health and social care. 6. Providing people with a louder voice.

4.1.5 Securing Good Care for Older People, (Wanless, 2006) stated that:

’enough lessons have been learned from pilot studies that the emphasis should now shift to moving assistive technology telecare and telehealth into the mainstream.’

4.1.6 Putting People First (2007) identifies that “Person centred planning

and self directed support will become mainstream and define individually tailored support packages. Telecare to be viewed as integral not marginal” (to this process)

4.1.7 Carers at the Heart of 21st Century Families and Communities

(2008) identifies the role of telecare in enabling carers to have more peace of mind and a degree of freedom based on the knowledge that the people being cared for still have support in place if they are not there.

4.1.8 Living well with dementia: A National Dementia Strategy (2009)

states the needs of people with dementia and their carers should be included in the development of housing options, assistive technology and telecare.

4.1.9 Think Local, Act Personal. The next steps for transforming adult

social care – (2011) is the sector wide commitment to moving forward with personalisation and community based support. The commitment to improve integration between health, housing and social care must lead to more cost effective outcomes being provided by better use of telecare and assistive technology.

4.2 Local Drivers

4.2.1 There are a number of local drivers influencing how we will

commission assistive technology and telecare.

Service Re-design and Modernisation- both the Council and NHS need to redesign their services in order to deliver national policy and improved outcomes for service users. In many instances doing this in partnership will result in more effective use of resources and a more streamlined service for users.

4.2.2 Bedford Borough Council completed the Care Services Efficiency

Delivery Telecare Strategy Self-Assessment Framework in January 2011. The framework is a tool that helped us identify and prioritise:

Strategic objectives: What are the overarching strategic objectives

of a telecare system? What outcomes and goals should we be seeking to achieve?

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Good practice, current status and next steps: What are the key elements of an effective telecare service? What are the critical factors that contribute to good practice and performance? How does the current service measure-up and what improvement actions are needed with what priority?

4.2.3 The results suggested that the use of telecare has been effective to

date in supporting people in independent living, particularly where it has been used as part of a wider support package. It has also resulted in significant efficiency gains, and this applies especially to people with physical disabilities and people with learning disabilities – where the availability of telecare has enabled them to remain supported in their own homes.

The evidence was less clear about the value of telecare where it has been allocated primarily for the purpose of reassurance for the service users and/or their carers

Overall, the evidence suggests we should extend the use of telecare to prolong independent living outcomes for people who use services and their carers, and to increase the cost-effectiveness of services – especially for people with physical disabilities, people with learning disabilities, and people with dementia.

The completed assessment produced an action plan which has been integrated into this strategy.

4.2.4 The Supporting People Programme – The supporting people

programme provides housing related support services to help vulnerable people live independently. It is a key contributor to promoting and sustaining the independence of vulnerable people through the range of services it funds including assistive technology and telecare.

4.2.5 Bedford Borough’s Joint Commissioning Strategy for Older

People’s Services (2010) identified that ‘Telecare can give older people and carers more personal freedom and time to concentrate on the human aspects of care and support as well as making a contribution to meeting potential shortfalls in the workforce.’ It contains the strategic objectives to:

Enable people to get any equipment, assistive technology or home

adaptations they need directly.

Ensure community alarms services meet agreed minimum standards.

4.2.6 The Bedford Borough Joint Commissioning Strategies for all client

groups make the same point: assistive technology and telecare has a critical role to play in maximising the effectiveness of limited resources by helping more people maintain independence.

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5. Conclusion and Strategic Action Plan

5.1 This strategy aims to achieve the integration of assistive technology and telecare within social care, health and housing services in Bedford Borough. It also supports the wider health, housing and social care policy agenda both nationally and locally.

5.2 The use of technology can enable people to live independently with

greater confidence and stimulate them to do things for themselves. That in turn supports relatives and carers. Technology offers alternatives to prevent or delay moves into formal care settings which for many people is a difficult and unwanted choice. By extending the capability of self caring to more people for longer, assistive technology and telecare can help safeguard the individual’s dignity and freedom.

5.3 This strategy builds towards realising the vision of Our Health, Our

Care, Our Say: A New Direction for Community Services (2006) and Think local, act personal (2011). This includes: better prevention services and earlier intervention; giving people greater choice and control, and supporting them to maintain independence and well-being; and working with a range of partners to deliver more joined up services.

5.4 Assistive technology and telecare has the potential to play a powerful

role in helping to achieve these outcomes for older and other vulnerable people in Bedford Borough.

The strategic action plan to move from potential to reality follows overleaf.

Assistive Technology and Telecare Strategy Action Plan 2011- 2014 Strategic Priority 1. Ensure Bedford Borough Council’s design of personalised social services includes easy access to assistive technology and telecare. Actions Timescale Promote assistive technology and telecare in the personalised model for social care

support in Bedford Borough. Jo Hawthorne

April 2013

Ensure that everybody eligible for services from Adult Social Care is encouraged towards the option of assistive technology and telecare services as part of their package with an initial target of 10% of individuals choosing to purchase an element of assistive technology or telecare with their personal budget.

Jenny McAteer

April 2013

Introduce new technology as it becomes available via our commissioned assistive technology and telecare service and as capacity allows.

George Hunt April 2014

Appraise options to include telecare equipment as part of a transformed community equipment service, consistent with the retail market model.

Alison Shepherd

April 2013

Publicise the benefits of assistive technology and telecare, and how to access it, to the general public and client groups most likely to benefit from raised awareness.

Gillian Abbott/Anona Hoyle

April 2013

Improve access of carers to assistive technology and telecare. George Hunt April 2013 Identify sustainable funding streams to maintain the commissioned assistive technology

and telecare services and the charging rules for service users. Simon White April 2012

Strategic Priority 2. Ensure people experience assistive technology and telecare as an integrated arrangement with other services so its use is as straightforward as possible.

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Actions Timescale Conduct an audit of customer satisfaction with assistive technology and telecare and

implement an action plan as indicated by the results. Rosalind Carter

April 2012

Train staff on the use of assistive technology and telecare and how it can reduce the need for more expensive interventions.

Jon Seth April 2013

Review opportunities to increase co-ordination of approach to assistive technology and telecare between social care, health and housing.

George Hunt

April 2013

Use available resources to tender for assistive technology and telecare services to better meet personalisation outcome measures.

George Hunt

October 2013

Appraise options for the delivery of a comprehensive response service to deal with non medical emergencies.

John Bruynseels

April 2014

Ensure implementation of assistive technology and telecare in Bedford Borough Extra Care housing schemes.

Andrew Kyle

April 2013

Consult as required on assistive technology and telecare via our partnership boards and related groups.

Chairs of Partnership Boards

April 2014

Strategic Priority 3: Ensure people have access to information, advice and support to use up to date technology as it develops Key Projects and Actions Timescale Ensure availability of accessible, up to date information including practical examples of

how technology can help, how to access it and what it costs. Gillian Abbott/Anona Hoyle

October 2013

Develop self purchase options so that people can take preventative and self-caring actions in their own lives without recourse to the council.

George Hunt April 2013

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Monitor whether self purchase actually delivers the self care and prevention behaviour expected.

Jenny McAteer

April 2014

LDPB Agenda 13.09.11110913 MinutesLDPB%2013%20Sept%2011%20PresentationsTelecare Strategy Final Draft 11 July 112.4 What is assistive technology and telecare?3.6 Dementia3.6.1 Dementia is used to describe a collection of symptoms, including a decline in memory, reasoning and communication skills, and a gradual loss of skills needed to carry out daily activities. 3.6.2 The prevalence of dementia increases markedly with age. Therefore, as the number of older people is going to increase significantly, there will be a substantial increase in cases of dementia. The number of people aged 65+ in Bedford Borough with dementia that results in severe cognitive impairment and functional disability is projected to increase by 80% between 2008 and 2028. 3.6.3 Dementia is such an important factor that it has its own strategy. Increasing the effective use of assistive technology and telecare to support people with dementia and their carers is a key goal towards achieving maximum independence for people throughout the course of their illness.Actions Promote assistive technology and telecare in the personalised model for social care support in Bedford Borough.Jo Hawthorne Ensure that everybody eligible for services from Adult Social Care is encouraged towards the option of assistive technology and telecare services as part of their package with an initial target of 10% of individuals choosing to purchase an element of assistive technology or telecare with their personal budget.Jenny McAteer Introduce new technology as it becomes available via our commissioned assistive technology and telecare service and as capacity allows.George Hunt Appraise options to include telecare equipment as part of a transformed community equipment service, consistent with the retail market model.Alison Shepherd Publicise the benefits of assistive technology and telecare, and how to access it, to the general public and client groups most likely to benefit from raised awareness.Gillian Abbott/Anona Hoyle Improve access of carers to assistive technology and telecare.George Hunt Identify sustainable funding streams to maintain the commissioned assistive technology and telecare services and the charging rules for service users.Simon WhiteActions Conduct an audit of customer satisfaction with assistive technology and telecare and implement an action plan as indicated by the results. Rosalind Carter Train staff on the use of assistive technology and telecare and how it can reduce the need for more expensive interventions.Jon Seth Review opportunities to increase co-ordination of approach to assistive technology and telecare between social care, health and housing. George Hunt Appraise options for the delivery of a comprehensive response service to deal with non medical emergencies.John Bruynseels Ensure implementation of assistive technology and telecare in Bedford Borough Extra Care housing schemes. Andrew Kyle Consult as required on assistive technology and telecare via our partnership boards and related groups.Chairs of Partnership BoardsKey Projects and Actions