OPEN

Older People’s Engagement Network

February 2017 Domiciliary Care Services

Stoke-on-Trent City Council

Jointly funded by Stoke- on-Trent City Council and Stoke-on-Trent CCG 1

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Contents

Page Introduction 5

Recommendations 6

Guest Speakers 8

Dialogue – Feedback from the questions posed;

In your opinion, what are the most important things for someone who 12 receives home care?

What concerns do you have about home care and what changes do you 16 think Stoke-on-Trent City Council should consider?

How can Stoke-on-Trent City Council most effectively communicate with 22 people who use the home care services?

Our Partners 26

Appendices 27 February 2017 Forum Programme

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OPEN Forum Attendees Meir Community Centre, 23 Feb 2017 (top left) Derek Brindley Chair of the OPEN Committee

All photographs contained in this report courtesy of Christine Humphreys, OPEN Committee member 4

Introduction

On 23 February 2017, Saltbox held an Older People’s Engagement Network Forum to discuss domiciliary care services contracted by Stoke on Trent City Council. Despite hurricane ‘Doris’ that swept through the country on that day, 50 residents aged 50+ attended the OPEN forum to give their views. Partner organisations had information stalls on the day and took part in facilitating the discussion sessions. The OPEN Forum focussed on the flowing themes:-

• How can Stoke-on-Trent City Council most effectively communicate with people who use the home care services?

• In your opinion, what are the most important things for someone who receives home care?

• What concerns do you have about home care and what changes do you think Stoke-on-Trent City Council should consider?

In addition, through the OPEN outreach work, a further 232 residents gave their views about domiciliary care services. This includes feedback from residents who currently use the Saltbox CareLink telephone befriending service who are housebound and isolated. The following 15 groups have been involved in giving their feedback:  Goldenhill Out and About Club  Ladies Self Support Group  Bucknall Methodist Church Lunch Club  St. Andrews Church, Sneyd Street, WRVS  Brindley Ford Snack and Chat Group  Outriggers Club, Trentham Lakes  Chatterley Centre Lunch Club, Stoke North Live at Home Scheme  Age UK Art and Craft Group at St. Johns Centre, Trentvale  Age UK West End Knitting Group, Stoke  Moss Green Friendship Group  Stroke Support Group, Longton  Potters Club Social Group, Birches Head  Wellesley Hall Tuesday Group, Sneyd Green  Heron Cross Allotments Group  Clients using the CareLink Service.

This report contains the valuable feedback from 282 residents and makes recommendations which will be used to inform commissioning decisions about older people’s domiciliary care services. 5

Recommendations On 07 April 2017, members of the OPEN Committee met to agree the recommendations to put forward following feedback from 282 residents living in Stoke-on-Trent about domiciliary care services.

In your opinion, what are What concerns do you have about home care and the most important things what changes do you think Stoke-on-Trent City for someone who receives Council should consider? home care?

Increase the time spent during a home visit to have Minimum of half-hour enough time to converse and chat with the client – appointments, (for customer service-just as important as practical care example two half-hour and can be done at the same time. slots instead of four 15 minutes slots).

What is the minimum standard of training for care workers? Customer service training should be mandatory – for example, all care workers should Consistency of call receive an agreed level/standard of customer times(currently they can service training. vary to what was agreed with the client).

Do the carers get paid for the hours that they work or just for their time visiting carers? Paid travel time should be part of the Stoke-on-Trent Consistency of the same City Council contract to deliver care to older carer(s) visiting clients. people.

Client’s needs can change in a short time – Consistency and quality of sometimes it can take 6 weeks for an the care provided by the assessment and then the client may have to wait different carers from again until their care needs are changed. Care different care providers need to respond quicker to the clients organisations. changing needs.

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How can Stoke-on-Trent City Council most effectively communicate with people who use the home care services?

Carers should be the appointed Additionally family members person for the city council to most should be consistently updated effectively communicate with about any changes to the clients’ people who use the home care needs/care provided. service.

For people who don’t have any family, how do they voice their views or be taken seriously? As part of everyone’s provision packs, contact telephone numbers should be displayed for the Care Provider, Stoke-on-Trent City Council and Healthwatch Stoke-on- Trent, in case of query or complaint. These telephone numbers should be listed clearly on the front page of the folder that is given to client.

From left to right; June, Pat and Ann, members of the OPEN Committee, Meir Community Centre, 23 Feb 2017

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OPEN Forum - Presentations

Feedback from the October 2016 OPEN Welcome & Introductions Forum/Community Conversation Lloyd Cooke Anna Collins - Head of Communications and Chief Executive, Saltbox Engagement, North Staffordshire and Stoke-on-Trent Clinical Commissioning Group

Anna thanked OPEN for their work in The Older People’s partnership with the Clinical Commissioning Engagement Groups during October 2016 . The OPEN Network is an Forum/Community Conversation discussed exciting project health services commissioned by the CCG to giving people aged help people stay independent, healthy and prevent trips and falls. 50+ opportunities to influence how services are provided. The findings from the discussions held at the forum have been fed back to the Patient and Public Involvement Steering Group and the top 8 recommendations have been approved for action by the board. Information sheets detailing the recommendations The service’s main focus is on ensuring that made were included in the packs made available to all attendees. conversations are held and that these are then fed back to services in order to improve the impact of service Anna confirmed that she would be happy to return in 6 months’ provision to people aged 50+. time to report on the progress being made by the CCG.

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OPEN Forum - Presentations

Age UK North Staffordshire Revival Help at Home Service Hospital Support Team and Home Improvement Agency Sue Kewley Alison Lawson and Michaela Burton

The service was set up in 2008 as a The Hospital Discharge service provides Social Enterprise. The funding, from support for people to get home from hospital. Stoke on Trent City Council, was It prevents readmission and helps people to part of ‘preventative funding’. The return home as soon as possible, enabling aim was, and is, to assist people them to remain independent. Revival can aged 50+ who were finding it provide the following services: difficult to manage everyday

practical tasks at home. We can assist with:  Allocated Support Worker

The Help at Home service can assist with shopping,  Home repairs and improvements  Aids and adaptations paying bills, collecting prescriptions, laundry at clients home or at the launderette and ironing.  Energy efficiency  Falls prevention The service also offers general cleaning including:  Dusting and vacuuming  Benefits advice/checks  Housing options  Cleaning - bathroom, kitchen, inside of windows  Changing bedding and making beds  Referrals to other organisations  Defrosting/cleaning of fridges  In certain circumstances, they can also provide escorted shopping calls.

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OPEN Forum - Presentations

Domiciliary Care Services Contracted by Stoke on Trent City Council Scott MacDonald - Adult Social Care Commissioning Manager, Stoke-on-Trent City Council

Home Care (or Domiciliary Care) is a care and support service, which is delivered in peoples’ own homes and is sometimes referred to as ‘Home Care’. Carers will visit service users’ houses and will deliver a range of support services, which can include elements such as assisting people to bathe and dress (personal care), help with medication and prepare meals.

The carers provide the support in line with a care plan, which has been developed by a social care professional following an assessment of the individuals’ needs. Some service users will only need one short care call per day, but some service users with more complex needs may require up to four care calls per day with two staff. We currently have about 1,100 people in the City who receive services in their home delivered in this way. Calls last a minimum of quarter of an hour, but most often these calls are half an hour, many calls are an hour long. Some are overnight stays, especially when people need

to settle back home following a hospital stay. Each call can be attended by one or two carers. In some cases even three. This means that, every year, over 1.2m care calls are delivered in Stoke-on-Trent.

We need to ask all people with a stake in these services what is important to them. We want to ask people who use the service, people who may need to use the services in the future and the families of all those people to find out what currently works

well, what needs to be reviewed and what we should be doing to improve the services. All of these elements will be factored into the decisions around how the new service will operate. We are looking for feedback, comments on the service; what works well, what needs to be reviewed, what we could be doing differently.

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Discussion Sessions, OPEN February 2017 Forum (top left) Laurie Scott, Saltbox Operations Director (bottom left) Cliff Hathaway, OPEN Engagement Officer

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DIALOGUE This is a full list of the feedback obtained from 282 residents during the OPEN Forum and during consultations with community groups of older people

1. In your opinion, what are the most important things for someone who receives home care?

Time slots that suit the individual and flexibility: • Fixed time slots/windows. • Same time appointments. • Comes at a time that suits the client. • To receive care at a time that suits the client and to a good standard. • That the client receives the care at a time that best suits them. One lady reported how her care worker did not arrive until late morning to see to her breakfast, by which time someone else was arriving with lunch. Another lady said how she was put to bed far too early, 6pm. • A flexible care plan (for good and bad days). • Flexibility. • Having care provided at times that suit the client. • Having care workers that have some flexibility to respond to the needs of the client.

Punctuality and communicating lateness: • Inform if late because of earlier task/traffic. • Let service users know if running 15mins + late. • The care worker arrives on time. • Care worker is punctual. • Arrives at the same time each day. • Consistent call times so people don’t have day wasted or are worried no one is coming. • Comes at the times agreed. • Contacts the client if they are running late. • Having carers that arrive on time • Having carers that inform clients if they are going to be delayed. • Late care services can have a knock on effect to daily plans/appointments. • Care staff using service users landlines to inform managers of daily care services being completed – length of call).

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Consistency of the same carer(s):  One lady reported how she had two care workers come each day, they cared for her very well, did a full half hour at each visit and did all the tasks they were meant to.  Familiarity, care and consideration.  Continuity of carers to avoid new carers coming in all the time.  Consistency of carer – rota of 3.  Same carers all the time so you can build up trust and relationships.  Same staff.  One lady had someone visit her once a week to check on how she was, same lady each time which was nice.  The same care worker or care workers make the visits.  Consistency of same carers visiting each client wherever possible as once familiar with dwelling no time wasted locating appropriate facilities.  To receive care from the same care worker as often as possible to allow a relationship and trust to develop between client and care worker.  The same care workers visit each week. • Having the same carers / continuity of carers. • Having carers that you can develop good relationships with. • Having carers that you can get to know and trust.

Completing agreed care plan activities and travel time: • The care worker undertakes all agreed tasks to a good standard. • Care workers should complete all their tasks. • Does the job properly rather than rushing and cutting corners. • That the care worker spends the agreed time at the client’s house. • Having carers that spend the full amount of time, as agreed, at the client’s house. • That the jobs are done that the care company is being paid to do. Pressure on care workers time means that many of the jobs that they are supposed to do are not done. One lady complained about the care worker not completing the jobs that she was supposed to, so she complained to the Council who got another company to send a care worker, but things did not improve, so she stopped having someone visit and managed with the help of friends/neighbours. • That the client has the care worker at their house for the amount of time they have paid for. One lady paid for a care worker to come 3 times a day for 30 minutes each time, but the care worker only spent about 10 minutes at the ladies house each time she visited because she included her travel time in the 30 minutes.

Longer call times and more time for social interaction: • Time to do their work, if a carer is rushing around it creates anxiety and stress for the person being cared for. • That plenty of time is allocated to each client because 15 minutes is not sufficient. 13

• Spends a minimum of 30 minutes with each client • The care worker spends a little time chatting to the client • Short calls no good for helping relieve loneliness, maintaining emotional wellbeing. • To receive care from care workers that can spend time doing the work they have come to do as well as have time for a quick chat. • Include enough time during the carer visits to help with needs as frail and infirm folk do not respond well if rushed along and are easily stressed. • Currently too much pressure on carers to complete tasks in 15 minute bursts as this leaves no time at all to get to know the clients and work together on the best way to deliver the support provided - for example one lady who cannot raise her arms was refused her request to wash her hair because of time available. • Carers are very rushed when they visit me. • The benefits of investing in a “socialising service “ would repay the cost many times over by reducing isolated and withdrawn older folk. • That there is time for a chat. • Will have a chat and build a relationship • Having carers visit for a minimum of 30 minutes. • Having care workers that will spend time communicating about what they are doing, listening to the client, encouraging the client to do things themselves if feel capable, working in unison with the client.

Care workers with the appropriate skill set: • Great customer service. • Care workers are able to communicate and listen well. • Care workers are thoughtful and understanding. • Care worker is easy to understand but not patronising. • Enjoys their job. • Has an aptitude for caring. • Having carers that care. • Communicates well and explains what they are doing and why. • The care worker listens and understands the needs of the client, works with the client to help them help themselves.

Cultural, gender, disability and age awareness: • Disability issues. • LGBT awareness. • Cultural differences of other religions and ethnic groups. • The gender of the care worker suits the client. • Having carers that respect each person’s individuality.

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Training for the care worker: • The care worker should be trained to deal with patients with dementia. • Ensure that carer training is good quality – holistic approach. • The care worker should be fully informed about what tasks they need to carry out for each client. • The care worker is competent and fully trained to carry out the set tasks. • To receive care from well trained, well paid, well treated care workers. • More consistency required with the quality of care provided – everyone has to be trained however there does seem to be an issue with varying standards of care received. • The care worker can administer medication. • Is sufficiently trained. • Having carers that have been sufficiently trained.

General feedback:  The City Council and/or company providing the care should speak to the family also to build up a profile of the person’s particular need. • Not all about low cost it’s about people delivering quality care. • Dignity and respect in their own home. • Physiotherapy services are so important, I had it for 6 weeks and then it stopped. • Simple system for calling in problems / concerns. • Need a champion to assist when negotiating care packages with Social Services and CCG’s as not a skill many people encounter before a package becomes a necessity. • Care workers that are trustworthy and are vetted by the Care Companies. • Help with shopping for those with no family support used to be provided but sadly no longer. • That people have proper warm meals prepared.

Discussion Sessions, OPEN February 2017 Forum (right)Suzanne Clarke, OPEN Engagement Officer (middle) Linda Stone, CareLink Team Lead 15

2. What concerns do you have about home care and what changes do you think Stoke-on-Trent City Council should consider?

More client time/lengthier calls and social interaction: • There is a pressure on professionals to put care plans in place that provide as minimal visiting time for a care worker as possible. If a client needs a longer visiting time, they really have argue their point of view. • Caring for people in the community – the City Council does not give adequate time for carers so that they can provide a decent service. • Time needed to build up confidence of person receiving care. • Concern that calls will be cut shorter and needs won’t be met. • Some carers did not always carry out all the tasks they were supposed to, often due to the time limits imposed on them. • Time pressures mean care workers do not have enough time to do what they are supposed to do properly and have no time to chat. Both clients and care workers would like time to chat to build better relationships and understanding of each other. • 15 minute visits are unacceptable. • 15 minutes is far too short amount of time in which to do anything. • What people wanted from a carer was less to do with providing services such as cleaning, making meals, dressing wounds etc and more to do with social interaction. The group agreed that the most important thing for many housebound people is having someone to talk to. • More time to chat to the client. • More time allocated during visits for the carer to listen to the needs of the older person. How can an older person convey their needs during a 15 minute visit? • That there is no time to chat. • A carer may be the only person a client will see in a day – there needs to be more time to allow for a more personal approach rather than rush in, rush out. • Care workers are often rushed and stressed. • Care worker are often too target, time driven, rushed. • I have someone come in for 15minutes to fix by dinner. It isn’t very long, but it breaks up my day and is it’s nice for someone to visit me. • I feel very isolated and would like a home care service that provides more social interaction. • It’s very depressing being by yourself, care is good but I need more opportunities to get out of the house or at least some more social interaction with my carers. • Not so much about the care but support to get out of the house to take people to social groups. • Some people seemed happier with the care they received from organisations that were selected independently of the City Council. They were still expensive but the care workers from these organisations spent the full time there that had been paid

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for and would engage in social and leisure activities. Also the same person came each time so they could build up a good rapport. • Older people who can’t talk – how do they communicate their needs to the carer?

Care workers arriving on time and completing tasks: • Carers often arrive late, leaving people in bed until almost lunch time. • A lady paid for a care worker to spend three quarters of an hour carrying out tasks, but they only spent 15 minutes. • Care workers are often late and are rushed, not staying long enough. • Spending call time filling in paperwork instead of delivering care. • Some carers proved better than others by showing a more human touch, some just filled in their records and did as required but without much thought for the person being cared for e.g. made a breakfast but left it to go cold. • Spend a lot of time filling in forms and less time doing what they are there to do. • Carers not turn up on time / often late and do not let you know that they are running late. • Concerns that jobs are not done. • Care workers have too much paperwork to do to the detriment of caring for their client.

Care visit times and flexibility to suit the client: • Most carers did their job but often not to the satisfaction of the person being cared for because it was not at the time they would like e.g. being put to bed at 8.30pm. The group agreed that carers need to be able to respond to the needs of the cared for by meals, putting to bed etc at the times they would like. • Everyone’s needs are different – there needs to be more flexibility around the times a carers visits. • Clients are not receiving services at the times they require, often services are delivered at very inappropriate times eg. being put to bed at 6.30pm. Services need to coincide more with the wishes of the client / normal body clock –more care staff needed. • Difficult to arrange care for people with dementia. • One lady upon leaving the Nuffield had some very good care arranged mainly with the help of the district nurse. She liked the carers but they came at unsatisfactory times eg. they did not come and help her out of bed until 10am. • Not turn up at convenient times for putting the client to bed – too early. • Care often not provided at times to suit the client. • Care workers work programmes seem very regimental. It might help both the client and the care worker if there was a bit more flexibility.

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Allow for travelling time between visits: • Travelling time between clients. • Travel time not included in pay, discourages recruitment/retention of staff re pay level. • Proper mileage rates. • Agencies need to give carers travel time between calls so they’re not rushing calls. • That paying for care workers travel time. • Carers need to receive decent wages and be paid for all the hours they are at work, including travel time. • There needs to be better planning by Care Agencies about which carer visits which client. One carer had to go from one of end of the city to another for a different visit and the agency didn’t plan for travelling time, especially in rush hour traffic. • Some carers did not turn up at all.

Different care workers visiting each client:  Multiple carers visiting one customer – I had to keep telling my carers what my needs are. For example, everyone likes to be washed in a different way but carers will come and try and force their way on everyone else. Care lacks the personal approach and takes away your individual preferences and rights. • Continuity of carers. • That different care workers visit rather than the same person each time. • Some weeks there are four different carers that come in every day - people need to feel safe in their homes and be able to get to know the carers that comes in. • Lots of different carers / not knowing who will turn up. • It is great when the same care workers come each week and the client is able to get to know them and feel at ease with them. • The client has developed a good relationship with the care worker – the care is done by the same person.

Hospital discharge and home care services: • More available care whether temporary or permanent for supporting people to be discharged from hospital. • A few months ago while working at the hospital ward 81 (women’s) side was full of women medically fit for discharge – 3 waiting for assessments to be done to access care homes, but the other women were waiting for packages of care. • Vicious cycle of hospital discharge and inadequate care therefore back in hospital. • Mother in law was discharged from hospital – had a care package but didn’t fit needs (weren’t co-ordinated with medication needs, ie. Not coinciding with medicine times). Also visits close together therefore medication too close together therefore reinforcing medical issues.

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• Discharge co-ordinator required to oversee discharges, care packages and monitor progress. • Lack of coordination / communication between health and social care professionals – caseworker to oversee hospital discharge and ongoing care. • Several ladies explained how they had care arranged for them whilst in hospital so that upon their discharge they had care workers coming into their homes to help with various things. Both ladies said how within a week they had changed the arrangements because they felt the care workers were unnecessary. • Nuffield and Macclesfield hospitals are less likely to help arrange care packages following dismissal from hospital. It was left up to visiting district nurses to help arrange. • Care not provided pre-hospitalisation only after. A complete package should also include a care worker helping to get the client to the hospital as well as getting the client home after their stay in hospital.

Recruitment of care workers and appropriate training: • We need to value and offer a higher pay scale to Care Workers. They are working with one of the most vulnerable groups of people, and yet, they are not paid well and have to deal with very stressful situations on a daily basis. You could work at Tesco for minimum wage - what does this say about how we value older people in our society? • Proper training for carers. • Carers that do not communicate well / unable to gel with them • Often young girls do not seem cut out for the job, more mature carers are often a lot better. • Often the care worker is not tuned in to the specific needs of their client, lack of awareness / understanding • Some carers not properly trained, one carer had no idea how to dress a client properly. • Concerns about young/inexperienced carers not taking the time to interact with you. They do the minimum and leave. No people skills, recruit more life experienced people. • Care workers suffer stress and low moral due to the demands of the job ie. long hours, poor pay, time pressures, poor car mileage allowance, inadequate training, inadequate staffing to meet demand. These issues need addressing. • Morale is low and care workers are often under-valued / stigma attached to being a care worker. Need to boost the value of care workers, perhaps re-brand, call them nursing assistants. • There is a high turnover of care workers – this needs addressing to ensure happy, motivated, caring staff. • Care workers not able to administer medication.

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• Often care workers are young and lack life experience, maybe more mature care workers would be better. • Often care workers are unable to communicate effectively with older people. • Care worker jobs are poorly paid with poor terms and conditions. Work programmes are very rigid often with little room for flexibility and use of common sense. • Need to improve retention of staff. Need to make care working more of a vocation – pay better, provide quality training, make it something people feel proud of doing. • Need to select right people to become care workers. • Do not treat people like individuals, no personal touches • Carers do not actually seem to care. Lack of interpersonal skills. Too young. • Not sure how well care workers are vetted. Need to ensure care workers and care companies are thoroughly vetted and are subject to on-going vetting / spot checks • On the whole most of the people spoken to that had received homecare or knew someone that had, were happy with the experience and were positive about the carers and the service they provided. Just one lady found the experience very poor, though she did say that one of the carers, a more mature chap, was good, he had nice manners, was personable and would phone if he was running late, but the rest were young girls who did not seem cut out for the job of caring.

Financial feedback and value for money • Charged for visits that never actually took place • Access to funding to pay for care benefit services. • Higher charges at certain times of year (eg. Christmas holidays). • Home care is not inexpensive, so the service needs to provide value for money. • That not receiving value for money. • Does commissioning reduce the quality of care because care providers competing against each other for contracts, so keep costs low?

General feedback: • I’m looked after very well and I don’t have any concerns. • One lady whose mother was being cared for left a book out for care workers to put comments in about the care they had provided her mother with that day and note any concerns and also for her to leave notes in for the care workers. • More assistance should be given to Voluntary organisations to help motivate community groups into helping to provide better care for older people. • People often have to wait a long time for equipment or adaptations to be made to their house which means they can be stuck in hospital for many extra weeks. Equipment and adaptation provision needs to be quick so as to help prevent bed blocking. • Can sometimes be difficult for an older person being cared for to deal with problems with their care provision themselves, they often need someone to help them sort out issues. 20

• People seemed happier with the care they received from organisations that were selected independently of the City Council. They were still expensive but the care workers from these organisations spent the full time there that had been paid for and would engage in social and leisure activities. Also the same person came each time so they could build up a good rapport. • Several other people said how they rely on family and friends for support. • A lady used her care allowance to pay to employ someone to take care of her which she found very satisfactory • One lady explained how she had terrible problems trying to find a good care home for her father, she went round a number and was not impressed by the quality of service and staff at any of them. • Very satisfied marvellous care, very friendly and kind. • Very concerned with the loss of the maintenance of home installations like the lifts through the ceiling. This could be a big problem is a disabled person is stuck in the lift late in the evening or over the weekend. Please consider your savings (maintenance and insurance) as very little compared to the increased problems for the disabled. Austerity measures will be more expensive in the long run and defeat the object. • Council contracting out services to private companies reviewing to make sure services are still satisfactory – fit for purpose. • Managers of care companies report to council on contracts not carers themselves. So care staff should be given the opportunity to share their views etc. • Taking care back under the council. • Overriding feeling that people who don’t have someone to represent them are “done to” with a minimal standard of care. • If the older person doesn’t have someone to speak up on their behalf they very much get what they’re given – done to rather than cared for. • Several mentions of family members who don’t drive finding it difficult to arrange transport to visit and support relatives to take pressure off carers • A few comments regarding being quickly offered private home care before knowing what was available from social services • Meals are unsatisfactory.

Hilary (left), OPEN Committee member 21

3. How can Stoke-on-Trent City Council most effectively communicate with people who use the home care services?

Council outreach services: • Several ladies explained how there used to be council facilities in the neighbourhoods where they could go to for advice on Council services. They suggested that having locally based Council offices was very useful for popping into to obtain information on all sorts of matters. • It was suggested that maybe some sort of pop up advice service could be provided whereby once a month the Council visit a neighbourhood and offer help and advice on all matters that the Council deals with including social care. • Suggested that the Council should have officers coming out to talk to groups about their services.

Hospitals, GP’s and Health Centres • Appears to be varying approaches and a lack of joined up working by the various organisations involved even within health centres where internal communication between those working in the same centre seems lacking with no clear, concise approaches being offered to clients. • Some found GP’s and hospital staff very informative whilst others were not given details and had to rely on family members to research assistance for example one lady claims was offered no help after hip replacement operations • Better information about domiciliary care should be made available at GP surgeries and in hospitals, especially hospitals. • A few people suggested they would like to feel that the hospital or their GP could provide good advice and have someone available to help arrange home care. • They suggested that key venues e.g. GP surgeries should have information about home care available e.g. leaflets and know who to sign post people to for help and advice about home care. • GP surgeries, hospitals. • Hospital tend to do a fairly good job arranging home care through social services and other service providers, though one lady said that she found the information was all a bit confusing and would have liked a pack that set things out more clearly. • Quite a few people would like to be able to go to their GP surgery for advice on home care, both to help arrange. • The group felt that it would be useful if they knew that they could go to their GP for advice on home care.

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Provide a point of contact: • First point of contact and make sure it reaches all levels. • Some issues with first point of contact to explain help available to folk when required for example where is first port of call to give advice on availability of care is it GP, hospital, social services or care providers? • It would be useful to have a phone number that would give a direct line to someone who can help them arrange home care provision. E.g. a card they could stick on the fridge. People using home care said that they know how to contact their care provider if they have any issues / problems. Effective communication systems established between care providers and clients with other emergency numbers.

Voluntary sector organisations: • Age UK is one organisation that people might contact about home care so would expect them to be well informed and able to signpost. • Residents suggested key organisations e.g. Age UK • It was suggested that the CAB, Saltbox, Age UK should all be well informed about home care so that if contacted by someone needing home care they know exactly who to signpost them to, or could help arrange home care on their behalf. • Would like more information available about home care, made available through organisations that older people are aware of e.g. Age UK, CareLink via Saltbox.

Telephone services: • The gentleman feels fully informed and has received a good amount of help and advice. He has contact details for some really useful people. • How do you complain when something isn’t going well with your home care – a telephone number would be good. • It would be useful to have direct line to social services to report problems and not have to go through lots of pressing different buttons depending on what service you need, a lot of older people find this confusing and think the voice is live and try to talk to it. • Most of the communication is by phone and this is most suitable for the client, especially now he has a hearing aid. • Most people when asked said that if they had reason to arrange home care they would phone social services, in which case it would be really useful to have a phone number that would get them directly through to someone who can be of help. Most importantly is being able to get directly through and having someone who can actually help rather than pass them onto someone else. • Most of the people asked said they would phone social services if they needed to arrange home care but that they do not know much about what care is available and what allowances/benefits they might be entitled to

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• Telephone call to check whether care is satisfactory. • Withheld phone number – unknown caller not known who to call back. • If carers are running late inform by telephone call. • Answer phone – are often not followed through. • On hold – Frustrating.

Emails/Internet/DVD:  The City Council could put together a DVD that explains all about the services they offer, what people are entitled to and sets out the service users rights from the beginning. • Use of emails for feedback – spam difficulties. • A lot of older people don’t have computers. • The majority of people said that they would not want to use the internet to investigate / access domiciliary services. • Most of the group would look to the internet for info on home care – this is unusual for most groups met. • Not so keen that information is provided on the internet because two thirds of the group would be unable to access the information that way and would need someone to do it for them.

Literature: • Newspaper adverts. • Through media such as the local newspapers, free papers etc. • Give a bag for life to all older people receiving home care that includes leaflets and information about the care services available in the city.

Face to Face - via the care worker/care plan assessment visit: • Leaflets to be distributed by staff carers. Train the staff to consult with people receiving care or their representatives. • Care plan initially along with risk assessment. • Face to face first preference • Care workers filling in questionnaires with service users. • Face to face. • Prefer someone they can speak to over the phone or face to face. • They suggested that it would be really useful if someone could visit and offer one to one advice, help sort out care provision and help sort out allowances/benefits. • Being visited at home is also a preferred means of communication.

Household bills: • Publicise via other mailings, such as council tax bill.

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Hospital discharge packs: • Hospital discharge packs (similar to packs given to new mums).

General feedback: • Publicise POA – completion of lifebook – will, accounts, funeral wishes etc. Later informing of care services are a good reminder of details (dates/times/services provided). • Suggested that a handbook on home care would be useful. It needs to be easy to understand and in plain English and available as a hard copy as well as on the internet. • Social services tend to sort problems out quite well but complaints made to the care companies are often not sorted out so well. • Often older people find it very difficult to manage their own home care and need someone else to do it on their behalf e.g. a family member, so it is important that communication from the care company/workers is not just with the client but the client’s family or some other appointed person. A card with a direct phone line on would be really useful, something that could be stuck on the fridge or put in their purse. • Many of the group were uncertain how they would find out about home care. • Many people would not know what to do and who to go to when needing to arrange home care. • Several ladies did not know who they would need to contact to arrange home care. • Most people would not know where to go to find out about domiciliary care services.

Forum Discussion Session, 23 February 2017

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Our Partners

 Age UK North Staffordshire, Help at Home Scheme

 Cancer Awareness

 Green Door

 Healthwatch Stoke-on-Trent

 Revival Home Improvement Agency

 Staffordshire University, City of Culture Bid

 Keele University, Psychology Department

 Disability Solutions

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February February OPEN 2017 Programme Forum Appendix A Appendix 27

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