Healthwatch Richmond Care Act Consultation June-August 2014 Acknowledgements Authors: Louise Smith, Keisha Forteau, Mariangela Presti & Adeola Adeleke Contributors: Mike Derry, Rachel Kidd, Bruno Meekings, Derek Oliver, Linda Nelhams and Nadine Hassler, Amanda Brooks and Peter Hughes. A big thank you to those who supported us throughout the consultation period: Kathy Sheldon, Margaret Dangoor and Allan Lockett. We would also like to extend our thanks to the individuals at the organisations we conducted outreach sessions to: Age UK Richmond, FISH, Ethnic Minorities Action Group, Alzheimers Society and the Twickenham Wellbeing Centre. Contents Summary .......................................................................................... 3 Introduction ...................................................................................... 4 What we did ...................................................................................... 5 What we found................................................................................... 6 Prevention ..................................................................................... 6 Information and advice ...................................................................... 8 Finance ....................................................................................... 10 Deferred Payments ......................................................................... 12 Eligibility ..................................................................................... 14 What Next? ..................................................................................... 15 Further information ........................................................................... 15 Appendix 1: Healthwatch Care Act consultation Event .................................. 16 Appendix 2: Care Act Event Facilitation Question Route ................................ 22 Appendix 3: Analysis of Event Participation ............................................... 24 Appendix 4: Healthwatch Richmond Surveys .............................................. 28 Summary Healthwatch Richmond conducted a multi-channel programme of community engagement to support the local council in responding to the Care Act consultation. We focussed on three sections of the Act; prevention, finance and eligibility. The results of our engagement are summarised in this report. Prevention Participants highlighted the need for more support services for carers and service users. There was a call for improving and increasing access to services for social interaction and recreational activities to encourage the community to remain fit and healthy. When asked about accessing information, participants identified the need for one point of contact to simplify the process. Most labelled their GP as the most important individual to go to for information. It also became clear that the local authority should make better use of networks of organisations, and that there was a need for better integration between services, carers and service users. Finance Responses to question on renting out the home to cover the cost of care were mixed. Many participants said they would not want to rent their homes; others expressed the need for logistical support, good communication from the council and good management of the process. Eligibility A separate survey on eligibility showed a high level of uncertainty about the eligibility criteria. Concerns were raised over a perceived lack of personalisation and flexibility affecting the ability to maintain the existing level of access to care. The importance of personalisation was consistently repeated. Individuals want one point of contact, one social worker and information from the GP. Also repeated regularly was the need for the local authority to improve their relationship with the community through open, transparent and clear communication and to work in partnership with the NHS, carers and service users to coordinate care in a meaningful way. Introduction Healthwatch Richmond is at the heart of the local community. As the independent local consumer champion for health and social care, we play a key part in enabling people to become active residents. We effectively engage and involve individuals, organisations, professionals and the wider public to facilitate genuine improvements in health and social care services in Richmond. Healthwatch Richmond ensures people are aware of the health and social care services available to them and how they can get the best out of these services. The London Borough of Richmond upon Thames presented us with an opportunity to support them with their engagement around the Care Act Consultation. We implemented a multi-channel engagement programme focussed on the Care Act working with key public stakeholders. The implementation period began on the 24th of July 2014 and ended on 12th of August 2014. This response is based on the findings gathered from all the work we have done during this period. What we did A number of methods were used to gather responses. Two online self-completion surveys on prevention and finance, and eligibility were conducted. We also provided the opportunity for the public to complete a free postal response survey. We received 64 responses to the surveys. A newsletter was produced explaining the Care Act in detail and was sent to the Healthwatch Richmond mailing list of 650 people. Additionally, we contacted and sent information to 26 organisations and sent posters and flyers to libraries and pharmacies and provided posters to be placed in the community notice boards. We also placed an advert for the event in the Richmond and Twickenham Times. We conducted 8 outreach sessions which involved around 150 participants in open- ended discussions about the Care Act. We also conducted a public event which engaged 65 individuals in a more in-depth explanation and discussion of aspects of the Care Act. Groups targeted through our outreach and engagement work included: carers, people over 65, service users, individuals with mental health needs and professionals. What we found We asked the following questions to participants during the consultation period, June- August 2014. The findings below are summarised from 8 outreach sessions across the Richmond borough, the Healthwatch Richmond Care Act event and through answers from the two paper and online surveys accessed through www.healthwatchrichmond.co.uk. Prevention Q1A.What could help prevent, delay or reduce the development of care and support needs and enable people to remain in their own home or continue caring for as long as possible? This question was intended to provide clarity to the local authority about the range of preventative interventions, the kinds of people who may benefit and the circumstances in which a person may benefit. The need for more support services for carers and service users was heavily emphasised. Community support was identified as a key support mechanism that needed to be increased in the borough. This included: More and enhanced support services; some carers found looking after their homes in addition to full-time caring was too much for them. “We need to be properly assessed, given the correct service for example, physiotherapy, meals on wheels, befriending, and help with housework.” Increased support for accessing regular social interaction Better transport facilities like free bus passes Day care centres Encouragement to use leisure and recreation facilities Better quality, longer visits from paid carers Better monitoring of domiciliary care providers More accessible peer support networks In addition, informal groups, networks and services which currently exist to support carers and service users were identified as needing extra help from the local authority in order to improve and continue their work. A large number of comments from participants highlighted the importance of GPs in the overall structure of care in the community. They were identified as having the potential to predict care needs and to provide a ‘social prescription’ for activities to enhance prevention. It was also agreed that GPs need to provide better information and signposting about community activities and organisations. Additionally, participants requested better integration between care services and the NHS and improved hospital discharge plans. Advocacy was also highlighted as an important service to have available, so individuals can access support and advice around their rights. The importance of personalisation was also drawn out of the responses to our engagement. Individuals want a single point of contact, one social worker, and information from their GP. Carers Our engagement included a question focussed on carers. As the Care Act gives the same rights to carers as service users, it was important to ask what kind of additional services would benefit carers in the community. If you are a carer, what services would help you to improve your wellbeing, remain healthy and able to continue caring? The majority of responses highlighted the need to be able to pursue personal interests, socialise and maintain active contact with support and peer groups. Having an opportunity to learn new skills was also identified as potentially contributing to their wellbeing. Additionally the following services were suggested: Support for the mental wellbeing of carers More respite care services Carers need support and information and encouragement in keeping fit and healthy More accessible peer support networks