Older Peoples Partnership Board

Ely Library
7 March 2016
Minutes
Present
CB Charlotte Black
HB Helen Brown
CBr Claire Bruin
SC Sally Cleghorn
GC Gloria Culyer
FD Frances Dewhurst
PD Peter Durrant
SG Sarah Gove
KH Kate Hales
RJ Rita Jones
DM Diarmid MacKenzie
BM Beth McCabe
TM Theodore Mfuni
LO Lynne OBrien
BP Barry Payne
MS Matthew Smith
LSta
LSte
AS
FS
BW
EW

Linda Starling
Lesley Stellitano
Anne Streather
Frances Swann
Brian Walker
Enid Wheatley

Service Director, Older Peoples Services, CCC

Chief Executive, Carers Trust Cambridgeshire
Service Director, Adult Social Care, CCC
Admin Officer, Cambridgeshire Alliance
Chair of Board, Chief Executive, Age UK Cambridgeshire,
Director, Cambridgeshire Hearing Help
Independent older person
Fenland District Council
Healthwatch
Services Manager, Alzheimers Society
Independent older person
Development Officer, Cambridgeshire Alliance
Strategy Manager, CCC
Service Development Manager (Older People), CCC
Independent older person
Asst Director, Improving Outcomes, Cambridgeshire &
Peterborough CCG
Independent older person
Independent older person
Chief Executive, Cam Sight
Supported Housing Manager, Cambridge City Council
Chair, Cambridgeshire Older People Enterprise (COPE)
Independent older person

1. Welcome and apologies

Apologies: Margaret Coles, Tracey Cassidy, Jenny Egbe, Pat Guy, Jane Wisely,
Ruth McCallum.
For operational reasons Agenda Items 6, 3 and 5 were dealt with in that order before
Item 2.

2. Independent Older Peoples feedback

The main issues discussed at the pre-meeting were as follows:
Difficulties of people accessing services

transport

motivation

knowing about what is available.

DM - Through the Credit Union two community groups approached them to set up
accounts. This supports older people. How do they know whats out there?
HB - theres been a national study on the elderly frail. Their main barriers to going
out are transport and continence.
PD - City Council has taken on Common Banking but CCC has not responded. Its a
challenge to get the statutory and voluntary sectors to work together.
BP - publicising is difficult. There are only 4 members of the Friends of Chatteris
Library and getting younger people is hard.
GC asked the Board what single thing each member could do and what can the
Board as a whole do to promote what was discussed at the pre-meeting?
GC highlighted that the Board accepted the last minute change to the running order
of the meeting but from now on IOP discussions should take priority.
TM - building resistance. He has to transfer strategies and ideas into action. At the
next meeting he will come with a plan. He wants to continue the conversation, looks
at the community as a whole. Wants to work with the OPPB to develop strategy.
Action: feedback to BM what goes on locally.
Action: BM could facilitate an intermediary meeting, wants action to come out of it,
ideas to help older people to get out etc.
GC - could the IOP meet in a cafe, share contacts?
DM - professionals have the will but there are challenges around paperwork,
resources etc.
3. Update from the Older Peoples Team
The challenge is to implement change fast enough.
1. Early Help i.e. that support is available before someone needs a formal
assessment.
Many older people want a personal phone call and/ or to meet someone.
The team has identified staff who will support Customer Services at the Call
Centre partly as triage and/ or to settle an issue on the spot. There will be
advice on benefits, financial assessments, equipment. An Occupational
Therapist will be on the team and possibly a representative from the voluntary
sector. CB is confident it can work.

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2. Safeguarding. The process is too complicated. Need to think about the

outcome for the person who complains.
3. Implementing Transforming Lives. Action on the two previous points
should eventually free up some staff. The aim is to be proactive.
4. Shared Lives scheme. On a paid basis a person is prepared to take an
individual for respite or on coming out of hospital. This is in the early
stages.
5. Work on sharing information with between CCG, CPFT and
Peterborough. Main focus is on way CPFTs Neighbourhood Teams
operate. Uniting Cares One View is not going forward.
6. Better Care Fund guidance came out late. Have received 30,000 from
the Local Government Association towards creating a directory. Mark
Freeman is the rep for voluntary sector.
7. Current care packages are being reviewed.
8. Keen to get re-ablement service working on prevention as much as on
discharge from hospital.
9. Day Centres how best to use them in connection with Transforming
Lives.
10. CCGs Vanguard project aims to improve responses to mental health
crises.
11. Home Care contract is due for re-tender and they are considering how
to improve the contract.
12. Accommodation Strategy Richard ODriscoll and others are working to
avoid an incremental approach.
13. Community Hubs to provide a one stop shop as part of work on
community resilience.
Q&A
DM - knows two villages where 180 people have personal care packages at
1.2m.
CB - it is a challenge to remain person-centred and to get staff.
PD advocated using the resources in the community.
GC - those with personal care are the frailest in the community.
CB they are often complex cases. Sometimes on leaving hospital high cost
care is put in place without any check say 6 weeks later to see if it is still
appropriate. Have had good examples of staff who have worked creatively to
put the right support in place but this can be intensive work.
BM - Will there be an opportunity for IOPs to be involved in the new Home
Care tender process?
Action: CB welcomes feedback via email directly on any of these items.
CBr said Ken Fairbairn would be happy to come to the OPPB. The tender isnt
due until April 2017.
Action: BM to invite Ken Fairbairn.

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4. Break
5. Support Planning Changes
CBr explained that she is Director for Learning Disability, Physical Disabilities,
Sensory Services, Autism as well as Social Work practice, Safeguarding,
Carers and Procurement.
Effects of the Care Act.
1. Have worked on support planning
2. Need to consider if the approach supports Transforming Lives but must
work within financial constraints.
3. Changes will impact on different people differently but it is important to
remember that planning of care and support is personalised.
4. Guidance to staff is key to successful delivery. It will be based on most
cost-effective service, not necessarily the cheapest. This can take more
investment early on but have better outcomes later.
5. Will focus on an individuals networks.
6. With learning disabilities packages have perhaps been too risk averse
and so have more staff just in case.
They are now trying a different approach, i.e. how to develop contingency
plans differently, aiming for outcomes that maintain independence. CBr gave
examples of people in a group location who share support staff rather than
having 1 to 1. Some people have 24/7 support but also go to day care so is the
council paying twice.
They are being more explicit about costs but also include choice.
A new element in the Care Act is that individuals can use their own resources,
so what will this mean for those who wish to provide services?
Q&A
FD - What back up is available for individuals?
CBr - if staff include a persons network in the planning then they must also
discuss contingency planning. They might need to be more pro-active in
monitoring a situation.
HB - how will outcomes be measured?
CBr - have tested it with a learning disability group. Have tried to capture which
interventions made a difference but without being time-consuming for staff.
FS The key policy lines in the presentation refer to identified eligible needs.
CBr - an assessment will identify the range of needs an individual has. The
Care Act gave national eligibility at Substantial and Critical which
Cambridgeshire is already using.

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FS - Housing related support often meets low and medium needs and is a
good preventative measure.
BM - there seems to be a direct conflict between personal choice and support
planning changes e.g. if a person currently lives alone in 24/7 care will they be
asked to move into a group or shared home?
CBr - They would possibly want to discuss this with an individual. If someones
needs could be met by living in a group this would be raised.
PD - seem to be on the edge of community development but not using
available research e.g. Bromley- by-Bow.
CBr - this is an ongoing process.
GC - do you have the figures for those who can use their own resources?
CBr Adult Social Care deals with around 8,000 Older People, 1,600 with
Learning Disabilities, 1,000 with Physical Disabilities, 1,000 with Mental Health
conditions. At financial assessment around 25% of those have sufficient
resources to pay a contribution i.e. they can pay for enhancements to their
package.
Action: HB will send BM the Dept of Health review on the Care Act.
One local authority (LA) has said if the care package costs more than a care
home then LA will only give that amount.
CBr said they had looked at this with legal advisers but it could destroy an
individuals social network.
AS - if someone has resources can they still have an assessment?
CBr - if someone has needs the council has a duty to assess. Can start with
re-ablement but dont discuss finances at that point. By the time they start
support planning they should know if a person has resources.
6. CCG: Update on end of UnitingCare contract

Stage 1 Focus on services. Following the ending of the contract CCG

took back all the contracts and concentrated on safety and continuity.

Stage 2 What is the future of the Older People and Adult Community
services?

What works well? What could be improved? What stopped? What will
happen in 2016/17?

At the consultation workshop on 25 Feb the main desire from all parties
was joined up care. They are now developing proposals for CCG and
local organisations.

There have been 2 reviews, one internal by CCG auditors and one
external by NHS England. Both have been conducted on the basis of
what can be learned rather than who to blame.

Continuity with plans set in train by UnitingCare namely:

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a) 16 Neighbourhood Teams covering community nursing and mental

health i.e. physical and mental health for older people. The next steps
will be joining with Primary Care, social care and finally the Third
Sector.
b) Joint Emergency Teams (JET) - Aims to have 2-hour rapid response.
Its not perfect but is a good basis to move forward.
c) Wellbeing Service this is particularly about how the Third Sector
works together in a coordinated way to prevent older people from
becoming ill. Identify those who are at risk of losing their independence.
d) One Call this will change to be a more local service including JET and
GPs.
Q&A
GC - what is the time scale for publishing the two reviews?
MS - the internal one should be in a few weeks and the external NHS England
one by the end of this month.
PD said it all seems to be top down. Why not involve older people in a
dialogue?
MS agreed that making this connection is very important and was another
theme that came up at the 24 Feb workshop. 16 local teams are an opportunity
to make that connection. There will be a directory to capture the range of
abilities. The eyes and ears of people on the ground are very important so that
people are supported early on to avoid hospital stays when its not necessary.
FD werent the JET teams making a difference in preventing people going
into hospital? And does the financial situation affect how much they can do?
MS yes there is evidence the JET teams are having an effect but its difficult
to identify what any one team is doing that makes a specific difference.
Are now looking at what they can do in 2016/17 but financial situation has had
some effect.
BW - how are 111 and Out of Hours services connected? Its difficult to know
which one to call.
MS from October 2016 111 and Out of Hours services will be integrated.
Also working with GPs about how to come together to deliver services.
LS - are staff being consulted and is there a current engagement?
MS we are continuing to engage with a range of stakeholders e.g. patients,
Healthwatch, NHS providers, Local Authorities, third sector.
If there is a significant change to services then they are obliged to have a
formal public consultation.
The CPFT is the major employer and has been working with staff over the last
8 months on how things have been working. They have conducted a training
needs analysis.

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7. Chair of OPPB elections

GC - the principle aim is to have an Independent Older Person (IOP) as Chair.
Her role was intended to be temporary and following success at encouraging
new members it was time to elect a new Chair and Vice-Chair.
BM - there can be self-nominations. Do members want to do that by the next
meeting? GC will buddy whoever volunteers.
GC suggested it would be a positive step to make it happen between
meetings.
HB - is support and training provided?
BM yes.
GC proposed nominations between now and next meeting. The Board agreed.
8. Adult Social Care Forum
OPPB will be involved in the new Home Care contract.
BP asked for the links to the UnitingCare reports to be circulated.
9. Action Log and next meeting planning
BM confirmed she is happy to arrange the first IOP intermediary
meeting.
BMs action to set up a meeting with CB to consider the role of Parish
Councils was undertaken by PG who was unable to be at todays Board
meeting.
The Board confirmed that Ely Library is a suitable venue.

Next meeting: Monday 6 June, 2:00pm 4:00pm PM, Orchard Park Community
Centre, Cambridge, CB4 2EZ
Please note that there will be a pre-meeting for independent members which
will start at 1:15pm

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