Agenda item

(a)       That the commitment across Health & Social Care organisations to deliver integrated support to those individuals living with Dementia and the joined-up approach to service improvements in the future be noted;

(b)       That the development of an ‘Integrated Dementia Action Plan’ and its implementation over the next three years be noted, recognising that it is ‘work in progress’ requiring further agreements in terms of performance measurement and monitoring arrangements;

(c)        That Members seek regular progress reports through the regular quarterly monthly reports; and

(d)       That awareness of issues such as Dementia be encouraged across all the Council’s services.

The Chief Officer (Social Services) presented a report on the strategic approach being taken by Social Services in Flintshire and its partners within the Betsi Cadwaladr University Health Board (BCUHB) to deliver integrated health and social care services to individuals living with Dementia, their families and carers.  He said that the content of the integrated Health and Social Care Dementia Action Plan, which was attached to the report, went beyond the recommendations from the Care & Social Services Inspectorate Wales (CSSIW) inspection earlier in the year to deliver improved outcomes for those affected by Dementia.

The Commission Manager explained that the comprehensive Action Plan would be rolled out over the next three years and contained seven themes which linked with work already progressed on the Council’s Commissioning Strategy for Dementia.  The three recommendations arising from the CSSIW inspection were being addressed through the co-location of Health and Social Care teams, more effective use of Memory Services and the provision of EMI placements.  Reference was made to the extra care facilities in the county together with a range of service provision aimed at helping people to remain living in their own homes.  The Commission Manager outlined work with the North East Wales Carers Information Service (NEWCIS) and Dynamic Care on improved education and management of Dementia where 20 people had already signed up to take part on an e-learning rolling programme.

Mr Sean Page, Consultant Nurse (Dementia) of BCUHB said that good work on Dementia Services in social care had been acknowledged but that there was a need to move to partnership working with a shared philosophy.  The Flynn/Eley review had reported mixed results on integrated Health and Social Care systems across North Wales, with Flintshire recognised as an area where excellent progress had been made.  Mr Page outlined work in a number of areas such as the potential rollout of the ‘Dementia Red’ (Respect, Empathy, Dignity) model across North Wales following a pilot in Denbighshire and the identification of Dementia Champions.  On Memory Services, he was pleased to report that waiting times had been significantly reduced over the past year following improvements to the process and recruitment of additional staff.  Further improvements were being sought through plans to seek accreditation to work to nationally agreed standards; the first in Wales to do so.  In addition, the ‘Butterfly’ scheme had been implemented in community hospitals in Flintshire as a means of helping those with Dementia to communicate and access care.

On request from Councillor Andy Dunbobbin, the Commission Manager agreed to provide specific dates aligned to actions within the Action Plan.

Councillor David Mackie fully supported the joint approach being taken by Health and Social Care on Dementia and thanked all those involved.

Councillor Hilary McGuill welcomed the introduction of an e-learning programme for families of those with Dementia and asked how information could be obtained.  The Commission Manager said that details were available from NEWCIS on Dynamic Care and would circulate an email to the Committee.  On the Dementia friends initiative, Mr Page said it was intended that each GP surgery in North Wales would hold one or two sessions per week where a trained individual was available to provide help and support.  It was hoped that this approach could eventually be extended to other areas of the community, such as supermarkets, to help those with Dementia be more independent and would help to raise awareness.

Concerns were raised by Councillor Stella Jones about monitoring people with Dementia living alone who had no regular contact with relatives.  She felt it was important not to pass responsibility to others, particularly community hospitals.  The Commission Manager referred to the ageing population and said that an increase in Dementia was an issue which required involvement from everyone in the community.  Whilst hospitals were not appropriate for long-term care of Dementia patients, there was sometimes a need for clinical intervention.  There was an awareness of those living alone and the aim was to provide an improved service rather than merely delivering meals.  The ‘Living Well’ initiative to be piloted would enable working with individuals to support their needs and sustain them for as long as possible in their own homes.  The approach was not to shift responsibility, but to work more effectively to support people with improved outcomes.

The Chair requested that for future debate on this item, it would be helpful for the Committee to receive examples of scenarios of different needs, including people who lived alone.

Councillor Arnold Woolley expressed his concerns about future provision of services and communication between sections in view of the reductions in workforce and resources and asked how this would be managed.  Mr Page accepted that this was a real risk and that a person-centred philosophy was needed, which required discussion on how best to communicate and become more preventative.  He spoke of progress already achieved, including the co?location of teams and said that BCUHB had taken on board the comments within the Flynn/Eley report.

The Commission Manager referred to the development of a single point of access across North Wales and the co-location of Health and Social Care teams to help find solutions for people in need of support/advice in a way that suited them.

The Cabinet Member for Social Services spoke of an initiative to develop Dementia-friendly communities, with involvement from Town and Community Councils, local retailers, GP surgeries etc.  Councillor Brian Lloyd said that Mold was one of the areas to be involved in this initiative.

Councillor Peter Curtis welcomed the idea for ‘Dementia friends’ to be located in some supermarkets but felt that putting this into practice may prove challenging.  He asked questions on the level of training required and the potential for including other forms of disability.  Mr Page explained that the expectation was for the individuals to have a basic awareness of Dementia issues rather than expertise, to enable them to recognise and offer help.  He went on to suggest that some people may want to become involved through a sense of compassion or being acquainted with someone with Dementia.  He felt that some supermarkets may respond positively to the initiative as it was in their best interests to encourage their customers to return.

Ms Sally Baxter of BCUHB spoke of the importance in encouraging and supporting awareness of all needs, including Dementia, to help understand how to make life easier for all, including consideration of inclusivity when designing facilities.  She spoke of a shift in care to divert resources and investment where they were most needed in preventative, community-based services.

The Chief Officer (Social Services) commented on the need for challenging decisions to be made across all sections of the Council as a result of reduced resources.  He felt that the Action Plan demonstrated creativity and a balanced approach of investment of service delivery in responding to the needs of individuals.  Whilst it was inevitable that the Council and the Health Board would need to make financial provision for Dementia services, the participation of communities was vital.

Councillor Marion Bateman referred to a recent panel meeting and stressed the importance of having medical professionals or Social Services officers in attendance to consider the needs of all individuals.  She would discuss further with the Housing Regeneration & Strategy Manager.

On a similar matter, Councillor Mackie said it was important for all areas of the Council to have an awareness of issues such as Dementia to ensure that service users’ needs were recognised and responded to accordingly.  This proposal was supported by the Committee.

RESOLVED:

(a)       That the commitment across Health & Social Care organisations to deliver integrated support to those individuals living with Dementia and the joined-up approach to service improvements in the future be noted;

(b)       That the development of an ‘Integrated Dementia Action Plan’ and its implementation over the next three years be noted, recognising that it is ‘work in progress’ requiring further agreements in terms of performance measurement and monitoring arrangements;

(c)        That Members seek regular progress reports through the regular quarterly monthly reports; and

(d)       That awareness of issues such as Dementia be encouraged across all the Council’s services.