Minutes:
Arising from
discussion the following points were made:
i.
A Member shared his recent experience of a
family members stay in hospital and raised concerns about the lack of
discussion with hospital staff prior to discharge regarding their reablement
needs. He suggested that a critical
factor that had not been but should have been considered early on was the level
of capacity and ability of the person prior to their stay in hospital. The Member suggested that this would provide
a baseline to assess a person against to help determine what support was needed
to help an individual’s return to that level of independence wherever possible. The Member further suggested that hospital
staff should be preparing patients days before their return home as part of
their care in hospital to reduce the amount of support, if any, the patient
would subsequently require. The Member commented that it was only after his
family member had been discharged from hospital that these discussions had been
held with the Homecare Assessment and Reablement Team (HART) by which time
their condition had already deteriorated resulting in more home care support
being required. It was suggested that
holding these discussions and providing early support would help avoid the need
for long term dependence on costly local authority adult social care services
in a number of cases.
The Committee thanked the Member for sharing their personal experience
which provided an important way of identifying issues within the system that
needed to be improved.
ii.
The Director commented that it was the view of
the Council that if part of medical treatment included a period of recovery,
that should be part of the whole NHS treatment pathway, and should not be seen
as separate, as recovery was as important as the treatment itself. However, the Director said that the sheer
number of people waiting for hospital treatment placed intense pressure on the
NHS to free beds. This had been
particularly so since the Covid-19 pandemic when a number of
operations had been cancelled. To
achieve the most effective long-term outcome for patients, they needed to be
helped more whilst in hospital. However,
this was not the most efficient approach for the NHS as this would mean beds
could not be released as quickly as needed for the large number of patients
waiting for treatment.
iii.
Members were assured that the treatment pathway
across the whole system of Health and Social Care was being looked at and
improvements were being made. The Council was working collaboratively with the
NHS, which was now funding the expansion of the Authority’s reablement service
considerably. At present the service did
not have capacity to assess all patients before they left hospital.
Approximately 20% of people currently left hospital and went straight to home
care without reablement support. The
added funding from the NHS would help to address this and ensure everyone got a
reablement assessment before leaving hospital in future. Avoiding a person’s dependency on long-term
home care was primarily in the patients best interest,
as well as avoiding more costly home care services.
iv.
Members noted that the Department was developing
a pilot aimed at getting support workers into the hospitals to work more
effectively with the patient particularly regarding their reablement needs, before they are discharged. Members acknowledged that this would be
easier to do in community hospitals and most difficult in an acute hospital
where treatment was fast-paced and where there were bigger queues of people
waiting for treatment and therefore greater demand on bedspace.
v.
Regarding out of County hospitals, there tended
not to be link workers on site in the same way as in County hospitals, simply
because there was not the resource to have people on site in every hospital.
There should, however, be contact and information forwarded on a patient to the
Authority in a timely way in order for a link worker
to meet the patient and family prior to discharge. It was noted there tended to
be better communication with some hospitals than others.
vi.
A Member noted that a positive example of
community working, was of a parish council who had stepped in to help with
funding for Hathern library which also acted as a
small community hub. The Cabinet Lead
Member noted the innovative work in museums and libraries, and increased
footfall which was higher in some places than before the pandemic. A letter had
been sent from the Director and herself thanking libraries and museums staff
for all of their work.
vii.
A Member noted that statutory guidance stated a
review of care plans should be undertaken every 12 months but that the Council
did not complete all such reviews within that timescale. The Director advised that under the Care Act
there was no time limit for carrying out initial assessments, but that reviews
should be conducted every 12 months, but to the best of his knowledge this had
not been tested in the courts. He added
that the Department had a 76% review completion rate within the required 12
months which was considerably above the national average of 55%,
but assured the Committee that the Department would continue to aim to
achieve more subject to resources. A Member queried if, amongst the 24% that
did not receive a review, if reasons were known, for example, refusal to have a
review. It was noted that the information on non-reviews was not captured.
RESOLVED:
That the report on
the update of the Adults and Communities Department’s performance for the year
2022/23 be noted.
Supporting documents: