Agenda item

The Strategic Director for Social Care and Education has sent invitations to the Clinical Commissioning Group, Age UK and Fire Service to attend the meeting to come and speak about what they can do, with regards to prevention, falls, fire and home safety.

The Strategic Director for Social Care and Education had invited the Clinical Commissioning Group, Age UK and Leicestershire Fire and Rescue Service to the meeting to speak about what they could do with regards to prevention, falls and home safety. Apologies were received from Age UK and the Fire Service. Information from the Fire Service is attached to the minutes for information.

Age UK had provided a statement prior to the meeting, in that they did not receive any funding for the type of work referred to and had no dedicated department or person to deliver the service. All staff received health advice on safety and other related training and so were in a position to offer advice and help where needed. It was further noted that up until recently Age UK hosted a falls clinic from a building in Melton Mowbray and had a UHL consultant on the Board whose specialism was falls and trips.

Mr Mark Pierce, Senior Strategy and Implementation Manager (CCG) was present and provided an overview of the system of care commissioned with Adult Social Care for those at risk, or who had previously had a number of falls. A falls prevention leaflet approved for use in the city is attached for information. The following information was provided:

·         Older people fell for a wide variety of reasons. Services not immediately connected to falls prevention were just as important in support, and there were range of medical and non-medical interventions.

·         The Local Authority had statutory responsibilities, for example, good state of pavements to prevent the infirm from falling.

·         For patients who had a trip hazard, a range of services would be commissioned i.e. practical help at home for minor home adaptations, smoothing of services (removal of rugs, etc.) good lighting at night, assistive technology service, either stand alone or plug in, sensors to show a front door had been left open.

·         There were over 5,000 types of devices – 2,500 people were using them.

·         A home-based assessment for environmental checks was carried out for 1,800 people each year. Assessors would also check whether home care was needed.

·         An integrated crisis response service, hosted by the Better Care Fund, had an average response time of 28 minutes, and was crucial in terms of keeping people at home and independent. A pendant alarm could be pressed and had a better response time than EMAS.

·         Patients also fall due to poor balance or heart problems. All GPs were familiar with assessing patients. For those where an initial assessment was not clear, commissioned in the city was a falls specialist at Leicester General Hospital, and included services such as Occupational Health in one place to assess. Balance training for core strength was given, and community-based services, for example gyms, could provide extended periods of physiotherapy, to increase balance.

·         Another group of patients in residential or nursing homes were of higher risk and had a tendency to fall more commonly given the degree of dependency. Further commissioned through LPT was a care team to assess high risk individuals – those who had fallen or were becoming infirm, prescribing equipment if needs be. Also, residential and nursing home staff were being trained to spot those at risk of having a fall.

·         Recently invested through the Better Care Fund were replacement podiatrist approved flat soled slippers to reduce further incidents of falling.

The Chair thanked Mr Pierce for the information.

The Director of Adult Social Care and Safeguarding gave a brief update on actions taken by the Fire Service:

·         Officers in the Fire Service were building relationships with vulnerable adults. Adult Social Care joined in with meetings with the Fire Service, who had a very well-established home safety checklist service, and would provide a home safety check on request.

·         The vulnerable person role was for officers to try to understand, for example, those residents having small fires within the home environment, which may have been caused through other issues, for example, a wheelchair user could not manoeuvre a wheelchair through doorways quickly enough to reach a stove.

·         There were clear lines of communication between ASC and the Fire Service. ASC were alerted and received referrals, which could then be followed up with the individual and families.

·         There was lots of information available with regards to seeking support and guidance, for example, the GP practice to establish a cause that might require further investigation.

The following information was provided in response to Members’ questions:

·         The Care Act included a definition of vulnerability. 5,400 people were in receipt of a service from ASC as they met the definition, but vulnerability was wider ranging. Equipment was provided free of charge, and not means tested under that threshold.

·         The Strategic Director for Social Care and Education sat on the Vulnerability Executive, which also covered domestic abuse.

·         Equipment available included kettle cradles to help tilt kettles, grab sticks, hand rails, specially designed cutlery, for example, for people with arthritis.

·         The Leicester Care Alarm was available to everyone in the city for a small fee (£3 per week if not paying for care), and was considered disability related expenditure, and taken into account as non-available income. The fee covered line rental and staff time. Anyone could have a community alarm and the threshold was low.

·         Persons living with a carer would probably have different equipment provided, for example, ability to support someone in the shower to stand, as opposed to a seat in the shower for someone living alone.

·         The Translation Service (or a competent member of staff) was used to engage with people. Generally a close family member would not be used to communicate with the person as officers needed to know what the person was saying for themselves.

The Chair recommended that the comments be noted and that also the ASC service worked with the communications team to look into putting up prevention materials already existing on the council’s website, in GPs surgeries and community centres as standard procedure. She also asked that the service look at a citywide campaign for older persons looking at prevention and what could be done, as prevention would result in savings for the service.

The Chair thanked officers for their contributions.

AGREED:

1.    That the comments made be noted.

2.    That ASC look into curating a citywide campaign on prevention awareness.

3.    ASC and the Communications Team look into putting prevention materials already in circulation into GPs surgeries and community centres as standard procedure.