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Highland Senior Citizens Network - January Newsletter

10th February 2013

Newsletter January 2013

Happy New Year to all!
This year looks like being even busier than last for the committee AND for all our members as we get more actively involved in planning and monitoring services for older people across the Highlands. Nothing about us without us has to be more than a slogan. We need to ensure that older people get the services they need, and have a right to expect, and to do that we all have to be involved in whatever way we can. Much of this newsletter is therefore focused on how every older person in the Highlands can be involved in the re-design of services in their respective areas.

We are conscious that focusing on what needs to be changed can sometimes give the impression that older people are a problem when, in fact, the reverse is true. We contribute to the richness of life and, massively, to the economy - as consumers, employees, carers, and volunteers (just to give a few examples).

While the HSCN supports the need for different approaches to delivering care we do not necessarily agree with the underpinning assumptions or their solutions to the problem of older people. For example: the Governments statistics show that, as a group, those who are elderly (over 65 years) provide more hours of care than they receive; and that while 40% of over 85s have long-term care plans most remain independent through their own resources. These facts are forgotten in the rush to empty hospital beds.

As part of the solution to creating fulfilling, healthy lifestyles we, as older people, need to play an active part in designing and developing the services we need wherever we live.

Re-shaping Care for Older People
Just to re-cap; re-shaping care is the Scottish governments response to an aged population which is expected to increase by around two thirds in the next twenty years. Unplanned admissions to hospitals and care homes account for nearly one third of the combined resources that we currently spend on health and social care for older people. Unsurprisingly, government policies are focused on reducing these costs by avoiding admissions to hospital and shifting care into the community. The government wants older people and voluntary organisations to be involved in re-shaping care and the HSCN is among those in what is known as the third sector who are now actively involved in the joint planning and commissioning programmes and processes for developing services for older people in the Highlands.
Nothing about us without us

In keeping with other non-statutory and voluntary agencies expected to contribute to the solutions, the challenges for the HSCN are many, but high on our list of priorities are:
Ensuring that the voice of older people is heard at all levels; particularly district partnerships
Ensuring that there are local solutions for local problems and that the dominant mind-set of one size fits all is changed.

Ensuring that community-based care for individuals and their significant others is tailor-made and provided as and when needed

Ensuring that quality is measured meaningfully

How will we do this?
In our last newsletter we informed members that we had been successful in our bid for government money from the Change Fund (the money made available by the Scottish government to help with re-shaping care). We planned to use this money to ensure that older people across the Highlands can be properly involved in all the proposed changes through the part-time appointments of a researcher and an engagement officer. We have been very fortunate in our recruitment of Hazel Allen as our engagement officer and Dr Sara Bradley as our researcher. Hazel and Sara have been working hard on our behalf since their appointments on 1st November 2012.

As engagement officer, Hazel is working with local groups across the Highland Region, to raise awareness of the Reshaping Care programme and to provide assistance to local groups to get involved in their own area with decision making and debate. An early task was an Action Guide explaining how decisions are taken and how to get involved. Please contact Hazel Allen on hazelallen[AT]hotmail.com or through the HSCNs postal address for copies of the guide, and to invite her to any local group meetings to provide more information on the issue.

The active engagement of older people in the development of services involves listening to people about the services that they need, not about the services that health and care providers are set up to deliver. For example, for many elderly people, meals on wheels is not just about the food, but about the company of the person delivering it. For the health care provider, the service is working if more people are fed. For the recipients, it matters if it is the same person, if that person is caring, and if they have time to chat, to listen, and to help the recipient stay independent. Peoples experiences of care (good and bad) are strong and compelling evidence of a successful or failing approach or service. Records of peoples experiences are legitimately used by academics and must not be dismissed by members of statutory agencies whose dependence on statistics have consistently failed to produce cost-effective services
HSCNs Action Research programme is seeking to gather peoples accounts of care in a structured way, to collect peoples experiences and report these back in a way that overcomes the ill-informed, dismissive anecdotal evidence tag. This programme has now started. The Project Officer, Dr Sara Bradley, would be very happy to hear from anyone who wants to talk about their experience of care (good or bad).

Members may wish to be involved directly in this CRITICAL work or might know of someone who may wish to contribute important information on the quality of care. Sara can be contacted at sbradley.research[AT]hotmail or through the HSCNs postal address. If Sara does not respond immediately, please do not think you have been forgotten it will take time to give people the attention they need and deserve.
If preferred, members can call our telephone number (07716884989) and ask to have their details passed to either Sara or Hazel.

Getting Involved
There are many meetings being organised by health and social services professionals as a way of involving local people in the re-design of services. Please watch for details of dates and places in your area and, if you can, go to the meetings and make sure you have your say in what happens in your area and in regard to shared services such as Raigmore Hospital. Our engagement officer, Hazel Allen, attends as many of these meetings as she can get to and recently attended a meeting in Halkirk, Caithness which concerned the re-design of adult services : not just those directly affecting older people but which many older people may use.

Several presentations from key professionals brought to the attention of the audience the challenges of an ageing population, reduction in public spending, and the costs of property maintenance. In spite of the emphasis on cost reduction there appeared to be a commitment to providing quality in re-shaping care and the desire for services to be designed around service users which, it was argued, would be more effective. There was agreement from the audience on the need for change in health and social care and on the importance of involving local people in the decisions affecting them. There was no obvious agreement on what had to change and the way in which the community could be involved.

This is a healthy position and demonstrates that local people care about services and will use this once in a lifetime opportunity to get the services they need where and when they are needed. In Caithness, as in other areas, this work will continue until there is an agreed action plan and, hopefully, beyond this. There are assurances from the professionals charged with implementing changes that the quality of services will not be sacrificed on the high alter of economy. We all have an obligation to make sure that this is so and that the changes improve the quality of life for all the people who use services lets have no more expensive window dressing, or be fooled by the emperors new clothes.

How can the HSCN Help?
There are various views on how older people should be involved in re-shaping services. It is important to recognise that having one or two older people on the District Partnerships that will be set up to plan and develop local services will not necessarily ensure that older peoples voices are heard or that their views will be reflected in the re-designed services. It is not acceptable to have an older person at meetings as a token gesture. The HSCN will work to support and empower local representatives, feeding back to regional groups, and at the highest levels of policy making. It is particularly important that services are re-designed with users in mind and not simply reconfigured. The HSCN will continue to work with statutory, charitable, and independent care providers to jointly promote and support the cultural change across all sectors to ensure that re-designed services have older people at the centre of decisions. Please attend meetings in your area if you can, or ask others to be there on your behalf. Make sure that you have your say.

We need your stories
This is repetition, but we do need to hear from you. Our researcher (Sara Bradley) needs to hear about your experiences of care, whether good or bad, to help us to monitor the quality of services and to support arguments for appropriate service provision. Sara will visit or talk with you on the telephone at a convenient time for you. You can contact Sara in writing at our address: HSCN, Box 301, 24 Station Square, Inverness IV1 1LD; by email: hscn[AT]hotmail.co.uk or by calling the HSCN telephone number: 07716884989. The person answering the telephone will ensure that Sara returns your call.

Delayed Discharge from Hospitals
One of the challenges facing those running the NHS, and Hospitals in particular, is the problem of discharging patients, particularly older patients, from acute hospital beds who are deemed fit for discharge by the medical staff but for whom ensuring suitable long term arrangements is a problem. These can be due to lack of support in the community or lack of a bed in a residential home or a nursing home. All the evidence shows that the longer the discharge from an acute hospital bed takes the poorer the ultimate outcome for the patient.

NHS Highland has set itself the target of having no patients appropriate discharge being delayed longer than 72 hours from April this year. This ambitious target is to be applauded. It does however have tremendous implications for those responsible. It will be impossible without the tangible transfer of resources from the acute sector into the community and the development of innovative ways of delivering community care. It must not result in unrealistic expectations on carers nor hasty readmissions because of lack of community support.
Please contact us if, when implemented in April, you are concerned that this ambitious target is having adverse consequences.

Scottish Older Peoples Assembly
The Scottish Older peoples Assembly was held on 2nd November 2012. The main event took place in Edinburgh and was video- linked to Aberdeen and the Borders (with contributions from Australia and Ireland) by video-link. In Inverness the video-linked event was held in the Chamber of the Highland Council Headquarters. Thirty three people attended the event in Inverness. The theme for the day was Care. In the morning there were brief contributions from a panel of representatives of statutory organisations in Scotland (Confederation of Scottish Local Authorities; Care Inspectorate; Civil Service Policy makers; Health Improvement Scotland; and, the office of the Chief Nursing Officer). Delegates described mostly poor experiences of care and became very angry and frustrated when the representatives of the various government agencies repeated policy mantras in response to questions and challenges, clearly demonstrating a massive gap between policies and the experiences of older people and their carers in Scotland.

In Inverness, there was a presentation from Alzheimers Scotland (Woodlands Day Centre) on a music-based programme which is helping staff to communicate with people who have dementia. Other presentations included the benefits of a talking and listening programme for older people who have low moods and depression (Borders); a computer training programme in a care home in Edinburgh demonstrating the benefits of IT for helping residents to stay in touch with families; an innovative approach to personalising care in Ireland; and, a description of the first ever University of the Third Age set up in Australia as a way of keeping older people mentally active and preventing loneliness.

The Health Minister, Alex Neil, sent a recorded message to the Assembly saying that the Government wanted to hear the voices of older people but, as the government representatives clearly displayed, these voices are not being heard. Consequently, Dr Ian McNamara (Chair of the Highland Senior Citizens Network) proposed a motion of No Confidence in the Care Inspectorate. This was debated for twenty minutes and approved by the majority of delegates in Edinburgh and the Borders, and all in Aberdeen and Inverness.

Motion of No Confidence
Members may wonder why the Care Inspectorate was targeted when all of the statutory agencies present at the Assembly seemed to be listening to but not hearing the voices of older people. The reason for this was because the Care Inspectorate is, allegedly, the independent agency charged with responsibility for ensuring the quality of care for older people in Scotland. The comments from across the country clearly indicated that the Care Inspectorate was failing in its duty.

The HSCN issued a press release about the motion of no confidence and following this a meeting was arranged with the Chief Executive of the Care Inspectorate.

Meeting with the Chief Executive, Care Inspectorate
Seven members of the HSCN committee met with Mrs Annette Bruton, Chief Executive of the Care Inspectorate, at the Inverness Office on 24th January to explore the issues surrounding the poor standards of care in care homes and the apparent failure of regulation and inspection. Mrs Bruton listened carefully to our concerns which were backed by evidence available in the Inspectorates own reports. Mrs Bruton, who took up her post last year, acknowledged that there is a need to develop a more rigorous methodology of assessing the quality of care, both in care homes and for community based care. She is working towards this goal. However, our reservations remain as we feel that the existing legislation within which the Inspectorate has to operate is not used effectively and in some situations does not give sufficient leverage to effect sustained change.

We made constructive proposals as to how residents, relatives and staff could contribute to monitoring care on an ongoing basis; but we need to do more. We feel that our concerns need to be addressed by both the Care Inspectorate and the Scottish Government and to that end we have written directly to Alex Neil (Health Minister), the MSPs, the Chairman NHS Highland, and Audit Scotland. There are some actions requiring a rapid response and others that will take longer to achieve: we will pursue the agenda vigorously.
Members should also be assured that care in the community will come under the same forensic scrutiny as we are using to address issues in care homes. But, this is everybodys business and we need your vigilance and to hear about your experiences.

HUG and Mental Health
In our last Newsletter we informed members that we were engaging with other voluntary agencies in the Highlands who have similar interests. Recently, we were asked to support a bid from HUG Spirit Advocacy, representing people with mental health problems, for funds to develop services for older people with depression. This is a major unmet need among older people and we are happy to lend support to this important initiative. The bid has gone to Comic Relief and we are hopeful that HUG will be successful.

Community Transport in Remote Areas
On 25th February Age Scotland will launch a campaign calling on the Scottish Government to make it possible for older people who depend upon community transport, rather than commercial transport, to be able to use the National Concessionary Travel Scheme (Bus Pass). We are aware that the Scottish Government has just reached agreement with bus operators to secure the future of concessionary travel for over-60s and people with disabilities, and hope that those who have no access to commercial transport can now be given appropriate consideration. The campaign will press for community transport providers to have 100% reimbursement of the fare and not simply the 60% the government reimburses commercial operators. This is because local community transport groups are not able to absorb full running costs in the way that commercial providers can. This campaign recognises the importance of free access to transport in preventing isolation and is to be welcomed.

Changes in Welfare Reform
Members will be aware that the UK government will begin implementing its welfare reforms this year. This will begin in April when Housing benefit Entitlement for working-age tenants in the social rental sector will be restricted to reflect the needs of their household. Claimants will see a reduction in their eligible housing benefit of 14% for under occupation by one bedroom and by 25% for under occupation by two bedrooms or more. Thus, those who wish to have a spare bedroom will effectively face rent increases.

People of State pension age will not be affected by the change in April 2013 but when Universal Credit rolls out in October 2013 other criteria come into place and these may affect older people.

We are collaborating with Age Scotland and the Department of Work and Pensions to assess the impact of these changes on older people and to ensure that the fullest information is provided at the earliest possibility.

Coffee Morning
On Saturday 1st December we held a very successful coffee morning at Inshes Church as a social event for members and their friends. Thirty people enjoyed a splendid array of home-bakes with tea and coffee contributed by committee members and their friends who also helped to prepare, serve, and clear up. While essentially a social event, we took the opportunity to sell cakes and other goodies; adding the sum of 247.00 to our funds. Those who attended have asked us to repeat the event regularly and we will! Hopefully, we will be able to hold similar events across the Highlands.

Annual Conference
This years annual conference will be held on Wednesday 17th April at the Lochardil Hotel, Inverness. Further details to follow.

Telephone Contact
In our Autumn Newsletter we promised to provide a telephone contact for members. We have chosen a mobile telephone as the best option. The telephone number is: 07716884989. The telephone will be held by members of the committee and the line will be active between the hours of 9am and 6pm seven days a week. There will be times when we are unable to answer calls immediately but missed calls are registered on our phone and we will respond at the earliest opportunity. We are aware that calls to mobile phones are expensive and so, to cut your costs, if you call we will take your number and call you back to continue the conversation. We cannot promise to solve your problems but we promise to try!

Other contact details
Mail: HSCN, Box 301, 24 Station Square, Inverness IV1 1LD
Email: hscn[AT]hotmail.co.uk
Website: www.hscn.co.uk

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