UK: Tips for Older People's Services

LONDON, England / The Guardian / Professional / July 29, 2011

Local Government Network
The best advice about providing services for older people
Kate McCann, Guardian Professional

The best bits from our live discussion about older people

Photograph: Linda Nylind for The Guardian

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Donal Hegarty is senior commissioning manger for adult social care, and Joelle Bevington is senior performance manager for adult social care, at Surrey County council
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Think about the bigger picture: Feedback in developing our strategy for dementia has highlighted gaps in services and the difficulty people have navigating the different health and social care services. We have addressed this by ensuring we have joint strategies with our health colleagues and any design models for services that we implement are underpinned by whole systems working. Its critical in this era of financial challenges that agencies work together to ensure the best outcome for vulnerable people and that collectively we can achieve value for money by looking at services from the perspective of whole systems.

Promote preventative care: Its important to provide people with the tools to make choices about what keeps them well and maintains their quality of life, empowering them to be responsible and active in their own community, reducing the dependence on social care.

Offer choices to ensure independence: Housing is a critical ingredient for supporting older people to live independently in the community for as long as they wish to do so. Investment in telecare is an important way of ensuring this independence whilst maintaining safety and unintrusive support. A range of choices in the housing market is important, in Surrey we are working with our 11 districts and boroughs to increase the options available, such as extra care and supported accommodation. We recognise that for some people living at home alone perhaps can increase the sense of vulnerability but it is important that we do what we can to understand and minimise this with regular support and monitoring to reduce the risks.
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Belinda Wadsworth is the strategy adviser for local and regional policy at Age UK
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Focus on workforce: The quality of any service depends on the people who deliver it. Quality of service is the most important aspect of our service delivery model - it's core to everything we do - and having a trained workforce which respects individual choice and promotes empowerment is both satisfying to the professional delivering a service and for the person receiving this good quality service.

Encourage feedback from staff as well as customers: Age UK are participating in the 'social work practice' pilot, enabling professional staff to manage and provide services for which they truly are accountable and believe in, which are designed with their input and experience of providing a service and listening to the daily feedback from people who use services.
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Roy McNally is a development manager for Foundations, the national body for home improvement agencies
___________________________________________________________________________Put the client's view at the heart of services: We've got to remind ourselves that these aren't just services for "older people". These are services we will all be using at some point - so essentially we've got to ask ourselves, 'what do we want of these services?' It is absolutely essential that the views of clients are at the centre of any development.

Hand responsibility back: Just because people get old doesn't mean they haven't got anything else left to give. It's in our collective interest to ensure people live as active and independent a life as possible so as to contribute financially and culturally to our society. When the coalition government came to power [prime minister] David Cameron announced "the end of the age of entitlement and the start of the age of responsibility". These are bold words, but not unattractive to many older people who want to take responsibility for their lives.

Accountability is essential: Services for older people are, in most cases not designed by older people. Recent legislation changes should make it easier to have people employed within a delivery organisation. Manchester Care & Repair is very proactive at employing service users on a paid and voluntary basis to deliver home improvement agency services - and it works. The issue of trust is a key aspect of accountability, and home improvement agencies are in a unique position in this aspect.
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John Galvin is the chief executive of Elderly Accommodation Counsel
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A code of practice is needed: Quality standards become even more essential when services are provided jointly - or even when clients are 'referred' from one agency to another. There is a lot of work to do to refine adequate solutions.
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Liz Hurst is associate locality director at South Essex Partnership University NHS Foundation Trust (SEPT)
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Approach care as a package, not individual elements: There are gaps in how services are provided which leads to a significant number of readmissions and delayed discharges as services are not joined up. In older people's mental health services the need for a holistic assessment of the person's physical and mental health needs are key to maintaining and supporting the person and their carer to remain in their own homes for as long as possible requires a commitment from all services to work together to achieve this. This is not always easy due to conflicting priorities and financial restraints both in the acute hospitals and local authority budgets. What would really help is a joint commissioning strategy across all agencies and even pool budgets.
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Philip Talbot is the chief executive of Age UK Herefordshire and Worcestershire
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Collaborative working and leaps of faith will drive change: There are hundreds of pilot schemes being developed by the voluntary sector in the country which have never had the money to be properly developed or implemented at stage two of a process. For innovation to play a part in the changes we are discussing, there are going to have to be a number of leaps of faith made. It does, however, offer an opportunity here for the voluntary sector to influence change and innovation. The fear is that the voluntary sector is being used as a cost cutting exercise and not a truly innovative source of service delivery.
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Nisha Kotecha is breaks-away coordinator at the National Benevolent Fund for the Aged
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There is a clear need for partnerships and central contact points: A lot of organisations are working too separately. This really affects the impact you can have, so it would be great if everyone could join together. We often tell older people who contact us about different organisations and how to contact them so they can gain as much support and advice as possible.

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