The Care of Older People in Norfolk Conference Report

“The Care of Older People in Norfolk” Conference Report

A conference on ‘The Care of Older People in Norfolk: Experiences of social engagement, informal care and volunteering’ was held in the Assembly Rooms Norwich on the 16^th September 2011.

The conference was organised by Mayumi Hayashi from the University of East Anglia. There were delegates from Norfolk, Cambridgeshire, London and Japan. The aim of the conference was to present the findings of a piece of research by Mayumi Hayashi, looking at community care and social engagement for older people and their carers. The research has received international recognition and looked at 21^st century care of elderly people in both the UK and Japan.

The event was held in association with CUE East (Community University Engagement) at the University of East Anglia which supports community-university engagement across all disciplines and is funded by the UK Higher Education Funding Councils, Research Councils UK and the Wellcome Trust. CUE East helped with the funding of the research. The interviews for the research are being turned into a sound archive. 

The research emphasised older people are undervalued in policy terms. The informal and the voluntary sector are very important to the care of older people. The research showed the importance and benefits of social engagement for older people, and the existence of unknown numbers of excluded older people, left isolated and struggling financially, physically and emotionally. There is a clear need to enhance services for older people to meet further demands and to compensate for the loss of public provision despite challenging circumstances. There is a mutual help network among older people. Considerable care is given by older people to other older people and care is also provided by other family members. However funding from the public sector is seen as vital. One contributor said that the Big Society cannot be funded on the cheap. There is a need for enhanced services for older people. The good practice identified has been fed into engagement activities and one-to-one befriending of isolated older people. The ‘voices’ collected have been shared through public talks, local carers’ meetings and school visits, enhancing links between the community and UEA and reaching a wide audience.  

In Norfolk people are consulted via the Older People’s Forums across the county and there is the Norfolk Older People’s Strategic Partnership Board. This is a multi agency group with a third older people’s representatives. There is a need to plan for 20 years ahead and the projected increase in older people. The government says that being an “older person” starts at 50. The implications of this are that with people living longer they could spend most of their lives as an “older person”. However most people who are 50 do not see themselves as old. There is an Action Plan which aims to help people to live independently for as long as possible. The Action Plan is for 2011 to 2014, however its implementation has been delayed because the cuts have to be factored in. In Norfolk the budget of adult social care has to be reduced by £16 million which is on top of a £11 million cut last year. Research is needed to see if older people are still able to live tolerably well after the first year of cuts.

The speaker from Age UK reported that there is considerable activity by many groups but it is fragmented and there are few links between different groups. They are also indentifying groups to work in partnership with. 

Age UK splits older people into four groups. The first group are fit and healthy, with a pension and they tend to be self sufficient. Age UK could not function without the help of this group as they are the bulk of their volunteers. At the other end of the spectrum are older people who are in need of 24 hour care and they tend to be in residential care or possibly being cared for at home. 

In between these two groups are those who are living on their own and are beginning to need some support and the other group are those who are less affluent but are surviving. Age UK has decided that they are going to focus their attention on these two middle groups to keep people out of the most needy category for as long as possible.

The Age UK review highlighted two key groups of excluded older people. The first group is Lesbian, Gay, Bi-sexual and Transgender people (LGBT). They may be resistant to speak up because of past laws. Age UK found that residential care providers are only now becoming aware that there are now older LGBT people.

The other notable excluded group is offenders and ex offenders. There is an increasing percentage of older people in prison. There are now units in the prison estate that are designed for older people. There are a number of older ex offenders of working age with limited legitimate work experience which hinders them from finding employment.

It was pointed out that as some men do not feel comfortable going to day centres it is sometimes better to have a meeting with men in a pub as there are opportunities to socialise and there is food available. It is also important to get young people and older people together. There is less contact in comparison to previous generations. There is also less contact between grandparents and grand children for a variety of reasons.

In Norfolk there are transport issues. How do you move people, especially those who are in wheelchairs, around the county in a cost efficient and sustainable way?

The Carers Forum has found that caring has an impact on the mental wellbeing of the carer. Many carers are over 65, with a substantial number over 75. Many provide over 50 hours of care a week, with some on call 24 hours a day, and consequently suffer from a lack of sleep. 81,000 people in Norfolk were identified as carers in the census. 11.6% of carers experience more ill health than would be expected. As well as providing care the carer also has to deal with other roles that they may not be used to such as finance and paying bills which can also increase stress. Carers can be fiercely independent and can refuse external help. There is a change in the relationship with the person cared for and carers have to cope with loss. There is an extended grieving process for the loss of the other person’s old persona. There is also grieving for the plans and hopes that are gone. The biggest step is making the decision that you cannot care for the person anymore. This often triggers more grieving. After the time of caring, there is stress caused by the loss of the person as well as the loss of a ‘job’. There is more psychological distress the closer the carer is to the person cared for. Support is needed at an early stage. 

Three points made in the discussions were:

Those supported by Social Services have an average age of 84 years. How do you help those who are aged 50 to 84 to age well?

How do you increase the quality of life for people in care homes? They are ‘paying customers’ and have a right to quality services.

It is important not to lose sight of preventative services as they will save money in the long run.

This event had a live twitter feed with #copn in the tweets. Thanks to all those who responded and sent retweets.

Changing The Shape Of Conferences

The influence of new media is changing the shape of conferences. The National Children and Adult Services Conference was held over 3 days in October. The twitter hash tag of #ncasc was used and over the 3 days of the conference 115,000 tweets were sent reporting on and commenting on the conference.

Following from the conference a blog was set up Connecting Social Care and Social Media blog http://bit.ly/pRKAtO with a hashtag #cscsm to follow. One of the early posts is called ‘5 reasons why social workers should use social media. http://bit.ly/qe9G2K

Using different methods of communicating

The SSRG executive committee have been looking at ways of cutting costs. One of the first results of this is that the newsletter is now delivered to your inbox. This is saving the cost of printing and postage. The same will happen to Research Policy and Planning.

Unfortunately not everyone can attend conferences. There are now ways to find out what is happening using the web. SSRGEC and careknowledge do live twitter feeds when there is a conference that they are attending. They use #hastags to help filter the input from a specific event.

SSRG has a facebook page. Please 'like' the page.

There is an SSRG group on Linkedin.

Which method of getting in touch suites you best? do follow like or join.

For those on twitter

Thanks to @careknowledge for his work at the recent conference organsied by SSRG in Scotland. He provided a live twitter report on the speakers through out the day. Thank you for all your efforts. This is the way forward as conferences notify the people who are interested but cannot attend what is going on through out the time - some even add photos as well !

A local conference on the future for Supporting People in Norfolk

Uncertain Times – a local conference on the future for Supporting People in Norfolk

We recently attended a conference organised by Norfolk Supporting People Team. The aims of the day were to:
-Increase our understanding of the changing environment in which housing support is provided in Norfolk
-Debate and share views with other providers and stakeholders about the key challenges and hot topics faced
by the Supporting People partnership
-Contribute to the work plan for the Supporting People Provider Elected Panel over the next year
-Influence priorities for Supporting People in Norfolk.

The initial presentation looked at what is on the horizon for housing support in Norfolk. There have been a lot of changes in Norfolk this year. Adult social services has recently been reorganised along with other county council departments to become part of Community Services. Also Norfolk and Suffolk Probation services have been combined into a single trust. In other areas of the country the Supporting People Team has been moved to other agencies, for example in some areas it is part of the Primary Care Trust. Both locally and nationally Supporting People is seen as a success. Nationally there have been £3.46 billion of savings due to Supporting People at a cost of £1.6 billion. Local work on estimating the financial benefits of the
programme indicates that there have been £24 million savings at a cost of £16.4 million.

Personal budgets are being introduced in social care and Supporting People has a part to play in this. Personal budgets will be linking users of services to a wide range of organisations, as part of the expansion of choice. Norfolk was a pilot area for what was then called individual budgets. During the pilot many people were looking to have their own tenancy, ‘their own front door’. The challenge for Supporting People is ensuring that they are able to access housing and keep ‘their own front door’.

There are opportunities as a result of the introduction of personalisation but also new challenges. In the pilot areas, older people as a group struggled the most with the practicalities of individual budgets, and found the new system ‘bewildering’. There are opportunities for new agencies to help older people, and other groups, to get the best from the new system. This does mean that there have to be realistic choices for them to choose between. The personalisation agenda also acknowledges that service users not only have the right to choose but they also have the right to make the wrong choice, to make mistakes and to take risks. Supporting People providers are working to help people make informed choices.  How do the ‘professionals’ feel about this?

For a while people attending the conference kept saying that there was uncertainty. There were two reasons for this. Firstly, the general election was one week away. Secondly, it was a way of not actually saying that there are likely to be cuts in various services. Some people voiced fears about the security of their own job. Eventually it was said, there is no uncertainty. No matter who forms the next government there will be a reduction in the amount of money available. It was therefore a timely conference to start the thinking about who might receive a reduced service. A reduction of 20% to 30% in the size of the budget was discussed. People were challenged to think about which service would you cut or how far would you raise the threshold levels, because these are the decisions that many people think are going to have to be made by someone in the near future. With a decrease in money there are decisions to be made on the priorities for the future, whilst not forgetting that there are ‘hard to reach groups’ that need services and should not be forgotten. Will a reduction in the budget create an increase in the quality of the services provided to the individual? The conference thought that this was doubtful. What could the fallout be and what might the tabloid press say? Somewhere a tabloid headline could read “Young drug addict gets services at the expense of keeping granny in her home”.

There are other certain changes. The population of Norfolk is older than the national average and this will continue for the foreseeable future. The majority of Supporting People funding goes to older people, so this is an important issue. Will more services change to being a ‘charged for’ service? Could the third sector, the voluntary sector and not for profit organisations fill the gaps? Are you thinking that this is an area where you could provide a service as a social enterprise?

There are calls to get rid of so called ‘silo thinking’. An alternate view is to change who has the ‘silo thinking’. There seem to be problems if professionals think only in the way that their profession thinks. The alternate view is to let the individual / the carer or the user of services be ‘the silo’ and the professionals work to the individual’s personalised budget requirements.

All in all, the conference provided a useful opportunity for people working with a variety of client groups to get together to discuss and debate common issues related to housing support.

Welcome SSRG

Following discussions on the SSRG Executive Committee, the subject of communications came up. So rather than the one way traffic of the website here is a blog site for members to communicate back to the Executive Committee and fellow members.