Health & Welfare

CROSSROADS (CAITHNESS) CARE ATTENDANT SCHEME
�Caring for those who care for  others in Caithness�
A N N U A L R E P O R T 2003/2004
Registered Office: Room L4, Business Centre, Scrabster, Thurso, Caithness, KW14 7UJ.
Tel/Fax: 01847-895483. A Private Company Limited by Guarantee, Company No: 171258 Registered in Scotland, Scottish Charity No: SC015037

The past year has seen a major change in the funding of the Scheme by Highland Council Social Work Services (HCSWS) and the Highland Health Board (HHB). As I mentioned in last year�s Annual Report, difficulties were being experienced by the eight Highland Crossroads Schemes in reaching agreement on the new form of contract � or Service Level Agreement (SLA), which was to replace the old grant system. The SLA was eventually signed by both parties on 17 October 2003, six months into the financial year. Basically, the SLA stipulates that HCSWS/HHB funding is only to be used to support carers referred by the funding bodies. The SLA also stipulates the hours to be delivered in the year and at what cost. There have been some �teething problems� but we now have it sorted out. While it was not the intention by the funding bodies, the new system of working has introduced some delays in setting up carer support and a reduction in the flexibility of the service, so much a part of the Crossroads ethos. The changed circumstances were explained in a letter sent to all the carers in September 2003, a copy of which is attached as an appendix to the annual report.

This new approval, coupled with increasing costs � insurance, regulation, inspection, affiliation, fuel, etc, has seen an 8% reduction in the care hours delivered in 2003/04 (7936). I believe this was due in part to the introduction of the new referral system during the course of the year.

Carers continued to take advantage of the larger periods of respite care through �BreakAway�, but the charitable trust funding for the project is almost exhausted. The scheme will have to make a case for new funds in the coming year.

The Scheme continues in a sound financial position with the aim of spending as much of the funds available within the year to provide carer support in Caithness. Maybe we were a little too cautious this year, due to the new referral circumstances and achieved a surplus of �5,793, which has been transferred to the reserves.

Preparations are well in hand to register with the new Care Commission � a necessity to allow the scheme to continue to support carers by providing domiciliary respite care. This will cost the Scheme �2,000/year � a lot of coffee mornings � to raise money to pay for new bureaucracy.

I would like to thank the Management Committee for all their support over the year, but without the dedication, experience and training of the Care Manager, the Admin Assistant and the Care Attendants there would be no Crossroads in Caithness. Well done to all of them.

OWEN PUGH

Chairman

Directors re-elected at the 5th Annual General Meeting in 2003 (Mr Owen Pugh, Mr Keith Muir, Mrs Eileen Spearing, Mr Gavin Pope, Mrs Angela Lewis and Mrs Cathy Wratten) continued to serve throughout the year. Mrs Penny Mathews became a Director in July 2003.

The scheme was sorry to lose the services of Mrs Lorraine Todd on her departure to the south of England. However, we were delighted to welcome Mr Andrew Hindle to the Management Committee in September 2003, and Mrs Marion Sutherland (an ex-Care Attendant) in March 2004.

Mrs Maggie Page continued as Care Manager supported by Mrs Fiona Robertson as Admin Assistant.

Appendix 1 shows the members of the Management Committee who served over the year and their attendance at Committee meetings is shown in Appendix 2.

The scheme relies on a number of sources of funding to provide support to those caring for others in Caithness.

Subject to individual care assessment.

Funding from Statutory Bodies

This was the first year of operating under the new Service Level Agreement (SLA) with Highland Council Social Work Services and the Highland Health Board.

The SLA is to provide respite care only to those people whom Social Work Services/Highland Health Board agree should receive support after a full assessment of the carer/client�s needs and resources and allocation of a Social Work identifier. Basically, the scheme is a sub-contractor to SWS under this arrangement.

Funding identified previously under the Carer�s Strategy eg, weekend/overnight care heading is now included in the SLA.

Purchased Care

In previous years the local area SWS purchased additional carer support (equivalent to home care) over and above that covered by respite grant system. 2003/04 is the last year the scheme can provide this service to SWS as the funding level is too low to meet service delivery and scheme overheads. 570 hours were provided up to September when the service was stopped.

The scheme has also supplied 1192 respite care hours requested and purchased by the carer or the person being cared for using allowances from statutory bodies identified for that purpose eg Independent Living Fund (ILF). The total of such purchased care hours has shown a small increase over 2002/2003 -1192 hours compared to 1087 hours.

At present Crossroads does not charge for its carer support. However, should a carer wish to enter into a private contract with the scheme, terms can be arranged. This contract of necessity must reflect the full costs.

Grants from Charitable Trusts

This is the final year we have had financial support from the Tudor Trust, Camelot Foundation and Scottish Business Achievements Award Trust (SBAAT) to our BreakAway Project.

2003/04 sees the end of support to the Wick Project by Tudor Trust, but support by Lloyds TSB will continue in 2004/05.

Donations

Donations totalling �6,664 have been received during the year

The scheme is extremely grateful to all who have supported us in this way. All monies received are directed to providing respite care to carers in Caithness. Appendix 3 gives details of donations above �100 received from organisations. Individual donations have been too numerous to mention and we do not wish to embarrass the donors by publication of their names

Fund Raising

Our Summer Coffee Morning held in Thurso Town Hall in June raised �630. Thanks are extended to all who supported us on the day either by selling tickets, baking for the stall etc or donating raffle prizes.

Once again, Management Committee members and Care Attendants sold programmes for the Halkirk Highland Games which brought in �930.

We have been able to hold one extra Coffee Morning this year which was held in January 2004 which brought in �351. Although on a Friday morning, it proved to be a very welcome occasion for the local ladies who had missed out on their coffee mornings since Christmas.

In February our Annual Raffle was held raising over �1,280 � our thanks are once more extended to all who sold tickets, all who bought tickets and most importantly to those who donated prizes. Due to inclement weather in February the prize draw had to be cancelled at the Weigh Inn and was held later in the month.

Our thanks go to all who helped in fund raising this year and in particular those who always bake for our sales table.

All events saw a grand total of �3,633 from scheme fund raising.

BreakAway

Over the year 172 hours of BreakAway care have been given to carers and clients. This time has been used for a number of purposes, although BreakAways have in general been taken locally to enable carers to have a night out or a longer break from their caring role.

The �Breakaway Project� has now exhausted funding provided by Tudor Trust, Camelot Foundation and the Scottish Business Achievements Awards Trust. The Project has provided 1745 hours of longer respite carer breaks, both locally and out of the county since its launch in 1998. This much appreciated longer break will not be funded by the SWS or HHB and further appeals will be made to major charitable trusts in the coming year to enable this project to continue.

Emergency Phones

Each care attendant continues to be provided with a mobile phone for use in emergency situations, such as bad weather, vehicle breakdown etc. In the last 12 months four handsets have had to be replaced due to failure of the batteries, which could not be replaced because they were no longer being manufactured. This project continues to be funded by a grant from SBAAT given in 2000.

Wick Office

The Wick Office, which opened in June 2002 (shared with Caithness Deaf Care) to provide more immediate contact for carers on the east of the county, has been successful in increasing referrals from that area. The three year project, funded from a �14,000 grant by Tudor Trust over two years, and �15,000 from Lloyds TSB over 3 years, has just one year to run. In the absence of further grants being obtained, the office will have to close in late 2004.

The aim of the scheme continues to be to provide a high quality, flexible, domiciliary respite care service to carers, delivered by a well-trained and dedicated work force. The service offered by the scheme is led by the needs of the carers and clients, but is limited by the amount of funds available. A formal assessment system is used in cases where it is necessary to accord priority for care due to resource limitations.

Any person, practice or organisation who wishes to refer a Carer to the scheme for respite care, can see the Client Groups which can be supported and the services which the scheme is able to provide in Appendix 8 and should contact the Care Manager. The Policies and Procedures under which the scheme operates within CROQAS are also shown.

Staffing

The scheme currently employs 18 part-time Care Attendants.

The Admin Assistant�s hours rose from 8 to 12 hours per week as from April 2003. The Admin Assistant now covers all bill paying and banking, donations (letters of thanks/receipts), photocopying, filing, timesheet entering, preparation of the payroll and statistics for HC SWS and Crossroads (Scotland).

Training & Communications

Care Attendants:

As part of a regular training/supervisory function, care attendants meet with the Care Manager on a regular basis. Care Attendants also maintain contact with the Care Manager by telephone and by visiting either the Wick or Thurso office.

A total of 257 hours were devoted to care attendant training and meetings against 185 hours in 2002/2003. The Care Manager conducted new Care Attendants induction, Food Hygiene and Moving and Handling courses.

Care Manager:

The Care Manager spent 158 hours attending meetings and offsite training sessions this year.

Management Committee representatives met with Care Attendants (but without the Coordinator) during the year. Points raised by the Care Attendants were taken on board by the Management Committee.

Liaison

Caithness (Crossroads) keeps in close touch with other organisations providing carer support, such as the Social Work Services, MacMillan Nursing, Marie Curie as well as other Crossroads Schemes in Scotland.

The Care Managers of the 8 Highland Crossroads Schemes now meet quarterly and are joined by the Chairpersons twice a year to discuss experiences and innovations in carer support.

The Care Manager continues to represent Crossroads (Caithness) at the following meetings :

The Care Manager continues to attend client case conference meetings when invited by the Social Work Services or Health Services.

Referrals

Nineteen new referrals were made to the scheme � a fall of over 50% compared with 2002/03 - the major fall being in self-referral by carers themselves (7 out of 24). Appendix 5 shows the client groups within the new referrals.

Appendix 6 shows the age of both clients and carers supported by the scheme.

At the beginning of the year the scheme had 71 carer/clients and ended with 72 clients on the books. 50 of the carers receive regular respite care hours, the balance being on a flexible basis.

Health & Safety

Two minor incidents to care attendants were reported over the year in the course of their duties � none required treatment

Respite Hours

Total respite care hours provided by Care Attendants were 7936 hours against 8627 hours in 2002/02 � a decrease of 8%. Appendix 7 shows the number of care hours provided by the scheme and the mileage for 2003/2004.

Mainstream hours totalled 4715 hours against 3719 hours provided in the previous year, a 26% increase. Dementia hours fell sharply at 1237 against 2010 last year - a 36% decrease.

Social Work Services purchased 570 hours and individuals purchased 1192 hours through Independent Living Fund arrangements. 172 hours were provided through the Breakaway Project.

Mileage

Care Attendants drove 54613 miles in providing care in 2003/2004 � an 11% increase on the previous year.

Care and Office Management

The Care Manager worked a total of 1945 hours, the Deputy 243 hours and the Office Admin Assistant 630 hours - 2818 hours compared to 2576 hours in the previous year. The Care Manager and the Deputy travelled 2017 miles compared to 5641 miles in 2002/03. This is shown in Appendix 7.

The audited accounts of the scheme for the year to 31 March 2004 are attached as Appendix 10. We thank Mr Sinclair and Mr Busby of Victor T Fraser and Company, Chartered Accountants, for their swift action.

The new Service Level Agreement (SLA) was for �82,422 to provide 6105 hours of respite care. Due to early difficulties in managing the new system and increasing costs, the scheme only delivered 5903 hours at a cost to the scheme of �84,944. The scheme had also accepted requests from SWS for carer support to be purchased in addition to the SLA. The purchased care hourly rate offered by SWS only covers direct costs (care attendant wages plus travel) with no contribution to management/office overheads (care management plus office, etc). This was realised too late in the year to avoid a commitment to 570 hours for which the scheme had to meet the overhead component at �2,742 from scheme funds.

The annual October pay review saw a wage rate rise in line with inflation for the Care Manager and Care Attendants and a change in times at which enhanced rates are paid.

Based on the audited accounts (Appendix 10) the total income was �123,656.

The total income of �123,656 is to be compared with �116,906 in 2002/03.

A breakdown of the 7936 hours delivered in 2003/04 shows an allocation to day, evening and weekend working of:

The care attendant wages and travel costs accounted for �77,083. Scheme management and administration accounted for �29,576. Office costs � rent, heat, stationery, lighting, postage, telephone etc with fund raising expenses, insurance, affiliation fees, audit, etc, accounted for �11,204

Scheme expenditure at �117,863 is the highest ever and is to be compared with �113,693 in 2002/2003. The trading surplus of �5793 is transferred to scheme reserves.

If all expenditure is set against the number of respite hours provided this year (7,936) this gives a cost per care hour of �14.85. If the care attendants� training hours (an essential cost) are included, the cost is �14.39 per hour.

Overall, a satisfactory year, yielding a small surplus with our unrestricted reserves standing at �37,398. Restricted reserves identified with the Wick Project stand at �4,790. The reserves are necessary to cover any staff redundancies in the event of having to close the scheme (hopefully, a very unlikely event) and also to cover 6 months operating expenditure in accordance with good company practice and to accommodate any late payment of grant money.

While the scheme continues in a sound financial manner, it was necessary, in the course of the year, due to under-recovery of overheads, to keep a close watch on the hours to be delivered. The overall care hour cost rose significantly compared with 2002/03 (�14.85/hour cf �13.18/hour). A close examination of �cost sources� is being undertaken, for while the direct care costs fell, the care management and office overheads increased.

There were no Board or Management Committee expenses.

All Members

Mr J Ryan, Chief Executive, Crossroads (Scotland)

Mrs Christine Bennett, Care Services Manager, Crossroads (Scotland)

Ms Harriet Dempster, Director, SWS, Highland Council

Mr Adam Palmer, Highland Health Board, Inverness

Mr Jon King, SWS, Highland Council

Ms Gillian Grant, SWS, Highland Council

Mr R Silverwood, Caithness & Sutherland Area SWS

Mr David Flear, Convenor, Caithness Area Committee

Companies House (Audited Accounts only)

Victor Fraser & Co, Auditors

John O�Groats Journal/Caithness Courier Office

Badenoch & Strathspey Crossroads Scheme

Nairn & District Crossroads Scheme

Skye & Lochalsh Crossroads Scheme

Inverness Crossroads Scheme

East Sutherland Crossroads Scheme

Lochaber Crossroads Scheme

Ross & Cromarty Crossroads Scheme

Crossroads (Caithness) Care Attendant Scheme Care Attendants

Local Medical Practices

Local Care Managers