Caithness Strategic Redesign Group

 Minutes of Meeting Held on Monday 1 December 2003

Present
Julie Catterall, Community Care Manager - Highland Council
Jane Coll - Caithness Community Care Forum
Ian Hargrave, Acting Area Manager – Caithness Highland Council
Katherine Lewis, Redesign Facilitator – Caithness Highland Primary Care NHS Trust
James McAdie – Highland Health Council
Alison Phimister, LHCCManager, Highland Primary Care NHS Trust
Bob Silverwood, Area Community Care Manager – Highland Council
Elizabeth Smith – Highland Health Council
Bill Fernie, Portfolio Holder – Area Housing & Social Work Committee
Stella Jones, Community Nurse, Learning Disability – Highland Primary Care NHS Trust
Mairi McLeod, Community Mental Health Team Manager – Highland Council
David McMillan, Finance

Apologies
David Flear, Chair – Joint Committee for Actio on Community Care
Doreen Bell, Lead Nurse – Caithness LHCC, Highland Primary Care NHS Trust

1.0            WELCOME & APOLOGIES

 Alison Phimister welcomed everyone to the meeting and apologies were received from Doreen Bell and David Flear.

2.0            MINUTES OF MEETING HELD ON 6 OCTOBER 2003

The Minutes of the Meeting Held on 6 October 2003 were approved as an accurate record. The Updated Terms of Reference that had been issued with the minutes, where also accepted.

3.0            MATTERS ARISING FROM THE MINUTES OF MEETING HELD ON 6 OCTOBER 2003

            3.1            Caithness & Sutherland Community Health Partnership (CHP)

Alison advised that the Scheme of Establishment had been submitted to the NHS Highland Board who would be meeting tomorrow, Tuesday 2 December 2003.  Copies of the submission would be circulated to everyone who had been involved in the proposal for Caithness and Sutherland, by the end of the week.

4.0            MENTAL HEALTH IMPLEMENTATION PROGRESS

            4.1            Place of Safety

Mairi advised that there had been some resignations from qualified staff but it was still hoped to be operational by the end of January.  The only remaining training was on Violence and Aggression the date of which had been set for 21 January 2004. 

Some minor repair work still needed to be completed with the final check by Health & Safety due to take place on 21 January 2004.

           4.2            Adult

Discussions were ongoing regarding the development of Out of Hours working with a third meeting due to take place this week. The group are considering options from previous meetings. The criteria suggested is for cover to start from 5.00pm Monday to Friday and throughout the weekend.  There has been mixed reaction from within the team about working out of hours. Mairi would be meeting with Shona Blance today who is has been facilitating the meetings. Mairi advised that they needed to be at the recruitment stage by January.

It was noted that approximately £60,000 had been awarded for developing this service.

 Mairi also noted that the team were at its full compliment for the first time this year, however resignations had been received from Lee Gordon and Derek McLean.

 Waiting lists had been cleared and there had been a change in the way the team worked.  A series of meetings had taken place looking at the pressures on the team and had resulted in a change from having team meetings weekly to having GP liaison meetings at the surgery on a weekly basis, meeting with GPs to discuss any referalls and discharges wanting to be made.  This has proved very successful in supporting the teams.

            4.3            Housing

Meetings had taken place with representatives from Birchwood and Pentland Housing looking at how to best draw up a business plan.  It was decided to start with a floating support plan to be able to provide support to people in their own accommodation. Pentland Housing did however note that it would not be a problem to use a bricks and mortar plan in the long term.  It was noted that Peter from Birchwood had accessed some money to be used in Caithness to appoint a Project Co-ordinator who would look at bringing support into peoples homes to retain their own tenancies.

It was also noted that funding was still available from within the LIG and agreement had yet to be reached on how best to use this money.  A meeting was due to take place soon of the Housing LIG to carry this forward.

 4.4            Social Inclusion

Work was still ongoing to develop a website that would incorporate all the mental health services within Caithness and also would provide a support mechanism for users via a chat room and notice board.   A bid had been placed for funding, via George Bruce.  The mental health team would not own the website but it will be managed and developed by mental health users.   This bid would be going forward to the Council this month.

Subsequent funding for IT equipment has been held off for the time being until broadband is available in Caithness as there was concern that the equipment identified would not be compatible.   Funding was also being considered for training mental health users on how to update and manage the website and how to use the internet.

Once funding had been identified/successful a meeting would take place to review the data to be collected on the website etc.

            4.4            Older Adults

A draft Project Proposal to provide respite care for up to six people with dementia had already been circulated to the group.  This document has been prepared and will be put forward in case funding becomes available. It was noted that funding was currently being considered for the refurbishment of Bayview and that submitting this proposal now may prove to be beneficial.

5.0            LEARNING DISABILITY PLANNING

It was noted that written plans had been developed by Stakeholders for Short Breaks, Integrated Teams and Dedicated Workers.

5.1            Short Breaks

Part of the plan for Short Breaks had in fact already received the green light with the refurbishment of Grant Street this was to enable access to time limited funding streams to enable  the work to be carried out, this may reduce funding for other options. The group identified a number of recommendations for providing short breaks as well as noting the need for housing to decrease the pressure/need for respite and day care.  Some of the options being investigated included children having integrated play schemes and people going on holiday with families to provide support to them.

            5.2            Specialist Integrated Teams

The Integration Project report – Proposal for Specialist Multi-Agency Learning Disabilities Support Team for Caithness, had already been issued to the Group. This report was based around how they would like the team to look and the plan would be taken forward with the hope of getting a start by April 2004 when it was hoped that funding would become available.

            5.3            Dedicated Workers Within Generic Teams

A report entitled “The Redesign of Learning Disability Services, Caithness”, November 2003, had already been distributed to the Group.  It was noted that CASE had expressed an interest in providing assistance. It was also hoped that funding for training could be obtained from CHANGE. It was felt that training should be made available to all generic workers and not just those based within the health service in order to provide a higher quality of training for everyone. This training would involve the users and also trainers from outwith the service.

It was noted that the long term goal was for the drop in centres in Wick and Thurso to become self funding. 

A lot of work had been obtained in relation to how the working groups wanted the work to be carried out and that the formation of another LIG group might be necessary to take this forward.  Developments on this would be discussed at the next Caithness Strategic Redesign Group meeting.

Questionnaire

The questionnaire had gone out to people with learning disabilities and about 150 had been returned, however, it was noted that some questionnaires had been duplicated.    The report on the response had not yet been finalised, however it was already noted that a high percentage had said yes to the question “did the plans meet the objectives for people in Caithness?”.    The additional comments received had still to be analysed.

LIG

There had been a good turn out last week and a lot of positive comments had been received.  The press had been invited, although at short notice they were unable to attend, however, an email had since been received expressing an interest to run the story.  It was agreed that perhaps a Press Release would be the most efficient way of getting the information out.

It was noted that there was not a lot of CHANGE money for this year.

The majority of people at the meeting want to form a new LIG to bring them altogether and bridge the gaps.

6.0            OLDER ADULT IMPLEMENTATION

            6.1            Rapid Response

The data collection questionnaires have been returned and now need to be considered by the group who will be meeting again on Thursday to look at this with a hope to shed some light on the demands for the service and develop a business case.

            6.2            Health Promoting Day Care

Resources have been made available to develop a business case for Falls Prevention.  District Nurses in Wick are providing two weekly visits to Laurandy. The development of a menu of individuals is still ongoing.  It was suggested that this be in the form of a booklet to help improve links between Day Care and Health Services.  It was noted that this booklet may be useful for other community groups in particular Bayview and Pulteney. 

Citizens Advice had been invited to participate but had not yet been involved.  It was noted however that a member of the group was attending one day a week for six weeks to progress work on Falls Prevention and the booklet.

Information Lunches

No feedback had yet been received and it was noted that the events had not been well attended.  It was noted however that the events had been well organised and a lot of useful information had been made available.  It was felt important that this information should be made available to users and the wider public.  Jane advised that she had collected a lot of leaflets and this information would be publicised in the Scorrie.   It was noted that the Caithness event had been a pilot for the Highlands and was aimed at people who worked with older people in both a voluntary and professional capacity.  Another similar pilot event had been held in Nairn but with day care attendors.

            6.3            Home Care

Sue Owen who is the lead for Home Carers across the Highlands attended the last meeting and agreed to provide information on medication policy and training for home carers.  It was hoped that we would get a copy of this policy document however it has to go to the Chief Officers Group before it can be distributed generally.

A foot care package has been delivered to home carers with podiatrists agreeing to deliver a package for informal carers when capacity allows.

It was noted that home care training events are being organised as and when required with strong links with community nurses and ward staff to provide informal training.

There are still contractual issues concerning home carers in particular hours of work and mileage payments and these are currently being addressed.

It was noted that the issues affecting the local group were now highland wide issues and that as a result the group may come to a natural conclusion.

            6.4            Joint Equipment

The Joint Equipment store in Thurso was now in situ.   A risk assessment had been completed and a dedicated washing area was being utilised.

Training for SSA Assessors had been arranged for late January. Once assessors had completed their training they would be able to make an assessment and collect equipment from the store directly themselves which would hopefully take some pressure off the work of the Community Occupational Therapists.  Access to the store would be seven days a week, 24 hours per day.  It was noted that at least ten people would be trained to access the equipment.

It was noted that a community infection control policy was still awaited from the Highland Wide Infection Control Group.

A stock system of marking equipment had been explored and a contact telephone number would be indicated on each item.

Training for Porters in installation had also been highlighted in order for them to deliver and install some of the equipment particularly in more rural areas, however this has not yet been actioned on.

Alison enquired if the group were now at a stage where they could do a costing of the joint store.  Kas advised that they do have an outline of the resources that would be required but they had no indication of the demand.  Alison advised that they would need to bring this plan into the CHP Development Plan before March next year.

It was noted that a venue for the Wick Joint Equipment Store was still being considered. A specialist equipment store was in place at the Town & County Hospital.  It was noted that the Social Work Department have a store at the Industrial Estate and investigations were underway to see if the adjoining property there could be used for a Joint Equipment Store.

6.5            Network Newsletter

Miles had drafted a newsletter which was hoped would go out with the next edition of the Scorrie, however as the next edition was not due out until mid January, it was felt that the information that had already been prepared could be displayed on the Caithness.org website and then updated in the New Year for the Scorrie.  It was noted that the best source for photocopying was still via the Caithness Voluntary Groups.

It was noted that the Minutes of the meetings of the Caithness Strategic Redesign Group could be posted on the Caithness.org website.  The Minutes of the last meeting were approved for this purpose.

7.0            A.O.C.B.

It was noted that Stephen Porter, Highland Project Manager for Same As You had commended very highly the work on learning disability being carried out in Caithness.

8.0       DATE AND TIME OF NEXT MEETING

The next meeting was agreed to take place on Monday 8 March 2004 at 10.00am in the Conference Room at Caithness General Hospital.