Minutes of Meeting Held on Monday 6 October 2003

Present
Doreen Bell, Lead Nurse – Caithness LHCC, Highland Primary Care NHS Trust
Julie Catterall, Community Care Manager, Highland Council
Jane Coll, Caithness Community Care Forum
David Flear, Chair, Joint Committee for Action on Community Care
Miles Greenford, Public Health Practitioner, Highland Primary Care NHS Trust
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 – LHCC Manager, Highland Primary Care NHS Trust
Bob Silverwood – Area Community Care Manager, Highland Council
Elizabeth Smith – Highland Health Council
Bill Fernie, Portfolio Holder – Area Housing and Social Work Committee

Apologies
Stella Jones, Community Nurse – Learning Disability, Highland Primary Care NHS Trust
Mairi MacLeod, Community Mental Health Team Manager, Highland Council

1.0 REVIEW & AGREEMENT OF TERMS OF REFERENCE
The draft Terms of Reference as produced by Alison, Kas and Bob was discussed and the following amendments agreed:-

1.1 Group Purpose
The first paragraph should read “To support the integrated planning of community health services and social work services …..”

Bullet point two should read “… have objectives in line with local, National and Regional strategies … “

1.2 Outcomes
Bullet point two should read “Establishes a forum for local interpretation of local, National and Regional policy.”

1.3 Group Membership
Agreed.

1.4 Frequency and venue
Agreed.

1.5 Reporting Mechanisms
It was agreed that reports should be made quarterly to the Caithness Area Committee and Caithness LHCC Executive Group and this will be done via the issue of the Quarterly Newsletter in order to avoid duplication.

1.6 Communication
It was agreed that the Caithness Network Newsletter would be issued quarterly.  This Newsletter would also be issued as an insert with the Scorrie Newsletter.  Communication would also be via the Caithness.org website.

1.7 Decision Making
This paragraph should now read “The group will make its recommendations by consensus. However, there may be occasions when consensus cannot be reached. On these occasions, the group will identify a way to take them forward.”

The importance of Governance was discussed and the support / approval of each representative’s parent organisation in recommendations made by the group.

1.8 Current Membership
The current membership list was approved, however, some members questioned whether it would be appropriate for a “healthy living representative” to be included ie. Graham Nicol, Community Learning & Resource Services Manager for Caithness & Sutherland ?. After much discussion it was agreed to invite Graham to the next meeting with a view to introducing him to the Group and thereafter he would be invited to attend as and when required on the basis of the Agenda tabled.

It was agreed that the Terms of Reference would be amended as noted above and issued with the Minutes of the Meeting.

2.0 INTEGRATED WORKING
Alison Phimister advised that as part of the implementation of the Joint Future Report and embodied within the local partnership agreement that went to the Scottish Executive, is the need to promote integrated working across health and social work for older adults.

Alison updated the group on the progress of this work which was overall progressing well and was in the process of being distributed to Chief Officers for further debate.

It was also noted that the Partnership Agreement was well received by the Scottish Executive who highlighted that Caithness was well forward in the process and forward thinking.

3.0 CAITHNESS & SUTHERLAND COMMUNITY HEALTH PARTNERSHIP (CHP)
Alison wished to advise the group on the Organisations response to the Scottish Executive White Paper, Partnership for Care. This promoted a single system for health in regions and within that Community Health Partnerships and service redesign were high on the Agenda.

CHPs were to design and deliver and take responsibility for principle community health services with substantive relationships with LHC colleagues and public engagement. A Scheme of Establishment will be produced to set out what we will do and how we will approach it.

An event was held in Brora at the end of August looking at the proposal for a single CHP for Caithness and Sutherland. This was attended by colleagues in both counties and the document has now been circulated to organisations, all staff, The Highland Council, Community Councillors and participants of the workshop. To date there has been only a positive response to the document which has now been submitted in draft to Jackie Agnew, the Project Manager for CHP Development with the Highland Primary Care NHS Trust.

The Highland Council also supports the Caithness & Sutherland CHP with only one area of concern being that Caithness General Hospital and the Belford Hospital should be consultant led and that this may involve the inclusion of a fourth CHP.

Care Without Barriers and NHS Highland response to Partnership for Care are putting forward a single organisation to lead health in the future. The consultation period closed today with a meeting arranged for tomorrow with a further special meeting on 14 October.

It was noted that the Trust will submit one Scheme of Establishment to the Board which will then be submitted to the Scottish Executive. It is hoped that feedback will be received from the Scottish Executive in December. In the meantime more formal guidelines were awaited from the Scottish Executive to enable discussions to progress.

4.0 PROJECT FEEDBACK

Mental Health
4.1 Social Inclusion
A web site is being developed for access by mental health users in Caithness. This work is being developed with help from the Community Mental Health Support Group. A bid has been submitted for discretionary allowance for the web site and a further bid submitted to “mobius” for IT Equipment and a decision is awaited on this. The next stage will be an open meeting with key stakeholders and mental health support groups in Caithness to develop the web site further and including agreement on content and how we monitor the web site and organise and monitor the “chat” facility.

A training plan has been developed with TAG, with a identified link person, to provide training for service users on how to use the internet and maintain the website. Miles is currently looking at options for funding for this training and CASE may be approached for assistance.

4.2 Older Adults & Respite
A business case is being developed for the downstairs of Bayview and this was due this month with the draft going to stakeholders. This will be discussed at the next meeting of the Strategic Redesign Group.

4.3 Housing & Accommodation
The Area Committee have agreed that housing is an issue for someone with mental health problems and that they will provide accommodation in line with allocations policy.

At the last meeting it was decided to invite someone from Birchwood Housing and it has now been decided to go to Birchwood to benefit from their experience and approach. The development of a handy man scheme for people in mental health was discussed and it was agreed that this was a very useful and much needed service.

4.4 Place of Safety
Alison advised the group that a number of people had been recruited for the place of safety which was hoped to be fully operational in the New Year. The interim period from October through to December would be used for staff training. The final walking through of each of the two facilities was planned to take place in the next few weeks.

It was noted that members of the team had been utilised in a recent call-out and it had proved very successful with the staff attending at the patient’s home.

Alison noted that the group should be commended on their hard work over the last two years in setting up the place of safety.

4.5 Learning Disability
Katherine distributed to the group a copy of a questionnaire entitled “Services for People With Learning Disabilities in Caithness” and explained the purpose of it. Katherine noted that Stella would be assisting people on a one to one basis if required for completing the form. Funding had been secured for this purpose.

The consultation exercise was due to be completed at the end of October and fedback to the Learning Disability Network on the 25th November when LIG leads would also present there business cases for addressing 3 of the “Same As You Objectives”. LIG leads are attending a highland wide event on the 10th of October to share experiences on participating in LIG’s. A community nurse and 2 service users will provide a presentation on behalf of Caithness

It was noted that work on the Grant Street property had been agreed and this would provide respite services for people in Caithness. The proposal to utilise the top floor of the premises as a short term hostel was also discussed. This would be discussed further at the Housing & Social Work Committee in November.

4.6 Joint Future & Older Adult Services
Rapid Response
The data collection is complete and the Audit Department were still inputting the information. The report is therefore still awaited. Over a four week period 36 forms were completed by people over the age of 65. This item will be discussed further at the next meeting of the Strategic Redesign Group.

Alison advised the group that a Winter Planning meeting had been arranged to take place later in the month.

MDT Day Care
Katherine advised the group on the work which was continuing to encourage health professionals to develop clinics within day care centres. A bid for funding had been submitted and the outcome was awaited to allow dedicated time from the Change facilitator to carry out some of the action points identified.

Two information sessions will be held at the end of October with the aim of providing information about current resources available for older people. The sessions are open to staff and voluntary groups working with older people.

Joint Equipment
Part of the old Physio department at the Dunbar Hospital had been highlighted as a possible area for a joint store in Thurso with somewhere in Wick still to be located. A meeting to discuss this was due to be held tomorrow. A list of equipment to be held in the joint store would be drawn up. It was noted that anyone who had completed the Single Shared Assessment would be allowed access to the store, however policies and procedures for access would be required to be developed.

Training has been confirmed as being available to all staff carrying out Single Shared Assessments. This training will provide assessors with the skills and knowledge to access some equipment without referral to an occupational therapist.

The return of equipment, in particular toilet equipment, was also discussed. There would be an infection control issue regarding this. Infection control however was not yet being fully considered until the outcomes were received from the Highland wide group which was currently considering infection control in the community.

4.7 Home Care
It was noted that foot care sessions for Home Carers was due to start this month. It is anticipated that once this facility was fully operational that this would prevent unnecessary referrals to Podiatry and provide a better service for users. The question was raised to ascertain if the sessions would be available to family/informal carers in the future, Katherine agreed to take this question forward.

5.0 ANY OTHER BUSINESS
Jane Coll noted that she was attending the meeting as a representative of the Community Care Forum and as a Care Worker for People with Parkinsons Disease. Jane advised that she was being made redundant from her post as Care Worker and that her future participation in the group would be reduced.

The question of voluntary workers attending meetings was discussed in relation to travel and associated expenses. David Flear agreed to speak to Simon Steer and Sheena Munro regarding this issue.

6.0 DATE AND TIME OF NEXT MEETING
The next meeting was arranged for Monday 1 December at 10.00am in the Conference Room at Caithness General Hospital.