The real world of joined up thinking, joined up working. Strathbrock Partnership Centre, West Lothian

1. The real world of joined up thinking, joined up working.Strathbrock Partnership Centre, West Lothian Lesley Moore & Angela Hudson. University of the West of England, Bristol

2. Aim • To share initial observations and inquiry of a partnership model between: Community Health Social Services and Housing (Council) Lesley Moore & Angela Hudson. University of the West of England, Bristol

3. West Lothian older population-2001 Census • 25,800 aged 60 and over = 16.2% of WL population. • 2004-2024 projected rate of increase = 72% compared to 39% in Scotland as a whole. • Need for “radical change in policies for the care and support of older people…focused on care at home… a radical rethink of services” Bowes & McColgan 2006. Lesley Moore & Angela Hudson. University of the West of England, Bristol

4. Visits: • Strathbrock Partnership Centre – 12 partners including Pharmacy, Café, Housing, Council Services, Health Centre, Justice Centre, OT and technology, Re-enablement team, Mental Health, social work, carers, Community Education, Capability Scotland, 3 GP practices. • Housing with Care Complex: flats, cottages with tenancy agreements. Lesley Moore & Angela Hudson. University of the West of England, Bristol

5. Visits • Customer Contact Centre • Council call centre • Group Manager, OT and technology. • Team leader, supported discharge and re-enablement team. • Director – a systems thinker. Philosophy – ‘What can we do to help?’ A can-do culture. Lesley Moore & Angela Hudson. University of the West of England, Bristol

6. “Opening Doors for Older People.” – 3 phased project. Objective: • To provide an innovative form of housing for older people with support needs that will sustain independent living through effective physical design, focused individual care planning and the efficient use of new technologies. West Lothian Council Lesley Moore & Angela Hudson. University of the West of England, Bristol

7. New model of care promoting: • Independence • Choice • Safety • Security • Improvements in quality of life – regaining capacity. • Peace of mind Lesley Moore & Angela Hudson. University of the West of England, Bristol

8. Mechanisms & resources • Single shared assessment • Tunstall Telecom Ltd & West Lothian Partnership- Telecare in the home- phase 1. • Upgrade of Council’s ‘Community Care Alarm Service’ to new ‘Home Safety Service.’ Alerts transmitted to 24 hour monitoring call centre. –phase 2 • Mainstreaming above to all people aged 60 and over.- phase 3. To date over 3,000 council & private homes with Telecare resources. Lesley Moore & Angela Hudson. University of the West of England, Bristol

9. Telecare basic resources for own homes. • Home alert console – call centre • 2 passive infra-red detectors to monitor activity & potential intruders. • 2 flood detectors, activated by leaking pipes, overflowing baths. • 1 heat extreme sensor, senstive to both high and low temperatures. • 1 smoke detector. Lesley Moore & Angela Hudson. University of the West of England, Bristol

10. Additional alarms: • Fall alarm, • Incontinence monitor – beds, chairs and under carpets • In the future telemedicine • Movement monitor for people getting in and out of bed – wandering as in Dementia Lesley Moore & Angela Hudson. University of the West of England, Bristol

11. Alarms in Housing with care complex: • Personal pendant alarm • Flood detector – any liquid spill • Heat sensor • Activity detector, intruder • Reminder of activities eg pill time uploaded onto telephone. Lifeline system • Video door entry system- shows up on the TV – instant. • Smoke detector. • Curtain, light and window control Lesley Moore & Angela Hudson. University of the West of England, Bristol

12. 3 year evaluation by Stirling University. • Interviews – 44 people with packages installed in their homes. • 11 informal carers • 79 staff from a range of disciplines • 29 people who moved into 2 new housing with care complexes. • 89 responses questionnaire – receiving Home Safety Service • Comparative study – local authority – statistics on demographics, care & support • Comparison of a sample of individuals receiving care and support over time • Value for money study – comparison with other Scottish local authorities. Lesley Moore & Angela Hudson. University of the West of England, Bristol

13. Some lessons learnt: • If technology is introduced without a careful review of the model of care, it may not achieve its full potential. • The new model of care caused staff to question their former ways of working, to focus on promoting independence for older people, and to provide ‘support’ rather than ‘care’. • Staff worked in new teams, in which traditional professional boundaries blurred, and there was more sharing of tasks formerly separate. Lesley Moore & Angela Hudson. University of the West of England, Bristol

14. Overall impressions • An excellent example of public consultation informing decision making. • Still some communication issues with professionals to address. • An excellent case study which demonstrates ‘joined up thinking, joined up working.’ A ‘zip’ in community care is visible but could be ‘wonkey’ if management changes the philosophy of care. Lesley Moore & Angela Hudson. University of the West of England, Bristol