Access and Prevention
The primary goal of the access and prevention service is to keep people at home and as independent, happy and healthy as possible, for as long as possible. This is achieved by providing a range of support services as well as giving people information and advice. There are two groups of support services, prevention services and the access team. Prevention services support people to remain in their homes and in the community they know and are part of. The access team provide a phone advice line manned by a team of social workers who work with local people to support them and help them to find the best support to meet their needs.
What have we done over the past year?
Over the last year the access and prevention team have been responsible for supplying a wide range of services. The team are involved in a constant cycle of trying to improve services delivered whenever new opportunities are identified. Ideas for improvements can come from anyone, staff, customers, complaints and also a recognition that other local authorities may have found better ways of providing services. By looking both to local people and organisations we aim to find better ways of delivering access and prevention services.
We asked our customers what you want from an access and prevention service. Detailed below are things local people have said are important to them and the work we have done to try and meet these expectations.
We want local people involved in shaping and improving local services
Dudley Council has an ambition to work much more closely with local people in shaping and improving local services. A range of innovations have been introduced to engage local people in shaping local services across the whole council. Co-production, where council staff and members of the public work together to agree how services are developed is becoming more common and is intended to become to norm. Established groups like the Dudley’s Adults Alliance and People’s Network are key forums that are used to ensure local people are able to have their say and drive improvement of services. Particular focuses are social isolation, transport and ageing well.
We recognise there is still more that can be done and feedback helps us further shape services and prioritise improvements representative of needs. It also provides an important reality check on how to best evaluate ways to present and communicate social information to our communities.
As part of the Dudley Borough Vision 2030 the whole borough will be invited to contribute their opinions on a range of topics and their thoughts on the way that local services are run and can be improved.
We want to have consistent and reliable information so we can access the right support faster
Communication from the council to our communities and residents is a common area of concern raised by local people. We understand that with the increasing ways that people can get and expect to get information we need to be smarter in how we share information.
It is vital that our customers, their families and carers receive information that is clear, current, standardised and timely to help them understand what we can do to help and support them.
All of our public information is tested to ensure our messages are clear and jargon free so people can make the right choices, confident that they have received and understood the right information.
We are getting smarter with how we communicate with people, instead of relying on leaflets we’re looking to increase the range of ways that we share information to include a wider range of electronic methods as well as the “Your Borough Your Home” magazine delivered to every household in Dudley Borough, whilst ensuring that the message of clear and consistent.
We’re also using events like the Living Well Feeling Safe ‘Get Connected’ event to raise awareness. People have suggested that similar events held with the support of local shops and organisations to help raise awareness would help widen the messages. This has been incorporated into our approach to spreading the word.
Our One Dudley Council vision also means that there should be no wrong door to the correct services and regardless of who you call or speak to in the council you will be answered respectfully, helpfully and guided to the services that will be able to support you further.
In 2018/19 three of these community events were held,
in Halesowen, Gornal and Hawbush, in which:
houses were contacted to give advice on safety and security and wellbeing in their homes
people were signposted to services to enhance their safety and wellbeing
people visited community hubs to get guidance and advice from prevention and wellbeing services.
These visits will we hope help people to keep safe and well at home and feel less isolated and lonely in their communities.
For more information visit: www.dudley.gov.uk/lwfs
Our occupational therapy team is one of the key teams who's aim is to help people to remain in their own homes. The team complete asset based Care Act assessments, this means the occupational therapist works with the person to consider their strengths and what is important to them. Assessments are based on the principles of the Care Act, focusing on the impact of a physical disability or mental health condition on wellbeing. Following the assessment, equipment to aid independence such as walking frames or minor adaptations such as stair rails are ordered. The team may also recommend major adaptations such as stair lifts, ramps or bedrooms.
To enable more staff to have the skills to assess safely and provide small pieces of equipment quickly, the occupational therapists have trained other staff as trusted assessors. There is now a total of 80 trained trusted assessors, supporting the occupational therapy team.
The occupational therapy team work closely with colleagues across access and prevention to offer timely assessment so that equipment and adaptations are provided before someone reaches crisis point. This reduces the risk of falls, supports carers and enables people to stay at home independently for longer.
Caring can be extremely complicated; we need to know what support there is so we don’t feel like we are caring alone
We understand that caring can be an extremely difficult role and carers have to make sacrifices in their lives and careers that are rarely acknowledged. Carers are essential to ensure that their loved ones are looked after with the care and devotion that they deserve but it is all too easy to put your own needs second when caring, which can lead to mental and physical health deteriorating.
We believe that supporting carers should be one of our top priorities and are looking at how we can increase support. One support mechanism that we have developed is the new Dudley Carers Hub, which launched in June 2019 and has proved very successful. We are now working in partnership with a newly commissioned organisation to maximise support for carers and reduce the number of carers falling into crisis.
carers provided with
carers given information
and advice and support
at the carers hub
carers assessed for care
Over the course of the year countless people have benefited from access and prevention services. Some people have been kind enough to share their stories of receiving support and advice, others have given permission for their stories to be told here. For privacy names have been changed.
Case study - Mary
Mary is a 79 year old widow. She live alone in her own house and her only child lives abroad. Mary has spinal pain, vertigo and undiagnosed Parkinsons Disease. She wants to stay living at home but was starting to feel unsafe and to struggle.
Mary was refered to Dudley Falls Prevention as she had fallen and was stumbling regularly. She received a whole range of support from the service and was also refered for a Living Well Feeling Safe assessment. This resulted in a key safe, door chain, second stair rail and telecare equipment. She was also helped to apply for Attendance Allowance. Mary is thrilled with the help and support that she has received, she said she thought she had ‘won the lottery.’ She feels safer on her own at home and is maintaining her independence. She has a contact at Living Well that she can contact if she heeds any further support.
Case study - Alf
Alf is an elderly gentleman who was having problems getting in and out of his armchair. His wife was struggling to help him in and out of his chair. Alf was also not eating or drinking much and refused to have more than two pieces of Weetabix a day and some weak tea.
An Occupational Therapy visit was requested and following an assessment of Alf’s needs it was decided to order a semi- rise recline chair and a transit shower chair. These would allow Alf to get in and out of his armchair unaided and also have access to toileting and showering facilities. The family were also encouraged to contact the District Nurse so that Alf’s eating and drinking could be discussed.
A few weeks following the initial assessment Alf and his wife were revisited to see how things were progressing. The equipment and nutrition support from the District Nurse had a big impact, the improvement in Alf’s health and wellbeing was amazing. Alf’s wife stated she would like to be able to take him out since he had regained his strength and confidence.
Occupational Therapy made a further referral to the housing adaptation team. They agreed to install a permanent ramp at the rear of the property and grab rails by the access door into the hallway.
Following another visit the Occupational Therapist noted that Alf looked much healthier, he was no longer looking pale and crouched but sat up watching the TV, the family said that he had resumed doing crosswords and reading the paper, something he had not done for some time.
Alf’s family stated that he had returned to his ‘old self.’ His daughter said she had a father back and Alf’s sister in law was shocked when she saw him stand up and walk to the kitchen on the Occupational Therapist’s request.
The support Alf received prevented him from going into respite care as his family had been at the point where they could not manage the strain of caring for Alf any longer.
Case study - Tom and Jean
Tom and Jean are co-carers who care for Tom’s mum. They also cared for his dad previously, before he passed away.
Tom’s dad had dementia and his mum has Alzheimer’s. Mum now lives with the couple. Jean continues to manage working, while Tom retired recently. They have both struggled with juggling their working lives with the demands of the caring role and have found this extremely stressful. So stressful that the couple both ended up on medication to manage the stress.
They both felt very alone in coping with their caring load and were finding it difficult to access information and services to help them. They heard about Dudley Carers Hub from a friend and have been thrilled with the support on offer.
Tom says “We felt lost and alone as carers, we didn’t know how to turn to. The Carers Hub has been such a lifeline.
We have met with support staff and even had home visits. We now know there is someone to turn to, at the end of the phone, or we can pop into the Hub. It really does feel like we are now sharing the load. We feel more positive about life, a lot less isolated and being able to talk helps massively.” The couple’s journey has been tough but the Hub has made a real difference to their lives.
Case study - Frank
Frank needed help from his daughter when standing, sitting and climbing the stairs. In order to help Frank be more independent and take the pressure off his daughter an occupational therapy general assessment was requested.
A number of options were identified to help including a raised toilet seat, power bath lift, bed lever and stair rail. Following a discussion with the family these were ordered. Once installed the equipment enabled Frank to be more independent and not have to rely on his children so much. Frank also has a package of care to support him.
Future working for access and prevention
Future working for access and prevention
Make people feel empowered to take on more responsibility for their own health and wellbeing and for supporting others
Being bolder and braver in focusing resources on prevention
Listening to the people and care professionals of Dudley Borough and being open and honest about the difficult choices we have to make
Continue to strive for seamless care by setting aside all organisational and professional boundaries
Empowering people for their own health and wellbeing
There is a growing recognition across health and social care that the person with the most expertise of a condition is the person living with that illness or disability. Helping people to understand that that THEY are partners in deciding what care and health interventions they receive rather than being dictated too has numerous benefits. People feel more in control of their lives, have a better understanding of why the proposed care is being suggested and are more likely to challenge decisions they don’t feel happy about. The result is better decisions being made with the person’s desires at the centre of their care.
We want people to be actively involved in decisions that affect them and their loved ones and therefore ‘Making people feel empowered to take on more responsibility for their own health and wellbeing and for supporting others’ is one of the four priorities going forward.
Being Bold and Brave
The majority of resources in the public sector are spent on supporting those people that are in urgent need of support. Preventing the situation from deteriorating to the point where expensive care and support is required is much more sustainable, both from a cost and a demand perspective. Spending money on preventing people getting ill when there are already people that require support is a very difficult thing to do but without refocusing our resources on prevention it will becoming increasingly challenging to support large numbers of people with more complex needs.
Listening, being open and honest
The best decisions are made when people trust and respect each other’s perspectives and opinions. To develop that mutual respect the people and care professionals need to listen to each other and be willing to have open and honest discussions about the difficult choices we have to make. Developing that relationship is a foundation of how adult social care wants to work with and for people and communities.
Striving for seamless care
People and their families are the first to suffer when organisations providing care fail to work together and agree to set aside organisational and professional boundaries. We are determined to put each person at the heart of the care they receive and to work with our partner organisations to make sure that we deliver the best services possible.