BOROUGH OF POOLE
COMMUNITY SUPPORT & EDUCATION SCRUTINY COMMITTEE
22 February 2005
REPORT ON THE
PROVISION OF A MEALS SERVICE TO ISOLATED OLDER PEOPLE
(“EATING WITH FRIENDS”) WORKING GROUP
1.PURPOSE
1.1To report the findings of the scrutiny undertaken by the Eating with Friends working group into success of current meals provision strategies and the possibility of developing an Eating with Friends meal service.
2.DECISIONS REQUIRED
2.1To note the report and findings of the Eating with Friends working group and to endorse the following recommendations in respect of older people:
2.2The development of an Eating with Friends Service not be pursued as, overall, clients were satisfied with the current meals service and there was little demand for this proposed new service.
2.3The further exploration of local solutions to isolation of older people be undertaken through partnership work between The Poole Older People's Strategy Group and Faithworks.
3.BACKGROUND TO THE REVIEW.
3.1At its meeting on the 27th April 2004 the Community Support & Education Scrutiny Committee agreed to establish a working group to examine the success of current meals provision strategies and to gather evidence with a view to recommending an “Eating with Friends” meal service be developed.
3.2Members also suggested that the review might include consideration of improving the social integration of those who do not receive a meal service but who cook for themselves and eat alone.
3.3The current delivery of meals needs to be considered in the context of a “Wheel of Meals” Appendix A. This is a continual process of rehabilitative care and accommodates different levels of dependency and isolation. The ultimate goal is to give people back their independence.
3.4Service users are assessed by care managers/social workers to ascertain which part of the wheel they will enter. A care package is formulated by selecting the desired services. Review dates are agreed to ensure that service users receive the correct level of care in the future.
3.5Adult Social Services Eligibility for care is based on critical, substantial, and moderate risk to independence. Service users who are assessed as having low risk to independence are not eligible for a commissioned subsidised service from the Borough although information and advice is offered.
3.6In an ideal situation if the dependency decreases, service users will continue their journey around the wheel. Some will stop at certain points but others will continue their journey until independency is achieved.
3.7Service users in a critical condition can receive a rapid response home care service which provides personal and domestic care. This is a block contract of 150 hours per week usually providing care for 25 service users at any one time. Alternatively they can receive a hot delivered meal. Adult Social Services Commissioning are currently delivering lunch time meals to 255 service users. The number of meals delivered per week increased from 724 in August 2004 to 1350 in January 2005.
3.8Residents who are admitted to Poole Hospital and Bournemouth Hospital can be eligible for the free 2 week Home from Hospital service to help them return home. This is usually provided to 20 service users at any one time totalling 120 hours per week
3.9Service users assessed as having substantial risk to independence can receive a specialised high dependency home care service. There are contracts with 2 independent providers and with the Adult Social Services Provider Unit. These are service users who normally receive more than 6 visits per week and more than 10 hours in total. Home care assistants are able to prepare breakfast, lunches and other meals within this contract. A total of 58 service users receive high dependency home care services.38 clients in the independent contracts totalling 872 hours per week and 20 clients in the Adult Provider service totalling 475 hours per week.
3.10Adult Social Services Commissioning, jointly with Poole Primary Care Trust, fund a rehabilitation home care service. This provides intensive home care over a period of 6 weeks in order to encourage people to regain skills, particularly washing, dressing and preparation of meals etc. The contract is for 200 hours per week and normally at any one time in excess of 21 service users are receiving a rehabilitation service.
3.11A large proportion of long term service users have been assessed or reviewed as having a moderate risk to independence. There are 423 long term home care service users receiving home care from independent providers totalling 3471 hours per week. 92 service users receive long term home care from the Adult Provider home care service totalling 584 hours per week. This is a total of 515 service users of which 80 continue to have a meal prepared at lunchtime by a home care assistant.
3.13Out of the total of 255 service users 89 older people receive the delivered meal service and do not have any other Social Services provision.
3.14 Agincare who are the company providing the Social Services delivered hot meals service at lunchtime also deliver hot meals to 150 Poole residents who pay privately. In addition Home Farm Foods and Wiltshire Farm Foods are companies which provide delivered frozen meals.
3.15Within the borough of Poole there are a number of luncheon clubs. These include:
- Methodist Church Oakdale Road
- Oakdale Luncheon Club
- Ashley Road West Friendship Club
- Salvation Army
- Broadstone Friendship Luncheon Club
4.APPOINTMENT OF THE WORKING GROUP.
4.1To enable a review to be undertaken the committee appointed a working group comprising;
Councillor Charles Meachin
Councillor Chris Bulteel
Councillor David Newell
The working group appointed Councillor Chris Bulteel as its chair.
4.2Community Support and Education Scrutiny Committee noted that work would be carried out in consultation with the Community Support Overview Group.
5.TERMS OF REFERENCE
5.1“To examine the success of current meals strategies and services and to gather evidence for development of” “Eating with Friends” services. (Appendix B)
5.2The working group included consideration of the following issues:
- Information collated by the Poole Health Action Area Isolated Older People.
- Involvement of service users in their views of the effectiveness of the current delivered meals service, identifying any areas of unmet need and future partnership commissioning.
- Consultation with service users to establish their priorities for services and aspects that they value.
- Consultation in partnership with Poole Older Peoples Strategy Group.
- Identification of the general principles behind what older people feel they need in terms of meals service in order to keep healthy and maintain their independence.
5.3The work of the group linked to council strategy which identified “building active communities” as being a theme of high priority in terms of responding to community needs and aspirations. Some of the key areas in which meals development could contribute to this strategy are:
- Supporting the development of neighbourhood services delivered by local people, groups etc.
- Creating an environment which fosters and supports new and existing voluntary and community groups, some of which could deliver meal services.
- Identify how the voluntary and community sectors role in service delivery can be developed to deliver improved services at local level.
5.4The joint review of Social Services in Poole made recommendations which linked to this working group:
- The need to develop a range of preventative services for older people with lower level needs, in partnership with Primary Care Trust.
- Ensure that users and carers are systematically asked for their views about current services and future developments, building upon current examples of good practice.
5.5The scope of the work included the following objectives:
- The refocusing of meals services, if necessary, in order that they respond to the key elements of the national agenda – promoting independence, rehabilitation and prevention.
- Comprehensive information be available to all users about what meal services they can expect.
- Evaluation of whether there is a necessity for alternative meals services to the existing ones provided by the local authority.
- Involvement of service users in their views of the effectiveness of current provision, identify any areas of unmet need and future partnership commissioning.
6.MEETINGS AND VISITS.
6.1The working group has met on 5 occasions (13th May, 11th June, 12th July, 1st September, and 20th December 2004).
6.2The following members of the Older Peoples Strategy Group became members of the working group in order to undertake semi structured interviews with service users receiving the delivered meals service:
Jean Baker, Jean Blackmore, Keith Chick, Brian Lacey, Hilary Lawson, Jill Legg, Barbara Mckeown, and Jane Perry.
6.3In addition the following councillors agreed to participate in the consultation process: Councillor Adams, Councillor Butt, Councillor Clements, Councillor Deas, Councillor Hillman and Councillor Wretham.
6.4The working group agreed to undertake a pilot consultation with service users. A letter was sent in July 2004 to 89 clients who lived alone, received the meals delivery service, but no other services from Social Services. The letter advised the service users about the project and the planned consultation and requested their participation in a 45 minute interview with a councillor and a member of the Older Peoples Strategy Group.
6.5There were 23 follow up telephone discussions with service users or their relatives/carers about taking part in the consultation exercise. Five interviews were undertaken on the 21st and 22nd July 2004.
6.6In June 2004, the Primary Care Trust held an event at the Lighthouse specifically for older people. A questionnaire was designed to gather views on the proposed ideas about “Eating with Friends” and 18 were completed.
6.7Having considered the results from the pilot the working party agreed to undertake further consultation. A further letter was sent to 61 service users in October 2004 advising that the pilot consultation had provided some useful information and that the councillors would like to interview more people who had the meals service.
6.822 interviews were arranged during the week commencing the 25th October and 10 interviews took place. The interviews were based on a semi structured format which is outlined in Appendix C.
6.9During its investigation the working group also received a considerable amount of information, including presentations from specialist staff (Appendices D; E; F; G).
7.SUMMARY RESULTS OF CONSULTATIONS WITH THOSE RECEIVING A DELIVERED MEALS SERVICE
7.1A key find of the survey was that, overall, clients were satisfied with the delivered meals service and that there was little demand for an Eating with Friends Service.
7.2Menus
Whilst not aware of the menu, the majority of older people interviewed did not feel it needed to be changed more often.
7.3Satisfaction
The majority of people were satisfied with:
- Having enough information before the service started.
- The food choice, quantity, temperature, quality and presentation.
- The overall reliability of the meal service.
- The continuity of the driver and arrangements when the regular driver is away.
- The ability to get things put right if they go wrong although the working group felt more information should be available about how to contact the manager of the service.
Everyone was satisfied with:
- The cheerfulness, general manner and care of the staff although would like the drivers to spend more time with them.
- The cost of the meal service.
The majority of those interviewed had also not experienced any problems with the service and felt no improvements were needed. However, one suggestion for consideration was to have difference portion sizes.
7.4Other Help
Although living alone and therefore spending a lot of time on their own, the majority had informal carers going in and regular visitors.
7.5Eating with Friends
The majority were not interested in eating with others or the suggestions put forward.
8.THE EVALUATION OF THE SCRUTINY PROCESS.
8.1Members of the working group thought it was important to evaluate the process of how the scrutiny group had worked in pursuing its tasks. The following points emerged:
- Very useful for Older People’s Steering Group members to work in partnership in this way.
- Users were given the opportunity to participate and were able to express their views.
- Aspects valued by users were established through the consultation.
- Service developments were considered.
8.2The working group was of the view that scrutiny process had been effective in investigating those issues and concerns set out in its terms of reference.
9.ACKNOWLEDGEMENTS.
9.1The working group would like to take this opportunity to thank:
- Members of the Older Peoples Strategy Group.
- Sally-Ann Webb, Adult Social Services Commissioning, for organising the methodology of the consultation.
- Karen Linaker, Principal Democratic Support Officer, for arranging and taking notes of the meetings.
- Councillors involved in consultations with service users.
9.2The participants have been thanked for taking part in the interviews and the summary results have been fed back to them.
Appendices:
A – Wheel of Meals.
B – Terms of reference.
C – Semi structured questionnaire.
D – The need for “Eating with Friends” services.
E – Meals and isolation.
F – Details of current meals service client based.
G – Public Health action area for isolated older people. Summary of Projects.
H - Notes of the Working Group Meetings.
Councillor Bulteel
Chairman – Eating With Friends Working Group
11th February 2005
PLEASE CONTACT KAREN LINAKER FOR THE APPENDICES TO THIS REPORT
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