1. To eliminate Age Discrimination

The Council’s annual user survey includes a question about age discrimination. Security of tenure in Older People’s Homes has been highlighted as an issue in the Survey findings.

Through the Public Service Agreement funding of a scrutiny group has been established

Age discrimination work to be integrated into the core equalities and diversity agenda. Improve access to mainstream social care and support services for black and minority ethnic persons.

Identify Practice and Management Champions for this area.

Review of policies by Strategic Policy and Planning Unit.

2. Person Centred Care

Older people are treated as individuals and they receive appropriate and timely packages of care. Single Assessment Process (SAP).

Single Assessment Process established. Limited implementation from April 2004 pending computer system development.

To refine local Single Assessment Process (SAP) policy and practice guidance and develop an electronic system for implementing SAP tools.

Fair Access to Care Services

Eligibility Criteria established as set out in the national guidance Fair Access to Care Services (FACS).

Model implemented from April 2003.

Monitor, evaluate and make any necessary changes.

FACS to be an integral part of induction and the Learning and Development Programme.

Impact Assessment on the use of FACS with Older People from Black & Minority Ethnic (BME) groups.

Planning

To build on the Joint Investment Planning process to provide a comprehensive Older People’s Services Plan within the overarching Community Planning framework.

3. Choice and Control

Older people have maximum involvement in identifying their needs and deciding on services.

The number of people aged over 65 receiving Direct Payments (DP) has increased from 2 in April 2001 to 30 people in April 2003.

A user led organisation is in development.

Care Management and Public Information has been revised to introduce Direct Payments early in the process and to prompt care managers.

To ensure that older people have a voice in the groups working to plan and modernise services

Older people have been involved in all relevant Best Value Reviews.

Divisional targets: An increase of 40 older people using Direct Payments from 1 April 2003 to1 April 2005.

Revised policy guidance to be developed in conjunction with the newly constituted Direct Payments Board (Care Managers are confident in the use of Direct Payments and routinely recommend them to service users.)

Use of Direct Payments to be included as part of core competencies for Care Managers to be considered at each appraisal.

A joint policy is being agreed between health and social care on patient choice during the hospital discharge process. This will include culturally appropriate choices.

Develop a consistent approach to user involvement across the Adult services Division that includes people from minority groups.

4. To provide Intermediate Care (IC) services

Inter-agency teams in development.

Integration of domiciliary and residential schemes.

Successful pan Devon bid with 6 PCTs to set up an Accelerated Development Programme (ADP).

Joint agency agreement and definition of Intermediate Care services has been reached with 6 Devon PCTs.

Evaluate the range of approaches to Intermediate Care services across the county to establish best practice. Finalise a multi-agency strategy (A project manager appointed to progress this work.)

Implement Accelerated Development Programme across Devon with partners.

5.Joint Agency Stroke Group: To reduce the incidence of stroke in the population and ensure that those who have had stroke have prompt access to integrated stroke services.

A Joint Agency Stroke Group has been established to oversee the modernisation of stroke services. This is under the P2 programme and includes a Project Team and 4 sub groups configured around National Service Framework (NSF) headings. Action plan completed. Service user representation included in the work of the project.

Our actions and outcomes in respect of this key area are complementary to and consistent with the key actions outlined in key area 4 above.

NB It will be important to map the needs of Black & Ethnic Minority People (BME) who have recently had strokes.  National research shows that people from BME backgrounds do not receive appropriate stroke care.

6. Falls: To reduce the number of falls which result in serious injury and ensure effective treatment and rehabilitation

Improve access to adaptations by integrating District and County Council Services: We have produced a user guide to adaptations and an integrated service that is being piloted/evaluated.

Review of Home Improvement Agency Services (HIAs).

To produce a single, integrated, NHS and Social Services Equipment Service.

Evaluate the pilot and agree a model for consistent development across the County.

Agree and implement new countywide specification for HIAs.

Implement improvements and expansion to achieve revised standards. East Devon Falls Development Project implemented and extended countywide. Funding available from performance fund.

7. Mental Health: to promote good mental health and to support those with dementia and depression.

Establish a joint agency dementia task group to translate the Intermediate Care template into Service Plans and to oversee their implementation. This will be reflected in the Service Plan for Older People 2004-2008.

To consider the development of specialist dementia teams across the County and to invest in specialist equipment and training to assist people with dementia to remain at home.

8. To extend the healthy life expectancy of older people

• Working with partners to map preventive services.
• Develop a framework for monitoring the progress of schemes and the outcomes achieved to ensure consistent approach in commissioning and provision.
• Develop and implement an information sharing process about preventive services, which is up to date and shared with staff, users, carers and other stakeholders.
• To improve preventive health care to BME persons.

9. Older people and staff should have clear and accessible information about services

Care Direct Pilot

The Pilot is nearing completion and will inform the development of a new Third Age Service and future Social Services Access arrangements.

Public information is now available in six languages.

Ensure that information published on services is up to date and accessible to all the communities of Devon including black and ethnic minority communities.

Better Care Higher Standards Charter

Draft Charter produced but not published.

To agree a revised approach to the Charter resulting in publication of information on standards in 2004/5. Ensure that the Charter addresses Human Rights and Equalities legislation.

10. Housing:

Accommodation needs of older people are addressed in the Supporting People programme and via "extra care" housing projects and other preventative initiatives.

Increase the availability of extra-care housing schemes across the county together with the associated support services. Develop joint agency strategy for extra care housing, reflecting service plans and undertake work to produce consistent admissions criteria. Develop and implement countywide specification for Home Improvement Agencies. To plan for Black and Minority Ethnic elders.

11. Best Value Review

Develop a coherent Commissioning Strategy for all sectors and services. This will be driven through the emerging Modernisation Programme which will clarify the envisaged market position for all sectors.

Modernisation and Best Value development team established and project managers appointed. Work has commenced on:

• Development of Commissioning Strategy
• Creating investment and dis-investment profiles; including a "fair-price for care" to stabilise the independent sector
• Identifying the role and function of in-house services.

12. To fulfil the Local Public Service Agreement (LPSA) objective for Older People by:

Reducing the numbers being admitted to hospital in an emergency;

Increasing the number of short-term interventions (relative to long term interventions) for people aged 65 plus to enable them to remain at home and independent of other services.

(Good progress is being made in some areas on reducing admissions.)

13. To reduce delayed discharges from acute hospital care to zero

A Peninsula wide policy and a County wide hospital admissions and discharge toolkit have been produced with agreed protocols, standards and outcomes to support the discharge process and the introduction of the Community Care (Delayed Discharges) Act 2003.

This process has been aligned to other developments such as Single Assessment Process and Continuing Care. Some reductions have been achieved by better partnership working.

• Additional investment of £500,000 for expanding Hospital Discharge Services with particular emphasis on Community hospitals and pre admission assessments. To develop and implement an agreed countywide approach to investment of the reimbursement grant based on pooled budget arrangements.
• Improve whole system modelling to establish best investment patterns.
• Identify and remove barriers to timely discharges. This includes a joint policy between health and social care on patient choice during hospital discharge process.
• Develop and implement an agreed countywide IT based framework for implementation of the Community Care (Delayed Discharges) Act 2003 to be based on the single assessment process.