Issue - meetings

The following witnesses will be in attendance for this meeting:

Mark Goddin (Leicestershire County Council) – Personalisation and Care Homes

Ruth Johnson (NHS Leicestershire County and Rutland) – Continuing Care

Sandy McMillan (Leicestershire County Council) – Continuing Care

Cindy Nicholls (Tudor Care Home) – Long term and respite care.

In continuation of the Scrutiny Commission’s review of care of people with dementia, three witnesses attended the meeting to provide information to Members and to answer questions.

Mark Goddin from Leicestershire County Council provided a presentation and spoke about personalisation, working with other agencies on healthcare matters (focussing on services for dementia patients), service transformation and support for care homes.

Cindy Nicholls, Manager of Tudor Care Home which was specifically for people with dementia, spoke to the Commission about the support provided in her establishment and the challenges faced, including reduced funding. She also highlighted the difference in the specialised care she provided compared to that available in some other homes.

Ruth Johnson from Leicestershire County and Rutland NHS spoke about Continuing Healthcare including the referral, assessment and appeal processes, the relationship with other agencies, specifically Adult Social Care, and the funding packages available.

Members asked questions of the witnesses and raised concerns and comments. During questions and discussion, the following points were made:

• The options for Personalised budgets were either a cash budget, managed budget or provider managed account.
• The importance of early intervention and prevention which often meant that ongoing support for dementia sufferers wasn’t required.
• A county-wide call centre for dementia care was being set up which would provide a 24-hour response service.
• The County Council provided support and training for carers.
• The “choose my support” website had been developed to assist people in accessing information and selecting the most suitable support for their needs.
• New dementia adviser posts were being created within the County Council and would act as a first point of contact after diagnosis to provide advice.
• ‘Fair access to care’ recognised four different levels of need – low, moderate, severe and critical, and assessments were made on an individual basis based on need rather than on diagnosis.
• Support for people with dementia had changed since the National Dementia Strategy had been published by the Government in 2009.
• The need to re-assess people with dementia regularly to ensure the care package provided is suitable and the ability for a review to be requested.
• Funding and income were such that care homes could only pay their staff minimum wage, whilst at the same time trying to provide the best care possible and employing suitable and experienced staff.
• Additional checks, monitoring and staff training were essential for homes caring for people with dementia.
• The cost of the care recommended was not taken into account by the NHS when assessing individual cases to ensure the decision enabled the most suitable care for the person concerned.
• There were some overlaps in support provided by Adult Social Care and the NHS, but for the user it should be a seamless transition between or combination of the two.

The Chairman thanked the witnesses for their very helpful presentations and valuable responses to questions from Members.

A report is attached which gives a background and baseline information to assist with the Commission’s review. The suggested timetable for the review is also attached, which includes a list of the witnesses who have agreed to attend.

A representative of the Alzheimer’s Society Leicestershire will be in attendance to give Members an overview. Members will then consider questions to put to witnesses at the following meeting.

Diana Smith, Locality Manager from the Alzheimer’s Society Leicestershire gave a presentation on dementia which included background information such as definitions and types of dementia, the work undertaken by the Society, current projects and schemes, links with other organisations, and future aims. Members had the opportunity to ask questions to further their understanding of the disease to enable them to support the review.

Howard Wilkins, a local Parish Councillor who had personal experience of supporting family members with dementia, outlined his experience and concerns to provide a different perspective to the Commission.

The two attendees were thanked for their contributions and Members felt that the information received would assist them in preparing questions for future witnesses as part of the Commission’s review.