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Advice and Information for the Elderly of Hammersmith: Gloucester House Research Report

Research report:
Looking into the need for an Advice and Information Centre in Hammersmith (Sycamore Gardens W6)

Report author: Ruthi Margulis
Date: Friday 21 November 2008

2. Context

“Social networks suffer as people get older and it becomes harder to make new friends. Social isolation leads to depression, loneliness, anxiety, which in turn stop people from interacting with their local community and accessing services they need”. (A Sure Start to Later Life)

“Many of use recognise that we, or members of our family, have additional needs if we have a lifelong disability or as we grow older and develop health problems. Despite these additional needs, we want solutions that remain within our own control, perhaps by identifying a service or piece of equipment ourselves. Often we are prevented from taking responsibility for what we need because of the difficulty of getting information on what support, help or equipment is available.” (Independence, Well-being and Choice)

The Hammersmith and Fulham Housing Needs Survey 2004 found that:

  • Around 80% of older person only households are living alone.
  • Over 60% of frail older people in the borough live in one person households.
  • Older women are more likely to be living alone than men as they outnumber men by nearly 2:1 in the older age groups.
  • Approximately 44% of older person-only households in the borough are owner-occupiers, 26% council tenants, 11% private rented sector 19% are RSL tenants.
  • Households with special needs – frail elderly people form one of the largest groups with special needs in the borough and are more likely than non-special needs households to be living in the owner occupied sector.

The 85+ year’s age-band remains relatively static in terms of numbers but makes up a steadily greater % of those aged 65 and older. The number of frail older people is on the increase and it is in this group that the highest levels of vulnerability are to be found. They need more support and make a proportionately greater use of services.

2.1 Providing advice and information to older people (4)

A recently published article in Community Care summarised the findings from a government research project entitled Public Information and Older People.  The research investigated the way older people access information and the challenges to service providers in providing information to older people.  This research is useful and relevant to this project and the key findings can be found below.

2.1.1 Challenges

The key challenges were that:

  • Older people often don’t seek information directly from the primary source or instigate or directly contact public services agencies to get information.
  • A limited role is played by information in decision making by older people in need of support.  Instead they draw on their own knowledge or perception of how things work and tend to use informal sources such as friends or the ‘grapevine’.
  • Many people are doubtful they will be able to understand the information available, because the processes/systems it describes are complicated.
  • They want to get hold of what they need quickly and easily and be able to make practical use of it.
  • They will turn to formal sources only when in great difficulty: examples, CAB used the most often, sometimes libraries, rarely the Council.

2.1.2 Best Practice

The research concluded that there is a need to think more carefully about the ways in which people are equipped with information, tools and support.  The report recommends that each local area has a central, easily identifiable information contact point that is responsible for gathering and disseminating information on all health, social care and voluntary sector services within that area.

Crucially, the use of staff/volunteers is key to success as it provides personal face to face contact with someone who:

  • Knows about the system concerned
  • Can explain it in a friendly and simple way
  • Is amenable to questions and open to direct personal interactions
  • Can interpret the information and explain what it means for the individual

The full article can be found at www.communitycare.co.uk (Date: 12.06.08)

2.2 Providing social care services to older people

2.2.1 Access to Care Services

Department of Health guidance states that, in general, councils may provide community care services to individual adults with needs arising from physical, sensory, learning or cognitive disabilities and impairments, or from mental health difficulties.

Councils should use the Department of Health eligibility framework – Fair Access to Care Services (FACS) – to specify their eligibility criteria. The eligibility framework is based on the impact of needs on factors that are key to maintaining an individual’s independence over time.

The eligibility framework is graded into four bands, which describe the seriousness of the risk to independence or other consequences if needs are not addressed. The four bands are as follows:

Critical – when:

  • Life is, or will be, threatened; and/or significant health problems have developed or will develop; and/or
  • There is, or will be, little or no choice and control over vital aspects of the immediate environment; and/or
  • Serious abuse or neglect has occurred or will occur; and/or
  • There is, or will be, an inability to carry out vital personal care or domestic routines; and/or
  • Vital involvement in work, education or learning cannot or will not be sustained; and/or
  • Vital social support systems and relationships cannot or will not be sustained; and/or
  • Vital family and other social roles and responsibilities cannot or will not be undertaken.

Substantial – when:

  • There is, or will be, only partial choice and control over the immediate environment; and/or
  • Abuse or neglect has occurred or will occur; and/or
  • There is, or will be, an inability to carry out the majority of personal care or domestic routines; and/or
  • Involvement in many aspects of work, education or learning cannot or will not be sustained; and/or
  • The majority of social support systems and relationships cannot or will not be sustained; and/or
  • The majority of family and other social roles and responsibilities cannot or will not be undertaken.

Moderate – when:

  • There is, or will be, an inability to carry out several personal care or domestic routines; and/or
  • Involvement in several aspects of work, education or learning cannot or will not be sustained; and/or
  • Several social support systems and relationships cannot or will not be sustained; and/or
  • Several family and other social roles and responsibilities cannot or will not be undertaken.

Low – when:

  • There is, or will be, an inability to carry out one or two personal care or domestic routines; and/or
  • Involvement in one or two aspects of work, education or learning cannot or will not be sustained; and/or
  • One or two social support systems and relationships cannot or will not be sustained; and/or
  • One or two family and other social roles and responsibilities cannot or will not be undertaken.

2.2.2 Local authority use of the FACS framework

In constructing and using their eligibility criteria, and also in determining eligibility for individuals, councils should prioritise needs that have immediate and longer-term critical consequences for independence ahead of needs with substantial consequences. Similarly, needs that have substantial consequences should be placed before needs with moderate consequences; and so on.

If a council determines that it only has resources sufficient to meet needs and risks falling into the critical and substantial bands, the councils’ eligibility criteria simply comprise the critical and substantial bands. In other words, a council’s eligibility criteria comprises the bands from the framework that represent the needs the council will meet, having taken its resources into account.

2.2.3 Access to Services in Hammersmith and Fulham

Hammersmith & Fulham provide services for people who have ‘critical’, ‘substantial’ and ‘greater moderate’ needs. The council has split the ‘moderate’ band into ‘greater moderate’ and ‘lower moderate’. They do not provide services for people who have ‘lower moderate’ or ‘low’ needs.

This has resulted in a high demand for non-council provided services such as:

  • Befriending
  • Home visits
  • Home help
  • Escorts
  • Community transport
  • Lunch clubs
  • Meals on Wheels

Voluntary and non-profit organisations currently providing these services to individuals who are not eligible for council services are oversubscribed with substantial waiting lists.  See consultation findings in section 4.2.

2.2.4 Better Government for Older People Hammersmith and Fulham

Better Government is a monthly consultative forum for older people.  It is a UK-wide networking partnership where older people are the key partners.  The aims of the organisation are to engage older people in decision-making and service development in order to:

  • Influence policy and practice
  • Develop partnerships
  • Share information and learning

The Consultative Forum is serviced by an external host and financed by the local authority and H&F NHS.  It calls upon officers of many service providers to explain and consult on their plans and policies to an entirely self-selecting group of older people on a monthly basis.  It also runs a number of sub groups including a transport group, a social group, a reading group who look at publications and letters etc for readability.

They work in partnership with a wide variety of local and national organisations including Age Concern, The Pensioners Forum, MIND, Mencap, CITAS, Shanti, Nubian Life, The Polish Centre, TfL, NHS, CAB, Carers Centre, Community Transport, PALS, ICHT, and many more.

Better Government wants to ascertain wider opportunities for distributing information on its work to local older people through developing a wider resource to publicise Better Government and developing a programme of activities and community events.

2.2.5 Hammersmith and Fulham Local Involvement Network (LINK)

LINK aims to give residents a voice in shaping service provision.  It is made up of independent networks of groups, individual residents, local businesses, forums and other local organisations.  These networks hold regular public meetings and work to find out what people want and investigate the issues affecting them and make recommendations to policy makers.

The H&F LINK is a statutory body with a remit to represent local peoples views on all aspects of health and social care.  It is tasked to gather information to consider priorities and plans set out by the service providers and to comment and advise upon them.  It is tasked to achieve responsiveness in the service providers to local needs and to ensure that the plans and policies of the service providers meet the priorities of the local population.  It is hosted by the same organisation that serves the Consultative Forum and is financed by the Government via a grant to the Local Authority.  It is entirely staffed by volunteers.

2.2.6 Hammersmith and Fulham Advice Agencies Forum

Hammersmith and Fulham Advice Agencies Forum is a cross-sector forum that brings together agencies providing advice and information services in the borough.

The Advice Forum meets quarterly and provides various advice agencies with the opportunity to network with other services and to discuss issues relating to changes in government legislation, training, new funding initiatives and issues relating to vulnerable clients and the problems they may be experiencing in accessing particular services.  By actively encouraging the participation of a wide range of agencies, the Advice Forum aims to gain a real understanding of community needs and to develop quality services that respond to these requirements.  It also attempts to co-ordinate funding applications for services in the borough in order to ensure that funding is used to best effect in tackling local problems.

2.2.7 Community transport services in Hammersmith

The Hammersmith and Fulham Community Transport Project provides hire vehicles for use by community groups in the borough.  An organisation must subscribe to this service.

Dial a Ride is available across the borough, and is widely used by older people.  It provides door to door transport for those who are unable to use public transport due to mobility problems. The Paddington Depot covers the Hammersmith and Fulham area.

Some local organisations and community groups also provide community transport for their clients.

The Better Government Transport Project Group looks at issues of concern to older people, including public transport, accessible/community transport and environmental issues.

4. Sources: Opportunity Age Information Indicators Feasibility Study 2008 www.dwp.gov.uk/asd/asd5/WP47.pdf;Opportunity Age: Meeting the challenges of ageing in the 21st Century 2005 ; Accessing Information about Health and Social Care Services, Picker Institute 2007. www.pickereurope.org/filestore/publications/information_access_final_web.pdf

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