MINUTES

/ Assynt House
Beechwood Park
Inverness IV2 3BW
Tel: 01463 717123
Fax: 01463 235189
/
Adult Social Care Practice Forum /

20th June 2016 at 10am. Board Room, Assynt House, Inverness

Present:
Janet Spence – Head of Care Services Improvement – CHAIR (JS)
Lyn Johnson – Manager of the Montrose Centre (LJ)
Ian Clayton – Resource Manager-Learning Disabilities (IC)
Sheilis Mackay – Manager of Advocacy Highland (SM)
Fabien Camus – Practice Support Officer (FC)
Ian Thomson – Acting Lead Social Work Officer (North and West) (IT)
Christine Macleod – Adult Support & Protection Lead Advisor (CM)
Moira Helliwell – Trainee Social Worker (MH)
Adam Palmer – Employee Director (AP)
Angela Longmate – Social Care Worker (AL)
James Bain – Team Leader (Resources and Performance)(JB)
Pamela McAllister – Care at Home Officer (PM)
Laura Maclean – Admin Assistant (LM) / In Attendance:
Laic Khalique – Technology Enabled Care Lead
SUBJECT / REPORT / ACTION
1. / APOLOGIES:
Shona Knight – Team Manager
Bernice Nott – Social Worker
Eilidh MacMillan – Lead Social Work Officer (South & Mid)
Christina Mudditt – Senior Social Care Worker
DECLARATIONS OF INTERESTS
None of the attendees has any interests to declare.
2. / WELCOME
Janet welcomedeveryone to the meeting and a round of introductions was made.
3. / MINUTES OF THE PREVIOUS MEETING HELD ON 18TH APRIL 2016
a) / APPROVAL
The draft minutes from the previous meeting were approved as an accurate record.
b) / MATTERS ARISING AND UPDATES
Transitions
JS reported that Claire Watt has been appointed to the post of Transitions Manager and she will take up post in early August. JS describedthe interview process whereby applicants firstlygave a presentation to and were interviewed bya panel of professionals, before being interviewed by a panel of service users. This worked well and JS recommended that this model of recruitment be considered for all posts where there is close working with service users.
ACTION / None.
4. / UPDATE ON LOCAL AND NATIONAL DEVELOPMENTS IN ASSISTIVE TECHNOLOGY – LAIC KHALIQUE
Laic began by explaining his own role and that of the Technology Enabled Care Service,based in the Centre for Health Science on the Raigmore Hospital campus. The aspiration is for Highland to be the leader in terms of adopting new technology.
Technology is being rolled out which allows individuals to self-monitor their conditions. Patients are also being encouraged to have a greater involvement and make decisions about their health care. There will be a significant switch from analogue to digital services in 2018. Currently, there are 2500 patients using the analogue service so this will be a major change.
Laic spoke about tablet computers which have the potential to become a digital waiting room where patients can attend Health and Social Care appointments from home. In readiness for this, some work has been done with senior citizens who have little or no experience of computers.
Laic spoke about the potential for dementia clients being tracked through Google; their movement and their behaviour can be monitored for changes which could be deemed to be unusual. This technology may help some individuals to remain in their own home. Developments may also help other service user groups, such as people who have a learning disability.
In answer to a question by IC about timescales, a business case is being developed and Laic anticipated that it would be roughly 18 months before the project is properly established.
Laic stated that patients and services users were generally receptive to the new way of working but there was a little way to go in getting the concept fully accepted at a clinical level. A great deal of work is being done to promote and encourage engagement.
CM had concerns that virtual appointments could potentially make loneliness a worse problem than it already is. Laic explained that the aim is for the technology to promote face-to-face communication, advice and support. This might include providing information about local community resources that could alleviate social isolation.
JS asked about the financial implications of the project. Laic stated that this is an area of focus for the Scottish Government and the details are yet to be worked out.
ACTION / None.
5. / HQA ANNUAL OBJECTIVES
JS sought feedback on of the level of members’ awareness of the HQA Annual Objectives. It was agreed that it would be helpful if Anne Gent be approached and invited to a future meeting.
ACTION / None.
6. / REALISTIC MEDICINE
A combination of technological advancements,major developments in health care and treatment interventions, public health initiatives and improved lifestyleshave resulted in people living longer. However, these benefits have resulted in a larger number of older people living with one or more long term conditions. This poses new challenges in the context of how best to manage these in a holistic person- centred way, and how to recognise the need for, and to provide, appropriate end of life care in the context of the ultimate inevitability of death.
The Chief Medical Officer for Scotland’s annual report for 2014-15 is entitled Realistic Medicine. The same theme has been picked up in the subsequent publication of the National Clinical Strategy for Scotland which sets out a framework for the development of Health services over the next 15 years.
A report on Realistic Medicine had been discussed at the May meeting of the Board and the views of the Practice Forum were sought.
The report was welcomed by members of the Practice Forum. They felt that this reflected an assets-based approach which is very much in line with current Social Work thinking, as is working in partnership with the person to establish what matters to them and what aspirations they have for a good life.
Members liked the strong focus on the greater role for the patient or service user in decisions about their care and treatment and its management. It is empowering for people and enables them to have a greater involvement in important decisions that affect them. Some members had professional and/or personal experience where clinicians are involving patients in a positive way and working very much in partnership. However there were other anecdotal examples given where patients did not feel as involved as they might be in the decision-making process. It was acknowledged that some people would need support to express their wishes and preferences and it was agreed that in some circumstances, there would be a role for independent advocacy.
Members felt that there would be challenges in adopting a Realistic Medicine approach in that some patients and their families may still be looking for every available treatment to be availed of, in order to prolong life. It was acknowledged that some patients may prefer to look to the clinician as the one “who knows best”. The challenge then would be for the clinician to be able to explain options in ways that are clear and easily understood. In some cases,they may need to have “difficult conversations” with their patients. This requires a particular level of skill and sensitivity, and potentially requires the clinician to spend more time with the patient. In order for this approach to be successful, members felt that not only would Health services need to change but there would also need to be a shift in societal culture and thinking. Clinicians will need to be given societal permission to practise differently,located withina clear professional and legal framework.
JS recommended that members look at the work of Atul Gawande on aging, dying and “Being Mortal.” This includes videos accessible through YouTube.
JS will compile a response for Dr Harvey on behalf of the Practice Forum.
ACTION / JS will draft a response for the Dr Harvey. / JS
7. / FEEDBACK FROM NHS HIGHLAND BOARD
It is proposed that Caladh Sona and Melvich Community Care Unit (residential care homes) are closed and replace by a hub facility. There will be a period of consultation, as this move constitutes major service re-design.
There has been progress on a number of fronts in Badenoch and Strathspey. Beds in Grant House and the Wade Centre are being used more flexibly. It was also noted that a greater number of Care at Home packages are being commissioned.
The review of Board governance is reaching a conclusion. The value of this Forum has been highlighted. It is anticipated that the Chair of the Practice Forum will working more closely with the Chair of the Area Clinical Forum. She will start attending meetings of the ACF as from July.
Over the next few months, the Board will be looking at a number of projects which will deliver efficiencies.
ACTION / None.
8. / FEEDBACK FROM THE HIGHLAND HEALTH AND SOCIAL CARE COMMITTEE
JS had no particular points to raise.
ACTION / None.
9. / NOMINATIONS FOR ELECTION OF A VICE CHAIR
JS intimated that she intends to retire in April 2017. There is a need therefore to appoint a vice chair who can take over the chairing role in the spring. There were a number of people absent so it was agreed that
JS/LM will send out an e-mail to members seeking for nominations in advance of the next meeting.
ACTION / JS/LM to e-mail the members to seek nominations for the role of Vice Chair. / JS/LM
10. / FUTURE TOPICS FOR CONSIDERATION
  • HQA Annual Objectives
  • My Home Life
  • Care at Home restructure
  • Shape of Care at Home services (particularly concerning professionalisation agenda) – LM to invite Liz Featherstone and Margaret Loughlin)
  • High Level Value Streams (JS to speak to Anne Gent)
/ LM
JS
11. / AOCB
11.1
11.2 / SVQs
There is a major focus on enrolling care home staff on SVQs and supporting them to complete the qualification. The focus will then move on to Care at Home staff in due course. It is estimated that approximately 470 Care at Home staff need to undertake an SVQ and it was noted that additional capacity for assessment will be required. LJ highlighted that she has a staff member who is an SVQ assessor currently sitting with no candidates. A major planning exercise is taking place in July.
Trainee Social Workers
AP asked when the next in-take of Trainee Social Workers will be. JS explained that there are currently no plans for another major recruitment but that Team Managers are still encouraged to think about re-designating Social Worker postsfor traineeship. AP stated that he had heard rumours about the scheme being cancelled due to financial pressures. JS gave reassurance that this was not the case.
ACTION / None.
Date, time and venue for remainder of 2016 meetings
Monday 15th August
Monday 24th October
The Board Room of Assynt House has been booked for both of these meetings (10am-1pm)

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