A joint inspection of services for older people in the Shetland Islands has found areas of strength but also identified areas where improvement is needed.
The joint inspection was carried out by a team of inspectors from the Care Inspectorate and Healthcare Improvement Scotland.
They looked at a wide range of services provided to older people by NHS Shetland and Shetland Islands Council, known collectively as the Shetland Partnership. The aim was to find out if health and social work services worked together effectively to deliver high quality services to older people.
The report notes: “The Shetland Partnership’s performance in respect of its services for older people was strong. Most of the relevant data indicated its performance was better than the national average.
“The Partnership faced challenges due to its geography across the islands in ensuring consistent service provision and outcomes for older people, but it had taken some actions to address this, including the deployment of advanced nurse practitioners. It needed to do more in some areas to improve how it measured the outcomes being achieved for older people.
“The Partnership was meeting the national target for delayed discharges from hospital, but faced challenges in discharging some older people from hospital who needed care home placements. However, the Partnership was doing well in its balance of care performance with older people being supported to remain at home.
“From our review of health and social work services records, we saw positive personal outcomes were being achieved for nearly all the older people whose records we read. It was clear that staff were in the habit of talking to older people about their wishes and choices as well as their needs.”
Across nine quality indicators used to assess services, four were assessed as “good” and five were assessed as “adequate.”
Among ten recommendations made for improvement, inspectors said the partnership should:
- ensure that pathways for accessing services are clear and that eligibility criteria are confirmed and applied consistently across services. The pathways should be based on a whole systems approach and be built around multi-agency working.
- ensure that improvement action plans are developed to implement recommendations when self-evaluation activity is completed in order to ensure learning is translated into improved practice and performance.
- take decisive action to address the problems which are adversely impacting on effective multi-agency discharge planning for older people in hospital.
- take action to review and improve its partnership working arrangements. This should include both external and internal partners and in particular the third sector partners.
Karen Reid, chief executive of the Care Inspectorate, said: “This joint inspection highlights where services are delivering good outcomes for many older people.
“We found evidence of improved leadership and a stronger focus on service development and improvement across the Partnership.
“We found a committed workforce who worked hard and flexibly to deliver those outcomes.
“Our report also outlines areas where services should improve further in order to deliver better outcomes for older people.
“Where there is room for improvement we have reported on this and expect the partnership to take the necessary action so that everyone can access services which meet their needs and respect their rights.”
Robbie Pearson, Director of Scrutiny and Assurance for Healthcare Improvement Scotland, said:
"Our inspection of The Shetland Partnership found that services for older people are strong, and that performance is better than the national average according to most of the relevant data. Older people and their carers were generally happy with the services provided to them and told us that these contributed to better health and wellbeing.
“The care centres and voluntary sector make an important contribution to supporting older people. We saw evidence that self-directed support was being discussed with older people, although the limited availability of third sector providers meant the Council is the main provider of social care and support.
“Clearly the Partnership faces challenges in ensuring consistent service provision and outcomes for older people due to its geography across the islands, but we're pleased to see that it has taken some actions to address this, including the deployment of advanced nurse practitioners."
You can download a copy of the report here