An inspection of services for older people in South Lanarkshire has highlighted areas of good performance and also made recommendations where improvements can be made.
The report, published today, follows a joint inspection by the Care Inspectorate and Healthcare Improvement Scotland which considered how well the health and social work services partnership in the area delivered good personal outcomes for older people and their carers, enabling older people to be safe, as healthy as possible and have a good sense of wellbeing.
Inspectors also wanted to find out what progress is being made towards health and social care integration by the South Lanarkshire Partnership of South Lanarkshire Council and NHS Lanarkshire.
The report of the inspection, which was carried out from September to November 2015, identified areas of good practice but also made nine recommendations for improvement.
Across nine quality indicators, three were found by inspectors to be ‘good’ and six ‘adequate’.
The report notes: “Positive personal outcomes were being achieved for most older people. The majority of older people we met were content about the care and support they received. There was evidence of effective multi-disciplinary working and a commitment to provide good standards of care to service users. Staff were generally motivated and worked well together. Most were enthusiastic about what integration of health and social care services could offer to improve outcomes for service users."
Some important measures used to judge performance were in line with the Scottish average, such as the rate of emergency admissions to hospital of people aged 65 years and over. However, in others performance was poorer, for example the proportion of older people who had to remain in hospital longer than necessary because of a lack of suitable alternatives including bed-based intermediate care and care at home services.
The balance between hospital, care home and community care provision was improving. The partnership was supporting most service users at home rather than in care homes. But while some progress had been made in joint commissioning of health and social care services, more work was needed to develop a commissioning approach that further shifts the balance of care towards community services.
There were also high levels of respite care provision for older people and this was valued by carers who received it. However, approval processes to enable respite to be provided for the first time were sometimes lengthy.
People with dementia did not always get the support they needed quickly following diagnosis.
Karen Reid, the Care Inspectorate’s Chief Executive, said: “The partnership had a clear vision for the future integrated delivery of health and social care services.
“We found that older people were involved in decisions about their care and support but self-directed support for older people was in its early stages and was not as extensive as for other groups of people. The options available for people were sometimes limited by the lack of services in some areas.
“We saw substantial investment in resources for tele-healthcare which effectively supported many older people to remain in their own homes and communities, including those with long-term conditions.
"Integration planning was progressing and joint management, governance and locality commissioning structures were being established. More work was needed to make sure that all staff understood the vision and priorities. While some joint working took place across the partnership, the management of change needed to become more effective.”
Robbie Pearson, Acting Chief Executive of Healthcare Improvement Scotland, said: "Our joint inspection involved meeting over 100 older people and carers who cared for older people, and around 550 staff and third sector workers.
"We found that the majority of older people we met were generally content about the care and support they received. The balance between hospital, care home and community care provision was improving with most service users supported at home compared to the proportion supported in care homes. This not only helped to reduce the need for admission to hospital but supported discharge from hospital as well as supporting service users to remain at home.
“However, there was room for improvement. The Partnership faced significant challenges in respect of delayed discharges from hospital. This was due, in part, to a lack of care at home capacity and bed-based intermediate care provision. This could result in negative outcomes for them, such as loss of confidence and capacity for self-care, and having to remain in a setting which was not best placed to meet their needs.”
The report is available here: http://badlink/SouthLanJointReport