Older people in Dumfries and Galloway are benefiting from some good quality health and social care services, but more needs to be done to improve care at home and reduce delayed discharges from hospital.
A joint inspection of services, carried out by the Care Inspectorate and Healthcare Improvement Scotland found that services across the Dumfries and Galloway health and social care partnership performed well in comparison to the rest of Scotland in relation to emergency admissions to hospital.
However, inspectors also noted that older people and carers found it very difficult to get care provided in their own homes.
These are just some of the findings of the joint inspection, carried out between January and March 2016.
Across nine key indicators of performance, inspectors rated two as ‘good’. These were the impact on staff including what employees thought and felt about working in the partnership, and the impact on the community which looked at how the partnership promoted positive engagement with service users.
Seven indicators were evaluated as adequate and inspectors have made 10 recommendations for improvement.
Inspectors said there was a structured approach to consultation with older people and a high level of engagement with older people and their carers.
And they found there were strengths in the way the partnership adopted approaches that involved individuals in their assessment of needs and in care planning, with a practical approach to support the design and delivery of future services.
There was however a rising trend in delayed discharges from hospital, as well as emergency admission, which the partnership needed to address.
Some carers did not always find it easy to access support and there was sometimes a lack of signposting to services and insufficient respite, which affected their ability to maintain their caring role.
Karen Reid, chief executive of the Care Inspectorate said: “This inspection took place during a period of transformational change across the Dumfries and Galloway Partnership with the establishment of the Integration Joint Board, which will steer the direction of health and social work services for older people in the future, as well as new management structures across the partnership becoming embedded.
“We were pleased to note a number of strengths which are making a positive difference for older people in Dumfries and Galloway and improving outcomes for them.
“We are confident that leaders will be able to build on their strengths and make the required improvements identified by this inspection, in particular by developing a coherent approach to improvement that supports early intervention and prevention, helping to prevent hospital admission, and support hospital discharge, and also improving support to carers.
“The partnership also needs to make sure that staff, older people, and their carers are kept informed and involved as changes are taken forward.”
Robbie Pearson, Acting Chief Executive of Healthcare Improvement Scotland, said: “We inspected the partnership at a critical time in integrating health and social care. In common with other health and social care services, the partnership was engaged in a high level of activity to finalise structures, strategies and planning.
"As part of our inspection, we heard from over 60 older people and their carers. We also heard from over 400 staff and people from the third and independent sectors who help people needing health and care support.
“Overall, we found good engagement with older people and their carers. We also found a structured approach to consultation, and a commitment to effective, meaningful communication between services, people and carers.
“The partnership showed some success in shifting the balance of care from hospital to the community, helping more people to remain living as independently as possible in their own homes. However, older people and carers found that getting care at home at short notice and in more isolated areas was very difficult.
“We also found that support to carers needs to be improved and action needs to be taken to improve anticipatory care planning. These plans should be accessible to all staff in all settings so they can better support people.”
The inspection report is available here