Shortfalls listed in social care survey

OLDER people in Cambridgeshire are still staying in hospital too long after treatment and those with mental health difficulties get a lesser degree of service . There is also a shortfall in some services including those with dementia, and waiting times f

OLDER people in Cambridgeshire are still staying in hospital too long after treatment and those with mental health difficulties get "a lesser degree of service".

There is also a shortfall in some services including those with dementia, and waiting times for occupational assessment are still too long.

These are just some of the findings of the latest survey of county council and primary care trust social care services carried out by the Commission for Social Care.

While agreeing that the county council and primary care trust (PCT) have done much to improve matters in the past year - particularly in more elderly people being helped to live at home - the commission believes more joined-up working is needed.

Inspectors also discovered both the county council and the PCT were not doing enough for older minority groups.

"There was little direct contact from the PCT or adult social care with black and minority ethnic or with lesbian and gay older people to strongly encourage participation," says the inspectors' report.

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"There was no whole-systems agreement between the council and all health partners to ensure the best outcomes for older people."

The inspectors say there is:

* no strategic plan to ensure the right workforce is in place

* some care management and social work staff are inadequately trained

* too many changes take away workers from their real jobs of caring for older people.

However the report strikes a more positive and optimistic note from previous findings and the inspectors list a broad range of achievements.

"From a low base in previous years, performance on most 'key threshold' and other social care indicators was improving as planned due to recent management action," says its report.

The inspection team says the challenges facing Cambridgeshire are immense, with the numbers of over 85s, for instance, likely to rise by 67 per cent by 2021, well above the national average.

But the inspectors say the council has problems with owners of private residential homes who were "of the opinion that the council was not fully engaging with them about filling known gaps in provision".

Fees paid were also lower than in other counties, and there remained shortfalls in temporary and permanent residential dementia care beds, specialist dementia day care and good quality home care.

The report also questions why "the cost of home care rose greatly in 2005/6, by 19 per cent for intensive home care and by six per cent for smaller packages of care.

"The council could not explain this level of increase, except that in previous years unit costs may have been calculated wrongly."

The inspectors highlighted inadequacies in training for care management staff noting that "only 22 of the 87 front line staff who replied our questionnaire said they had received training in the last two years to help them work effectively with mentally ill older people."

The inspectors also said it was "unfair" that day centres and lunch clubs, most of which were not run by the council, charged highly variable fees for similar services.

"We saw the many differences in services, structures and processes across the county as a key issue, because they sometimes led to different or unequal outcomes," says the report.

"Despite some good council initiatives, lack of flexible transport remained an obstacle to social inclusion and independence for older people in rural areas."

Councillor Roy Pegram, cabinet member for environment and community services, said the council was delighted that the report noted the progress being made by the council and the PCT.

"Equally we are determined to take measures to address the weaknesses they identified," he said.

"Older people's services are struggling to meet ever increasing demand at a time when Government resources to meet the cost of social care nationally are tightly constrained."

Matthew Winn, chief operating officer for the PCT, said the report recognised the benefits being realised through integration of health and social care teams.

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