Partnerships for Older People Project (POPP)

1. Partnerships for Older People Project (POPP) Wigan 2006 - 2008

2. Plan of talk • Overview of Wigan Partnerships for Older People Project (POPP) • Overview of local evaluation in Wigan

3. An initiative led by the Department of Health, providing £1.76m funding to Wigan-based partnerships. The Projects aim to: • provide a range of needs led services based on what older people have asked for; • encourage investment in preventative approaches which promote health, well being and independence for older people; • test and evaluate innovative approaches that enable a sustained focus on prevention; • provide more low level care and support in the community with a view to preventing or delaying the need for higher intensity and more costly care; • reduce avoidable emergency admissions to hospital.

4. Why POPP The focus of the project is on moving away from the need for acute or institutionalised care by providing support for older people who are experiencing times of challenging transition, such as the loss of a partner or following discharge from hospital. Older people today have much greater needs than their counterparts of 10 years ago and the future demand for acute and long-term care is likely to increase greatly in coming years. It is through POPP that patterns of service delivery can change and networks complementing mainstream services to improve quality of life can be established to meet this change in demand.

5. The following partner organisations have come together to enable independence during changing times: • Wigan Council: Adult Social Services Department • Community Protection Department: GM Police • Wigan and Leigh Housing • Wigan Leisure and Culture Trust • Ashton, Leigh and Wigan Primary Care Trust • Age Concern Wigan Borough • Wigan and Leigh Pensioners Link • Greater Manchester Police • Victim Support and Witness Service • Wigan and Leigh Crossroads Care Scheme • Groundwork Wigan and Chorley • Arena Options Care and Repair (Wigan)

6. BME Mental Health Project Ashton, Leigh and Wigan Primary Care Trust will establish a Health Development Worker to address the mental health issues impacting upon older members of the ethnic minority communities. The service will tackle access and service utilisation issues which have long presented problems for health and social services. The project will address any lack of understanding of service provision, fear of racism, barriers to effective communication and cultural norms

7. Carers BME Project The Carers Support worker will be part of the Adult Services team and will help to identify carers from ethnic minority backgrounds and aim to: • gain equal access to support services; • breakdown the barriers where there are cultural and language difficulties; • support community projects within the BME community; • promote advocacy and support; • and access information/support from organisations.

8. Sheltered Housing Improvements POPP’s will finance adaptations and improvements to the sheltered housing schemes managed by Wigan and Leigh Housing to enable residents to remain in their own homes and not have to move on to residential or nursing homes. These will include hearing induction loops, ramp access and disabled toilet facilities. The project will improve the well being of tenants of sheltered housing schemes and people living in the surrounding community by contributing to the creation of a home for life. It will aid both discharge to the community and prevention of admission to residential and nursing care.

9. Respite Project Wigan and Leigh Housing will co-ordinate a generic respite facility and a community resource facility based with The Rowans Sheltered Housing Scheme. The facility will be equipped with a range of assistive technologies aimed at reducing the risks of falls. This will be a short term respite facility which will be used as an alternative to residential care.

10. IT Project POPP’s will provide at least 8 computers and printers in communal lounges within a number of Wigan and Leigh Housing’s sheltered schemes. The project will improve the well being, skills and knowledge of tenants of sheltered housing schemes and people living in the surrounding community by linking prevention to maintaining independence through access to lifelong learning.

11. Stepping Out Project Wigan and Leigh Leisure and Culture Trust will promote physical activity for older people. The major outreach project will provide: • Health talks • Six week introduction to exercise courses to local groups • Taster activity sessions • Health Walks • Senior Peer Mentoring • Moving More Often Training.

12. Community Health Development Workers Ashton, Leigh and Wigan Primary Care Trust employ 6 Community Health Development Workers to visit older people in their own homes. They will visit people, where there is a health concern following a change in the person’s life, but which does not require input from a specialist health professional. The workers carry out a range of assessments, including basic health checks, diet, accessing equipment to help in daily life, safety of walking aids, home environment checks to prevent accidents and falls, the provision of benefits assistance and referral on to other agencies and projects.

13. Handy Person Project The Age Concern Handyperson Project is a service that carries out small household jobs for people over the age of 50. Home safety and security are a main area of priority as well as completing various types of jobs within peoples homes to ensure older people remain independent. The objectives are to reduce the potential of accidents within the home, increase feelings of security, reduce vulnerability and to contribute to better mental health through practical improvements in the home and in the garden. The cost for this service is £15 for the first hour and £10 for subsequent hours, plus the cost of materials.

14. Counselling Project Pensioners Link will provide Individual Counselling and Group Therapy Sessions which will: • Prevent acceleration into serious mental health problems or stress related physical illnesses; • Enable the older person to take back control in their lives; • Alleviate the need for prescribed medication – avoiding dependency, and unpleasant side effects; • Maintaining independence and well being, preventing the need for mental health and social care interventions.

15. Time Limited Support Project This project at Pensioners Link, aims to prevent changing times escalating into crisis situations for older people. The scheme will provide: • Regular telephone contact; • Home Visits; • Information; • Help with transport arrangements; • Practical Assistance; • Help in becoming more involved in social and community activities.

16. Crime Prevention Awareness Distraction burglary is where bogus callers or conmen trick their way into an older persons home to steal property. The Greater Manchester Police will mount an intensive borough wide campaign aimed at raising the awareness of older people in relation to the problem of Distraction Burglary. This will be based mainly around bus advertising, using both advertising space within and on the outside of the bus.

17. Stop and Lock Project Victim Support will focus on upgrading the security of approximately 15 houses per week by fitting various security items including locks, bolts and window alarms. This work is carried out by a joiner and co-ordinated by a part time Project Manager. The service is free and available to anyone over the age of 50 whose life is affected by their fear of crime or level of vulnerability. The objectives are to reduce the numbers of elderly people becoming victims of burglary; reduce the fear of crime; raise awareness and provide reassurance.

18. Rapid Intervention Project Crossroads provides a flexible respite service, at short notice, to enable Carers to manage an urgent situation. This will be provided by a fully trained (NVQ2) Carer Support Worker. The care will be limited to periods up to a maximum of 72 hours to: • help maintain independence; • prevent unplanned or inappropriate admission to hospital or residential care for either the Carer or Cared for persons; • help maintain the Carers well-being during changing times; • provide access to an immediate respite service.

19. Gardening Project The aim of the Groundwork Gardening Project is to ensure that the gardens of people with a disability and people over 50 are maintained by providing a safe, reliable and affordable service when personal circumstances make it impossible for them to cope, or get help with essential gardening. The Garden Squad will offer a variety of gardening services form general tidying, weeding and mowing the lawn, to flagging, planting, repairs to fencing and cropping of fruit trees. The Garden Squad is not intended to be a weekly service e.g. grass mowing etc. The idea is to make the gardens safe, low maintenance and accessible. The cost for this service is £10 per hour, plus the cost of materials.

20. Care and Repair Project The existing Arena Options – Care and Repair Project currently receives a high level of enquiries across the Borough in comparison with other similar sized Home Improvement Agencies. The POPP’s funding, will enable the Project to employ a second Property Services Officer and Customer Services officer, to ensurthe Project can meet the rising demand of enquiries from elderly and disabled Home owners within the Wigan Borough. Care and Repair offer a Home Safety Check on every visit along with a Home Energy Check. The price of each home improvement is calculated individually and grants may be identified to cover some of the costs.

21. Opportunities for Volunteers Many people will not need the services or support offered by Wigan POPP, but can still get involved through volunteering We want to recruit volunteers to: • Use their practical and experiential skills • Deter feelings of isolation or redundancy

22. Project Evaluation An evaluation team from Keele University will test the effectiveness of the POPP’s scheme by looking at: • peoples’ wellbeing and Quality of Life • the outcomes of each project • complimentary work within the borough • the effectiveness of engaging with older people • the long-term sustainability

23. Why evaluate (1)? To generate information to: • Support the development of schemes. • Demonstrate the “impacts” of schemes. • Guide plans for sustaining schemes.

24. Why evaluate (2)? • To facilitate shared learning and “research” capacity building.

25. A “Whole Systems” Approach to Health and Well-Being for Older People Community Strategy Environment Information Self Care Support Preventative Services Integrated Services (Mainstream) Assisted Support Continuum of Support Older People Integrated Active Case Management / Complex Care Intermediate Care Intensive Management Acute Hospital

26. Evaluation Strategies include: • Clients and client needs • Processes of care • Outcomes • Whole system indicators • Quality of life

27. Clients and Client needs POPP monitoring form collects data on: • Client demographics. • Source of referral. • Recent “changes” affecting client. • Service(s) provided.

28. Why Client and needs data? • Profiling clients and their needs allows; • Appropriateness of services to be determined • Gaps in service provision to be identified

29. Process Measures • Assessing partnership working • Exploration of governance issues • Identification of “barriers” to implementation of schemes

30. Partnerships • Who are the partners? • Measuring effectiveness of partnerships • Within the POPP initiative • Beyond the POPP initiative, i.e. with other agencies / organisations • Strengths & weaknesses of partnerships • Challenges to partnerships

31. Delivery processes • Information flows and information management • Referral issues (e.g. awareness, delays, blurring with other services) • Staff / volunteer issues (e.g. recruitment, training, roles) • Acceptability of POPP schemes to clients and to other services

32. Other process measures • Economic issues (e.g. resources, staff levels, facilities, equipment) • Sustainability

33. Wigan’s POPP schemes and the “Whole System” Crime prevention awareness Self Care Support Stepping out Counselling Project Assisted Support Continuum of Support Older People Rapid Intervention Project Respite Care Intensive Management Acute Hospital

34. Outcomes (1) Whole System Indicators to monitor changes in: • Acute hospital bed days. • Residential care placements. • Packages of home care. • Uptake of direct payments by older people.

35. Outcomes (2) • Local Indicators to more closely explore the impacts of specific schemes include: • Uptake of services • Profile of users • Follow on referrals • Numbers • Types of services • Use of other POPP schemes

36. Outcomes (3) Quality of Life • Instruments proposed include • EQ-5D • Short-Form Ryff • Service Use questionnaire

37. Quality of LifeEQ – 5D • Questions on health status such as; • Mobility and walking about • Self care, washing and dressing • Usual activities such as housework, work or family • Pain / Discomfort • Anxiety / depression • Health state today

38. Quality of life; Short form Ryff • Short Form Ryff • Psycho-social dimensions • Elements such as; • Relationships with others • Purpose in life • Daily life and environment

39. Quality of Life;Service use • Questions include use of; • Primary care services • Home care services • Leisure and transport services

40. Outcomes (4) “Local” assessments Suggested questions: • What has been your experience of the care / services that you have received so far? • Has the service helped you? • If so, how has it helped? • If not, say why? • How could we improve what we do, your care / services? • Do you have any suggestions?

41. Summary • The Partnerships for Older Peoples Project aims to improve the health and wellbeing of "older people". • Research activities will be used to support this initiative and promote shared learning.

42. Any questions? • Dr Roger Beech¹ r.beech@hpm.keele.ac.uk • Mrs Deborah Gent³ d.gent@wiganmbc.gov.uk • Prof. Brenda Roe² b.h.roe@ljmu.ac.uk • Dr Wanda Russell¹ w.b.russell@hpm.keele.ac.uk • Miss Michelle Russell¹ m.j.russell@hpm.keele.ac.uk • ¹Keele University, Centre for Health Planning and Management. • ²Liverpool John Moores University, • ³Wigan Council, Department of Adult Services. • Website address; www.wiganpopp.org