Older Citizens’ use of Scrutiny

1. Older Citizens’ use of Scrutiny A workshop presentation by Sharon Brearley, Director Age Concern Salford Natalie Davies, Project manager LinkAge Plus, Salford Primary Care Trust Paulette Holness, User Development Worker, Older People and Disabled People Salford City Council Mary Murphy, Development Worker Age Concern Representatives of Salford Forum of Older People

2. Why Scrutiny? • Members of Salford Forum seek to improve life for older citizens • Representatives have taken part in Strategic service developments over 10 year period in partnership with city council, NHS and voluntary organisations • Explored different ways of promoting the voice of older people, influenced by learning from taking part in ‘Clear Voices’ study

3. Some Learning from our journey • Older citizen representatives are valued members of Development and Partnership Commissioning Boards in Salford • Implementing National Service Framework for Older People created new opportunities for working together • Process of Developing a Strategy for Wellbeing of people growing older was opportunity to think about further positive roles for older citizens • Engagement of commissioners and service providers essential for change

4. Our starting point • Roles of citizen representatives on Boards agreed and defined • Charter of rights, responsibilities and values developed by older citizens underpins Board activities and meetings • NHS organisations had examined age discrimination as part of NSF implementation • Wellbeing Strategy work in 2005 led to the idea of scrutiny by older citizens, initially of services provided or commissioned by public sector • Wellbeing Strategy work outlined an ‘Ageproofing’ questionnaire, to be used as an enquiry tool • Advice from council scrutiny support team

5. The Way Forward • Support worker identified for process, to be based with Age Concern Salford • Initial discussion with some Forum representatives of what might be involved in a scrutiny process • Recruitment of older citizen volunteers via Forum and open event • Set up ‘Citizen Scrutiny Team’, explored scrutiny and described a process • Agreed to adopt an ‘Ageproofing’ questionnaire developed during Wellbeing Strategy work

6. First Steps • Agreed potential subjects for scrutiny, initially Arts and Leisure services • Agreed key questions to help focus scrutiny • Director of Community, Health and Social Care influenced ‘buy in’ from services • Identified lead officers/managers • Identified potential sources of information, including any existing studies • Support worker introduced lead officer to ‘Ageproofing Tool’

7. The Process • Based on findings of Ageproofing Tool, scrutiny team members visited a range of services with a list of points to check out for themselves • Discussion with managers led to a series of recommendations which were put into a report. • This was taken to appropriate Boards by members of the scrutiny team • Support was given to the recommendations, an action plan agreed, funding implications identified and resources sought. • Formal feedback is given to the Forum. • To date action taken includes an additional library van incorporating an advice centre, expansion of various exercise classes led by monitors, improved toilet facilities in new libraries

8. Adapting the process to another subject • The second area to be scrutinised was long term home care • In Salford, this service is commissioned from independent and voluntary sector organisations • Information available to scrutiny team included Salford specific data from PSS survey of home care users and inspection findings from CSCI

9. Some challenges • How to manage scope of scrutiny? • More than 1,600 service users each day • 16 provider organisations • Ever changing market: withdrawal of contract to a major provider during scrutiny, takeover of another provider • Vulnerable service users • Low paid, low status staff with training needs

10. Managing the challenges • Team identified what needed to know: key questions to focus scrutiny • Needed an understanding of the ‘whole system’ including market conditions, care management and available training for care workers • Given existing data from PSSRU and CSCI, team members suggested face to face structured discussions with home care workers to better understand issues • Forum members who were/had been service users also completed questionnaires about their perceptions

11. Most but not all providers completed ageproofing tool, which was customised • After negotiation, several discussions achieved which provided insights • These signposted need to learn more about training offered • Scrutiny team moved from negative perceptions about agencies and their services to wanting to make recommendations which would help address problems constructively without ignoring difficulties • Report led to action plan: city wide project initiated by commissioners, citizen scrutiny representatives on project board

12. Does older citizen scrutiny influence? • Provides different insights • Requires much dedicated time • No single ‘one size fits all’ model, need to adapt to local circumstances and subject • Seems to have credibility • Action being taken by commissioners/providers • Essential that scrutiny sits within a reporting structure • In Salford process developed organically, not an ‘add on’ • Older citizens continue to volunteer to do this work: seen as worthwhile • Conference discussion offers opportunity to identify ‘enablers’ and barriers’ to citizen-led scrutiny, consider its value