Agenda item

The Committee will receive a report on the Prevention Strategy, including the prevention and reduction of falls.

The Committee received a report on the Prevention Strategy which was developed in 2011 by the Adult and Health Transformation Programme.  This strategy was developed on behalf of partners participating in the programme.  The partners included London Borough of Havering, NHS Outer North East London and now subsequently the Havering Clinical Commissioning Group, North East London NHS Foundation Trust and HAVCO. The strategy’s primary focus was to promote independence, increase value for money and better outcomes for people to remain in their own homes.

There were three strands of prevention, these were:

·         Promoting wellbeing (primary prevention) – aimed at people with no particular social care need.

·         Early intervention (secondary prevention) – aimed at identifying people at risk to stop or slow down any deterioration.

·         Enablement and reablement (tertiary prevention) – aimed at minimising disability and deterioration from established health conditions.

The Committee noted the themes of prevention included: strong leadership and a clear vision; a coordinated approach across the Council and other stakeholders; sustainable community capacity that increases engagement and motivation; a focus on safeguarding to help reduce social isolation and encourage participation; accessible and targeted information and advice; an enabling and empowering workforce culture; and stimulating the development of a diverse market.

In order to ensure that the objectives of the strategy were met, the following needed to be undertaken:

·         Age proofing existing mainstream service to ensure inclusion.

·         Provide information for all, including self funders, so that everyone can make an informed choice about their lives and their care.

·         Build capacity into local neighbourhoods and encourage volunteering

·         Support all services that promote wellbeing and reduce social isolation.

·         Encourage participation in the diverse range of social, cultural and leisure services in the borough.

The strategy stressed the need for a whole system approach to delivering its aims and how important the partnership working was within the organisations.

The Committee noted the number of projects which had already been implemented and the outcomes of some of those projects for vulnerable and older people.

The Committee was informed that within the Prevention Strategy was the Fall Prevention and Bone Health Strategy.  This strategy had four objectives, these were:

·         To improve patient outcomes and improve efficiency of care after hip fractures though compliance with core standards.

·         To respond to the first fracture and prevent the second through fracture liaison services in acute and primary care.

·         To ensure early intervention to restore independence through falls care pathways, linking acute and urgent care services to secondary prevention of further falls and injuries.

·         To prevent frailty, preserve bone health and reduce accidents through encouraging physical activity and health lifestyles and reducing unnecessary environmental hazards.

The Committee was informed of the implementation progress and the services that had been put in place to assist with prevention.  These included the falls care pathway in collaboration with GPs, clinicians from the Acute Trust, London Borough of Havering, voluntary groups and service users; Hip fracture care of guideline standards; Osteoporosis prevention and management, together with community services.

The Committee noted that there had been a 30% drop in falls, which coincided with the awareness and promotion of the programmes.  This in turn led to cost avoidance for Social Care and a better quality of life for the residents.

A member asked that when someone falls and has undertaken reablement, if their own property is assessed, for dim lights, trip hazards etc.  Officers stated that all Occupational Therapists are specialist and therefore the property is visited before discharge home, to check all of these things.

The Committee agreed that there had been an improvement in the service made available however there was still cases of isolation.  Officers stated that they were mindful that the borough was asset rich but capital poor and therefore there were a number of self-funders, however some were just over the threshold for Adult Social Care funding, this was monitored on a regular basis.  If the services were extended to self funders this could include Meals on Wheels, Telecare and Telehealth.  A member stated that local GPs would need to take a better interest in their patients to drive these projects forward.

There was a lengthy discussion about how services could be promoted and publicised to residents over 65 years old, together with finding out who would benefit from the service, who were not known to Social Care, in order to reduce isolation.

Members raised a question about if an elderly person is flagged up as being discharged from hospital and there are number of services which would help them, however the elderly person declines any service and how was this dealt with. Officers stated that before the discharge the Social Care team would carry out an assessment of the persons needs.  If they decline the services there is nothing that Social Care can do, they are kept on the system byt there was nothing in place to check on their progress.