1. Better Services To Older People through Person Centred Planning
Nina Spofforth

2. Putting Things In Context
What does the government say?

3. National Services Framework for Older People (Mar 2001)
Standard Two: Person-centred care
Aim
To ensure that older people are treated as individuals and they receive appropriate and timely packages of care which meet their needs as individuals, regardless of health and social services boundaries
Standard
NHS and social care services treat older people as individuals and enable them to make choices about their own care
This is achieved through:
the single assessment process
integrated commissioning arrangements and
integrated provision of services, including community equipment and continence services.

4. Person-centred care requires managers and professionals to:
listen to older people
respect their dignity and privacy
recognise individual differences and specific needs including cultural and religious differences
enable older people to make informed choices, involving them in all decisions about their needs and care
provide co-ordinated and integrated service responses involve and support carers whenever necessary.
NSF Older People: Standard 2

5. Good practice examples and case studies: standard two (person-centred care)
Age Well programme in Sandwell Health Action Zone
Wolverhampton Health Action Zone's Older People's Forum
North Nottinghamshire Health Authority
Services for Older People in Thanet
Good practice examples and case studies: standard two - person-centred care (DH 2004)

6. Age Well programme in Sandwell Health Action Zone
publishing an A-Z of services for older people
developing an approved list of local builders and tradesmen
extending the availability of chiropody and similar services at local level
enabling people to remain in their own homes by making increased investment in adaptations to support their needs
piloting work to prevent accidents through Primary Care Teams in areas with high elderly populations
Good practice examples and case studies: standard two (person-centred care)
Good practice examples and case studies: standard two - person-centred care (DH 2004)

7. Wolverhampton Health Action Zone's Older People's Forum
bringing about improvements in a range of health indicators affecting older people
- including coronary heart disease, stroke
and winter pressures
close participation of older people in the development of local services
monthly participant's forum and
peer health mentors work closely with older people in the community to address their health needs.
Good practice examples and case studies: standard two - person-centred care (DH 2004)

8. North Nottinghamshire Health Authority
working in partnership with both local CHCs
establishing good practice guidelines and a "Bill of Rights" for service users and carers
= "code of conduct" for all those
within the health community
involved in planning activities
Good practice examples and case studies: standard two - person-centred care (DH 2004)

9. Services for Older People in Thanet
A guide to Services for Older People in Thanet
written for older people living in and around Thanet
lists the organisations which work for older people
brings together helpful information and advice from different sources
Good practice examples and case studies: standard two - person-centred care (DH 2004)

10. Programme 1: Dignity in Care
A New Ambition for Age Next Steps in Implementing the National Service Framework for Older People (April 2006)
Programme 1: Dignity in Care
“There are still reports that the experience of many older people remains unacceptable. A renewed commitment to ensuring respect for the dignity and human rights of older people will be central to the delivery of care in all care settings.”

11. Our Health Our Care Our Say (Jan 2006): 4 Big Ideas…
Looking after your own health and well-being
Services will listen to what you want
Services will be easier to use
People who need care for a long time – The Expert Patient

12. Big Idea 1: Looking after your own health and well-being
People will be in charge of their own health
People will get better information so that they can make choices about staying healthy and well
Our Health Our Care Our Say (Jan 2006)

13. Big Idea 2: Services will listen to what you want
Services will treat service users as important
They will make sure the things people want are taken seriously
They will help people do as much as they can for themselves
They will help people be in charge of their own health and the things they need to keep well
Our Health Our Care Our Say (Jan 2006)

14. Big Idea 2: Services will listen to what you want
Direct Payments - more sorts of social care services
Individual budgets – people make decisions about what social care services they do and don't want
Services need to make sure that people choose to use them and not go somewhere else
Councils and PCTs only work with services that listen to what people want and treat them as important
Meetings to give people a say in what sort of services councils and PCTs should run
Our Health Our Care Our Say (Jan 2006)

15. Big Idea 3: Services will be easier to use
People will be able to choose different types of services
Services will be nearer to where people live
They will be in the places and at the times people most want them
Our Health Our Care Our Say (Jan 2006)

16. Big Idea 4: People who need care for a long time
If people need care for a long time they will be able to get better information and more choice about services
People who have a health problem for a long time know a lot about it
They can help other people with the same health problem keep healthy or get better
This is called being an Expert Patient
There will be more people recognized as Expert Patients
There will be better ways for people to make plans about the support they need
Our Health Our Care Our Say (Jan 2006)

17. The Change Agent Team
“The Health and Social Care Change Agent Team (CAT) was set up in 2002 to help health and social care communities tackle the problem of patients staying in hospital longer than necessary (delayed transfers of care).
Since then, our remit has grown and now we provide advice and support on a wide range of issues that affect the care of older people.”

18. Dignity In Care Campaign (Nov 2006)
Launched 14 November 2006 by the Minister for Care Services, Ivan Lewis
The campaign aims to:
- stimulate a national debate around
dignity in care
- create a care system where there is
zero tolerance of abuse and
disrespect of older people

19. Dignity In Care Campaign (Nov 2006)
The Dignity in Care champions network – an army of volunteers committed to this cause working together to raise the profile of dignity in care locally
The Dignity in Care Practice Guide – online and produced in partnership with the Social Care Institute for Excellence (SCIE) and the Care Services Improvement Partnership (CSIP)

20. Commissioning framework for health and well-being (DH Mar 2007)
8 steps to more effective commissioning:
1. Putting people at the centre of commissioning
2. Understanding the needs of populations and individuals
3. Sharing and using information more effectively
4. Assuring high quality providers for all services
5. Recognising the interdependence between work, health and well-being
6. Developing incentives for commissioning for health and well-being
7. Making it happen – local accountability
8. Making it happen – capability and leadership

21. What do Older People say?
Putting Things In Context
What do Older People say?

22. Joseph Rowntree Foundation Consultation
Choice, control and independence are not variables, inevitably diminished in the equation when older people need to have support
Service users in general are fully able to exercise choices, though a range of strategies may be required to facilitate this
it would be good to focus on two key issues
(a) the capacity to deliver and
(b) older people as co-equal stakeholders.
Consultation response to DWP: Link-Age: Developing networks of services for older people (JRF, Nov 2004)

23. What do Older People Want?
It may be that user-led or voluntary organisations should be funded, not to deliver more cost-effective care, but rather to uphold the rights and needs of the individual older person
Consultation response to DWP: Link-Age: Developing networks of services for older people (JRF, Nov 2004)

24. What do Older People Want?
Older people have said that they:
- want ‘help not care’
- would find it helpful to know who to contact
when life changes
There is a concern that planning and delivery of services for older people is informed by a ‘deficit model’ of old age, and many older people have said that they are looking for more positive engagement in lifelong learning, ‘keeping busy’, being valued.
‘Can we agree that if the system works for planners, organisations and service deliverers…but does not work for users, then inherently, it does not work?’
Consultation response to DWP: Link-Age: Developing networks of services for older people (JRF, Nov 2004)

25. What do Older People Want?
Health and social services need to break out of a dated, service-driven approach
Crucial that older people are involved in the design, implementation and monitoring of services so that services will reflect the detail of their lives.
Involvement in older people
- right at the start;
- more than one or two token older people
- allocating the necessary time, resources and
commitment to involvement
Consultation response to DWP: Link-Age: Developing networks of services for older people (JRF, Nov 2004)

26. “If only one message had to go out…it is that if programmes or strategies about older people do not have the fullest possible involvement of older people in their development, they are very unlikely to stand the test of time”
Consultation response to DWP: Link-Age: Developing networks of services for older people (JRF, Nov 2004)