Coventry Adult Social Care Annual Report 2021/22 (Local Account)

The previous section contained a volume of data and comparisons across a number of areas of performance. To summarise this as succinctly as possible would be to say that Coventry continues to support a relatively low number of people with ongoing care and support needs and as a result is a comparatively low spender on Adult Social Care.

This position has largely been arrived at by our approach to Adult Social Care and Support which is based on supporting people to be as independent as possible. Where independence Key achievements - based on our Adult Social Care Offer has been lost or reduced, we work with people to regain skills and where levels of independence have been limited, we work with people to improve this. Our goal is for people to be living independently within their own homes. This is not always achievable and in many cases living independently is only possible with support. The examples below give a flavour of how we have delivered this approach. We have used real examples given with the consent of those involved.

• Saba's story
• Ahmed's story
• David's story
• Making the best use of resources
• Joined up care and support
• Ian's story
• Carers at the heart of everything we do
• Committed workforce

Making a strength-based approach - promoting strength, independence, diversity and inclusion in our Shared Lives Scheme - Saba's story

Shared Lives is the essence of family living; sharing a home, life and community with like-minded people. We pride ourselves on our rigorous matching and introduction process, ensuring the adults we support have the greatest opportunity of finding the right family, right home and support to lead a happy and fulfilling life whilst having their individual needs met. This process cannot be successful without placing the adults we support at the heart of everything we do. Individuals living in Shared Lives are supported to express their wishes, explore their dreams, and share the highs and lows of living as part of a family. Here Saba shares her story in her own words about what it's like to be supported by the Scheme.

Hi I'm Saba. I moved to England in 2008 from Pakistan where I lived with my Grandparents and Uncle. When I moved to England, I was diagnosed with a Brain Tumour, I spent a lot of time in hospital meeting Nurses and Doctors and other children. I was taken into Foster Care in 2010, I was very unhappy during this time and struggled to settle in, I had different foster carers. In 2011 I met the perfect foster family; I now live with the family as part of Shared Lives and my younger sister lives with us too.

Shared Lives has made a massive difference to my life, now I am an adult I’m treated like an adult, Mandy and Mem are my shared Lives Carers, they support me with my independence and encourage me to do as much as I can. Mandy manages all my medical appointments and supports me with my health needs, but she has taught me about my medication and injections, I can now manage my own medication and do my own injections, I’m proud of this.

My biological family are so important to me, I love going to see my Mum and Dad, Mandy has always supported me with this, I can now do this on my own on the bus. My relationship with my Mum is so much better now, and we meet for drinks and go shopping together. I also like to go shopping on my own as I have the confidence to do this because Mandy has supported and encouraged me. As a Muslim I can celebrate my culture and all the festivals and events that are important to me, I share these with my Shared Lives family. Mandy always ensures I have Halal meat and we often cook traditional meals together.

What I like about living in Shared Lives is I can make some great memories, I have some lovely holidays with Mandy and Mem, we have been to Spain and Turkey, as well as short breaks to Butlins, I love going to amusements parks, although I don’t like the fast rides. 

I love living in Shared Lives, I have a great future to look forward to, I feel I am free to live my life and do what I want to do, I am looking forward to starting an apprenticeship in September, my aim is to find a job. Since coming into Shared Lives aged 18 years of age, I have had a financial appointee to manage my money, my aim is to manage my own finances which Mandy is supporting me to work towards, I feel confident I will be able to do this.

Another wish of mine is to return to Pakistan for a visit, I have been unable to do this because of the COVID-19 pandemic and my health needs, but this is something I plan to do in the future.

I love my life and wouldn’t have it any other way. 

• www.coventry.gov.uk/sharedlives
• Follow us on Twitter: @SharedLives18
• Facebook: Shared Lives Coventry

Helping people stay at home - Ahmed - a home adapted to meet my needs

Ahmed is a 29-year-old young man with physical disabilities who lives with his parents. He and his family wanted safe and independent access to a sleeping area, toilet and showering facilities on the ground floor. His health conditions included respiratory failure, chronic back pain, weight problems and poor mobility. He was sleeping on a mattress in the lounge and was not able to get to the bathroom to use the toilet or shower; his mum was washing him on the mattress in the lounge. Although there were two reception rooms, Ahmed could not get into the second room due to the width of the doorways.

A request was sent in July 2021 by the Occupational Therapist (OT) for a joint visit to
establish the best way of meeting his needs. Between the OT and the Housing Officer they identified that a Disabled Facilities Grant (DFG) could be provided to:

• Widen doorways to enable Ahmed to access the whole of the ground floor
• Alter the layout of the kitchen to enable him to pass through to the bathroom
• Bathroom alterations to remove the existing cubicle and provide a level-access shower
• Alterations to the back door so that Ahmed could go outside

The OT also arranged for a hospital bed to be provided so that Ahmed could sleep in a bed, not just a mattress. This also meant that he was able to get in and out of bed without his mum pulling him up from the floor. 

Whilst carrying out her assessment, the OT noticed that Ahmed’s mother was also struggling with her mobility, so she was able to arrange for a stairlift to be fitted for her.

Nigel Goode, Home Improvements Officer, commented;

"In my role I am fortunate to be able to support people in ensuring their homes are adapted to meet their needs, it’s a great pleasure and a true sense that we are helping people in our city. Ahmed’s life changed when the work was completed, he was able to mix with his family rather than being confined to
his room, have improved facilities to look after his personal care and access the wider community and meet up with his friends".

Permission for the DFG scheme to go ahead was given by the private landlord in November 2021 and three contractors were allocated to provide quotes for the job. The most cost-effective quote was accepted and the grant was approved in January 2022.

The work was completed in March 2022 and Ahmed’s mother wrote in to thank the Housing Officer and the OT for all their support and understanding in dealing with the
adaptations at their property. She stated;

"You have made a young man very happy".

She also thanked the contractor for going beyond their expectations in keeping them updated and addressing any concerns without hesitation.

The purpose of a Disabled Facilities Grant is to enable disabled people to have access in and around their home. 

A Disabled Facilities Grant can help, for example, to pay for a ramp, to widen doorways or replace a bath with a shower and is a process made up of a number of stages from an initial assessment, applying for a grant, getting estimates for the work and completion of any work. 

To find out more about DFGs please see our webpages

Aideen Staunton, (pictured) Head of Service, Partnerships and Social Care Operations said;

"It’s great to see the difference this has made to Ahmed’s life. An accessible home is so important and has a direct impact on our
health and wellbeing."

Currently, awards through the grant scheme are mandatory but a new updated Housing Assistance Policy agreed in 2021/22 enables the Council to use a more discretionary approach to the awarding of grants. This more flexible approach will help more people who apply to us for funds. This will mean grants awards that do not exceed £6,000 would no longer need a financial assessment while there will be a new option to top-up grants that exceed £30,000.

Living and ageing well - David's journey towards more independence

David is 84-year-old man who has been profoundly deaf for most of his life following a fall from a great height as
a small child. David uses British Sign Language (BSL) to communicate. To add to his challenges David cannot read or write and has started to lose his sight due to Glaucoma and cataracts.

David has always been independent but due to his failing sight he tripped whilst out due to an uneven pavement and since such time he has lost his confidence and stopped going out altogether. It was at this time that his daughter made the referral to Adult Social Care for an assessment.

David said:

"I hardly leave the house anymore as I'm embarrassed when I keep bumping into people".

David has no contact with the outside world and over the years his friends have passed away, so he has become more isolated, he also stopped attending the Deaf club and other social venues due to his failing sight.

"My only lifelines are Facetiming my daughter on the iPad and watching western films, without those I'd have
nothing else to enjoy".

David’s main aim was to be part of the community and to have a social life without having to rely upon his daughter. 

To enable David to fulfil his outcomes he received an assessment visit from the Visual and Hearing Impairment Team who provided him with a white cane to use when he is out, he also needed to learn a new form of communication before he lost all of his sight. The social worker and deafblind assessor identified a specialist service to teach David ‘hands on signing’ where David would gently place his hands on top of his communicator
guides hands to feel the movements of the signs.

Learning ‘hands on signing’ will take a lot of practice, however, David is embracing and enjoying learning a new skill, he has gained in confidence.

He has started to go out with the guide to the shops and is looking forward to joining the Coventry Resource Centre. David is also teaching his daughter some of the signs so that when the time comes they will be able to communicate. David still worries about his future and doesn’t want to become completely isolated.

“I wonder what I will do, if it does become dark for me. Will I go into a home, just sit there in my chair and sleep  more, just to be able to see in my dreams?”.

Short Term Services to Maximise Independence (STSMI) are provided to promote people’s independence with the purpose of enabling people to regain skills, confidence and to hopefully achieve what’s important to people and promote their strengths. This service has not only improved David’s quality of life now but will also help to prepare him and his family for the future when his needs change.

Janet, the social worker involved said;

"Working with David has given me the opportunity to use services creatively, seeing the transformation through his continued journey and how much he has gained in confidence with a positive outlook is very satisfying. On reflection, I think “I’m just doing my job” but “just doing my job” has made such a difference to David’s life and future".

In law, people are regarded as deafblind if their combined hearing and sight loss causes problems with communication, access to information, and mobility. People regarded as deafblind all have difficulties in these three areas caused by the interaction of the two impairments. 

It is estimated that there are nearly 400,000 deafblind people in the UK. This is expected to increase to over 600,000 by 2023 due to our ageing population.

Deafblindness affects people of all ages, including children and young people, but it is more common in older people as our sight and hearing naturally worsen as we get older.

The Care Act 2014 says that a suitably qualified person who can understand the impact of both sensory losses must assess a person who is regarded as deafblind. We are pleased to say that following a successful training course we now have 2 more social workers trained as deafblind assessors in Adult Social Care. 

Making the best use of resources - supporting Adult Social Care staff through digital innovation

Adult Social Care continuously looks for ways to support the workforce, through the use of digital and innovative tools and developments. One of the ways we are currently doing this is through the use of a digital dictation tool. ‘Dragon Anywhere’ is an application that supports staff to create documents of any length and edit, format and share them directly from a mobile device (usually a mobile phone), offering the following benefits; 

• Saves time typing and eases pressure on administrative tasks
• Removes the need for social workers to travel to the office to make case notes saving time and reducing delay 
• The software is intuitive and easy to navigate
• Dictation can be used as a memory aid 

Stephanie Lamb, Community Case Worker and one of the members of staff taking part in the trial gives the following feedback on the tool;

"You can use it within 30 seconds. Just press the record button and, after you've finished,  you can email it to yourself - it’s that simple. It really is quick. I can now spend 10 mins dictating all the points I want to write, it saves time and is easy to use and it can help with long assessments and phone calls".

Adrian Flynn, Mental Health Social Worker also commented; 

 "I love the app and use it after all of my assessments. I find it very helpful, and it makes my work life a lot easier".

Hear more from Adrian directly about what this means in practice.

Louise Ferro (pictured), Head of Business Systems and Continuous Improvement said; 

"We are really keen to support our workforce in ways which can reduce time spent on recording and  administrative tasks to enable more time to be spent having valuable conversations with people. Following evaluation later this year, if deemed a success the tool may become part of a suite of digital options available to staff to support them in their everyday tasks".

Online animated self-assessment tool

Coventry City Council Adult Social Care has been part of a small group of Local Authorities who have worked together with an organisation called ‘Looking Local’ to develop an innovative online self-assessment form using short animations to support accessibility with what can seem a very complex process. Social workers, occupational therapists and technical experts were fundamental in ensuring the self-assessment tool included all the right questions in an easily accessible format covering all of the Care Act 2014 domains of care eligibility. The tool has been embedded into our initial contact process, and people making first contact with Adult Social Care are asked to complete the self-assessment process prior to being contacted by our Social Work Initial Contact Team. The tool also offers to signpost information and guidance to enable those people who are not eligible for or do
not require social care interventions to find local support through other organisations. 

This process will also support people and our social work teams by saving time during later assessment processes and help people navigate the Adult Social Care system when we are expecting an increase in requests for support. 

Joined up care and support - Community Discharge Team rises to the challenge

Based at the University Hospital Coventry and Warwickshire NHS Trust (UHCW) our Community Discharge Team are hard at work supporting people to be discharged safely home, 7 days a week. The team has had to respond to significant change over the last 2 years.

In March 2020, revised measures were put in place nationally to manage the COVID-19 pandemic. This fundamentally changed the offer to people across health and social care nationally and impacted on the way patients were discharged from hospital. 

Some of the requirements included:

• It was required that the discharge of patients would be extended to have discharge support available seven days a week
• Services needed to be available to support patients from 8am to 8pm daily 
• Services to support effective discharge needed to be in place and this included brokerage, administration, equipment and therapy services in addition to social work

During this time the world's attention was brought to UHCW as it became the first hospital to issue the Covid vaccination with Margaret Keenan (pictured opposite) being the first person in the world to be vaccinated with the Pfzer Biotech jab!

Margaret returned to the hospital in 2022 to receive her spring booster.

Working at the hospital over the last 2 years brought about some key challenges, but at the heart of the team was ensuring that people who were in hospital were well supported on discharge. 

Staff working during this time said; 

"Not being able to see loved ones whilst they were in hospital, I think was incredibly difficult for any family and not having a regular point of contact. I hope I helped alleviate some of that anxiety by passing on any messages, even if it was just a quick hello or to say that their pet was being looked after".

"Ever-changing requirements for COVID-19 swabbing of residents in hospital for discharge back to care providers. This was challenging and very complex with high risk. The team had to be dynamic and adaptable."

"The pandemic also in some instances helped build resilience of staff working under stressful and dangerous circumstances".

"Throughout the pandemic the team was able to take on two social work students. Which was a fantastic way of
gaining valuable work experience as front-line workers during a crisis".

The team continued to work at the hospital during the pandemic and held daily huddles to ensure that staff felt supported and were up to date with the Government changes.

They established the affectionately known ‘FAB’ team who worked with people who were isolating or had been exposed to the virus in commissioned services outside of the hospital setting. 

In response to the requirements from the Government the Hospital Social Care Team and the Short-Term Therapy Team based at the Opal, came together as the ‘New’ Community Discharge Team, delivering services over seven days 8am to 8pm.

The 7-day offer has seen several improvements with people who are medically fit to leave the hospital being able to be discharged faster and supported to leave the hospital at the weekends. 

In addition to the discharge capacity for patients, the central safeguarding function for West Midlands Ambulance Service (WMAS) referrals has been extended to cover seven days 8am to 8pm via the hospital-based Community Discharge Team. This has proved particularly successful in both responses to safeguarding and admission prevention.

The Community Discharge Team works to positively promote the ‘home first approach’ by using the established discharge pathways together with the Community Discharge Therapy team implementing a service that helps people regain and develop their skills.

Integrated Care Record goes live

In a further example of how we are joining up care and support, during the year Coventry City Council took its first step in going live on the Integrated Care Record (ICR). This is an important development that will allow other health and care organisations to view our records and ultimately help us deliver better, safer care for people. It is widely recognised that the sharing of relevant data in a timely and secure manner supports the delivery of effective care.

As well as our own data, Coventry City Council professionals providing care for people will soon be able to see corresponding health care records. In the meantime, if you’d like to know more, please visit the ICR web pages.

 

Keeping people safe - Ian's story - a comfortable new home

Ian is a 65-year-old man with mental health problems who was admitted to hospital with an infection and  confusion having collapsed at home. After 4 weeks in hospital, he was discharged to accommodation within a Housing with Care complex. 

What was the situation?

Ian was on a very low income as he was under pension age and on Universal Credit. His income was £74 per week only. He had no family or friends who he was in contact with. He had a flat which was not in a habitable state to return to as it was in a state of disrepair and needed extensive cleaning. Ian also had rent and council tax arrears. Ian did not want to go back there as he associated it with becoming ill and being on his own.

Before going into hospital, a safeguarding concern had been raised due to concerns about his living conditions and that Ian was self-neglecting. It is likely that his poor health was a result of his environment, living conditions and not eating a balanced diet and Ian needed multivitamins and other minerals to be prescribed for him whilst
in hospital. 

Whilst staying at the Housing with Care complex, staff reported that Ian needed prompting with personal care, with preparing healthier food choices and with keeping his accommodation tidy. Ian did not want to go back to his previous home. He was keen to live in a Housing with Care environment. He enjoyed talking to people and likes the company of others. 

However, there were a number of barriers to moving;

• Low income, debts and not being on the right benefits 
• No help from friends or family 
• No furniture or belongings to take with him other than clothes
• No money in the bank to buy new furniture and carpets
• Difficulties managing money and budgeting

What did we do?

With the help of staff at the complex Ian was assisted to apply for the right benefits and applications were made for a Community Support grant to be able to access a new bed, kitchen items and bedroom furniture. The staff also gathered donations of furniture and white goods. Ian was referred to a money advisor for help with his debts
and was eventually helped to move into a new flat in another Housing with Care scheme. 

Stephanie Lamb Community Case Worker in the Older People’s team said; 

‘When someone has a low income and no family support there can be a lot of obstacles to moving house. A joint approach from teams in the Council and Adult Social Care meant that Ian was able to move and not return to an environment which might have made him ill again."

How are things now?

Ian is now settled in his new flat and really happy with it. He has made friends and enjoys going to the restaurant for meals. Within days he had a TV donated to him from another resident. Ian was awarded backdated benefits which allowed him to clear his debts. 

"Life is precious to me; I feel so lucky that people helped me to move here. I have made friends and have a garden to look out on, I feel I have my life back now. I reach my retirement age in September and can spend my retirement here as I have a lot of my life  left to live."

Since moving into the Housing with Care environment Ian’s physical and mental health has improved. Ian was getting depressed at the thought of going back to his old tenancy as he did not want to live alone, had memories of the conditions he was living in and associated it with the trauma of being found on the floor collapsed. He is reassured by having staff on site who he can go to if he needs help. Having the right living environment can help
people be as independent as possible and have a positive impact on their health and well-being.

Housing with Care, sometimes known as Extra Care, is housing designed for older people, with various levels of care and support available on-site. People who live in Housing with Care have their own self-contained flats, their own front doors and a legal right to live in the property. In Coventry, there is a range of Housing with Care schemes run by both the Council and private companies. 

If you are experiencing difficulties due to the rising cost of living the City Council has a web page dedicated to information and advice concerning how to reduce outgoings and get help and support.

Carers at the heart of everything we do - Carers Trust Heart of England get creative

Within Coventry we work in close partnership with the Carers Trust Heart of England to ensure that we can support as many people across the city who have caring responsibilities. Supporting carers is such an integral part of the way we work in Adult Social Care. Here the Carers Trust Heart of England tell us a bit about their work throughout 2021/22 with a focus on coming out of pandemic restrictions and what carers told them was important. 

The impact of the pandemic lasted longer than any of us imagined with the ever-changing social restrictions. This led to all of us constantly changing the way we work and socialize and undertake our daily routines. The impact on those with additional caring roles was immense. Here at Carers Trust, we continued to adjust what we did to ensure we continued to support Carers on their caring journey in a way that responded to those changing needs.

Like many organisations, the hybrid way of working was born. Delivering services both digitally and face-to-face, will be a lasting legacy from the pandemic which has changed service delivery for everyone. The service continued to utilise the enhanced funding from Adult Social Care:

• To support carers who were isolated and lonely
• Supporting carers experiencing grief and loss
• Ensuring hard-to-reach communities were involved
• Supporting carers who don’t have access to technologies
• Supporting carers experiencing financial hardship
• Worked with employers to support carers who are juggling work and caring
• Providing direct payments for carers to help achieve outcomes

Supporting Carers to take a break

This year we developed our offer on respite opportunities for carers. The last year had an 
unprecedented impact on carers connecting socially and interacting with other carers and accessing vital respite and peer-to-peer support. We secured additional funding to complement and enhance our contract within Coventry. This funding gave us the additional resources to offer a variety of respite opportunities to carers both face-to-face and digitally.

Connecting carers – The Carers Creative

We ran a programme of activities and events, the most popular were creative activities, such as flower arranging, gardening, pinch pottery, also relaxation sessions such as Yoga, Zumba, Mindfulness and Aromatherapy and events around festivals such as Diwali and St Patricks Day. For many carers it was a tentative step back into the community and doing something for themselves after many months of staying at home worrying about the impact of the pandemic keeping themselves safe and those they care for. Doing something fun and engaging also
helps us connect with carers in a way that helps explore other support such as offering a carers assessment or identifying the need for a direct payment. 

"Coming to the flower arranging session enables me to do something I enjoy and take something home to show my loved one what I have done. Learn a new skill and make new friends". 

"When I am being creative I am putting myself first not last, I know now this is ok to do. Thank you, carers Trust,  for giving me the space for an hour". 

"The last two years I have been so lonely, coming to the flower arranging I am doing  omething wonderful and now have some good friends who understand me".

Reaching out in new ways

In the last year, we started to make use of podcasts. We released a number of podcasts 
during Carers Week and are continuing to produce content for them, this includes an episode on Lasting Power of Attorney with Emma Austin from the Central England law centre. You can listen to all episodes online.

We are so excited to start recording these podcasts. It’s so accessible to everyone and we can really focus on information and services that we know really impact the Carers we support as well as highlighting real Carer stories.

Committed workforce - working in Adult Social Care, making a difference

Recruitment and retention within the Adult Social Care sector has been an ongoing issue for a number of years and has been further exacerbated by the COVID-19 pandemic. To support our providers in
drawing in new recruits and retaining their existing staff through these challenging times, the Adults Commissioning Team worked to produce a 2-minute animated video for use free of charge by providers, aiming to highlight the benefits of a career in care and the wide variety of jobs available.

The video directs potential applicants to job roles advertised through the Find A Job website and acts as a valuable resource to support recruitment. 

Promotional work was undertaken with a wide variety of partners in the city including The Job Shop, Coventry University, voluntary sector organisations and Health, to drive recruitment and increase retention within the city’s social care workforce. 

The video has so far been viewed over 600 times on YouTube, displayed in the window of The Job Shop and has been used by a number of providers in their own recruitment and advertising campaigns. The video remains available for any provider needing to supplement their own recruitment practices. 

 Neil Byrne, Service Manager Adult Commissioning said;

"The pandemic, although a particularly challenging time for recruitment and retention in the adult social care workforce, brought attention and recognition to the sector on an unprecedented scale; more people than ever before became aware of the value and importance of those working in the care sector. 

"To build on the increased public appreciation, a more innovative method of recruitment was needed. The video offered a more personable and relatable means of advertising which could be used to target a wider audience than traditional recruitment campaigns. The video worked to show our commitment in supporting the provider market and we encourage feedback from all Coventry providers on how we can best support with recruitment on an ongoing basis. Most recently, we have worked with the Council’s Migration Team and The Job Shop on a recruitment event where 10 people were recruited to roles in care."