Agenda item

Mrs Julie Glen provided an overview of the content of the paper. The Chair enquired of the status of a para-professional and Mrs Glen advised that it was someone who was not a fully qualified social worker. Cllr David Parker commented that the Strategic Planning Group were supportive of the proposal and had suggested it had good potential in relation to integration with SBCares and Home First and better resilience outcomes for individuals. Dr Lynn McCallum commented that clinically it was the right thing to do and would produce better outcomes for people. She questioned how it would be accessed and rolled out across the Borders given Home First were operating at full capacity. She also enquired if it would be a gradual process of moving from a focus of permanent care for people to reablement or a process associated with it. Mrs Glen commented that the pathfinder was underway and would be scored separately to Home First. Early conversations had commenced with Mr Paul Williams in terms of potential scoping and involvement of a project team from Scottish Borders Council and NHS Borders. She further commented that currently to access SBCares reablement the approach was through START and they would refer and do an assessment and determine if there were rehab goals to go to home care. When the 4 system was integrated it was expected that a further scope out of the actual pathway would be required. Dr McCallum enquired given the exceptional pressures in START if there were any people who were medically fit and able to go home that needed to be captured before 10 days down the line, as it took up to 10 days to allocate a social worker for the review and the deconditioning of those people was significant in that timeframe. She suggested consideration needed to be given to access and how to make it slicker for Home First and not to rely on START specifically who were overwhelmed. Mrs Glen echoed Dr McCallum comments. She suggested that the scoping exercise would assist in identifying future gaps. Mr John McLaren enquired about levels of engagement on the Homecare Reablement approach. He sought assurance that appropriate engagement had taken place and would continue to take place as the proposal progressed. He further suggested that the Joint Staff Forum be engaged with on the proposal prior to its submission to the Strategic Planning Group. Mrs Glen commented that there would be challenges for the project groups and there would be HR and Trade Union representation on the groups. In terms of staff engagement that had not yet happened as the proposal at the current stage was for a pathfinder project, however she assured the Board that full engagement would take place on any proposal to be progressed from the findings of the pathfinder. Mr Tris Taylor commented that he fully understood that the direction was to look at a pilot, however he was concerned at the quality of the paper given it contained some inconsistencies in regard to legislative requirements especially in regard to conducting a full impact assessment (IA). He enquired how the nigh service that was to be decommissioned was outwith the scope of the Reablement project. He suggested IA guidance did not appear to have been followed in the sense of providing clear evidence and the involvement of people representative of equality groups. The Chair commented that a further IA would be required to be completed as part of the next stage of the pathfinder and she asked that the comments raised by Mr Taylor be taken into account when that further IA was progressed. Mrs Glen commented that a pathfinder was being taken forward in Peebles to decommission the night support service and transfer the staff into the reablement service. That pathfinder was due to be evaluated at the end of September and once concluded and if evaluated positively it would then be rolled out across all of the localities and all night service staff would be realigned to the reablement service. At that stage a full IA would be produced. The Chair commented that there appeared to be 2 separate issues, the completion of the IA and the decommissioning of the night service and she asked that both be addressed. Mrs Lynn Gallacher suggested that both would impact on unpaid carers both positively and negatively and she asked that a carers representative be included so that the voice of carers and the impact on carers would be heard and fully understood. The Chair asked that Mrs Cathy Wilson and Mrs Glen look at additional ways to engage with carers on the proposals.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the Reablement work by NHS Borders and SBCares that was already underway and the benefits of the approach.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed that a further business case would be submitted for discussion following the completion of the Reablement Pathfinder, its subsequent evaluation and discussions on a future Borders wide operating model.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed to the progression of the scoping of one integrated SB Cares / Home First service.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed to a future proposal being submitted later in the year with an outline approach for an Integrated Reablement Service with SB Cares and Home First.