Care Quality Commission – Sheffield needs to do more for older people

Phil Holmes, Director of Adult Services, Sheffield Council
Phil Holmes, Director of Adult Services, Sheffield Council

Older people in Sheffield are more likely to be admitted to hospital and then struggle getting  care when they’re back home, says a health watchdog.

The Care Quality Commission (CQC) reviewed 20 councils in different parts of the country in the winter of 2017. Sheffield was chosen because performance was not as good as many other parts of the country on a number of measures.

The CQC acted after the Department of Health and Social Care said older people in Sheffield were more likely than most places to be admitted to hospital.

They were much more likely to stay an extended time and less likely to stay at home in the longer term once they left hospital.

When they needed support in their own home to be able to leave hospital, it often took a significant time to arrange this.

And when they received support at home, after three months they were more likely than older people in many other areas to be back in hospital or supported in a care home.

Now Sheffield Council has launched what it calls a wide ranging and complex plan to tackle the problems.

Phil Holmes, Director of Adult Services, says its absolutely essential that progress is made and maintained because the CQC could visit Sheffield again soon.

“It has been a national concern for quite some time that older people often find support with their health and care needs to be not well coordinated,” says Mr Holmes in a report to the healthier communities and adult social care scrutiny committee.

“Even though individual professionals are most often excellent and truly committed, the older person’s experience of the overall system is fragmented. They do not always receive the right support in the right place at the right time.

“The plan needed to address the issues stopping older people becoming stuck in hospital for longer than they needed to be and preventing a revolving door situation where some people who left hospital returned relatively quickly.

“It is important to note that Sheffield’s frontline staff, both in the NHS and social care, work with skill and dedication.

“However the messages from CQC are firstly not just to respond well to crisis, but to prevent it occurring in the first place, and secondly to quickly build on Sheffield’s strong foundations so that older people here experience better outcomes from a much more joined up approach.”

Mr Holmes says although the CQC report could have been written more clearly, the comments are valid

“Frontline staff almost always do an excellent job in extremely difficult circumstances. The CQC challenge to Sheffield is that better leadership can improve circumstances both for staff and local people.

“The most prominent issue was that Sheffield’s health and care services did not seem to be designed with the needs and preferences of the older person at their very centre.

“This meant that although individual staff did all they could, people could get a bad experience as they travelled between different services.

“There was also a strong sense that Sheffield’s system was not only difficult to navigate for older people but similarly so for staff.”

The CQC says organisations need to work together more clearly and robustly. A large amount of innovative NHS and social care work in Sheffield is showing some good results but too much was on a restricted or pilot basis which was limiting its impact.

These successful services need to be rolled out and consistent. Funding organisations in Sheffield also need to come together to use money in the best possible way.

The CQC report can be viewed here https://www.cqc.org.uk/sites/default/files/20180522_local_system_review_sheffield.pdf

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