Community alarms
4.29 Community alarm services across County Durham offer an alarm monitoring and response service 24 hours a day, seven days a week, 365 days a year to the clients at home. Staff respond to calls and visit the client if required. Currently, the service is provided by the in-house agency, Care Connect, in all the former districts except for Chester-le-Street, where Cestria HA are the provider.
4.30 There are a total of 21,218 connections at the moment: of these, 13,265 are funded by Supporting People, with the maximum contract capacity being 13,889. The balance of service users are self-payers.
4.31 The service targets a wider age range but 75% customers are people over 65 years.
4.32 The service is linked to the mobile warden service, which is described in the section on floating support. This new service was established in 2007. Originally the majority of units were in socially-rented sheltered housing and many were hard-wired installations. The new scheme was established as a multi-tenure scheme with the explicit intention of making the service more accessible to private sector tenants and owner-occupiers. Overall, there has been a shift from a ratio of 86% social housing and 13% other tenures in 2007, to 80% social housing and 20% other tenures in 2009. Mapping connections identifies a low level of supply in rural areas to the west of the county and recent work to market the service more widely will target this and the other areas identified as low supply.
4.33 An important link for this service has to be with the falls prevention service; the good protocols being developed on this in some areas clearly need replicating elsewhere. The survey of stakeholders also highlighted an issue around the fact that the service cannot be provided to older people who do not have a landline phone line; this is presenting issues of equality of access.
Telecare
4.34 The Joint Commissioning Strategy estimated that 1,000 telecare installations have been carried out to date. 667 were installed in the homes of older people during March 2010, and an additional 50 or so are installed in homes in extra care housing schemes. 20 units are used to provide a four-week lifestyle assessment, bringing the total of older people benefiting from telecare to around 740. Turnover is very roughly 20% per quarter. Access is restricted to those who meet the critical or substantial criteria in the fairer access to care services regime. On the basis of supply figures at March 2010, older people use around 83% of units.
Telehealth
4.35 Telehealth is available but at a very low level of 35 units, largely used by specialist nurses to monitor people living at home with heart and lung conditions. This service is not within the scope of this strategy but we have been surprised at this low usage level, given Durham was a pilot area.
Floating support
4.36 Following the Supporting People strategic review of older persons’ housing-related support and alarm services, there are no accommodation-based support services for older people across the area except in relation to extra care housing (considered later in this section). However, County Durham has very high levels of floating support specifically for older people. All the Community Alarm units already described are linked to the mobile warden service, operated by Care Connect and Cestria HA and this service provides support to all community alarm customers, though at different service levels of low, medium and high. These are defined as:
Low – a quarterly visit and equipment maintenance check – as this is a welfare check rather than housing-related support, we have not included numbers in our overall supply of support. Around 50% of people with community alarms receive this level of service
Medium – a monthly visit – target 40% of community alarm customers
High – a minimum of a monthly visit with the capacity, as need arises, for anything up to daily visits in particular circumstances – target 10% of customers.
4.37 The targets vary only in Easington where the targets are low support 46%, medium support 50% and high support 15%.
4.38 While in some areas the range of services open to self-payers is the same as described above, we do not have information on the take up in terms of level of service. It is probable that the majority of self-payers will only opt for the basic service. We have therefore not made any allowance for self-payers receiving a floating support service.
4.39 85% of the service users are classified as ‘older’ people, although this is 60 years and over so we have reduced the number of support units available by a further 10% to 75% to make figures comparable across all services. This apparently low adjustment reflects the fact that there will be a higher proportion receiving the service in the higher age bands. Our estimate of floating support provision through the mobile warden scheme is therefore 5,367 units.
4.40 A specialist scheme, operated by Creative Support, provides support to older people with mental health problems, including dementia, Huntington’s Chorea and Parkinson’s Disease, general anxiety and depression. The age criteria is 50 years plus. This provides a flexible and holistic service, including the following:
Practical support such as transport (of particular significance in rural areas) Support with daily activities such as shopping, bill paying, etc
Emotional support
Assistance with managing finances Signposting to other agencies.
4.41 The service is supported by an out-of-hour’s duty worker on call and provides, on average, three hours of support per person per week.
4.42 The service is available to 95 people at any one time across the County and some people will also be receiving one of the basic service packages through the mobile warden scheme. Although a full age split wasn’t available, we have counted all 95 units for the purposes of supply modelling, as the numbers of service users under the age of 65 are relatively few.
4.43 Stonham Housing Association provides a generic floating support service across the County. Of the total 532 unit of support, just 20 are currently supplied to older people, although the provision of support is based on identified need rather than age. We have included 20 units to recognise this provision.
4.44 Issues raised by stakeholders about floating support were largely about the adverse impact on sheltered housing communities, including their popularity with applicants for housing, as a result of the removal of the scheme-based wardens or scheme managers. There was also a concern that more emphasis should be put on maintaining people’s independence on an ongoing basis rather than on simply monitoring health and responding to crises.