Adult Social Care for the over 65s - year 1

Healthwatch Norfolk report on the first year of a three-year project, commissioned by Norfolk County Council. The project is focusing on areas of current and expected high demand for adult social care for the over-65s in Norfolk. It focuses on three main areas of people’s experiences: how well older people are listened to by adult social care, adult social care’s role in hospital discharge, and experiences of adult social care after a dementia diagnosis. They interviewed 61 people receiving services and their carers, 30 health and social care professionals, and received 270 responses to the project survey. 

Most people felt well listened to by social care services, and were happy with the information that they were provided. A minority had less positive experiences. For example, 14 per cent felt that they were not understood when first contacting Adult Social Care, and 14 per cent had problems with understanding or discovering their care options during their needs assessment. People wanted help to navigate the large number of organisations and services in the sector, and wanted to know what social care could offer them, so that they would know what to request. They also wanted professionals to guide them through the information, and wanted information about how much they would have to pay for care when the time came for them to pay for it. 

Most people were happy with their Care Act Assessments, but a 19 per cent of respondents (26 people) said that not all of the people they wanted were involved in their assessments. Ten people in the in-depth interviews said they thought they had been signed-off too early after their assessment, and wanted someone to check in with them to see if their care package was working well. 

The NHS is the lead partner in discharging patients from hospital, and is responsible for ensuring that patients and their Carers are involved early in discharge planning conversations. Healthwatch found that much progress remains to be made in this respect, as significant proportions of people said that neither they (33 per cent or 31 people) nor their Carers (46 per cent or 37 people) had been consulted about what care (if any) they would receive after leaving hospital. 48 per cent (58 people) said that they did not receive information about care in good time for their discharge. Women were significantly more likely to be unhappy with discharge communications. People also reported some miscommunication over who would pay for their care after they left hospital. 

We found that significant proportions of respondents diagnosed with dementia felt that there was insufficient support to learn more about their future (33 per cent or 22 people), or support to plan for the future (47 per cent or 32 people). People wanted more information on the progression of their condition and on who would pay the costs of care, and regular check-ins from professionals. Some people mentioned problems with care providers commissioned by the local authority, particularly with domiciliary care agencies’ performance in caring for people with dementia and a mental health condition. Many people and their Carers also reported that they had lost most or all of their social connections since they had developed a care need (61 per cent or 71 people). 

There are a number of recommendations on information provision, check-ins and reviews, improving the discharge process and support to people with dementia.