Agenda item

A presentation and discussion for Panel Members on prevention and early intervention. An evaluation report on Local Area Coordination is provided for background information.

Rochelle Jamieson, Head of Strategy – People, and Andrea Wershof, Local Area Coordinator, introduced this item with a presentation on early intervention and prevention in Haringey which included the following points:

• That services are geared to solve problems for people and that solutions are based on what would work best from the services available.
• The approach aims to intervene to enable people to access help at an earlier stage and stay as independent as possible.
• The feedback from residents is consistently that they want help to prevent things from going wrong, they want to be involved in helping to shape services and they want services to be well joined up and for any long-term support to be holistic when needed.
• Other suggestions from residents have included:

o   That there needs to be a care navigator to help people access the internet and available services.

o   That services need to be close to people as it can be difficult for people with mobility issues to travel far.

o   That older people want to stay in their own home for as long as possible and have a better quality of life rather than live in a residential care home.

• A critical part of the approach is providing information, support and guidance and developing a network of options to provide people with the support that they need. The aim is to create an environment that enables and empowers all residents to live well and achieve their potential including by helping people to find their own solutions.
• There are no access criteria for the early intervention and prevention service and this prevents the need for people to ‘jump through hoops’ before they can get access to help.
• The different levels of intervention were displayed in one slide as a “care cone” with four levels:

o   Keeping people healthy, safe and well through public health services.

o   Early intervention and prevention to provide a network of options to help people.

o   Care and support through coordinated multi-agency teams.

o   Specialist/emergency, including specialist palliative care.

• The Local Area Coordinator role was described as person-centric because it aims to be led by the residents including those who are needy and may have felt disenfranchised previously. By being on their side it can be transformative for someone who is on their own and by helping to connect them with various types of support it can help them to achieve their vision of a ‘good life’. Examples were given including helping an isolated individual with learning disabilities through his re-housing assessment process after his parents had died.

Will Maimaris, Director of Public Health, advised the Panel that there are currently just two Local Area Coordinators covering Hornsey and Northumberland Park but there are plans in place to expand the programme with an additional four to operate mainly in the east of the borough.

In response to questions from the Panel, Will Maimaris, Rochelle Jamieson and Andrea Wershof said:

• That there are usually three or four ‘touch-points’ that the Local Area Coordinators visit each week but there are other assets such as libraries, schools and community cafes where they also might visit people. Populations of each area covered is limited to about 18,000-20,000.
• Asked about how to reach isolated people, Local Area Coordinators are well known in the local community by, for example, shopkeepers, cafes, schools and faith groups. These often let the Local Area Coordinators know about people who need help who might not otherwise ask for help.
• Asked about evidencing the savings from this programme, this is always a challenge but there is an evaluation and also a collection of case studies with professionals who can set up what would have happened had the Local Area Coordinators not been in the area. This type of evidence can be incrementally built up over time and there is work ongoing on continuing to evaluate this work. The investment in the programme so far is relatively modest with £120,000 per year provided to cover two Local Area Coordinators plus the evaluation work. Will Maimaris said that he was convinced that there are significant savings resulting from this across the system, particularly if it prevents the need for just a few high-cost packages. However, it can be difficult to quantify savings to adult social care, including because some individuals helped by the Local Area Coordinators may not have been in contact with adult social care system at that stage without this contact being made.
• In terms of small grants for community groups, the embedded nature of the Local Area Coordinator work can help to generate intelligence to help shape what the Council commissions. They can also help advise community groups about consulting their user groups and evaluating projects that they have done which can help them to improve their funding applications.
• Asked about continuation of service when a Local Area Coordinator is on leave or in the event that they leave the Council, it was acknowledged that it can be difficult to delegate the relationships that Local Area Coordinators build up. However, it is not an emergency service and issues can generally be picked up after a short period of leave. By expanding the number of Local Area Coordinators from two to six in future will also help, with a larger team better able to cover for a colleague where necessary.
• On why there were significantly more ‘Level 2’ interventions in Hornsey than in Northumberland Park, this was likely to be because in Hornsey there are typically more inventions involving older people who often require longer-term support whereas the populations in Northumberland Park was more likely to involve younger people and families.
• On why a large proportion of outcomes that were not captured in Graph Eight in the report, this was due to inadequacies of the form with limited options and so many outcomes were captured as ‘other’.

Florence Guppy, Programme Lead – Connected Communities, then presented to the Panel with an overview about the Connected Communities programme. It had started about a year previously as a migrant integration programme funded by the Ministry of Housing, Communities and Local Government (MHCLG) and focused on support for new arrivals to the borough in employment, housing, parenting & early years, English language and community groups. As the programme has developed it has become clear that it works to the same principles as other initiatives such as the Local Area Coordinators and the Community First trial, including by being resident-led, strength-based, locality-based and without entry thresholds, and so these programmes were becoming more closely linked.

Data collected in relation to the Connected Communities programme has shown that it had worked with 1,186 residents between September 2018 and July 2019, 931 of whom were female. There were also a higher than expected number of Albanian nationals in contact with the programme than had been expected. Showing the impact of the early intervention work is a challenge but the team is looking at ways of measuring the social value, social connections and the savings to the Council. The programme is not a stand-alone service, but more a part of a wider network of support including other existing Council services.

In response to questions from the Panel, Florence Guppy, Beverley Tarka and Charlotte Pomery said:

• That the programme has two funding streams, the original one from the MHCLG with a focus on migrant integration including employment advisers, housing support, etc, and then the additional funding from the Transformation Board to embed the principles of Local Area Coordination.
• That next steps include working with health provision which will involve trialling Connected Communities/Community First at two GP practices and also at North Middlesex Hospital’s A&E department and so this will involve linking up with Enfield colleagues as the hospital serves both boroughs.
• That there are different funding streams for the various programmes, but there are a range of different ways of working with residents so this has enabled various approaches to be tested and evaluated.

Cllr Pippa Connor asked whether a basic guide of the main officers and points of contact for each programme could be distributed to Councillors. (ACTION)

Andrea Wershof said that if any Councillors were interested in shadowing either of the Local Area Coordinators for a half-day or full-day they would be very welcome to do so.

Cllr Pippa Connor thanked all the officers for their presentations and for the useful information provided.