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City of York Council

City of York Council is a unitary local authority providing services to around 200,000 people in an area covering approximately 105 square miles. In York, the number of people aged 65 and over is expected to increase by 10% to 40,100 in 2020, with 6,200 of those predicted to be over 85. This means nearly a quarter of our population will be over 65. It is estimated that 13,779 people over 65 will be living on their own, with this increasing to nearly 15,000 by 2020. City of York Council spent £22,805m on older people in 2013/14, with nearly half of that being used on residential care. We also provide a range of support to enable people to continue living independently in their own homes. It is estimated there are around 2,725 people living with dementia in York and this is expected to rise to 3,209 by 2020. During 2013/14 £5,990m was spent on supporting people with Dementia.

Updated:
17 April 2018
Location:
Yorkshire and Humber
Sectors:
Local Authorities
Local Alliances:
York Dementia Action Alliance, Yorkshire & Humber Dementia Action Alliance

1. Action Plan

The national Dementia Declaration lists a number of outcomes that we are seeking to achieve for people with dementia and their carers.  How would you describe your organisation’s role in delivering better outcomes for people with dementia and their carers?

 
The council are committed to the aspiration of York becoming a dementia friendly community and are very keen to support progress towards this.  The Adult Social Care Directorate is also responsible for delivering our statutory responsibilities in relation to adult social care. These include the provision of universal advice and information, individual assessments of social care need and carers assessments, provision of home care and accommodation/care home options, and quality monitoring of social care provision in the city. 


The overarching vision for older people in York (jointly agreed with colleagues in health), is one where a higher proportion of older people remain within the community, having fewer hospital and care home admissions and are able to enjoy: greater independence; a wider choice of accommodation options; and greater social engagement.

What are the challenges to delivering these outcomes from the perspective of your organisation?

A key challenge continues to be reducing stigma in relation to dementia, within the wider community.

It can also be difficult to identify people and their carers at an early stage, who may benefit from some lower level community based support, as they are not always known to social services perhaps until they present in a crisis situation.  Carers can therefore sometimes be under great strain or isolated. There are also many other people with dementia living on their own, which can lead to loneliness and isolation.

The changing health and social care landscape and integration provides both a challenge and an opportunity.  From October 2015 there has also been a change of provider for the Vale of York CCG mental health contract, which includes the cognitive impairment service. 

April 2015 saw the introduction of the Care Act, which brings significant new responsibilities for the Local Authority at a time of continued budgetary challenge.

Sufficient supply of suitably skilled workers for the adult social care market in York is a challenge, due in part to the low levels of unemployment in the city. We continue to work with providers to attract new staff into the sector and promote social care as positive career opportunity.

Sustaining momentum for our aspiration to become a dementia friendly community remains a challenge due to everyone’s competing priorities, and encouraging colleagues from other teams to see dementia as everyone’s business continues to take time and commitment.

Member website

www.york.gov.uk

2. Actions

  • 2017 Action Improving experiences of transport

    •Our Right to Get out and About, Innovations in Dementia Project supported by YDAA. Three DEEP groups (York, Scarborough and Bradford) supported to tackle inequality in transport accessibility from a right based perspective.

    •Transport focused YDAA event (October 2017) to build on progress made.

    •Contact re-established at York Station with Regional Service Delivery Manager for Virgin East Coast Trains.

    Link established with First Buses.

    Status:
    Completed
  • 2016 Peer Support and Carer Education

    We will continue to commission and monitor the Alzheimer's Society to provide peer support activities for people with dementia and their carers, and facilitate carers education courses.
    Status:
    Completed

    2017 - First Quarter Update

    Alzheimer's Society during 2016 and 2017 have continued with supporting individuals and their families.

  • 2016 Promoting Action

    We will continue to contribute to the York Dementia Action Alliance Steering Group, and have a key role in encouraging other teams within the council to contribute to our aspiration of making York a dementia friendly community. Our CYC Communications Team have supported the work of the York Dementia Action Alliance by developing our communication strategy for partners on the YDAA Steering Group, and they will continue to support by raising awareness of dementia and the work of the YDAA in on-going media opportunities and on social media We will promote the Dementia Friends initiative and encourage all CYC staff to become a Dementia Friend, by running a series of Dementia Friends lunchtime sessions on dates throughout the year.
    As part of our work to make York a dementia friendly city, alongside our aim of preventing or the delaying the need for people to access statutory adult social care support where this may not be required, in 2015/16 we are planning to invest in a number of new preventative projects in the community.  We will therefore be seeking ideas for small community projects for people with dementia and their carers.

    Status:
    Completed
  • 2016 Development of care facilities

    There is a significant programme of work underway in relation to our CYC Older Persons Homes; to address the longer term needs of York’s ageing population and modernise accommodation.  We have already started work to make best use of York’s existing Sheltered Housing by making it more accessible for people with higher care needs, and are working towards replacing the council’s seven out-dated Older People’s Homes with more modern accommodation. As part of this programme of work we will ensure that the specific needs of people with dementia are at the forefront of our planning.

    From October 2015 one of our CYC care homes has developed a new facility providing care for people living with Dementia; Poppy fields is a small household that provides care for 8 older people , this includes 2 respite rooms providing short term breaks for people living in their own homes to allow their carer to have a holiday.  The vision is to enable people to maintain their daily living skills through occupation, and there will be a variety of stimulating activities for the residents to be involved in, enhancing their quality of life. The environmental design and approach is based on current research and best practice.

    Status:
    Completed
  • 2016 Training

    Dementia training will be included in CYC training prospectus, which is available to all the social care workforce in York. The Workforce Development Unit will continue to analyse the demand and suitability of dementia training. We will also work with Skills for Care to promote a new Dementia Training Course which is available to staff working in residential/nursing homes and for domiciliary care providers in the city. The course is supported by Health Education Yorkshire and The Humber and will be delivered by the Bradford School of Dementia. It will be running in 2015/16

    Status:
    Completed

    2017 - First Quarter Update

    A range of training has been delivered and as a result practice and udnerstnading has improved. Whilst hte action has been compelted, the training element continues in 2017 and 2018.

  • 2016 Carers support

    The Carers Project is one of CYC Adult Social Care New Operating Model projects; Within this programme of work we are reviewing our Carers Offer and developing a new partnership approach across the voluntary and statutory sector The vision for this partnership approach includes the development of a single point of contact for carers and timely access to carers assessments, as per the requirements of the Care Act.; The project will also include a review of replacement care options and all support available to carers. We will ensure that the specific needs of carers of people with dementia are recognised, and are already actively engaging with local specialist organisations to achieve this.

    Status:
    Completed

    2017 - First Quarter Update

    This work has been completed, the Carers project is fully operational

  • 2016 Integration

    We will work with partners in the Vale of York Clinical Commissioning Group and Tees Esk and Wear Valley Foundation Trust (the new mental health provider), to identify opportunities for joint commissioning of community health and social care. 

    We will work with partners on specific projects, such as a Social Prescribing pilot which began in October 2015, and a range of projects as part of the Better Care Fund.  Our joint work will also include consideration of the recommendations in the ‘JRF Evaluation of the York Dementia Friendly Communities Program’ (2015).We will also work with partners to develop a new dementia strategy for York, by 2016.

    Status:
    Completed

    2017 - Fourth Quarter Update

    Closer working relationships have developed between health and social care, there is a more robust integrated approach which includes the STP, joint events and support with commissioning to improve diagnosis rates and ensure care is offered in partnership. A dementia strategy is been considered, invovlement with North Yorkshires strategy has also taken place.

  • 2016 Telecare

    We will continue to install and use a range of telecare within CYC homes, such as night lights, pendant alarms and call bell systems. We will also look for examples of best practice in the use of telecare when monitoring our independent sector care homes.

    The potential use of telecare is integral to the customer assessment process, so we will continue to promote the use of telecare where this may be appropriate and beneficial to the person with dementia and/or their carer.

    Status:
    Completed

    2017 - First Quarter Update

    Telecare has been fully implemented, in particular one home has reduced hospital admissions by working with PMG and utilising telecare equipment. Staff in care homes and in Independant Living services use pendants, sensors, to alert staff. This will ocntinue to develop in 2017/18

  • 2016 Development of best practice in CYC Care Homes

    Following on from the Dementia Care Matters programme of work in our CYC care homes last year, we will continue to implement best practice in dementia care. This includes:- all CYC homes now using the Dementia Environment Checklist developed by the Kings Fund, and this will form part of our environmental audit process- reviewing resident and staffing levels in order to effectively meet peoples need - applying the Questionless Question approach (from the Contented Dementia Trust) in all CYC care homes - raising awareness of the Prime Ministers Challenge on Dementia 2020 within all CYC home 3 CYC Home Managers will be completing the Bradford School of Dementia Training in 2015/16 - development of a sensory garden at Windsor House in October 2015

    Status:
    Completed

    2017 - First Quarter Update

    Best practice in the CYC homes has been fully implemented, residents receive a high quality care with staff using a range of tools and techniques.

  • 2016 Raising awareness of appropriate language and terminology

    We are working towards the principles in the Dementia Words Matter & DEEP Guide and will continue to promote this with partners internally and externally. This is part of our continued work to develop a positive culture within the organisation; We will challenge the use of inappropriate terminology and language in relation to dementia, including in meetings, care delivery and the media for instance.

    Status:
    Completed

    2017 - First Quarter Update

    The use of terminology and correct language has been embedded in the healtha nd social care cutlure with staff in care homes udnerstanding postive words to use. However, this is ongoing and thorugh dementia firends sessions and general training staff understnad htey need to challenge colleagues.

  • 2017 Identifying people and supporting their involvement

    •Dementia Small Grants Panel involving people living with dementia.

    •Grants awarded to community projects aiming to support more people living with dementia. •

    •Coordinator attended varied groups throughout year to hear about issues most important to people.

    •York Flourish Women with Dementia group are working towards a Flying Squad!

    Status:
    Completed
  • 2017 Developing a communication strategy

    •City of York Council and York CVS Comms teams working together to support YDAA communications.

    •Both YDAA webpages updated and traffic increased.

    •Twitter accounted reactivated, following increased. 

    •Monthly Newsletter established.

    Status:
    Completed
  • 2017 Working with GPs to improve diagnosis experience

    •Healthwatch York Dementia Guide published.

    •Clinical Event for GPs organised by CCG, supported by YDAA to start to address low diagnosis rate and lack of knowledge about support and services.

    •Coordinator working with two medical groups to support to improve services.

    •Alzheimer’s Society provided Support Worker Advice Sessions within 3 GP practices.

    Status:
    Completed
  • 2018 Identify community resources and ‘Dementia Champions’ in local areas/wards

    Working together within local areas/wards to build dementia friendly communities. By identifying dementia friends/champions, local people who can support their communities. An initial community mapping exercise is taking place to identify ward areas and using an asset based approach understanding what each area has to offer.

    We want to build coherence, consistency and coverage

    Status:
    Planning
  • 2018 Work with Local Area Coordinators, Community Facilitators and Ward Teams

    Working together within local areas/wards to build dementia friendly communities. Across York there are five co-ordinators who can develop links with communities, and understand where people are at risk of social isolation, where communities have strong assets and support and where diagnosis rates are low. We want to build coherence, consistency and coverage
    Status:
    Planning
  • 2018 Continue to work with local businesses to raise awareness.

    Working together within local areas/wards to build dementia friendly communities, this includes local businesses through links with York Cares and building on the transport work ie with taxi companys/trains/buses. We need to ensure businesses are dementia friendly using signage/orientation/customer service.

    We want to build coherence, consistency and coverage

    Status:
    Planning
  • 2018 Continue to work with GP practices to improve diagnosis and signposting

    Working together within local areas/wards to build dementia friendly communities. By working with GPs to improve diagnosis rates through CYC and CCG. This includes support from Dementia Forward, Minds and Voices, TEWV and local groups to work with GP practices to ensure a diagnosis is given but the person is then correctly signposted ie to memory services, local support groups, health and social care services. We want to build coherence, consistency and coverage.
    Status:
    Implementation