Borders older people’s services no longer under scrutiny, thanks to improvements

Services for older people in the Borders are improving, a follow-up inspection by Healthcare Improvement Scotland and the Care Inspectorate has found.

By Kathryn Wylie
Thursday, 27th February 2020, 10:30 am
The Borders General Hospital at Melrose.
The Borders General Hospital at Melrose.

The region’s health and social care partnership for delivering services to the elderly on behalf of the Scottish Borders Integration Joint Board has been under scrutiny since it came in for criticism during a previous inspection in 2017.

A follow-up review, published in a report out now, focuses on the significant weaknesses the board was pulled up about and given 13 recommendations for improvements to implement three years ago.

The findings say the joint board, made up of Scottish Borders Council and NHS Borders bosses, along with members of the public, has made progress in addressing the issues highlighted and is now “generally in a better place than it was in 2017”.

Inspectors praise senior managers’ “commitment to a shared direction of travel” and improved joint working relationships between the different sectors working together, as well as stressing the importance of continuity of staff to offer “much-needed stability” for the service.

They also say planning and commissioning efforts that were “piecemeal to start with” have become more “strategic and focused”.

Ann Gow, deputy chief executive of Healthcare Improvement Scotland, said: “This was a positive review, with progress made in key areas.

“In order to continue making progress, the partnership recognised the need to improve both self-evaluation and ongoing evaluation of initiatives and approaches.

“In addition, engagement and consultation with stakeholders needs to become more meaningful, and appropriate representation must be included and valued.”

Peter Macleod, chief executive of the Care Inspectorate, added that while it will not conduct further scrutiny of the board, “a lot of work” remains to keep up the positive trend for services in the region.

“People want to experience care that is consistently high quality, with health and social care staff working well together to support people in a way that promotes their rights and choices,” he said.

“There is still a lot of work for this partnership to do to continue to improve services for older people across the Borders health and social care partnership.”

Inspectors do, however, highlight the introduction of what matters hubs and hospital-to-home provision as key examples of good joint working in the region.

They also recognise that the mental health transformation programme is resulting in encouraging changes for people diagnosed with dementia.

Improvements are also noted in the waiting time between referral and assessment, as well as the overall support provided.

Stephen Mather, chairman of the integration joint board, said: “The board has worked hard to ensure a professional and supportive relationship operates across all partners involved in the delivery of health and social care services.

“This includes health, council, housing, care providers, carers, our voluntary sector and directly with those people who benefit from our services.

“This report gives all of these partners recognition of their efforts and commitment to improving the lives of all who live in the Borders.”

In 2017, provision of care for the elderly was rated weak in three key categories, adequate in five others and good in only one.

The joint board was told at the time that it needed to put in place a process for monitoring progress on its strategic plan.

Council chief executive Tracey Logan said: “I am pleased to note that the excellent work of our staff has been so positively reflected in this review report and that the impact of our ongoing action plan has been recognised.

“We are deeply committed to supporting our community of older people here in the Borders, and for this to be acknowledged in this way is something we can all be very proud of.”

NHS Borders chief executive Ralph Roberts added: “We were pleased to hear that, when speaking to older people and their families, inspectors found that they valued the services they received, which are of a good quality.”

“It was encouraging to note that service providers had worked hard to achieve these outcomes which had made a positive difference to people’s lives and that people were able to find information and who to contact if they wanted to access services.”

However, more needs to be done to tackle an apparent lack of public involvement in how care for the elderly is being delivered, according to former integrated joint board member Colin McGrath.

Mr McGrath believes the new report’s findings are not as positive as they might first seem and much more progress needs to be made.

“The report is all worded around intention and making commitments to do things,” said the Kelso community councillor. “It’s all speculative and nothing is actually happening.

“They should be getting together and working together, and that’s not been happening over the years.

“I was fortunate to have been there for two years, so I saw it all happening before my eyes. I did raise the issues many times but, as a public member, didn’t have any voting rights.

“It’s all a good say, but it’s not action, and action needs to be done.”

He highlights that the report, while being hailed as positive, does throw up issues he thinks are still a concern.

“There has been no public representation on the board for over 12 months now,” he said. “That’s no public involvement, which they are really meant to have as a legislative requirement.”

Mr McGrath also believes a lack of consultation with elderly people in the Borders needs to be addressed, as does the time is it taking for the joint board to be fully functioning as an integrated body.

“The population is getting older, but nobody has properly consulted with elderly people in the region,” he added.

“It’s young people on the board making decisions, but you need input because anybody making decisions should have empathy with the people they are making decisions for.”

“I hear it all the time that people don’t feel they’re being listened to.

“And while the report says there will be no further scrutiny, it’s clear that the inspectors mean they will be keeping a watching eye on this, particularly on the issue of integration.”

“They want that to happen and they hope it will happen so that means they will keep an eye on the board.”