As promised, I now write my account of the recent meeting that I attended at my local Council. This was the first meeting I have ever attended and it was held mid-week at 7.00 pm. Attending were more than one local Councillor (c6 of them, I have just counted). Also invited to attend were Church of England Diocese Representative as well as Catholic Diocese Representative, a Parent Governor Representative, one Scrutiny Officer and one Scrutiny Manager.
Welcome and Apologies;
Declaration of interest;
Exclusion of Press and Public;
Call in of Report on Co-mingled dry recycling, Mixed Organic Wastes, Food Waste and Garden Waste – recommendation for contract award;
Looked After Children (Reports to be heard from Head of Services concerned);
Better Care Fund (Report to be heard from BCF Programme Manager);
Care Act 2014: – 6 month update (Report to be heard from Acting Director of Health, Housing and Adult Social Care);
Residents Priority Fund Evaluation (Report to be heard from Head of Performance Management);
Work Programme 15/15;
Minutes of Meeting last held;
Matters Referred from the Exec. Council to Scrutiny. – How they should be progressed;
References to Cabinet;
References From Scrutiny to Cabinet/Council and other bodies: monitoring update;
Dates of Future Meetings;
The Attendees of the meeting sat in the centre of the room, whilst I took my seat alone on the rows of empty seats to one side. Because I was the only member of the public who attended, I was invited to sit at the end of the table with everyone else which I did but I was not formally introduced to anyone but I could see some of the names on name plates around the table. No sooner had I taken my seat in the public area on arrival I was asked to leave and I was puzzled as to why- if this is a Scrutiny Meeting then noone should be asked to leave and everything should be open and transparent. I was not the only one asked to leave for the first half an hour of the meeting and whilst I sat in a waiting area I was talking to two people (council employees) who I did not know personally but later found out they were Heads of the “Looked After Children” team, so I believe. We waited until the councillors and everyone had finished their private discussions before we were called into the meeting. I thought it was good to be invited to sit round the table with all of them but I sat there quietly throughout and did not comment and only on one occasion, was I asked who I was and I just said “a mother” . I was also asked what I thought of the meeting and I said that I found it interesting and informative. However, I had also voiced my opinion earlier on to the other attendees (also excluded) for the first part that I thought it was wrong to have a scrutiny meeting- any part of it in secret.
Of course, my main interest is in care and it was interesting to hear what the Committee members had to say and listen to the presentation of their reports.
Figures of how many children in care were presented and from the information supplied, figures would suggest growth over the last year relating to young people aged 15 + for reasons such as: “chaotic home situations” or through criminal justice process maintaining them in stable placements and engaging them in education which was stated to be a significant challenge for the services. Comparison was made to a other local Boroughs and of course the comparison came out very well in the Council’s favour by stating lower numbers.. Apparently, the majority of children in care were in foster care.
The reasons children became looked after were given as “not safe to remain in the care of their families; when families refuse to continue to care for them; unaccompanied asylum seeking children; remanded through criminal courts. Various charts highlighted different matters, including ethnicity of looked after children,placement types- YOI /prison, semi-independent, secure unit, residential school, placed with parents, other LA /Foster Placement , Mother & baby unit, In-house Fostering, Hospital, Family & Friends , Children’s Home, Agency Fostering, Pre- Adoptive. The chart gives you all the applicable figures of how many placements in each category. There was also comparative figures from years 2010/11 to present in the local Borough, inner London, outer London and national numbers percentages per 10,000 children aged under 18 years. Another chart gave details on age starting care. Apparently Benchmarking data is used to compare performance of local authorities on their work with looked after children and this is available at national, regional and statistical neighbour levels. My local area looks as though it is the best on this chart with the lowest percentage! “Maintaining children in safe, stable placements has been shown to be a key factor in improving their long term outcomes. The placement stability of looked after children is closely monitored by the DfE through two specific measures. The first counts the percentage of children who have experienced three or more placement moves in a rolling year.” More charts are provided giving figures on stability of placement (length of placement) in the local area and other councils and nationally. Every school child in care must have a Personal Education Plan (PEP) For young people age 16 and above the PEP is incorporated into a Pathway Plan. Yet another chart on Percentage of care leavers in education, employment or training in the year 2013/14. I could go on and on about these charts as there are so many to feature but I noted my local area come out quite high on adoption levels compared to other boroughs. Under Issues/Challenges are mentioned the costs of caring for the growing number of looked after children which are increasing at a time when budgets are facing unprecedented pressure. How very interesting from my point of view. “Following the Government’s focus on encouraging more potential adopters to come forward there are now far more adopters available than children waiting for placements.” There is a proposed move to a regional approach for adoption and this is under active discussion to determine the most appropriate model for London.
The meeting then went on to discuss the BCF Overview and 6 Month Progress Report:
A new integration Board established and working well!
Good progress being made on developing shared care record across social care, GPs and hospitals.
Many other thing are listed and claims of progress being strong are made and towards targets.
Many other things are listed and recommendations given.
Apparently in 2013 the Government announced the creation of a new Better Care Fund from April 2015. This was designed to accelerate development of integration of Health and Social Care Services by shifting money from health into pooled budget with social care. “Intention to focus on efforts on preventative and rehabilitative services so that interventions could be made “upstream” to lessen impacts “downstream”” The figures given for my local area are over £20m. There is explanation of how this figure is made up. Very interesting, especially how this figure is made up.
How the Fund will be Spent:
This gives the figures for protecting adult social care, for providing more integrated care, for a contingency fund against reduction of non-elective admissions and this is held by the CCG in accordance with national guidance . Then there is the figure given for Disabilities Facilities Grant requests. The BCF investments are focussed on :
Integrated care for older people
Adults with mental ill health
Adults with long term conditions
Children/health and wellbeing.
Target outcomes from work streams :this goes into several areas – I think the most applicable to Elizabeth would be “reducing admissions to nursing or residential care services and improving patient and service user experience of services. I could say plenty on these points from my own personal experience.
Then there is under heading of Update how excellent and highly recognised at national level the local area was in performance re this scheme.
There is so much information on this that I will be all day typing this but it goes into Next Steps, Performance Issues, Reduction of Non-Elective Admissions, reductions in delayed transfer of care – just skimmed through this and nothing really applies to Elizabeth as she is not under care thank goodness. However, it then goes on to talk about Enablement Services and this is something that Elizabeth has not wanted anything to do with and especially since all that has happened. “To embed the use of “trusted assessor capacity” in order to make assistive technology a key part of the enablement offer”. As Dr Johnson would say “Truth Trust and Consent” – We were taken to court, bullied, harassed and serious allegations have been made about “someone?” that the Director of Psychosis recommends files not to be released. This was around the time they were trying to force return her back into care. When the most nasty comments are said behind your backs, not only about me but my carers too and the threat of a CTO being planned behind your back, severance of contact with family and deprival of liberty how can someone be expected to trust and work together with professionals who have on their agenda to take you to court time and time again? I as a mother have been accused of standing in the way /interfering with “care” however I have left every message on my answerphone for Elizabeth to contact various people if she so wishes and she has made it clear she does not wish to go to another area for their clinic and what is more it would appear we were being recorded last time on someone’s phone. I completely understand how she feels and my carers feel the same way too. If only there were such a thing as Open Diaglogue but there is nothing like this in my local area and allegations made can be so serious that they cannot be dismissed by carers and all of this has affected working relationship with the team. Now that Elizabeth is no longer in a care home hundreds of miles away from home I have evidence of not only how well she is doing at home but as to how someone vulnerable was not being properly supported as far as money is concerned whilst in care. An allowance of £30 a week is apparently was given at the care home and this is supposed to cover all food etc for the week and if that allowance is overspent then that resident goes without food at the weekends. This sounds very unsatisfactory to me. I agree that residents should be encouraged to budget but someone who has been in hospital along time needs a lot of support. This has happened to Elizabeth as I can see and I do not know how many times that this occurred but no attempt was made to contact anyone in the family to provide extra funding. Besides the team would have no idea of what it is like to be on high quantities of mind altering drugs which impair thinking ability at times. When so much money is being spent on such “supportive care” in terms of care homes then there should not be any instances where residents go without food at weekends. Elizabeth was going downhill yet was being pushed to go back to this care home and I would like to know how much extra funding it cost for a CTO to be arranged. No wonder the consultant psychiatrist was “happy” to manage Elizabeth on a CTO – I would like to hear how much is spent on this. It should never have arisen that a vulnerable patient like Elizabeth who had been stuck in care for three years should be allowed to go without any food ever!.
The local Council go on to mention Dementia and this is something else I have had experience with regarding my father who had Alzheimers and who I kept out of a care home for man years and whom is no longer alive. I had 24 hr care in place with my father paying for parts of his care and Direct Payments so that I could provide carers and this arrangement worked so well for numerous years. There was a brilliant team involved. Crossroads, Age Concern, a private agency, my own carers and Day Centre but transport. It took up a lot of my time caring for my father and this meant I could not have holidays etc. I was pleased that I kept my father out of going into a care home. I am not allowed to speak of what happened to him but he died aged 90 but had to undergo a hip operation. My father had two brilliant social workers who worked with the family extremely well. I wish I could say that about Elizabeth.
Next was discussed Overview and Scrutiny Committee (OSC) – reporting on the Care Act 2014.
Briefly the local Council received a report in Feb 2015 setting out key requirements of the Care Act 2014. The Care Act summarised “general duty on local authorities to promote ‘individuals’ wellbeing and the intentions of the Act to rebalance adult social care towards prevention, wellbeing and independence.” So they are accumulating data about costs of care in care homes and comparative figures with other London Boroughs. In relation to impact of funding reforms and introduction of individual personal budgets IPBs which at the time of Feb 0SC meeting were due to be introduced in 2016 but now postponed by 4 yrs. Well that is very interesting!
Care Act funding reforms include cap on costs of care due to come into force in April 2016 but Gov announced recently delayed until April 2020. The reason for this delay will allow time to be taken to ensure everyone is ready to introduce the new system and look at what more can be done to support people with costs of care. The announcement was made by letter from the Care and Support Minister Alistair Burt to the Chair of the London Government Association (LGA). There are so many other points listed but applicable to Elizabeth is Point 4.,3 Local Authorities must promote wellbeing when carrying out any of their care and support functions in respect of a person This is sometimes referred to as the “wellbeing principle” because it is a guiding principle that puts wellbeing at the heart of care and support. Wellbeing is a broad concept and is described in the Act as relating to the following areas:
Personal dignity – What is personal dignity when a drug such as Clozapine is deprived for nearly four days etc. What is personal dignity when no one bothered in the first instance when Elizabeth decided to come home, apart from making every attempt to destroy the family and force return her back into care.
Physical and mental health and emotional well being “I wish they would leave me alone, Mum – when is all this going to end” – Elizabeth’s comments when we were being taken to court and regarded as a ‘special case’“.
Protection from abuse and neglect – at least at home Elizabeth does not go without food. She is being encouraged to be independent and is no longer treated as a ‘prisoner’. At least she is not in a coercive environment being forced to choose between Mum and Dad and can see the rest of the family whenever she wants.
Control by individual over day to day life – at least Elizabeth is not being written about in a nasty way any more. I am trying to provide things that encourage her to go out bearing in mind her Agoraphobia which she has developed since being wrongly incarcerated for several years. I am trying to help Elizabeth become independent with her money too but am giving a bit more than just £30 per week, encouraging Elizabeth to make shopping lists etc and today Elizabeth was handed her bank card to do her shopping and was encouraged to walk halfway up the road which she did on her own although every so often Elizabeth had to grab the walls as she feels dizzy.
Participation in work, education, training or recreation. As Eliizabeth is on a “high level” of Clozapine she is very limited to what she can do. She feels dizzy as though she is going to fall – even on taking her to the zumba classes she has to stand close to the wall . Socially she is doing well away from MH care as she is mixing in with people who are either ‘surviviors’ or people unaffected with MH issues. Although she has lost tremendous confidence she is making every effort to go out socialising and taking part in conferences and organisations such as ISPS and their workshops. If the drugs were reduced. then that would be good but in my area they drug people at high levels so I have seen in the files and ignore the patient when that patient requests to be reduced. They could save money if they gave less drugs and especially if they offered the tests that I have had to turn to Holland for.
Social and economic wellbeing – at home Elizabeth does not go without and valuable things do not go missing. Socially Elizabeth is benefitting by going to lots of different events and being with her family at home and seeing her cat on a day to day basis.
Suitability of living accommodation. Elizabeth has her own room, surrounded by her possessions and she an come and go as she pleases as she has a key and is not restricted and treated with dignity but at the same time is encouraged to clean and do her own chores and now I am hoping to help her on money and managing it as well as the internet . Therefore it is very suitable to be home .
The individual’s contribution to society – by having Eliizabeth home I am saving £60000 in care home fees whilst nothing whatsoever is provided but Elizabeth is on last resort drug Clozapine which renders her disabled. Elizabeth does not want to see certain people and neither do my carers. This is for very good reasons. There are no facilities where someone can go in to be reduced from these drugs and once someone is given a label by a consultant psychiatrist that label sticks for life unless you can prove there is a physical illness. This is why I hope Chy Sawel can be set up looking properly at nutrition and minimal drugs unlike current care on many acute wards. I would love Elizabeth to one day have a job but right now and having been in care for c three years she struggles to do some essential and basic chores such as washing up and cleaning effectively, throwing away rubbish etc – she is too afraid to even go out however she is really trying and does not refuse to tidy up, do washing, ironing and household chores. She is no longer in bed at 6.00 pm which is good. The best thing I have come across is direct payments but this has never been given to Elizabeth and if this was to be given I would be able to provide a therapist to work on Elizabeth’s ability to go out alone but in my local area families are excluded and confidentiality played upon so if for instance there are for example any appointments Elizabeth may have been advised of , if family are not advised then things can be overlooked and Elizabeth would need help in getting there at the moment. You are treated like you are invisible as a parent apart from when a team want to get rid of you by way of court and then you are regarded as “special”. I felt like speaking about Open Dialogue at this Scrutiny Meeting as this would I think bring about massive improvements. I am doubtful this would be considered in my local area especially if meetings such as this are held in secret and this goes against the wonderful idea of Open Dialogue as this is all about openness, honesty and trust as well as inclusion.. There are plenty of organisations giving advice and information but in reality it comes down to money this is not always being given to provide for those who are vulnerable and there is blatent discrimination in some cases especially when someone disagrees about care and diagnosis. Instead funding is being spent on in-house services, private sector care, incarceration and court of course whereas it should be spent on providing those with MH problems to be integrated into society with the right level of support. A social worker once said “Elizabeth will be happier with her own kind”. How very wrong this social worker is with her comments. I have proven otherwise and comments like this make you wonder how some professionals can even comment on what is the best interest for someone.
Mention is made of carers assessments and I have not had one. I have seen much discrimination and undignified treatment in my local area concerning Elizabeth and despite all reservations by certain team members after, 1 year and three months since Elizabeth has come home everything has worked wonderfully. Having been taken to court so many times results in you just wanting to stay clear of such people who have their own agenda and think they know the family but they do not. You do not know what they are saying about you – they might be nice to your face but behind your back are saying the most nasty things and everything is being recorded and now I have obtained all of this. This is why I would like to see Open Dialogue as you can trust professionals this way and this is why I like the ISPS organisation as service users and carers are treated with dignity and professionals who really care attend such conferences. In Tornio, Finland MH patients are treated with dignity and respect unlike in the UK and the UK should stop wasting time in presenting all these figures and provide what is needed open transparent care that provides dignity and honesty and inclusion to parents/service users alike.
As for Safeguarding Adults – not one incident at home unlike whilst under care as I can see.
Anyway, I was amazed that I was the only one present at this meeting from the public and I think more people should attend such meetings and take an interest in what is going on. I do not think Elizabeth would have enjoyed sitting around for 2 and a half hrs but feel like bringing her to a future meeting (part of) so that everyone can scrutinise how well she is doing at home and look towards saving money by not spending it on expensive court actions. They also need to look at equality and discrimination and I see this being a major problem in my area. So I presented my local Councillor with my story called “Get Her Back We are Paying for That”. She was unable to answer me when I asked how comes no one intervened as deprived the chemical Clozapine leaving Elizabeth without this chemical for 4 days. The main excuse to get rid of me is my views on the chemicals but as far as I am concerned I have the best interests as all I would like to see is the minimal level of drugs, bearing in mind physical health. So the team are in favour of the drugging of Elizabeth with this chemical for life but they do not stop to consider physical health and this is where I as a mother have had to go to the very top and contact those who fully know the workings of the drugs and this has taken me beyond the UK to Holland. How wrong they were to assume that I would just stop giving this chemical just because of my own views even though my views happen to be correct. In fact it was certain team members who were responsible for depriving this drug as they made it impossible to get it anywhere in the local area forcing me to have to go to Harley Street and beyond. I told the Scrutiny Committee at the end of the meeting that I had to turn to Holland for help for accurate treatment and that no one will be able to argue with such accurate results and how these results could benefit everyone and should be adopted by the NHS so that everyone can benefit by being on the lowest possible dosage and assessing for adverse drug reactions before giving the treatment on a trial and error basis. I am still waiting for these results in full but I am delighted to hear from the Professor as I expected that Elizabeth is unable to metabolize some anti-depressants. This proves my point. Bearing in mind the first chemical given was Prozac this puts into question the diagnosis and treatment as consultant psychiatrists should not just jump to conclusions without proper evidence based data and I hope to present the full facts to the Scrutiny panel at a future meeting – that is if they have not banned the public altogether by that time.
Anyway, now turning to my week. I had an accident on Monday that left me lying in the road – a hit and run driver who lost her wing mirror. Had it been the car itself that hit me I may not be around today however I was not going to miss the Liberty Awards for anything and I refused to go to hospital. I would praise some bystanders, complete strangers who stepped in to help me , the police and ambulance services were brilliant. I will write about the Liberty awards next time.
Yesterday I took Elizabeth out with me all day. Together we took part in the Contour Makeup Artist Course and afterwards ” I wanted to go out somewhere nice. I took Elizabeth to a wonderful pub in Fulham for lunch and then onto a show – we saw the fabulous show Memphis which I would highly recommend Today I have plenty to catch up on so this blog is being done very quickly so I apologise for any spelling mistakes however the facts and information are 100% correct. I would also state that I have been looking at “Open House” I have probably left it too late to book for some buildings as this is due to take place next weekend. I would not mind going to Downing Street but most importantly I would like to meet Mr Cameron and Mr Hunt – there is much to be discussed as far as mental health care goes and I would like to see choice in care being given and facilities to properly assess and check for underlying physical illness and to be reduced off these mind altering drugs especially when diagnosis and treatment is in question in terms of ‘treatment resistance’ – POOR OR NON METABOLISER. Look at what money could be saved by giving less drugs (minimal levels) and proper tests like I am having done in Holland and as already said these tests should be available to everyone in my opinion. I would also like to speak to them about the court system and the way vulnerable people are not being treated fairly and not forgetting those who are given up on – those who are incarcerated for many years and deprived of their human rights to see their family and visit home. I know many cases such as this and this is costing the taxpayer a fortune. It would be cheaper to give direct payments to their families and work together using the open dialogue method.
Last of all I am looking forward to attending the conference MORE HARM THAN GOOD at Roehampton University – looking forward to meeting everyone and taking Elizabeth along to this.
My next blog will be about the Liberty Awards and this wonderful conference.