Integrated Impact Assessments – Overnight Responder Service
Overnight Responder Service
The Partnership aims to increase the use of remote technology / overnight responder service where this is assessed to be a safe and effective alternative to providing care within the persons home. This model of service delivery is person-centred and can replace the provision of sleepovers which are a more restrictive model of support. There are additional benefits in assisting the individual to be less digitally excluded including connectivity with family and friends and person-centred applications of benefit to the individual.
An initial pilot of an overnight responder service involved working closely with service users and their families to change from sleepover provision to the responder service where it was appropriate to do so.
The overnight responder service has been discussed at several Edinburgh Learning Disability Advisory Group Meetings as noted in agenda/ minutes.
Comments from adults who have a learning disability include;
- We should always have a choice if we want (technology) or not;
- People may prefer face to face support;
- Some people would like to have less staff in their house
- Not everyone is technology savvy.
It is also important to highlight where an overnight responder service is considered appropriate this would always require social work assessment, consultation with the individual and family, and provider risk assessments. If it was assessed as not suitable for an individual then other support options would be put in place.
Is the proposal considered strategic under the Farer Scotland Duty?
Yes
19 August 2021
Identify facilitator, Lead Officer, report writer and any partnership representative present and main stakeholder (e.g. NHS, Council)
| Name | Job Title | Date of IIA training |
|---|---|---|
| Jayne Kemp | Strategic Planning and Commissioning Officer / Report writer | |
| Sarah Bryson | Strategic Planning and Commissioning Officer/ Facilitator | |
| Linda Gibson | Senior Occupational Therapist | |
| Grant Macrae | Citizen Representative, EIJB | |
| Elaine Wishart | HR Consultant | |
| Margaret McLauchlan | Assistant Care and Support Manager |
| Evidence | Available – detail source | Comments: what does the evidence tell you with regard to different groups who may be affected? |
|---|---|---|
| Data on populations in need | Data collection within services | Monthly demand from adults who have a range of support needs in their own home or moving to supported accommodation – part of the support can be to access a suitable responder service. |
| Data on service uptake/access | Data collection within service area | Currently there are 80 people with a range of support needs using a responder service. This has grown from an initial pilot of 30 people, expanded to 50 and now at 80. Additionally, the current responder service has a waiting list of over 30 people. |
| Data on socio-economic disadvantage e.g. low income, low wealth, material deprivation, area deprivation. | Scottish Learning Disability Observatory | The individuals who will be accessed for a responder service in the main are in receipt of universal credit with little paid employment, therefore have typically low incomes and little opportunity for wealth. Individuals who have disabilities can have lower levels of employment. Total population in full time work is 41.5%, for example in people who have a learning disability it is 5.5% and for autistic adults it is 9.6% |
| Data on equality outcomes | Keys To Life
https://keystolife.info/strategy/ Keys to Life Implementation framework 2018-2021: https://keystolife.info/wp-content/uploads/2019/03/Keys-To-Life-Implementation-Framework.pdf |
The Keys to Life sets out the Scottish Government’s ten year strategy for improving the quality of life for people with learning disabilities. The implementation framework for the Keys to Life has four strategic outcomes which relate to the United Nations Convention on the Rights of People with Disabilities:
The proposed change aims to enhance each of these national strategic outcomes, particularly relating to independence and these are further enhanced within the implementation Framework; 2019-2021. Services shall be designed to minimise the effect of mental disorder and give the person the opportunity to lead lives which are as normal as possible. |
| EHSCP Strategic Plan 2019-2022:
https://www.edinburghhsc.scot/wp-content/uploads/2020/01/Strategic-Plan-2019-2022-1.pdf |
Implementation of an overnight responder service would contribute to the following Strategic priorities:
|
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| https://www.gov.scot/publications/carers-scotland-act-2016-statutory-guidance-updated-july-2021/pages/5/ | Considers the potential of digital connectivity in communicating with, and supporting carers. | |
| https://www.carersuk.org/news-and-campaigns/features/10-facts-about-women-and-caring-in-the-uk-on-international-women-s-day | Overall woman are more likely to take on caring roles that men. Of the 6.5 unpaid carers in the UK 58% are women | |
| https://www.gov.scot/publications/mental-health-care-treatment-scotland-act-2003-code-practice-volume-1/pages/2/ | Services shall be designed to minimise the effect of mental disorder and give the person the opportunity to lead lives which are as normal as possible. | |
| Research/literature evidence | Evaluation and increase from previous uptake | Previously remote technology was proposed for 30 individuals. After this was successful, it quickly increased to in excess of 80 individuals. |
| EHSCP Strategic Plan 2019-2022:
https://www.edinburghhsc.scot/wp-content/uploads/2020/01/Strategic-Plan-2019-2022-1.pdf |
References in the Strategic Plan; P33 – overnight strategy, conversation 3 P58 – Overnight support offering P135 – Independent Living, to create a responder service that reduces the need for sleepover staff |
|
| Public/patient/client experience information | Previous reviews of individuals overnight support | A previous review and implementation of increased remote technology for approx. 80 individuals has proven successful with positive feedback and outcomes. There was a small number who after initial attempts didn’t transition to remote digital support and maintained the support previously in place. |
| Feedback from current provider | Comments from service users and carers are included in monthly reports and indicate a high level of satisfaction in this model of service provision. | |
| Evidence of inclusive engagement of people who use the service and involvement findings | Edinburgh Learning Disability Advisory Group (ELDAG) | Agenda item at several ELDAG meetings 2020-21. This group includes adults who have a learning disability and support organisations. |
| Social work assessments | All new service users will have social work assessments to determine if an overnight responder service the most appropriate model of support, service users and families will be involved in this person-centred assessment. | |
| Evidence of unmet need | Yes – from current provider | Current responder service submits monthly reports – demand has grown steadily since the pilot that supported 30 service users, expanded to 50 the 80 , and now a waiting list of over 30 people in place |
| Good practice guidelines | Scottish Social Services Council (SSSC) | The SSSC is the regulator for the social service work force in Scotland. Their work means the people of Scotland can count on social services being provided by a trusted, skilled and confident workforce. They protect the public by registering social service workers, setting standards for their practice, conduct, training and education and by supporting their professional development. Where people fall below the standards of practice and conduct they can investigate and take necessary actions. |
| Health and Social Care Standards, My Life, My Support. | All health and Social Care providers are governed by these standards and inspected by the Care Inspectorate. The standards provide clarity on what should be expected when using health, social care or social work services in Scotland. They seek to provide better outcomes for everyone; to ensure that individuals are treated with respect and dignity, and that the basic human rights we are all entitled to are upheld.
The service specification will require that the provider meets the above standards. |
|
| Carbon emissions generated/reduced data | Model of service provision | There will be reduced travel of staffing travel to and from peoples homes to provide physical care. A reduction in utility usage and costs may also be evident from less overnight staff activity as a result of technology or shared resources. |
| Environmental data | N/A | |
| Risk from cumulative impacts | N/A | |
| Other (please specify) | N/A | |
| Additional evidence required | No | |
Equality, Health and Wellbeing and Human Rights
Positive
Previous and similar change has resulted in more positive outcomes for individuals with less restrictive supports in place and encouraging personal independence.
Regardless of any additional protective characteristics everyone who will be reviewed will have equal access to support which is identified as appropriate to them. It is not foreseen that any individual will be affected due to any other protected characteristic.
Devices used in the overnight responder service can also assist in increasing a service users access to technology and reduce digital exclusion. The technology could be used to have face to face interactions with family who are not local, interact with friends, shop online, automatic heating and lighting and other befits. Carer stress will be reduced as the supported person will have the appropriate level of support.
Negative
For some individuals there may be the perception that physical overnight support continues to be required and believe a change to remote technology will have an adverse effect on them or leave them at risk.
Affected populations
Primarily adults with a range of support needs. Some people may also have additional protective characteristics such as age, gender and race.
Environment and Sustainability including climate change emissions and impacts
Positive
The use of technology in organisations and teams will result in less duplication and costs, such as for staffing and energy/utility.
There will be increased learning opportunities for staff in providing and supporting people to access remote technology.
Enhancing the use of technology will provide a modernised approach to service delivery and encourage sustainability, from increased opportunities and options available for people seeking more independent living now and in future.
Negative
In some organisations there are increased payments for those working out with normal operating hours. There will likely be reduced staffing from a reduction in traditional models of overnight support. The impact will be evident within staff groups and may for some impact on either their employment contract or pay. A reduction in pay or change in contract may then impact on any dependents of employees or staff groups.
Affected populations
Primarily adults who have a range of support requirements. Some people may also have additional protective characteristics such as age, gender and race.
Employees and staff groups from a variety of age groups who may have additional protective characteristics.
Economic including socio-economic disadvantage
Positive
An overnight responder service, where appropriate. will decrease service dependency and increase personal independence for individuals. This will also shape how reviews are conducted in future and how new support options are commissioned, ensuring a fair and equal process for everyone with disabilities and removing the assumption that high support presence is the primary option for overnight support.
There is increased opportunity for third sector providers to engage in, provide and support people to access remote technology.
Some staff may view the change as providing a better work/ life balance with a reduction in non-social hours.
Negative
For some individuals with disabilities and their family, representative or care provider, there may be a perception that this is viewed only as a means to reduce costs. The care provider may view this as a loss of income.
For many staff groups and employees working within care, pay is nationally recognised to be low. For some, particularly living in circumstances where there is only one wage within the household, any further reduction may impact further on staff and other dependents within the family home. This impact should be minimal as there is a recognised shortage of care staff across most organisations and on various shift patterns.
Affected populations
Primarily people with mental health issues, learning disabilities and/ or physical disabilities. Some may have additional protective characteristics such as age, gender and race.
Overnight support is mainly provided by voluntary and/or private sector organisations, All equality, human rights, environmental and sustainability issues are registration with relevant statutory bodies, good practice guidance or the contracted terms and conditions. Any impacts identified throughout implementation will be considered and any mitigations put in action.
It will not be necessary to communicate with children and young people within this change, however a large proportion of people with support needs will require additional communication tools in order to understand the change. Some parents and carers may also need additional tools to support their understanding.
Communication will be carried out on an individual basis and as is appropriate. Examples may include use of picture symbols, talking mats, large type, discussion with someone known by the service user, language interpretation, sign language and social stories. An easy read document has already been produced.
If yes, it is likely that a Strategic Environmental Assessment (SEA) will be required and the impacts identified in the IIA should be included in this.
No.
If further evidence is required, please note how it will be gathered. If appropriate, mark this report as interim and submit updated final report once further evidence has been gathered.
No
| Specific actions (as a result of the IIA which may include financial implications, mitigating actions and risks of cumulative impacts) | Who will take them forward (name and job title) | Deadline for progressing | Review date |
|---|---|---|---|
| 1. Develop appropriate implementation plan. The implementation plan will include details on objectives, planning, risks and mitigations. Discussions with key contacts during implementation will determine any impacts on staff groups and financial sustainability of the provider and any supportive measures which can be implemented. | Service provider and Jayne Kemp, Strategic Planning and Commissioning Officer. | 1 October 2022 | 1 April 2023 |
| 2. Develop appropriate communication plan and where required ensure accessible formats for people who have additional communication needs. The communication plan will detail key contacts and highlight the benefits of an overnight responder service. | Service provider and Jayne Kemp, Strategic Planning and Commissioning Officer | 1 October 2022 | 1 April 2023 |
| 3. Ensure the development of a range of information sources to promote understanding of an overnight responder service including leaflets and a website on what the service providers, all must be available in a variety of accessible communication formats when required. | Service provider and Jayne Kemp, Strategic Planning and Commissioning Officer | 1 October 2022 | 1 April 2023 |
This change will continue to be reviewed when implemented and discussed with all stake holders to ensure further understanding of any impacts, its ongoing success and ensure any changes where required are acted upon.
Name Tony Duncan, Service Director, Strategic Planning
Date 28/02/2022
Completed and signed IIAs should be sent to strategyandbusinessplanning@edinburgh.gov.uk to be published on the IIA directory on the Council website www.edinburgh.gov.uk/impactassessments