Invitees:

 

Sue Cooper – Corporate Director - Social Services and Wellbeing

Councillor Philip White – Cabinet Member Adult Social Care and Health and Wellbeing

Avril Bracey – Group Manager – Mental Health Safeguarding and Quality

 

The Chairperson on behalf of Members, welcomed the Invitees to the meeting.

 

The Head of Adult Social Care made a very brief opening introduction, following which she introduced the Group Manager – Mental Health Safeguarding and Quality to give a resume of the report.

 

The Group Manager – Mental Health Safeguarding and Quality outlined certain background information contained in the report, and then confirmed that the mental health project of the Western Bay Programme had become the mental health delivery group, reporting to the LPB on progress on the “Joint Commitments Strategy”. Bridgend was represented on this group and contributed to the various work streams that comprised the mental health project.

 

She referred to paragraph 4.1 of the report, and the list of priorities identified within the Mental Health Commissioning Plan as identified by Western Bay.

 

Paragraph 4.2 of the report and its sub-paragraphs then outlined progress that had been made in certain areas of support that had been put in place to assist individuals suffering from mental health problems. Examples of these, were as follows:-

 

·         The Local Primary Mental Health Support Service (LPMHSS), Arc

·         A single point of access (SPA) for GP referrals into secondary mental health services (pilot) in Bridgend

·         Review of community mental health teams (to establish a new model of service)

·         A single procurement and brokerage process for high cost specialist mental health placements

·         Improving provision for those in crisis (objective of the mental health commissioning plan)

·         Improvements in terms of engagement with service users and carers

·         Introduction of The Time to Change Wales (TTCW) campaign (a Welsh Government initiative aimed at changing attitudes within the Welsh workforce in respect of mental health)

·         Addressing issues of stigma and discrimination, another priority in the mental health commissioning plan

·         Raising awareness of mental health and wellbeing with young people at schools

·         Supporting the development of an electronic library containing issues that can lead to mental health problems, and self-help guides for this

·         Supporting carers in their caring role, including the establishment of a forum  to assist this further

·         The appointment of a Local Area Co-ordinator to focus on early intervention and signposting for persons suffering from mental health issues

·         A consultation and engagement exercise on the dementia strategy and delivery plan

·         Maximising the potential of technology to support dementia sufferers through the introduction of a ‘Just Checking’ system, ie for monitoring individual movement to confirm levels of individual support required (pilot)

·         The development of a North Community Network in order to establish a dementia friendly community.

·         Collaborative initiatives within Directorates of the local authority, ie to develop a range of accommodation options for dementia sufferers eg, a floating support scheme and extra care housing

·         Funding avenues made available via the Western Bay community services project to further support dementia co-ordinators in Bridgend

 

The Group Manager – Mental Health Safeguarding and Quality gave an explanation on each of the above, further details upon which were expanded upon in the report.

 

She explained to Members that whilst much had been achieved over the last year, a lot of work still needed to be completed and in the face of significant challenges that lied ahead, as explained in paragraph 4.3 of the report. These related to demographics, complexity issues, matters of crisis, problems associated with stigma and transitional plans.

 

A Member asked if the Local Primary Mental Health Support Service (LPMHSS) Arc was a first point of contact in terms of early intervention.

 

The Group Manager – Mental Health Safeguarding and Quality confirmed that it was a base where early intervention of problems being experienced by individuals could be addressed.

 

A Member referred to paragraph 4.2.2 of the report, and the single point of access for GP referrals into secondary mental health services successfully piloted in Bridgend, and she asked the Officer if she could expand upon this initiative.

 

The Group Manager – Mental Health Safeguarding and Quality, advised that Bridgend had undertaken a qualitative evaluation together with Neath and Swansea, and had sampled a number of GP’s for the purpose of the above pilot, with work  presently ongoing in respect of this. An update would be given to Committee Members as soon as further developments had been made and outcomes known.

 

The Members asked if the above initiative when it was developed further, would require extra resources to support the initiative and ensure that it’s successful.

 

The Group Manager – Mental Health Safeguarding and Quality, confirmed that work in respect of an SPA for GP referrals into secondary mental health services would be supported by existing Nurses and Social Workers initially, and as the service became more established, further support would be looked at from Local Primary Mental Health Service Review teams.

 

In terms of the different avenues of therapy that were available for people suffering from mental health related problems, a Member enquired how long people had to wait to receive these.

 

The Group Manager – Mental Health Safeguarding and Quality, confirmed that the waiting list for therapy options was normally in the region of 6 – 9 months, though as part of the review of the overall service, it was hoped that this could eventually reduce to 3 months. The main reason for this, was that it had been agreed in principle, for an increase of therapists through the ABMU. In relation to the more acute cases however, people seeking help here would be able to access services as a matter of urgency ie within days or even immediately.

 

A Member once more referred to paragraph 4.2.2 of the report, and the pilot in Bridgend with regard to the SPA for GP referrals into secondary mental health services. She asked how much funding for this was being contributed by the ABMU.

 

The Group Manager – Mental Health Safeguarding and Quality advised that this was a jointly funded arrangement between the Community Mental Health Teams and Local Primary Mental Health Services. Most initiatives that were being undertaken collaboratively with neighbouring local authorities and other key agencies under a joint working arrangement were jointly funded she explained.

 

A Member asked if a patient’s permission was required in respect of a GP referral of this nature.

 

The Group Manager – Mental Health Safeguarding and Quality confirmed that this was the case.

 

A Member asked if there were any walk-in services available.

 

The Group Manager – Mental Health Safeguarding and Quality, confirmed that the LPMHSS ie the Arc, was a drop-in Day Service Centre as were certain other establishments such as Leisure buildings and Community Centres where help for an individual could be arranged to be provided. This followed a similar model previously introduced in Glasgow, Scotland. The ideology behind this, was to allow people to seek help in buildings that would ordinarily be publicly visited by other members of the public for alternative reasons. This allowed visitors to these buildings for the purpose of seeking support for their mental health problems to feel less stigma than would otherwise be the case if they visited, for example, a clinic purely designed for mental health sufferers.

 

A Member referred to paragraph 4.2.10 of the report, and asked if there were leaflets available for Members to share with their constituents, advising that there was an electronic library available offering self-help guides for people who were experiencing mental health symptoms as part of the Western Bay Collaborative Programme.

 

The Group Manager – Mental Health Safeguarding and Quality confirmed that she could send the link to Members, and this would sign post those interested to leaflets and video footage contained within the electronic library.

 

A Member whilst noting that certain services could be accessed in places such as the Arc, asked what type of support services people had to wait up to 6 months to receive, ie the less urgent cases.

 

The Group Manager – Mental Health Safeguarding and Quality advised that individuals experiencing problems could arrange to see their GP in the usual way, or through the referral system. The more serious cases such as people experiencing a bad nervous breakdown could receive attention and support as a matter of urgency through being referred to a hospital. The individuals who had problems and whilst they required help for these, they were managing these problems even though in some cases they may possibly be difficult to manage as part of day to day life. There were drop-in centres such as Arc for these people, where group therapy could be discussed and accessed fairly quickly. However, if this therapy was required on a one to one basis, then an appointment for this purpose could take up to 6 months to obtain. She added that although further therapists had been appointed in an attempt to make waiting lists for one to one appointments shorter, more therapists were still required to meet the levels of support that were needed.

 

A Member asked if the Glasgow model Bridgend was following was introduced to combat alcohol related mental health problems.

 

The Group Manager – Mental Health Safeguarding and Quality confirmed that in Glasgow Health Services had tracked 9,000 people that had been receiving mental health services, and this revealed that a considerable number of these patients were reluctant or hesitant in seeking help in Mental Health clinics and other similar institutionalised places. As a result of this the service in this city concentrated more upon early intervention and prevention measures to support individuals who fell foul to the symptoms of a mental health related illness. The service also however, introduced less formal settings and establishments where people could go to receive help and support in a more discreet type of environment. This reduced stigma and other discrimination type issues, and resulted in more people coming forward to seek help for their illness than may have been the case if more conventional methods had continued to be used.

 

A Member asked the Officer how many people accessed the services offered in drop-in centres like the Arc.

 

The Group Manager – Mental Health Safeguarding and Quality referred the Member to paragraph 4.2.1 of the report which contained certain data in relation to this point, however, she added that she could give further such data in respect of other places that offered these type of local primary mental health services..

 

A Member noted this data as contained in this section of the report, but asked over what time period did patients attend the different sessions that were held in these type of services.

 

The Group Manager – Mental Health Safeguarding and Quality confirmed that this data covered April to September 2015.

 

The Head of Adult Social Care added that increased publicity was required to be made available electronically in order that the public were aware that these type of services were now available in various communities, and also through service user and Carer groups for those individuals who were not so IT literate as others.

 

A Member felt that it was important to ensure that data such as that referred to in paragraph 4.2.1 of the report was accurate ie that the same people did not use different therapeutic classes and sessions that were available as if this were the case, this would skew the figures overall.

 

The Group Manager – Mental Health Safeguarding and Quality confirmed that there was more quantitive data available than that shown in the report should Members wish to have sight of this. Some visitors to the different types of services and classes available did attend more than one of these, but not all did.

 

The Chairperson suggested that the Authority as part of the Western Bay arrangements should look for increased help from the third sector to deliver mental health services, via groups such as Mental Health Matters and the Coalition of Disabled People.

 

The Group Manager – Mental Health Safeguarding and Quality confirmed that there was a Regional Mental Health Partnership Board that had been set-up and this included participation from the third sector.

 

A Member felt that it may be of some benefit if representatives of certain provider groups such as the third sector be invited to a future meeting to share with Committee their views on the success or otherwise of joint working initiatives such as those related to the support of Mental Health and other Wellbeing services that are being delivered collaboratively.

 

In terms of Contract monitoring processes, the Head of Adult Social Care confirmed that these were regularly undertaken with external providers such as Domiciliary agencies, Care Homes and third sector support organisations through a framework that was robust, rigid and fairly fool proof. This was to ensure that the services that were being supported were value for money and provided to the required high standard as was necessary when dealing with the more vulnerable groups in society. This framework included regular feedback from service users including an Annual survey. She agreed that it would be of some benefit to discuss Service Level Agreements at a future meeting. 

 

Conclusions:                     The Committee noted the report, which provided Members with an update on the provision of mental health services, the Mental Health Commissioning Plan and the Dementia Strategy and Delivery Plan.

 

·         Members asked about the methodology used to evaluate the pilot of single point of access (SPA).  The Officer responded that the approach used was based on a research methodology which had been used to evaluate services by other Authorities.

·         Members were concerned that people may currently be waiting for up to six months for 1 to 1 therapy and support.  The Officer responded that there was some provision for interim support, i.e. walk in centres and local support groups.  It was acknowledged that there is a need to address the issue of waiting time for therapy and two more therapists will be appointed to BCBC.

·         Members asked how third sector service provision is being monitored.  The Officer responded that SLA requirements include performance reporting and that there is an option for Committees to scrutinise service areas and activities.

·         Members asked how many people were currently receiving after care services as required under section 117 of the Mental Health Act, and whether progress had been made in addressing issues regarding weaknesses in applying the process raised following an audit carried out by Internal Audit Shared Services in 2014. 

·         Members asked about the meeting which has been arranged with head teachers to raise awareness regarding mental health and wellbeing in schools, and whether access to information and support is also being provided to teachers and other staff. 

 

Members raised concerns regarding the current provision of services for people who have a sensory impairment, particularly in relation to improving support when using public transport.

  

·         Members asked whether any specific provision, such as ‘talking buses’, was being considered to improve access to services for people with sensory impairment.

·         Members asked about the ‘Just Checking’ system for monitoring people with dementia, and the cost of the service and equipment.  The Officer responded that this was a pilot and that therefore, currently, there was no cost involved.

·         Members asked whether there were any action plans in place to address the future challenges identified in the report.

 

 

Recommendations

 

·         The Committee recommend that access to information and support regarding mental health and wellbeing in schools be provided to teachers and other staff.

·         The Committee recommend that people with sensory impairment are engaged in identifying and addressing issues that they encounter when using services, such as when using transport in and around the county.

 

Further Information requested

·         The Committee requested more detail on the evaluation of the single point of access (SPA), including information on outcomes and the methodology used to measure them.

·         The Committee requested information on how people were being made aware of services and where and how people can access information, i.e. leaflets and self-help guides.

·         The Committee requested information on the number of people currently receiving after care services as required under s117 and on progress against recommendations from the Internal Audit Shared Services audit.

·         The Committee requested information on the cost of providing the ‘Just Checking’ system for monitoring people with dementia if the service is retained following the pilot.

·         The Committee requested to see the action plan which will address the future challenges identified in the report.