Enable more adults to live longer, healthier and happier lives
What this means and why we think it is important
Many residents in west Cheshire live healthy and independent lives. The borough has real strengths, with more residents benefitting from a good quality of life, strong communities and a relatively good life expectancy. We are currently working with the local NHS to deliver a joint five year Place Plan to improve residents' health and wellbeing. Nevertheless there are challenges we need to address.
- We have significant health inequalities and the more deprived areas of the borough experience poorer health than more affluent areas. On average, men live 10.4 years less in our more deprived areas and women 9.1 years less. This challenge cannot be addressed solely by health services but requires a wider approach to tackling issues such as employment, housing, and access to good education.
- It's great news that people are living longer. By 2035 28 per cent of our residents will be over 65. Our challenge is to ensure that older people are supported to be independent for as long as possible and that those extra years are as healthy as possible. This isn't limited to health services but is also about fostering strong communities that can support each other.
- Social isolation and loneliness is also becoming more of a challenge and can affect both physical and mental health. Again, strong and active communities are vital to combatting this challenge.
- One in six adults aged 16 and over in England report experiencing symptoms of a common mental health disorder. This translates as over 46,000 adults in west Cheshire.
- At the time of writing, the Government is not clear how social care will be adequately funded in the future and a proposed White Paper has been delayed for three years. New ways of working will be needed to make sure that we achieve the best for those who need support. It will be particularly important to ensure that resources are prioritised towards prevention and community support in order to reduce the need for long term and crisis care but this will require significant change.
What residents think
Local residents feel that their health and wellbeing have remained stable over the past few years with 72 per cent of respondents continuing to rate their health as good or very good - the same as surveyed in 2017. Over the same period, people's rating of their mental health has also remained the same.
Those in receipt of adult social care are reporting a consistent quality of life score over the past two years which is better than the regional and national averages. They are also more likely than the national average to feel in control of their daily life and to have as much social contact as they want. However, satisfaction with social care services for both service users and carers has declined locally and is below the regional and national average.
Over three-quarters of respondents support the Council's proposals for this priority, particularly on improving the quality of housing, shaping places to support independence and equipping our workforce. Discussion focused on communities supporting one another through community social events and volunteering as well as the themes of appropriate housing options and improved public transport which recurs across all the priorities in this plan. Again, over three-quarters of respondents supported all ideas of what residents could do, particularly giving to others and continuing learning. There was also support for other organisations to offer support through better integration of services, running projects and initiatives within communities and signposting services. Community and Voluntary Sector representatives also championed the need to work together to develop joined-up services and social prescribing.
Help people who need support to come together with those who don't and make friends thus reducing the amount of people in the community who are lonely and don't see many people.
Play Your Part respondent.
What our partners think
Our health services partners remain committed to working with us and other partners to enable joined-up care to be provided closer to people's homes by developing new, integrated models of community care. They have also highlighted that one of their main priorities is working with Public Health to support people through behaviour change - especially encouraging healthy lifestyle choices.
Community and voluntary sector partners highlighted the need to develop strong communities to support independence and their role in co-ordinating activity to extend social prescribing, to develop a new approach to mental health and strengthening friendship and relationships support and reduce health inequalities for our learning disability communities.
What success will look like
- more people living a healthier, happier life for longer
- reduced gaps in health and life expectancy between more and less deprived areas
- more resources spent in the community
- more residents having a better experience of health and social care
How the Council will play its part
We have committed to being a World Health Organisation 'Age Friendly' borough and we are having conversations with residents to improve our understanding of what will help them to live healthier, fulfilled and more independent lives. There are some outstanding examples of how communities can support each other with some help from the Council and other bodies, and we want to build on the existing work with ward members, town and parish councils.
The Community Connector project for example provides people in crisis with practical advice and support, joining up all community support around the individual. We feel more could be done to work with the voluntary sector to strengthen communities, particularly to tackle social isolation. We want to extend social prescribing where GPs prescribe attending specific community activities and clubs that provide an opportunity for social interaction and healthy living rather than traditional medical interventions. We will pilot the introduction of safeguarding angels, trained volunteers who champion and uphold the rights of vulnerable adults, and we will bring people together through the spectacular social butterflies arts project. We will also continue our commitment to the Armed Forces Covenant, supporting our local armed forces and veterans. We're interested in how digital technology can support thriving communities to help each other and are determined to improve resident information, advice and guidance on what is available. We also want to extend inter-generational schemes where different generations come together as a community. Finally we want to strike a new deal for carers where we give more tailored help and support.
Through our planning and regulatory powers, we have the opportunity to create a physical environment that supports good health and independence. This is supported through the provision of a dedicated accessibility officer. We particularly want to create age friendly communities where the design of our neighbourhoods support the older generation to live fulfilling lives through appropriate housing, public spaces, transport and community facilities.
We will develop housing plans that support a range of people to be independent for longer. Using our land, resources and planning powers we will shape a housing offer that enables people to live longer in the community. We will also work to create more affordable and decent housing for lower income groups which will have a long term beneficial impact on health and wellbeing.
Employment and income are critical to mental and physical health. We will work with businesses to extend good employment practices and encourage good jobs that are fairly paid. We will continue to promote the west Cheshire local living wage.
Issues such as smoking, alcohol consumption, poor diet and sedentary lifestyle have a long term impact on health and wellbeing. A range of initiatives will help to persuade more people to live healthier lifestyles, including the Food Active Partner Pledge which commits a range of local organsations to working together to promote healthy weight across the borough. A wide-ranging review of our leisure services will also take place with health considerations at the centre of any decisions.
We will support residents with mental health challenges through cultural and leisure services such as the Natural Health Service which helps provide outdoor activities to improve wellbeing. We will build on the success of the Cheshire and Wirral Wellbeing Hub and work with health partners to extend this and the Crisis Cafe model. We will also focus on prevention, better advice and guidance and greater integration with NHS mental health services.
The pathway to independence builds on the foundations already in place by redesigning some of our services, strengthening relationships with the voluntary and community sector and making better use of equipment and technology. It focuses on working with people earlier to keep them healthy, independent and ensures that they get advice, information and support in a much more timely way. Our aim is to focus on what people can do for themselves and find creative and meaningful ways to support them and their families rather than commissioning traditional support. By doing this people can remain in control of their lives and we can avoid unnecessary admissions to hospital and long term care. We continue to improve timely discharges from hospital so people can return home as quickly as it is safe to do so, and provide more support at home such as equipment to help with every day activities. There is now a single point of access into the authority via the Cheshire West Community Access Team which deals with phone queries or via the Live Well Cheshire West website. Both services offer information, advice and guidance to people who choose whether to contact the department if they cannot find the information they are looking for. We also aim to regularly review the support we are providing, people will now receive the right support, at the right time, in the right setting to help them recover quickly or prevent their needs from increasing so they don't have to wait for a crisis to get help.
We have had increasing instances where our care providers have hit financial difficulties. When this happens, care provided by these organisations needs to transfer to other providers which is very disruptive to service users and sometimes costly. We are working with providers to see what we can do to stabilise the market by offering a fair cost of care, sharing best practice and putting in place an early warning system so we can take action before providers get into serious difficulty. We will also continue to make the case to Central Government that social care should be adequately funded.
Far too often care is provided in a fragmented and reactive way across health and care services. Our vision is to join up social care services with our NHS partners. We also want to join up further the delivery on the ground and build our services around nine care communities, supported by integrated teams of health and care professionals who focus on those most at risk of crisis. This will mean more services being delivered in the community rather than long term care, joined up workforce practices and better sharing of information. Crucially this approach will not just join up health and care services but all support in the community ranging from culture, leisure, housing and the voluntary sector.
Delivering all the above will require us to develop careers pathways for care workers and equip our workforce to be multi-skilled with the right tools to support the independence of residents. This workforce is not just within formal care and health services but across the wider voluntary and independent sector workforce. We will also maintain our commitment to the ethical care charter to benefit care workers and so the people they look after.
How residents can play their part
For some time we have been promoting the five steps that we can all take to improve our wellbeing.
Connect with the people around you: your family, friends, colleagues and neighbours. Spend time developing these relationships.
You don't have to go to the gym. Take a walk, go cycling or play a game of football. Find an activity that you enjoy and make it a part of your life.
Learning new skills can give you a sense of achievement and a new confidence. It could even help you change careers or improve your earning potential.
Even the smallest act can count, whether it's a smile, a thank you or a kind word. Larger acts, such as volunteering at your local community centre, can improve your mental wellbeing and help build stronger communities.
Be more aware of the present moment, including your thoughts and feelings, your body and the world around you. Some people call this awareness "mindfulness".
We recognise the vital part that local people play in delivering large scale change. The focus of the Community Conversations process was to explore how we can work together to support people with long term conditions to stay as well as possible, for as long as possible.
Community Conversations were held with 243 individual participants. In addition, 100 individual participants engaged in condition/ carer specific conversations and 226 individual participants engaged in the process via telephone conversations, supported completion of surveys and self-completed surveys.
The 'What Matters To Us – Community Conversations Report' was launched at a dedicated event, highlighting the 64 recommendations developed by participants. The recommendations were used to inform the Cheshire West Place Plan (2019-24).
Community Conversations featured as an example of good practice in the Local Government Association Case Study of the Cheshire West and Chester Health and Wellbeing Board. Feedback from those involved in the process has also been extremely strong.
We've been listened to about the things that would make it easier to manage our conditions.
Investing in our priorities
We plan to spend £124.9 million on services to support health, wellbeing and independence in 2020-21. This would be 14 per cent more than the current budget for this area.
We also plan to invest £13.7 million of capital into this challenge area over the next four years from Government grants. This will fund improvements to adult social care facilities and adaptation to homes. The Council's wider £77.1 million housing programme will also include ambitious schemes to support housing for older and more vulnerable people.
Who needs to be involved to make this happen?
Key services within the Council that contribute to this priority include:
- Adult Social Care
- Commissioned services including care at home and residential care
- Housing Strategy and Housing Solutions
- Public Health
- Youth Services
- Youth Offending Service
Supporting plans and strategies
- Adult Safeguarding Board Annual Report
- Carers Strategy
- Director of Public Health Annual Report
- Equality and Diversity Plan
- Health and Wellbeing Strategy
- Health Improvement Strategy
- Learning Disability and Autism Strategy
- Market Position Statement
- Place Plan
- Transforming Adult Social Care
- Workforce Strategy-Adult Social Care
- World Health Organisation Age Friendly Cheshire West Strategy