Healthcare framework for adults living in care homes: island communities impact assessment

Healthcare framework for adults living in care homes My Health - My Care - My Home - Islands Community Impact Assessment

Please ensure this template is completed in conjunction with the Island Communities Impact Assessment (ICIA) Guidance on the Scot Gov Website

Name of Policy, Strategy or Service

My Health – My Care – My Home: A healthcare framework for adults living in care homes

Step one – develop a clear understanding of your objectives

• What are the objectives of the policy, strategy or service?

Our aim is to develop a national framework for adults living in care homes. The Framework will seek to fully integrate the Health and Social care system in Scotland that meets the needs of people living in care homes and ensure that it is:

• What are the intended impacts/ outcomes and how do these potentially differ across the islands?

• Person centred, holistic and rights focused
• Relationship based, inclusive and collaborative
• Responsive to needs 24/7
• Accessible, Seamless and Flexible
• Equitable
• Safe and Effective
• Committed to quality improvement and shared learning

Local arrangements or practices may differ across the islands but as the framework is aimed at a national level there is unlikely to be any particular impacts for island communities specifically.

Everyone should have the same access to health care wherever they live, one of our main aims is to ensure this is equitable across the country

Step two – gather your data and identify your stakeholders

• What data is available about the current situation in the islands?

The team has held large scale engagement sessions which have included stakeholders from across the Island communities, including Shetland NHS Board and Shetland Health and Social Care Partnership (H&SCP), Western Isles NHS Board and Western Isles H&SCP, Highland NHS Board, Argyle and Bute H&SCP, Orkney NHS Board and Orkney H&SCP, Angus H&SCP, North Ayrshire and Arran NHS Board.

• Who are your key Stakeholders?

People living in care homes, care home staff, health and social care providers, health boards, families, GPs, agency workers and the third sector.

• How does any existing data differ between islands?

The data does not differ between Islands.

• Are there any existing design features or mitigations in place?

No.

Step three – consultation

• Is there are information already gathered through previous engagements?

Yes, 674 stakeholders participated in 29 engagement sessions from across Scotland.

• How will you carry out your consultation and in what timescales? Public meetings/Local Authorities/key Stakeholders

6 months of engagement has taken place resulting in 29 engagement events, in which 674 stakeholders were involved. An online survey was issued to every care home in Scotland. We received 508 survey responses from across the country. 73 examples (11 of which from Island communities) of good practice examples were also received from Health Boards across the country, 11 of which from Islands. There was 6 focus groups, several sub groups meetings (including representation from Islands) monthly to form chapters of the framework, weekly meetings to discuss the framework internally, monthly writing group meetings with external stakeholders November – present.

• What questions will you ask when considering how to address island realities?

We specifically asked about each of the framework's key areas of focus to ensure islands communities were able to accommodate any pending recommendations around the fundamental aspects of the framework. Multidisciplinary team meetings are a fundamental part of the framework so it is important that those in Islands have access to technology that allows team meetings.

• Separate consultation events for Island communities/Local Authorities?

Island communities attended the engagement sessions mentioned above and were invited to share their views and concerns. Workforce challenges, including staff shortages and changing training needs, were the main causes of concern from all stakeholders.

Island communities have access to our regular blogs and the opportunity to contribute to the conversation via twitter where updates on the healthcare framework are shared.

Step four – assessment

• Does your assessment identify any unique impacts on island communities? (Further detail in the Guidance):
  • Demographic
  • Economic
  • Gaelic
  • Social

• Demographic: No, the document is a national document for all to access.
• Economic: Local arrangements may impact delivery. There are particular workforce challenges in remote and rural areas, whilst this is not specific to care homes it does mean that all services will be looking to recruit the same staff.
• Gaelic: No, Gaelic translations of the framework could be produced if there is a demand for it.
• Social: No, there will be positive social impacts on rural and island communities, by strengthening the continuity and access to healthcare for people living in care homes. The framework will also enhance the assessment, monitoring and response to the forever changing health and healthcare needs of people who live in care homes. The benefits are not unique to the Islands, and there will be similar impacts on the mainland as well.

• Does your assessment identify any potential barriers or wider impacts?

No, the healthcare framework should not create potential barriers or have wider negative impacts on island communities.

• Are there mitigations already in place for these impacts raised?

Economic: Opportunities for interdisciplinary working – skill sharing and to look at utilising Advanced practitioners. This would be broader than just advanced nursing practitioners as it provides additional flexibility.

Is a full Island Communities Impact Assessment required?

You should now determine whether, in your opinion, your policy, strategy or service is likely to have an effect on an island community which is significantly different from its effect on other communities (including other island communities). To form your opinion, the following questions should be considered:

• Are there mitigations in place for the impacts identified and noted above from stakeholders and community consultations? (If further ICIA action is not required, complete the section below and publish).

The framework is a national document for the whole country to access and we do not believe that the impact on Island communities would be significantly different to other parts of the country.

• Does the evidence show different circumstances or different expectations or needs, or different experiences or outcomes (such as levels of satisfaction, or different rates of participation)?

The Framework has set out a series of recommendations to enable people to live their best life when living in the care home. The mode of deliver can be adapted to fit with local needs and assets.

• If your answer is 'no' to the above questions, please complete the box below.

• If the answer is 'yes', an ICIA must be prepared and you should proceed to Step 5.

The recommendations in the document have been developed through stakeholder engagement and in alignment with wider policies and frameworks. Implementation will be determined and driven locally depending on needs and circumstances. For example, the frequency of MDT meetings will need to be adapted. The outcome will be a tailored approach for the person living in the care home and the local community which will enable an asset based approach encouraging the care home and those who live there to be an engaged positive resource for the local community.

A full Islands Community Impact Assessment is NOT required

In preparing the ICIA, I have formed an opinion that our policy, strategy or service is NOT likely to have an effect on an island community which is significantly different from its effect on other communities (including other island communities). The reason for this is detailed below.

Reason for not completing a full Islands Communities Impact Assessment:

The framework is a national document and we do not believe that the impact on Island communities would be significantly different to other parts of the country. It does not exclude or place different recommendations on island communities.

Screening ICIA completed by
Karis McCallum

Position
Policy Officer, Adult Social Care Oversight and Assurance Support

Signature and date
21/06/2022

ICIA authorised by
Jennifer Veitch

Position
Deputy Director, Adult Social Care Oversight and Assurance Support

Signature and date
21/06/2022

A full Island Communities Impact Assessment IS required

Step Five – Preparing Your Icia

In Step Five, you should describe in the box below, the likely significantly different effect of the policy, strategy or service.

Assess the extent to which you consider that the policy, strategy or service can be developed or delivered in such a manner as to improve or mitigate, for island communities, the outcomes resulting from it.

Consider alternative delivery mechanisms and whether further consultation is required.

Describe how these alternative delivery mechanisms will improve or mitigate outcomes for island communities.

Identify resources required to improve or mitigate outcomes for island Communities

Step Six – Making Adjustments To Your Work

• Should delivery mechanisms/mitigations vary in different island communities?
• Do you need to return to the consultation participants in respect of mechanisms or mitigations?
• Have island circumstances been factored into the evaluation process?
• Have any island-specific indicators/targets been identified that require monitoring?
• How will outcomes be measured on the islands?
• How has the policy, strategy or service affected island communities?
• How will lessons learned in this ICIA inform future policy making and service delivery?

Step Seven – Publishing Your Icia

• Does your ICIA need to be presented in Gaelic or any other language?
• Where will you publish your ICIA and will relevant stakeholders be able to easily access it?
• Confirm appropriate level of sign off?

ICIA completed by (name)

Position

Signature and date

ICIA authorised by (we recommend DD level)

Position

Signature and date