The report, published today, follows a joint inspection by the Care Inspectorate and Healthcare Improvement Scotland which looked at how well the health and social work services partnership in the area delivered good personal outcomes for older people and their carers.
Inspectors looked at whether health and social work services worked together effectively to deliver high quality services to older people, which enabled them to be independent, safe, as healthy as possible and have a good sense of wellbeing.
Inspectors also wanted to find out what progress the East Lothian Health and Social Care Partnership had made with health and social care integration.
The report of the inspection, which was carried out between June and November 2015, identified key areas of good practice but also made ten recommendations for improvement.
Across nine quality indicators, three were found to be good. These were “impact on staff,” “policy development and plans to support improvement in service,” and “leadership and direction.”
Six indicators were found to be adequate.
The report notes: “The East Lothian Health and Social Care Partnership delivered good outcomes for many older people. As a consequence of the partnership’s efforts, many older people had enhanced wellbeing, and led healthier, included, independent, and fulfilled lives.
“The partnership needed to effect continuous improvement to minimise the numbers of older people who experienced poor outcomes, such as when their discharge from hospital was delayed or they had to wait for the deployment of care at home services.
“Support to unpaid carers and the roll-out of self-directed support to older people were areas for continuous improvement.
“The partnership benefitted from strong, purposeful leadership and management. It needed to develop and enhance its leadership and management capacity to make sure that all elements of the new integrated structure profited from competent, consistent strategic and operational leadership and management.
“We considered that the partnership had made good progress with health and social care integration, and it had the capacity to lead, manage and deliver required improvement.”
Karen Reid, the Care Inspectorate’s Chief Executive, said: “The East Lothian Partnership had taken a very promising approach to preventing avoidable emergency admissions of older people to hospital and preventing older people experiencing a delay in their discharge from hospital.
“The partnership had a clear and compelling vision for the future integrated delivery of health and social care services to older people and their carers in East Lothian.
“This well-articulated vision had at its core the imperative that older people and their carers should lead healthy, safe, included, independent lives, and have a good sense of wellbeing. There were promising signs that at this early stage the partnership had good, well-informed governance and leadership from the integration joint board.
“Consultation and communication with its staff and the promotion of its vision was an area for continuous improvement.
“There were areas which the partnership could further improve in relation to support for carers, implementing self-directed support for older people, and securing enough care at home provision to meet the needs of older people.”
Claire Sweeney, Interim Director of Quality Assurance for Healthcare Improvement Scotland, said:
"Our joint inspection of health and social work services for older people in East Lothian involved meeting over 50 older people and carers, around 200 staff from health and social work services, the third sector and the independent sector, and reading 99 older people's records.
"We found that outcomes for older people and their carers were predominantly good and the partnership benefitted from strong, purposeful leadership and management. The partnership's approach to reshaping the design and delivery of care for older people had a clear focus on maintaining their independence, their good health, and wellbeing. Older people and carers we met were satisfied with the quality of support services they received and the desired personal outcomes these services delivered.
"However, the lack of capacity in care at home services meant that some older people had to wait for care at home and, in a few instances, this led to their delayed discharge from hospital. Other areas for improvement for the partnership include taking steps to improve anticipatory care plans and ensuring that people diagnosed with dementia and their carers receive post-diagnostic support."
The report is available here: