BLACK AND MINORITY ETHNIC COMMUNITY FOCUSED … · Alongside The Taking Part Team And Transforming...

BLACK AND MINORITY ETHNIC

COMMUNITY FOCUSED OUTREACH

AND

INFORMATION EXCHANGE

SELF DIRECTED SUPPORT

April - December 2009 By Arise Enterprises Limited

Alongside

The Taking Part Team

And Transforming Adult Social Care Oxfordshire County Council

Arise Enterprises Limited

CONTENTS Page WHY THIS WORK WAS DONE 1 1. Background of How Arise Enterprises Were Invited to Do This Work 2. Outline of Objectives Arise Enterprises Had to Undertake WHO WE MET 2 1. Community Groups or Agencies and Representatives Met 2. One to One Work HOW WE DID IT & CONTINUITY PLANS 4 1. Working with the Taking Part Team 2. Communication, Use of translation and Interpreters 3. Ongoing involvement WHAT WE HEARD AND WHAT HAS BEEN DONE IN RESPONSE SO FAR 7 1. Commonly Raised Questions 2. Process Questions 3. What has been done so far? OBSERVATIONS AND LEARNING 11 1. Accessible information 2. Collaborative working within public, community and voluntary sector CONCLUSIONS AND RECOMMENDATIONS 13 1. Involvement and engagement 2. Information 3. Collaborative working and workforce development 4. Continuing outreach and actions FEEDBACK 17 APPENDICES 18 1. List of languages and Weblinks 2. Introduction letter for Arise Enterprises by Taking Part Team 3. Sign posting guidelines for referring professionals 4. Traveller Women’s group response letter by Taking Part Team 5. Case study 6. Some quotes from people who took part

Arise Enterprises Limited May 2010 1

BLACK AND MINORITY ETHNIC COMMUNITY FOCUSED OUTREACH AND INFORMATION EXCHANGE IN SELF DIRECTED SUPPORT

April- December 2009 By Arise Enterprises Limited alongside Taking Part Team

WHY THIS WORK WAS DONE

1. Background of How Arise Enterprises Were Invited to Do This Work

Oxfordshire County Council’s Taking Part Team are employed to support and develop the involvement of service users, carers and the public in the planning, development and improvement of the work of Social and Community Services. Transforming Adult Social Care is a major national change programme for adult social care aimed at improving support for adults in need of care. In Oxfordshire, this has been seen as an opportunity to engage Black and Minority Ethnic people and communities both in the development of self directed support and in accessing social care services which many communities may have found difficult to use. In January 2009 the Taking Part Team were asked by the Transforming Adult Social Care team to help improve participation and involvement by Black and Minority Ethnic (BME) communities in the development of self directed support. The Taking Part Team worked with Alan Foulkes, who was employed on a temporary basis to start the project. Through links the Taking Part Team have with the Community Development Workers for Black and Minority Ethnic Communities (Mental Health, Oxfordshire Primary Care Trust), Arise Enterprises was identified as a social firm whose networks and experience made them ideal to carry on the work. They were then appointed to deliver the objectives as described below.

2. Outline of Objectives Arise Enterprises Had to Undertake

1. To build up a Black and Minority service user and carer input into the new self

directed support agenda in the following ways; a. To identify and arrange information days with Black and Minority Ethnic

groups/ organisations and individuals to inform them of how self directed support works, the role of the Taking Part Team and wider Social and Community Services

b. By the end of information sessions to identify people who will be committed to get involved in self direct support and related work. This would include awareness of the self directed support Learning Exercise, training for informal carers, and participation in an advisory group whose aim would be to improve accessibility and use of self directed support in general by Black and Minority Ethnic communities

2. To identify new service users and their carers who would like to be part of the self directed support Learning Exercise.

3. To identify Black and Minority Ethnic groups / organisations and individuals and offer them capacity building and training in the role and functions of brokerage in self directed support

4. To pull together existing directories and networks for the Taking Part Team to develop a database of Black and Minority Ethnic community groups, agencies and individuals


WHO WE MET? We reached a wide range of groups and individuals as can be seen from the tables below. Some were carers, others were being cared for and many found the information relevant in social care terms. The majority of people were hearing about social care for the first time, and had many questions about self directed support and other options in Social Care. The Transforming Adult Social Care agenda was seen as a technical term or jargon and some people asked what difference it would make in comparison with existing Social Services. Part of the work was therefore to explain the terms used and the concept, not just of Transforming Adult Social Care but of social care itself.


1. Community Groups or Agencies and Representatives We Met

Community Groups/ Agencies Met How Many People - West Indian Day Centre Committee/members- Drop leaflets for information day - West Indian Day Centre self directed support event

4 3 41 people (60% women)

African Carers members African Carers

5 21 adults 12 children

Improving Reach Reference Group 5 Self directed support Launch in Banbury 3 Black Minority Ethnic Community attend

amongst majority of over 100 Central Mosque plans with chairperson 1 BK.Luwo Women’s group Drop in 6 Madina Mosque drop in to Secretary/ leaflets 1 Happy Place ( Chinese Group) 1:1 and group visit11 carers and 2 cared for at meeting

62 stayed for self directed support discussion

Public Health Manager 1:1 and Black Minority Ethnic staff meeting and follow-up

6

Community Action Group (forum of People of African Heritage)

11 people

ACCAN Health Event 100 people ( all age event) Open Door Drop in ( Bandini, Arabic, English) 8 + translated leaflets Outreach Central Mosque before Ramadan 400 people leafleted Asian Cultural centre Information event 4 (2 carers, 2 health advocates) 1:1 Traveler Community contact Travellers Women’s Group meeting

2 4

Sahara Carers’ group (Urdu &Punjabi speakers) 7 (5 carers and 2 professionals) Black Minority Ethnic Community Champions officials meeting * Members are also a link for us to meet Bangladeshi Community

4 (Willing to work with Taking Part Team to organize an information event to reach a wider Black Minority Ethnic audience)

Pastors Forum 1:1 1 and follow-up to individual churches for future outreach

Outreach to Launch of Polish Support Group Over 25 in The Mill ( Oxford Mind) Polish Community information event in Witney

Leaflets emailed to County Council’s Community Development Officer for EU migrant communities

Banbury carers 5 Mental health team meeting & exchange 4 Total including leafleting Total = 745 people

2. One to One Work

People met one-to-one were referred on as appropriate to the County Council Access Team, Carers’ Centres, Community Mental Health Team, or GP

Female Carer Older female cared for by friends Male Carer Red Cross Director Male with injuries Male recovering from mental health problems Turkish community contact Total 2 carers, 4 cared for, 1 professional in caring charity


HOW WE DID IT & CONTINUITY PLANS

In all service provision and service development the public as users and potential users of services are the most important stakeholders. However, due to what is sometimes called ‘Black and Minority Ethnic consultation fatigue’, we could not have taken on this project without first understanding how self directed support could benefit communities, and including in our work the spreading of this information. We call this ‘Information Exchange’ which is a two-way process to disseminate and gather information. The terms ‘Black and Minority Ethnic’ and ‘Black and Minority Ethnic service users’ includes all minority ethnic groups, Travellers, Refugee and Asylum seeking communities and all migrant communities. The Learning Exercise referred to in the report was the start of the County Council’s roll out of self directed support in North Oxfordshire, with the aim of lessons learnt there being shared with the rest of the County.

Information Communication Technology: Telephone, Fax, email, letter Home Visits Groups Meetings Leafleting self directed support leaflets to streets, venues & gatherings ‘Piggy back’ existing events with shared costs & resources Purposely organized information events Interpretation service in group and one to one meetings Translated leaflets to 13 languages (Acholi, Punjabi, Hindi, Bengali, Badini, Urdhu, Polish, Pashto, Mandarin, Cantonese, Arabic, Swahili and Somali) Appendix 1 and link as follows http://www.takingcontroloxon.org.uk/wps/wcm/connect/Taking+control/Home/TC+-+home+-+invitation Meeting professional teams with shared objectives, in statutory and voluntary sector ( for example Carers Centre, Red Cross, NHS Oxfordshire Health Advocates and Community Development Workers- mental Health Team, and the County Council’s Community Development Team Built up personal understanding of self directed support in national and local policy context Meeting faith based groups and leaders

1. Working with the Taking Part Team Arise Enterprises took the lead to coordinate and deliver on the objectives set at the start. However, we saw it as important to include the Taking Part Team so that the work would be certain to carry on after the end of our involvement, by building trust and knowledge within communities and the team. We worked closely with the Taking Part Team, aiming to develop and build links with grassroots networks. In carrying out the outreach and information exchange in self directed support we used a range of strategies and employed a variety of techniques and tools. The Taking Part Team provided us with a letter of introduction which explained our role and the objectives of the project. (See Appendix 2)


The majority of County staff are Caucasian, and Arise shared practical experience in the use of interpreters in community events. This included pre- event meeting with the interpreter to clarify key messages, explain jargon and plan out a step by step plan and the timing of the presentation. With the help of interpretation services non Black and Minority Ethnic professionals can reach out to Black and Minority Ethnic communities regularly, so that reaching out to this group is not left only as a responsibility of Black and Minority Ethnic staff, or short-term projects commissioned to external agencies (such as Arise) to deliver. There are clear indicators of collaborative work between Taking Part Team and teams whose focus is to reach out to particular ethnic communities.

2. Communication, Use of translation and Interpreters

Because the target groups had, in some cases, English as a second language, a useful tool that helped us simplify information was using analogies. A visual description by several interpreters described Oxfordshire County Council’s structure like a tree with many branches and showed how different teams fitted in the various branches. We employed the services of interpreters to provide interpretation in group meetings, over the phone where appropriate and also in translating key documents into the mother tongue of those with English as an Additional Language. We designed brochures and flyers in these mother tongues and the self directed support team provided us with translated leaflets which we included in our outreach to support discussion. While there might be an assumption about a lack of literacy skills among some Black and Minority Ethnic groups, we asked various groups for their feedback, which was positive. In the Chinese Community meeting in Happy Place, West Indian Day Centre, African Caribbean Community Action Network event, and during outreach at the central mosque many people said they found translations useful and others took English copies also. The Acholi language was distributed to members of BK. LUWO women group and one member commented that it was the first time Oxfordshire County Council had translated information about a service in her own language. She was very happy that she could read the information for herself rather than asking for help from other women or her grandson. NHS Oxfordshire’s Health Advocates, Community Development Workers, the County Council’s Community Development Officers and most of the groups and individuals on the table in page 3-4 have received hard or electronic copies of leaflets and feedback has been received. When we have needed assistance for interpretation in meetings, we used translated leaflets to break down our presentation / talk in stages. We also used the introductory letter from the Taking Part Team. Apart from self directed support translated leaflets we designed and distributed separate leaflets for specific events detailing venues and dates of those events. What one can never tell is when a leaflet or DVD, or a talk at an event causes a response or change of mind set. Diversifying ways to make any information accessible is useful, and Arise found it valuable having information in different languages.


Most Black and Minority Ethnic people take time to see whether a service or product works and when it does, most of them will pass on their news by word of mouth to people they know. This can be through family ceremonies, weddings, faith based gatherings and other special days or events unique to each group. Professionals can find out about these networks in their outreach work.

3. Ongoing involvement

As a part of the process Arise Enterprises identified people who were interested in committing to self directed support as part of an advisory or guiding group and this list has been shared with the Taking Part Team, and with Antony Thorn (County Council) who is currently working on the development of brokerage for self directed support in Oxfordshire.


WHAT WE HEARD AND WHAT HAS BEEN DONE IN RESPONSE SO FAR

The following section is divided into three parts. The first two are the questions asked during the discussions, visits and meetings during the work. We have faithfully recorded the questions raised and reproduced them here because they are a reflection of the issues and concerns people had. Many of the questions were answered at the time, but some will need further detailed responses (see ‘Conclusions and Recommendations’).The third part is about what has been done in response to issues raised so far.

1. Commonly Raised Questions

Is self directed support ready to be rolled out or dependant on the learning exercise in the North Oxfordshire Learning Exercise? Have all countywide staff in frontline adult social care been briefed on self directed support and what system is in place for them to feedback their experiences or observations? How is it filtered to the management and how is feedback filtered back to the users? What Guide is there for professionals who work with possible clients that can be referred to access self directed support? Is there a visual breakdown of the organizational structure of Social Care to help clarify which teams do what? (Simple visual like the tree analogy used above) Can unpaid carers qualify for county wide accredited courses for personal development? How can carers be paid for their care for family member or friend considering unknown carers may not be appropriate? Is there a possibility that carers and their families can support each other when they need to work or respite without facing any legal problems? What help is available for carers living in Oxfordshire but caring for someone outside the county? Why does County Council offer short term jobs for Black Minority Ethnic positions or workers whose role is to work with Black Minority Ethnic communities, instead of employing dedicated persons in permanent positions? How can the Health Advocates and NHS Oxfordshire Community Development Workers and County Council Community Development Officers help in accessing services such as self directed support or social care? This was asked by the West Indian Day Centre who felt, a professional should be available at the venue so that they can help with making calls, making follow ups to other services they would like to access. Can a user purchase caring services from a friend or relative instead of care agencies? Is self directed support replacing direct payments? How does self directed support differ from direct payments?


Can Social Care help you live your life as you recover from injury, operation or illness? Why is it means tested? One should not have to pay for their care and it is not fair on those who have been good at saving money or have a’ kitty’. What happens with your care when the government stops the pensions schemes suggested recently on news? Is it possible to set up a mobile phone as a link for groups such as West Indian Day Centre to access self directed support or other Oxfordshire County Council services? Is it possible to have someone/ professional you can confide with our centre to talk to and who has an understanding of our culture and issues? Does self directed support fit in with NHS personalization agenda? How is the user helped not to get confused? If it is not contracted and many people take self directed support, does that mean more money is made available for people already in care? Is the use of a broker currently free, does this mean the cared for will meet cost in future? How does self directed support improve access to specialist older people’s mental health services equipped to meet the needs of those especially with dementia? Is there support available for people to be assisted in asking to be assessed for social care, in particular from BME workers who understand the issues faced by communities? Can self directed support allow members of a family to accompany someone who needs support on respite breaks? This could provide everyone in the family with a chance to recharge their ‘body batteries’ or energy. What is adult social care? Can the leaflet about Transforming Adult Social Care explain this differently? Several groups said this is not the way that they describe looking after someone who needs support. Continuity and trust are very important to us – can we make contact with someone who will be a main link to the County Council? If people join an ‘advisory’ or guiding group for BME involvement in self directed support, can they be paid to cover their time, travel, and child care and caring costs?

2. Process Questions In analyzing the questions that Black and Minority Ethnic communities raised, it became evident that there were a number of important process questions emerging as queries that self directed support should take into consideration in continuing to develop service provision. These are outlined below: Who is the immediate contact for service users to call regarding self directed support or other social care services?


If the person cared for is not in control of their budget but the family or friends are, is there a system in place to make sure that quality of care is not affected? What kind of process is involved from when you call the County Council’s Access Team, to when you are assessed to fit or not the self directed support criteria? How long does it take from one stage to another roughly? Is there a separate budget for brokers only in the short term or all the time? This may inform how many take up self directed support or might be put off by it. Participants’ hope is that in self directed support, the relationship between users and broker is equally important and broker not perceived to take more preference Does the budgeting of self directed support require me to have a separate account, does it affect other benefits I receive and how long do I or my family get help in managing these finances? Access Team seem reachable by phone only, is this not a barrier? Has the North Learning Exercise helped to draw out a step by step guide to outline the journey a ‘service user’ goes through? Sample of number of days taken from one stage to another would be useful for carers and those cared for or professionals who are asked these questions? Several carers who are using direct payments for the care commented that once their direct payment system was in place, the Care Manager support ceased from monthly to 3 monthly and to some only inconsistent follow ups and request for reviews on care plans. The monitoring is then left for the family which is added pressure for them. The risk is that on those who don’t know their rights to this support, will be at a disadvantage. How can this be improved and how will self directed support be different? People with Mental Health issues among Black and Minority Ethnic communities face stigma which makes it difficult to offer appropriate support for them and their families. How does self directed support or Transforming Social Care take into consideration the non Western interventions if clients, for example, decline to take their medication?

3. What has been done so far? Arise Enterprises have worked with the Taking Part Team in listening to queries and maintained the two way approach to communicate with those concerned. Where possible questions were answered and any suggestions acted upon during the period we had. Below are examples of what we have done.

o We have sourced directories and databases for the Taking Part Team to update

their contact lists with a Black and Minority Ethnic focus to facilitate the continuing process of involvement in planning and development of services.

o The Taking Part Team worked with the Transforming Adult Social Care team to

produce a Signposting leaflet for people working with Black and Minority Ethnic people in the community and health services. This guides professionals through


the process of supporting someone in finding out about self directed support. (Appendix 3)

o We followed up client queries and made referrals where appropriate (see case

study Appendix 5) We liaised with a variety of professionals in public, voluntary sector, individuals and groups to ensure that culturally appropriate meetings and information days were held. These should be continued.

o In response to identified needs and the aim to reach as many Minority groups as

possible, the self directed support information leaflet was translated into 13 languages (Appendix 1 thanks to Transforming Adult Social Care team and the County Council Oxfordshire Language Service for this) They are all now accessible through this link - http://www.takingcontroloxon.org.uk/wps/wcm/connect/Taking+control/Home/TC+-+home+-+invitation

o We fed back to the Transforming Adult Social Care team comments from the

Traveller Women’s Group and then wrote back to the group (Appendix 4).

o People from Black and Minority Ethnic Communities with disabilities were signposted to Jenny Tricker, the Taking Part Team lead person who will link them up with ‘Unlimited’ a user-led organisation which is a voice for people with physical and sensory difficulties.

o Identified contact names for groups and communities that needs to be revisited by

the Taking Part Team in collaboration with Primary Care Trust Mental Health Team, Health Advocates, Community Development Workers and others in Social & Community Services and to include in data base for future communications.

o Compiled names of groups and individuals interested in understanding the role of

Brokers, or volunteering to take part in a reference group. Contacts were also forwarded to Antony Thorn (County Council , working on Brokerage) in December 2009.

o We fed back to groups and individuals that there is training available for informal

carers through the County Council, as well as for people to learn about becoming a Broker for self directed support. Communication needs to continue in conjunction with professionals in public and charitable sector about this (see ‘Conclusions and Recommendations’)

o The questions about payment for involvement in self directed support were partly

answered by sharing the NHS Oxfordshire and County Council Social and Community Services draft policy for payment and expenses for service users and carers who are involved in planning and developing services. However there is more work to do on this (See ‘Conclusions and Recommendations’)


OBSERVATIONS AND LEARNING

From discussions, events, meetings and visits

The following are observations by Arise Enterprises based on the work carried out with Black and Minority Ethnic groups and individuals. They are divided into two sections, one about accessible information, and one about collaborative working between health services and social care services in both voluntary and statutory organisations. The sections, however, overlap significantly, as effective collaboration improves access to information. The observations will be re-visited in ‘Conclusions and Recommendations’ later in the report.

1. Accessible Information

Cultural sensitivity: Older people, people who are ill and people with disabilities are isolated and find it difficult to engage in mainstream centres. We observed that when and where they were in their culturally organised events (day activities), their outlook is happier. This poses a dilemma for the service providers to think of how to make sure they have staff trained in culturally sensitive issues (e.g. in hospital, care homes etc.) and develop Black and Minority Ethnic specific services at grassroots. The role of the NHS Oxfordshire Health Advocates and Community Development Workers and of the County Council Community Development Officers is acknowledged as essentially important here.

Social care and health care: There seems to be a good know how on the role of secondary health care services (or NHS), but there is confusion and varying understanding in the role of the Primary Care Trust and Social Care. While there is a little bit better understanding of what support is available for older people and people with disability there is little knowledge for what help is available for those not well (either mentally ill or long term illness). This information knowledge varies from one Black and Minority Ethnic group to another and this applies to Caucasian families too. After doctors discharge a patient from hospital, many Black and Minority Ethnic people take the responsibility to care for their loved ones without question. But many do not know there is a social worker in hospital or social care team to look in to people’s social care needs in the community to enable them to live independently. The Red Cross Director observed the same thing including Caucasian families. The Red Cross have a link or shared space in the hospitals to help them identify those that need assistance when they go back home. The County Council and Primary Care teams should forge links to collaborate with such charities as it is vital both to link up with new cases and to address gaps in delivery of support for those in need. Information Technology: With increased use of information technology at work, there is a high dependency on emails for example to disseminate information internally with the hope each person will forward information to those in their networks; therefore there are less hard copies circulated and less outreach. For example, though the launch of self directed support in Banbury was well attended, the representation of service users and carers from the community at large versus the staff from service providers was not balanced.


2. Collaborative working within public, community and voluntary sector

We observed the positive beginnings of collaborative work between various teams in health and social and community services. However, some individuals welcome this shared responsibility more easily than others. Good communication internally helps develop appropriate strategies for engagement and involvement with a wide range of services providers and users. We recognise that many teams and individuals within the County Council have good general knowledge and commitment to involving service users and carers but are affected by working targets that seem to affect their focus on quality. Lonah attended the Social and Community Services Directorate Managers’ meeting whose focus was about Involvement in November 09. She was involved in her capacity as a carer and heard views from managers and other service users and carers. Some felt they already knew the ‘involvement’ principles but that it was good to be reminded of how it applies to their personal and team practice. We noted collaborative work with the voluntary sector is not sufficiently proactive and continuous enough from grassroots level to charities at strategic level (who have roles of providing capacity building, or providing services for specific people in need of care).


CONCLUSIONS AND RECOMMENDATIONS The conclusions and recommendations from this work are split into four parts:

• Involvement and engagement • Information • Collaborative working and workforce development • Continuing outreach and action planning

As in the previous section, these areas overlap. Some recommendations apply to the continued development of self directed support, some to the wider Transforming Social Care agenda, some to the County Council overall and some to all those involved in health and social care across organisations and communities.

1. Involvement and Engagement

o It is our firm conclusion reached after using a range of research and outreach

techniques that in extending any kind of new service or product of the significance and importance of self directed support that a ‘No One Uniform Approach’ policy should be adopted.

o Some groups feel cultural sensitivity is lost when mainstream organisations/

service providers take the lead compared to when they work in equal partnership with Black and Minority Ethnic groups. Where equal partnership is provided, there is a more positive grassroots development within Black and Minority Ethnic communities and therefore also greater service take up, providing a win-win situation. This highlights the need for service providers to involve Black and Minority Ethnic groups at every level. Such a policy mitigates the mindset of lack of transparency, poorly clarified time scales, what is in it for the user, the volunteer, or the thought that it is just a ‘token Black Minority Ethnic face’.

o Some people interviewed felt their input is not acknowledged in records and

professionals take all the credit. It was suggested that community involvement should present an open-door dialogue and what ever the outcome, volunteers and communities input deserve to be acknowledged as equally as the professionals.

o Many marginalised groups including Black and Minority Ethnic communities build

a better rapport with an advisor or support worker they meet face to face compared to those on telephone. They also try to gauge from a friend or relative if the service works and when it does to spread by word of mouth and people they trust.

o There is a need to understand Black and Minority Ethnic groupings and

specifically how they are formed, how they work, whether they are formal or informal. In some cases, for example, the West Indian Day Centre or Travellers Women’s Group one really needs to know who is the lead person or committee to contact. The Happy Place Chinese Group, for example, prefers that you go through the Community Development Officer or Health Advocate.

o Remuneration of some kind would be welcomed to encourage engagement from

any interested community group. As with all communities, Black and Minority Ethnic communities are juggling jobs and family, but they also have the added pressure to participate in community forums.


• Incentives could include the use of involvement for work experience and over a period of time gain referees in the search for jobs.

• The Taking Part Team should inform all that have shown interest in

joining a Black and Minority Ethnic ‘advisory’ group about the Payment and Expenses Policy (NHS and Social and Community Services Draft) and the County Council’s Volunteering Policy so that they know what to expect in terms of payment or expenses

o People who have shown an interest in getting involved further should be invited to

a meeting that will define their roles and input in the process.

o Everyone who requested information about training for informal carers and about the role of Brokers in self directed support should receive information about these to help inform their choices and decisions (Anthony Thorn, working on Brokerage has been given names and contact details).

2. Information

o There is lack of awareness about the role of adult social care services, the welfare system generally and what to do or who to contact when the need arises. Factors such as culture, language and not knowing where to start contribute to this. Some communities are better informed than others. We have not focused on identifying why this is the case as it requires in depth research and study.

o Jargon can alienate people, or make services harder for them to reach. The use of

simple language is an essential key to all communities including Caucasian families. For example the use of the word ‘services’ in isolation of the word ‘social’, to some might mean a mechanical service of a car or other object. But the use of words such as support or assistance will bring a human element to it. When giving a talk such words can be clarified, on a leaflet it is difficult for some people to know where to start asking. (see Appendix 4)

o The initiative Arise Enterprises took to build a bank of leaflets and brochures

aimed at specific Black and Minority Ethnic groupings who would benefit from translated services is something that the National Health Service and Oxfordshire County Council could promote more widely, as a part of Equal Opportunities Policy and Accessibility Issues. This could be further extended both via web based processes and through the development of DVD based media which would support communication of self directed support into the future outreach and engagement of all vulnerable groups in a broader sense. For example videos shown on the www.takingcontroloxon.org.uk website can be used at outreach meetings at grassroots level. If the County Council provides staff with laptops the use of visual aids like these can help professionals who are meeting people on a day to day basis.


3. Collaborative working and Workforce Development

o A common issue raised by Black and Minority Ethnic communities is the need to employ Black and Minority Ethnic staff who are culturally aware and if possible speak the language of specific groups. While some emphasise the need for an employee from their own ethnic groups, others have a view that no one professional can have specialist skills to manage and engage all Black and Minority Ethnic groups. We conclude there is a need for additional help to all staff through personal development to address some of the issues and aid them do their job better.

o There were a couple of requests made by some Black and Minority Ethnic groups

that Lonah or other Black and Minority Ethnic staff or professionals are present in meetings when the Taking Part Team attended as they realised there weren’t Black and Minority Ethnic staff in the team. In some groups it was suggested that the community will trust and engage well if continuity of those people seen is ensured. Trust takes a long time to build up.

o There is a common outcry for Black and Minority Ethnic professionals to be in

positions at grassroots level and management to better reflect current demographics (BME represents 15% of the population). Representation both in jobs and leadership on a long-term basis will make a difference in service accessibility.

o Every County Council employee needs to have a shared responsibility in how their

work practice fits in within the bigger picture of the duty the Council has for all residents. Each team needs to clarify for the public how they are interlinked in service provision, and to work together. Without this there is a risk that the needs of groups or individuals all teams wish to serve do not have their needs fully addressed.

o There is an ongoing need for engagement with Black and Minority Ethnic

professionals and their forums to reach carers and those that need care (Social Workers, Mental Health professionals, nurses, and Public Health Teams etc). With this is a need to monitor how the Sign posting Guidelines work out as was developed as a result of working with these teams. (See Appendix 3).

o There is a need for a proactive rather than a reactive partnership between public

and voluntary sector with clear strategies to continually engage and develop opportunities to increase knowledge, awareness on service choices for grassroots communities and those in need of care.

4. Continuing Outreach and Actions

o There is need for continued outreach and follow up with this initiative at community level to make it relevant to different audiences. The strategy used to introduce the Taking Part Team / self directed support to community groups, charities and public sector will aid the follow up, though more work is needed to reach more

o The lack of confidence that people have when calling service providers and asking

for a service or referral themselves indicates the need for Oxfordshire County


Council to develop partnerships or tendering processes to source culturally sensitive service providers at grassroots. For example the Chinese Community Centre providing support for their communities

o There is an ongoing need beyond the time Arise Enterprises has to build up Black

and Minority Ethnic Service user and carers input into self directed support and feedback from this group needs to be monitored.

o From the ‘Learning Exercise’ in the North of Oxfordshire, there is need for a step

by step guide to outline the journey a service user and their family or carers go through to use self directed support. This could sample the number of days / weeks taken form one stage or another.

o The commonly asked questions earlier in this report could be used to produce

information about self directed support.

o There is need to track Black and Minority Ethnic take up of any service just as any other data is collected from inquiries. During the time Arise was involved it became clear, for example, that calls to the County Council Access Team don’t always generate such data. This information would assist service providers and users to address any gaps. Callers are, however, asked if they require an interpreter, and tracking the answers to this question could be used as an indicator, just as gender or age are monitored nationally.


FEEDBACK

We believe that the process of rolling out self directed support in Oxfordshire offers an excellent opportunity for County Council teams and their partners at community level to work together on shared goals and outcomes. We believe that this is an opportunity to gain credibility and respect in the eyes of Black and Minority Ethnic service users and carers who are named in every policy, but as a stakeholders, they are often passive participants and strategies used to engage them may be short term. One of the advantages in the roll out of self directed support is that it has not been designed as a short- term project, but another long term choice for those in need of social care. Accessibility ought to be consistent and include persistent proactive outreach to inform and clarify questions to people wishing to make informed choices. Self directed support is likely to be welcomed by those in a position to benefit from support as it involves family and trusted people who those in need of care want to involve. While it has to be acknowledged that not every suggestion gathered can be put into action, there is a feeling within communities that there is usually little action put in place to reflect suggestions gathered from such community consultations. One method of obviating this feeling is to provide good, clear and consistent feedback. In a snapshot, there is need for a change in mind set, driven by a shared vision, shared responsibility and working strategies among all professionals (both voluntary and public sector), collaboratively with all service users and the public with the aim to provide a fair and equal service for all. All the Black and Minority Ethnic groups gave a clear message that the tradition within their families and communities is to provide care for their families and friends when needed. This interdependence should be acknowledged by service providers as they drive the agenda for independence. (See case study, Appendix 5)

Self directed support is an opportunity to achieve this balance.

This report has been prepared for the Taking Part Team, Social and Community Services, their managers, community groups and individuals involved in the work Arise Enterprises did. Anyone interested in the report can request a copy from the Taking Part Team (see contact details inside back cover).


APPENDICES

APPENDIX 1: List of languages and Weblink

Translated leaflets to 13 languages (Acholi, Punjabi, Hindi, Bengali, Badini, Urdhu, Polish, Pashto, Mandarin, Cantonese, Arabic, Swahili and Somali) and link as follows http://www.takingcontroloxon.org.uk/wps/wcm/connect/Taking+control/Home/TC+-+home+-+invitation

APPENDIX 2: Introduction letter for Arise Enterprises by the Taking Part Team

Val Wilson Taking Part Team

Oxfordshire County Council County Hall (4th Floor)

New Road Oxford

OX1 1ND e-mail [email protected]

Val Wilson Tel 01865 323623 07786022217

Lonah Hebditch 07827822640 1st June 2009 Dear Sir or Madam A new way of getting social care is starting in Oxfordshire! Lonah Hebditch of Arise Enterprises is working with the Taking Part Team in Oxfordshire County Council for a few months. Her work is to reach out to Black and Minority Ethnic people and communities to give information and to ask for advice about a new way in which social care is available in Oxfordshire. By ‘social care’ I mean support and care which can help people live their lives as independently as possible whether they are older, disabled, have mental health problems or are unwell. What is the new way of getting support? It is called self directed support. If you are assessed as needing support and care from social services, it means you have control of what care you want and need. If you are eligible financially, you will also have a personal budget to spend on it. You will be offered the services of a ‘broker’ such as Age Concern or Style Acre who can help you work out what you want to do. If you are not eligible for financial support from us, we will still be able to provide information and advice on what support may be suitable for your situation. Self directed support is starting in North Oxfordshire and then later on will be used throughout the County. Why are we asking you about this right at the beginning? Black and Minority Ethnic communities don’t always feel able to use social services in the way it has traditionally been delivered to people. There are many reasons for this. But self directed support is an exciting opportunity because it can be shaped to suit


people themselves. It is only just starting in Oxfordshire and we want you to tell us how it can best be developed to work well for you. We want you and your communities to know about the possibilities it opens up, and we want your help and advice on how to make self directed support work for you. Who are the Taking Part Team? We are part of Oxfordshire County Council and our job is to make sure that people are involved in planning and decisions in social and community services. We need to involve people from a variety of backgrounds and with different experiences, particularly people who use services, those who could use services, and their loved ones, families, friends and neighbours. At the moment Lonah is working with us to launch a project aiming to make sure that people from Black and Minority Ethnic communities have their say in the way that the new self directed support develops in Oxfordshire. What could self directed support mean to you? It is about what helps you live your life, what opens up opportunities for you, and what breaks down barriers. This is what we are calling ‘support’, and it could be all sorts of different things, some of which might be provided by Social Services, some of which might be quite separate. Some examples are given here, but what’s important is what you think matters. Maybe you…

• Visit a day centre run by a local community group

• Go to a lunch club in your village hall

• Are on a training course or working

• Have your own transport

• Have good access to public transport

• Get lifts from a neighbour or friend to go to the shops

• Have visits from your family and friends

• Go out on trips

• Go swimming or play sport

• Have a hairdresser come to your home

• Are a member of a social club

• Go to the cinema or theatre

• Go walking Any of these might help you live your life as you wish to. You might think of something else altogether. It’s up to you! As long as the support is lawful, effective and affordable it can be whatever works for you. Do you want to get involved? You can talk to Lonah and to me at the Taking Part Team about your views or to ask questions; please invite us to meetings or to visit groups who might like to get involved, or phone or e-mail us directly. If your professional work brings you into contact with Black and Minority Ethnic groups who might be interested in this, please pass on this letter to them.


Do you want to find out more? You can talk to someone at the County Council about being assessed for self directed support or with general enquiries about Adult Social Care by contacting the Access Team on 0845 050 7666. Or talk to your GP first if you prefer. You can also look at the following website www.takingcontroloxon.org.uk and will be linked to where you will find translated information in over 12 languages. Thank you very much for your time in reading this. Best wishes Val Wilson Taking Part Team


APPENDIX 3: Sign Posting Guidelines for Referring Professionals (Please note some of this information has been updated since it was used for this

project. Contact [email protected] for latest)

Self directed support

Signposting notes

Self directed support is a new way to access adult social care which gives the person who needs the care more choice and control over what will support them in living as independent and fulfilling a life as possible. The Taking Part Team (Oxfordshire County Council) is working on a project with people from Black and Minority Ethnic (BME) communities to involve and inform them in the development of self directed support. A person assessed as needing support can get help to choose the things which will really work for them. Maybe what the person really wants and what will meet their needs are social activities, walking, shopping, leisure, hairdressing, to employ a neighbour or friend to help with cooking, transport or a personal assistant. They can use the services of a ‘support broker’ – this can be through an organisation or individual who knows the local area and can help plan and set up the support. If they are financially eligible they might choose to receive the money for these things directly as a ‘Direct Payment’ Getting Involved Self directed support is being introduced in stages, starting in north and west Oxfordshire. The first phase is being evaluated and the resulting model will be rolled out across the whole county over the next two years. As it is still being developed in Oxfordshire, it’s a great moment to make sure that people from BME communities have their say on the future shape of self directed support, and have a say in what will work best for them. Information People from BME communities have sometimes found more traditional social care services hard to use or inappropriate for their needs. As self directed support encourages people to think about what will really suit them and fit with the way they live their lives, it could be an opportunity for BME people to get the support they are entitled to. Feedback so far The Taking Part Team has been talking to BME people and groups over the past few months, with the support of the County Council Community Development Team and alongside a BME independent consultant. We have received a lot of positive feedback, as well as hearing a number of concerns and questions. One issue raised frequently has been the need for information and support in coming forward for self directed support, especially for people who have not accessed social care before, who may have a first language other than English, or may find the idea of phoning social services very daunting. Signposting The following is a brief guide for those working with BME people in the community, in hospitals or in primary care about how to signpost on to available support, assessment for self directed support, finding out more about it, and getting involved in how it works. The questions cover some of the things which people have asked us about so far.


How can I find out more about self directed support?

visit www.takingcontroloxon.org.uk, Oxfordshire’s information portal for self directed support

phone the Access Team on 0845 050 7666. They can send information in the post or arrange for someone to contact the caller back

email the team on [email protected] contact your social worker or care manager if you already have one

Is self directed support different from Direct Payments? Yes! Direct payments are one of several ways of accessing the money available for care and support. Self directed support is not just about making the money available to the individual, but about looking at everything that is important to a person when they are planning their support. It gives far greater freedom to find creative solutions to care and support needs. Where can I find out about Direct Payments

www.oxfordshire.gov.uk/directpayments Contact Access Team

Who should I contact if I want to be moved over to self directed support?

Social Worker / Care manager Email [email protected]

Who should I ask if I want to be assessed to have social care for the first time?

Access Team What if I live outside north or west Oxfordshire? Everyone can ask for an assessment by phoning the Access Team. We look at requests from people who want to plan their own support via self directed support on a case-by-case basis until the introduction of self directed support is complete in April 2011 English isn’t my first language

Access Team – part of the team’s role is to help with interpreting Val Wilson, Taking Part Team, can give you leaflets about self directed support in a

range of languages I’m a carer – can I apply for self directed support? No, unless you have a need for care or support yourself. However, you can ask for a carer’s assessment and there is a lot of support available in Oxfordshire for carers. Visit the Taking Control website for useful information, assessment forms, links and contact details for carers. I’m not a British Citizen can I get self directed support? Self directed support is available to people with permanent residence in the UK and who have eligible needs. The person who needs social care is a child – can we get self directed support? Children are looked after by the Children Young People &Family directorate in Oxfordshire. Self directed support is currently only for adults.


Who should I talk to if I use social care services and I’m about to become an adult? Your current care manager will be able to help. I want to be involved in developing self directed support – who can I talk to?

Val Wilson Taking Part Team, Oxfordshire County Council 01865 323623 / 07786022217 or [email protected]

There is a service user carer reference group in Oxfordshire which contributes to the Transforming Adult Social Care programme. Email [email protected] to express interest

I’ve got views about self directed support – how can I get them listened to?

Val Wilson Taking Part Team, Oxfordshire County Council 01865 323623 / 07786022217 or [email protected]

I want to complain!

Comments and Complaints, Oxfordshire County Council, FREEPOST RRYR-XTBE-GBTZ, County Hall, New Road, Oxford OX1 1ND or 01865 323589 or [email protected]

Access Team

I need help with setting up a group to support each other in my community – who can help?

Anne Honeyball Community Development Team, Oxfordshire County Council 01865 323581 or [email protected]

Mental Health BME Community Development Workers (Primary Care Trust) based at East Oxford Health Centre - Nigel Carter on 01865 264915 or Neelam Rizwani on 01865 264936

I would be interested in training to be a Support Broker for self directed support – who can help me?

Antony Thorn, Oxfordshire County Council 01865 323686 [email protected]

None of this is what I want to ask about – who shall I talk to about my issues?

Access Team Further information – websites etc

www.takingcontroloxon.uk www.oxfordshire.gov.uk/transformingsocialcare www.oxfordshire.gov.uk/selfdirectedsupport www.oxfordshire.gov.uk/directpayments www.oxfordshire.gov.uk/safeguardingadults

Using this guide This guide is for those who work in communities and is designed to make sure they have the information to signpost people on to the right places for advice and information about self directed support. It is not intended as an information leaflet for the public and it should only be used as part of a conversation. If you have any comments or feedback about how the guide works in practice we’d be keen to hear from you - please contact Val Wilson [email protected] 01865 323623 or 07786022217


APPENDIX 4: Traveller Women’s Group Response Letter by Taking Part Team

Val Wilson Taking Part Team

Oxfordshire County Council County Hall (4th Floor)

New Road Oxford

OX1 1ND 01865 323623 07786022217

16th December 2009 [email protected] Dear Kit and Travellers Women’s Group I’m sorry it has taken me so long to get back to you after our meeting in November about self directed support in ‘social care’. By ‘social care’ I mean support and care which can help people live their lives as independently as possible whether they are older, disabled, have mental health problems or are unwell. This might be something families do themselves, or something that is provided by the County Council or another organisation. What I said I’d do was to pass on your comments about what we talked about to the self directed support team here at the County Council. I have done this and I told them that: • Traveller women would be interested in services which allowed members of a family

to accompany someone who needed support on respite breaks – breaks which give everyone in the family a chance to recharge their batteries and some time for themselves.

• The group would be interested in giving feedback about the general information

leaflet on self directed support. For example the title of the leaflet doesn’t make sense, as they don’t use the term 'adult social care' to describe looking after someone who needs support.

• Continuity of who people see is very important to Travellers, and trust takes a long

time to build up. I hope you think this is what your group said – please let me know if I have covered everything accurately. I also said I would send you information about a group called the Service User/Carer Reference Group who meet up to talk about the changes in adult social care and pass on views to the Council. This is a group of people who care for others, people who use social services such as home support or day centres, and organisations like Age Concern who represent older people. I’ve enclosed the Reference Group’s ‘Terms of Reference’, which says how often they meet. The person from the County Council who helps run this group, Flo van Diemen, is very keen that someone from your community gets involved – would you or anyone else be interested? The dates coming up are:


Tuesday 26 January 2010 Tuesday 23 March 2010 Tuesday 18 May 2010 Tuesday 13 July 2010 Tuesday 14 September 2010 Tuesday 9 November 2010 Meetings will start at 12.30 with sandwiches and a chat, the meeting itself starts at 1pm, at 2.30 they will aim to stop for a coffee break, and at 4pm they will finish. Because Flo needs to book a suitable venue and order lunch for each meeting, she does need people to let her know they are attending. It is not a problem if people really cannot make it on the day and/or can't attend each meeting. People are paid expenses if they come. The January meeting is a particularly good one for new people to join, because they will be giving an overview of the programme and Flo has invited the Transforming Adult Social Care team to come for lunch and meet people informally. It's good for people to have faces to names. That way new members of the group will not feel too 'new'. The Transforming Adult Social Care Team are the people who are setting up self directed support, better information and advice for everyone as well as other things which will give people more choices and more control if they need or want support. You can contact me or Flo directly if you want to know more about the group or would like to come along in January. It would be so good to have your experience or that of other Travellers contributing to the way this develops. I hope this is helpful I hope you have a good Christmas and thank you for your time with this Best wishes Val Val Wilson, Taking Part Team


APPENDIX 5: Case Study

During this Black and Minority Ethnic project Arise Enterprises was invited to visit a carer in Oxford City. Our home visit was to a parent of 2 and a carer of an elderly parent in their late 70’s. With age, the cared for elderly parent continues to require more assistance in duties like cooking, personal care, shopping and needs regular medical appointments and their carer has to come and interpret for them. The carer has had to learn the nutritional needs for a person with diabetes who also suffers from high blood pressure and requiring a hip operation. Some of the foods are expensive and you need to shop in various shops as the stock sometimes run out quickly. The cared for has a flat in one end of the city, and the carer does twice of every task when the elderly parent is in their own home. The need to manage chores, shopping for both homes and school run for two schools is quite stressful sometimes. A relative that could help has young children and can only help once in a while. The home of the carer and the cared for are both small and when the cared for parent is very ill, the family see the need to bring them to their house for closer care and to monitor them closely. This anxiety has been triggered by a heart attack the cared for had in their own home, and due to language issues and sense that they were feeling very ill called their carer who then called the ambulance service an gave the address of the elderly parent. They then drove to see their parent and found the Ambulance service on scene, but needed an interpreter for her non English speaking parent. Since then whenever their parent is not well, they crowd in the carers house. Another pressure is from the Job Centre for them to get a job. In our visit the carer felt this was adding pressure and did not know what to do considering the caring responsibilities was like a fulltime job in itself. On our two home visits both taking over 2hours, they had read a translated leaflet we gave before our visit and wanted to know how self directed support works. Once we explained they wanted to know what kind of assessment is needed for their elderly parent and what help was available for them as a carer. Since the carer did not know about the Carers’ Centre or any support for them we explained the possibility to register as a carer and that they will have a support worker assigned to assist them. To get a feel of how it all works, we called the Oxford Carers’ Centre (Bullingdon Road, Oxford) who accepted our referral by filling a form over the phone, identified a support worker for the carer and booked them an appointment. They offered to support the carer in dealing with the Job Centre, offering her time to talk through her caring responsibilities, social activities and training. We also called the County Council Access Team who needed the interpretation of keys questions and wanted to know who Lonah and Arise Enterprises was. Upon our telephone follow up, the carer said after three days, Access Team called them to arrange a home visit in a week’s time by a Social Worker that works with adults in need of care. Due to our initial visit, the carer felt she needed to update us of the progress of both her support in the Carers’ Centre, the Access Team and ask further questions that were worrying them. The introductions to the two services provided a point of contact and continuity for the service users, as Arise Enterprises contract is short term. Despite


explaining this, both carer and cared for felt it was good to receive help from someone who understands their culture and knows how the Welfare Services in United Kingdom works. They were informed a carer’s group that brings together carers form their ethnic group run by the Community Development Worker’s team in Social and Community Services, and a contact person in their community given as a back up for their confidence. They were keen to attend other events to get a feel of what Social and Community Services does and attended a review of care services for the elderly for Oxfordshire. They would like to be trained as a carer to be able to earn a living in caring for their parent and not to be stressed by Job Centre. They also know the right to have an interpreter and their parent were in hospital or health centre alone, they have a right to ask for an interpreter from Language Line. There is clear they need time to understand how all these works and they can then recommend the service to others. In the meantime we hope they have knowledge of where to get help for themselves and their loved ones.


APPENDIX 6: Some Quotes from People Who Took Part ‘I am pleased to find there will be more choice in how I can be supported’ ‘I feel hopeful that I will be trained to look after my loved one well and safely’ ‘It is good that Carers are now recognised and that this could lead to payments allowing us to continue what is a full time job’ ‘I’m glad the council appreciates the hard work families do and that there is support for people like me’ ‘What is social care?!...(after explanation)…that’s what I do for Nan!’

Prepared by: Lonah & Nick Hebditch , Arise Enterprises Ltd. along side Taking Part Team

Nick and Lonah Hebditch Arise Enterprises Ltd

58 Victoria Road Bicester

Oxon OX26 6PH

Lonah 07816816205 [email protected]

A Social Enterprise supporting community work and entrepreneurs in

1. Business Guidance 2. Event Management and facilitation

3. Consultancy; specialising in engaging with marginalised communities

The Taking Part Team

Supporting involvement across Social, Community

and Health Services

Contacts: Lisa Gregory (Team Manager) 01865 323606 [email protected]

Mobile 07827822602

Val Wilson (Service Development Worker) 01865 323623 [email protected]

Mobile 07786022217

[email protected]

Taking Part Team Strategy and Performance Oxfordshire County Council

County Hall, (4th Floor) New Road, Oxford, OX1 1ND

Produced by: County Print Finishers. Tel: (01865) 815672 • Fax: (01865) 204309 S141-02 (07/10)

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