Equality Impact Assessment

Overview:

Assessment Name: Commissioning Services at Oak Park Health and Wellbeing Campus
Department: Adult Services Date Created: 05/08/2011 15:39:21
Lead Author: Martin Parker Lead ID: sshqopmp
Additional Authors (if applicable): Martin Parker
Edward Walton
 
 
 
Aims and Objectives: The commissioning of nursing care and Extra-Care Housing care services within the Oak Park Health and Wellbeing Campus in Havant.
Main Activities: The provision of nursing care and an alternative housing solution for people who are older and have frailities, disabilities or mental health issues, particularly dementia, to provide personalised services to prolong their independence
Who's intended to benefit: People who are older and who have frailities, disabilities or mental health issues in the Havant area.

Summary of Report:

Summary of Main Findings: That in general, where data is available, the characteristics of people using Adult Services support in Havant meet the characteristics of the local Havant population. The assessment has identified that Nursing Care in particular is used primarily by people who are older and who have frailties, disabilities or mental health issues, and it is to support the health and social care needs of these people that is being targeted with the commissioning of services at the proposed Oak Park Health and Wellbeing development.

Although there is a primary target group, there will be no exclusions in terms of age, sexuality, race, faith, gender, disability or socio-economic factors but this will require some specific actions. These will be to ensure:

1) that a specification is written for the service that ensures the service provider makes reasonable and appropriate adjustments as required to meet the needs all people referred to the services

2) that there is regular contract monitoring of performance against a key performance objective in relation to ensuring that the service provider works in partnership with Adult Services to ensure the service user charecteristics match the local demography

and 3) that provider and Adult Services staff receive age, sexuality, race, faith, gender, disability and socio-economic awareness training and development to ensure that there are no exclusions on those grounds and that all people are treated as individuals with their personal needs met where appropriate and reasonable.

Age:

What do you know about the breakdown of people who use your services compared to the community profile: Havant generally has an older population than Hampshire overall, and the number of older people in the area will increase over the next two decades. POPPI figures (accessed August 2011) suggest that from a 2010 baseline, by 2015 the number of people in Havant aged 65+ will increase by 14% (25,400 to 29,000) and by 37% by 2025 (25,400 to 34,700). POPPI figures also indicate that in Havant the number of people with dementia is likely to increase from approximately 1,850 people in 2010 to around 2,100 people by 2015 (a 17% rise) and to nearly 2,900 people by 2025 (a 59% rise).

Of the approximate 1870 people supported by Adult Services in Havant, approximately 1030 (55%) of them are older than 65. Of the 178 people in Havant supported with nursing home services, 157 (88%) are over 65 (Comm Care VR5 - July 2011). It is clear that the prominent client group in Havant is those over 65 and that Nursing homes support in Havant is predominantly used to support people over 65.

Will some people be unable to use or benefit from the service: The services being commissioned will primarily be aimed at people who are older and have either a specific nursing requirement (could be due to a mental health or physcal health issue or could be supporting the enablement of the person) or who specifically require Extra-Care Housing (a housing model primarily aimed at older people).

There are no exclusions and no reason why people who are younger could not use the services being commissioned provided they are eligible to receive adult services support and they meet any specific requirements of the development, however there are also other alternative support models for people under 65 that may be more appropriate.

How could the iniative improve equality of access: - The services being commissioned will primarily be aimed at people who are older, however wherever possible, and with consideration to the needs of other residents, appropriate and reasonable adjustments to meet the needs of younger people (e.g. different activities, changes to decoration of units, placed with people of similar age) can be made.

- Supported by Housing Benefit, Extra-Care Housing can provide an alternative housing option that supports all people to remain as independent and socially active as they choose.

- A focus on reablement beds will increase resources available for reablement and support a wider range of people to remain independent and within their own communities, avoiding lengthy stays in hospital.

Disabled People:

What do you know about the breakdown of people who use your services compared to the community profile: 45% of people supported by Adult Services in Havant are disabled people. Of the 178 people receiving nursing home support, 21 (12%) are disabled people (Comm Care VR5 - July 2011). It is very likley, however, that these disabled individuals are using nursing services that meet thier specific needs. There are likley to be people with disability who require the need for specific dementia services (no figures available) that also support their disability needs. However it is not anticipated that this will be a large number of people.
Will some people be unable to use or benefit from the service: The services being commissioned will primarily be aimed at people who are older and have either a specific nursing requirement (could be due to a mental health or physcal health issue or could be supporting the enablement of the person) or who specifically require Extra-Care Housing (a housing model primarily aimed at older people).

There are no exclusions and no reason why people who are disabled could not use the services being commissioned provided they are eligible to receive adult services support and they meet any specific requirements of the development, however there are also other alternative support models for people with disabilities that may be more appropriate.

How could the iniative improve equality of access: - The services being commissioned will primarily be aimed at people who are older, however wherever possible, and with consideration to the needs of other residents, appropriate and reasonable adjustments to meet the needs of people with disabilities (e.g. hoists, accessible toliets / bath, appropriate surfaces) can be made.

- It is anticipated that, due to planning regulations and best practice guidance, all buildings will be disability appropriate (e.g. a number of rooms and units will be at a minmum wheelchair accessible, accessible toilts, accessible communal spaces).

Faith:

What do you know about the breakdown of people who use your services compared to the community profile: Population estimates ((POPPI, August 2011) show that the majority recorded faith of people over 65 in Havant (of those stating a faith excluding those registering as no faith (approximately 50%)) is christianity (approximately 94%), however there are small numbers of people from other faiths including Buddhists, Hindus, Jews, Muslims and Sikhs. The faiths of people using Adult Services nursing or Extra-Care Housing services in Havant is not known.

Will some people be unable to use or benefit from the service: There are no exclusions and no reason why people who are from different faiths could not use the services being commissioned, provided they are eligible to receive adult services support and they meet any specific requirements (of which faith is not one) of the development.
How could the iniative improve equality of access: - The services being commissioned will, wherever possible, and with consideration to the needs of other residents, make appropriate and reasonable adjustments to meet the needs of people with different religious practices (e.g. appropriate fixtures and fittings, diets).

- The provider of services and Adult Services department managers should ensure that front line provider care or Adult Services staff are supported (Adult Services staff ensuring faith appropriate changes are made when referring and provider staff ensuring faith appropriate delivery of services) through faith awareness training and development.

- Contract performance measures (numbers of the Faiths of people using the service) will be used by provider, and Adult Services, staff to work together to ensure the balance of different Faiths using the services is appropriate.

Gender:

What do you know about the breakdown of people who use your services compared to the community profile: As at 2010 the percantage split of over 65's in Havant was 44% male and 56% female. Over the next 5 years this will change slightly to 45% male and 55% female (POPPI August 2011). Life expectancy for people in Havant although above the national average is one of the worst across the Hampshire Boroughs and Districts. Life expectancy for males is lower than females, which infers that women are likley to live alone longer and are therefore more likley to access and remain in the developed services longer.

The proportion of people receiving Adult Services support in Havant (approximately 1870 people) reflects these figures with a split of 62% female and 38% male, and for older people the percentage of women is higher with a 70 % : 30% female to male split (Orders and Assessments, August 2011).

Will some people be unable to use or benefit from the service: Due to the differring life expectancy across gender in Havant it is likely that the proposed commissioned services will cater mainly for women although there will be no exclusions and services will be available for male or female clients who have either a specific nursing requirement (could be due to a mental health or physcal health issue or could be supporting the enablement of the person) or who specifically require Extra-Care Housing.).

How could the iniative improve equality of access: - The services being commissioned will, wherever possible, and with consideration to the needs of other residents, make appropriate and reasonable adjustments to meet the needs of people from different genders.

- The newly commissioned beds and care will ensure that there are sufficient and appropriate services available in the Havant locality to meet the gender demographic changes both in proprotion of male : female but also as both men and women live longer.

Race:

What do you know about the breakdown of people who use your services compared to the community profile: It has been reported that one of the primary issues effecting the lifestyles of BME people in Havant is their lack of visibility and the common perception that there are very few people from BME communities living in the area. 2007 mid year estimates show that the % of BME population in Havant is growing from 3% in 2001 to around 6% of total population, compared with South East 12% and England 16%. However these basic statistics appear to point to a small, but significant and growing portion of the Havant population that identify with BME groups. These BME people appear to be from a wide variety of backgrounds, with no single minority community dominating the local picture (Jon Piper, Community Development Officer - Havant and Gosport). For people over 65 it is estimated that some 98.5% have recorded themselves as white (British, Irish and Other White) (POPPI August 2011).

Of the approximately 1870 people receiving Adult Services in Havant 97% are recorded as being white (Orders and Assessments, August 2011). This is slightly below the overall Havant BME population % but in line iwth POPPI estmates of the over 65 population.

Will some people be unable to use or benefit from the service: There are no exclusions and no reason why people from different racial backgrounds and cultures could not use the services being commissioned, provided they are eligible to receive adult services support and they meet any specific requirements of the development.
How could the iniative improve equality of access: - The services being commissioned will, wherever possible, and with consideration to the needs of other residents, make appropriate and reasonable adjustments to meet the needs of people from different ethnic backgrounds (e.g. diets, washing practices, ensuring people sharing similar racial charecteristics can spend time together if required).

- The provider of services and Adult Services department managers should ensure that front line provider care or Adult Services staff are supported (Adult Services staff ensuring ethnic background appropriate changes are made when referring and provider staff ensuring the appropriate delivery of services for people from different etnic backgrounds) through cultural awareness training and development.

- Contract performance measures (numbers of the race mix of people using the service) will be used by provider, and Adult Services, staff to work together to ensure the balance of different races using the services is appropriate.

Gay, Lesbian, Bisexual:

What do you know about the breakdown of people who use your services compared to the community profile: Sexual orientation figures have not been found for either a Havant population analysis or for an analysis of the sexual orientation of people who use services in Havant.
Will some people be unable to use or benefit from the service: There are no exclusions and no reason why any person could not use the services being commissioned, provided they are eligible to receive adult services support and they meet any specific requirements of the development.
How could the iniative improve equality of access: - The services being commissioned will, wherever possible, and with consideration to the needs of other residents, make appropriate and reasonable adjustments to meet the needs of people who are gay, lesbian or bi-sexual (e.g. same sex bedrooms and necessary adjustments).

- The provider of services and Adult Services department managers should ensure that front line provider care or Adult Services staff are supported (both when discussing and referring gay, lesbian or bisexula people to services or when directly providing services) through sexual orientation awareness training and development.

- The provider shall ensure that any issues that residents may have with other residents sexuality are dealt with in a sympathetic yet respectful manner through providing appropriate information and support to those residents raisning the issues.

Socio Economic Factors:

What do you know about the breakdown of people who use your services compared to the community profile: Deprivation in Havant is higher than average, sitting in the bottom quarter of English Authorities in terms of % of population living in the most deprived area and with 4 wards in the bottom 20% of all English Wards (Index of Deprivation 2010). Life expectancy is 7.9 years lower for men and 6.2 years lower for women in the most deprived areas of Havant than in the least deprived areas (Department of Health, Health Profile 2011).

Adult Services eligibility and financial assessment processes should ensure that those people who are most vulnerable and disadvantaged should be supported, however no information on the socio-economic breakdown of service users in Havant is available.

Will some people be unable to use or benefit from the service: The services being commissioned will primarily be aimed at people who are older and have either a nursing requirement (could be due to a mental health or physcal health issue or could be supporting the enablement of the person) or who require Extra-Care Housing. Referral to services will be for eligible individuals who meet these requirements. It is likley these individuals will be from the most disadvatngaed areas.
How could the iniative improve equality of access: - The maximum support for services should be for those individuals who are most disadvantaged both econmoically and socially due to eligibility and financial assessment criteria, and should therefore improve the life expectancy of those people from the most deprived areas of Havant closer to those in the least deprived areas.

- The development should create further affordable housing (Extra-Care Housing) for the local population.

Rural Isolation:

What do you know about the breakdown of people who use your services compared to the community profile: Havant Borough Council is a predominantly urban Borough Council. No information on the urban / rural breakdown of service users in Havant is available.
Will some people be unable to use or benefit from the service: There are no exclusions and no reason why any person could not use the services being commissioned, provided they are eligible to receive adult services support and they meet any specific requirements of the development.

People from rural areas may not be aware of the support that can be provided by Adult Services, both across all services and in respect of this specific services, hwoever this is beyond the scope of this particular project. Information on the new services will be made available through as many different sources (e.g. GP's, newspapers, local councillors, provider services) to improve the chance that people from rural areas will get to know about the services.

How could the iniative improve equality of access: - Referrals will be accepted from Havant or the surrounding area.

- The service will be part of a range of services being provided by NHS Hampshire and Adult Services to minimise travel time for people from more rural locations.

Other groups affected:

Are there other groups affected not already mentioned: None

Conclusions of Potential Impact:

Possible Impact: At all stages of the commissioning of services and the development of the buildings, it will be made clear to the developer / provider that whilst predominatly services are for people who are older, all reasonable and appropriate adjustments will need to be made to meet the needs of younger people, disabled people, people from different faiths, races and sexuality.

If any groups are disadvantaged is this likely to be unlawful: Adult Services has a duty to offer any Adult over the age of 18 an assessment and meet any identified needs. The majority of people accessing the service will be over 65 due to the nature of the service provisions and of their disabilities being largely age related. It is likely that Adults who do not have age related mental or physical impairments are likey to want to choose other services although if appropriate any adult can ask to attend the services being commissioned.
Group Affected: Due to the nature of the service it is unlikley that any group will be adversely affected.
Evidence: The service will be set up to meet specific needs (physical and mental detioriation, reablement) and although predominantly aimed at people who are older due to the nature of age related illnesses, they will not be age, disability, faith, race, gender or sexual orientation specific. Further actions will be taken to ensure that the provider, and care management staff, are aware of potential impacts and make all necessary and appropriate adjustments.

Further Actions to be taken:

Action: 1) Specification to ensure clear that although predominantly for older people, there are no referral exclusions, and that the service provider is aware of the need to make all appropriate and reasonable adjustments.

2) Contract performance measures will be used by provider, and Adult Services, staff to work together around ensuring there are no exclusions and wherever possible service user charecteristics match the local community charecteristics.

3) Cultural awareness training and development for all front line provider care and Adult Services staff will be provided.

Responsibility: 1) Contract Manager to ensure appropriate clauses are added in specificaton for services.

2) Provider and contract monitor - through regular (at least quarterly returns and contract montioring meetings)

3) Provider and contract manager - provider to ensure training available and contract manager to ensure that all staff attend.

Also Adult Services Mangement, ensuring that all staff, especially frontline staff receive appropriate cultural awareness training and development.

Timescale: 1) By commencement of tendering process - likely to be June 2012.

2) From start of contract and through contract period - likely to be between 2014 and 2019.

3) Provider initially when development opens and then for all new staff (By 2014 and then ongoing). Adult Services Management should be providing ongoing awareness training (by 2014 and then ongoing).

Expected Outcomes: 1) A clear specification that is enforceable if there are any exclusions due to age, gender, sexuality, race, faith, sociio-economic or disability.

2) Provider and contract manager working together to ensure that there are no excluded people and that service user charecteristics match the local community charecteristics.

3) Provider and Adult Service staff have growing awarenes and understanding of issues relating to age, gender, sexuality, race, faith, sociio-economic or disability.

Review Summary:

Review Update: