Physical Disabilities and Sensory Impairment Partnership Board

7 September 2017 2pm – 4:15pm

Orchard Park Community Centre, Cambridge, CB4 2EZ

Minutes

Present
PA-W Philippa Avey-Walters PD Joint Team Manager
AB Amanda Bavin Registered speech to text reporter
EB Erika Brown Hunts Society for the Blind
PB Pauline Brown Independent member
JM James Catmur Observer
SC Sally Cleghorn Development Officer, CAIL
HD Heather Davison Coordinator, Healthwatch Cambridgeshire
LF Lucy Forrest Assistive Tech. & Telehealthcare Team, Manager
MH Mark Howell Adults Committee
AK Alison Keclik Quality & Governance Team
LK Lulu Kirby Cam Sight
GL Graham Lewis Development Officer, CAIL
PM Paul McCloskey Cambridgeshire Hearing Help trustee
LM Lee McManus Service Development Manager, CCC
FR Flora Raffai CEO, Cam Sight
MS Mick Scadden Independent member
FS Frances Swann Cambridge Home Improvement Agency, Manager

1. Welcome, introductions and apologies

Apologies: Jane Scott, Jill Johnson, Andy Palmer, Helena Melbourne.
Welcome: James Catmur and Frances Swann were welcomed as board members.

2. Minutes of the last meeting and matters arising

2.1 Minutes
The Minutes were agreed.

2.2 Matters arising

PB will send GL her contact for the Tinnitus Group.
Fen House, Fen Road, Cambridge, CB4 1UN
Tel: 0300 111 2301 Email:admin@cambridgeshirealliance.org.uk
Registered Charity No. 1132290 Company limited by guarantee No 06861653
3. Updates from board members
FR said CamSight had received £25k from the Masonic Charitable Foundation. She
thanked everyone who had voted for CamSight.

4. Feedback from other meetings

4.1 GL – CAIL had a cross board event for independent members of all the
partnership boards to discuss both member training and the theme for the annual
cross board public event. Development Officers are now in the process of setting
this up.

4.2 Cambridge Bus Users Forum was initiated by Daniel Zeichner MP. It includes
people with disabilities and the Guide Dogs Forum. Talked about why the same
bus card cannot be used both for Stagecoach and Whippet; audio visual
announcements. The Managing Director of Whippet explained the problems of
running a service in a rural area.
The Forum will happen regularly and CAIL will attend.
MS said Stagecoach has introduced new buses without audio or visual. By 2020 it
will be required by law. They seem reluctant to use audio-visual and ask
passengers to rely on the driver.
PB – there is a screen on the Guided bus.
GL – we do raise this issue regularly.
PB – Whippet route 477 has changed to 478 and the X3 has changed its route
without notice. She has informed everyone who lives where she does.

4.3 Wheelchair Users Forum

CAIL has set up a cross-board forum. Wheelchair users met to talk about broader
issues than just their condition. They will meet again. GL said there were many
stories about how the service was not as good as it should be. Wheelchairs have
been provided that are not suitable for a person’s house or car.
Wheelchair Personal Budgets are being introduced. HD said these have been piloted
in Worcestershire. The aim is to take a holistic view to cover health and social care
needs.
GL – the Wheelchair Service had its contract extended.
HD – this is because of the national work being done.
GL – people were clear that they wanted a representative from the Clinical
Commissioning Group (CCG) and the Wheelchair Service at the next meeting.
HD – there were two people who had chosen to opt out of the NHS provision. There
were interesting stories on the use of crowdfunding and Healthwatch would be really
interested in finding out about this hidden group.
MS – I met a wheelchair user who was paying £50 a week to lease a wheelchair.

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LM – there are other people who have care privately that Cambridgeshire County
Council does not know about. Under the Care Act the Council has a duty of care to
advise people about the quality of provision around the County. People can ask the
Council if what they pay for services is reasonable.
PM commented on how the Boots and Specsavers model have diverted people from
the NHS.
MH – how is the Wheelchair Service funded?
HD – it will remain with the CCG.

5. Updates from the PD and SI Teams

LM has changed roles and is now Commissioner.
 He works across the County to ensure best quality of services.
 Is working closely with Peterborough City Council and the CCG.
 Many Physical Disability and Sensory Impairment contracts end this year or
next. He will be working with stakeholders to ensure a more seamless
provision and more uniform service.
GL – does that mean you won’t attend these meetings in future?
LM – only to answer commissioning issues. Most queries are about how things are
working properly. There have been team changes and new initiatives. Philippa can
answer operational questions.
PA-W – I’m standing in for Mimi Vidot-Blanc today. She is retiring shortly and no
replacement has been appointed. The Autism Team is moving to the learning
disability partnership.
PM – is this the last of the changes?
LM – there will be a few more partly because of funding pressures and partly
because of the drive to work more closely with Peterborough City Council.
JC – My postcode is Stevenage and I have trouble persuading the Council I live in
Cambridgeshire.
PA-W – the Contact Centre has a simple map to check this.
LM – there are similar issues for those who live along the Norfolk border.
LF – the Sensory Team does not anticipate any huge changes in the short term.
Mary Godden has left, Helena is on holiday.
GL – is Mary being replaced?
LF – No. There will still be someone with special skills for those who have a sensory
impairment. There just isn’t the volume of work to maintain a part-time worker for
this. It is better to blend what we have.
PB – I’ve had a lot of support from Sensory Services. It would be a shame if there
were changes to services.
LF – there is still the Visual Impairment Rehabilitation Team. There are no plans to
change this.

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LM – there remains a huge commitment by staff to maintain high quality services.
LF – the decision to remove the Sensory Impairment social worker was because
there was not enough work. They thought there was a better way of delivering
expertise.
LK – is that because the criteria to have a social worker is quite high?
LF – if people need a sensory input they will get it.
LK added that people with dementia, MS or a learning disability, which can be
complicated cases, seem not to get a social worker.
MS – when there is a sensory impairment it can also affect your mental health.

6. Eligibility Criteria for Care

 The following documents were handed out:
o Eligibility outcomes for adults with care and support needs
o Eligibility – key points lifted from the Statutory Guidance (July 2017)
o Practitioner factsheet – Eligibility – Informal (unpaid) Carers
o Practitioner factsheet – Eligibility – Service User.
 AK explained that these are the resources that social workers have.
 The terms substantial and critical are no longer used
 The criteria apply nationally. This means there is no postcode lottery.
 The local authority cannot determine if an individual is eligible until a social care
assessment has been carried out but they can put in support if there is an
immediate need.
 There is a 3-stage process to go through. The individual assessor is the
decision maker. (Reference: Practitioner Factsheet – Eligibility – Service User).
PA-W This refers to statutory services. If someone is not eligible for statutory
services there would still be other services available.
AK – There is still a duty to provide advice and information.

Q&A
PB – is it means-tested? Are assessors qualified? What about progressive
conditions?
AK – to have an assessment is not means-tested but formal statutory care is.
The assessors should have adequate skills to do that. If further support is
needed, for instance an individual has a sensory impairment, then that will be
provided. However assessors are not necessarily social workers.
PA-W If someone consents for GP to be approached then they would do so. Other
professionals are involved.

MS – If someone cannot give a contribution what happens?

AK – The Council still has a duty to meet need.
EB – Is property taken into account?

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AK – only if an individual is moving into care.
On progressive conditions there is a statutory duty to review every 12 months but an
individual can request a review. Can do planned and unplanned reviews.

LK – as part of a social care assessment is any weight given to questions answered

under PIP application? Would the DWP allow the information to be made available?
AK – they could be used to inform an assessment.
PA-W – people send in their social care assessments in applying for PIP.
LK – a lot of older people have difficulty accepting they have a need.
FR – can people query an unfavourable result?
PA-W – it depends on the circumstances
AK – the local authority’s word is final if there is no further information.

PB commented that it is distressing when vulnerable people have to go through the

PIP process and then have an assessment.
PA-W – it’s not a new process. In the past contact was always with an assessment
first.
LM added that most people who have social care were assessed in the past. They’re
not assessing everybody.
PB – I used to have support but after review I was told I would have to pay back
£10,000.
HD – Healthwatch has observed the difficulties people are having getting into the
system. They are passed from pillar to post particularly people on their own who
have no one to advocate for them.

LM – The idea around Transforming Lives is to ensure people do not have to wait for
their assessment. It is working differently across the County as it is being rolled out.
JC – I agree with Heather. I used to spend up to two hours a day managing my
wife’s care.
PB – there are people with dementia who are on their own and have no support.
How are they being supported? They need professional help.
AK – if someone is deemed unable to participate in their own social care assessment
the County has a duty to approach a profession advocate.
MS – the GP should pick up on this.
LM- asked Healthwatch to let him know of any such cases.

PM – feel that using the private sector for equipment, and asking people to go
through lengthy processes is a way of spreading dwindling resources.

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 7. PIP Strategies
 Personal Independent Payments are for people aged 16 – 64 to cover the
extra costs incurred by their disability.
 The amount ranges from £22 - £141.10p per week. It depends on a person’s
ability to access daily living but is not condition specific.
 There are two levels for daily living and Mobility at Standard (8 points) and
Enhanced (more than eight points) . (Daily living standard rate = £55.65 per
week, enhanced rate = £83.10 per week; Mobility Standard rate = £22.00 per
week; enhanced rate = £58.00 per week – each can be paid at the standard
or enhanced rate)
 There are no longer lifetime awards. Some are awarded indefinitely but it
seems that the longest is for 10 years.
 Reviews have speeded up and can be every 2 years. It’s good that a person
is asked if their condition has changed, got better or got worse.
 Have to have had difficulties with daily living for three months and expect it to
continue for nine months longer
 In theory people with sight impairment should get the enhanced rate.
 If a person gets support the support worker should attend the assessment
 You have one month to return the form. This is not always enough if help is
needed to fill in the form.
 The majority of clients are invited to a face to face assessment. This can take
place at home and last approximately one hour.

LK commented:
Every claimant finds the process stressful
You have to try to fit information into the most appropriate section
Home assessments seem to have less favourable outcomes because a person
knows where everything is and appears more confident than they might outside the
home.
An assessment where both claimant and support worker are present usually have a
better outcome
Assessors have some medical background but are not specialists in any one
condition
Assessment centres are not anywhere near where a claimant lives.
CamSight’s clients do not seem to follow the apparent national trend of having
benefit cut.
The PIP process is still being reviewed. All DLA claimants should have received
notification of the change to PIP.

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Q&A
MS – his first assessment was a waste of time and money because the assessor did
not take account of his guide dog (12 points).
PB – what happens when people turn 65?
LK – once on PIP you stay on it. You cannot get both PIP and Attendance
Allowance.
PB – going to Peterborough is difficult, there was very little notice for my home
assessment, my sister had to help with my appeal.
LK – going to appeal has a better outcome but it is still traumatic.

8. Adult Social Care Forum (ASCF) - items for and from

 The draft minutes are now circulated to the PDSI Partnership Board
 GL highlighted that Elaine Fleet asked that the ASCF Watching Brief be
aware that Cambridgeshire Hearing Help (CHH) clinics, funded through the
Cambridgeshire Clinical Commissioning group, should be monitored.
 PM spoke as trustee of CHH. They get funded through the CCG and
Cambridgeshire County Council. Service for Hearing Loss has been
contracted to Specsavers. These are low level tests and need a GP referral.
MS – why aren’t GP services doing them?
PM – they haven’t done them for some time.
 GL – for those on Direct Payments the County is exploring the use of pre-paid
payment cards.
HD – money from the Council will be loaded on the card.
 Mental Health – this board has asked who covers this. GL met Aly from Mind.
GL explained that Peterborough Mental Health Forum has expanded to cover
all Cambridgeshire and is moving towards a partnership board model.
HD asked if there were any signs that partnership boards might combine.
GL – discussions have started. CAIL’s contract ends in March 2018. CAIL does not
deliver services.
 Item for ASCF. Through Purple and the Voices for Choices project it has been
reported by people in receipt of Direct Payments that the payments process
has not worked as it should. Home care is a concern.
The Board agreed this should be raised.

9. Action Log
Home care. The Council has run several drop in meetings. The Contracts Team was
very involved. Board agreed to remove this action but will continue to raise concerns
if they arise.
PB asked about the Wheelchair Forum.

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GL – it was a cross-board initiative because all partnership boards raised issues
about wheelchairs. It was widely advertised and held on 27 July at The Meadows
Community Centre. Next meeting is in November, date to be confirmed, not in
Cambridge.

10. Any other business

 Cambridgeshire and Peterborough CCC early discharge service for stroke
survivors.
Action: GL to circulate details when they are available.

 Guide Dogs met Police and Crime Commissioner about parking on

pavements. He has written to Cambridge City Council.
Action: Board agreed that GL should write a letter of support
 Letter from Trish Reed asking if she could speak to the PDSI board about the
adaptations pathway work, encouraging a broader outlook of people’s housing
options.
Action: Board agreed GL to invite Trish Reed.
 Cambridgeshire Accessibility checker. GL to recirculate invitation. P A-W
added that they want people to visit, photograph and report on premises.
 MS warned that there have been attacks on assistance dogs. It is important to
report any incidents to the police.

Date of next meeting: Tuesday 5 December, 2pm – 4:15pm, March Community

Centre, Station Rd, March PE15 8LE

Kindly note there will be a meeting of service users just before each meeting
between 1:15 and 1:45pm

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