Enter and View findings from Care Homes in Rye and Rother

What we did

Our Enter and View activity involved authorised representatives (Healthwatch volunteers and staff) visiting 19 care homes across Rye and Rother (12 specifically for people with a learning disability and autism and 7 for older people) with the goal of exploring two lines of enquiry:

1. Assessing the degree to which residents are supported and enabled to access the local community and any issues related to being in a more rural setting.
2. Identify the levels and ways in which residents are actively supported and enabled to access healthcare support and healthcare professionals and whether there are any issues related to being in a more rural setting.

Semi-structured discussions were held with residents, managers and the staff of the care homes using questions developed in collaboration with representatives of the East Sussex Registered Care Association.

What we found

Our Enter and View of Care Homes in Rye and Rother identified:

• The residents we met stated that they did not have any significant issues about access to health and social care services, with the exception of dentistry.
• Residents preferred face-to-face meetings with health professionals, and this is what generally happens.
• A few care homes had a dedicated phone number and email for the GP surgery, and this enabled quicker and better access to healthcare services and support. This enabled prompt access to support, without the need to work through the main switchboard at GP practices.
• Examples were identified where residents with a learning disability and autism experienced challenges in accessing healthcare at hospitals.
• Feedback from care home staff was that people with a learning disability and autism had not been given priority for the Covid booster vaccine.
• Care homes for people with a learning disability and autism reported that some local authorities provide additional funding specifically to enable the service to support
  people to access the community, whilst others did not provide such additional funding.
• The biggest challenge for care homes in rural areas is the lack of an effective public transport system, which impacts staff recruitment, limiting the pool of available staff. Some care homes had taken proactive steps, such as providing additional transport, to ensure that they were able to recruit and retain staff at their establishments.

Each Care Home received a report outlining the key themes identified by authorised representatives in that setting. The findings and trends from across all of the Care Homes visited were collated and used to develop the attached summary report.

Our recommendations

Our report identifies five recommendations, all focused at sustaining positive improvements in Care Homes in Rye and Rother, including:

1. As part of the Enhanced Health in Care Homes programme, Primary Care Networks (PCNs) could ensure that all GP practices provide regular contact with all care
   homes in their area, with this being either by a visit or a phone contact. Consideration could also be given by GP practices to provide a direct phone line or method of contact for care homes.
2. Healthwatch East Sussex should investigate with the hospital trust in East Sussex whether they have specialist support systems in place for when people with a learning disability and autism visit the hospital. If the trust does not have any such system, then they need to consider how they can best meet the needs of people with a learning disability and autism.
3. NHS Sussex Integrated Care Board should consider how they can ensure that adequate and appropriate NHS dentistry services are provided to care homes to support oral health.
4. Healthwatch East Sussex should liaise with the Flexibus service commissioned by ESCC to ascertain how it can meet the needs of people (residents and staff) in care homes in rural and isolated areas.
5. East Sussex Adult Social Care should review their funding mechanisms to ensure that they provide additional funding to enable services to support residents to access the community, if such funding is not already provided. Within this, consideration should be given to additional weighting for care homes in rural or geographically isolated locations.

Next steps

As the public champion for local health and care services, Healthwatch East Sussex will continue to work in partnership with commissioners and providers to monitor the experiences of patients and the public in accessing health and care services locally and explore how ongoing improvements may be delivered.

We will share the attached report with East Sussex County Council, NHS Sussex, East Sussex Registered Care Association, Healthwatch England and others to share this insight and encourage its incorporation into future initiatives.

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