People in Somerset will be given a strong voice to air their views on health and care services in the county – thanks to plans by Evolving Communities, the new provider of the local Healthwatch service. After a recent tender process, Somerset County Council appointed Evolving Communities to provide the local Healthwatch service from 1 October 2017. Evolving Communities, the parent community interest company of Healthwatch Wiltshire and Healthwatch Gloucestershire, plans to increase opportunities for volunteers, support the introduction of digital technology to help people find information about health and care, and continue to involve local people in shaping their health and care services. As well as setting up a scheme to involve young people in health issues, Evolving Communities plans to have more of a focus on research and increase collaboration with health and care providers and commissioners. An office in Somerset will be opened to ensure there is a local presence and the well-known Healthwatch Somerset brand will remain the same. There is an invitation to local people who have been involved in the work of Healthwatch Somerset so far to continue with that involvement. Chris Graves, Chair of Evolving Communities, explained: “The role of a local Healthwatch is to make sure the health and care system in the area meets the need of the people who use it. We gather feedback from patients and their families on services such as GP surgeries, care homes, hospitals, mental health services and care. “We then take these findings to the organisations which plan, pay for and deliver health and care services. We have great experience in this area and are delighted to have the opportunity to work with the people of Somerset under this new contract. “We are looking forward to building on what’s been achieved so far and working with local people on the health and care issues which matter to them the most.” Cllr David Huxtable, Cabinet Member for Adult Social Care at Somerset County Council, said: “We are pleased to award the Healthwatch contract to Evolving Communities. It is so important that we hear about people’s experiences of health and social care services in Somerset and that feedback is used to make improvements to local services. “We look forward to working with Evolving Communities and learning from their experience of delivering similar services in other areas. Together we can deliver real change for the people of Somerset.”

Members of this support group run by the Parent Carer Forum shared their concerns and experiences with us. Many of the group had common issues with assessments and having their needs met at GP surgeries. Key findings The group agreed that patient environments need to consider the needs of those with sensory processing, communication or autistic spectrum conditions and that often, a health professional understanding of these conditions needed to be enhanced. It was also thought that GPs needed to clearly identify their carers’ champions, and ensure they had the skills and knowledge to support carers. In addition more awareness of autistic spectrum disorders was needed by front of house GP surgery staff. The group were keen to be supported by us to gather more information about these issues from the group, and other similar groups around the county with the aim of reporting the issues and recommendations to the Clinical Commissioning Group and the Health and Wellbeing Board. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

Our report following a visit to Somerset Court, which provides residential and support services for people who have autism. A key priority laid out in our work plan for 2016/17 is to engage with people who have a learning disability. The service is located close to the village of Brent Knoll near Highbridge. There are six purpose-built houses set in 26 acres, which operate as independently registered residential homes for people with autism. Recommendations That plans to partition the large communal space at Lakeside House are considered. It would be useful for the manager of Blackdown House to visit Knoll House which had lots of plants, visual timetables for the customers to see near the door, gardening opportunities and a very welcoming environment. To explore opportunities for the horticultural and woodworking areas to make, grow and sell products to the local community. Somerset Court contact ‘Reminiscence Learning’ who coordinate the Archie project to explore if this can be adapted. Local NAS branches may also be able to help. That individual menus are considered to further support the development of independent living skills. Planning for future sharing opportunities between houses would bring benefits to all houses. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

We engaged with members of the carers support group who meet monthly at the GP Medical Centre in Ilchester. We informed the group about our work and role of Healthwatch, and listened to their queries and concerns about the health and social care services that they use. We also introduced our survey on ‘How Connected are You?’ Key findings Three people said that there are long delays getting carers assessments. The group co-ordinator also added that she has chased a number of assessment referrals stating they are urgent, but has not heard back. We were informed that sometimes people die due to the long waits which are often 10 weeks and on occasions longer. Carers at the group said that many people won’t ask for an assessment until they are at crisis point and often carers don’t realise they have reached this point until it is too late. Having to wait another 2 to 3 months just for an assessment is unacceptable. The group co-ordinator noted that safeguarding referrals are also not working well. There are often long waits before anyone gets back to them, and sometimes the staff don’t seem to know what to do with the referrals. The co-ordinator commented that she referred a case where it was suspected the daughter of elderly residents was physically abusing her parents. Despite having followed up several times requesting the referral be treated as urgent, the matter is still ongoing and was first reported in October 2016 (7 Months ago). The commentator believed this was in part due to new staff. Three carers reported problems going through the Continuing Health Care Assessments (CHC). One commentator said that her mother ticked all of the boxes but was told that they wouldn’t qualify and the assessment would be a waste of time. More guidance on assessments eligibility and how to access them is needed. Feedback about Summervale GP Surgery in Ilminster was generally good, and two carers praised the nursing and dispensary. All at the group said getting an appointment was generally easy. One carer commented that they had had poor advice from a GP about mental Health. Bracken House Mental Health Unit also received good feedback from one carer while another carer had experienced delays in being referred to a dietitian of two months, and thought that the care workers were overloaded with caseloads. Carers were concerned that paying for care would bankrupt them. One carer noted it was £67 for a sitter per half day, and that they could no longer participate with meetings where they gave feedback and input to Carers Voice UK. One carer commented that the ‘This is me’ form from the Alzheimer’s Association designed to give important information about patients who have dementia when they go into hospital is great. However, her husband who has Dementia went to Musgrove Hospital last year, and although the form was noted in the nurses records it was not displayed by the bed which resulted in serving staff and porters not treating her husband in the best way, for example, food was placed on the wrong side and her husband struggled to eat it due to a disability. When she raised this with PALS she was told that it is data protection that prevents the form from be displayed. Commentator noted this led to poor care. One carer noted that she had a 12 week wait for referral to the Somerset Partnership’s continence service. She had to use her attendance allowance and pension to buy incontinence pads. When they were eventually prescribed her husband had an allergic reaction to them, and she was told these were the only ones available from the service and she would have to buy others herself. Other carers echoed that finding time to find information out (such as which continence pads to buy) takes time and effort that people who are caring often don’t have. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

We engaged with members of the carers support group who meet monthly at the GP Medical Centre in Martock. We informed the group about our work and role of Healthwatch, and listened to their queries and concerns about the health and social care services that they use. We also introduced our survey on ‘How Connected are You?’ Key findings It can be difficult to get through to the GP Surgery at South Petherton. One member of the group commented that they had felt unwell and called the surgery and described her symptoms as being headache, muscle spasms and weakness, which are symptoms of a stroke. She had to wait two hours for an appointment with GP. The GP asked for an ambulance to be called immediately once he had seen her. However the phones at the GP were not working and a further delay was incurred while he had to get reception staff to contact 999. Husband has ongoing health needs and his care plan states that if he needs an ambulance from home he must be taken to Musgrove Park Hospital. Despite this an ambulance took him to Yeovil District Hospital. The care plan was not followed and the commentator asked why was the ambulance service not notified of the care plan and the need for her husband to be taken to Musgrove. Delays at Yeovil District Hospital were then incurred while transport was arranged. A group member commented that they had driven to Dorchester Hospital for an operation, but once they arrived she was informed that they could not do the operation as Musgrove Park Hospital had not sent her records or medical notes. A group member said that their partner was discharged from Yeovil District Hospital being told that they would need a weekly ECG at their GP surgery in South Petherton. This was not communicated with GP surgery. A member of the group was pleased that the heart failure team at Musgrove Park Hospital telephoned them regularly to monitor and advise on their partner’s heart condition. Two members of the group said that we were always very good at getting back to them and had understood their concerns and provided useful information about signposting. One group member reported that while their partner was being treated at Musgrove Hospital recently there was only one shower for 24 patients and staff were too busy to assist her partner into the shower. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

We engaged with members of the carers support group, who meet monthly at Quantock Vale Surgery, Bishops Lydeard. We informed the group about our work and role of Healthwatch and listened to their queries and concerns about the health and social care services that they use. We also introduced our survey on ‘How Connected are You?’ Key findings There were problems with information being available to hospital staff and information being lost: One member of the group reported that they were in being treated in Musgrove Hospital for some months and had been transferred to Dene Barton Community Hospital. They were discharged from Musgrove at 11pm and when they arrived at Dene Barton the staff did not know any medical history or care plan. When staff phoned Musgrove Hospital to get an update as to the patient’s care and treatment it was quickly established that they would not be able to treat him and he had to be returned to Musgrove hospital. Another member of the group reported important information about her husband’s care and treatment was not communicated to staff at Yeovil District Hospital. She had complained, but got no response. The group had been made aware that Compass Disability would not be continuing with carers support groups or services after September 2017, and that the Community Council for Somerset would be taking over the services. Members of the group were concerned that it had not been confirmed if the support groups would continue under the new service. A member of the group reported that a district nurse who was treating a neighbour had assessed that the patient was too ill to be left and had asked her as a neighbour to stay with him as she had to go to another visit. The commentator did not know the neighbour or what risks were involved and felt it bad that they were asked as opposed to a professional. They felt this potentially put them and their neighbour at risk. One member of the group commented that they had received good signposting from the Symphony Project which has now expanded to Taunton. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

We visited the Hearing Voices support group in Taunton to introduce our work and the role of Healthwatch and to listen to any issues or concerns the group wanted to discuss. Key themes Not knowing where to find help to get a job. Needing support to access support. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

We attended a meeting of representatives from SSAFA (Soldiers, Sailors, Airmen and Families Association) to introduce our work and the role of Healthwatch, and to hear their comments, issues and concerns. Key findings Several members of the group raised concerns about the way that universal credit is processed and these are detailed in this report. Others noted problems incurred by long waits for Occupational Therapy assessments. Universal Credit processing often results in customers being up to 7 weeks in arrears by the time the first payment is received. We heard concern from case workers that new claims from April 2017 of Universal Credit will be limited to only two children which will leave larger families worse off. From April 2017 couples consisting of one person of working age and one person who has retired will see changes that could mean the couple will be significantly worse off. This is because a change in procedure means only the younger working age partner will be able to claim which will result in other pension benefits not being received. Case workers for SSAFA reported that there is a 3 month wait for occupational therapy assessments. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

We consulted with members of the Somerset Polio Support Group to document the care they receive from the NHS in relation to their condition, at both primary and hospital level, in order to raise the understanding of PPS with NHS health commissioners. Conclusions The majority of responses indicate the lack of GPs understanding of PPS symptoms and treatment available to support patients and some reluctance by GPs to learn more. The members’ response to this is to find out about PPS themselves and then try to gain GPs confidence and understanding to help them gain knowledge and support the patient better or just look after themselves with minimal primary care input. Regional specialists with understanding of PPS are few, so many people attend Lane Fox PPS Clinic at St Thomas’ Hospital in London for diagnosis, and management of the illness. British Polio Fellowship has a major role to play in helping members (and potentially non-members) gain understanding of their health situation and living with it better. Support groups such as the Taunton group are helpful in this area. 63% of members who responded to the project are under 75, 31% of members who responded were in 60’s, so their disabilities and Symptoms of PPS, although some can be related to old age, are affecting them even before and during the early years of retirement. There is evidence of mental stress, depression, feeling of isolation and anxiety caused by the lack of proper and timely diagnosis and lack of willingness of GPs to accept the patient as more knowledgeable than themselves about PPS. The orthotic service seems to need improvement. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

We identified the area of mental health as part of their our plan priorities from 2015-2016. This report summarises the visits that formed part of a wider project running from November 2015 to July 2016. Our Enter and View Representatives visited each of the nine wards in Somerset that provide treatment for people with acute mental health issues. Recommendations The issue of availability of appropriate supported housing is highlighted as affecting timely and successful discharge to patients. We ask the JSNA to share this research with commissioners of supported housing consult on the issue with commissioners and the Somerset Partnership NHS Foundation Trust. We will ensure the Health & Wellbeing board are aware of the issues related to supported housing and successful discharge. Regarding the difficulties recruiting qualified staff and the lack of a university in Somerset and provision to study nursing & mental health nursing in the county; We ask the JSNA to comment on how they will use the information identified in the report and any next steps in addressing or further researching the issue. It is our view that current young person’s education provision in Wessex ward is inadequate and it is recommended that a review of the education service level agreement with the local authority is needed. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286. Enter and View report: Mental health inpatient wards in Somerset Service provider response

In September 2016 we returned to visit this group to find out how their report on Post Polio Syndrome (PPS) was progressing and to hear the key issues identified so far. Key findings Responses to the survey carried out by the group indicated a general lack of GP awareness of PPS Symptoms and treatment. The lack of proper diagnosis of PPS left some members to feel stress, depression and anxiety which can lead to feelings of isolation and loneliness. Concerns about the orthotic service were common among the group and areas that need to improve were identified. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

We engaged with the Burnham-on-Sea Support Group to hear their experiences of accessing health and social care services in the area. Key themes Difficulties in accessing Parkinson's Support nurses. Difficulties in accessing doctor appointments for patients registered with Burnham and Berrow Medical Centre. This report was produced by the previous Healthwatch Somerset service provider, The Care Forum. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.