Resilience within our communities is promoted and people are supported to fulfil their potential by actively encouraging and supporting people who need care and support, including carers, to learn, develop and participate in society
Providing practical and emotional support for carers
Welsh Government’s Strategy for Unpaid Carers prioritises the need to support life alongside caring, which includes the need to provide the opportunity to take breaks in order to support carers’ resilience and their ability to maintain their caring role. Following the Covid restrictions during 2020-21, the Welsh Government Carers Respite Grant for 2021-22 aimed to prioritise support for the increased demand for day centres and more traditional sitting services, whilst also encouraging more innovative models of delivering respite short breaks.
We worked with our third sector carer organisations so that they could enhance their offers to carers, to meet the aims of the grant and emphasising the need to be flexible, and needs-led.
This included additional funding for established sitting services and children’s respite, to support the provision of an increased number of hours. Additionally, a number of flexible and innovative projects were funded.
Credu provide support for young carers, and were able to extend their provision of respite support in more flexible ways according to young carers’ own preferences and circumstances. For some, this meant a greater opportunity to engage in collective family respite, accessing activities together as a group, and creating opportunities for valuable shared time together. For others, this may have meant funding to access individual pursuits that the young carers find beneficial to their personal wellbeing.
Hafal provide support for carers of people with mental ill-health, providing carer assessments and individual support. Throughout the pandemic the need for low-level counselling to help support carers with personal stresses and anxieties has escalated, and a six-week programme was funded, along with wellbeing days and events, according to carers’ own needs. Opportunities to enhance peer support were also achieved via some development of the North Wales Clic web resources.
Carers Outreach support around 1000 carers within Conwy in a wide range of ways, from information provision, emotional support, home visits, low level advocacy, individual and group support and emergency planning.
Through the additional carer respite funding, their offer was enhanced to be able to offer person-centred respite, focused on the needs of individual carers. This may include additional access to traditional breaks like sitting services, family days out, and holidays and weekends away. Recognising that a “short break” can mean different things to different people, the funding was used flexibly to purchase items such as outdoor furniture, tablets, exercise equipment and memberships to clubs such as gyms, golf, or any other form of exercise that carers identify as being beneficial to their wellbeing.
The new Carers Trust dementia centre was also able to extend provision of their ‘Hafan Ni’ group sessions by offering an additional 22 weekly sessions (5 hour sessions) per week from October to March. This regular social interaction is a preventative service, and can provide regular stimulation which can delay a deterioration in the cared for’s mental health and improve the health and wellbeing of the carer. These regular breaks can mean the difference between a carer managing in their caring role or hitting a crisis point.
What were the challenges?
Ongoing Covid precautions were clearly a concern, with providers carefully risk-assessing their activities to mitigate risk. As is often the case with short-term grant funding, timing can be an issue due to factoring in finalising guidance from Welsh Government, engaging with providers, allowing time for Welsh Government to approve plans, and providers reaching out to people to maximise take-up of the offer; all this needs to take place within the boundaries of the current financial year.
What’s next?
Short breaks for carers will always be a priority in our overall carers strategy, as they significantly affect carer resilience. We will also consider the need to move towards more flexible and personalised respite care offers; a continued funding commitment for short breaks would help to ensure this vital priority for carers can be met.
Conwy Family Centres
Despite the ups and downs of Covid restrictions, this year has provided some exciting new opportunities for the Family Support Teams and Family Centres in the five areas of Conwy.
Alongside the usual day-to-day groups and tailored one-to-one support we provide for families, we have been able to develop new activities in response to local needs. Here are some examples:
- We have started a new weekly teenage parents group in the east of Conwy. This has given them confidence in how to look after their babies, and helped them meet and make friends with other young people in a similar situation.
- We have run joint drop-ins with the Youth Service in the north area, which have helped us identify young people at risk of exploitation. We have put on information sessions for parents in the central area to help them keep their children safe.
- We have been able to engage with a hard-to-reach group of parents in a parenting course in Kinmel Bay through working in partnership with the Family Liaison Worker in the school.
- We have established a new baby group, where there has been a ‘baby boom’ in a very rural area, through engaging them in a baby massage course, which now has a focus on wellbeing and peer support.
- We have built stronger relationships with schools in the central area, often supporting schools to engage families, and have restarted face-to-face and virtual drop-ins in schools.
- We have re-established the daily drop-ins rotating around the west area of Conwy, and have added a stay and play element to help engage families.
- During Safeguarding Week, we launched a new information hub for families and communities to raise awareness and prevent Child Sexual Abuse.
- The Assistant Family Worker role has been key to help the teams re-engage families in group activities and increase capacity to provide outreach activities and information, advice and assistance.
- School-readiness is an emerging theme as a result of the pandemic. We worked with partners from BCUHB to launch new child development resources and video clips for parents and carers of pre-school children.
Families have told us that the one-to-one support they have had through their Family Workers has made a truly positive difference:
I feel I now have the confidence to move forward in my life thanks to the Family Centre and my support worker.
The support we have received has been fantastic. This is all very new to us, and we wouldn’t have known where to start with all the things that are available. Our son has started a playgroup as well with the help from our worker, which has helped him so much.
The new Disability Family Worker role has proved to be invaluable. This is a joint venture with Disabilities Services, and sits within the Family Centre teams. The role was evaluated by a researcher in Bangor University this year, and we plan to secure funding to recruit to this role for each of the five areas of Conwy. An example of the group and peer support opportunities is a new ‘Let’s Get Sensory’ group, which provides a friendly and comfortable environment for neuro diverse families.
One family interviewed for the research said:
You feel like you’re failing. This role… I wouldn’t lie, I do wish it had been there two years ago. Cos who knows what the outcome might be now – it might be much different… Without sounding so dramatic, she’s almost saved me.
What were the challenges?
It has been challenging to maintain engagement with families through various restrictions, some of which were an additional barrier to already vulnerable individuals. We have found creative solutions in response to this.
What’s next?
We’re looking forward to being able to put on more group and multi-agency activities in Colwyn Bay as we open up our new family centre, Canolfan Ffordd Douglas, incorporating green principles such as air source heating and solar panels.
Following consultation in 2018 we used a combination of Conwy Capital, Flying Start Capital Funding and the Integrated Care Fund (ICF) to develop a Victorian school in the centre of Colwyn Bay (Central Area). We moved into the building during February and March 2022, and now benefit from the following facilities:
- A fully disabled toilet and shower wet room with hoist
- An activity room with hoist
- A crèche
- Multi-agency meeting and consultation rooms
- A kitchen for group work and café-style activities
- Multi-agency work spaces
We are engaging with services that can support families and use our new space, and already these have included; Youth Service; Libraries and Culture; Domestic Abuse service, and some third sector organisations.
Next year also brings exciting new developments in Eryl Wen, the Family Centre in Llandudno, which is currently being refurbished. Work started in February 2022, and is planned to be complete by July 2022. Works include making better use of the space for groups and courses, opening out to the garden area more, and additional rooms for families to meet with various services and family workers, and additional parking.
Autism Code of Practice
Autism is a lifelong condition which presents a wide spectrum of need. On average 1 in 100 people in the UK have a diagnosis of ASD (Autistic Spectrum Disorder). 40% of people who have a learning disability also have autism. In Conwy, that represents approximately 1,250 people.
The first Autism Strategic Action Plan, first published in 2008, created a local authority infrastructure which was supported by funding from the Welsh Government. Each of the 22 Welsh local authority areas has an autism local action plan which is developed, implemented and reviewed by a local stakeholder group. In addition, each local authority has an ASD Lead Officer. The ASD Lead Officer’s role is central to the delivery of autism services at a local level by bringing together professionals to work collaboratively in local authority areas as well as providing a local point of contact for both autistic people and families/carers seeking support.
The current ASD Lead Officer in Conwy is the Disability Service Manager, whose service spans both children and adult services.
The ASD Lead Officer has a wide range of roles and responsibilities some of which include increasing awareness, knowledge, acceptance and understanding of autism among the public, and across public, private and voluntary services. The role also includes:
- Working with local authority training departments to identify any staff training needs.
- Ensuring that practitioners carrying out needs assessments and assessing an autistic individual’s eligibility for social care support has sufficient knowledge and skills to understand the impact of autism.
- Signposting parents and autistic individuals to appropriate support.
In addition to the role of the ASD Lead Officer, Conwy has developed a Code of Practice on the delivery of Autism Services. The Code of Practice clearly sets out the duties and responsibilities on the Social Care service to support individuals with autism and their families.
Community Wellbeing sessions
The Community Wellbeing team have provided a wide range of both virtual and in-person sessions during the reporting period. Online provision included exercise sessions, cultural activities, such as arts and crafts, wellbeing sessions to support people with their mental health, and some really helpful information sharing sessions. Between April 2021 and January 2022 the team offered over 20 different topics, including:
- Line dancing and Bollywood dancing
- Singing
- A regular monthly self-care session in partnership with Cartrefi Conwy
- Seated exercise and yoga
- Preparing for Winter sessions, in partnership with Welfare Rights and Groundwork for Wales
- Stepping Out With Confidence course
- Food is Fuel sessions
- Astronomy
- Internet Security, in partnership with Digital Communities Wales
Once Welsh Government guidance permitted the team to deliver in-person sessions, we arranged a variety of walks across the county in areas such as Llanrwst, Llandudno, Kinmel Bay, Llanfairfechan, and Colwyn Bay. In addition, we set up physical exercise programmes, including Seated Qigong, Zumba Gold, and Tai Chi. Between April and January we delivered 111 sessions which were attended by 800 individuals. We have included some case studies in this report to demonstrate how impactful these have been.
What were the challenges?
- Not all individuals with access to a digital devices were confident enough to use them in order to access our online sessions. We responded by setting up an over-the-phone digital support service to help anyone who was struggling.
- Reacting to changes in government guidance at times resulted in some in-person sessions being cancelled, and the team needing to respond quickly to increase online provision to ensure a good variety of wellbeing sessions were still available.
- Planning of in-person sessions took longer as the team needed to ensure that all protocols were in place, and that all planned activities were thoroughly risk-assessed for the safety of all those attending.
- In order to adhere to social distancing guidelines, all in-person sessions were advertised as booking only, and a limit set on the number of people able to attend. Where possible, additional sessions were arranged for those which were oversubscribed, in order to accommodate as many people as possible.
What’s next?
New online sessions are planned for the rest of the reporting period, including Posture Alignment, Strictly Fitsteps, Pilates, and Singing for Lung Health.
New in-person sessions will include historical walks in Conwy, Deganwy, Colwyn Bay, and Rhos on Sea. We’ll be holding reminiscence sessions for people living with dementia, and their carers. We’ll be Singing for Fun in Llanrwst, Having a Natter in Rhos on Sea, enjoying a team walk from Trefriw to Llanrwst and a Biodiversity Walk in Llandudno. For St David’s day we made peg dolls at the Llandudno Museum.
Case Study: Tai Chi in the Park
A lady in her 70s saw an advert on Facebook for our free sessions in Pentre Mawr Park and thought it would help with her restricted mobility following a hip replacement. She also suffered from a range of respiratory problems and had been shielding during the Covid-19 pandemic. One of our Community Wellbeing Officers kept in communication with the lady throughout the course to check on her welfare and to share information on any other relevant groups and courses.
Osteoarthritis and respiratory problems can be quite debilitating, however these can be helped with movement and having a purpose. The Qigong class offers both, alongside controlled breathing techniques. The sessions have also helped her to increase her social circle, and she has enrolled on the next six-week indoor Tai Chi course. The lady has provided us with some feedback on her experience and the benefits of joining the class:
I thoroughly enjoyed it, it was absolutely brilliant and really relaxing! It benefited me mentally and physically but also socially. I have made new friends. From the original group in the park, we have met up for coffee, we have spoken to others who would also like to meet up for coffee. I felt energised and positive after each session. I seriously think that if more people who have pain or are lonely should reach out and join this type of group it would be really so beneficial to them. Thank you!
It was so lovely meeting new people and I have learned a lot. I hope we can have some more sessions like this. It made such a difference to my life.
Case Study: Zoom Sessions
A lady in her 60s has struggled with various health issues, including high anxiety and depression. Her husband also has health issues, and recently a close relative has been diagnosed with dementia; both feel very worried and anxious.
The reduction in community-based activities and groups due to Covid-19 exacerbated her mental health and anxiety issues and reduced the number of opportunities for social interaction.
One of our Community Wellbeing Officers kept the lady informed about suitable sessions as they became available. As a result she signed up to a number of online activities. She also received digital support in order to become more confident using Zoom.
The regular sessions gave the lady a positive focus and she experienced less anxiety. She knew that the sessions would be taking place, regardless of the weather, and this gave her something positive to look forward to without getting anxious that it might be cancelled. Her social circle increased as she met new people in the group and kept in touch with some of them after the course came to an end. Encouraged by one of her new friends, she got back to sewing and also started painting flowers, something she finds very relaxing.
Carers Week activities
As part of National Carers Week the Community Wellbeing Team and Carers team arranged two sessions for carers, an in-person walk along the promenade in Llandudno and a virtual self-care session via Zoom.
Both sessions were positively received, with one lady who joined us on the walk saying that:
It was so nice being able to walk with others, especially people who cared for their loved ones like me…..we had lots in common to talk about.
Another lady who came said that she had really enjoyed being able to do something with her Mum whilst having the company of others, and at the end stayed to chat and have coffee with one of the other ladies, which was nice to see.
Over the past six months, over 40 carers have attended a range of online and in-person sessions organised by the Community Wellbeing Team.
What are the challenges?
Again, not all individuals with access to a digital device were confident enough to use it in order to access the online session; the Community Wellbeing Team offered over-the-phone support to enable carers to participate.
What’s next?
The Community Wellbeing Team continue to support carers with their ongoing programme of activities, both online and in person.
New sessions for carers currently being planned by the team include:
- Bringing back the Virtual Dementia Bus to Conwy on 2 August 2022.
- Getting Back Out There sessions for carers of those living with dementia.
- Making a Fidget Cuff session for carers and those living with dementia, in partnership with the Llandudno Museum.
Summer of Fun and Winter of Wellbeing activities
Summer of Fun ran from 1 July until 30 September 2021 and provided a range of free leisure, recreational, sporting and cultural activities for children and young people aged 0-25 to help support their social, emotional, physical and mental wellbeing.
The event had three main objectives:
- Supporting fun and the opportunity for children and young people to express themselves through play.
- Community-based interactive, creative and play-based initiatives for all ages.
- Providing opportunities for children and young people to play with friends and peers.
In Conwy, 29 projects were offered through a variety of third sector organisations, private providers and through various Council services, including Social Care, Education, Libraries, Leisure, and Youth Services.
A wide range of activities were offered, including outdoor adventure sessions, indoor fitness activities, play sessions for 3-11 year olds, activities for foster children, family activity sessions for children with learning disabilities, golf and other sporting activities in rural locations. We offered inflatable sports sessions, outdoor cooking, tennis, arts and crafts, Lego play sessions, yoga, ski centre activities, stone balancing and land art, science workshops and much more.
In total, 1,959 attendances were recorded across all sessions. The feedback from children, young people, parents and staff members was very positive, highlighting the important benefits that these activities have made towards families, particularly following Covid-19 restrictions.
Thank you for the opportunity to do the summer of fun. The kids and parents have had a blast. It’s been lovely to see friendships grow through the activities and families try different activities they never would have thought possible.
Staff member from Conwy Connect
In relation to the various art and culture activities for families we received some positive comments:
Awesome time!
Little boy really enjoyed, thank you.
My children loved it.
Great couple of hours’ fun.
My children loved it, they had a great afternoon, diolch yn fawr.
Participants
We had good positive feedback from parents in general but I think it was because they were just glad to get out and about after a tough few months and were really appreciative of all the creative activities. The same goes for our facilitators as many freelancers hadn’t been working so were really happy to get back out a deliver some brilliant sessions.
Staff member from CCBC
What were the challenges?
Additional funding was provided to run a similar programme of activities under the name ‘Winter of Wellbeing’ from October 2021 and over the winter period. The Welsh Government grant guidance was finalised in December and so this presented some challenges in confirming the programme agenda to ensure all activities would be within the grant criteria.
In order to create a varied programme of activities for various age groups and abilities we needed to work with many partners to reach potential providers who could contribute to this programme of activity, whilst ensuring variety and good distribution of offers across the county.
Other challenges experienced by the providers included marketing, in order to publicise their events to maximise take-up.
What’s next?
We now have a more established database of providers to draw on for future programmes, together with valuable information about which activities were in high demand. We also have feedback from children and their families which will help influence decision-making when creating programmes of activities in the future.
Dementia Services: Dementia Support Workers
Intermediate Care Funding has afforded us the opportunity to increase the number of staff we can dedicate to dementia support in Conwy and to this end we have appointed five dementia support workers to support each one of our five Community Resource Teams (CRTs).
These individuals accept referrals from any member of the Multi-Disciplinary Team. There is no formal eligibility criteria for their services and they have a lot of autonomy. This makes the role quite unique through the flexibility of how an individual living with dementia and their informal carers are supported. The support offered is not determined by time and task, nor is it time-limited, instead it focuses on the outcomes identified. Within some families they are the lynchpin that keeps everything on an even keel.
The Dementia Support Workers have a good knowledge of what support and community activities are available in their local area, enabling and encouraging individuals to remain involved and be a part of their own community, to achieve ‘what matters to them’ and to live well with their dementia. They also have links with other organisations within the local community such as the Alzheimer’s Association, Carers Trust, Men’s Sheds and with wellbeing events and activities. They are also able to set up community groups when a gap is identified, such as a Knit and Stitch group established in our rural area CRT.
Supporting individuals and their informal carers to access training was identified as a key objective of the role, and this has proven to be very important, especially as spouses find their role changing within a relationship to that of a care giver, often in later life. As an example, families have been supported to access the virtual dementia experience on the travelling Dementia Bus.
They have provided support to individuals during formal assessment, during the safeguarding process and at memory clinic appointments. This has proven to be, at times, key to achieving a positive outcome for people.
The role is also key in supporting the carers as well as the individual; their support has been valued and has proven to be a success as the support worker has been able to form a respected and trusted relationship with the individual and their wider family.
By supporting carers to acknowledge the good work they are doing and increasing their confidence, we make a difference in how they feel about their caring role.
The Dementia Worker has access to technology which can support people to remain independent in their own homes. They are able to loan equipment such as an iPad and Alexa, allowing time to assess the benefits to the individual.
What were the challenges
The temporary nature of the funding made the initial recruitment into the posts challenging but as this has now changed to recurrent funding, we have been able to make the five posts permanent.
As involvement of the Dementia Workers has become valued to individuals, their informal carers and the CRT, they are sometimes not able to withdraw their support, therefore they are unable to take on new referrals. Through joint working, utilising technology, and working with the third sector and the community to source alternative support, we have been able to resolve the problem.
Technology can assist individuals to live independently and well with their dementia, for example GPS, Alexa devices, and digital clocks. Unfortunately many individuals do not have WI-FI access at home to benefit from tablets etc. and this can be a barrier to accessing many services which could relieve some of the carer stress.
What’s next?
To continuously improve and develop the service we ask individuals and their carers to complete quality monitoring forms from which we can learn and improve.
Feedback received from members of the CRT suggest that the Dementia Workers have become integral team members, and being accessible by all has worked well, especially the fact that they are autonomous with no eligibility criteria.
As this has been a new concept and job role within Conwy we have had to learn as each new challenge presented itself.
Case Study
Our involvement with X and her husband provides routine and consistency. This helps her as she prefers things to be done in routine and to be at the centre of her care. Her husband, and primary carer, needs the support, and he values my visits. He appreciates that I am there to support and to signpost, as he finds life in general to be hard. X has a range of complex medical needs and I have supported her, and her husband by facilitating appointments with them.
X’s dementia is very challenging, and makes her dependant on her husband. I am able to provide emotional and practical help and support for them both, which has helped to avoid carer breakdown and the need for any social care interventions so far.
Dementia Services: Dementia Support Team
Intermediate Care Funding has also enabled us to test the concept of a more flexible approach to delivering care and support in the community for people living with dementia, and their carers.
The Dementia Support Team, comprises of eight support workers who provide flexible, personalised outreach support using a “team around the individual” approach from first diagnosis, enabling people to live well with dementia, within their own homes. This includes adults with early onset dementia, including those with learning disabilities, and is provided bilingually according to the choice and preference of those using the service. The team provides an element of community navigation (signposting to other services) and advocacy support for people with dementia and their carers. The team is also skilled and competent to deliver delegated healthcare duties, e.g. taking blood samples. The team acts as a key point of contact for families, to help them navigate the complex health and social care system.
Flexibility is key; workers will respond to need and don’t provide support according to rotas. They provide extra support for those where traditional domiciliary care is failing, and more flexible support is needed to maintain independence.
The team has enabled people living with dementia to maintain their independence and remain at home, avoiding unnecessary admissions to hospital or residential care, and delaying the need for such services. They have also reduced delays when someone is due to be discharged from hospital. Within the local context, this means a reduction in incidences of Delayed Transfer of Care from the psychiatric hospital, with reduced use of out of area placements, thus reducing disruption and distress for families and with associated savings in placement costs. It is anticipated that this more effective support for carers of people with dementia will impact positively on carer resilience and reduce crises.
What were the challenges
Again, the temporary nature of ICF funding has made recruiting to the team extremely challenging, and we have never been able to appoint into every position.
The past two years has impacted severely upon our plans to trial a more flexible service at our Elderly Mentally Ill residential home (Llys Elian) and link it with the work of this team. We had hoped the team could access overnight and day respite at Llys Elian as needs escalate, but due to Covid restrictions across the care home sector, we have not been able to progress this at all. Regardless of this, the team itself has had a positive impact on some individuals’ lives.
What’s next?
We have recently been advised that funding will be recurring, and this will hopefully help with recruitment issues into the service. We also anticipate that, as Covid restrictions are relaxed, that we can progress with the plans to enhance the links the team has with the services currently provided at Llys Elian, which in turn, will help inform the future service delivery model provided here.
Bwthyn y Ddôl
As part of the regional vision for seamlessly locality based services and in response to “A Healthier Wales”, the Peripatetic Multi-Disciplinary Team and Assessment Centre, Bwthyn y Ddôl is a key transformation project for the central area of North Wales undertaken with Conwy County Borough Council, Denbighshire County Council and BCUHB.
The multi-disciplinary team is a short-term (12 week) multi-professional therapeutic assessment and intervention team. At the end of the 12 weeks there is a detailed formulation for the family and the referring agencies. The team work collaboratively with the families to understand their child and create positive change in the way families function with a goal to;
- The child/children to remain at home safely.
- The child/children to return home or to a family members home safely.
- To help inform and guide appropriate alternative plan for the child/children when retuning home is not appropriate.
All while enabling parents to transform their parenting skills in order to meet the needs of their children.
Management data and interviews with parents suggested that once a referral had been accepted, the Bwthyn Y Ddôl team were able to respond within a matter of days. A rapid response was vital in many cases, as family care was at the point of breakdown or had already broken down.
In the period from April to December 2021, the team has delivered 69 consultations, 189 evidenced-based interventions, and a total of 878 weeks of care avoided.
What were the challenges?
The Covid-19 pandemic has caused disruption to the service due to the risk assessments preventing face to face consultations, along with cancelled appointments due to staff and family members needing to self-isolate.
The planned Children’s Residential Assessment Centre (Bwthyn Y Ddôl) is an integral part of the Multi-Disciplinary Team model. The build was has been delayed and is now expected to be operational in the summer of 2023.
What’s next?
The provision of the Children’s Residential assessment Centre (Bwthyn Y Ddôl) is an integral part of the MDT model and an interim Centre is being sought to provide an interim assessment Centre, until the construction is completed.
The team have started well. The model of care is embedded with multi-agency working at its heart and there are promising indications that children, young people and families are beginning to experience positive changes in their lives. The MDT will continue to develop their skills and deliver interventions to cohorts of children, young people and their families who had not been well catered for in the existing system of health and social care services.
