the cit: community innovations team. cit – an integrated team cit hcc adult services voluntary...

The CIT:

Community Innovations

Team

CIT – An Integrated team

CIT & HCC ASD’s “Hampshire Model” 3 Core Themes to The Model:

• Self Directed Support (mainly long-term)• Crisis care & re-ablement (acute)• Prevention & Early Intervention – “PEI” (maintaining well-being, preventing deterioration)• CIT is located in PEI, which is located within

“Wellbeing & Partnerships” within HCC Adult Social Services (ASD).

CIT & The Universal Offer:• Access to quality information & advice• Access to everyday life• Active citizenship• That ‘little bit of help’ to manage own health

& wellbeing

Wellbeing & Partnerships - Vision

• A single network of support - with an early intervention and prevention pathway - for people who require support but who are not in the care system.

• There are a wide range of services currently in existence without which the only option for many older people would be care services

Eligibility• Older people in the Community over the age of 55

years• Struggling to maintain their independence, or• Require some support to lead a fulfilling lifestyle• Who are not in crisis • Not in receipt of statutory support (not FACs eligible)

Increasing independence

CIT involvement

No need

Low need

Moderate need

Substantial need

Critical need

Who Do CIT Work With?

What We Do

Increase Independence

Improve Health and Wellbeing

Early Intervention and Prevention

Reduce Risk

Multi – Disciplinary Team

OT

CDW

SW

CSW

LinkNurse

Occupational Therapist• Wellbeing Assessment• Create support plans with client• Equipment and Adaptations• Anxiety Management• Memory Work• Meaningful Activity• Signposting• Links with Adult Services and Health

Social Worker

• Wellbeing Assessment• Create support plans with client• Housing & Benefits• Grief Work• Social Interaction• Carers• Signposting• Care needs; links with Adult Services

Community Support Worker• Hands On • Turn support plan in to reality• Establish rapport with the client• Build Confidence• Graded support to attend social activities

Council of Voluntary Service (CVS)– Community Action Fareham

– Gosport Voluntary Action• Support for voluntary and community groups• Provision of services: Dial-a-Ride;

Shopmobility; Home-Helps; Gardening; Befriending; Car Schemes

CIT and OT Direct

• Don’t Quite Meet Eligibility Criteria• Unable to Fast Track• ‘Just Not Sure’ Referrals• Memory Difficulties or Anxiety• Socially Isolated and Lonely• Limited Meaningful Activity• Employment and Volunteering

Case Study

69 years old

Low mood

Mobility difficulties

Lives aloneOPMH referral

Bathing

Lonely

Re-housing

Adoption services

Sensory needs

Key Findings

• Socially isolated.• Low in mood.• Concerns re housing

• Couldn’t manage shower or bed transfer

• Mobility difficulties.• Information required on POA.• High risk sensory needs. • Emotional support due to adoption.• High risk of falls.

Support Plan - CSW

• Shower board and bed lever • Pendant alarm/Telecare• Low mood management/liaison with OPMH.• Medication management.• Meaningful activity – books and banter, art classes• Contacted In Touch – Home Improvement Agency • Sensory referral• Adoption services- accessing records• Finance advise- POA.• Falls assessment.• Environmental health support.• First Wessex referral- ongoing support

Fareham and Gosport CIT

• Covers all local authority areas• All GP practices within the council boundaries• Referral from any source, self-referral,

voluntary, relative and via Hants Direct • Client permission & agreement essential

Fareham and Gosport CIT• Average age referral 75• Referral source ,self/adult services and partners in

health• Average support plan provided four or more services

ranging from :-• OT Support, Domestic and support services,

Voluntary services through driving, support with groups and clubs/social interaction, exercise groups

• Referral to statutory services/GP/mental health services

Further Information & Contacts

• Simon.Crouch@hants.gov.uk PEI Manager – South & East Tel: 07590 774265 / 01962 832174 • CIT Fareham: Tel: 01329 514116 Based at Fareham Reach on A32 (Fareham Adult Services Office)• Jenny.Wilford@hants.gov.uk: Team Leader Social Worker (F&G)• Cathy.Guernier@hants.gov.uk : Occupational Therapist• Katie.Clements@hants.gov.uk : Community Support Worker• CIT Gosport: 02392 432001 • Based at Gosport Adult Services Office, Stokes Rd, Gosport• Jenny.Wilford@hants.gov.uk: Team Leader Social Worker (F&G)• Sophie.Litchfield@hants.gov.uk: Social Worker• Lindsey.Hay@hants.gov.uk: Community Support Worker• Alice.Fenlon@hants.gov.uk: Occupational Therapist

Any Questions