1. Changing Lives Induction Jenny Atkinson Innovation, Organisational and Community Development Manager

2. Welcome Aims : For all staff to have a greater understanding of how their role and their team fits into the organisations overall aims and objectives and forms part of the Age UK Cornwall jigsaw For all staff to have an understanding of the organisation and be able to reflect on their own behaviour in relation to the values of the organisation. Agenda: Introductions Who we are and What we do How and why do we do what we do? How do we continually improve what and how we do Format: informal, discussion based, consolidation, refreshments, time Housekeeping:

3. Mission Statement “ working to improve the wellbeing of people in later life”

4. Age UK Cornwall & The Isles of Scilly Organisation Chart

5. Care Services Organisational Chart

6. Working with Volunteers – Why?

7. Why do we do what we do? Human Rights Mental capacity Equality and Diversity Person Centred Thinking Safeguarding Vulnerable Adults

8. The Context Person Centred approaches Human Rights Mental Capacity ActEquality and Diversity

9. Refreshment Break

10. Living Well

11. It starts with a conversation…………

14. Shifting Dependency Person Family and Immediate friends Community and neighbourhood e.g Social and recreational Groups Church / Religious Groups Common Interest Groups Health and Social Care providers in ongoing relationship with client e.g Community Health staff - Community Nurse, CPN ASC staff - Case Co's, Key Workers Formal carers Short term health and Social care / formal interventions e.g. GP Hospital staff MCST Balance and Stability / Falls prevention Exercise Classes Expert patients programme Active Plus community Courses Independence Model to show ‘normal’ relationship of person to their health and well being providers

15. Acute Dependency Model to reflect changes in relationship to care providers during short term acute illness. Person Family and Immediate friends Community and neighbourhood Health and Social Care providers in ongoing relationship with client Short term health and Social care / formal interventions

16. Rehabilitation Model showing relationship to care providers during rehabilitation in the community. Person Family and Immediate friends Community and neighbourhood Health and Social Care providers in ongoing relationship with client Short term health and Social care / formal interventions

17. Self Management Model showing role of Voluntary sector services in changing the relationships from health and social care dependency to independence and engagement with own community. Person Family and Immediate friends Community and neighbourhood Health and Social Care providers in ongoing relationship with client Short term health and Social care / formal interventions.

18. What process

19. Health and Care Coordination What is the role of the Living Well coordinator ? Keeping the person’s goals at the forefront of health and care planning Multidisciplinary teams and care coordination Complex situations v non complex Extending the value base The importance of communication Gaining consent

20. No patient personal or medical information shared at this point Person is offered a referral to Living Well and gain consent to share relevant personal and medical information with Living Well Coordinator Offer accepted. Offer declined. No further action Practice phones person to offer a referral to Living Well Coordinator and gains consent to share relevant personal and medical information with Living Well Coordinator Practice writes to person to offer referral to Living Well with opportunity to opt out of referral and consent to share relevant personal and medical information with Living Well Coordinator Person Proactively Identified by Practice Referral to Living Well Coordinator made via Referral Form -template on computer or hard copy or verbal conversation Living Well Coordinator completes Guided Conversation, goals and action plans defined. Written consent gained to share information Further discussion may take place with other relevant practitioners. Living Well Coordinator will feedback short summary of Goals and Action plans following Guided Conversation Further info. can be offered e.g. leaflet Complex Referred to GP practice MDT meeting Action plan coordinated by appropriate key worker Non Complex Discussed directly between referrer and other relevant practitioners. Action plan coordinated by appropriate key worker Ongoing coordinated support and reviews by key worker until goals are achieved. Referral to GP MDT meeting if situation becomes complex Ongoing support and review at MDT meeting. When complexity reduces, discharged from MDT meetings with ongoing coordinated support and reviews by key worker, until goals achieved. Referral and Communication Flow Chart Person Identified at point of contact

21. Community structure

23. Risk assessment Help or Hindrance?

24. Communication Who to communicate with, why, how and when Different forms of communication Newsletters, websites, social media, press

25. Continual Improvement Induction Programme Staff and Volunteer Handbook Training and Development Programme Appraisal Continual Learning and Reflection Learning from Listening to Others

26. Summary We have covered? Who we are and What we do How and why do we do what we do How do we continually improve what and how we do things We have looked at Communication, Human Rights, Person Centred Thinking, Mental Capacity, Equality and Diversity, Safeguarding, Risk Assessment, Changing Lives, Customer Care. Aims: For all staff to have a greater understanding of how their role and their team fits into the organisations overall aims and objectives and forms part of the Age UK Cornwall jigsaw For all staff to have an understanding of the organisation and be able to reflect on their own behaviour in relation to the values of the organisation. Any questions?

27. Thank you