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What does Adult Care do?
Commissioning and Care Management Care managers (social workers and occupational therapists) in the adult care, learning disability and hospital fieldwork teams are responsible for assessing the needs of individual disabled or ill adults and elderly people and their carers who are referred to the Department for assistance.

Users and carers are encouraged, as far as possible, to describe their own needs and how they would prefer them to be met.

The aim is to enable people to be as independent as possible, to support them in the community, to prevent unnecessary admission to hospital and to safeguard vulnerable people who are at risk.

The fieldwork teams work closely with health services to co- ordinate assessments and care plans. A particular feature of Wiltshire's approach to community care has been the co-location of Social Care' teams with General Practices in several areas of the County and also the deployment of care managers (linkworkers) in other General Practices.

Older People
Numerically, older people are the largest group with community care needs. Although the majority of older people are active and independent, the prevalence of ill health and disability increases with age and therefore older people present some of the highest needs for health and social care.

In 2001 it is estimated that there were nearly 71,000 people aged 65 years or over in the new County of Wiltshire. Of these, 34,213 were over 75 years of age and 9,037 over 85 years of age. The most elderly group of people, over 85, is expected to have increased by up to 3.5% over five years. It has been estimated for each person in this age group, Social Services spend, on average, £3,387 per year. The total increased demand cost for this projected growth is therefore some £0.102m over the next five years for total 85+ population.

With the increasing growth in the numbers of older people and also changes in health service policy, with a significant reduction in long-stay beds and faster throughput of patients, the demand for social services provision has been exceeding the resources available. As at March 2002, Social Services was supporting 2,234 people in residential and nursing homes in the independent sector through Community Care funding. As a result, it has been necessary to prioritise and target resources to those most in need.

Mental Health
Specialist mental health services are delivered through community mental health teams in each of the Districts. Staff work with people with a range of mental health problems with the focus being on those with serious and enduring mental illness. From 1 April 2001, Social Services and Health Services have been incorporated into a single integrated Trust for Mental Health Services.

Important legal requirements are placed upon the Department by the Mental Health Act 1983. This includes the provision of Approved Social Workers who have a key role in assessing people for possible compulsory detention in hospital. Together with the Health Authority, there is a statutory duty to provide after-care services to those people who have been compulsorily detained.

The Code of Practice to the Mental Health Act lays out detailed guidance on its implementation. Co- operation, collaboration and joint work with other agencies, particularly Health and Housing are vital to effective provision of service in all aspects of mental health work. This is particularly true in working with mentally disordered offenders where good communication is required too with Criminal Justice Agencies in working to balance the needs of the individual against the protection of the public.

Substance Misuse
Any user of the Department's services may have problems created or exacerbated by misuse of alcohol and/or drugs. In each area there is a specialist worker in substance misuse. They assess individuals' needs for specialist treatment and/or rehabilitation in order to deal with the substance misuse problem. Together with colleagues from the Health Service and voluntary agencies, they offer ongoing counselling and support.

People who are Deaf, hard of hearing, blind or partially sighted
The Hearing and Vision Team is a specialist team based in Devizes that provides services across Wiltshire to children and adults who have service needs because they are Deaf, hard or hearing, blind or partially sighted.

Services provided by the Hearing and Vision team include

• service information
• specialist assessment
• supplementary assessment
• awareness training
• skills training
• equipment on loan
• resource centres; and
• "Drop-in" sessions.

Learning Disability
Learning Disability Services provide information, assessment, and support to people with a learning disability, their families and carers through its four multi disciplinary specialist teams. The teams provide, or work together with specialist social workers, community nurses, psychologists, psychiatrists, occupational therapists, physiotherapists, specialist challenging behaviour nurses, and speech therapists.

Specialist multi disciplinary assessments and services are offered to those people with complex needs, with multiple learning and physical disabilities and/or challenging behaviour. Specialist Learning Disability teams work closely with specialist Mental Health teams to assist those with learning disability and additional mental health problems. The Children, Education and Libraries´ Child Health teams offer a service to children with learning disability and their families up to the age of 18 years. Special emphasis is placed on arranging a smooth transition from Children's to Adults' Services.

Physical Disability
Assessment and services for older and younger adults with a physical disability are provided through the Department's geographically based Adult Care teams. The teams are made up of social workers and occupational therapists. Domiciliary, nursing, residential and respite care packages are arranged and monitored by individual care managers and purchased through the team's budget.

There is a scheme for Direct Payment that enables Users to manage their own care arrangements. To find out more about this scheme see:

www.workablewiltshire.info

Drug & Alcohol Team
The Wiltshire Drug and Alcohol Team is the local partnership responsible for delivering the National Drug Strategy "Tackling Drugs to Build a Better Britain" at a local level.

This is a 10 year strategy, which aims to address drug/substance misuse in four key areas.

Young People - To help young people resist drug misuse in order to achieve their full potential in society.

Communities - To protect our communities from drug related anti- social and criminal behaviour.

Treatment - To enable people with drug problems to overcome them and live healthy and crime free lives.

Availability - To stifle the availability of illegal drugs on our streets.

The DAAT is a multi-agency partnership comprising senior representatives from:

• Wiltshire County Council
• Wiltshire Constabulary
• Wiltshire Probation
• Primary Care Trusts
• Avon and Wiltshire Mental Health
• Partnership NHS Trust
• District Councils
• HMP Erlestoke
• Swindon and Wiltshire Alcohol and
• Drug Service (Voluntary Sector)
• Home Office (Drug Prevention Advisory Service)

What is Community Safety?

`Community safety is an aspect of quality of life in which people, individually and collectively are protected as far as possible from the criminal or anti-social behaviour of others, and are equipped or helped to cope with those they do experience. It should enable them to pursue, and obtain fullest benefits from, their social and economic lives without fear or hindrance from crime and disorder and anti-social behaviour.´

The Crime and Disorder Act 1998 inroduced requirements and powers for councils and the police. Requires councils and police to consider crime and disorder reduction while exercising all their duties. Community Safety in Wiltshire Wiltshire Constabulary has a gross revenue budget of £82.8 million in 2002/3. Of this, the force spends an estimated £278,000 on specialist community safety work at divisional level. There is a team of six community safety staff at police headquarters, with a community safety inspector in each of the three police divisions. Many other police personnel contribute directly to community safety work, for example community beat officers.

Major items of spending in 2002/3 include:

• CCTV in Salisbury (£382,000)
• Youth Offending Teams (£1,282,400)
• Drug and Alcohol Action Teams (2,208,300)

The councils, police and other partner agencies such as primary care trusts and probation service work together in a number of ways, such as:

local community safety partnerships in each of the four district council areas local strategic partnerships in each district the Witlshire Strategic Board, covering the Wiltshire County Council area. In addition, the Wiltshire and Swindon Research and Development Group brings together community safety staff from councils and the police.

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