Working within Neighbourhoods
Adult Social Care in Sutton is aligned with community health services and GP networks so that local services truly understand the needs of their local populations. The model is arranged around four neighbourhoods: Carshalton, Cheam, Sutton and Wallington, each serving a population of approximately 50,000 people.
Neighbourhoods work as integrated multi-disciplinary assessment and review teams, including social workers, OTs, nurses, therapists and specialist workers, supporting older people and those with sensory and physical disabilities to maximise their wellbeing. Sutton is ambitious to implement a strengths-based approach to care, supporting people through their own communities, with clinical and care services to help them, as needed. Mental health services are also embedded within neighbourhood working models.
Sutton Learning Disability Service works across the borough as a single service supporting people with learning disabilities. Sutton is committed to enabling people to live the life they want, maximising their potential for independence and wellbeing. The service is defined through the recently refreshed Sutton Learning Disability Strategy, which is focused on reducing health inequalities and supports those people with learning disabilities who are able to work to get into employment. The service also includes a transitions team, as people move from children’s to adult services and a clinical health team for people with LD.
Hospital Discharge Pathways and Reablement
The Hospital Discharge Pathways and START reablement teams operate across Sutton, principally working with St Helier Hospital. These teams work with the acute trusts to support people who are medically fit for discharge – but may have some residual needs to re-adapt to life at home – to leave hospital in a timely and effective way.
Discharges are often managed through an episode of short-term reablement or using the Council’s contracted brokerage service to source long-term placements or negotiate packages of care. Teams also work with community health services where people may have short-term clinical or medical needs following a hospital discharge.