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Swansea Social Services

December 2011

Citizen Directed Support Changing lives together

Welcome Address from Head of Adult Services Welcome to the final

of the financial situation

edition of CDS for 2011.

and the massive change

Looking back over the year

agenda within Local

we have achieved a lot

Government and

and I would like to thank

specifically Social

everyone for their hard

Services.

work, commitment and

As ever we really do

enthusiasm.

need to listen to, learn

Many staff and service

from and include front-

users have lost loved ones

line staff and service

throughout the year and I

users in all of the

am always deeply touched

changes - so please

by the individual stories. I

come along to the lunch

am sure our thoughts will

time events to make sure

be with them over the

your views are heard.

Christmas period. This

I hear we are introducing

year has seen many changes within the Social Services Department with both Chris Maggs and Steve Walker leaving (was it something I said?) but Phil Hodgson and Dave Howes have come quickly to the rescue and I get the sense that Adult Services and Child and Family Services will be working more closely together over the next few years. Next year will be another challenging one in terms

guest editors next year I wonder if that has anything to do with me always holding up the deadline!!! Merry Christmas and Happy New Year to you and yours. Deborah Driffield Head of Adult Services

In this issue:  Welcome from the

Editorial Team

2

 Local Authority

Trading Company Update

3

 Assessment and

Care Management Update

4

 Citizen’s Alliance

Update

4

 Transformation

Agenda Update

5

 Staff Challenge -

lunchtime workshops

6

 Work with Paul

Thomas—the evaluation phase

7

 Fforestfach ATC -

40 Years of Social Development

8

 Beyond Person

Centre Care Seminar

9

 The Mental Health

Measure

11

 Active Support

Initiative at Glandwr Day Service

13

 One Man and his

Pan - Cooking Initiative at the Flexible Support Unit

13

 Life Story Work in

Dementia Care  Photo Tales

14 14


Welcome Welcome to the Winter 2011 issue of Social Services’ newsletter focusing on Citizen Directed Support. We look back briefly over projects that have been major themes during 2011 – the Local Authority Trading Company and the work with Dr Paul Thomas – and look ahead to 2012, including a new approach to developing assessment and care management practice and some developments in the

Attitude is a little thing that makes a big difference Winston Churchill

national picture. Early next year we hope to bring you more about how the Citizen Directed Support agenda is being taken forward across Wales. Thanks to everyone who has provided information or articles for this newsletter. Please keep sending them in even if it’s just a few lines we can find a corner for it. If you have a photo too, better still! And if there’s something you’d like the newsletter to cover, let us know.

The achievements of an organisation are the results of the combined

Colleagues in independent sector and voluntary

effort of each

organisations are also very welcome to submit

individual. -

contributions.

Vince Lombardi

Work is also going on to refresh the Citizen Directed Support website www.swansea.gov.uk/cds . This can hold longer documents that may be useful to share with colleagues, as well as links to other websites with relevant information. If you know of something you think would be useful for the website please contact Andrew Fung andrew.fung@swansea.gov.uk

Quality means doing it right when no one is

The next newsletter will be published in February and the copy deadline for contributions is 20

th

January. A few

looking. Henry Ford

articles have already been promised, so we’re looking forward to a bumper issue! If you have anything to contribute to a future newsletter – an article, a question, a tip, a link or even an idea for an article you’d like someone else to write – please contact the editorial team. Helen Barney

636902

helen.barney@swansea.gov.uk

Angela Morgan

636414

angela.morgan@swansea.gov.uk

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Swansea Social Services

December 2011


Local Authority Trading Company – where are we now? Most readers of this newsletter will have seen a Briefing Paper from the Head of Adult Services following the Cabinet meeting on 20th October. For anyone who missed it, here’s a summary.

The secret of success

At that meeting Cabinet considered a report from

is to be ready when

the Corporate Director of Social Services which

your opportunity

explored the potential costs, benefits and risks

comes. -

associated with the creation of a Local Authority

Benjamin Disraeli

Trading Company (LATC). That report concluded that there are too many uncertainties both locally and nationally to progress any further with the development of the LATC at the present time. Instead a phased approach will be undertaken, with the first phase being around service review and remodelling.

I am not

The following recommendations were accepted by

discouraged,

Cabinet: 

Services are reviewed and remodelled as per the commissioning plans.



An update on progress is presented to Cabinet

because every wrong attempt discarded is another step forward—Thomas Edison

in September 2012. 

A decision on whether to proceed with the development of a LATC is made at that time taking into account the outcome of the various reviews ongoing.



Officers continue to work with Collaborative Communities (ERDF funded Social Enterprise support project) to conduct feasibility studies into the viability of new business/income generating ideas.

We have to go for what we think we're fully capable of, not limit ourselves by what we've been in

The Cabinet Report and Business Plan are available

the past. -

via the Council’s website.

Vivek Paul

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Swansea Social Services

December 2011


Assessment and Care Management—where next? A focus on practice, not just

centred practice in Swansea, which was

process – plans for a new

also the subject of the OPAN seminar

collaborative

held in Cardiff in October 2011. There

working group in

assessment & care management

is an article on page 6 about this event.

services

The work with Dr Paul Thomas, with all

A recent Demos report in England

its ups and downs, has also highlighted

‘Personalisation must work for those

the fact that frontline staff are

who need it most…’ (available at:

motivated when they feel they can have

www.demos.co.uk/files/Tailor_made_-

a say in developing practice at the

_web.pdf?1318945824 ) has high-

frontline, rather than having processes

lighted concerns that the

imposed on them from above.

personalisation agenda in England has

In response to this, it has been decided

become pre-occupied with process more than practice development:

to establish an Assessment & Care Management Service Group, which will

‘Personalisation does not just mean

bring frontline staff, principal officers,

giving a person choice and control over

team leaders and planning officers

the services they receive. It also entails

together to explore and develop prac-

providing those services in a personal-

tice. This group will be established early

ised way – having a ‘personal touch’.

in the New Year, and will link closely

(p23)

with the TASS ACM Steering Group.

This report supports the work we have

Nick Andrews

been doing on developing relationship

Citizens’ Alliance – a brief update The Citizens’ Alliance is making good progress in forming itself into an independent group. A full meeting on 3rd October led to the formation of a Steering Group which will be focusing on the remit and aims of the group and how it might work with the Local Authority. A change of name is also being considered. Andrew Hubbard is currently acting informally as Chair of the Alliance. The Steering Group met on 15th November and the full meeting of the Citizens’ Alliance took place on 6th December. Andrew Hubbard has promised an article on the Citizens’ Alliance for the next newsletter.

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Swansea Social Services

December 2011


So - remind me again, why are we doing this transformation thing? The Welsh Government has recently

more do. There are plenty of 80 year olds

updated the Daffodil Website – a site

in Swansea living independently with just a

which projects the need for care services

bit of family support. However, once

in Wales. The figures are worked out on

people turn 85, the figures show that

the assumption that trends that have

almost two thirds need help to do things

happened to the past in the population will

like bathe, dress, and take medication.

happen in the future. On the basis of this

Fast forward a bit and by 2020 the

update, I wanted to remind people about the main change that is facing us, and which is one of the big reasons for the TASS project.

projections suggest that there will be an extra 1000 people aged 80-84 and an additional 1200 people aged over 85. That is in just 8 years time... A 28% increase in

I want to focus on the projected growth in

the number of people aged 85 or over, of

the numbers of people living in Swansea

whom around a third will be living with

who are aged 85 plus, and what this

dementia, and nearly two thirds unable to

means for social services (and for the

self care. And there are also going to be

NHS, and the rest of the Council...)

getting on for an additional 4000 people

As of today there are around 6,200 people

aged 70 to 79 as well, some of whom will

aged 85 and over living in Swansea.

be unable to self care and /or will have

3,122 of these have dementia, with

dementia.

around 1,000 living with moderate

Even without the economic meltdown we

dementia and 350 with severe dementia.

are currently experiencing, it is

By 2015 (just 3 years ahead) there will be

impossible to imagine that the

an extra 580 people aged 85 and above,

Older People’s Social Services budget

and 232 of them will have dementia,

would increase by a proportional

around 80 with moderate dementia and 25

amount?

with severe dementia. The proportion of

As Wales has a greater number of older

people with dementia rises with age, so that as people live longer, there are more living with

dementia. There will also be

an additional 440 people in Swansea aged 80- 84 – 7% more than now. Some of these people (around 10%) will also have dementia.

And the NHS budget?

people than the UK average, and Swansea has a greater number of older people than the Wales average, we are in a more difficult position. However, this is something that all areas of the UK are having to face.

So – in just three years time there will be 9% more people aged 85 and over, and 7% more aged 80-84, than there are now.

Continued/…..

Not everyone aged over 80 needs social care, but as

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people get older more and

Swansea Social Services

December 2011


Another scary projection is that the number of women (and men, but at the moment it is mainly women who are informal carers) in the 45 – 64 age group over the same 8 years is reducing , and this is the age band that at the moment is most likely to be providing care for their ageing parents. We are moving towards a scenario where increasing numbers of women in their late 70’s and early 80’s are going to be the main support for people aged 90 plus. By 2025 - 13 years away - there will be an 26% more 80-84 year olds (up 1,690) and 51% more people 85 or older in Swansea (3170 more people). In 2030, 18 years hence, there will be 3530 more people aged 80-84 than at present, up 55%, and 4830 more people aged 85 plus- up 78%. That is 1600 more people with dementia and more than 3,000 more needing help with self caring. The biggest rise will be in the number of very old men - from 2240 aged 85 plus today to nearly 4000 in 2025 and 4,600 in 2030, more than double. They will still be outnumbered by very old women – the 3, 900 in 2011 will increase to 6, 470 in 2030. I might be one of them! Heather Hughes Planning Manager

Staff Challenge Lunchtime Workshops A series of lunchtime workshops around the Transformation of Adult Services, facilitated by Deborah Driffield, will be held between December and February. These workshops are aimed at staff within Adult Services who feel they would like to know more / or do not know enough about what is happening in relation to the Agenda for the Transformation of Adult Social Services. Staff are invited to contribute and share what knowledge they have of the Transformation of Adult Social Services and in particular the Commissioning Priorities for each Service Area that should now be driving any change. Principal Officers and some representatives from the Commissioning Support Unit will also be in attendance. Workshops will take place at the Staff Development Unit at Llwyncelyn on the following dates. Places are limited to 30 per workshop. Wednesday 14 December 2011

-

12.30 pm – 2.00 pm

Wednesday 21st December 2011 -

12.30 pm – 2.00 pm

Friday 6th January 2012

-

1.00 pm – 2.30 pm

Monday 30th January 2012

-

1.30 pm – 2.45 pm

Friday 17th February

-

1.15 pm – 2.45 pm

Please note that Lunch is Not Provided.

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Swansea Social Services

December 2011


Work with Dr Paul Thomas – the evaluation phase During the last week in October some people were interviewed by Paul’s researcher, Phil Crocker, to gauge any changes (positive or negative) in the way assessment and care management staff feel about their roles and the Department. These results were contrasted with what people had said in a similar exercise at the start of the project. This was followed on 21st November with Paul and Phil giving a brief presentation on the outcomes of their involvement with the five assessment and care management teams to the Assessment & Care Management Steering Group. Their final report will be presented to Deborah Driffield later this month. A brief internal evaluation, carried out by Nick Andrews and Matthew Dardecker, was also presented. This focused on how staff had responded to the ‘Paul Thomas experiment ‘. Responses were mixed, with significant and positive change in the way some staff felt about their roles and involvement contrasting with others who felt confused and frustrated by the whole process. The findings of this work will be taken forward by a newly formed Assessment & Care Management Development and Performance Group which will focus on practice rather than process. (See page 4 for more about this group.) One practical example of a positive change that has come out of the work Paul Thomas has been doing to empower assessment and care management teams. The Morriston Hospital Social Work Team had been frustrated by the way in which the ‘letter of the law’ impacted on how service users were charged for Lifeline alarms. The rules state that alarms can be provided at no charge to people who are in receipt of a domiciliary care package; anyone else pays an annual charge. What was happening was that people were being discharged from hospital having been assessed for a package of care, but were still waiting for the service to start. Therefore, these people were being charged for their Lifelines. Social workers felt this was causing unnecessary confusion, sometimes distress, to service users. The issue was discussed with Paul Littlewood, the Principal Officer responsible for the community alarm service. As a result, management were able to introduce changes to procedures which mean that any service user who has been assessed and is waiting for a package of domiciliary care (or a direct payment in lieu) to start can be processed through the system as though they are already in receipt of care, and no charge will be levied for the alarm. Thanks to the Morriston Hospital Team for sharing this positive story.

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Swansea Social Services

December 2011


40 Years of Social Development In 1971 Fforestfach Adult Training Centre opened for the first time. Thanks to the local Council and Government a new focus and direction was adopted for adults with learning disabilities, ensuring that individuals had opportunities to upskill. The focus was necessary at that time to complete tasks for a training allowance. This shifted to allow individuals to be more visible within the community. Service Members started off by stamping prescription pads for local doctors’ surgeries, going out in to the community, learning to be independent and having a voice. Things have changed a lot through the years. Service members now have opportunities to attend Social Development, Work Development and, for the retired, Abergelli, all based at Fforestfach. More recently Fforestfach Social Development Service has had a group of 50 service members attending daily; accessing the community, learning to be independent, attending college sessions and gaining qualifications, going away with our dedicated staff on trips, learning home, money and social skills. We have now split Social Development up into 3 projects: Tŷ Lafant, based at Fforestfach, Toronto in Penlan and the Gorseinon Project. Both external projects, Toronto and Gorseinon, have gone from strength to strength forging friendships and real interaction with other local community members. Life Long Learning access both projects, helping us in our drive for valuable social experiences in a safe and supportive environment. This has enabled a better quality experience of service for those attending and has also seen us link with other community groups that value the experiences they have shared with us (elderly, partially sighted and disabled groups). Through this the staff at Tŷ Lafant provide a more intensive service for those who need a little more support. This enables staff to focus on more intense active support in order that all individuals gain a service geared towards individual needs. Russell Bevan, pictured left, was asked to tell us about how he feels about the new changes to Fforestfach: “ I like our new building, we have a lovely garden, I cant wait for the summer so I can start planting vegetables and prune the plants, Tŷ Lafant has a more homely feel, I feel more proud of this service, we all take pride by tiding,

cleaning and giving ideas.”

On a lighter note we had an amazing fund raising party for the anniversary. Service Members and staff dressed up, we had Kevin John and local bands in to get us up and dancing, we raised money by doing a five mile walk, selling cakes, raffles and lots of fun games. From all this activity we raised over £1000 for the PSA. At the end of the day we had new Service members interviewing our long serving veteran Malcolm Baker, pictured right. Malcolm said: “I have been coming to the service for 40 years, things have changed a great deal, I still love coming here.”

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Swansea Social Services

December 2011


‘Beyond Person Centred Care’ – researching the role of relationships and interdependence in social work and nursing practice in Wales An OPAN Research Development Grant seminar was held in Cardiff on 26th October in partnership with the SSIA. Eleven delegates from Swansea attended. Forty delegates from social policy, research, regulation and frontline practice came together to discuss person/relationship-centred approaches to social work and nursing practice with older people. These approaches place the patient/carer at the centre of the care experience in order to achieve good outcomes and challenge more traditional forms of social work and nursing which are often viewed as over overly bureaucratic, and with their focus on process and meeting targets. Through discussing issues around person/relationship-centred approaches, the aim of the event was to stimulate a number of research questions on this theme which would attract funding to conduct a research project in Wales. In order to set the scene for the day, and to help inform the development of research questions, a number of presentations – as outlined below – were given prior to the group discussions. Peter Beresford from Brunel University recapped on the first in-depth examination of the development of person-centred support, or ‘personalisation’, from the perspectives of service users, carers, face-to-face practitioners and middle managers. Among other things, he was critical with the English focus on process rather than practice. Sheffield University academic Professor Mike Nolan shared a similar concern about the prevailing culture within nursing care for older people. He outlined a recent research report on cultural change in acute care settings entitled, ‘From metrics to meaning’, and also outlined a theoretical framework for relationship centred practice which recognises and promotes the interdependent well-being of older people, carers and face-toface staff. Colin Slasberg delivering a presentation on reconciling person-centred support with the need to work within increasingly tight budgets

Continued/…..

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Swansea Social Services

December 2011


A number of social work staff and a carer who had multiple caring responsibilities outlined their ideas and feelings about practice at the front line, including how excessive bureaucracy can stifle creativity, motivation and effective person-centred support. They made an impassioned plea for putting people not processes first. Finally, Colin Slasberg, an independent consultant who previously worked in commissioning for Thurrock Council, delivered a short presentation on the difficult

Do not go where the path may lead; go instead where there is no path and leave a trail. Ralph Waldo Emerson

subject of reconciling person-centred support with the need to work within increasingly tight budgets Subjects covered in the presentations were further explored in lively morning discussion groups. After lunch these groups were ask to develop a number of potential research questions which can be submitted for substantive funding. Initial feedback from the event was very positive and it was felt that the event contributed not only to the development of research questions, but also to the Welsh debate on Citizen Directed Support, which will be quite distinct from the English model of

I find out what the world needs. Then, I go ahead and invent it— Thomas Edison

‘personalisation’. In terms of next steps, the research questions will be refined and possible funding sources identified. Health and social care agencies across Wales will be invited to get involved in the research, which will be participative, involving older people, carers and face-to-face staff. If you would like more detail on the event you will find a short a write up, presentations and a DVD of the day

It is not the strongest

from the following link www.ssiacymru.org.uk/opan. If

of the species that

you would like to get involved in this work and a

survive, nor the most

renewed focus on relationship-, rather than process-

intelligent, but the

centred social work and nursing practice, then please

one most responsive

contact Nick Andrews, Planning Officer for Older

to change. -

People, City & County of Swansea –

Charles Darwin

nick.andrews@swansea.gov.uk

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Swansea Social Services

December 2011


The Mental Health Measure A Measure is a piece of law made by Welsh Ministers. It has the same effect as an Act of Parliament, i.e. we have to

coordinators and any other persons in

do it!

relation to their functions under Parts

Final consultations are taking place before

2 and 3 of the Measure. These Parts

this Measure is put into practice in stages over the next 12 months. The Measure is made up of four separate but interrelated parts. Part 1 is aimed at ensuring that throughout Wales there will be Local Primary Care Mental Health Support services. These will be delivered by Health Boards and Local Authorities in

make provision in relation to care and treatment planning and care coordination for users of secondary mental health services, and in relation to the provision of assessments for former users of secondary mental health services. Care and treatment should be comprehensive, holistic and

partnership, and it is expected that these

person focused

services will operate within or alongside

In order to ensure that care and

existing GP practices.

treatment is most effective in

Part 4 provides for an extended statutory

maximising recovery, the assessment,

scheme of Independent Mental Health Advocacy, both for patients subject to compulsion under the Mental Health Act 1983 and, incrementally, for those in hospital informally. Part 2. Coordination of and Care and Treatment Planning for Secondary Mental Health Users

planning and delivery of that care is to be holistic, addressing a broad range of medical, psychological, social, physical and spiritual needs that, in the case of children, are developmentally appropriate. In formulating the care and treatment plan care coordinators need to focus on the needs of the individual, rather

Part 3. Assessments of Former Users

than the services that currently exist

of Secondary Mental Health Services

and could therefore be provided.

These two parts of the Measure concern

In addition to services available in

how we work with service users in

specialist mental health services,

planning care within secondary mental

consideration should also be given to

health

broader services such as education,

services. It is this part of the

Measure that has a Code of Practice

training, employment and leisure

attached to it.

services that may assist in a person's

The Code is provided as guidance to local

recovery.

authorities, Local Health Boards, and care

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Swansea Social Services

December 2011


Recovery in this context means

to be proportionate to need and risk, as

regaining mental health to the

they are tools to assist in the delivery of

maximum extent possible and

effective care and for the review of

achieving the best possible quality

outcomes. In some cases this may

of life, lived as independently as

require a detailed plan reflecting the

possible.

complexity of the patient’s need.

People with mental health problems, and

However for many patients the plan of

their carers, should live as fulfilled a life as possible, with additional support delivered in a timely manner through evidence based interventions, where possible, to help them achieve this goal. Care and treatment plans for all individuals within secondary mental health services should focus upon the minimisation of the impact of their mental health problems on living as fulfilled a life as possible and the maximisation of their independence, community integration, mental and physical health and wellbeing. Care and treatment planning should therefore be

care may be relatively uncomplicated. It is important, in order to ensure that the delivery of treatment and care is maximised, that the care and treatment planning process reduces the burden of bureaucracy whilst ensuring good quality planning, monitoring review and recording. It is currently anticipated that Parts 2 + 3 of the Measure will commence in June 2012. In order for care coordinators to become aware of this guidance and the principles and practice attached to it training will be rolled out during January and February 2012.

based upon a recovery approach. This requires a positive, strengths-based approach taking incremental steps to achieve long term goals. It should be

James Thomas Staff Development and Service Provision Manager—Mental Health Services

recognised that for some people these may only be small steps and that for some, especially those people with degenerative disorders, the focus may centre on maximising a person's functioning within a process of gradual decline. Care and treatment planning should be proportionate to need and risk Whilst the development of an effective care and treatment plan is essential to meet the requirements of the Measure and the Part 2 Regulations, plans ought

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Swansea Social Services

December 2011


Active Support, Mutual Support Active Support was introduced to the Glandwr Day Service in September, where service users are more than happy to contribute to the development of the service. Active Support focuses on improving the quality of daily life. It’s not about thinking of special activities someone can do, but about how staff can involve individuals in what is naturally occurring around them. Some of the work includes recycling, shopping in the local supermarket, light duties and looking out for each other. Active Support Certificates have been awarded to Pat Davies, Stevie Askham, Gillian Frost, Derek Cox and Sean Woods in recognition of both their enthusiasm and invaluable contribution whilst attending Glandwr Day Service.

One Man and his Pan The ‘Men-Only’ club being run by the Flexible Support Service has put some fun into the idea of cooking for one.

It has long

been suggested that men who live on their own are usually rubbish at this sort of thing and often prefer takeaways and pot noodles to healthy nutritious meals. So with that in mind we decided to brush up our talents – or lack thereof – and invite Daniel Bamsey from the Swansea People First Health Advocacy Project, for a little 1:1 cooking instruction. Drawing on his own personal experiences as a student living on his own and on a shoestring! he showed the group how to make a tasty and healthy pasta dish with minimal cost and ingredients. The group loved the session and felt themselves energised to try some more cooking for one at home. The success of the group has meant more ‘cooking for one sessions’ are to be arranged and indeed a simple recipe book is planned for the future.

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Swansea Social Services

December 2011


Life Story Work in Dementia Care Previous editions of the newsletter

particularly good video presentation

have included articles on how we are

on this subject by Dawn Brooker, who

developing more person centred

spoke on this subject at a Life Story

services to support people living with

Network event in 2010:

dementia and their carers.

www.lifestorynetwork.co.uk/video/

Fundamental to this work is the use of life story, something which all older people are rich in! The use of life story work matched to functional ability can transform support planning and service delivery for people living with dementia, as has been evidenced in some of our care homes and day services over the past 12 months. The following web link is to a

prof-dawn-brooker-keynote-at It lasts about half an hour, but why not watch it while you eat your sandwiches one lunchtime? You can join the Life Story Network online free of charge, and receive regular e-mail updates and access to resources: http:// www.lifestorynetwork.org.uk/

There’s another service user story you might like to read on the Citizen Directed Support website. Photo Tales is an innovative visual arts project that provides a range of activities for individuals experiencing serious illness, disability and/or social disadvantage. Click on this link to read about it. http:// personalisation.ccos.me.uk/category/refocusing-on-communities/communityfocus/

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Swansea Social Services

December 2011


Citizen Directed Support Newsletter - December 2011  

Citizen Directed Support Newsletter

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