Agenda item

Purpose of report: Scrutiny of Services/Policy Development and Review

The Adult Social Care Directorate has been implementing the Personalisation agenda. The Committee continues to monitor the success of this and will scrutinise progress in ensuring residents are supported to make appropriate decisions about their care, including through the use of Personal Budgets and Direct Payments.

Declarations of interest: None

Witnesses:

Sarah Mitchell, Strategic Director for Adult Social Care

Dave Sargeant, Assistant Director for Personal Care & Support

Gail McCulloch, Assistant Manager, Transformation

Carol Pearson, Chief Executive, Surrey Coalition for the Disabled

Cliff Bush, Chair, Surrey LINk

Key points raised during the discussion:

1.    The Assistant Director for Personal Care & Support described the journey in implementing the Personalisation agenda culminating with the roll out in mental health services which has proved complex.

2.    The Chief Executive of the Surrey Coalition for the Disabled reported that where personal budgets have been allocated, there have been improved outcomes but they hope to see better outcomes for people during the day, for example, employment and the ability to move around and socialise. It is disappointing that three years on only 42% receive a personal budget and Surrey will struggle to meet the 70% target nationally in the next few years.

3.    The Strategic Director for Adult Social Care responded that given the enormous changes, Surrey has managed implementation at an appropriate pace. The Assistant Director for Personal Care & Support reported that 70% of older people have a personal budget, 40% of the physically disabled and 25% of those with learning disabilities. Unlike other authorities, in Surrey the majority of those with learning disabilities are in transition from residential care into the community; efforts are being made to increase personal budgets for people with learning disabilities.

4.    Members raised the findings of the Personal Budgets Outcome Evaluation Tool (POET) survey in 2012 and the fact that only 88 people out of a possible 700 had responded. Similarly, out of 300 carers only 74 responded. How is it possible to get better feedback? Respondents, whilst being positive about the impact of personalised budgets expressed negative aspects of the process which caused stress and worry. Members queried what these negative aspects were, as often much can be learnt by looking at the negatives rather than just positive outcomes.

5.    The Strategic Director for Adult Social Care informed the Committee that there was some way to go in evaluating how the Personalisation agenda actually helps people get back into employment and otherwise improve the quality of their lives. Issues around choice and control are dictated by the market; Adult Social Care is concerned about peoples’ dignity, mental well being and independence. Between October and December 2012, there has been a 5% increase of the number of people supported on a personalised budget; demand has been greater than anticipated.

6.    The Committee discussed personal budgets and self directed support and the possible confusion of language. Self directed support is enabled through a personal budget. It is expected that as more and more people take up direct payments and plan their own support, they will work out more creative and cost-effective ways to achieve their outcomes.

7.    The Strategic Director for Adult Social Care advised the Committee that the revised 70% target of providing people eligible for on-going social care with a personal budget by April 2013 was more pragmatic but some people do not want a personal budget and there is also the issue of finding practitioners to administer it. In allocating cases there has to be a balance between those that are complex and others that merely have to be kept an eye on. Over 1.2 million people come to the attention of the Service and to whom it has a safeguarding responsibility.

8.    Members sought clarification of the numbers contained in paragraph 33 of the report and the Strategic Director for Adult and Social Care agreed to provide clarification.

9.    The Chairman raised concerns about the roll out in mental health services. The Assistant Director for Personal Care & Support advised the Committee that the Council and Surrey & Borders Partnership NHS Foundation Trust have established a joint management board focussing on social care issues and key managers from the Trust meet monthly with the personalisation support managers. The Manager, Transformation outlined the complexities of the integration process given the different structures in health and social care; including different computer systems. Successes include a clear structure and strategy in place and completion of a full training programme for professionals so that learning can now be embedded.

10.  Members expressed concern that unlike Adult Social Care, there is reluctance in Mental Health teams to be transparent resulting in confusion as to where responsibility lies: there should be the same level of transparency. The Chairman suggested that the outcomes of the project looking at the partnership arrangements between Surrey County Council and Surrey & Borders Partnership NHS Foundation Trust arising from the Mental Health PVR should be done jointly with the Adult Social Care Select Committee and the Health Scrutiny Committee.

11.  Members discussed issues concerning recruitment of staff and care managers and whether people not in regular contact with Mental Health teams have a point of contact in an emergency. The Assistant Director for Personal Care & Support advised the Committee that it is the ambition that everyone has a named worker and this is happening as staff vacancies are filled. There is the duty service for crises and for those with an allocated worker this worker is the first point of contact. Everyone without an allocated worker has been provided with the contact numbers of locality teams and the duty desk will respond accordingly.

Recommendations:

1.    The Service is commended for the work to date in implementing the Personalisation agenda;

2.    Recognising that there is still more work to do, the Committee would like to work with the Service on improving service user engagement;

3.    The suggestion from the Director that we should benchmark our results against comparable authorities is welcomed and the creation of a more realistic target is supported; and

4.    The scrutiny of the outcomes of the Mental Health PVR project looking at joint working arrangements with Surrey & Borders Partnership NHS Foundation Trust should be done jointly with both the Adult Social Care Select Committee and the Health Scrutiny Committee.

Actions/further information to be provided:

The Strategic Director for Adult Social Care to provide clarification of the numbers contained in paragraph 33 of the report and confirm numbers of people of different client groups who have a personal budget and have had a supported self assessment. These are to be circulated to the Committee.

Select Committee Next Steps:

None