Agenda item

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

This report and accompanying presentation gives a ‘position statement’ for Adult Social Care in 2009 and charts the achievements and progress made to date.

Declarations of interest: None.

Witnesses:

Sarah Mitchell, Strategic Director, Adult Social Care

Dave Sargeant, Assistant Director for Personal Care & Support

Debbie Medlock, Assistant Director for Service Delivery

John Woods, Assistant Director for Transformation

Anne Butler, Assistant Director for Commissioning

Key points raised during the discussion:

1.    Officers gave an outline of the successes and challenges faced by Adult Social Care following the Annual Performance Assessment in 2009. The Committee was informed that a particular success was felt to be the reduction in levels of staff sickness and absence.

2.    Officers highlighted that co-design with carers, users and stakeholders had been central in ensuring the success of the service. In particular the Equality Impact Assessment (EIA) completed in relation to savings targets was identified as a positive example of this. Also highlighted was the use of co-design in the development of a Sensory Services strategy, and the provision of lip-reading classes for those with hearing difficulties.

3.    The Committee was informed that the recent Local Government Association (LGA) Peer Review had identified both the work around the Health & Wellbeing Board and the work connected to the Public Value Review (PVR) for services for people with learning disabilities as areas of good practice within the Council. It was also highlighted that the service had been a finalist in the Redefining Quality in Adult Services category of the Management Journal Awards.

4.    The Committee was told that the service was developing a more community-based approach, with greater engagement with partners and the development of Citizens’ Hubs. Officers highlighted that the “Right To Control” pilot had been praised by user organisations at a regional level.

5.    In regard to Personal Care and Support, it was outlined to the Committee that the number of younger people in residential care had decreased significantly. The view was expressed that the service had improved in its identification of users for whom residential care was appropriate.

6.    The Committee was informed that there were now safeguarding advisors in each of the locality areas. It was also commented that transition was improving, with more Adult Social Care staff attending reviews for young people.

7.    Officers outlined the increased role of Quality Assurance in the service, and the greater strategic view in identifying what needs, resources and outcomes were in place around commissioning. This was linked to the development of locality profiles jointly with the NHS, and the provision of a home from hospital service with the Red Cross. Officers commented that current work was being undertaken to ensure a consistent service in relation to this is available across the county. Members queried where the responsibility lay for a patient’s care upon discharge from hospital. It was clarified that the NHS held responsibility for 30 days following any hospital discharge, and that Adult Social Care would also have a responsibility in relation to this dependent on circumstances.

8.    Members highlighted concerns regarding the provision for care for patients following discharge from hospital. Officers commented that there were sometimes challenges in working with partners around hospital discharges. The Cabinet Member for Adult Social Care highlighted that there was an undertaking by the Health & Wellbeing Board to look at this matter over the next year, and that there were likely to be a number of incremental changes over that time.

9.    The Committee questioned what measures were in place to ensure that the service was continuing to review and assess its progress. Officers commented that a peer review had just been undertaken with Buckinghamshire and that a “local account” was being developed that featured the service’s Key Performance Indicators.  Members commented that they would like to see the “local account” shared with the Committee in order to give an evidence-based approach to the service’s successes. The Committee strongly advised that an annual peer review should replace the discontinued annual assessment inspection regime.

10.  Officers highlighted the changing relationship between Adult Social Care, carers and users, and that this involved the service asking users what they could do themselves, and how would it be known that the level of care was working. It was emphasised that this was about enabling users and carers, but also about identifying areas in which cost could be reduced. The role of personal budgets was highlighted as being an integral part of this.

11.  Members questioned whether Brockhurst Care Home had received a further follow up visit following the Care Quality Commission’s (CQC) previous inspection. Officers commented that the CQC had not made a further inspection to date, but that the service was confident that the identified issues had been addressed.

12.  Members asked officers to comment on what they felt were the key challenges faced by the service in the coming year. It was outlined that amongst these was the need to meet savings targets, the recommendations following the Dilnot report, the continuing need to manage the market and working collectively to identify where costs can be removed from both commissioned and in-house services.

13.  The Committee was thanked by the Director of Adult Social Care for their role in the scrutiny of the service. The Chairman then proceeded to praise the passion and dedication of officers within Adult Social Care, and congratulated the Director of Adult Social Care on her commitment to continuous improvement.

Recommendations:

a)    That the Committee considers as key items for scrutiny:

i)      The viability of proposals to meet the cost savings arising from the Council’s 2013/14 budget;

ii)     The need to ensure that the provider market remains strong; and

iii)    The strength of the Council’s safeguarding procedures

b)    That the Service is commended and congratulated on the work over the last four years;

c)    That the Committee will ensure it continues to be involved in the development of key strategies, such as the Self-Funder Strategy and the development of maximising social capital and will place these on its 2013/14 Work Programme; and

d)    That the Service is encouraged to continue improving in all areas, especially embedding personalisation, ensuring all service users and carers have a named practitioner and ensuring services fit the needs of service users.

Actions/further information to be provided:

None.

Committee Next Steps:

None.