Purpose of the item: To provide a progress update for the programmes which make up the Adult Social Care 2020/21 transformation programme.
Sinead Mooney, Cabinet Member for Adults and Health
Kathryn Pyper, Senior Programme Manager, Adult Social Care
Liz Uliasz, Deputy Director of Adult Social Care
Simon White, Executive Director of Adult Social Care
Key points raised during the discussion:
1. The Select Committee was shown two videos used to train Adult Social Care (ASC) staff in the roll out of the strengths-based approach. The first video showed a group of people with lived mental health experience talking about their experiences of accessing mental health services and the advantages of the strengths-based approach to mental health. The second video showed a carer talking about how the ASC system should best approach and interact with carers.
2. A Member asked what the new care pathway programme of work involved and what the timescale was for its roll out. The Deputy Director of ASC replied that the care pathway involved setting up a consistent front-door offer (i.e. place of initial contact with the social care system) across the whole of the Council, not just the ASC service. The Senior Programme Manager added that other areas included in the new pathway would be community and prevention, ongoing work around the reshaping of reablement, and workforce redesign to support the work on the front-door offer. Moreover, it involved linking in with partners, such as Community Connections. The Deputy Director stated that a specialist reablement service was being developed for learning disabilities (LD), mental health and autism. In practice, the new care pathway involved improvements to signposting and monitoring, and digitalising certain systems. It was important that service users felt that the service provided meaningful, effective signposting and support and that service users’ outcomes were at the heart of the system. The Cabinet Member for Adults and Health offered to arrange a briefing session to inform Members on this subject. The Select Committee agreed this would be useful.
3. A Member expressed concern that the Council was approaching the planning application system in a way that meant applications for Extra Care Housing and Independent Living sites were unlikely to be approved. The Cabinet Member encouraged the Member to share any specific examples with her for a further response. Good communication with the local community was important and could be effective in tackling this issue.
4. A Member asked when it was expected that the heads of terms issues regarding the Pond Meadow site would be resolved, what impact this had had on timelines and what would be learnt from this experience. The Cabinet Member responded that the issue should be resolved quickly and there was ongoing communication between Surrey County Council and Guildford Borough Council. The impact had been minimal. The Executive Director of ASC added that the Council was in regular contact with the developer of the site.
5. A Member asked what had been learnt from the discovery phase of the Enabling You with Technology programme and feedback received on the programme. The Deputy Director of ASC stated that as a result of the discovery phase, a company called Public Digital had given recommendations on the programme. A pilot in Mole Valley would go live in January 2021, whereby an occupational therapist (OT) and an advisor would work together at the monitoring centre in Mole Valley to detect care needs – a fall, for example – and dispatch services as appropriate. The Council was looking at ways for residents to provide feedback on the service.
6. The Co-Chair of the Surrey Coalition of Disabled People requested more information about the Enabling You with Technology programme and enquired how the service would train its staff in the programme and measure outcomes. The Deputy Director of ASC replied that the programme involved the OT working with the Mole Valley monitoring centre to agree what the required technology-enabled care was. Changes in activity would become evident over the course of the programme. It was anticipated that the programme would enable service users to remain independent and feel secure living in their own home, by using the technology available to them. The Cabinet Member added that a principle aim of the wraparound pilot was to prevent falls. A way of measuring outcomes would be to measure the number of ambulance call-outs; reducing these would be of significant value to the NHS. Algorithms were also being used to monitor the programme. If the pilot was successful, the programme could be rolled out to the learning disability and autism (LD&A) service, particularly with regards to tackling isolation and independent travel. The LD&A service had received some funding for a technology project and would start to build a business case for this. The Executive Director of ASC explained that the Enabling You with Technology programme was expected to pay for itself due to the reduction it would produce in the need for other forms of care. He also expressed optimism about the opportunities this programme could create.
7. A Member enquired what the target savings were in the LD&A transformation programme. The Executive Director informed the Select Committee that the savings target in LD&A in 2021/22 was £4.67m. It was anticipated that the LD&A service would deliver an underspend this year. These savings represented reductions in assumed demand and therefore an increase in relative spending while making savings.
8. A Member remarked that some care homes struggled to provide the necessary level of care when relying on the Council’s funding (even prior to the economic effects of the pandemic) and that residents who purchased care privately effectively subsidised care services in these cases. The care market was shrinking due to economic difficulties and it would be more difficult to source the care packages needed. The Executive Director of ASC acknowledged the need to be careful about the medium- and long-term impact of Covid-19 on care providers; however, there were plenty of providers willing to offer services at the Council’s guide price and, putting Covid-19 to one side, he expressed the opinion that there was not a problem with supply in the market.
9. A Member asked what proportion of private care home placements were occupied by Surrey County Council-funded residents. The Executive Director replied that this could vary significantly depending on the type of contract, and agreed to provide this information to the Select Committee after the meeting.
10. A Member enquired what motivational interview training involved and whether this would be provided to mental health staff. The Deputy Director explained that mental health staff had been offered training on various subjects during the transition of mental health services from Surrey and Borders Partnership to Surrey County Council ASC. Training on the strengths-based approach had been completed. The motivational interview training was a counsellor-based approach and involved encouraging the trainee to be aware of their own behaviour and to change that behaviour if they wished. It was agreed that the Select Committee would be given the opportunity to attend and observe motivational interview training sessions.
11. A Member expressed concern that the Practice Improvement transformation programme was being brought to a close despite the fact that it was still RAG (red, amber, green) rated amber. The Deputy Director explained that the Practice Improvement programme would not completely stop; rather, it would just cease to be a transformation project and would transition into business as usual. Practice would continue to be improved. Removing Practice Improvement from the list of transformation projects freed up transformation resource for other projects. The ASC service would review lessons learnt within the Practice Improvement programme.
12. The Deputy Director of ASC agreed to provide more information to the Select Committee on Liquid Logic.
1. The Select Committee requests that a report on Enabling You With Technology is presented at a future Select Committee meeting;
Actions/further information to be provided: