Agenda item

To provide details of the work in progress for the Adult Social Care Strategy

The Chair welcomed Ali Gilbert, ICS Director of Place to the meeting to provide an overview of the development of the North Northamptonshire Adult Social Care five-year strategy for adult social care provision and commissioning covering 18-year-olds to adults, including progression transition from 14 years onwards.

The meeting noted that the strategy was being co-produced with the Council’s Adult Social Care workforce and service users, demonstrating solid engagement and wide ownership. It was heard that the strategy was currently in its 13^th draft iteration and was progressing through partner organisations and internal meetings for comment. Details of the five-year vision, aims and ambitions including values and behaviours had been developed based on staff practice framework outputs.

The panel heard that the strategy was designed to align with A New Sense of Place (Local Area Partnerships (LAPS) and to support North Northamptonshire Voluntary Community and Social Enterprise (VCSE) collaborative initiative as well as the statutory requirements of the Care Act.

It was reported that the development of the strategy had been ongoing since April 2023, with a view to implementation by March 2024, with a sub-group of the Operational Working Group currently examining the development of a co-production framework. Further governance details were provided to the meeting, with reference made to the focus on community hubs through the Moving Forward with Place sub-group.

The meeting noted that the vision for the strategy was to co-produce Adult Social Care Services in a way that was meaningful, and person centred by incorporating the core values for North Northamptonshire which included:

·       Customer Focussed: Individuals, their families and carers, could expect person centred care, tailored to the circumstances, strengths and needs of the individual and that demonstrated their desired outcomes.

·       Respectful: Individuals, their families and carers could expect to be always treated with dignity, having support that recognised their capability and ambitions whilst promoting independence and being treated as equals.

·       Trustworthy: Individuals, their families and carers could expect open, honest and regular communication in a manner and frequency agreed by them that involved active listening to ensure mutual understanding and where needed, additional support to aid participation and understanding as well as increased involvement and recognition of their role as experts in their own lives.

·       Efficient: Service users and their families could expect timely, high-quality information, advice, assessments and support to ensure that their individual needs were met, a shared understanding of what constituted high quality care and how this was demonstrated and measured.

·       Supportive: Individuals, their families and carers would be able to make decisions about what is right for them, their quality of life was improved, and they were enabled to participate as valued members of the wider community.

The meeting noted that behaviours and cultures within the adult social care team were very important, and the draft strategy, once approved, would represent a cultural shift in the way of working following feedback from staff.  Details of the future strength-based way of working were detailed as follows:

·       Person-centred strength-based safe care

·       Single route of access into Adult Social Care with the right allocation to community places / hubs

·       Information, advice and signposting embedded in initial conversations

·       Carers, friends and families involved most of the time when appropriate

·       Strengths-based three conversations embedded with entire Adult Social Care workforce

·       Co-production embedded

·       Safeguarding culture owned by all making safeguarding personal

·       Reduction of handoffs between services supported by the right technology

·       Appropriate and timely housing and accommodation offers

·       Needs-based population commissioning, contracting underpinned by integrated brokerage and commissioning based at Place

·       Reducing demand and enabling timely reviews

·       A strong market meeting the needs of the population

·       Provision of quality social care services through contracting, clear accountability and regulatory compliance, with value for money and continuous improvement embedded

·       Appropriate skill and competency of all staff with clear career development opportunities available to all in support of staff wellbeing, recruitment and retention

·       Connected digital technology

Cllr John McGhee spoke to note a lack of reference to housing within partnerships, stating that this was a key factor for many people, especially for older people being discharged from hospital to their home and facing significant waiting times before reablement or other support visits could take place. Cllr McGhee suggested that this sort of arrangement should be sorted prior to discharge from hospital, noting that social care teams had previously been based in hospitals to assist in that regard.

The ICS Director of Place responded to note that housing was contained within the case for change within the report and referred to the developing Housing Strategy taking a place-based approach to complement and problem-solve as part of the alignment of strategies.

Cllr McGhee then made reference to the prevention agenda and it being key to healthiness, with a lot of work in this regard undertaken by the voluntary sector. Cllr McGhee queried how small a place would be included as part of a reference to place-based commissioning.

The ICS Director of Place noted that the voluntary sector worked with social care teams, however, currently this was after service demand had arrived as opposed to filtering demand before it was received. It was noted that consideration needed to be given to an alternative approach to referrals. Local Area Partnership work had a preventative element, with current commissioning based on the needs of North Northamptonshire. There was a need to understand the needs and requirements of local areas prior to local commissioning taking place. A detailed plan for place-based commissioning would commence from early 2024 during finalisation of the strategy.

Cllr McGhee stated that in relation to micro-commissioning and the voluntary sector, funding being only provided on a short-term basis prevented long-term planning and prevention work, with longer-term commissioning required to reduce workload on both the voluntary sector and the Council and to provide certainty.

The Chair responded to note that frameworks being put into place for service providers contained provision to allow for micro-businesses to be set up, especially in rural areas where home care was difficult to obtain. In relation to the voluntary sector, some of these organisations would be on existing framework with annual uplifts providing elements of certainty. There was a need, however, to provide more certainty regarding what the Council could commit to financially, although this was also a wider national issue in terms of government funding for Councils not being long-term.

The ICS Director of Place noted the voluntary sector survived on funding, with the integrated care system seen as an opportunity, although involvement would be a challenge as it was a new culture to adapt to. The Director of Public Health spoke to state that work was ongoing with the voluntary community sector to what assistance the Council could provide in relation to their infrastructure requirement, ensuring a more sustainable sector.

Cllr McGhee noted that the voluntary sector needed to be given time to transition their way of working, with support offered to enable them to do this. Staff on the front line need to be onboard with changes outlined as they were the ones delivering the services, and it was positive to hear that their voices were being listened to.

Cllr McGhee noted that feedback from service users indicated a desire to have a streamlined process with reduced numbers of contacts and dates of service provision. In response, it was heard that currently a variety of interdisciplinary conversations took place but these were not sufficiently joined up, one possibility was having a key person in place to help service users navigate through the future model.

The Chair noted that staff engagement and ownership of the strategy was vital, and the team was commended for the genuine engagement undertaken enabling staff to be the basis for developing the new strategy. In addition, it was vital that service users and their families were kept engaged and provided with an understanding of the Adult Social Care processes they were involved with.

Cllr McGhee noted the financial and time implications inherent in any transition process, and questioned the financial cost involved in the changes outlined and whether this still affordable given government announcements in relation to social care. In addition, Cllr McGhee queried whether a recent report regarding social care placements that had been through the Council’s scrutiny function was related to the strategy before members.

The ICS Director of Place noted that in terms of finance, Adult Social Care was a demand-led service but there was need for collective ownership of the right demand coming into the service, which was why Place was also involved in the development process.

The Assistant Director for Adults Services stated that service demand was growing, but the Adult Social Care Strategy was fundamentally the right thing to do and would not necessarily cost more money. If the most effective connections with the voluntary sector could be made, demand could be managed, realising time and interaction efficiencies that offered a real benefit.

The Chair stated that if processes were correct from the outset, financial and other efficiencies could be realised.

Cllr McGhee raised an issued with data sharing challenges between organisations. The Assistant Director for Adults Services stated that data sharing had historically been a challenge, a significant amount of work undertaken to improve this position, with the advent of the iCAN system referenced. An example of real-time information provision at Kettering General Hospital was provided to the meeting, as well as a partner organisation data sharing warehouse that was an active workstream.

Cllr Paul Marks queried procedures for dealing with people who needed care assistance but would not accept it. The Assistant Director for Adults Services stated that engagement was always attempted with vulnerable people, with reference made to key legislation in this regard. Details of the Adult Risk Management process were provided in an attempt to reduce the risk faced by an individual.

The Chair concluded debate by stating that salient points raised during the meeting would be reflected back in the Forward Plan feedback loop. It was agreed that the strategy would be submitted to a future meeting of the panel prior to being formalised.