Agenda item

To inform the Forward Plan

The Chair invited Samantha Fitgerald, Assistant Director for Adults Services to provide a service presentation for Adult Services.

The meeting was provided with an outline of the staff that comprised the team, noting their diverse backgrounds and that the Chief Principal Social Worker worked across all portfolios. The Assistant Director for Adults Services stated that there was a desire to invest in the workforce, to allow for sustainability moving forward and to produce staff in-house, noting that work was underway to build this culture within the Council and answer some of the challenges faced in both recruitment and retention.

Details of the service objectives were provided, with the meeting noting that the ultimate role of the team was to undertake the statutory assessments of need in line with the Care Act 2014 by focussing on a strengths-based practice to deliver that outcome.

The meeting heard that the team supported Adult Social Care Services through a ‘Three Conversation Model’ offering a person-centred and outcome-focused service. The service worked in partnership with those requiring support to help individuals live more independently and achieve the right outcomes for them. It was noted that this could be through their own resources, their family and friends, community networks, or formal support through a variety of locations and teams as detailed below:

·       Community Hubs (4)

·       Inclusion Hubs (4) 

·       Learning Disability Hubs (2) 

·       Dedicated Adult Social Care Hospital team  

·       Continuing Health Care Team

·       Care Home Review Team

·       Reablement North 

It was heard that within all the teams and services work was undertaken alongside partner agencies putting service users at the centre of activity to produce consistently better outcomes for people. As the place project continued work would be undertaken to ensure hubs were as accessible as possible.

The meeting was advised that the service operated a strengths-based approach working with adults over the age of 18 and supporting adults with mental health, physical health, vulnerabilities, age-related issues and learning disabilities. A significant amount of work had been undertaken with staff to assist in the understanding of this approach.

The “three-conversation” model for service users saw initial contact to connect and listen to the outcomes people wished to achieve from the service. Conversation two would consist of intensive work with the person seeking support, with conversation three providing longer-term formalised care and support.

Details of the service road map of the journey through Adult Services was provided to the meeting. Cllr John McGhee queried the timescales involved between interventions for service users and noted in response that they were specific to the individual and dependent on their needs.

The meeting received details regarding Community Hubs as being the “front door” for the service, managing all new referrals coming through Adult Social Care, with the exception of those with learning disabilities. Referrals were then progressed through the ‘three-conversation’ model focusing on early intervention and outcome-focused services. ?Community teams also provided long-term social care support to people over 65 years of age, including re-assessment and reviews as well as working closely with all key partners to ensure an integrated support system as offered to people approaching Adult Social Care. ?It was noted that the current system did present issues with hand-offs of service users, however there was an aim to bring together a larger, more resilient team offering efficiencies around core functions and resulting in a more seamless service.

Details were provided of the Council’s Inclusion and Learning Disability Teams, with service users for the latter preferring a single place of service access to connect with the support network. Looking to the future, there were opportunities for service integration and additional work with health partners with an aim of achieving a reduction in hospital admissions, an increase in people being able to reside in their own homes for longer and being able to access employment opportunities.

The panel was provided with key figures relating to the service, noting current staff levels of approximately 300, with around 30 vacancies, primarily frontline social workers and assessment workers with these positions actively being recruited, offering a clear career pathway whilst minimising use of agency staff. The net budget for the service was £99.2m, with 4598 service users currently receiving support from Adult Services, 2862 being over the age of 65. Those receiving care in their own homes were the largest volume of service users, with those in residential care second.

Risk and challenges faced by the service were outlined to the meeting, that noted a significant increased demand for Adult Social Care; an increase of 25% for older persons and 15% for young adults across the last financial year. It was therefore vital that the model for the service allowed as much to be dealt with at initial contact stage to ensure demand was met in the correct manner.

Other areas of risk included availability of social care provision, specifically nursing care and residential for older persons, difficulty in recruiting to key roles, hospital pressures and volumes of provider failure. Waiting lists for assessment and reviews also remained a concern.

The meeting received details of the Hospital Team that provided support for all adults who had been identified by hospital staff as being in need of reablement, and/or long-term care and support needs, to facilitate their discharge from hospital. Key performance details for the team were provided, including details of the percentage of patients discharged to their home as well as residential care outcome figures.

The meeting received details of the activities of the Reablement Team North as well as performance data for the team. The Chair queried how reablement service users were identified as needing help, with a response noting that the majority came through the transfer of care hub as well as primary care referrals.

Cllr McGhee stated that the priority was to get service users back to their homes, and that getting necessary adaptations completed and support provided in timely fashion was absolutely essential in achieving this. The Assistant Director for Adults Services provided figures for the reablement service to indicate current timescales involved.

The panel then received performance details for the Thackley Green Specialist Care Centre in Corby, noting that the site was integral to supporting hospital discharge demands, offering rehab and reablement plus additional resources. Details of referral totals and timescales for length of stay were provided.

Cllr McGhee queried how many of those receiving care were around the average length of stay and how many exceeded that timeframe and questioned how the service assisted those that had been in the care centre for long periods. The Assistant Director for Adults Services noted that those in the care centre long-term had good reasons for being there, usually relating to aids and adaptations and that there were currently only two long-term patients in Thackley Green.

Cllr McGhee queried how the service prioritised aids and adaptations and how timescales involved could be reduced. In response it was noted that the service worked closely with the Housing Team and was examining how the Disabled Facilities Grant could be best utilised to reduce wait times.

Cllr McGhee asked whether the Council had sufficient Occupational Therapists to support current demand and heard that there was suitable capacity, however delays in service progression could impact that capacity.

Data was provided to the meeting that detailed Adult Social Care discharge by pathway, from patients returning home, into short-term care or residential care. It was noted that demand had exceeded levels anticipated.

The meeting then received details of areas for service focus across the next 12-month period, while noting that the service faced unprecedented demand. The Chair queried whether this demand was likely to continue at such levels and could continue to be met by the service. It was noted that regionally and nationally increased demand figures were similar, although North Northants was facing higher demand levels than the regional average. Work was underway across the service and partner organisations to understand the reasons behind this and to look at ways of reducing demand on services.

Cllr McGhee noted the service backlog and the need for a big change in the way social care operated nationally to improve the situation. Reference was made to day care centres and the positive impact these had had on people’s lives. In response it was noted that such centres did still operate and offered people meaningful occupation.  

Cllr McGhee concluded debate by noting that whilst the service faced a difficult set of operating circumstances, efforts of the team to maintain services were appreciated, with the success of the Adult Social Care strategy anticipated.