Annual Performance Assessment: Adult Social Services

AGENDA ITEM 15

BOROUGH OF POOLE

CABINET

2 DECEMBER 2008

ANNUAL PERFORMANCE ASSESSMENT: ADULT SOCIAL SERVICES

1.Purpose of Report

1.1.To report to the Cabinet the Annual Performance Assessment in relation to the Borough of Poole’s Adult Social Services.

2.Decisions Required

2.1.That Cabinet Members:

2.1.1.Record their appreciation in regards to the work of employees and carers of the Borough of Poole and of partner agencies which are central to the assessment of the Borough of Poole as a Three Star Adult Social Services Authority.

2.1.2.Refer the full Annual Performance Assessment report to the Health and Social Care Overview and Scrutiny Committee.

3.Context

3.1.The Commission for Social Care Inspection (CSCI) is the organisation responsible for undertaking performance assessments of all Local Authorities with Adult Social Services responsibilities and determining every year an overall performance rating for them. Authorities are judged on a star rating system, ranging from zero to three stars, with three stars being the highest award and zero stars being the lowest.

3.2.CSCI’s overall judgement for 2007/8is that for the third year running the Borough of Poole’s Adult Social Services is awarded the highest rating of Three Stars. The service has been judged as “Good” in terms of delivering outcomes with “Excellent” Capacity to improve. This result reflects the dedication, commitment and professionalism of Social Services staff as well as the commitment of partners from the voluntary/statutory sector to secure successful partnership working. It also shows that there is clear support of service users and carers in helping to continually develop services.

3.3.In order that elected members can set the Borough of Poole’s performance in a national and South-West context, the following table sets out the numbers percentages of authorities assessed in each Star Rating band:

Zero Stars / 1 Star / 2 Stars / 3 Stars
England / 0 / 19 (12%) / 75 (50%) / 56 (38%)
South West / 0 / 6 (38%) / 7 (44%) / 3 (18%)

Source: Commission for Social Care Inspection

3.4.The award of the three-star rating is only one part of the Quality Assurance process for Adult Social Services. Instrumental to achieving better outcomes for the people of Poole is the on-going requirement to work with key partners and stakeholders (including service users and carers) as well as using business plans, review meetings with CSCI and feedback from various sources to actively plan for continuous improvement.

3.5.The Cabinet are asked to recommend that Health and Social Care Overview and Scrutiny Committee consider the CSCI full assessment of Poole’s Adult Social Care Services. The assessment identifies further “Areas for Development” which officers and elected members will wish to ensure are addressed.

3.6.The Summary Report of 2007/08 Annual Performance Assessment of Social Care Services for Adult Services for Poole is attached as Appendix 1.

3.7.The full report is available at and

Report of:

John Dermody, Service Unit Head, Adult Social Services (Commissioning)

Charlie Sheldrick, Service Unit Head, Adult Social Care and Wellbeing

Jan Thurgood , Strategic Director (Adult Social Services)

Contact:

Jan Thurgood, Strategic Director, Borough of Poole, Civic Centre, Poole BH15 2RU

Tel: (01202) 633203, Email:

Dear Jan

PERFORMANCE SUMMARY REPORT of 2007-08 ANNUAL PERFORMANCE ASSESSMENT OF SOCIAL CARE SERVICES FOR ADULTS SERVICES FOR BOROUGH OF POOLE

Introduction

This performance summary report summarises the findings of the 2008 annual performance assessment (APA) process for your council. Thank you for the information you provided to support this process, and for the time made available by yourself and your colleagues to discuss relevant issues.

Attached is the final copy of the performance assessment notebook (PAN), which provides a record of the process of consideration by CSCI and from which this summary report is derived. You will have had a previous opportunity to comment on the factual accuracy of the PAN following the Annual Review Meeting.

The judgments outlined in this report support the performance rating notified in the performance rating letter. The judgments are

Delivering outcomes using the LSIF rating scale

And

Capacity for Improvement (a combined judgement from the Leadership and the Commissioning & Use of Resources evidence domains)

The judgment on Delivering Outcomes will contribute to the Audit Commission’s CPA rating for the council.

The council is expected to take this report to a meeting of the council within two months of the publication of the ratings (i.e. by 31st January 2009) and to make available to the public, preferably with an easy read format available.

ADULT SOCIAL CARE PERFORMANCE JUDGMENTS FOR 2007/08

Areas for judgment / Grade awarded
Delivering Outcomes / Good
Improved health and emotional well–being / Excellent
Improved quality of life / Excellent
Making a positive contribution / Good
Increased choice and control / Excellent
Freedom from discrimination and harassment / Adequate
Economic well-being / Good
Maintaining personal dignity and respect / Good
Capacity to Improve (Combined judgment) / Excellent
Leadership / Excellent
Commissioning and use of resources / Excellent
Performance Rating / 3 star

The report sets out the high level messages about areas of good performance, areas of improvement over the last year, areas which are priorities for improvement and where appropriate identifies any follow up action CSCI will take.

KEY STRENGTHS AND AREAS FOR DEVELOPMENT BY PEOPLE USING SERVICES

Key strengths / Key areas for development
All people using services

Effective and clear leadership - the council is in a good position to take forward the Putting People First agenda.
Excellent practice learning training for adults
Free transport to attend events enhanced engagement with the wider public to provide information and promote healthy lifestyles
All people have access to assessment through brokerage and wide publication of help desk
571 more people received a review than previous year and numbers of reviews are expected to rise again next year.
Interagency assessments and commissioning to prevent falls, improve prevention and rehabilitation with increased assistive technology enables people to receive the care and support they need at home.
A local voluntary organisation awarded the LINks contract is developing outreach to the high street to connect with groups and individuals.
Most People continue to receive timely assessments and services within 4 weeks showing that care management processes are sound.
The single assessment process and electronic records are fully implemented enabling people to tell their story once.
Disabled people are involved in taking actions forward with Disability Equality Scheme rewritten to make it more ‘user’ friendly and understandable to the general public.
A joint integrated service across Benefits, DWP and Adult Social Care provides financial advice to all people to maximise up take of benefits to support their care.
Collaborative working with the PCT to broker CHC and non-CHC care constructively, has helped maintain the market to meet demand and offer choice
Improved safeguarding awareness led to an increase in referrals that led to robust action plans and targeted training.
A SMART review of independent care services, and CRILL/LAMA data resulted in targeted training to improve the quality of care

The percentage of assessments that lead to a service being provided
Customer First a first contact point for council services will be developed to include adult social care to increase access to information for potential service users as well as self assessment becoming easier to achieve.
The number of people receiving direct payments has slightly increased but needs further improvement to achieve the LAA stretch target, particularly from BME groups

People are looking forward to receiving individualised budgets through the planned total system business transformation for personalisation.
A payment or credit card is planned to enable people to purchase their own care directly, minimising bureaucratic burden.
To progress the plan to enable 45 people back into work through the ‘Bridge to work programme’ by 2010
Good engagement to ensure equality and diversity with hard to reach groups needs to become consistent and council-wide
More safeguarding training is required to enable Poole to achieve the performance of comparator groups
More people have moved on to open employment however further improvement is required to achieve levels by comparators.
To consider reasons for the higher than planned staff turnover
More effective performance monitoring systems and governance arrangements are planned across the council to enable systematic evaluation of value for money.
The cost of intensive home care and intensive social care is very high against comparators.

Older people

POPPS project has led to more engagement with older people and is now linked into the wider community agenda, e.g. Safer communities. A major cultural shift generated through joint working has been a key factor in the success of the Poole Intermediate Care Scheme (PICS) that was integrated into a mainstream service.
A massive rise in people receiving PICS in their own home has prevented hospital admissions and reduced occupied bed days.
More people are enabled to remain in their own home at the point of crisis which would otherwise precipitate residential care or hospital admission
Budget efficiencies were found by making better use of human resources, modernising service delivery for dementia care and better commissioning and use of block contracts
Voluntary sector have been commissioned to work with older people and people with memory loss to enable isolated individuals to access the full range of statutory services.

A relatively small but improving amount of intensive home care is purchased via Direct Payments
A joint strategy is planned in 2008/9 to develop the dignity and respect agenda for older people
Poole aim to redesign long term home care, working more closely with health they will link high dependency home care with district nursing service with plans for joint commissioning of these services by Jan 2009.

People with learning disabilities

Investment in the Poole forum (an independent organisation of adults with learning disability) enables people to seek qualitative improvements and has led to inclusion in various community activities. Increased advocacy funding was made available in the learning disability development fund.
A dedicated team was established to assess needs for people with profound learning disability in NHS campus. Individual service designs and financial and procurement plans for housing and care services now inform a realistic plan to move people into accommodation.
A tendering process for preferred providers is underway. 4 supported housing sites have been identified for future housing. One person said ‘Person centred planning has been brilliant – the best yet’
The council has done a needs analysis for care provision and are encouraging new providers into the market, working with the PCT, to ensure sufficient capacity of good quality services.
Direct payments paperwork, and recruitment processes were hard for people to understand. Their experiences have been considered and support and administrative processes have been simplified

To support people to move from NHS Campus into a home of their choice
People and their carers were frustrated by the delay between the excellent person centred planning process and provision of new community services
A new Commissioning strategy is currently under consultation
To implement the planned strategy to introduce more opportunities for self-assessment through the Personalisation & Efficiency Programme, thereby freeing up staff to concentrate on reviewing the care that is commissioned.
To further improve the number of people with learning disability into paid and voluntary work in line with planned improvement

People with mental health problems

Poole Social Services Gateway combines the council’s community access team and primary mental health support service to act as gateway to GP counselling and psychology services. Gateway service has won a Community Care award for partnership working.
There is an open access to mental health services through the social service help desk and FACS criteria are not used.
Improved engagement for people with drug and alcohol (D&A) addictions and a service user forum enables people to be actively involved with developing services. A texting service has been set up to remind people to attend treatment.
An increased range of D&A services, including pre-treatment and a new aftercare service.
Progress was made on LAA stretch target 3 to improve the emotional wellbeing and mental health of adults in Poole.
Service users say retention rates are not particularly helpful to the process as providers sometimes look at the target rather than the service users. People say this is now shifting to be more responsive to service users needs.

Initial difficulties in measuring correct data and baseline to improve the emotional wellbeing of adults with mental health problems
Services for D&A addictions are being developed to increase the proportion of services available for harm minimisation to increase the number of people being retained in treatment.
Discussions with PCT about joint commissioning regarding alcohol services.

People with physical and sensory disabilities

More people with physical disability are receiving help to live at home, with speedier access to minor adaptations assisted by new contracts with three additional providers
People who are blind are known to the council and they receive a prompt and reliable service

Poole Intermediate Care Scheme (PICS) is to be extended to all adult services in 2008.
Poole intend to undertake a review of sight and hearing services in2008 to benchmark and prepare for the personalisation agenda

Carers

Carers now lead the development of a multiagency strategy. Carers say processes have improved this year and they are listened to.
A debit card is planned for direct payments in 2008/9 to include Direct Payments made to carers
4 health and wellbeing events were held with a specific focus being support to carers

Carers say they would benefit from information packs on direct payments, individualised budgets, guardianship and support to go through benefits.
The number of assessments and short breaks for carers deteriorated in the first quarter however following analysis improved by year-end. Further improvement is planned to provide more diverse respite and support services based on carers views.
The carer’s self-assessment document is being reviewed.
A consultation on priorities is planned for 2008-9 to develop carer’s skills to renter the workplace.

KEY STRENGTHS AND AREAS FOR DEVELOPMENT BY OUTCOME

Improved health and emotional well–being

The contribution that the council makes to this outcome is Excellent

There are excellent integrated services with health, particularly for older people as an extension of a successful POPPS scheme, but also in mental health early interventions and drug & alcohol services. Learning from POPPS is sustained and becomes Poole Intermediate Care Service (PICS). Now looking at progressing learning from POPPS integration/engagement into the wider community agenda -safer communities

More reviews were undertaken though the percentage of reviews deteriorated and there was an increase in hospital discharges delays in the first half of the year. Analysis of the delays resulted in the PCT funding step down beds that improved performance. There was a good reduction in occupied hospital bed days. Significantly more people benefited from receiving non-residential care to prevent hospital admission

Partnership working with Leisure Services, & Culture and Learning has led to several successful healthy lifestyle events and courses. People have been supported to access a wide range of leisure and learning opportunities focussed on promoting healthy lifestyles. The council provided free transport to encourage excluded groups to attend events

The PCT has been selected to be a pathfinder for a new psychological therapy service. The PCT selected Poole Social Services Gateway Service as the preferred provider

Planning commenced on the Personalisation & Efficiency Programme to introduce more opportunities for self-assessment, thereby freeing up staff to concentrate on reviewing the care that is commissioned.

Key Strengths

Good joint working resulted in the development of PCT funded step down beds to decrease delays in hospital discharges. A continued good reduction in occupied hospital bed days and comprehensive intermediate care service enables people to remain at home.
People have improved access to events that promote healthier lifestyles with the council demonstrating integration into wider community agenda. A feeling of safety and wellbeing is evidenced.
People who misuse drugs and alcohol are now prompted by texts to attend their treatment to improve retention rates
There is open access to mental health services with excellent joint working with health through the gateway service improving access to psychology.
Joint work is well underway identifying individual service needs and funding to enable people with learning disability to move from the NHS campus

Key areas for development

To enable all people with a learning disability to move from the NHS campus with an individual service designed around their stated priorities.
To complete the planned introduction of self assessments across service users group to realise efficiencies by freeing up staff to undertake more reviews in response to increasing demand.
To ensure the new strategy devised with the PCT to purchase ‘step down beds’ continues to reduce discharge delays from hospital
To continue the modernisation of extra care strategy to meet tenants needs with Occupational Therapy secondment to housing

Improved quality of life