Progress Report on Personalisation Programme

AGENDA ITEM 6

BOROUGH OF POOLE

PROGRAMME MANAGEMENT BOARD - PERSONALISING ADULT SOCIAL CARE

07 MARCH 2011

PROGRESS REPORT ON PERSONALISATION PROGRAMME

1. Purpose of Report

1.1.To provide board members with an overall update on the Personalising Adult Social Care programme as we approach the end of this three year government agenda. The report will also identify the next steps we need to take to build on the past three years and harness the government’s on-going vision for Transforming Adult Social Care “Think Local, Act Personal”.

1. Decisions Required

2.1.Board to decide if they need to meet again on 16 May 2011, or whether Board can now be dissolved.

2.2.If meeting agreed for May,Board topropose items for the final agenda.

1. Programme Overview

3.1.Throughout the Programme we have used the Putting People First Milestones to monitor our progress. There are 5 key milestone areas to the programme and achieving these has provided us with a solid foundation as we move beyond March 2011, with the Programme no longer in place.

3.2.The underlying principlesfound in these milestones will continue to be fundamental to our work as we move beyond March 2011 and help us build on the progress to date. These principles include:

• Involving people in designing and developing services
• Giving greater choice and control
• Partnership working to provide cost effective services
• Preventative services to help maintain independence
• Quality information, advice and advocacy
• Care and support services based on needs of the local population

3.3.Although these principles continue to be reflected in any new work we do, such as contracts, service developments or information and advice, we will continue to make sure that individuals’ outcomes are being met in a personalised way.

3.4.With the Personalising Adult Social programme ending, Poole Adult Social Care has introduced newmeasures to oversee all service developments planned beyond April 2011. This will enable both units to manage any further work required as part of the business planning process.

3.5.As of the 1st of April the Personalisation and Efficiency Team will no longer exist. The team has reduced over last few months as projects have finished and people have moved in to other areas of responsibility. However, as new initiatives have become part of routine practice, key leads across both units have been identified to continue oversee future developments.

1. Engagement, Quality Assurance, Advocacy and User Led Organisations (Milestone 1)

4.1.Milestone 1 was concerned with councils introducing both formal and informal ways to enable services users, carers and the wider public to contribute to the design and delivery of services. Several changes in Poole have been introduced to achieve this milestone, as described below.

4.2.Service User and Carer Engagement Framework – The Framework has been signed off by Senior Management Team. Nikki Brown (Quality Development Manager) will be giving a presentation to members of the Programme Board at the March meeting – see separate presentation.

4.3.Developing Advocacy Services for all –The Dorset Advocacy Pilot for Older People, people living with Long term Conditions and Carers continues to operate well and achieve positive outcomes for individuals. From July to December 10 people have been supported and there are a further 6 people on a waiting list; all referrals are assessed to ensure that Advocacy support is provided to those with the most urgent need. The pilot has evidenced the requirement for Advocacy in the Borough and discussions are ongoing to confirm how support can continue in 2011/12 within the funding available. Kerry Flann Principal Officer Joint Commissioning remains the lead for this work at present.

4.4.Access Dorset – User Led Organisation (ULO) Update – ‘Access Dorset’ a new registered charity that will act as an umbrella organisation for user led organisations supported by Poole, Bournemouth and Dorset. Access Dorset fulfils the milestone requirement to have a ULO modelled on existing Centres for Independent Living by December 2010.

4.5.The public launch of Access Dorset took place on 20th January 2011. 150 disabled people, older people and carers attending as well as key partner organisations, representatives from the Department of Health South West and the three local authorities.

4.6.Key partners include Dorset Advocacy, Pro Disability, Dorset Mental Health Forum and Poole Forum as well as a number of others. Together they offer a range of services to support people to live independently. The new website is now live to the public and can be found at:

4.7.The project has been hailed across the region and nationally as an example of good practice and successful partnership working. A DVD on the creation of Access Dorset has been made by the Social Care Institute for Excellence and is due to be launched in March at their national conference. The Department of Health has written to the Prime Minister citing Access Dorset as an exemplar of ‘Big Society’ in action.

4.8.The Borough of Poole is committed to working with Access Dorset and this is reflected in the new Service User and Carer Engagement Framework overseen by Nikki Brown. We are in the process of agreeing further funding at this stage, although as an organisation they plan to become self-sufficient by the end of 2013.

1. Self-Directed Support & Personal Budgets (PPF Milestone 2)

5.1.Milestone 2 focused on ensuring people eligible for support were informed upfront how much funding was available and supported to take greater control over their care whether commissioned by the council, taken as a Direct Payment, or received as a mixture of the two.

5.2.Personal Budgets are now offered to everyone who is eligible for long term support and who is due to be re-assessed. All of our social care teams use the self-directed support process.

5.3.Over 1100 people have been advised if they are eligible for a personal budget allocation and how much their personal budget will be to meet their identified outcomes, (as at 11th February). This is a significant increase compared to the figures of 600 last reported in December.

5.4.The needs of carers are assessed in the Joint Carers Assessment, which forms part of the Supported Assessment Questionnaire. Carers with possible eligible needs will complete an individual assessment to determine FACS eligibility and if there is a need for further support, beyond our generic carers services.

5.5.Poole has achieved all milestones to date by introducing Personal Budget across all teams. The final milestone was to ensure at least 30% of eligible service users and carers had a personal budget. In Poole we estimate we are likely to achieve around18% by the end of March. However,66% of local authorities in the South West have also said they will not meet the 30% target. There have been some issues with how this target is calculated and the new Coalition Government has announced a change in response to this problem.

5.6.These proposed changes mean we are performing much better at this point. At the end of January, Poole had achieved 27% using the revised indicator and aims to achieve 40% by the end of March 2011. The government wants 90% of people eligible for long term support to be given a Personal Budget by 2013. We do not anticipate any problems achieving this moving forward.

5.7.A suite of person centred planning tools have been developed for staff. The tools will assist in supporting individuals to:

• Work in partnership to help plan their life and future
• To assist people to choose how, when and where they receive support
• To provide information to inform people of their choices of support and who supports them
• Describe what they can do for themselves to consolidate and affirm what they can do for themselves
• Show how they can take risks safely
• Identify support systems and responsibilities to reduce risks

5.7 A review of the Self Directed Support process Resource Allocation System will be undertaken over in the early part of the new financial year.

Direct Payments

5.8Since April 424 people have received a Direct Payment at some point in the year to purchase services to meet their eligible needs, instead of Adult Social Care commissioning services on their behalf.

5.9The current contract with the Direct Payment Support Service, PRO-Disability, an established local user-led organisation runs until 31st December 2011. Work has now started for the retendering of this contract. We will engage with people to establish what sort of support service they will want in future to meet their needs, and involve them throughout the whole process. Jo O’Connell has the commissioning lead for this piece of work.

5.10The Personal Assistant (PA) register PRO Disability has set up as part of their on going development, continues to grow. Nearly 100 people (as at January 31st) have expressed an interest in joining the register, an increase of 30% compared to the report in December. Nearly 40 people have been fully vetted and are ready to start work.

5.11Below are some examples of how the register has benefitted some individuals:

• Miss X – her regular personal assistant(PA) has been off sick, she does not like to use agencies. Pro-Disability were able to find her some temporary support using a PA from the register.
• Mr Y– required a pa for 30 hours and we matched a pa from the register with his needs and this is now going very well.
• Miss Z– this lady has in the past, been unsuccessful with employing a pa. Pro-Disability matched her requirements with pa’s from the register and found 1 suitable person. With support from Pro-Disability the individual interviewed and appointed this PA and all is going well.

6Prevention and Cost Effective Services (PPF Milestone 3)

6.1Milestone 3 is concerned with developing services and support in partnership with key stakeholders, in particular health services,in order to help people stay independent for as long as possible.

6.2There are a number of initiatives with health as part of the ‘Transforming Community Services’ programme for Poole and Bournemouth. This is lead by Sally Sandcraft the Deputy Director of Joint Commissioning and Partnerships(Adults & Older people) for NHS Bournemouth and Poole. This programme includes the following:

6.3 Integrated Health and Social Care Locality teams–aimed at supporting older people and people with long term conditions, Poole Adult Social Care Services unit will be working with Dorset Healthcare Foundation Trust to establish multi-disciplinary teams consisting of Social Workers, District Nurses, Care Management and Occupational Therapy staff across the four localities in Poole. As part of the restructure of the Adult Social Care Teams new Locality Managers have recently been appointed.

6.4 Re-ablement Service – Although Poole already has an Intermediate Care Service (PICS) to help support people at home for a short period of time and reduce need for hospital admission, it is recognised that investing in re-ablement services can help keep people out of hospital and independent in their own homes for longer. A working group lead by Sally Sandcraft is developing a model for re-ablement for Poole and Bournemouth using funding by the Department of Health in 2011/12.

6.5 Assistive Technology and Telecare – People in Poole already use a range of equipment such as ‘lifeline’ to help them stay at home. As well as re-ablement services the working group are also exploring how other forms of electronic monitoring equipment might help support people.

6.7Extra Care Housing – Delphis Court a new purpose built extra care housing scheme for people over 50 or people in need or support is now open. It has 40 units and people are moving in on a weekly basis. Support is provided by a scheme manager and the Borough of Poole Home Care Service out of hours. Delphis Court will be invaluable in enabling people to remain in independent living rather than being admitted into residential care.

7Universal Information and Advice (PPF Milestone 4)

7.1Milestone 4is concerned with ensuring people being able to easily find relevant quality information and advice about services within their community.

7.2The Poole Adult Social Care Information and Advice Strategy for informationhas been produced and published on the Borough of Poole website. It recognised the work already completed in improving public information regarding social care services across the town, in places such as libraries, council offices and GP surgeries.

7.3Furthermore, the strategy has a three year implementation plan; however the first key piece of workto develop an information web directory will be delivered by the end of March 2011 using Open Objects Ltd.

7.4‘Source’ the new information website directory developed in partnership with Bournemouth and Dorset is now live. Although this project has been challenging, launching it in stages has promoted good partnership working and has ensured timescales have not been jeopardised. The first stage was for service providers to register their details on the website. The next stage was to promote ‘Source’ to all staff, (end of Feb). The final stage will be to officially launch to the publictowards the end of March with a launch event and articles in Poole News and the local press.Marketing materials will be available across all customer contact points within the council and sent to local GP and health services.

7.5The new website will be closely monitored by all three authorities and enhancements made following customer and provider feedback. A pan-Dorset service user group will be established to work with officers to agree any improvements.

7.6To support the ongoing universal information and advice theme, work to modernise our current ASC helpdesk service is being planned for. Accessing accurate and up to date information is critical if we are to strengthen the focus on people within their natural communities and support the changes to service delivery models across the council.

8 Day Service Redevelopment (Seaview ) - (PPF Milestone 5)

8.1The redevelopment of the site will ensure we have a facility for the future that will meet the complex and differing needs of people who still want to regularly visit a local day centre. The modernisation of the building will offer more space for use by health, voluntary and community organisations. Subject to approval by councillors, construction work will start in June with completion scheduled for January 2012. Geoff Colvin has and continues to meet with service users and carers to update them on plans and timescales.

8. Local Commissioning (PPF Milestone 5)

8.1This final milestone focuses on how we commission services in the future that address the needs of the local population. Poole Adult Social Care Commissioning and Improvement Unit’s key role is to help deliver this agenda. In addition to the new joint Bournemouth and Poole Older Persons Commissioning Strategy, the Dementia Joint Commissioning Strategy, the Joint Carers Strategy and the new 1 in 4 Mental Health Strategy, work has now started on a Poole and Bournemouth Learning Disability Strategy and will take into consideration the learning from the Adult Social Care annual survey now underway. The results and learning from of this survey are not expected to be available until early June. Jonathan O’Connell, Principal Officer Joint Commissioning (Learning Disability and Mental Health) is leading on this work.

8.2 Care in the Home Contract Update - A Tender Evaluation Process was undertaken during the later part of 2010 and earlier part of 2011. There have been 9 providers awarded the Care in the Home contract to start from April 1st. There will be a transition period of six months where new providers take over from unsuccessful providers currently providing services. A project team will work to minimise any disruption to services users and carers as these changes take place.

9.0 Integrated Community Equipment Services Update

9.1Equip for Living is the Bournemouth and Poole health and social care community equipment service which was launched in April this year in partnership with the equipment retailer Nottingham Rehab Services, (NRS). The equipment store relocated to Wallisdown Road and now includes a demonstration and retail centre ‘Enable Me Centre’ for people to go for advice and to purchase equipment privately.

9.2People eligible for equipment from Adult Social Care services will be assessed in the usual way by the community occupational therapy service. The equipment is generally delivered within three days. We are progressing the Driver Technician service which is where the NRS trained drivers have authority to provide some specific kits which will assist people maintaining their independence without the need to await an Occupational Therapy visit.

9.3The contract includes a recycling service so that equipment is collected when no longer required. The equipment is then cleaned in a specialist recycling facility before being reissued. This continues to keep costs down whilst also benefitting the environment.

9.4 A new personalisation catalogue is now available on the ICES website,which will give people the option to visit the Enable Me Centre following assessment and choose between a standard stock item using an equipment prescription, or pay extra to have an alternative model. .