Venue: County Hall, Worcester
Contact: Emma James /Jo Weston Overview & Scrutiny Officers
Apologies and Welcome
Apologies were received from Cllr Phil Grove.
Declarations of Interest
Members of the public wishing to take part should notify the Head of Legal and Democratic Services, in writing or by email indicating the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 13 March 2019). Enquiries can be made through the telephone number/email address below.
Confirmation of the Minutes of the Previous Meeting
The minutes of the meeting on 23 January 2019 were agreed as a correct record and signed by the Chairman.
In attendance for this item were:
Avril Wilson, Director of Adult Services
Richard Keble, Assistant Director of Adult Services
Kerry McCrossan, Operations and Integration Manager
Andrew Morley, Business Operations and Development Manager
Cllr Adrian Hardman, Cabinet member with Responsibility (CMR) for Adult Social Care
The Panel had requested an update on progress since the introduction of a new social work approach; the Three Conversations (3C) Model.
The Assistant Director of Adult Services talked through a shorter version of the presentation included in the Agenda (circulated at the meeting).
The 3C approach to social work had now been fully implemented with the exception of Mental Health teams (which would start by the end of Quarter 1 2019/20).
The Assistant Director reminded the Panel of the objectives of the 3C model, which were to:
· listen better to concerns and views of adults and families
· remove barriers to accessing social work advice and support
· improve experiences of adults through a broader wellbeing approach
· make better use of community networks and resources
· encourage greater creativity and remove unnecessary bureaucracy
· improve opportunities to prevent, delay and reduce reliance on costed care packages
· create a better working environment and more satisfying staff role
· better deliver against the spirit of the Care Act and core social work values
· encourage more direct collaboration between Social Work teams, the community and other agencies.
The new model was fluid, and enabled things to get done quickly, as opposed to the previous linear way of working. This approach could be more challenging for Social Workers (SWs) used to a linear way of working, but staff had adapted and rediscovered what it meant to be a SW. Average wait times from initial contact had reduced from 42 days to 80% of people having contact with their SW by day 3.
Graphs charting figures for resolution of new work at each conversation stage, enabled monitoring and indicated that approximately 75% of new work was resolved at the end of Conversation 1.
A map showed that SW teams were located as close as was practical to local populations, which was important for the model to work.
Area team conversion rates (percentage of people who go on to have a long-term care package after contact with Adult Services) was a very important measure of success and the Directorate maintained it would be possible to reduce this figure by 50%. The graph showed that figures in Redditch for those going on to need a long-term care package had halved under the 3C model. Therefore, cost avoidance figures totalled approximately £1.2million, although it was important to note that the amount spent on each care package had not changed.
The culture change needed for the 3C model was important and Staff surveys indicated growing confidence with the new way of working. Staff felt that use of community resources had increased or was about the same and agreed that the model supported Care Act principles.
The Officers believed that all objectives had been achieved and that the 3C model ... view the full minutes text for item 310.
In attendance for this item were Cllr Adrian Hardman, Cabinet Member with Responsibility (CMR) for Adult Social Care, Avril Wilson, Interim Director of Adult Services and Mark Astbury, Interim Head of Finance.
The Chairman explained that performance and in-year finance monitoring was now scheduled for all the scrutiny panels on a quarterly basis. The format of information was still being worked on and it was hoped this would be improved for the future. The Chairman asked the Panel to highlight any further performance information (PI) required.
The Director of Adult Services provided context for the performance information, including the Panel’s recent overview of the Adult Services Business Plan and the national Adult Services Outcome Framework (ASCOF) which enabled a focus on national performance indicators and comparison with other local authorities.
Admissions to Permanent Care per 100,000 (18-64) - ASCOF 2a(1)
· The Director highlighted this as an area of concern, since Worcestershire was a heavy user of beds, higher than the comparator figure. Work was in hand to understand the reasons for this, which would then be reported back through an action plan. Once an individual had been placed in residential care it was difficult to move them, although this could still be an option where it was safe to do so.
· When asked about any other related national PIs, the Director agreed to forward details of action plans from the Association of Directors of Adult Social Services (ADASS). The Panel was reminded that its work programme now included an annual update on the full set of (ASCOF) outcome measures and the Director suggested these be circulated again in case Panel members wished to incorporate any other PIs into the quarterly monitoring sessions.
· A member suggested that progress for both under 65s and over 65s did not look much different and the Director said that she felt the Council was doing better than previously although this was against quite a low base. The data indicated the need to be wary of Worcestershire’s demograph which may bring further challenges as more people got older.
Admissions to Permanent Care per 1000,000 (65+) – ASCOF 2a(2)
· The Director pointed out that while ASCOF 2a(2) figures were above the national comparator level, this was starting to level off with fewer high-end packages of care and it was felt that the 3C model was starting to take effect.
· Figures were high due to pressures to move people through the hospital system and the Director highlighted the importance of people’s choices being respected and not being inappropriately placed in residential care - she referred to some disturbing recent research by Newton on the numbers of people being wrongly placed due to delayed transfers of care (DTOC) pressures, which she would circulate.
· A member pointed out that the graph lines for the comparator and England average figures were quite close and asked why this performance level was so much better than for Worcestershire? The Director ... view the full minutes text for item 311.
· Delayed transfers of care
· High cost care packages (Learning Disabilities)
The Panel was also keen to schedule member visits to relevant social worker Locality Teams.