Agenda item

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 was proving very successful for residents and staff as well as avoiding costs. The Council was not the first to implement the 3C model but was now probably the leading Local Authority using it. However, the Assistant Director acknowledged the difficulty in getting feedback from service users and this would be something the new Principal SW would be targeted with improving. Work was also taking place with the University of Worcester.

The Chairman invited questions and the following main points were raised:

·         Members felt the model had a more human approach but was more challenging for staff.  Officers explained that the previous model had been task focused and the 3C was a more fluid model which was easier for some staff than others.

·         A member asked for more detail about the fact that the model had created some challenges and was advised that the key area was moving from a linear way of working to one which was very fluid and did not conform to a neat flowchart; some social workers experienced in the old working style found this very challenging, whereas others found it brilliant and liberating. There had been some challenge around transferring systems and paperwork to the new model. Additionally, the new area-based focus was a challenge for some social workers since their work may now require them to deal with a greater range of issues and crisis which previously would have been handled by other teams.

·         Staff surveys had been largely positive and the main area staff found challenging was about not being told what to do. The new style of working involved less triage although the vast majority of staff had come around to this. It was recognised that some staff felt exposed to an unfamiliar side of work and managers worked with any such individuals. Some staff had also expressed frustration where an area lacked a service to address an identified need, which was useful information for commissioners.

·         A member asked whether unions had been involved in staff surveys but was advised that the exercise was about staff feedback as professionals rather than as Council employees. Approximately half of SWs had responded which was quite a high response.

·         Overall there had been very little negative feedback. Staff felt they were leading the process and met weekly to share resources and deal with any issues.

·         It was clarified that cost avoidance figures for Redditch South Locality Team were lower than other areas because they only referred to part of the year, and Redditch South was now combined with Redditch Central.

·         Officers would provide information on the total number of packages of care and the direction of travel, and the Director also advised that there were performance indicators in place to help measure success in enabling people to maintain independence, for example those included in the Panel’s performance monitoring.

·         A member asked how the model made use of community networks and resources and what had been found? The Officers explained that this had been part of the 12-week innovation period for each site before going live. Staff were tasked with going out into the community and collating information on whiteboards, which had since been collated and made available through a mobile app. Staff had enjoyed this work and had discovered lots of small, informal groups. Sometimes what a person in need required was simply as in the example given of someone with a van helping move furniture, which sounded very simple but was not something on the list of available options under the previous way of working; the 3C model gave staff permission to be creative thinking.

·         The CMR was very supportive of communities helping to keep people independent and explained how parishes had helped gather new knowledge about community networks.

·         The Director welcomed input from all members about community knowledge and would provide Panel Members with a form which they could complete about community activities in their areas. 

·         It was clarified that average care package costs were higher in Wyre Forest because current numbers were relatively low, and a very expensive care package would significantly impact on the average cost.

·         A member asked how the Directorate ensured consistent standards of service across Worcestershire. Officers acknowledged the importance of adhering to a framework of standards and advised that they were working within the Care Act, that benchmarking was used and an audit tool. The Director felt confident that current measures would allow Officers to see if areas required more input – the Panel was pleased to hear this.

·         When asked whether the Directorate monitored those who took up services in the community outside of Worcestershire, the Officers advised that it did not, however the Directorate did monitor those who came back to the County Council requiring services and while the evidence showed that promoting independence enabled people to remain independent for longer, there was always the opportunity for people to get back in contact with their locality Team. Additionally, social workers tended to wait until they were confident that the prescribed solution was working, before closing an individual’s case.

·         Referring back to the challenge felt by some social workers in adapting to the new way of working, a member sought further assurance about how this was managed and what safety net was in place. Officers explained that the teams comprised social workers and social care workers and whilst it was preferred for the staff member picking up the call to work with the individual concerned, if it became apparent that a more experienced staff member was appropriate then this conversation would be had with the individual member of staff concerned at an early stage.

·         A member asked whether numbers of occupational therapists (OTs) were sufficient for the 3C model and was advised that a few were employed by the County Council but there was a shortage nationally. The Directorate was exploring the possibly of a reablement team which would combine the skills of OT and social work.

·         When asked for numbers of SW vacancies and numbers of agency staff, the Officers would confirm these figures, however recruitment of SW and agency staff had not been problematic and the increased cost of agency staff was managed within the budget (a full time SW equated to two thirds of an agency SW in cost terms). SW and social care worker capacity had been particularly crucial during the innovation period of the 3C model. The Directorate looked at staff numbers and turnover across the year and a greater concern was the increasing age profile of the current workforce.

·         When asked about any variance in staffing across the Locality Teams, the Officers reported that there had been a good response from student social worker to a recent recruitment, which meant the Directorate would be able to recruit to wherever was most needed; the 3C model attracted staff.

·         The Panel congratulated the Directorate on the introduction of the 3C model, and the CMR paid tribute to Andrew Morley, Business Operations Development Manager, who was leaving the Council, for leading this work, his input and inspiration, which meant Worcestershire was now a leading 3C county.

·         A member asked about whether the 3C model was having an impact on patients being able to leave Acute hospital settings and was advised that such patients needed to be medically fit for discharge, although the 3C model would help with social care needs which may prevent them leaving.

In summing up, the Chairman verified the information requests arising from the discussion and would consider further updates as part of the Panel’s work planning.

The following information was requested:

·         total number of care packages and direction of travel

·         a form which Members could complete about community activities in their areas

·         numbers of SW vacancies, agency staff and staff turnover.