Meeting documents

Outcome

Area for Development

Comment

Action (if required)

Status

Lead

Improved health and emotional well-being

Continue to reduce the level of delayed transfers of care

This is a Partnership issue and one on which we remain very focused with an emphasis on ensuring people coming out of acute care receive the right/best outcomes for their needs following a stay in hospital.

The new Community Rehabilitation Service is helping to facilitate earlier discharge for people who have sustained head and spinal injuries.

Work commissioned to look at discharge thresholds, transition care beds (including residential & nursing homes and supported to return home) and access

Meeting targets

Jeff Saffin

Improved quality of life

Around the same number of older people were helped to live at home in the council area this year although there is evidence to show that this support is more targeted. However there is no overall growth in performance and the council is falling further behind comparators.

New composite measures for all client groups, that include adjustments for socio-demographics, will improve these figures in the coming year. As we are now fully functioning as a Partnership and do not differentiate between health & social care clients, it will rightfully be possible to include Older People receiving "Continuing Health Care" which will also have a positive impact on performance figures.

NI 136 for all groups currently showing an English average ranking of 68th (150 Councils)

Sarah Shatwell /Lesley Hutchinson

Improved quality of life (cont)

The council needs to ensure that sufficient support and preventative services are available for people living in the council area to avoid further increases in the level of admissions to residential care.

Latest figures for admissions to residential care are considerably reduced for 2007/08.

The Enablement Service and Community Rehabilitation Service both fully operational and showing a positive impact.

On target

Jeff Saffin

Carers are a clear priority for the council, evidenced by targets in the local area agreement and increasing resources to provide support services. However comparatively not enough carers are getting a service and the council needs to ensure targets stretch this performance.

A Community Carer Development Worker Service has been commissioned through Care Network. The service will work closely with G.P Practices to identify carers and increase awareness of information, services and access to assessments.

Work is also being undertaken with service providers to ensure they have robust systems for data capture.

Undertake data quality exercise

Underway

Angela Smith

Richard Brewer

The pattern of breaks in the council area demonstrates a high level of breaks, but that fewer people benefit than in comparator areas and at a high cost. The council intends to increase the numbers of carers offered a breaks service and new resources into the service this year will support this.

Consultation exercises have been held with carers through the Care Network to establish the types of breaks that carers would find most helpful.

Currently exploring the possibility of having a full time respite care bed facility.

Explore further options for break services

Undertake data quality exercise

On-going

Underway

Angela Smith

Richard Brewer

The level of breaks for black and minority ethnic carers remains low and the action plan needs to be implemented.

One of the specific tasks of the Community Carer Development Worker Service will be to identify carers who have not previously been known to AHSC&H and to explore where there are special requirements that need the development of additional services.

Undertake data quality exercise

Underway

Angela Smith

Richard Brewer

Disabled people receive a low level of support to live at home. The council believes support is targeted at areas of greatest need and that increasing numbers of peoples needs are met through the services provided by health partners. However the level of intensive home care, home care and day services provided are also low and spending is at levels below comparator councils, suggesting this may be an under resourced area of social care provision.

The enablement service is now fully functional and as a result there has been a 60% reduction in people receive on-going home care packages. This is a positive and planned effect.

A new Community Rehabilitation Service has been commissioned and is now fully operational. Clients with moto-neuron disease are now all being case managed through this team. The team is also supporting generic teams to better case manage people with long term neurological conditions.

The Physical and Sensory Impairment STIG has been re-convened to ensure issues are addressed appropriately.

Corinne Edwards

Improved quality of life

Currently not enough people with learning disabilities are helped to live at home. Plans to increase the range of supported accommodation are expected to impact in 2008/9

Bath & North East Somerset is currently ranked 22^nd in England, it would appear that the actions set in place are showing positive results.

Continue with planned strategy.

Undertake data quality exercise for LD case

In the top quartile

Underway

Mike MacCallum

Richard Brewer

Making a positive contribution

People are only able to assess their own needs for a small number of services. This is expected to develop with the new integrated teams and moves towards the personalisation agenda.

Work being taken forward as part of the transformation / personalisation agenda. The Core Assessment Framework (CAF) Stage 2 working group are currently considering the best way to achieve improved access to self assessments.

To follow from working group recommendations

underway

Sarah Shatwell /Lesley Hutchinson

As systems for monitoring contracts with domiciliary care providers are developed the council needs to formalise arrangements and clarify the extent of influence of people who use services

Systems are now in place for monitoring and review of services. This includes quality assurance service user feedback forms used by social workers during reviews and staff feedback forms to enable both positives and areas of concerns to be shared with partner agencies.

Further develop service user involvement in monitoring of contracts in the new year and introduce zone meetings with providers.

Angela Smith

Increased choice and control

People are not receiving as timely a provision of services in the council area this year and there is room for improvement in the time taken to complete assessments.

Work is on-going to improve recording systems with a positive effect.

Continue current improvement work

On track to achieve target

Jeff Saffin

More older people have been admitted into residential care this year

A break down of the figurers shows an increase in the number of people with dementia. The new shared Community Strategy for Older People with Mental Health problems has been designed to reduce the burden on residential care. The Councils now has 3 fully open Community Resource Centres with specialist dementia day care facilities

Implement shared Community Strategy for Older People with Mental Health problems

Andria Morland

There are still too many people with learning disabilities living in residential care.

There is a planned program of closures for residential care facilities, however this is not a quick fix and is being done at a steady and realistic pace to ensure all involved are engaged and prepared for the changes.

Continue with planned program

On-going

Mike MacCallum

Not enough assessments for carers of older people with learning disabilities are conducted

This will be picked up through the work of the Community Carer Development Worker Service described earlier.

Undertake data quality exercise

Underway

Mike MacCallum

Richard Brewer

Increased choice and control

Carers do not currently have access to an emergency service.

An emergency service has been commissioned as part of the new domiciliary care partnership

Completed

Angela Smith

Improvements have been made to joint working around assessment processes however people do not yet benefit from a full single assessment process.

An Integrated Joint Assessment tool is currently being piloted in several health and social care teams. The pilot is due to end in the middle of January 2009.

Evaluate Integrated Joint Assessment tool - February 2009.

Underway

Lesley Hutchinson

More people should be enabled to use direct payments, with a particular focus on carers and people from black and minority ethnic communities

This is covered and addressed with the Action Plan for Putting People First and the transformation of social care

Actions and progress monitored through the Transformation Projects Board

On target

Sarah Shatwell /Lesley Hutchinson

Freedom from discrimination and harassment

The council has not given sufficient priority to implementing the equalities standards and improving council performance around the diversity agenda. The adult social care department is working to lead improvements in the council.

The council has committed to reach the "achieving" level of the new Equalities standard. An action plan to achieve this is in place and monitored by the Corporate Equalities Group.

Underway

Samantha Jones

Freedom from discrimination and harassment

The councils equality schemes are available for the public to view, however progress towards implementation of them is not accessible.

The Council will be publishing a single equality scheme by April 2009 which will be updated to show progress on the public website

Samantha Jones

Economic well-being

Disabled people do not currently benefit from a wide enough range of employment initiatives. The council has ideas to progress this, which need to be made into concrete plans.

A series of initiatives are being developed - further information to follow.

Underway

Janice Hancock

Continue to increase the support for carers to remain in work

Community Learning Service are working with Care Network to provide training courses for carers. Consultation questionnaires were sent to over 780 carers. First courses began in Sept 08

Evaluation of courses for carers due in March 09

Underway

Lynne Atherton

Maintaining personal dignity and respect

The council needs to monitor safeguarding through audits conducted to consider quality and improved outcomes for people who have been through the safeguarding process.

An audit and assurance framework is being implemented throughout the safeguarding partnership

An audit of the outcomes for all safeguarding referrals is underway to be completed by the end of January 2009.

Underway

Shirley Ward

Leadership

The council needs to improve ethnicity recording ensuring staff understand the value of this.

The failure rate for the recording of ethnicity is less than 5% in all client assessments (including AWP). This is considered to be good but it is recognised that it could be improved.

Briefing for staff to reaffirm the importance of recording information on all equality streams

Jane Shayler

Develop clear action plans with specified timescales for the implementation of the Putting People First agenda

Action plans with timescales have been completed.

Actions and progress monitored through the Transformation Projects Board

On target

Sarah Shatwell /Lesley Hutchinson

Commissioning and use of resources

High cost placements in mental health and learning disability services continue to be a challenge for the council.

High cost residential placements have reduced in both mental health and learning disability services however this is now beginning to have a knock on effect on Supported Living Services particularly in mental health services.

Strategies to continue the reduction are in place and will continue to be implemented

Improve contractual arrangements with Supported Living Providers to ensure good quality, outcomes and Value for Money

Early stages

Lessons from improving domiciliary contracts should be used to improve residential contracts in 2008/9.

New draft residential care contract being developed

Draft contact due end Jan 09

Caroline Round

People's needs are not yet comprehensively drawn together in a JSNA. The council has taken a modular approach, focusing on agreed priorities, from which commissioning plans will be made. Involvement from the public and internally from Overview and Scrutiny needs improvement.

These have been completed and published for 2008-09.

Public engagement and involvement work has been undertaken

Incorporate outcomes from the public engagement and involvement work into the JSNA

Underway

Kieran Morgan

People with physical and sensory impairments who live in Bath and NE Somerset do not have as much money spent on them as in other council areas.

The Council prioritise spend according to assessed needs. This will be kept under review and will benefit from increased efficiency and partnership working