Agenda item
DIRECTOR BRIEFINGS - ADULT SOCIAL CARE & CHILDREN & YOUNG PEOPLE
The Panel will receive an update on this item from the Directors of Adult Social Care & Children & Young People.
Minutes:
The Director of Adult Social Care, Complex and Specialist Commissioning
addressed the Panel, a summary of her briefing is set out below and will be attached as an online appendix to these minutes.
Out of Hospital Discharge to Assess Arrangements
As of the 31st of March the national funding for the D2A (Discharge to Assess) process ceases. People who are discharged up to and on the 31st of March will continue to be supported for no longer than six weeks. However, those discharged on the 1st April will not and there is no indication of funding being available beyond that date. In the recent policy paper: Integration and Innovation: working together to improve health and social care for all the government states that there will be a legal framework developed for a ‘Discharge to Assess’ model to replace the existing legal requirement for all assessments to take place prior to discharge. There is, however, no indication of whether there will be any funding provided to support these duties. The Council are, therefore, discussing with the CCG how this work can be progressed within current resources.
Specialist Mental Health Care and Support – proposed whole system procurement
The Specialist Commissioning Team have developed a revised strategic commissioning approach for specialist services for adults with complex mental ill health. The team have recommended a phased approach to procurement whereby they identify a partner (or more than 1) to work with to develop a consortium approach. The formation of a consortium is aspirational and will take longer than other procurement methods such as block contracts and Frameworks on a sector-by-sector basis. However, this approach will mean the council will have a co-produced, flexible, adaptable and meaningful pathway of support for people and partners alike.
This procurement delivers on our statutory responsibilities which include the promotion of quality in the provision of services; is a key action in our draft strategic commissioning intentions; will ensure alignment with the transformation of community mental health services; and is a Council Commissioning Intention.
Mental Health White Paper – January 2021
In January 2021 the Government published the Mental Health White Paper - a set of proposals around changes to the Mental Health Act; it is intended to be a consultation document despite its ‘White Paper’ title.
The Mental Health Act was changed from the 1959 Mental Health Act in 1983 and despite some minor amendments in 2007 the White Paper is considered to be one of the most far reaching reforms of an Act that could be accused of not having kept up with the changing times particularly in regard to a person’s rights and wishes. The principles of 1983 Act are acknowledged to be based on a paternalistic approach to the care and support of people with mental health needs. The White Paper?is therefore an important step forward.
Consultation is due to end on the 14th April 2021 and Local Authorities, Mental Health Trusts and the Third Sector are currently working to formally respond. Parliamentary time has not been set aside to debate the proposals and the responses and the White Paper is not expected to become law until 2023/2024.
Consultation on Changes to Direct Payments
Direct Payments (DPs), are “monetary payments made to individuals who request to receive one to meet some or all of their eligible care and support needs.” (Care Act 2014). These payments can be used to pay a Personal Assistant (PA), to support the DP recipient. PAs support DP service users to meet their unmet needs identified in their Care and Support Plan. Direct Payments provided by Children’s Services are done so under The Carers and Disabled Children Act 2000. On 22/02/21, there were 266 adults using DPs in B&NES.
The intention is to have standardised hourly rates and a new on-cost model across Children and Adult services. As this will constitute a change in policy and practice for B&NES, we will conduct a full 12 week public consultation. At the same time, we will consult on the introduction of pre-paid cards for DP users which is another initiative to improve the management and oversight of DPs. The timing of the consultation will depend on when the project management resource for introducing prepaid cards is in place – likely to be within the next 2 months.
Introduction of Operational Pressures Escalation Level (OPEL) System for Adult Social Care
The Directorate have developed and implemented an Operational Pressures Escalation Level (OPEL) status tool which helps us to review and identify the level of risk and pressure across adult social care. This has supported conversations with systems partners and enabled us to prepare for levels of escalation. The OPEL status framework is one that health partners use routinely.
The broad descriptions are shown in the box below. Each service within the Directorate updates their OPEL status weekly based on agreed criteria. We review our position on a weekly basis and across the Directorate we are currently declaring OPEL 2 and we report this into the Council and to the CCG to be shared on system partnership meetings.
OPEL Two – adult social care
The local adult social care system is starting to show signs of pressure. The local authority will be need to take focused actions in support to organisations showing pressure to mitigate the need for further escalation. Enhanced co-ordination and communication will alert the whole system to take appropriate and timely actions to reduce the level of pressure as quickly as possible. The Adult social Care teams will proactively keep BSW, regional and national colleagues and partners informed of any pressures, with detail and frequency to be agreed with these organisations. Any additional support requirements should be agreed with SLT and would expect to stay within budget or met within available resources and reserves.
The Director of Adult Social Care, Complex and Specialist Commissioning confirmed that she is to leave the Council and introduced Alison Elliott to the Panel who has taken on the role Interim Director of Adult Social Care.
The Director of Education, Inclusion and Children’s Safeguarding addressed the Panel on behalf of the Director for Children & Young People, a summary of her briefing is set out below and will be attached as an online appendix to these minutes.
Practice week
Children’s Services held their first practice week the week beginning 25/01/2021 where we focussed on our work with Care Leavers. We were able to observe some really fantastic and inspiring practice with care experienced young people. Our Lead Member and Chief Executive took part.
Lockdown
During this lockdown, B&NES staff from social care and education have ensured that vulnerable children (Children with a social worker or EHCP) had access to an education placement if considered in their best interests. As a result, B&NES has had one of the highest school attendance rates of vulnerable children in the South West. This work has been complemented by our continued expansion of our Virtual School, which now supports children in need and children on a child protection plan.
All Children’s Services colleagues continue to work hard to see all of children young people within statutory timescales despite the challenges of being in a third lockdown. We are working hard with other agencies to support schools re-opening next week.
Safeguarding outcomes
Children Social Care re-designed the safeguarding outcomes part of the service in June 2020. The service is currently finalising its evaluation report to consider the positives that this has brought to practice and outcomes for children and families.
Covid-19 – Return to school
As children now return to school, B&NES Children’s Services and Public Health teams will continue to offer advice to support schools to manage Covid-19 and allay parental fears and anxieties about returning their children to school. The Education Psychology service will continue to provide on-line training and bespoke sessions on supporting children and staff’s mental health.
The Chair thanked both Directors for their briefings on behalf of the Panel, welcomed Alison Elliott to the Council and wished Lesley Hutchinson the best of luck in her new role.