Meeting documents

Purpose:

The Committee has been regularly reviewing and challenging Adult Social Care’s Better Lives transformation which is organised into 3 tiers.  This item reviews progress within tier 2 "Regaining Independence".  Regaining Independence is focussed on working with people and their families to help the individual gain or regain the skills they need to live independently.

There are two key work streams in this tier– short term intervention and preparing for adulthood.

Attendees:

Mrs W Mallen, Deputy Cabinet Member for Health & Wellbeing

Ms G Quinton, Executive Director, Communities Health & Adult Social Care

Ms S Westhead, Service Director (ASC Operations, Interim)

Papers:

Report attached

Intended outcome:

For Members to assess whether sufficient progress has been made within the two work streams to enable a successful and timely delivery of tier 2 transformation.  For Members to seek reassurance that the projects within the work streams will deliver better outcomes for social care clients.

The Chairman welcomed Mrs W Mallen, Deputy Cabinet Member for Health & Wellbeing and Ms S Westhead, Interim Service Director, Operations.

The following main points were made during the presentation and the discussion.

·         Adult Social Care tier 2 transformation "Regaining Independence" was focussed on working with people and their families to help the individual gain or regain the skills needed to live independently.

·         There were two work streams within this tier – Short term intervention and Preparing for Adulthood.

·         It was acknowledged that tier 2 had been the most challenging portfolio of projects in the Transformation Programme.

·         The initial focus had been on aligning the Council’s Reablement and Occupational Therapy teams with the Hospital Trust’s Rapid Response & Intermediate Care service to form a single short term intervention service.  Whilst there was still the ambition, the short to medium-term focus was on bringing together the Council’s two short term intervention services to improve outcomes and productivity.

·         There was a shift towards putting therapy at the centre of Reablement to make it a therapy based service. This would improve the patient experience and make their journey through the system easier.

·         A Member expressed concern about the performance indicators around older people who were still at home 91 days after discharge from hospital into reablement/rehabilitation services which showed Bucks score at 66.3% against a high of 90.8% in the regional comparator group.  Ms Westhead explained that Bucks was one of the top performers for Delayed Transfer of Care for Adult Social Care in the region.   

·         The development of the Single Point of Access, an integrated health and social care Hospital Discharge team and a Reablement therapy centred service would be the catalyst to improve Bucks performance in this area. 

·         A Member expressed concern in relation to the pace of change around tier 2 transformation and felt that regular communication, particularly around timescales for delivery would be required.

·         In response to a question about delivering a quality service whilst making almost £1 million of savings, Ms Westhead explained that with more people using the rehabilitation/reablement services, this would mean fewer packages of care (the aim would be to move to 80% of patients to the reablement service and thereby delivering the savings).

·         A Member asked about the plans for workforce development and the current vacancy rates for Occupational Therapists and Reablement workers.  Ms Westhead confirmed that the retention rates were good for both areas but there were challenges around recruiting highly skilled Occupational Therapists.  Plans were being developed for upskilling reablement workers to provide training around health and social care.  Discussions were taking place with partner organisations to introduce "grow your own" workers in a similar way to social workers.

·         In response to a question around what "good looks like", Ms Westhead explained that Officers would be visiting Essex County Council on 23rd July.  The Council had introduced hybrid reablement workers who had both social and health skills.  Officers had also visited Luton and Dunstable, who had introduced areas of good practice.

·         In recognition of the recent Healthwatch user engagement exercise, a Member asked what mechanisms were in place to ensure the feedback from the patient voice and experience was used to improve other parts of the system.  Ms Westhead explained that another piece of work would be commissioned shortly as it was recognised as an area which required more work.  The Hospital Trust supports this work.   

·         A Member commented that within the Preparing for Adulthood (P4A) work stream, there were a number of good initiatives taking place but expressed concern that these were not known about across the organisation and felt that opportunities could be lost through not sharing this information. 

·         The P4A project focussed on the young person, aged 14-25 to support them and their families to meet their needs.  The aim would be to start the transition process earlier.

·         A Member asked for more comparator data to evidence the improvements being made in both work streams at a future meeting.  The information should also include benchmarks, timeframes for delivery and specific evidence of improved outcomes for users, particularly around the P4A project.

Action: Ms Westhead

The Chairman thanked the presenters.