Agenda item

This report provided an update on adult social care, both locally and nationally. It included details on demand within the sector and budget as well as information on key work which had taken place within the last six months. Adult social care had:-

·         Provided advice, guidance and support to an average of 3,200 residents each month. This was helping to manage the increase in demand for support.

·         Improved the way that the Home Independence Team works. This had increased the capacity within the team, which had improved the number of hours it had been able to work with residents from 471 hours per week in November 2023 to 652 hours in January 2024.

·         Made improvements to hospital discharge. Adult social care staff were now working with NHS staff as part of an integrated team to assess people in hospital ready for discharge. Staff were also working with NHS in the Transfer of Care Hub, a single unit that organised discharges from hospital. As a result of these changes there has been a 40% reduction in the number of people who were waiting in hospital unnecessarily when they were medically fit for discharge.

As a result of more people going home or straight into a permanent placement, the improved support to residents had also helped the system to reduce the number of interim care home discharge beds. These have been reduced from 46 in March 2023 to 20 in March 2024 and the length of stay in such beds had also reduced to 41 days.  These changes have been better for people leaving hospital and had meant a better use of available capacity for the system.

However, alongside improvements and successes, adult social care was still experiencing some significant challenges, including:

·         Increasing demand for services and support for people with  more complex needs

·         Increasing unit costs for services, with external care providers struggling with recruitment pressures and a high cost of living

·         The national shortage of qualified professionals

·         The high number of safeguarding referrals made to the Council, which was twice the rate of similar authorities. When triaged, it was clear that many of these referrals did not relate to safeguarding issues.

RESOLVED –

That the latest developments in relation to adult social care, both locally and nationally, be NOTED.

This report provided an update on adult social care, both locally and nationally. It included details on demand within the sector and budget as well as information on key work which had taken place within the last six months. Adult social care had:-

·       Provided advice, guidance and support to an average of 3,200 residents each month. This was helping to manage the increase in demand for support. There had been improvements to their website and the customer service team so residents could be triaged more effectively. The Bucks Online Directory was also being updated. 

·       Improved the way that the Home Independence Team works. This had increased the capacity within the team, which had improved the number of hours it had been able to work with residents from 471 hours per week in November 2023 to 652 hours in January 2024.

·       Made improvements to hospital discharge. Adult social care staff were now working with NHS staff as part of an integrated team to assess people in hospital ready for discharge. Staff were also working with NHS in the Transfer of Care Hub, a single unit that organised discharges from hospital. As a result of these changes there has been a 40% reduction in the number of people who were waiting in hospital unnecessarily when they were medically fit for discharge.

·       The service area were currently preparing for the CQC assessment.

·       In safeguarding the service were addressing 96% of cases within 48 hours. The service area were working with partners to reduce inappropriate referrals to safeguarding.

·       The transformation programme was focusing on prevention and reablement to deliver savings.

As a result of more people going home or straight into a permanent placement, the improved support to residents had also helped the system to reduce the number of interim care home discharge beds. These have been reduced from 46 in March 2023 to 20 in March 2024 and the length of stay in such beds had also reduced to 41 days.  These changes have been better for people leaving hospital and had meant a better use of available capacity for the system.

However, alongside improvements and successes, adult social care was still experiencing some significant challenges, including:

·       Increasing demand for services and support for people with  more complex needs

·       Increasing unit costs for services, with external care providers struggling with recruitment pressures and a high cost of living

·       The national shortage of qualified professionals – there were vacancy rates of around 24%.  There had been a cut nationally to adult social care apprenticeship training.

·       The high number of safeguarding referrals made to the Council, which was twice the rate of similar authorities. When triaged, it was clear that many of these referrals did not relate to safeguarding issues as mentioned above.

The Cabinet Member reported that they were still waiting for changes from the new Government with regards to social care reform and the implications of a National Care Service and how this would be funded. There was no mention of social care in the King’s Speech in July.

During discussion the following points were made:-

·       The Council had worked very hard with the Integrated Care Board and Hospital Trusts over setting up a transfer of care hub so patients could be assessed and triaged more quickly and moved to the right place for their needs. This might include providing interim care home beds if they were not quite ready to move back to their home. Social workers had also been co-located within the hospital. There was also the reablement service which was proactive and aimed to get people back on their feet and reduce their need for ongoing care. There was also a principle of Home First getting people living at home with home care support. The Council procured the home care contract 18 months ago which had increased capacity in the market place. The Health and Wellbeing Board had discussed the winter plan at their last meeting.  South Central Ambulance Service (SCAS) were in the process of changing their IT systems which would help the triage process.

·       It was a historical issue that the Council had a higher number of safeguarding referrals. They were undertaking targeted work with the SCAS and Thames Valley Police. They had now developed a better triaging system and threshold protocol to enable the numbers to be reduced with more appropriate referrals. In terms of Section 42 inquiries the Council was at the national average.

·       There were 150,000 vacancies nationally in the care sector.

·       In terms of putting pressure on government it was noted that the Leader was the Lead on Adult Social Care at the County Councils Network who made representations and wrote articles on adult social care. Several reports had been commissioned on issues with adult social care and why the system needed rethinking and refunding. The Cabinet Member for Health and Wellbeing sat on the Local Government Association Community Wellbeing Board which lobbied government. The Leader reported on a piece of work looking at the whole structure of supporting working age adults and funding.

·       Reference was made to the digital switch over and moving from analog to digital telephone lines. The Corporate Director reported that he was working with communication providers and sharing information around vulnerable customers. In addition the Council was working with the equipment provider (NRS) to ensure that they were notifying clients.

·       Housing was a critical area and there was a need for more supported living accommodation and different types of accommodation for working age adults and older people. A housing needs assessment had been undertaken by adult social care which would feed into the Local Plan.

RESOLVED –

That the latest developments in relation to adult social care, both locally and nationally, be NOTED.