CARING AT HOME CAREER PROJECT

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1 HEALTH AND SOCIAL CARE COMMITTEE: 5 SEPTEMBER 2013 POLICY AND RESOURCES COMMITTEE: 12 SEPTEMBER 2013 CARING AT HOME CAREER PROJECT Report by Chief Executive, Comhairle nan Eilean Siar PURPOSE OF REPORT This Report updates Members regarding the Caring at Home Career Project. COMPETENCE 1.1 There are no legal, financial, equality or other constraints to the recommendation being implemented. SUMMARY 2.1 The Caring at Home Career Project contributes to the following change programmes; 1. Modernising of community support services 2. Shift in services from inpatient to community based support 3. Integration of health and social care agenda 2.2 The Project Officer was appointed in April This Report outlines the progress with the project to date. RECOMMENDATION 3.1 It is recommended that the progress and direction of the Caring at Home Career Project be noted. Contact Officer: Jane Ballantyne, Background Papers: Appendix 1 - Project Aims, Objectives, Outcomes and Outputs Appendix 2 - Project Governance and Roles Appendix 3 - Overview Plan Appendix 4 - Draft Communication Plan JB/KM 31/07/13

2 BACKGROUND 4.1 The demographics of the Western Isles present a profound scenario for the challenges of shifting the balance of care. The increasing rates of the elderly population combined with our illness and disease profile will inevitably present additional pressures on services, but this is compounded by the projected second largest decline in the working age population for a region in Scotland. Unless change occurs the demand for service will be far beyond the supply capacity of public or voluntary sources. 4.2 The Local Authority and NHS provides care and support to people in their homes and in care homes throughout the Western Isles. The initiative described below aims to put the necessary elements in place to enhance the care provided to service users and to enable services to be better prepared for the longer term demands expected through the changing demographics. 4.3 This project is one of a number of Change Fund programme projects that will come together to deliver modernised community based support for older people. Although the focus is on older people, with the onset on integration, a programme of change must deliver integrated holistic individualised support to people living at home. 4.4 This project was initiated and approved in August A full time project officer, Jane Ballantyne, was appointed in April The scope of this project is to identify the changes required within the Comhairle s community services to deliver support that enables people to live and remain in their own home and to also develop an implementation plan to deliver these changes. 4.6 The aim of this project is to provide a workforce capable of meeting the demands of increased anticipatory care activity within homes or homely settings by addressing the key priorities of the workforce development agenda; career pathways and training, workforce integration, asset and infrastructure requirements and service planning. 4.7 The project will initially focus on the Comhairle s home care services by considering the future demands on providing support to enable people to live at home. This will involve transforming the current services by focusing on person centred support systems, generic roles and integrated functions and teams. 4.8 It is acknowledged that this project contributes to work that commissioners will need to undertake to design, develop and commission a range of services and supports that will enable people to be supported in their communities. 4.9 It is also acknowledged that there is further work to map other community based services, for example, day support, respite, residential and nursing care and housing support services Appendix 1 provides an overview of the project scope and project deliverables in the context of the strategic change programme.

3 PROJECT MANAGEMENT 5.1 The first year of the project will focus on mapping and analysing the current situation with regards to staffing, service users, service provision, and training. Whilst it is acknowledged that there is a considerable effort and work currently being undertaken with regards to information management systems, the speed and ease of collating this data will improve when there is uniformity in collecting and inputting data and a clear specification of the information required to design, develop, deliver and commission services. This will also provide the basis for a comprehensive and robust performance management framework. 5.2 This project is inextricably linked to the operational and strategic plans in adult community support services, the role and function of the commissioners and the operational management of the home care service. 5.3 Appendix 2 details the project structure and governance framework which has been developed and implemented. Despite the six months slippage, the ambition for the project is to adhere, where possible, to the timescales set out in the change fund application. 5.4 Appendix 3 provides an overview of the actions and work required to deliver the project outputs and outcomes. 5.5 Appendix 4 details the project communication plan that will also contribute to overarching communication strategies and plans. 5.6 It is essential that there is a dynamic relationship with the management and staff in operational services to facilitate the delivery of holistic, sustainable change and improvement. It is important that the project interfaces with the work currently being undertaken by home care services via the service improvement plan. PARTNERSHIP WORKING 6.1 The project is accountable to the change fund team and the joint planning group. This accountability ensures that the project embraces both the Comhairle s services and the NHS community support services. The contribution of NHS is essential to achieving the desired outcomes for key elements of the project around workforce development and career pathways. 6.2 NHS Western Isles will work in partnership with the Comhairle to ensure that the project outcomes deliver what the community needs. One measure of success will be the completion of the project which will have SMART targets, however key success measures will be feedback from service users, carers and the employees who will deliver the integrated service. At present the majority of service is delivered by the Comhairle and NHS Western Isles with elements provided by the Third Sector.

4 RECRUIT AND RETAIN PROJECT AIMS AND OBJECTIVES 7.1 Recruit and Retain is a Northern Periphery Programme (NPP) project which sets out to find solutions to the persistent problem of difficulties in recruiting and retaining high quality people to work in the public sector in the remote rural areas of Northern Europe. The project commenced in June 2011 and will finish at the end of May It has eight individual partners based in Canada, Greenland, Iceland, Ireland, Norway, Scotland (2) and Sweden; NHS Western Isles is the L ead Partner. Outputs from this project will include the development of products and services aimed at addressing the issues identified by the responses to the questionnaires and structured interviews carried out across the partner countries. 7.2 It is acknowledged that there is a strong synergy between the two projects. The common ground is workforce planning, in particular the recruitment, retention and sustaining of a rural workforce. By working together a product has been identified which will meet the requirement of both projects and produce a product that has multiple purposes that can be transferred to different settings. PROJECT OVERVIEW 8.1 The project was proposed with a two year implementation plan. 8.2 In Year one the project officer will work with departments in the Comhairle and with NHS Western Isles on a sustainable career path for community care workers. This will examine service user and career requirements, anticipated future needs, assets and infrastructure and models for future service delivery. 8.3 Through Year one and into Year two, the project officer will continue to work with NHS Western Isles and other key partners on workforce development. This will take into account the competencies, skills and training requirements for a future workforce and examine options for a community based structure to support these workers to deliver an excellent service to the community. Work with training providers will be crucial in the development and delivery of qualifications designed to meet community care need. By the first quarter of 2014 it is aimed to be in the following position: Area Responsibility - Lead Profile of current service users, their needs Project and type of accommodation by geographical location (including community nursing t eam patients) Profile of current carers and their needs Project Information about the level, type and cost of Project/Operational support. Profile of current home care workforce Project Profile of training providers Project Number of people estimated to use the service Commissioners/Project in the next 5/10/15 years and their needs Profile of current service providers (SLA) and Commissioners cost of the service via service level agreements

5 The model, function, structure and cost of the service it is wished to develop based on needs profile (service specification Commissioning) Commissioners Service Improvement Plan implemented Operational Learning, development and staff performance Project/Learning & plan Development Team A robust performance management Operational/Project/Commis framework sioners Recruitment and retention plan (rural, YP, Project male link to economics) A defined career structure Project Competencies that support needs and function Project of service/supports Define services that need to be Commissioners decommissioned & commissioned How the new service interfaces with Joint Planning Group community teams (assessment & care management) & Commissioning role) Types and level of additional support services Commissioners/Project required to maintain people in their home (commissioning) telehealth/assistive technology Detail regarding the buildings that are required Commissioners/Project Capital programme link with commissioning (includes individual homes) Integration agenda PROGRESS AGAINST PROJECT PLAN 9.1 The project governance framework has been developed and implemented. The project steering group has met twice, as listed in the Terms of Reference at Appendix A communication plan has been prepared and is being implemented. 9.3 A draft career pathway framework has been developed with the Recruit and Retain project. This pathway encompasses the current community support services across health and social care. The career pathway maps the current position and proposes competencies for a generic support worker role. 9.4 Key messages to be conveyed via the pathway: The range of job opportunities in adult support services that can be tailored to individual lifestyles and needs Opportunities for people looking for a career change, thinking of returning to the sector or starting working life from School and College A worthwhile job that can provide a rewarding long term career 9.5 Benefits of the career pathway tool: Provides a framework for succession planning Helps organisations to identify training and personal development needs Individuals can see at a glance the job roles required in community support services. Individuals can see what range of skills, qualifications are needed Provides a framework for marketing and publicity material

6 RRHEAL and Orkney Health & Social Care Partnership are currently working on the development of a rural generic support worker role a post which encompasses nursing, allied health professionals, home care, and mental health and learning disability skills. This involved extensive work to map the current and the future competencies required for a generic support worker role in the context of a health and social care workforce and have completed a significant amount of work that we can draw upon. However, this work has been focused on one level rather than on the development of a career pathway and the identification of career progression and sector crossovers. 9.6 The rural generic support worker role is conceptualised as the professionalization of a number of different roles, all of which are roughly equivalent to healthcare support workers (NHS) or social support workers (CnES) who operate primarily in rural settings. Currently, such workers operate in what amounts to silos with little crossover between workers in CnES, NHS, the private and third sectors. It is envisaged that if equivalencies in vocational qualification and experience between these roles can be highlighted, it will make it easier for those employed in these sectors to move between sectors. Employers and potential employees will be able to identify desired skills and experiences needed by different sectors, thus making it easier for such workers to cross sector boundaries. Underpinning this is the notion of the professionalization of such a workforce, making the career pathway more attractive. This, it is considered, will have the two-fold benefit of retaining workers within this sector and mitigating, to some extent, the issue of depopulation of rural areas. 9.7 Quarterly and annual monitoring reports will be completed for the change fund programme. 9.8 Contacts and connections will be made with a broad range of staff in health and social care staff in adult, education and children s services, careers, providers both locally and nationally. 9.9 Pre scholarship for adult social care and support building on the excellent work with the pre nursing scholarship, the process of developing a scholarship that will inspire and provide the skills, learning and knowledge for young people to take up a career in community support services has been commenced There are also two pipeline projects; one working with young people in Uist to support their desire to work in social care and support and the second is focussed on recruiting and retaining men into the workforce. FINANCIAL CONSIDERATIONS 10.1 There are no financial considerations arising from this Report.

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