Equality Impact and Needs Assessment (EINA) Adult and Culture Services

Transcription

1 Equality Impact and Needs Assessment (EINA) Proposal Operations Care Management Budget proposals Date of assessment October 2011 Officer responsible for EINA Assessment Team Cathy Bull C Bull, A McDowell, J Jamison, S Winter, G Daglish, E Dick, C Dugdale, A Marshall, C Williams, D Forster, T Metcalf Review Date 31 January 2012 This is our assessment of the potential equality implications of this proposal, based on the available evidence. It is a living document; we have reviewed it throughout the consultation period and will continue to do so while carrying it out. We will continue to consider comments and information from all stakeholders, research or new and emerging policy. We invite all stakeholders to comment on this impact assessment. You can comment on any budget EINA by ing letstalk@newcastle.gov.uk.

2 1. The proposal Care management Care management systems and processes in adult social care services date from the early 1990s. It is how social workers assess the care needs of vulnerable people and then identify services to meet those needs. Social workers are also responsible for continuing review and management of the care plan. With the transformation of social care including self-directed support (SDS), direct payments and personal budgets, care management is no longer appropriate. Older People, Specialist Services (Learning disability, physical and sensory disability), and Mental Health are the main service areas. In 2009/2010 the care management service completed almost 8,000 Community Care Assessments and had 9,613 adults receiving a Care Package. The Review considered all possibilities to achieve a more simplified and more efficient process, but focused specifically on: Reducing staffing by reviewing processes and documentation, for example fewer assessments following reablement. This should not create a risk to people in need, however other care management proposals may impact on this Brokerage: introducing brokerage (either in-house or externally commissioned) is already considered in the directorate s Personalisation project, in line with many other Authorities. There are likely to be benefits from introducing this new approach in improved outcomes for service users and more cost-effective use of Personal Budgets. The review will examine the evidence for any impact on the efficiency of the care management system. This will be further researched and considered during 2012/13 Skill Mix: examining the potential benefits of changing or introducing new roles and creating a different skill in staff. However, although there are potential savings to be made through this approach, any savings would be heavily offset in the short term by redundancy costs, particularly given the age profile of staff. This will be further researched and considered during 2012/13. System improvement (ICT and Lean Review) Review how the IT system supports the care management process. This is known to be cumbersome and time-consuming. Investing in improved ICT systems, linked to a lean review of processes and procedures, could produce significant savings in staff time, thereby creating potential savings. Identify opportunities for agile working to reduce the need for office space while still being accessible to the public. This will reduce the need for office space by encouraging staff to work in various settings. This aims to reduce the need for one desk for each staff member. Reviewing Team. The Reviewing Team is part of the Commissioning division but the activity is part of the statutory care management process and therefore will be included in work to streamline the system. 1

3 Customer access Consider further improvements to Social Care Direct, the frontend. This includes a proposal to create a single point of access for health and social care. This is a joint project with Newcastle Hospitals Trust. Integrated working with the NHS. As well as the work on customer access, we are also redesigning first response services in a project with Newcastle Hospitals Trust. Any redesign will include a streamlined process of assessment reducing duplication. For cashable savings, in the short term the NHS are likely to benefit most but better outcomes for service users will deliver social care efficiencies by reducing the need for ongoing services. Review of management structures Review activity in care management teams which sit outside core business and may be able to be done in a different way. For example service user/ community engagement which is part of what the Sensory Support social work team now do, which is outside core business. Staffing Implications This proposal involves deleting 8.2 posts which represents 5% of the care management posts funded by the Council (some posts are funded by NHS Trusts). This will be accompanied by intensive work to streamline the core systems of care management and changing the way people work to make it more efficient supported by technology. 2. Evidence and research What research, information or other intelligence have you used to develop this proposal? Information source Putting People First transformation of social care CQC Inspection Report 2010 What has this told you? The concordat, Putting People First set out the policy direction of social care in the UK. The policy drivers are Prevention: The right support to help people stay independent and well for as long as possible; and Personalised care and support: Services built around people s needs and the way they live. Increasingly, social care will be arranged through personal budgets. Services will be personally designed and locally delivered rather than delivered to groups in designated buildings. The annual inspection of services for adults by the Care Quality Commission has rated Newcastle City Council s efforts to improve the health, well-being and quality of life of city residents as excellent. It recognised us as one of the top performing Grade 4 councils in the country this is the highest possible rating for the 2

4 second successive year. Inspectors found Newcastle s services in four of the seven outcomes areas - including improved quality of life and increased health and well-being - to be of the highest possible standard Service User Survey 63% respondents were extremely/ very satisfied with help they received from Adult Services. 29% were quite satisfied, 6% neither satisfied nor dissatisfied, 2% extremely/ very dissatisfied. 3

5 3. Engagement Engagement - date Who did you invite How many attended? What groups did they represent? All care management staff All social workers, social were briefed by managers care assessment officers by December 14th and Occupational therapists Main issues The ability to respond to spikes in demand with reduced capacity. This will need greater flexibility across teams to ensure allocation of priority work 4. Assessing the impact Age (younger people or older people) Do the proposals impact on staff or customers? Some proposals will impact on service users and staff. Others will only impact on staff. Could the proposals lead to any groups being disadvantaged or treated unfairly? Please explain why. Care management - Less staff capacity to respond to spikes in demand allied with a growing elderly population making increasing demands on Care Management. Increased demand will absorb at least some of the efficiencies in processes, so any reductions in staffing may be real cuts in staffing. How do you plan to remove, reduce or justify this? Who will have responsibility for the identified action and what are the timescales involved? A single point of access that is Integrated with the NHS could see the initial response to service users being improved, again with reduced signposting/ handoffs. Could the proposal promote equality? Please explain how. The process will include all service user groups. A reduction is staffing levels regardless of a more efficient care management 4

6 Do the proposals impact on staff or customers? Could the proposals lead to any groups being disadvantaged or treated unfairly? Please explain why. system may still not be able to absorb the increase in demand due to the ageing population. How do you plan to remove, reduce or justify this? Who will have responsibility for the identified action and what are the timescales involved? Could the proposal promote equality? Please explain how. Skill Mix: Social Workers prioritise their work, responding to service users in complex crisis. Qualified Social Workers are required for this type of work and there will be less capacity to do this, potentially leaving service users at risk. It is difficult to mitigate this risk while reducing qualified social work and Occupational Therapy posts. Disability (including carers) As Above Sensory support user engagement is currently carried out by the social Work team. This will be centralised in line with current practice and thinking in the council. As Above Marriage or civil partnerships There is no evidence to suggest the proposal will have a disproportionately 5

7 Sex or Gender (Includes Transsexuality, pregnancy and maternity) Sexual orientation Race Do the proposals impact on staff or customers? negative impact on people because of their marital or civil partnership status. There is no evidence to suggest the proposal will have a disproportionately negative impact on people because of their sex or gender. There is no evidence to suggest the proposal will have a disproportionately negative impact on people because of their sexual orientation. There is no evidence to suggest the proposal will have a disproportionately negative impact on Could the proposals lead to any groups being disadvantaged or treated unfairly? Please explain why. How do you plan to remove, reduce or justify this? Who will have responsibility for the identified action and what are the timescales involved? Could the proposal promote equality? Please explain how. 6

8 Religion or belief Do the proposals impact on staff or customers? people because of their race. There is no evidence to suggest the proposal will have a disproportionately negative impact on people because of their religion or belief. Could the proposals lead to any groups being disadvantaged or treated unfairly? Please explain why. How do you plan to remove, reduce or justify this? Who will have responsibility for the identified action and what are the timescales involved? Could the proposal promote equality? Please explain how. Brokerage: If different workers are involved in different aspects of the Care Management process there is the potential for handoffs and lack of continuity in service for Service Users. Conversely service users will receive a specialised service from workers who are experts in their field.. 7

9 5. Assessing the impact on community cohesion and social inclusion Developing social care services will benefit community cohesion by helping older people and disabled people stay in their homes and their communities longer. This is because it contributes to capacity building or maintenance of capacity, within communities to allow or enable cohesion to occur. Personal budgets, greater access to information and community based opportunities will enable older and disabled people to play a role in cohesion between communities. The problems identified in the Cantle Report, of people and communities from different races or ethnicities living parallel lives could be reflected or exacerbated in communities if older people or disabled people live in institutions, separated from the mainstream. We do not think this proposal will have a significant, negative impact on community cohesion. On social inclusion, social care services based on a model of personalised services, including community based day care and respite care enables people to remain in their own homes and communities. This means people are able and enabled to continue to be socially included, to a greater extent than is possible in institutional care, such as nursing homes or residential homes. All service users have a care plan and annual review, which is holistic and expressly includes their inclusion in the life of the city. We will need to consider the impact and the accumulative effect of other proposals, for example a reduction in services, a reduced workforce and delay in response times could create an impact on users and carers in the community. 6. Any other areas for consideration 8

10 PLEASE NOTE Information in this document may be available to the public. This means that any information used in decisions should also be available. Once the form is complete, your Directorate E&D rep will share this document for review and challenge. This is a living document. Actions identified need to be monitored and reviewed. Date of review Reviewing officer Comments For further help or advice contact: Tony Metcalf, Business Assurance Manager Phone Mobile tony.metcalf@newcastle.gov.uk 9