Care Act Implementation Results of Local Authority Stocktake

Transcription

1 Care Act Implementation Results of Local Authority Stocktake Stocktake 3: January/February 2015 February 2015 Care Act Stocktake 1

2 Contents Background and scope slide 3 Care Act implementation timeline slide 4 Headline findings slide 5 Support slide 17 Analysis on key areas slide 19 Methodology slide 38 26/02/2015 Care Act Stocktake and support 2

3 Background and scope The Care and Support Reform Programme Board has committed to undertaking three Care Act Stocktakes in advance of the introduction of the Care Act in April 2015, and further stocktakes in advance of April The purpose is to inform local, regional and national preparations and to ensure councils have the support and resources they need for implementation This is a summary of the third stocktake carried out from 13 January to 3 February 2015, completed by all 152 authorities with responsibility for social care. The first stocktake was completed between May/June and the second in September/October The results can be found on the LGA website The key findings are focused on responses to proxy questions in the report, supplemented with information from discussions with a random selection of local areas. There are 11 proxy measures in stocktake 3, up from the 9 in stocktake 2 (addition of market sustainability, self funders and safeguarding, with leadership awareness not tracked due to high confidence in Stocktake 2) These slides summarise the main findings for both 2015 and 2016 changes, and flag potential areas of support needed to assist with implementation locally. 26/02/2015 Care Act Stocktake and support 3

4 LA Readiness Stocktakes Implementation Support Regional and AIA Support Care Act implementation timeline Care Act Delivery 2015 Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Consult on Pt.2 Regs & Guidance Cost monitoring Cost modelling Part 1 Effective General Election Comprehensive Spending Review Final Pt.2 regs & guidance S3 S4 S5 S5 R3 * Call for Best Practice ideas R4 R5 Specify support products Specify products (2) Year 1 Products available Commission support products (batch 1) National products available Commission support products (2) Bespoke support (as needed) Bespoke support (as needed) Bespoke support Follow-up Deep Dive Discussions Follow-up Deep Dive Discussions Follow-up Deep Dive Discussions On-going engagement (via PA and AIA) Revised regional and national structures and expectations in place Regional Training and Implementation Support 26/02/2015 Care Act Stocktake and support 4

5 Headline findings - summary Overall it positive picture for changes from April % of councils say that they are very or fairly confident that they will be able to deliver the Care Act Reforms from April 2015, compared to 97% in stocktake 2 and 9 in stocktake 1. Of the 4 authorities who reported low confidence in stocktake 2, 3 are now fairly confident and 1 is very confident. 1 authority has gone from fairly to not very confident. 75% of councils say they are on track in their preparations for the Care Act in 2015/16, the remainder being slightly behind Confidence has increased on 6 out of 10 proxy measures from stocktake 2 to stocktake 3. The exceptions are self funders, carers assessment, costs and information, advice and advocacy Councils are confident about April 2016 changes too, despite the unknowns 9 of councils are very or fairly confident they will be able to deliver the Care Act reforms from April % are not very confident and 6% don t know. 79% of councils say they are on track in their preparations for the Care Act in 2016/17, 16% are slightly behind, 1% don t have a plan A small number of councils flagged that they may potentially require support In total, 7 councils flagged concerns all with 5+ proxy measures, 1 with low confidence 26/02/2015 Care Act Stocktake and support 5

6 Headline findings main concerns However, the survey did flag several specific areas of concern. These are outlined below, along with feedback from direct conversations with a handful of Directors 1. Demand and costs The most significant areas of concern relates to the unknown demand from carers (26% potentially requiring support, a 12% increase from stocktake 2), and the associated costs (33% potentially requiring support, a significant 28% increase from stocktake 2). The unknown demand from self funders (13% potentially requiring support, a 4% increase from stocktake 2) is also an early indication of potential concern. Councils are confident with their own preparations, but the vast majority cited uncertainty about actual demand, resulting in concerns about whether budgets will be sufficient. Insufficient funding for some areas, including prisons due to lack of market choice, more generous eligibility which is likely to result in additional packages of care, additional costs due to paying minimum wage including travel time, advocacy and further potential budget cuts Additional cost pressures on budgets relating to Deprivation of Liberty and Safeguarding (DoLS) duties were flagged by several councils 2. Market sustainability Although all councils are maintaining a regular dialogue with providers (before April 2015), 12% wont have a contingency plan for provider failure, and 24% say they won t have an understanding of the sustainable cost of care until after April 2015 Councils recognized that a clear understanding of the sustainable cost of care and working with providers was critical for preparations throughout 2015/16 26/02/2015 Care Act Stocktake and support 6

7 Headline findings main concerns 3. Finance and IT systems although overall confidence has increased (15% potentially requiring support vs 2 in stocktake 2), a significant number of councils will not have all their systems fully up and running from April Several councils cited the challenging timelines and significant work required to get systems ready for April However, 96% are confident they will be adequate to manage statutory duties from April, and councils report that further changes will be made throughout 2015/ Information, advice and advocacy 25% (a 4% increase from stocktake 2) of councils potentially require support based on the responses to Q11. The small change is driven primarily by councils who will not have set up an information and advice service (11%) or not commissioned new advocacy services (11%) by April Concerns are driven mainly by the time required for workforce and training of front line staff and whether the voluntary sector market has the capacity ready and able to cope. 26/02/2015 Care Act Stocktake and support 7

8 Headline findings Deep dives The conversations with local areas also flagged up a number of other important issues: Overall - confidence is realistic and as expected for this stage of implementation. There is a greater sense of ownership and grip at Director level and conversations have been very different to previous stocktake follow ups. The reluctance to say they will have everything in place for everyone by 1st April is more realistic and a sense of pragmatic leadership than lack of preparation, and what we should be expecting at this point in time. Workforce/training councils were concerned about the level of required culture change with front line staff within the timeframe, recognising need for ongoing training and development (particularly within providers), and for some - staff recruitment and retention Prisons - Directors spoken to have worked closely with NHS colleagues to develop the model for prisons - in effect buying into the NHS provision and taking a multidisciplinary approach. They recognised the need to review that once actual demand is understood Safeguarding - Directors were confident that their SABs had understood the challenge but that there was more work to do on agreeing how the new responsibilities would be built into their current ways of working, in particular with NHS and Police colleagues. 26/02/2015 Care Act Stocktake and support 8

9 Headline findings - Other key messages What else the survey tells us Regional variation There is some regional variation in the number of councils potentially requiring support, based on their own assessment. The East Midlands is generally more confident on most measures (except self funders and commissioning), and the South East tends to be less confident. There is no other strong discernable pattern. Local awareness (Q28/29) While awareness within the council is high, they are less confident that some partners were aware of the impact on them, particularly NHS providers (27% not very or not at all confident) and the voluntary sector (15%). Councils also flagged low awareness of current service users (52% not confident), future service users (64%), carers (35%) and the general public (67%). Prioritizing investment for 16/17 (Q41) Councils said that they will be prioritizing their IT systems and recruiting and training the workforce to handle the anticipated volume of self funders assessments (including online) and management of care accounts through to April Minimum wage (Q35) - 7 of councils know or will know by April that all providers in their area are paying the minimum wage (including travel time), and 86% by April Other challenges (Q46) a significant number of councils flagged that the delay in publishing regulations, guidance and tools was a significant area of concern, inhibiting implementation locally 26/02/2015 Care Act Stocktake and support 9

10 Headline findings - council confidence Q38 asked councils how confident they are that the council will be able to deliver the Care Act reforms required from April Overall confidence has gone up - 99% are very or fairly confident, up from 97% in the second stocktake (September 2015) and 9 in the first stocktake in Spring % of councils say they are on track in their preparations, up from 69% in stocktake 2. The remaining 25% report that they are slightly behind in their preparations. At this stage 9 of councils are confident about preparations for changes in 2016/17. 7 Confidence in ability to deliver the care act reforms 10 Plan on track April 2015 April 2016 Stocktake 1 Stocktake 2 Stocktake 3 Very confident Fairly confident Not very confident Not at all confident Don't know Potential support required Broadly as expected As expected 26/02/2015 Care Act Stocktake and support 10

11 Headline findings - council confidence Number of measures where potential support idenitfied Number of measures where potential support idenitfied The number of councils with significant concerns across the board (4 or more proxy measures) has fallen based on comparable measures from stocktake 2, although the analysis also suggests that there are fewer councils with no concerns. Stocktake 3 analysis identified 7 councils (in dark blue) with 5+ who potentially require further support. Stocktake 3: Number of measures where potential support identified (out of 11) Stocktake 2 vs stocktake 3: Number of measures where potential support identified (out of 9 comparable measures) Percentage of LAs Percentage of LAs Stocktake 2 Stocktake 3 26/02/2015 Care Act Stocktake and support 11

12 Headline findings proxy measures Summary of progress against proxy measures PM11, Confidence PM10, Market sustainability PM9, Market shaping PM8, Commissioning PM7, Workforce PM6, IT & Financial systems PM5, Understanding of costs PM4, Safeguarding PM3, Information and advice PM2, Meeting increased demand for carer assessment PM1, Self funders Potental support required Broadly as expected As expected Please note, these proxy measures have been aggregated from responses across a number of questions in the survey, and do not represent the council s own judgement. Slide 40 provides further detail on the proxy measures. 26/02/2015 Care Act Stocktake and support 12

13 Headline findings tracking progress Self funders, S1 Self funders, S2 Self funders, S3 Carers' Assessments, S2 Carers' Assessments, S3 Workforce, S2 Workforce, S3 Commissioning, S1 Commissioning, S2 Commissioning, S3 Information, advice and advocacy, S1 Information, advice and advocacy, S2 Information, advice and advocacy, S3 Prisoners, S2 Prisoners, S3 Funding, S2 Funding, S3 Market shaping, S2 Market shaping, S3 Confidence, S1 Confidence, S2 Confidence, S3 Leadership awareness, S1 Leadership awareness, S2 Finance and IT systems, S2 Finance and IT systems, S Plan on track, S1 Plan on track, S2 Plan on track, S Potential support required Broadly as expected As expected These measures are based on comparable measures of progress between stocktake 1, 2 and 3. As with the proxy measures, they are aggregated from responses across a number of questions and do not represent the council s own judgment. The analysis is based on the actual response categories selected by councils, not the three-colour rating system reported in our national results (round 1) publication. Slide 40 provides further details. 26/02/2015 Care Act Stocktake and support 13

14 Headline findings Although overall confidence for changes in April 2016 is high (9. Slide 10), there is a degree of caution about the demand from self funders (see risks slide 15), and a recognition of significant work still to do throughout 2015/16. In particular, around IT and finance systems and workforce, which is where councils say they will be prioritising investment (Q41) 12 IT and finance systems, 2016 (Q22) 12 Workforce sufficiently prepared (Q24 for 2015/16 and 2016/17) Systems impact of strategy for handling selffunder assessments and Care Accounts agreed with IT support staff Decision taken as to what system will process Care Account Software upgrade plans agreed internally and with system supplier(s) As expected Broadly as expected Potential support required 6 2 Workforce within the council, 2015/16 Workforce within the council, 2016/17 Workforce within Workforce within providers including providers including voluntary and voluntary and community sector, community sector, 2015/ /17 As expected Broadly as expected Potential support required 26/02/2015 Care Act Stocktake and support 14

15 Headline findings - key risks Councils were asked to outline the key risks to delivery (Q39a), and to rank them in order. The lower the average rating, the bigger the risk. Total implementation costs for 2016/17 Uncertainty about additional demand from carers Total implementation costs for 2015/16 Uncertainty about additional demand from self-funders Managing additional assessments Lack of funding to commission or maintain preventative services IT systems not ready in time Impact on local provider market New national eligibility threshold Uncertainty over key national policy decisions Public expectation (including legal challenges) New duties relating to prisoners Deferred payment agreements Workforce not sufficiently prepared Engagement from key partners locally 10 89% 9 65% 88% 81% 66% 66% 68% 46% 43% 69% 15% 13% 39% 21% A V E R A G E R I S K R A T I N G 10 These figures remain consistent with the risks identified in stocktake 2, although the number of authorities flagging costs for 2015/16 as a risk has reduced from 87% to 65%. Councils also flagged additional risks (Q39b) around staff recruitment and retention, complexity of partnerships, delays in guidance and wider lack of funding. Per cent mentions Average rating 26/02/2015 Care Act Stocktake and support 15

16 Headline findings risk mitigation Councils were asked to spell out how, where possible, their most significant risks were being mitigated (Q40). 64% of councils responded to this question Top risks and typical examples of how they are being mitigated (Q40) Total costs (both 15/16 and 16/17) Unknown demand from carers and self funders IT systems not ready Impact on providers Public expectation Delays to national policy decisions Funding for prevention Managing and reprioritising budgets based on risk. Alignment with CCGs. Sensitivity modelling on demand. Flexing existing staff, developing unqualified assessor roles, divert through online self service, building infrastructure across the third sector. Pan regional modelling Brought in additional operational capacity. Ongoing dialogue with providers Collating data from Providers Ensuring high quality information, advice and advocacy services. Development of case scenarios for care managers to assist with determining eligibility. Comms outlining budget constraints within the council Aligned expected timetable with local decision making timetable. Additional capacity brought in to respond quickly to guidance Integration with health 26/02/2015 Care Act Stocktake and support 16

17 Headline findings - support Following the responses to stocktake 2, councils were offered support: 1. Adult Improvement Advisers spoke to all councils with low confidence or multiple (4+) proxy indicators. They were offered further direct peer support (4 areas took this up). Deep dives were also offered to all areas (5 accepted, 3 in progress) 2. For councils broadly as expected or potential support required on up to three proxy measures, support was provided through the regions 3. For all councils, support products were commissioned, and regional events held Feedback suggests that all support has been well received by at least of councils Most helpful tools/support very or fairly helpful (Q42/43) Most frequently requested additional tools, guidance or information (Q44/45) Regs and guidance for 2015/16 99% DH Fact sheets 98% SFC learning & development 91% TLAP I&A strategy resource 9 Stocktake analysis 88% LGA Must Knows 87% SCIE Assessment guide 87% Financial support including modelling More timely release of regulations and guidance Sharing local tools/best practice Communications tools for key user groups Legal support including appeals, duty to assist Market shaping and provider tools National eligibility criteria support 26/02/2015 Care Act Stocktake and support 17

18 Support next steps Learning for future support Regional approach and support materials has provided a quick and informal route for communications between the national programme and local councils. But more timely publication of high priority support materials and guidance is needed. The most significant risks are associated with unknown demand and associated costs, and councils will be looking for assurance that the assumptions underlying the model are transparent and that the costs will be met by the Government. Support on a number of areas (including IT systems, workforce, market sustainability) will require continued focus throughout 2015/16 as demand comes forward A small number of councils may require more intensive hands on support What we have done already We have spoken to 6 councils at random to inform this report and support discussions We have arranged follow up calls/meetings with all 8 councils with 5+ proxy measures or low overall confidence, to offer support if needed All councils who have raised concerns have access to varied types of support nationally and within their own region, Deep dives, and bespoke support coordinated through the regions What next? Greater emphasis on supporting networks and ease of access to resources, rather than support products exclusively Review stocktake to identify gaps in support, and build into future support offers Review the methodology for the Deep Dives to inform next wave Board Challenge session in March and future scenario planning to address ongoing risks and support requirements 26/02/2015 Care Act Stocktake and support 18

19 Analysis: Costs (PM5) All authorities This measure assesses the confidence in the Councils budget for implementation of the Care Act in 2015/16. It is based on responses Q All LAs Potental support required Broadly as expected As expected 67% of councils are very or fairly confident they have a sufficient amount in their budget. 10 By region 10 By authority type E EM GL NE NW SE SW WM YH C UA LB MD 26/02/2015 Care Act Stocktake and support 19

20 Analysis: Costs (PM5) What the survey tells us Overall, 33% of councils are concerned that there is not enough money in councils budgets for implementation The number of councils potentially requiring support based on comparable measures has increased since stocktake 2, following the announcement about funding allocations However, the responses indicate a cautious response with only 3% of councils saying they are very confident and only 7% who are not al all confident There is a significant range (-56%) between regions (East Midlands and South East) who say they are not confident. The confidence of the East Midlands and South East is broadly consistent with stocktake 2, although there is no discernible regional bias. There is no significant variation by type of authority What our initial discussions with councils have told us Concern about the total costs is very widely shared, although it is the unknown actual demand that is the biggest driver of this concern Several councils flagged specific cost pressures that will require further exploration Ongoing support considerations Clarity about how and when unplanned activity will be funded will be critical to assure councils about costs 26/02/2015 Care Act Stocktake and support 20

21 Analysis: Carers assessment (PM2) All authorities All LAs Potental support required Broadly as expected As expected This measure tests whether councils have an estimate for the number of carers (Q8) and how they will meet additional demand (Q9). 95% of councils have a working estimate of carers assessments, and 63% of councils have made a decision about how demand will be met. 10 By region 10 By authority type E EM GL NE NW SE SW WM YH C UA LB MD 26/02/2015 Care Act Stocktake and support 21

22 Analysis: Carers assessment (PM2) What the survey tells us Overall, councils are now slightly less confident they will have made a decision about how demand for carers assessments will be met, with 76% saying before February 2015, compared to 86% who said by January in stocktake 2. However 97% of councils say they will have made a decision before April The East Midlands seems to be more confident, with the North West and West Midlands less so. There is no significant variation by authority type, although county councils seem to be slightly more advanced than metropolitan districts What our initial discussions with councils have told us Directors spoken to were relatively sanguine about the potential new demand from increased numbers of carers. They are confident about the work they have done already with carers to identify the number, although remain concerned about the cost of any additional demand. Ongoing support considerations Specific issues picked up through existing national and regional support 26/02/2015 Care Act Stocktake and support 22

23 Analysis: Self funders (PM1) 45% 35% 3 25% 2 15% 1 5% All authorities All LAs Potental support required Broadly as expected As expected In response to Q3 95% of councils say they will have an estimate of self funders by February 2015, and 99% by April. However in response to Q5 21% of councils say that they don t expect to have a plan for undertaking self funders assessments until after April By region 10 By authority type E EM GL NE NW SE SW WM YH C UA LB MD 26/02/2015 Care Act Stocktake and support 23

24 Analysis: Self funders (PM1) What the survey tells us Although 99% of councils will have an estimate of the number of self funders by April, 13% of councils won t have an estimate for the number of people who will actually present themselves until after April (compared to 1 in stocktake 2). 21% don t anticipate having a plan and timetable for how assessments will be undertaken until after April, although 98% are clear about the methodology (Q6) At the same time, councils are estimating differently about how many early assessments they will have completed by April % say less than a quarter, 27% a quarter to half, 22% half to three quarters and 2 over three quarters Yorkshire and Humber are most confident, whilst the West Midlands are the least Counties and London Boroughs are less confident than Metropolitan Districts and Unitaries What our initial discussions with councils have told us Directors are confident about the modelling work that has been undertaken, but feel less confident about predicting the actual number who will present. They report that local Members are keen for the national media campaign to begin before a local one so that they can dovetail into, rather than lead publicity. Ongoing support considerations Specific issues picked up through existing national and regional support 26/02/2015 Care Act Stocktake and support 24

25 Analysis: Information, advice and advocacy (PM3) All authorities All LAs Potental support required Broadly as expected As expected By region 10 Q11 looked at the provision of information and advice and advocacy. Councils were asked about their progress in making timely changes for implementation of the Care Act in 2015 addressing: Universal information and advice services Online information and advice Signposts to financial advice, and An appropriate level of local advocacy services. By authority type E EM GL NE NW SE SW WM YH C UA LB MD 26/02/2015 Care Act Stocktake and support 25

26 Analysis: Information, advice and advocacy (PM3) What the survey tells us Overall 25% (a 4% increase from stocktake 2) of councils potentially require support based on the responses to Q11. The small change is driven primarily by councils who will not have set up an information and advice service (11%) or not commissioned new advocacy services (12%) by April Over half of councils say that these services won t be set up until April 2015, meaning a significant proportion haven t yet done so. There doesn t seem to be any variation by type of authority, although the East and East Midlands seem to be more confident about their preparations than the North West, South East and South West What our initial discussions with councils have told us Concerns are driven mainly by the time required for workforce and training of front line staff and whether the voluntary sector market has the capacity ready and able to cope. Ongoing support considerations Specific issues picked up through existing national and regional support 26/02/2015 Care Act Stocktake and support 26

27 Analysis: IT and finance systems (PM6) All authorities All LAs Potental support required Broadly as expected As expected This headline measures looks at confidence in the adequacy and preparedness of the council s financial and IT systems (Q21) and whether a system will be in place to cope with increased demand for carers assessments (Q22) 10 By region 10 By authority type E EM GL NE NW SE SW WM YH C UA LB MD 26/02/2015 Care Act Stocktake and support 27

28 Analysis: IT and finance systems (PM6) What the survey tells us Overall confidence has increased (15% potentially requiring support vs 2 in stocktake 2) 98% of councils were clear what online self service they are planning on offering to people and carers (Q23) The East and East Midlands potentially require less support than London and the Southwest What our initial discussions with councils have told us Directors spoken to were on top of the IT systems and assessments arrangements and the Care Act has been worked into what they are already doing in terms of modernising systems. What they are concerned about is getting the culture change right in staff behaving differently, having different conversations and maintaining that level of transformational change whilst integrating with health and managing the money. Whilst that had been understood before, the focus on training, the tools which are being used and the recognition that this was at a level which had been required for personalisation previously was feeling daunting. Ongoing support considerations Specific issues picked up through existing national and regional support 26/02/2015 Care Act Stocktake and support 28

29 Analysis: Market sustainability (PM10) 5 45% 35% 3 25% 2 15% 1 5% All authorities All LAs Potental support required Broadly as expected As expected This measure looks at market sustainability in terms of dialogue with providers (Q32), an understanding of the sustainable cost of care (Q33) and whether the council has a contingency plan for provider failure (Q34). By region By authority type E EM GL NE NW SE SW WM YH C UA LB MD 26/02/2015 Care Act Stocktake and support 29

30 Analysis: Market sustainability (PM10) What the survey tells us Although 10 of councils already have or will have a regular dialogue with providers before April 2015 (Q32), 4% of councils won t have an understanding of the sustainable cost of care until after April 2016 (Q33) and 24% after April % wont have a contingency plan for provider failure until after April 2015 (Q34) 7 of councils are confident all providers are paying the minimum wage including travel time before April 2015 (Q35), with 87% before April 2016, and 13% later or don t know 68% of councils flagged provider failure as a risk to implementation (Q39) The South West and London are flagged as potentially requiring more support than other regions What our initial discussions with councils have told us The cost of care and market capacity issues was a cause for concern as Directors are managing current demand whilst preparing for the future. Ongoing support considerations Further support needed - tools, best practice and support to be built into support 26/02/2015 Care Act Stocktake and support 30

31 Analysis: Workforce (PM7) All authorities All LAs Potental support required Broadly as expected As expected By region 10 96% of councils responded that they are confident that changes made by the council will be adequate to manage the statutory duties in 2015 (Q25). This headline measure on the confidence in preparedness of the workforce encompasses responses to Q24, with a focus on the council workforce, and Q26 on the analysis of the implications of the Care Act for the workforce and analysis of the gaps in workforce capacity. By authority type E EM GL NE NW SE SW WM YH C UA LB MD 26/02/2015 Care Act Stocktake and support 31

32 Analysis: Workforce (PM7) What the survey tells us Overall councils are more confident from stocktake 2, with 10 of councils confident that council staff are sufficiently prepared (Q24) and 99% confident that council staff will be sufficiently trained to meet statutory duties in advance of April 2015 Councils are less confident about changes to the workforce within external providers, with 17% not confident that provider workforce will be sufficiently prepared for April What our initial discussions with councils have told us Continued concerns around workforce capacity and capability within providers Concerns about availability of suitable workforce remain in some areas Recognition that workforce cultural changes will take time to embed, but are critical to successful implementation Ongoing support considerations Continued support around workforce awareness and training 26/02/2015 Care Act Stocktake and support 32

33 Analysis: Market shaping (PM9) All authorities All LAs Potental support required Broadly as expected As expected This measure looks at the timeliness and effectiveness of council s market shaping. It uses responses to Q31 (publication of market position statement) and Q37 (level of confidence that the market shaping and commissioning function will enable it to deliver improved preventative and integrated care and support). Overall confidence has increased from stocktake 2 By region By authority type E EM GL NE NW SE SW WM YH C UA LB MD 26/02/2015 Care Act Stocktake and support 33

34 Analysis: Commissioning (PM8) All authorities This measure looks at when the council estimates it will have a strategic commissioning plan in place to deliver the duties in the Act and ensure effective provision of care and support for the future. It uses responses to Q30. All LAs Potental support required Broadly as expected As expected By region By authority type E EM GL NE NW SE SW WM YH C UA LB MD 26/02/2015 Care Act Stocktake and support 34

35 Analysis: Safeguarding (PM4) All authorities All LAs Potental support required Broadly as expected As expected This questions uses responses to Q13, which asks for councils confidence that the new safeguarding board will be able to respond to safeguarding concerns, respond to enquiries caused by the council, include all statutory partners and enable effective information sharing. 10 By region 10 By authority type E EM GL NE NW SE SW WM YH C UA LB MD 26/02/2015 Care Act Stocktake and support 35

36 Analysis: Council confidence (PM11) All authorities All LAs Potental support required Broadly as expected As expected 99% of councils report that they are very or fairly confident that their council will be able to deliver. These are the results based on Q38, which asks councils how confident they are at this time that their council will be able to deliver the Care Act reforms required from April By region 10 By authority type E EM GL NE NW SE SW WM YH C UA LB MD 26/02/2015 Care Act Stocktake and support 36

37 Analysis: Prisons All authorities All LAs Potental support required Broadly as expected As expected For councils with prisons, Q12c asks councils to specify the completion date for a range of duties resulting from the Care Act: contact made by the council with prison premises (5% later than April), confirmed arrangements for undertaking assessments (9% later than April), confirmed the model for delivering care (1 later than April) and staff trained and security cleared (21% later than April). 10 By region 10 By authority type E EM GL NE NW SE SW WM YH C UA LB MD 26/02/2015 Care Act Stocktake and support 37

38 Methodology This is the third and final Care Act stocktakes before April 2015, with the next stocktake planned for June The purpose of each stocktake is to develop a collective picture of progress across the country in a way that is useful both nationally and locally, providing information to facilitate local strategic discussions, map progress and identify support needs and opportunities for shared learning. All councils with responsibility for adult social care completed the survey. 98% of Directors of Adult Social Services signed off their council s response to this stocktake. Councils assessed themselves across a range of questions. We have aggregated some of these measures to make up the proxy measures highlighted in this report. The basis of assessment for each of the proxy measures is detailed on slide /02/2015 Care Act Stocktake and support 38

39 Areas covered in the stocktake Local authorities were asked to respond to 48 questions addressing the following topics: Programme management and governance People (Self funders; meeting duties for carers assessment; preventing needs for care and support; provision of information and advice and advocacy; prisoners; safeguarding) Money (cost modelling; and deferred payments agreements (DPA)) Systems (IT and financial systems; workforce) Communications strategy and planning Market shaping, market sustainability and commissioning Support self assessment on current position Feedback 26/02/2015 Care Act Stocktake and support 39

40 Proxy measures questions covered Proxy measures Code Label Question no Section PM1 Self funders Q3 B) People Q5 PM2 Meeting increased demand for Q8 B) People carer assessment Q9 PM3 Information and advice Q11_1 B) People Q11_2 Q11_3 Q11_4 PM4 Safeguarding Q13_1 B) People Q13_2 Q13_3 Q13_4 PM5 Understanding of costs Q14 C) Costs PM6 IT & Financial systems Q21 Q22_3 D) Systems PM7 Workforce Q24_1 D) Systems Q26_1 PM8 Commissioning Q30 F) Market Shaping and Commissioning PM9 Market shaping Q31 F) Market Shaping and Commissioning Q37_1 Q37_2 PM10 Market sustainability Q32 F) Market Shaping and Commissioning Q33 Q34 PM11 Confidence Q38 G) Support Prisoners Prisoners Q12c_1 Q12c_2 Q12c_3 Q12c_4 B) People 26/02/2015 Care Act Stocktake and support 40

41 Proxy measures criteria for assessment. Potential support required Broadly as expected As expected A response of don t know in any of the questions highlighted below is identified as potential support required PM1 self funders PM2 carers assessments PM3 information, advice and advocacy Q3 Do you have a working estimate of the number of self funders (both homecare and residential), and the number who will present themselves, in your area? If not by when will this be done? Q5 Does your council have a detailed plan and timetable for how assessments will be undertaken? If not by when will this be done? Q8 Has your council made a decision about how it will meet increased demand for carers assessments? If not by when will this be done? Q9 Has your council made a decision about how it will meet increased demand? When the responses to one or more of the questions areas is marked as By June 2015 or later than April When the response to either question is By April, Later than April or Don t know, and all others are the same or earlier Q11 In your council, have the When the responses to one or following taken place in relation more of the four sub areas is to changes to information, and marked as later than April advice and advocacy, for implementation of the Care Act in 2015? If not, when? At least one responses is By April All are Yes we have a working 2015, and all others are the same estimate Yes we have a detailed or earlier. plan or By February When the responses to at least one of the questions is By February 2015 and all others are the same or earlier. When the responses to at least one of the sub areas is By February 2015 or By April 2015, and all others are the same or earlier. Both are Yes we have a working estimate and Yes we have agreed the delivery model When responses to all four sub areas is marked as Already complete PM4- safeguarding Q13 How confident are you that When the responses to one or your councils statutory more of the four sub areas is safeguarding board will be able to marked not very confident not deliver the following from April at all confident or don t know 2015? When responses to all four sub questions is fairly confident When responses to all four sub questions is very confident 26/02/2015 Care Act Stocktake and support 41

42 Proxy measures criteria for assessment. Potential support required Broadly as expected As expected A response of don t know in any of the questions highlighted below is identified as potential support required PM5 - funding PM6 finance and IT systems PM7 workforce PM8 commissioning Q14 How confident is your council that there is sufficient money within its budget for implementation in 2015/16? Q21How confident are you that your council s financial and IT systems will be adequate to manage the statutory duties from 2015? Q22 Have the following taken place in relation to changes in case records management IT systems for implementation of the Care Act? If not, by when? Q24 How confident are you that your in-house workforce will be sufficiently prepared for implementation of the Care Act in 2015?, and Q26 Have the following tasks been carried out in relation to changes to workforce capacity and training for implementation of the Care Act in 2015? analysis of the implications of the care act for the workforce, and analysis of the gaps in workforce capacity (both council and external providers). Q30 Has your council embedded the new duties within the Act within its commissioning strategies to ensure effective provision of care and support for the future? If not by when will this be done When the response is either not very confident, not at all confident Flagged if the response to: Q21 is Not very confident, or not at all confident; OR Q22 System put in place to cope with anticipated increase in carers assessment and support planning response later than April Flagged if the response to Q24 is not very confident, or not at all confident to workforce within the council, OR if for Q26 the response to analysis of the implications of the care act for the workforce is by April 2015 or later than April 2015, or don t know. If the response to Q30 is By October 2015 or later than October When the response is fairly confident If the responses include any combinations of the following: Q21 Very confident, or fairly confident AND Q22 System put in place to cope with anticipated increase in carers assessment and support planning response is already complete, by February 2015, or by April So long as the response to either Q21 is fairly confident, or Q22 is by April Flagged if the response to Q24 is very confident or fairly confident, to workforce within the council, AND if for Q26 the response to analysis of When the response is very confident If the responses include all of the following: Q21 Very confident, AND Q22 System put in place to cope with anticipated increase in carers assessment and support planning response is already complete,, or By February Flagged if the response to Q24 is very confident, to workforce within the council, AND if for Q26 the response to analysis of the implications of the care act for the implications of the care act for the workforce is yes this has been the workforce by February done At least one of the responses will be either fairly confident (Q24), or by Feb 2015 for Q26. If the response to Q30 is April 2015 or July 2015 If the response to Q30 is yes we have already embedded the new duties By February /02/2015 Care Act Stocktake and support 42

43 Proxy measures criteria for assessment. Potential support required Broadly as expected As expected A response of don t know in any of the questions highlighted below is identified as potential support required PM9 market shaping Q31 Does your council have published a market position statement/s or equivalent that covers all service users and commissioned services? Q37 How confident are you that your council will have plans in place to meet its new responsibilities under the care act, including ensuring people receive services that prevent their needs becoming more serious and can access a range and choice of sustainable integrated services that promote their wellbeing If the response to Q31 is Later than April 2015, OR if the response to Q37 for either receive service that prevent needs becoming more serious or can access a range and choice of sustainable services is not very confident or not at all confident. If the response to Q31 is we have already published a market position statement/s, or February 2015 or by April 2015 AND if the response to Q37 for BOTH receive service that prevent needs becoming more serious AND can access a range and choice of sustainable services is very confident or fairly confident. At least one of the responses to the above will be Q31 By April 2015 or Q37 fairly confident. If the response to Q31is we have already published a market position statement/s, or By February 2015 AND if the response to Q47 for BOTH receive services that prevent needs becoming more serious, AND can access a range and choice of sustainable services is very confident. PM 10 market sustainability Q32 Does your council maintain a regular dialogue with providers about market sustainability and the needs of service users? If not by when will this have started? Q33 Does your council have a robust and comprehensive understanding of the sustainable cost of care for the services it commissions which underpins all its contract prices? Q34 Has your council developed contingency plans to follow if a major local provider were to go out of business? If not, by when will this be done? If the response to Q32 is Later than April 2015, OR if the response to Q33 is By April 2016 or later, OR if the response to Q34 is Later than April Any responses of Don t know will be counted as potential support required. Where responses for at least one of the questions falls below the level determined for As expected but where the response to Q32 is at least Feb 2015 OR By April 2015, or the response to Q33 is at least By January 2016, OR the response to Q34 is at least By February 2015 or By April If the response to Q32 is yes we maintain a regular dialogue, AND the response to Q33 is Yes, we have a robust and comprehensive understanding or By October 2015 or earlier, AND the response to Q34 is Yes, we have plans in place. PM11 - confidence Q38 At this time, how confident are you that your council will be able to deliver the Care Act reforms required from April 2015? If response is not very confident or not at all confident If response is fairly confident If the response is Very confident Prisoners Q12c Have the following been completed in relation to assessments, reviews and services for prisoners? If not by when will they have taken place? When the responses to one or more of the four sub areas is marked as later than April When the responses to at least one of When responses to all four sub areas the sub areas is By February 2015 or is marked as Yes we have completed By April 2015, and all others are the this task same or earlier. 26/02/2015 Care Act Stocktake and support 43

44 Progress tracking across stocktakes Proxy measures Code Stocktake 1 Stocktake 2 Stocktake 3 1 Self funders Q8 - When does your council expect to Q4 estimate of total self funders have a working estimate of the number of As expected Already have an estimate, by November self-funders in its area? As expected Sept 14, Jan 14 Broadly as expected April 2015 Potential support required Later than 2014, by January 2015 Broadly as expected By April 2015 Potential support required By June 2015, Later than June 2015 April Carers assessments 3 Information, advice and advocacy Only partially tracked can t be mapped Q14 how likely is it that the following changes will be in effect from April 2015 As expected All very likely Broadly as expected At least one fairly likely Potential support required At least one not very likely or not at all likely Q9 and Q12 As expected Either are yes we have a working estimate or yes we have agreed the delivery model or by November Broadly as expected Either by January 2015, and others the same or earlier Potential support required either by April 2015, later than April 2015, Don t know, and all others the same or earlier Q15 (1,2,3,4) As expected - All Already have arrangements in place or By November 2014 Broadly as expected At least one of the sub areas is By January 2015 or By April 2015, and all others are the same or earlier. Potential support required - one or more of the four sub areas is marked as later than April 2015 or don t know 4- Safeguarding Not tracked Not tracked New question 5 - funding Q15d When does your council anticipate having an estimate: As expected by September 2014 (plus those responding with Yes, this has been done, or No, but this is underway to question 15) Broadly as expected by January 2015 Potential support required By April 2015, later than April 2015, Don t know Q17 When does your council anticipate having an estimate: As expected We already have a working estimate Broadly as expected By November 2014, by January 2015 Potential support required -, by April 2015, later than April 2015, Don t know Q3 estimate of total self funders As expected Already have, By February Broadly as expected By April 2015 Potential support required By June 2015, Later than June 2015 Q8 and Q9 As expected Either are yes we have a working estimate or yes we have a delivery model Broadly as expected Either are February 2015, and the other the same or earlier Potential support required When the response to either question is Later than April or Don t know, and all others are the same or earlier Q11 (1,2,3,4) As expected - All We have completed this task Broadly as expected At least one of the sub areas is By February 2015 or By April 2015, and all others are the same or earlier. Potential support required - one or more of the four sub areas is marked as later than April or don t know Q14 Confidence there is sufficient money As expected very confident Broadly as expected fairly confident Potential support required not very confident, not at all confident, don t know. 26/02/2015 Care Act Stocktake and support 44

45 Progress tracking across stocktakes Proxy measures Code Stocktake 1 Stocktake 2 Stocktake 3 6 finance and Only partially Q26 and Q30 IT systems tracked can t be As outlined previously mapped 7 - Workforce Only partially Q31(1) and Q33(1) tracked can t be Q31 (1) How confident are you that your in-house mapped 8 Commissioning Q26 Do you have an aligned commissioning strategy which delivers the duties in the Bill? As expected - Yes Broadly as expected - Potential support required - No workforce will be sufficiently prepared for implementation of the Care Act, and Q33(1), response to implementation of changes in relation to workforce capacity, part 1 Analysis of the implications of the Care Act for the Workforce. As expected Q31(1) Very confident, AND Q33(1) Already complete. Broadly as expected at least Q31(1) Fairly confident, and Q33 (1) By January Potential support required Q31(1) Not very confident or worse, or Q33(1) By April 2015 or later. Q38 Will your council have published a market position statement(s) or equivalent that covers all service users and commissioned services. As expected we have already published a market position statement, by November 2014;, or by January Broadly as expected April 2015 Potential support required if the response is By September 2015 or later. Q21 and Q22 As outlined previously Q24(1) and Q26(1) Q24 (1) How confident are you that your in-house workforce will be sufficiently prepared for implementation of the Care Act, and Q26(1), response to implementation of changes in relation to workforce capacity, part 1 Analysis of the implications of the Care Act for the Workforce. As expected Q24(1) Very confident, AND Q26(1) Yes this has been done. Broadly as expected at least Q24(1) Fairly confident, and Q26 (1) By February Potential support required Q24(1) Not very confident or worse, or Q26(1) By April 2015 or later. Q30 Has your council embedded the new duties within the act within its commissioning strategies.. As expected Yes we have embedded the new duties or by February Broadly as expected By April 2015 or By July Potential support required By October 2015 or later. 26/02/2015 Care Act Stocktake and support 45