Care Act Implementation Results of Local Authority Stocktake

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1 Care Act Implementation Results of Local Authority Stocktake Stocktake 4: May / June 2015 August 2015 Care Act Stocktake and support 1

2 August 2015 Care Act Stocktake and support 2

3 Contents Background and scope slide 4 Care Act implementation timeline slide 5 Headline findings for 2015/16 slide 6 Headline findings for 2016/17 slide 7 Headline findings potential support needs slide 9 Headline findings proxy measures for 2015/16 slide 11 Headline findings main concerns slide 12 Feedback from discussions with councils slide 14 Headline findings key risks slide 16 Headline findings support slide 17 Reviewing impact of changes from April 2015 slide 18 Detailed analysis of proxy measures slide 19 Methodology slide 47 August 2015 Care Act Stocktake and support 3

4 Background and scope This is the fourth Care Act Stocktake but is the first since the introduction of Care Act reforms in April The Care and Support Reform Programme Board has committed to undertaking a series of Care Act Stocktakes to understand the impact and readiness for implementation of Care Act requirements in April 2015, and in 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 fourth stocktake carried out from 26 th May 2015 to 16 th June 2015, completed by all 152 authorities with responsibility for social care. Three earlier stocktakes were carried out in May/June 2014, September/October 2014, and January/February The results can be found on the LGA website. Key findings focus on responses to proxy questions in the survey, supplemented with information from discussions with some local areas. The 11 proxy measures in stocktake 3 are included in stocktake 4. There are four additional proxy measures with a specific focus on preparedness for April These slides summarise the main findings for both 2015 and 2016 changes, and flag potential areas of support needed to assist with implementation locally. August 2015 Care Act Stocktake and support 4

5 LA Readiness Stocktakes Implementation Support Regional and AIA Support Care Act Delivery Care Act implementation timeline Apr 15 May June July Aug Sept Oct Nov Dec Jan 16 Feb 16 Mar 16 Apr 16 Cost monitoring Part 1 Effective General Election Comprehensive Spending Review (CSR) Decision on appeals S4 S5 S6 R4 R5 R6 Year 1 Products Visits to Phase 2 innovators Develop support products (batch 1) Specify and commission products (batch 2) Support products available (batch 1l) Further practice materials on Phase 2 L&D suite (inc. e-learning) available Bespoke support (as needed) Bespoke support (as needed) Bespoke support (as needed) Bespoke support Follow-up discussions Follow-up discussions Follow-up discussions Regional Training + Implementation Support fund Revised regional and national structures and expectations in place Local learning networks in place On-going engagement (via PA and CHIA) August 2015 Care Act Stocktake and support 5

6 Headline findings for 2015/16 Overall it is a positive picture for changes from April 2015 (social care reforms) but there are increasing concerns around some areas of implementation. Overall, councils confidence in their ability to deliver the Care Act Reforms in 2015/16 remains high, with 99% very or fairly confident. 57% say that they are very confident compared to 35% in February % of councils say that they are on track with their implementation of the Care Act in 2015/16. The remaining 11% report themselves as only slightly behind. However, despite high overall levels of confidence more councils are identified as having potential support needs. 33 councils recorded 5 or more (out of 11) key measures with potential support needs relevant to 2015/16. This compares with 6 councils in the last stocktake based on the proxy measures. The TEASC risk assessment tool has encouraged a more realistic assessment of current risks and issues faced, and these are reflected in the stocktake returns. August 2015 Care Act Stocktake and support 6

7 Headline findings for 2016/17 Councils were also confident about implementing April 2016 funding reforms At the time of the stocktake councils were planning to implement funding reforms from April The Government has since delayed introduction until % of councils said that they were very or fairly confident they will be able to deliver the funding reforms set out in the Care Act for April % of councils reported themselves as on track for 2016/ councils were identified as having potential support needs for 2016/17. Five of these councils also showed potential support needs for 2015/16 implementation. Confidence 2016/17, All authorities 10 Plan on track 2016/ All LAs Potental support required Broadly as expected As expected Stocktake 3 Stocktake 4 Potential support required Broadly as expected As expected August 2015 Care Act Stocktake and support 7

8 Headline findings for 2016/17 Comparing stocktake 3 with stocktake 4, the percentage of councils with potential support needs has increased in relation to workforce (7% to 8%), but improved for IT & financial systems (8% to 3%) (changes delayed until 2020). 79% of councils are as expected in relation to IT compared with 35% on a comparable measure in stocktake 3. Proxy measures for 2016/17 and over time Leadership awareness (2016), S4 IT (2016), S2 IT (2016), S3 IT (2016), S4 Showing progress Workforce (2016), S3 Workforce (2016), S4 Confidence (2016), S3 Increasing support needs Confidence (2016), S Potential support required Broadly as expected As expected August 2015 Care Act Stocktake and support 8

9 Headline findings potential support needs Measures where potential support identified The number of councils with significant concerns across the board (5 or more proxy measures where potential support needs are identified) has increased based on a similar basket of proxy measures used in stocktake 3. Stocktake 4 identified 33 councils (in dark blue), compared to 6 councils in stocktake 3 (in dark purple). The number of councils expressing concern, but who have not exceeded the threshold, has also increased. Stocktake 3 compared to Stocktake 4 - number of measures where potential support needs are identified (out of 11 proxy measures for 2015/16) Stocktake 4 Stocktake Threshold for support out of /16 proxy measures 5% 1 15% 2 25% 3 Percentage of LAs August 2015 Care Act Stocktake and support 9

10 Headline findings potential support needs Threshold for support out of /16 proxy measures 10 8 Summary of progress against proxy measures focused on 2016/17 5 with potential support needs for both IT & Financial systems (2016) Confidence (2016) Workforce (2016) Leadership & awareness (2016) 33 councils with potential support needs for 2015/16 implementation 16 councils with potential support needs for funding reform implementation As expected Broadly as expected Potential support required August 2015 Care Act Stocktake and support 10

11 Headline findings proxy measures for 2015/16 Below is a summary of analysis across each of the 11 proxy measures highlighted in this stocktake, for 2015/16 implementation. Summary of progress against proxy measures Confidence (2015) PM1, Self funders PM2, Carers PM3, Prevention PM4, Information and advice PM5, Safeguarding PM6, Costs PM7, IT & Financial systems (2015) PM8, Workforce (2015) PM9, Commissioning PM10, Market shaping PM11, Market sustainability Potential 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 47 provides further detail on the methodology behind the proxy measures. August 2015 Care Act Stocktake and support 11

12 Headline findings main concerns Initial findings from the stocktake highlight market sustainability, arrangements for self funder assessments, provision of information, advice and advocacy, and preventing needs for care and support, as key areas where potential support are greatest for 2015/16. When reviewing changes since the last stocktake (February 2015) the proportion of councils with potential support needs has also increased for commissioning and market shaping. 63% of councils were identified as having potential support needs in relation to arrangements to undertake self funder (PM1) social care assessments, compared to 13% in stocktake 3. 41% of councils were identified as having potential support needs in relation to changes to information, advice and advocacy (PM4), compared with 25% in stocktake 3. 37% of councils were identified as having potential support needs in relation to arrangements for preventing needs for care and support (PM3), compared to 29% in stocktake 3. 36% of councils were identified as having potential support needs concerning market sustainability (PM11), compared with 17% in stocktake 3. the proportion of councils with potential support needs increased in commissioning (PM9) from 13% to 23% and in market shaping (PM10) from 9% to 23% of councils from stocktake 3 to stocktake 4. A more detailed analysis of all the proxy measures and change over time is provided in this report. August 2015 Care Act Stocktake and support 12

13 Headline findings main concerns Self funders, S1 Self funders, S2 Self funders, S3 Self funders, S4 Carers' Assessments, S2 Carers' Assessments, S3 Carers' Assessments, S4 Prevention, S3 Prevention, S4 Increasing support needs Showing progress IT (2015), S2 IT (2015), S3 IT (2015), S4 Workforce (2015), S2 Workforce (2015), S3 Workforce (2015), S4 Commissioning, S1 Commissioning, S2 Commissioning, S3 Commissioning, S4 Information & advice, S1 Information & advice, S2 Information & advice, S3 Information & advice, S4 Safeguarding, S3 Safeguarding, S4 Market shaping, S2 Market shaping, S3 Market shaping, S4 Market sustainability, S3 Market sustainability, S4 Understanding costs, S1 Understanding costs, S2 Understanding costs, S3 Understanding costs, S Potential support required Broadly as expected As expected Confidence (2015), S1 Confidence (2015), S2 Confidence (2015), S3 Confidence (2015), S Potential support required Broadly as expected As expected These charts track comparable measures across stocktakes 1, 2,3 and 4. 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. The measures have been designed to provide comparison across the stocktakes across the key areas addressed by the proxy measures. For comparability over time, some measures will differ to the current proxy measures. The arrows are an indication of overall change between stocktakes 3 and 4. August 2015 Care Act Stocktake and support 13

14 Feedback from discussions with councils Discussions were initially held with a random selection of 9 councils and discussions are now underway with a further 44 councils who identified a need for support across a number of proxy measures. Feedback from discussions so far is summarised below: All councils contacted reported that they were confident about implementation for 15/16 and the majority felt that whilst plans were underway for the 16/17 funding reforms there was a sense of relief that these have been delayed. Carer s Assessments: Most councils mentioned an increase in carers assessments however levels of increase were variable. Those councils who reported significant increased numbers were able to attribute this to increased local publicity prior to April 2015 and work with local carers organisations to raise awareness, provide information and advice or carry out trusted assessments. Whilst this was viewed as good practice there was some caution expressed by DASS s about the potential subsequent increase in demand and cost. Workforce: More than half of the councils spoken to so far have expressed concerns about workforce and recruitment. August 2015 Care Act Stocktake and support 14

15 Feedback from discussions with councils Culture change: those contacted were at different stages of service redesign or transformation with regular mention of new models of prevention and information and advice. Whilst the stocktake identified potential concerns in these areas this has not been highlighted as a major concern in the discussions. Market sustainability: several councils discussed over provision of residential and nursing care as a challenge and the need to move to community based models of care. Market rates were raised as a concern by several councils both in terms of requests for uplifts and that providers have been pushed to margins on price. Sustainability of the home care market is a key challenge both in terms of working towards an outcomes based approach and getting the right level and quality of provision. Impact of the living wage has also been raised as a concern. Commonly identified risks can be summarised as: Markets: sustainability (particularly during winter periods), pricing, quality and impact of the living wage Workforce: recruitment and retention General cost pressures: concern that Care Act funding is withdrawn or reduced. August 2015 Care Act Stocktake and support 15

16 Headline findings - key risks Councils were asked to outline the key risks to delivery (Q40a), and to rank them in order. The percentage of councils who highlighted the risk as significant to their council is shown in blue, and the average risk assigned is shown in red. Total implementation costs for 2016/17 (1) Uncertainty about additional demand from self-funders (4) Total implementation costs for 2015/16 (3) Uncertainty about additional demand from carers (2) Managing additional assessments (5) Lack of funding to commission or maintain preventative services (6) Uncertainty over key national policy decisions (10) IT systems not ready in time (7) Pressures on the NHS (NEW) Impact on local provider market (8) New national eligibility threshold (9) New duties relating to prisoners (12) Deferred payment agreements (13) Workforce not sufficiently prepared (14) Public expectation (including legal challenges) (11) Inspection from regulators (NEW) Provider performance (NEW) Engagement from key partners locally (15) 10 Per cent mentions Average rating 100 A V E R A G E R I S K R A T I N G The figures in brackets represent the position of the risk in stocktake 3. Total implementation costs for 2016/17 and uncertainty about additional demand are the highest ranked risks faced by around 9 of councils. Key risks relating to the now delayed implementation of funding reforms are greyed out. August 2015 Care Act Stocktake and support 16

17 Headline findings support A number of support materials have been developed to assist local implementation. The Joint Programme Office use feedback from the stocktake to inform the future national, regional and local support offer. 95% of councils said that they found the Deferred Payment Agreements implementation toolkit to be very or fairly helpful. Around 9 of councils also found the Regulations and guidance for 2015/16, the SCIE Assessment and Eligibility resources, the Deferred payments sample legal agreement, and the Commissioning for Better Outcomes framework to be very or fairly helpful. 26% of councils highlighted better arrangements for sharing good practice as something that would help their area to embed the changes during 2015/16. When asked to outline specific additional support or guidance that would help to increase confidence in or preparations for April 2016, 33% of councils requested support on financial issues, and 29% highlighted timely release of final national regulations and guidance. When asked to outline other particular challenges or areas of concern in implementation for their council, 23% highlighted financial issues (including uncertainty, funding gap, planning and charging) and 22% highlighted timescales, including delays in the regulations and guidance and timely release of information and tools. August 2015 Care Act Stocktake and support 17

18 Reviewing impact of changes from April 2015 In this stocktake councils were asked to provide a small number of metrics to inform our collective understanding about any changes in demand. Given the timing of the stocktake it is recognised that there is a very short window to assess. There is not yet clear evidence of any increase in the number of carers coming forward for an assessment or receiving services The significant majority of councils are not seeing any self-funders coming forward yet for an early assessment There is evidence to Care show Act a small implementation increase in the timeline number (TO of UPDATE) people asking for a deferred payment Most local authorities with prisons or approved premises in their areas are not yet recording completed assessments or services in place for prisoners. Further follow up work is needed to interpret the emerging picture. We will work with councils to understand the impact of changes. August 2015 Care Act Stocktake and support 18

19 Detailed analysis of proxy measures The following pages highlight each of the proxy measures in turn, focusing first on those highlighted on slide 12 where potential support needs are greatest. For each of the proxy measures there is an overall view of progress alongside a detailed view of how this varies by council type and by geographical regions. 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 47 provides further detail on the methodology behind the proxy measures. August 2015 Care Act Stocktake and support 19

20 Analysis: Self funders (PM1) Self funders, PM1 Stocktake 2 Stocktake 3 Stocktake 4 As expected Broadly as expected Potential support required This measure looks at whether councils have, or by when they will have, robust arrangements in place to undertake self funder social care assessments. 63% of councils were identified as having potential support needs in this area, up from 13% in stocktake PM1, By authority type 10 PM1, By region C UA LB MD As expected Broadly as expected Potental support required E EM GL NE NW SE SW WM YH As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 20

21 Analysis: Self funders (PM1) What the survey tells us 32% of councils say that they already have robust arrangements in place to undertake selffunder social care assessments. 5% say they will have arrangements in place by July. County councils have the highest proportion of councils with potential support needs at 89%, followed by London boroughs at 71%. Geographically, the South East (84%), East Midlands (78%), South West (75%) and London (71%) have the higher proportions of councils highlighting potential support needs, and the North East the lowest at 42%. Support products available now Assessment and eligibility process map (PMO) Proportionate assessment (PMO) Supported self-assessment (PMO) Support planned or underway Briefing on approaches to managing demand in response to the Care Act (PMO) Example materials from visits to local authorities (PMO) How to guide on approaches to online self-assessment (PMO) Local learning networks (via ADASS regions) Potential guidance for financial assessors (NAFAO) Risk Toolkit (TEASC) 15/16 cost modelling (PMO) August 2015 Care Act Stocktake and support 21

22 Analysis: Information, advice and advocacy (PM4) Information, advice and advocacy, PM4 Stocktake 2 Stocktake 3 Stocktake 4 As expected Broadly as expected Potential support required PM4, By authority type This measure looks at councils progress in making timely changes for implementation of the Care Act in 2015 in setting up comprehensive universal information and advice services; setting up an online information and advice service that promotes self service and prevention; establishing signposts to financial advice, and commissioning an appropriate level of local advocacy services. 41% of councils were identified as having potential support needs in this area, up from 25% in stocktake 3. PM4, By region C UA LB MD E EM GL NE NW SE SW WM YH As expected Broadly as expected Potental support required As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 22

23 Analysis: Information, advice and advocacy (PM4) What the survey tells us 49% of councils are making the expected level of progress regarding information, advice and advocacy, and a further 1 are broadly as expected. There is some variation in the percentage of councils where potential support needs are identified: by council type from 56% of county councils to 38% of unitary authorities; and geographically from 57% of councils in the North West to 17% in the North East. Support products available now Strategy tool for development of an Information and Advice strategy (TLAP) Guide: the development of online services for information and advice supporting the Care Act 2014 (ADASS IN) Facilitating access to independent financial information and advice: practice guidance for local authorities (SVARfair) NHS Choices content syndication feeds Commissioning Advocacy guide and self-assessment tool (SCIE) Support planned or underway Information and Advice - regional action-learning sets (TLAP) Advocacy training materials (City and Guilds) Information and Advice as a key focus for forthcoming regional learning networks of operational staff, supported by CSRP funding August 2015 Care Act Stocktake and support 23

24 Analysis: Prevention (PM3) Prevention, PM Stocktake 3 Stocktake 3 Stocktake 4 As expected Broadly as expected Potential support required This measure asks councils about the arrangements they have in place to identify and support people who would benefit from preventative services. 37% of councils are identified as having potential support needs in relation to preventing needs for care and support. This is up from 29% based on a similar measure in stocktake PM3, By authority type 10 PM3, By region C UA LB MD E EM GL NE NW SE SW WM YH As expected Broadly as expected Potental support required As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 24

25 Analysis: Prevention (PM3) What the survey tells us 64% of councils already have a cross organisation strategy through the health and wellbeing board, and 81% say they have arrangements to identify people who would benefit from preventative services. Overall, 58% of councils are making the expected level of progress on this measure, and a further 5% are broadly as expected. There is very little variation by authority type, but on a regional level the percentage of councils with potential support needs ranges from 57% of councils in the North West to 17% in the North East. Support products available now SCIE Prevention library ASCE Programme case studies Pioneer and BCF support Building community capacity Support to Health & Wellbeing boards Support planned or underway Systems Leadership Skills programme to enable DASSs and Providers to lead across local areas to sustain preventative services SCIE Prevention forum for sharing issues and tools Better access to learning from Pioneer and BCF programmes Local learning networks (ADASS) August 2015 Care Act Stocktake and support 25

26 Analysis: Prevention (Q10) What the survey tells us In question 10, councils were asked to tell us about any examples of how their council is responding to this duty to prevent needs for care and support for the wider population. Numerous examples were provided, and some of the key themes emerging can be summarised as follows. 57% of councils said that they are doing more joint working with others such as health partners, the voluntary sector, and other council departments including IT and commissioning. 48% of councils said that they were improving their information and advice services, including online, telephony, and face to face, making information available in a wide range of places where people naturally go for help. 38% were approaching this through community support, including examples such as a good neighbour scheme, using social clubs run in community centres, assessing community capacity, and working together with voluntary and third sector provide services in the community and with housing around adaptations and telecare. 24% mentioned providing targeted help, support and activities for older people. For example programmes around ageing healthily and prevention, developing their community connections, offer of reablement, equipment and adaptations to people who would benefit from these services, and working with CCGs to extend independent at home for one year longer through coordinated health and social care voluntary services. August 2015 Care Act Stocktake and support 26

27 August 2015 Care Act Stocktake and support 27

28 Analysis: Market sustainability (PM11) Market sustainability, PM11 Stocktake 2 Stocktake 3 Stocktake 4 As expected Broadly as expected Potential support required This measure looks at market sustainability in terms of dialogue with providers (Q31), an understanding of the sustainable cost of care (Q32) and whether the council has a contingency plan for provider failure (Q34). 36% of councils were identified as having potential support needs in this area, up from 17% in stocktake PM11, By authority type 10 PM11, By region C UA LB MD As expected Broadly as expected Potental support required E EM GL NE NW SE SW WM YH As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 28

29 Analysis: Market sustainability (PM11) What the survey tells us Overall, 71% of councils are actively using their market position statement to shape sustainable local care and support services. 79% either have a robust and comprehensive understanding of the sustainable, fair cost of care or will do by September % have contingency plans in place. There is some geographical variation on this measure with potential support needs identified for 58% of councils in the North East to 13% in Yorkshire and Humberside. 7 of councils reported that winter pressures on emergency admissions and delayed discharges had caused a significant (27%) or slight (43%) decrease on the capacity of the local provider market. 7 of councils have already put in place arrangements to assure itself that the care providers from which it commissions services are paying at least the national minimum wage (including travel time). 5% will have these in place by July 2015, and a further 18% before the end of December Support products available now Market sustainability guidance and toolkit (Cordis Bright) Support planned or underway Provider failure toolkit (LGiU) August 2015 Care Act Stocktake and support 29

30 Analysis: Commissioning (PM9) Commissioning, PM9 Stocktake 2 Stocktake 3 Stocktake 4 This measure asks councils if they have, or by when will they have, embedded the new duties within the Act within its commissioning strategies to ensure effective provision of care and support for the future. 23% of councils were identified as having potential support needs in this area, up from 13% in stocktake 3. As expected Broadly as expected Potential support required 10 PM9, By authority type 10 PM9, By region C UA LB MD E EM GL NE NW SE SW WM YH As expected Broadly as expected Potental support required As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 30

31 Analysis: Commissioning (PM9) What the survey tells us 53% of councils say that they have already embedded the new duties within the Act within its commissioning strategies. A further 7% will do this by July Metropolitan district councils have the highest proportion of councils with potential support needs at 31%. By geographical region the South East (42%) and North West (29%) have the highest proportion of councils with potential support needs in commissioning, compared to the North East (8%) and East (9%) which have the lowest proportion with potential support needs. Support products available now Top tips commissioning for market diversity (TLAP) Co-production in commissioning (TLAP) Support planned or underway Commissioning for Better Outcomes Peer Challenges Commissioning as a key focus for forthcoming regional learning networks of operational staff, supported by CSRP funding Provider engagement (PMO) August 2015 Care Act Stocktake and support 31

32 Analysis: Market shaping (PM10) Market shaping, PM10 Stocktake 2 Stocktake 3 Stocktake 4 As expected Broadly as expected Potential support required 23% of councils have potential support needs in market shaping, up from 9% in stocktake 3. Using Q30 (publication of market position statement) and Q38 (confidence that the market shaping and commissioning function will enable it to deliver improved preventative and integrated care and support), this measure reviews the timeliness and effectiveness of a council s market shaping arrangements. 10 PM10, By authority type 10 PM10, By region C UA LB MD As expected Broadly as expected Potental support required E EM GL NE NW SE SW WM YH As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 32

33 Analysis: Market shaping (PM10) What the survey tells us This measures combines responses to Q30 (publication of market position statement) and Q38 (confidence that the market shaping and commissioning function will enable it to deliver improved preventative and integrated care and support). 7 of councils have a published market position statement, 98% of councils are very or fairly confident that the council has adequate plans in place to ensure that people receive the services that prevent their care needs becoming more serious, and 93% are very or fairly confident that their plans ensure that people can access a range and choice of quality and sustainable integrated services that promote their wellbeing. There is some variation by authority type, with potential support needs identified for 37% of counties, compared with 13% of London boroughs; and geographically with 42% of councils in the North East compared with 7% in the West Midlands and Yorkshire and Humberside. Support products available Market Shaping toolkit to support dialogue and innovation with SME providers (IPC) Resources for developing a Market Position Statement (IPC) Commissioning for Better Outcomes toolkit Support planned or underway Commissioning for Better Outcomes Peer challenges Good practice on engagement with providers (PMO) August 2015 Care Act Stocktake and support 33

34 Analysis: IT & finance systems (2015/16) (PM7) IT & Finance systems (2015/16), PM7 Stocktake 2 Stocktake 3 Stocktake 4 As expected Broadly as expected Potential support required PM7, By authority type 10 19% of councils were identified as having potential support needs in this area, up from 15% in stocktake 3. 97% of councils are very or fairly confident that the systems will be adequate to manage the statutory duties. 83% of councils say that systems are either already in place or will be in place by July 2015 to support the anticipated increase in carers assessments and support planning. PM7, By region C UA LB MD As expected Broadly as expected Potental support required E EM GL NE NW SE SW WM YH As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 34

35 Wider changes - IT systems What the survey tells us Councils were asked to tell us about any examples of wider changes they are making to their IT systems and what difference the changes will make locally. 29% of councils mentioned the use of self-service portals, including for example selfassessment, and provision of information. This included a single information portal for all client groups across adults and children, and a review of first contact technology to ensure that a variety of online and offline routes are available. 27% of councils mentioned integration with other organisations, including CCGs, other health partners, neighbouring local authorities and with other departments across the council. 2 of councils said that they were making changes to general finance systems, including a council wide customer portal for on-line transactions aimed at increasing customer autonomy, minimising processes and in turn, supporting internal staff resources. 16% of councils mentioned a general system upgrade in order to be Care Act compliant this includes changes to existing systems and upgrades to or commissioning of replacement systems, and ensuring that staff are using the technology to its full potential to manage demand and performance. August 2015 Care Act Stocktake and support 35

36 Analysis: IT & finance systems (2016/17) IT & Financial systems 2016/17, All authorities All LAs Potental support required Broadly as expected As expected IT & Financial systems 2016/17, By authority type % of councils were identified as having potential support needs in this area. 75% of councils are very or fairly confident that the systems will be adequate to manage the statutory duties during 2016/17. 79% of councils say that the systems impact of strategy for handling self-funder assessments and Care Accounts are agreed with IT support staff or will be in place by December IT & Financial systems 2016/17, By region C UA LB MD As expected Broadly as expected Potental support required E EM GL NE NW SE SW WM YH As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 36

37 Analysis: IT & finance systems (2016/17) (over time) Finance and IT systems (2016/17) Stocktake 2 Stocktake 3 Stocktake 4 As expected Broadly as expected Potential support required Over time, this measure looks at progress in relation to changes to case records management IT systems for implementation of the Care Act 2016 changes, focusing on systems impact of the strategy for handling self-funder assessments and Care Accounts. This is slightly different to the proxy measure for IT & Finance Systems for 2016/17 which also incorporates councils assessment of their confidence that their systems will be adequate to manage the statutory duties in 2016/17. Only 3% of councils have potential support needs in on this measure, down from 8% in stocktake 3. Support products available now IT specifications Supplier engagement Support planned or underway Care Accounts IT specification (DH) August 2015 Care Act Stocktake and support 37

38 Analysis: Workforce (2015/16) (PM8) Workforce (2015/16) Stocktake 2 Stocktake 3 Stocktake 4 As expected Broadly as expected Potential support required PM8, By authority type 10 Just 3% of councils were identified as having potential support needs in this area, down from 8% in stocktake 3. 97% of councils are very or fairly confident that their in house workforce arrangements are sufficient for implementation of the Care Act in 2015/16. PM8, By authority type C UA LB MD C UA LB MD As expected Broadly as expected Potental support required As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 38

39 Wider changes - workforce behaviour & culture What the survey tells us Councils were asked to tell us about any examples of how the changes they have made as part of the Care Act have started to make a difference to behaviours and the culture within the council. 35% of councils mentioned training and development including co-produced and codelivered training 26% mentioned wellbeing and prevention, including increased recognition amongst staff of their role in wellbeing and prevention 21% mentioned examples relating to a person-centred approach. August 2015 Care Act Stocktake and support 39

40 Analysis: Workforce (2016/17) Workforce (2016/17) Stocktake 2 Stocktake 3 Stocktake 4 As expected Broadly as expected Potential support required Workforce 2016/17, By authority type 10 8% of councils were identified as having potential support needs in this area, up from 7% in stocktake 3. 92% of councils are very or fairly confident that their in house workforce arrangements are sufficient for implementation of the Care Act in 2016/17. Workforce 2016/17, By region C UA LB MD E EM GL NE NW SE SW WM YH As expected Broadly as expected Potental support required As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 40

41 August 2015 Care Act Stocktake and support 41

42 Analysis: Leadership awareness (2016/17) Leadership awareness 2016/17, All authorities All LAs Potental support required Broadly as expected As expected Leadership awareness 2016/17, By authority type This measure looks at the awareness of the Chief Executive and Council Leader of the challenges, risks and progress associated with delivering the Care Act funding reforms from 2016/17. 5% of councils were identified as having potential support needs in this area. 98% of councils say that their Chief Executive is very or fairly aware, and 97% say that their Council Leader is very of fairly aware. 10 Leadership awareness 2016/17, By region C UA LB MD E EM GL NE NW SE SW WM YH As expected Broadly as expected Potental support required As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 42

43 Analysis: Prisons Prisons Stocktake 2 Stocktake 3 Stocktake 4 As expected Broadly as expected Potential support required Prisons, By authority type 87 councils responded to say that they have prisons or other approved accommodation in their local area. The analysis shown here is based on those 87 councils only. Potential support needs were identified for 39% of the councils with relevant premises, up from 27% identified in stocktake 3. The proportion of councils whose progress is as expected increased from 2% in stocktake 3 to 48% in stocktake Prisons, By region C UA LB MD E EM GL NE NW SE SW WM YH As expected Broadly as expected Potental support required As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 43

44 Analysis: Carers assessment (PM2) Carers' assessments Stocktake 2 Stocktake 3 Stocktake 4 As expected Broadly as expected Potential support required PM2, By authority type 18% of councils were identified as having potential support needs in this area, down from 24% in stocktake 3. This measure asks if councils have robust arrangements in place (Q8) for how it will meet increased demand for carers assessments. 74% of councils say they already have robust arrangements in place, and a further 8% will by July PM2, By region C UA LB MD E EM GL NE NW SE SW WM YH As expected Broadly as expected Potental support required As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 44

45 Analysis: Safeguarding (PM5) Safeguarding, PM5 Stocktake 2 Stocktake 3 Stocktake 4 As expected Broadly as expected Potential support required PM5, By authority type 11% of councils were identified as having potential support needs in this area, up from 4% in stocktake 3. This measure uses responses to Q15, which asks about councils confidence that their statutory safeguarding adults board has robust arrangements in place to deliver its duties, including responding to enquiries and sharing information between organisations to ensure that services do no harm. 10 PM5, By authority type C UA LB MD C UA LB MD As expected Broadly as expected Potental support required As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 45

46 Analysis: Understanding of costs (PM6) Understanding of costs, PM6 Stocktake 2 Stocktake 3 Stocktake 4 As expected Broadly as expected Potential support required PM6, By authority type 26% of councils were identified as having potential support needs in this area, down from 33% in stocktake 3. Based on responses to Q16 this measure assesses the councils confidence that there sufficient money in its budget for implementation of the Care Act in 2015/16. 74% of councils are very or fairly confident, however 53% of South East councils were identified as having potential support needs in this area. PM6, By region C UA LB MD As expected Broadly as expected Potental support required E EM GL NE NW SE SW WM YH As expected Broadly as expected Potental support required August 2015 Care Act Stocktake and support 46

47 Methodology August 2015 Care Act Stocktake and support 47

48 Methodology This is the fourth Care Act stocktake, but is the first since the introduction of Care Act reforms in April 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. 99% 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 from slide 49. August 2015 Care Act Stocktake and support 48

49 Areas covered in the stocktake Local authorities were asked to respond to 48 questions addressing the following topics: Programme management and governance People (national eligibility; self funders; meeting duties for carers assessment; preventing needs for care and support; provision of information, advice and advocacy; prisoners; and quality and 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 August 2015 Care Act Stocktake and support 49

50 Proxy measures questions covered Proxy measures Code Label Question no Section PM1 Self funders Q5 B) People PM2 PM3 Meeting increased demand for carer assessment Preventing needs for care and support Q8 Q9_1 Q9_2 B) People B) People PM4 Information and advice Q12_1 to Q12_5 B) People PM5 Safeguarding Q15_1 to Q15_4 B) People PM6 Understanding of costs Q16 C) Costs PM7 IT & Financial systems (2015/16) Q21 (2015/16) Q22_3 D) Systems PM9 Workforce (2015/16) Q24_1 D) Systems PM9 Commissioning Q29 F) Market Shaping and Commissioning PM10 Market shaping Q30 Q38_1 & Q38_2 F) Market Shaping and Commissioning PM11 Market sustainability Q31 F) Market Shaping and Commissioning Q32 Q34 Confidence (2015/16) Confidence Q39 (April 2015) G) Support Prisoners Prisoners Q13c_1 to Q13c_3 B) People August 2015 Care Act Stocktake and support 50

51 Proxy measures questions covered Proxy measures Label Question no Section IT & Financial systems (2016/17) Q21 (2016/17) Q22_6 D) Systems Workforce (2016/17) Q24_3 (2016/17) D) Systems Confidence (2016/17) Q39 (April 2016) G) Support Leadership Awareness - reforms from 2016/17 Q2_3 (Chief Executive) Q2_5 (Leader) A) Programme Management and Governance August 2015 Care Act Stocktake and support 51

52 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 Q5 Does your council have robust arrangements in place to undertake self funder social care assessments? If not, when will this be done? By September 2015 or later By July 2015 Yes we already have robust arrangements in place PM2 carers assessments Q8 Has your council got robust arrangements in place for how it will meet increased demand for carers assessments? By September 2015 or later By July 2015 Yes we have robust arrangements in place PM3 - prevention Q9 Does your council have arrangements in place to identify and support people who would benefit from preventative services? If not, by when will this be done? When the response to either Q9_1 or Q9_2 is By September 2015 or later When the responses to at least one of the sub areas is By July 2015 and the other is the same or earlier When the response to both Q9_1 and Q9_2 is Yes, we have arrangements in place PM4 information, advice and advocacy Q12 In your council, have the following taken place in relation to changes to information, advice and advocacy, for implementation of the Care Act in 2015? If not, when? When the responses to one or more of the five sub areas is marked as September 2015 or later When the responses to at least one of the sub areas is By July 2015 and all others are the same or earlier When responses to all five sub areas is marked as Yes, this has taken place PM5- safeguarding Q15 How confident are you that your council s statutory safeguarding adults board is currently delivering the following? When the responses to one or more of the four sub areas is marked not very confident not at all confident or don t know When the response to at least one of the all four sub questions is fairly confident and all others are the same or earlier When responses to all four sub questions is very confident August 2015 Care Act Stocktake and support 52

53 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 PM6 - funding Q16 How confident is your council that there is sufficient money within its budget for implementation in 2015/16? When the response is either not very confident, not at all confident When the response is fairly confident When the response is very confident PM7 finance and IT systems (2015/16) PM8 workforce (2015/16) Q21 How confident are you that your council s financial and IT systems will be adequate to manage the statutory duties during 2015/16 and 2016/17 (Response to 2015/16 only)? 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 will they have been done (Part 3 only)? Q24 How confident are you that your council s arrangements to recruit and train its workforce are sufficient for implementation of the Care Act in 2015/16 workforce within the council (Part 1, 2015/16) 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 of September 2015 or later. When the response to Q24 is not very confident, or not at all confident If the responses include one of the following: Q21 Fairly confident AND /OR Q22 System put in place to cope with anticipated increase in carers assessment and support planning response is By July So long as the response to either Q21 is the above or better, or Q22 is above or better When the response to Q24 is fairly confident If the responses include both 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 When the response to Q24 is very confident PM9 commissioning Q29 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 to Q29 is later than September When the response to Q29 is by July 2015 or September 2015 When the response to Q29 is yes we have embedded the new duties August 2015 Care Act Stocktake and support 53

54 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 PM10 market shaping Q30 Does your council have a published market position statement/s or equivalent that covers all service users and commissioned services? Q38 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 Q30 is By September 2015 or later, OR if the response to Q38 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 Q30 is By July 2015 OR if the response to Q38 for ONE OR MORE of receive services that prevent needs becoming more serious, and can access a range and choice of sustainable services is fairly confident. So long as the response to all of the three questions is as the above or better If the response to Q30 is we have already published a market position statement/s AND if the response to Q38 for BOTH receive services that prevent needs becoming more serious, AND can access a range and choice of sustainable services is very confident PM 11 market sustainability Q31 Is your council actively using its market If the response to Q31 is By position statement or equivalent with providers to September 2015, or later OR if the shape and deliver sustainable local care and response to Q32 is Later than support services? December 2015 OR if the response Q32 Does your council have a robust and to Q34 is By September 2015 or comprehensive understanding of the sustainable later 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? Where responses for at least one of the questions falls below the level determined for As expected but where the response to Q31 is at least July 2015 AND the response to Q32 is at least By December 2015, AND the response to Q34 is at least By July 2015 If the response to Q31 is yes we are using it to shape sustainable local care and support services, AND the response to Q32 is Yes, we have a robust and comprehensive understanding or By September 2015 or earlier, AND the response to Q34 is Yes, we have plans in place Confidence (2015/16) Prisoners Q39 At this time, how confident are you that your council will be able to deliver the expected outcomes outlined within the Care Act during 2015/16 (April 2015) Q13c 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 response is not very confident or not at all confident When the responses to one or more of the four sub areas is marked as By September 2015 or later When the response is fairly confident When the responses to at least one of the sub areas is By July 2015 and all others are the same or earlier When the response is Very confident When responses to all four sub areas is marked as Yes we have completed this task August 2015 Care Act Stocktake and support 54

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