Adult Social Care. Strategic Service Plan 2015/16

Adult Social Care Strategic Service Plan 2015/16 Ensuring that adults with support needs are able to maximise their independence through enablement linked to recovery and rehabilitation Andy.sharp@bournemouth.gov.uk Bournemouth Borough Council 2014/15 291214 v8

Strategic Service Plan 2015/16 Adult Social Care 1. Service Scope What does the service unit do? Adult Social Care assesses and meets the needs of the most vulnerable adults and their carers in Bournemouth, supporting them to maximise their independence and remain in their own home for as long as possible. This Plan sets out our strategic direction for 2015/16 and beyond. It includes reference to the actions needed to deliver our objectives, covering all Service Groups and teams in Adult Social Care. These are: Locality Services Enablement Services Disability Services Provider Services Principal Social Worker Policy and Service Development Our Mission, Principles and Values Our mission within adult social care is to ensure that adults with support needs are able to maximise their independence through enablement linked to recovery and rehabilitation. The aims within our mission statement will be achieved by working in partnership with other council services and external partners to; 2 promote and protect people s health and wellbeing by encouraging the development of early intervention and preventative services adopt enablement approaches to increase people s independence and quality of life move away from more traditional models of service delivery to a more personalised approach develop community-based alternatives to traditional social care services, working closely and positively with community and voluntary organisations to focus on support and care closer to home only directly provide services where there is a demonstrable gap across the marketplace. Our principles and values - that underpin the delivery of all of our services - are; Supporting people to stay active and healthy through prevention services Helping people maintain and regain independence and control over their lives Treating people with respect, dignity and openness at all times Helping people at risk of harm and abuse to stay safe Treating clients and carers with dignity and fairness, respecting differences in culture, religion and belief, race, age, gender, sexual orientation and disability Improving the quality of services purchased and provided Listening to what people have to say about our services and acting on feedback Working together with colleagues, other agencies and the independent sector to make the best use of available resources and provide the best possible services to the people of Bournemouth. This will include Public Health, Community Safety, the NHS, Housing, charities, voluntary organisations and private sector service providers Putting things right as quickly as possible if things go wrong and improving our services and responding to complaints in a timely way.

How are we organised? The senior management structure of Adult Social Care is described in the structure chart below. These roles form the Adult Social Care Leadership Team: ADULT SOCIAL CARE MANAGEMENT STRUCTURE Andy Sharp Service Director - Adult Social Care Bev Cook PA to Service Director Hayley Verrico Service Manager - Disability Strategic Lead for Safeguarding Mental Health Learning Disability Transitions Aspergers Safeguarding & DOLS Hilary Jenkins Service Manager - Locality Strategic Lead for coproduction Localities Team Jenni Collis- Heavens Service Manager - Provider Strategic Lead for quality Residential provision Building base day services Community Support First Point/First Point Plus Shared Lives Tim Branson Service Manager - Enablement Strategic Lead for personalisation Bournemouth Enablement Team (BET) Reablement Home Care Broadwaters Hospital Social Work Team Kevin Balchin Adult Social Care Development Manager Sarah Webb Principal Social Worker AMHP lead Community Employment Leven House Core responsibilities for safeguarding adults across all Service Groups This section of the Plan sets out the responsibilities of all social care functions and staff across Adult Social Care to safeguard adults from harm. Those specific to a Service Group are included in their section of the Plan. Promoting well-being, carrying out timely, personalised assessments and reviews Safeguarding vulnerable adults in all that we do Helping people at risk of harm or abuse to stay safe and helping individuals to recover from abuse. Undertaking Deprivation of Liberty Safeguards best interest assessments under the Mental Capacity Act. Providing advice to care homes about aspects of safeguarding and Deprivation of Liberty Safeguards. Working closely with our partners, particularly the Police and the NHS, to promote safe living Working with the Safeguarding Adults Board, learning from Serious Case Reviews and national reviews such as Winterbourne View 3

What are our key risks and assumptions? This section of the Plan sets out the risks and assumptions that apply across Adult Social Care. Those specific to a Service Group are included in their section of the Plan. The key risks facing Adult Social Care in Bournemouth relate to increasing demands in an environment of reducing resources. On a local level the amount of investment required to meet forecast demands is not an option, and over the course of the next three to four years the amount of money available to provide services will reduce by around 20%. However we will still be spending significant sums on the provision of services (around 62M for adult social care) and the challenge for us is to use these resources more effectively, as well as recognising the need to change our role from one of provider to commissioner and facilitator. The table below shows these key demands and risks, as well as the key assumptions we are making in designing solutions we know that we can manage the demands facing us only through using alternative models of provision. Demands and risks Demographic changes in Bournemouth mean that there is the potential for significant increases in the aging population (although there are indications that this may be peaking in Bournemouth) and from the numbers of people with disabilities and mental health issues. National data suggests that if demand and current spend continue on the same trajectory then we would need to double our investment in care services by 2026 Increases in statutory work a significant increase on demand for Deprivation of Liberty assessments has arisen nationally from legal rulings, on top of other statutory demands such as Safeguarding Increased expectations national legislative and policy changes require Adult Social Care and all public services to operate in ways which support people to retain their independence and exercise choice and control over the support and services that they receive. Such new ways of working represent a major shift in practice which is likely to require a significantly increased level of input at the assessment, support planning and reviewing stages Increases in demand arising from the requirements of the Care Act 2014 which will result in extra demand for assessments, and also introduces care capping, additional funding requirements and a move to a universal deferred payment scheme. There is a need to ensure systems and processes are in place to deal with this, for example, an ICT and finance package to be able to provide annual care 4 Assumptions and solutions ASC are working on the assumption that 80% to 90% of new clients that approach us as a direct result of the Care Act 2014 will receive general advice and support and/or simple services such as equipment without the need for a full home-based assessment A shift to digital by design for the majority of our clients, i.e. we will design simple ways to help them assess their needs and deliver a simple support plan via self-service online facilities Ensuring that the outcome of their assessment is a timely, objective calculation of the personal budget we will make available to them and how much they will have to contribute to it A direct link from their support plan to a marketplace service allowing them access to a wider range of care and support solutions so they can find, choose and buy their own services All services we provide, commission or support will focus on delivering better outcomes for our clients and carers, ensuring they are personalised to meet each person s health and wellbeing and that they encourage independence We will promote the growth of better, wider ranging preventative and enablement services in our local community to improve the quality of life for our clients and carers whilst also reducing the financial burden that increasing levels of need and demand might place on the local authority A transformation to our processes and structures, building on phase 2 of Core

Demands and risks accounts and statements, etc. Increased numbers of young people moving from Children s Social Care to Adults Social Care The budget pressures facing Bournemouth Borough Council and all local authorities arising from reductions in central government funding Shortages of capacity in the local market for care services, leading to difficulties in buying services for Bournemouth and other local partners Assumptions and solutions Service Transformation and linking to the wider work of the Council. This plan recognises that during 2015/16 and beyond we will have to consider further changes to our models of provision which will contain new service structures and roles What were our key achievements in 2014/15? 1. Achieved Cabinet approval for our Provider Services to move to a Local Authority Trading Company 2. Successfully supported and managed the safe transition of vulnerable clients during a number of private sector care home closures 3. Managed to keep the number of clients whose discharge from hospital was delayed for reasons attributable to the Local Authority to within target despite 30% increases in urgent and emergency hospital admissions. 4. Continued to successfully support our clients to regain their independence through our in-house reablement service 5. Completed the transition to a new Service Manager structure delivering significant savings 6. Achieved significant savings through our Core Service Transformation programme 7. Achieved a balanced budget despite significant financial pressure. Customer and stakeholder analysis Adult Social Care is a business unit led by customer need, and as a result we have a number of well established engagement and consultation mechanisms already in place, many of which were enhanced during 2014/15. Some of these arrangements are local; others are based upon national arrangements linked to the Adult Social Care Outcomes Framework (ASCOF) and the Sector Led Improvement agenda for local authorities. All of our engagement processes are overseen by appropriate research governance arrangements. National Arrangements Annual Local Account, acting as a retrospective review and statement of future intent Carers Survey, assessing carers outcomes and quality of life ASCOF satisfaction measures, a set of indicators derived from customer surveys The Safeguarding Adults returns (SAR) Local Arrangements Assessment & Care Management Survey, a survey is being developed to engage customers who have been through assessment and review to gain feedback on their experience and the areas covered with them by the social work practitioner. This on-going survey commenced in 2014. On-going feedback collected from clients following reablement and rehabilitation, reported to ASCLT quarterly Learning Disability Partnership Board for customers and carers linked to LD services in Bournemouth and Poole includes an annual self-assessment of the work of the Board Complaints and complements procedure: on-going customer feedback used to inform decisionmaking and shape services Local Carers Survey, the national carers survey takes place every two years but we intend to conduct a local survey in the intervening years related to those areas highlighted as in need of 5

improvement through the national survey. This will allow us to track our progress and assess the impact of improvements that we put in place. The national survey will be in February 2015. Home Care Satisfaction Survey, an annual survey replacing the former national arrangements which came to an end in 2011. The survey will assess satisfaction with domiciliary care commissioned by the Council. This survey was conducted in Autumn 2014. POET survey The Personal Outcomes Evaluation Tool (POET) has been developed by a national user-led organisation called In-Control in association with Lancaster University. Bournemouth Adult Social Care participated in the POET survey for the first time during 2014/15. The information gathered from the survey has helped to shape the future development of our local offer of personalised support for residents of Bournemouth. Equality and diversity The Council is committed to equality and diversity. Within Adult Social Care we take issues of equality and diversity seriously in relation to the provision of services which meet specific needs and requirements for eligible customers. To support this approach we will:- 6 analyse employee data (e.g. requests for flexible working and outcomes) by age, religion and ethnicity continue to measure responses from surveys by age, needs and ethnicity analyse the levels of people contacting the service, being assessed, receiving a service and level of funding by age, needs and ethnicity extend current enablement services from older people to other client groups to equalise opportunities We will also continue to ensure that equality issues are considered in any changes to policy, procedure and delivery of services, and that equality impact needs assessments are completed, as set out in the document linked here: ASC Equality & Diversity Plan 201516 Employee Engagement and Development Our staff are our most valuable resource, and without their genuine engagement in supporting the delivery of our priorities and plans it would be impossible for us to deliver the services that our clients and their carers deserve. Ensuring that we have a highly skilled, well motivated and empowered team of the right people in the right place at the right time is essential. Training and Development We will ensure that managers and staff are well placed to deliver the priorities and demands of the changing and evolving agenda within adult social care, using our Workforce Development Group to; develop quality standards for all of our services that will set out what our clients and carers can expect in the way of service delivery. The quality standards will support our Quality Assurance audits. develop competencies which managers staff will be expected to meet. These will apply across the service to all service groups, all professions, and all roles. Expanding the breadth of our current training plan for adult social care to ensure that all required learning and development opportunities that support the service s objectives are available to staff within adult social care and the Workforce Development Group Analyse the current and future workforce requirements, and address current recruitment difficulties by identifying creative solutions Adult Social Care has also applied the corporate Appraisal policy, so that all members of staff have an appraisal during July and August each year, in addition to any regular individual or group supervision, which sets out an individual s objectives for the year as well as identifying their development needs. A training plan is also in place to identify the core and desirable training needed for each post in Adult Social Care. It supports the current direction of Adult Social Care and its Service Plan, and meets National Legislation and good practice guidance. The training plan also helps to consolidate the Staff Competency Framework.

Engagement Our aim during 2015/16 is to build upon the mechanisms we already have to engage with staff and to ensure that they are fully engaged in our mission, principles and values so that they in turn will promote them to our clients and carers. We expect them to be involved in the development of our service and the underlying policies and processes that keeps them running. We already have a range of engagement mechanisms across the broad and diverse range of services provided and commissioned by adult social care and we will review our Employee Engagement Action Plan with members of the newly formed Staff Advisory Group consisting of staff from across the unit. The Staff Advisory Group has been set up as a forum to help improve 2 way communications between ASC staff and ASC Senior Management. The group meets on a monthly basis to exchange information and give and receive feedback/staff views on matters relating to Adult Social Care. We are also implementing a Capability framework which sets out the expected capabilities, behaviours and competencies for all staffing groups within ASC, also used to support staff in meeting standards set by their regulatory body. It is anticipated that the framework will be completed by end of April 2015. A Workforce Plan for ASC will also be introduced to focus on how we can ensure that its workforce has the appropriate skills, experience, attitudes and behaviours to deliver a high quality service. Workforce Planning is about organising and developing resources to make sure that there are enough staff who are appropriately trained to help meet business objectives in the short, medium and long term. A workforce group meet on a monthly basis and are currently developing the Capabilities Framework for ASC staff, other initiatives include a career progression model for Social Workers, Care Managers and Occupational Therapists. In the past year we have also introduced additional ways to communicative with staff across the services and these are designed to be two way to encourage feedback and debate including:- Monthly Service Director Blog which acts as core brief and is delivered at all team meetings Quarterly Managers Forum Appointment of a Principal Social Worker 7

2. What are our key activities in 2015/16? What are the core service activities we deliver? These are all 2014/15 targets and will be updated by April 2015 Table A Council priority 2015/16 Associated Key activity/action outcome / objective / performance measure manager driver target Maximise the efficiency of contact and diversion functions Improve performance against our key local safeguarding indicators Extending the level and efficiency of reablement service delivery in the unit AC3 improving health and wellbeing and reducing health inequalities for residents; AC2 helping to improve older people s quality of life AC5 working with others to ensure people are safe and feel safe; EC5 working in partnership AC3 improving health and wellbeing and reducing health inequalities for residents; AC2 helping to improve older people s quality of life; EC5 working in partnership Local measure to be introduced around Number of referrals closed without an assessment or review measures are awaited via our Safeguarding Board but provision indications show that the following will be maintained: L11 - repeat referrals L12 - number of enquiries L16 - number of safeguarding enquiries that become statutory investigations 2B (part 1) - Older people still at home 91 days after discharge from hospital into reablement/rehab services 2B (part 2) - Older people offered reablement services following discharge from hospital 45% Targets pending national definitions Unchanged at 85% Awaiting national guidance on measure TB HV TB Other key service dependencies Care Direct Digital by Default 8

Key activity/action Council priority outcome / objective / driver Associated performance measure 2015/16 target manager Other key service dependencies Ensure we deliver and exceed standards of assessments AC3 improving health and wellbeing and reducing health inequalities for residents L4 (A) - % of service users with no package or reduced level of care post reablement L2 - Timeliness of social care assessments L3 - Carers receiving needs assessment or review and a specific carer's service, or advice and information Unchanged at 77.0% 70% for 2015/16 75% for 2016/17 80% for 2017/18 30% HV/TB Carers lead Care Act impact target to be reviewed June 2015 Delivering improvements in the planning and delivery of support to clients AC3 improving health and wellbeing and reducing health inequalities for residents; AC2 helping to improve older people s quality of life; EC5 working in partnership; EC3 Managing sound finances 1C (Part 1a) - Adults over 18 receiving self-directed support 1C (Part 1b) - Carers receiving self-directed support 1C (Part 2a) - Adults over 18 receiving direct payments 100% Target pending 35% TB Carers lead TB/HV Contracts/ Commissioning/ Brokerage/ DP Support Team/ Processes Finance 1C (Part 2b) - Carers receiving direct payments Target pending Carers lead 2A (part 1) Clients under 65: Permanent admissions to residential and nursing care homes 21 HV/IC 9

Key activity/action Council priority outcome / objective / driver Associated performance measure 2015/16 target manager Other key service dependencies Ensure we deliver and exceed standards of reviews and ongoing support AC3 improving health and wellbeing and reducing health inequalities for residents; AC2 helping to improve older people s quality of life; EC5 working in partnership 2A (part 2) Clients 65+: Permanent admissions to residential and nursing care homes L9 - % of service users receiving an assessment or review [either a support plan review or a full reassessment] 1E - % of adults with learning disabilities in paid employment 1F - % of adults in contact with secondary mental health services in paid employment Target pending TB/IC Better Together revised targets awaited 70% for 2015/16 75% for 2016/17 80% for 2017/18 6.5% 5.4% HJ/HV HV HV What new projects, activities and service improvements will we undertake in 2015/16? Table B Key activity/action Implementing the Assessment and Care Management CST by further streamlining assessments (of care needs and of finance) and support plans to ensuring a focus on the outcome the client wants to achieve whilst also delivering quicker responses Council priority outcome / objective / driver moving from traditional services to a more personalised approach AC3 improving health and wellbeing and Associated performance measure New Local Measure - Number of assessments completed 2015/16 target 15% increase on 2014/15 out-turn manager TB/HV/HJ Other key service dependencies 10

Key activity/action Build upon the corporate digital by default programme to deliver on-line self assessments of needs, finance and support planning and meeting needs in a prompt manner Reassessing relative funding levels across client groups and types of services in order to implement clear and transparent methods of up-front resource allocation and support plan delivery, hence ensuring identified needs can be promptly met Implement new improved ways of delivering and managing client care Promote and extend the use of assistive technology Council priority outcome / objective / driver reducing health inequalities for residents; AC2 helping to improve older people s quality of life moving from traditional services to a more personalised approach EC5 working in partnership; EC1 becoming a 24/7 council; EC3 managing sound finances moving from traditional services to a more personalised approach ; EC3 managing sound finances moving from traditional services to a more personalised approach ; EC3 managing sound finances; EC4 Making best use of our assets promoting and protecting people s health and wellbeing ; AC5 working with others to ensure people Associated performance measure L2 - Timeliness of social care assessments New Local Measure - support plans completed New Local Measure - DP clients transferred to payment cards New Local Measure - number of clients with an Individual Service Fund Awaiting Personalisation Strategy 2015/16 target manager 70% for 2015/16 75% for 2016/17 80% for 2017/17 TB/HV To be set in year 100% by 31/3/16 20 by 31/3/16 Target to be set HJ/TB/HV TB TB Other key service dependencies DbD and new mobile Assessment and Support Plans ASC Personalisation Strategy ISF target to be reviewed Q1 ASC Personalisation Strategy 11

Key activity/action Meet the Council s Medium Term Financial Plan Driving the development of preventative, early intervention and enablement services in our local community Identifying and implementing new market and partnership opportunities in delivering services through the LATC, as well as actively seeking opportunities to improve current facilities and Council priority outcome / objective / driver are safe and feel safe; AC3 improving health and wellbeing and reducing health inequalities for residents; AC2 helping to improve older people s quality of life moving from traditional services to a more personalised approach EC3 managing sound finances; EC4 Making best use of our assets; EC5 working in partnership promoting and protecting people s health and wellbeing ; EC5 working in partnership; AC3 improving health and wellbeing and reducing health inequalities for residents; AC5 working with others to ensure people are safe and feel safe only directly providing services where there is a demonstrable gap Associated performance measure Balanced budget as at 31/3/16 To be developed in conjunction with CLC after Q2 To be developed in conjunction with Poole and Dorset after LATC 2015/16 target Variance within +/- 0.5% To be determined To be determined manager ASCLT AS AS Other key service dependencies 12

Key activity/action release high-cost property assets Analyse and action-plan for the implications arising from report of the Social Work Reform Board Phase 3 restructure of operational fieldwork services To review and improve joint policy and practice in the Transitions process between Children s and Adults Social Care Review and implement existing and revised workforce frameworks for Adult Social Care: Implement a Workforce Development and Training Framework for all staff Agree and implement a capability framework for all posts in the service Revise all policy and procedure documents and implement new methods of ensuring all staff Council priority outcome / objective / driver across the marketplace ; EC5 working in partnership; EC4 Making best use of our assets; EC3 managing sound finances; moving from traditional services to a more personalised approach; EC2 Developing our workforce; moving from traditional services to a more personalised approach; EC2 Developing our workforce; moving from traditional services to a more personalised approach; EC3 managing sound finances; EC5 working in partnership; moving from traditional services to a more personalised approach; EC2 Developing our workforce; Associated performance measure launch on 1/7/15 Implications for ASC reported to ASCLT Complete HR implementation Workforce Development Plan agreed and implemented Capability Framework agreed and implemented 2015/16 target Report by July 2015 Complete restructure by September 2015. Plan completed by 30 September 2015 Framework agreed and implemented by 30/9/15 manager SW AS TB SW/ Gill Tanner/ KB Other key service dependencies CST re-structure Social Work Reform Board Childrens Service Plan 13

Key activity/action understand and adhere to them Develop our services in line with our customers expectations through improved engagement and co-production Council priority outcome / objective / driver developing communitybased alternatives to traditional social care services ; EC5 working in partnership Associated performance measure Priority policies and procedures revised Co-production Toolkit implemented 2015/16 target Policies & procedures revised by 30/9/15 Toolkit introduced by 30/9/15 manager HJ Other key service dependencies Corporate Engagement What services/activities will we be stopping? Table C Activity that will be stopped during 2015/16 Reason for stopping activity Potentially ending direct provision of care services if our Provider Service Group moves to an LATC New activities in 2016/17 and 2017/18 Likely to focus on implementation of the later elements of the Care Act Care Cap and the Dilnot recommendations Activities likely to stop in 2016/17 and 2017/18 None. Fees and Charges Proposals 2015/16 14

Table D Description of Fees/Charges CLC have applied increases of approximately 2% for all provider fee rates the precise percentage varies according to the specific sector. Similar increases have been applied for provider services. Proposed change from 2014/15 to 2015/16 either a % or variation Inflation only Reasons for applying non-inflationary changes including freezing charges 15

3. Resourcing Statement Hard Assets Usage (Indicative) Adult Social Care Planned disposals: Dorset Enterprises building Draper sites Nortoft Day Centre hand over to Linwood School Reprovision of Broadwater (see Capital section of future budget implications ) 000 4,000 New acquisitions: New site for Broadwaters (see Capital section of future budget implications ) Site for potential new care home (see Capital section of future budget implications ) Site(s) for potential new disability facilities (see Capital section of future budget implications ) 000 16

Expenditure description Financial Resources Adult Social Care 2014/15 2015/16 000 000 Direct salary costs 15,634 16,187 Other employee costs 0 0 Premises costs 364 363 Transportation costs 329 337 Supplies and services 1,044 572 Internal recharges expenditure 5,622 5,621 Other direct costs 50,058 50,683 Service expenditure 73,051 73,763 Fees, charges and rents (9,254) (9,275) Grants and contributions (14,469) (15,756) Internal recharges income (619) (619) Other income 0 0 Service income (24,342) (25,650) Total net budget 48,709 48,113 2016/17 000 2017/18 000 Explanation of year on year variances 17

Grade description Staffing Resources Adult Social Care 2014/15 2015/16 No. of No. of FTEs FTEs employees employees Service Directors 1.0 1 1 1 Heads of Service / Service Managers 4.0 4 4 4 Managers (grades 11 13) 25.91 28 22.91 24 Operational (grades 8 10) 114.24 133 111.09 130 Admin/Service (grades 5 7) 215.63 298 236.61 311 Admin/Service (below grade 5) 108.93 158 88.48 129 Total 469.71 622 464.09 599 Recorded sickness rate (latest rolling 12 months) % of available staffing resource Explanation of year on year variances ASCLT propose that the service sickness target be 13.1, a reduction from the 2014/15 target of 14.1. This will be achieved by extending the reporting of, and response to, sickness to Team level with each team being monitored and set targets for improvements on a quarterly basis. The full implementation of this action is dependent on delivery of the HR Dashboard by Mouchel HR. 18

Savings and Efficiencies Adult Social Care Already 2015/16 achieved 000 000 Increased fees & charges 200 2016/17 000 2017/18 000 In Year Total 200 Cumulative Total 19

Reserve description Service Unit Reserves Adult Social Care Opening Proposed balance transfer Purpose in/transfer out 000 000 Estimated closing balance 000 Total value of reserves Service plan sign off This service plan has been agreed for operation from 1 April 2015 by: Portfolio Holder: Councillor Blair Crawford Blair Crawford Date: 16 th April 2015 Executive Director: Jane Portman Jane Portman Date: 14 th April 2015 Service Director: Andy Sharp Andy Sharp Date: 24 March 2015 20