Health and Social Care Update No 64 : 30 January 2015 Hampshire Adult Services news Revenue Budget Adult Services 2015-16 Many of the savings / efficiencies to be achieved this coming year were set in the budget plans put forward last year. The paper for the Executive Member states that the ongoing position between the increase in demand and reduction in resources continues to be a major challenge, with work to ensure that resources are targeted at those with the greatest needs and on meeting statutory duties. However, helping people improve their health and wellbeing as they move into later life is ultimately the only way to tackle an otherwise inexorable growth in demand. Hampshire has been undertaking fundamental reviews of how it supports people in the community. The outcome of these reviews has started to be implemented during 2014, and will focus on continual enablement as a fundamental principle. Further work is ongoing with the district and boroughs on how to achieve significant efficiencies in the commissioning of services to homeless and socially excluded people. The main growth is in care at home. Demand has outstripped supply at times in some parts of the county. The Council has just announced its new service providers for care at home, saying that the new model seeks to address quality and labour market issues and the need to ensure that all interventions (short or long term) are aimed at enabling people to achieve their maximum capacity. The Dept was given a savings target for 2015-16 of 40.666m. It is now anticipated that full year savings of 29.276m will be achieved in 2015-16 with the shortfall against the target being made up from alternative savings delivery. For Adult Services, the 2015-16 revenue budget includes income of 58.266m from fees and charges to service users. This is an increase of 1.568m (2.76%) on the adjusted original budget for 2014-15. Adult Services grant programme A paper for the Executive Member largely seeks approval of grant allocations of 574,972 between 40 organisations. Despite receiving fewer applications than previous years, the programme has still been significantly oversubscribed. At the end of the paper it states that during 2015 there will be a review of the grants programme ready for 2016-17, given the imperatives of the Care Act 2014, Transformation to 2017 and the need to drive greater efficiency in Adult Services care spending.
Advocacy Services Under the Care Act, the County Council will become responsible for the arrangement of an Independent Advocate to help service users and carers if they are having substantial difficulty in being fully involved in social care processes of assessment, care planning, review, safeguarding and accessing information and advice and have no one else to support them. At present there is very limited access to advocacy for older people (an annual grant covering older people living in Winchester) or those involved in safeguarding and no access to advocacy for people with a physical disability. The legislation applies to any potential service user or carer seeking information or advice and any service user or carer involved in the above processes. This includes young people in transition from Children s Services and young carers. In Hampshire, advocacy provision for young people in transition will be the responsibility of Adult Services commissioning but advocacy for young carers will sit within contracts commissioned by Children s Services. The County Council is in the process of developing long term plans to cover all types of advocacy support within a single contract from 1 April 2016, including advocacy that is required under the Care Act 2014, the Mental Health Act 1983 and the Mental Capacity Act 2005. There is an intention to go out to tender later in 2015. In the meantime, the existing contract for Independent Mental Health Advocacy, Independent Mental Capacity Advocacy and general mental health advocacy is to be extended for a further year. A document covering advocacy services is available on Hantsweb. This also covers a request to go to tender and award a twelve month contract for Care Act Advocacy, a new requirement of the Care Act 2014, with effect from 1 April 2015 using an accelerated restricted process. Developing extra-care housing for younger adults A paper to the Executive Member for Adult Social Care and Public Health for her meeting on 27 January 2015 outlines the Council s plans to develop extra-care housing for younger adults along similar lines to such schemes for older people. HCC s long term strategic approach is to offer high quality accommodation and support for individuals aged below 65 who will primarily have a learning disability, mental health problems or a physical disability. Specific capital funding of 6m to facilitate the development of Extra-Care Housing for Younger Adults was agreed by the County Council as part of the Capital Programme Review in September 2014. The supported living models that emerged in the last two decades are no longer seen as offering the full potential for independence and value for money. A savings target of 1.2m has been assigned to this project. Unit costs of extra-care housing for younger adults will be considerably cheaper than the average costs of residential care accommodation. A large factor within this is that individuals living in such schemes will be expected to pay for their own hotel costs. Savings of 365 on average per week per placement have been suggested. Based on these figures, the working assumption is that there will need to be a minimum of 64 units delivered by April 2016 that are Action Hampshire, 30 January 2015 Page 2
occupied by individuals moving out of residential care accommodation to achieve the savings target. individual service funds (ISFs) It is envisaged that contracts for care and support will be procured through one of the existing frameworks developed over the past year, as most appropriate for each scheme. However, an alternative option for the delivery of care and support will be explored through the development of ISFs. Under an ISF, the money is held by the provider on the individual s behalf and the service user directs the provider in how the care and support is delivered. The following areas have been identified as having the highest demand for alternative services to residential care and are therefore priority areas for development of new supported housing services across Hampshire: North Hampshire: Basingstoke Town Centre, Farnborough Town Centre, Aldershot Town Centre. East Hampshire: Havant Town Centre, Waterlooville Town Centre, Fareham Town Centre, Gosport Town Centre. West Hampshire: New Milton Town Centre, Waterside/Hythe Town Centre, Ringwood Town Centre, Andover Town Centre, Eastleigh Town Centre, Winchester City Centre The preferred model for Extra-Care for Younger Adults will range in size between 6-18 units per scheme, Charges under the Care Act These relate to: arrangement fees for people who fund their own care and who ask the Council to arrange care for them deferred payments scheme Under the new regulations the Council is permitted to cover its costs but not to make a profit. arranging care for self funders The Care Act states that where an adult s needs for care and support meet the eligibility criteria but their financial resources are above the financial limit, the local authority must still meet the adult s needs if the adult asks the local authority to do so. From April 2015, local authorities are required to provide this service to all self funders who ask them to arrange non-residential care. The requirement for councils to broker residential and nursing care for self funders who ask them to do so is expected to be introduced in April 2016. The Care Act will allow the council to charge an arrangement fee to cover the cost incurred in arranging care. This can include the cost of negotiating and/or managing the care contract with a provider and covers any administration. It is proposed that the Hampshire County Council set-up fee for arranging care would be approximately 600, and thereafter there would be an annual fee of approximately 320 to cover additional routine finance administration. The 600 set-up fee includes care management brokerage, back-office finance support, paying invoices to the provider and invoicing the client. Action Hampshire, 30 January 2015 Page 3
deferred payment scheme This scheme allows an individual who has less than 23,250 in savings, not including the value of their home, to use the value of their home to defer paying care home costs. The individual is still required to make a contribution towards the costs from their income and any savings, if they are assessed as financially able to do so. The care costs that are being deferred are paid by the council during the period of the Agreement and are then recovered when the property is sold. Councils will have the power to charge interest from the start of a Deferred Payment Agreement but this is not a legal requirement and the government is not specifying a particular interest rate that should be charged. Regulations do however specify that the maximum rate of interest will be set nationally and how it will be calculated. At the current time, this maximum interest rate would equate to 2.6% and the interest is charged on a compound basis. It is proposed that from April 2015 the new fees for a routine deferred payment agreement should be a maximum of 1,190 for set-up (slightly below what they had proposed in a consultation) and 312 for administration of the loan agreement in subsequent years. HCC also proposes charging the maximum interest rate permissible. Read the paper here. Buy with Confidence to become Buy with Confidence Plus Care Hampshire currently offers information and advice, the Care choice website, and publications to help people find care independently. In order to support self funders find appropriate care, the County Council is planning to expand its Buy with Confidence Scheme. From April 2015, Buy With Confidence Plus Care will provide a list of businesses and/or individuals providing care and support services who have been successfully approved, demonstrating that they have undergone the appropriate training and met background checks. These checks will be performed by HCC s Adult Services Dept and Trading Standards Service. Initially the scheme will provide a Buy With Confidence Plus Care approved list of domiciliary care agencies, but it is hoped that it will be expanded in due course to include other types of social care services. Additional social care funding to help ease pressure on Hampshire's hospitals Leader of Hampshire County Council, Councillor Roy Perry has welcomed the news that the County Council is to receive additional central government funding of some 500,000 to support extra reablement and interim social care packages to help people move out of hospitals and support them in regaining their independence. Successful application for transforming care funding The five Hampshire CCGs have supported the Hampshire Adult Services and Learning Disability Directorate, in their successful application for 800,000 from the Dept of Health s Transforming Care Programme Fund to support the Winterbourne View agenda, namely moving people who should not be in hospital out into community-based placements instead. The money needs to be spent by the end of March 2015. The awarded funding will be used to invest in additional or improved housing and accommodation projects to facilitate supported housing options for people with learning disabilities, autism and challenging behaviour. Action Hampshire, 30 January 2015 Page 4
Support to stay at home Hampshire County Council has selected the care agencies it wants to work with to deliver home care services (a kind of souped up domiciliary care). It has reduced the number of providers it will be working with from about 70+ down to 11, who all seem to be national or regional providers. HCC says that these new contracts, starting later this year, will deliver a better service, focusing on increasing independence, exploring what support is available in the community, and putting in place equipment or systems such as Telecare. The Council also argues that these providers will receive sufficient business to allow them to invest in service quality and offer better rates of pay and training for their staff. It added that there are many agencies that are currently paying above the minimum wage, paying mileage and offering excellent training and it wants this to become the standard. The total value of contracts that can be called off under the new framework will be up to 585m over seven years. The agencies that have been selected are: Aldershot and Alton Area: Alexander's Care & Support Agency; The Human Support Group Ltd; Somerset Care Ltd Andover and Winchester Area: Alexander's Care & Support Agency; Agincare UK Ltd; Carewatch Care Services Basingstoke Area: Aldershot & Alton Care; All Care GB Ltd Eastleigh Area: AQS Homecare; Carewatch Care Services Fareham and Gosport Area: Mears Care Ltd; AQS Homecare Havant and Petersfield Area: Guinness Care & Support Ltd; Mears Care Ltd New Forest Area: The Human Support Group Ltd; Agincare UK Ltd; Willow Tree Events & training FREE social care event for frontline managers 4 February, Southampton The National Care Forum (NCF), Sue Ryder and Voluntary Organisations Disability Group (VODG) are holding six free events in January and February 2015. They are coming to Southampton on 4 February! The aims of these events, which are for voluntary sector organisations only, are to: provide managers with an understanding of the wider social care policy context and resources available to assist them in supporting frontline staff improve the quality of service delivery promote understanding of what the new regulatory and monitoring framework looks like and its implications for staff development Highlights of the day will include discussion and workshop sessions on: the latest developments on the new Care Act and what it means for managers staff development: care certificate, the social care commitment and how to access free resources CQC changes to regulation with particular emphasis on the new performance ratings system For more information and to book a place, go to the National Care Forum website. Action Hampshire, 30 January 2015 Page 5
End of Life Care three workshops about better information and support The workshops are for anyone who is interested in better information and support around end of life care for them and the people they work or are connected with. You may be a carer, patient, service user, volunteer or professional from a statutory organisation or the voluntary sector. The workshops, organised by Carers Together, are running on 9 and 25 February, and 3 March (9.30am-1.00pm). The cost is: statutory sector professionals 15.00; voluntary sector/charities 5.00; and free for individuals. Places are limited, and bookings should be in by the end of January; email Carers Together. There is more information on the Carers Together website. Making personalisation and integration a reality 10.30am - 3.30pm, 24 February, London Making health and social care support truly personal continues to be an aspiration and a challenge. A number of initiatives (NHS Health and Social Care Act, Better Care Fund, personal budgets, integration pioneers and personal health budgets), as well as action on the part of agencies and professionals, have attempted to give additional impetus to the user-led movement for change. However, the evidence suggests that at best the experience of service users is variable. This free seminar aims to explore: developments in personalisation how developments in the integration of health and social care have progressed personalisation examples of good/better practice in personalisation and integration the role of voluntary and community sector in delivering change ways to ensure personalisation and integration promote equality Book your place here. Early years conference - Time to invest in our children's future 10.00am 2.45pm, 13 March 2015, (registration 9.30am) Winchester Guildhall A conference hosted by Home-start in Hampshire to highlight the importance of early intervention and early years support. The aim of the conference is to: influence child and family support strategies in Hampshire and beyond evidence the need for early years intervention provide a forum for organisations to network and establish effective partnerships The conference will be chaired by Alastair Stewart, OBE; the key speakers are Camila Batmanghelidjh, founder of Kids Company; Dr Alain Gregoire, consultant in Perinatal Psychiatry and Maternal Mental Health Chair; Zoe Munby, director of the Early Years Foundation; and Rob Parkinson, CEO Home-Start UK. Places are limited so early booking is advised. Tickets are 30.00; please book on the Home-start in Hampshire website. Cerebral Palsy awareness workshop 10.00am 4.00pm, 1 April Passfield Business Centre, Lynchborough Road, Passfield GU30 7SB This workshop, delivered by a trainer with cerebral palsy (CP), will increase your knowledge to help you deliver enhanced support to your CP service users and will include Action Hampshire, 30 January 2015 Page 6
definition of CP myths and truths discussion groups and question & answer session To book a place, Contact Debbie or Vikki on 01428 751764, or email All Inclusive. Healthwatch news Listening to the Transgender Community Working with local charity Chrysalis, Healthwatch Hampshire has created a powerful and touching film about the health and social care needs of the transgender community. This film explores experiences of the 'patient pathway' through NHS services from initial GP appointment and referral to a Gender Identity Clinic to hormone treatment and surgery. It is available to view on their website. Funding, finance & awards Short Breaks for Disabled Children HCC grant window now open! Grants are available from Hampshire County Council to organisations who provide any type of short breaks activities out of school hours activities, play schemes/youth clubs for children and young people with disabilities and/or additional needs. Grants are available for activities carried out between April 2015 and March 2016. large grants (over 5,000) Applications will be accepted until the end of Sunday 15 February 2015. HCC have apologised for the unusually short window for applications and have cited the recent public consultation on short breaks as the reason for this. small grants (under 5,000) and the Support for Individuals to participate in mainstream/inclusive activities grant (up to 5,000) The grant window opens on Friday 27 February 2015. These grant applications will be considered at regular grants panels during the year, beginning in mid-march. For full information and to apply, please go to the Hampshire County Council website. Red Nose Day Community Cash Grants Grants of 500-1,000 are available to small organisations that are doing great work to help local people who may be living in difficult circumstances. If this sounds like you, make sure you apply for a Red Nose Day Community Cash grant by 27 February. Comic Relief has teamed up with the Hampshire & Isle of Wight Community Foundation and BBC South to bring Red Nose Day Community Cash grants to Hampshire, IOW, Portsmouth and Southampton. To be eligible to apply, groups need to: be working in a disadvantaged or deprived areas be small local groups with an income of less than 100,000 run by local people have limited access to other sources of income aim to deliver social outcomes Action Hampshire, 30 January 2015 Page 7
They are interested in a range of activities including advancing people's physical and mental health, wellbeing and safety. For more information and to apply, please visit the Hampshire & IOW Community Foundation website. Macmillan s Supporting You to Help Others grants This grant programme helps give people affected by cancer the opportunity to use their experiences to support others, while also receiving support themselves. They especially welcome applications that contribute to achieving Macmillan s inclusion vision of a health and social care system where equal access to, and delivery of, the best cancer services are available to everyone living with and beyond cancer. Grants on offer: start up funds: to support the start up of a new self-help and support project for people affected by cancer development funds: to support the ongoing activities and development of self-help and support projects for people affected by cancer user involvement grants: to encourage the involvement of people affected by cancer in the design and improvement of cancer services individual development grants: to enable people affected by cancer to develop their skills and use their cancer experience to help support others affected by cancer Grants can be for up to 500 for projects that have been running for less than 12 months and up to 3,000 for projects that have been in existence for more than 12 months. Grants for individual development are provided for the actual cost of the activity. The 2015 deadlines for application are 13 March, 15 May, 24 July and 16 October 2015. Healthy Heart Grants Heart Research UK Grants of up to 5,000 and up to 10,000 are available across the UK for new, original and innovative projects that actively promote heart health and help to prevent, or reduce, the risk of heart disease in specific groups or communities. There are two grant rounds each year. Applications to the May round must be submitted between 1 January and 28 February 2015. Regulation and registration Care Quality Commission inspection rating to be clearly displayed by all health care organisations New rules introduced to parliament will result in hospitals, GP surgeries and care homes having to display the inspection rating that has been awarded by the Care Quality Commission (CQC) showing whether they are outstanding, good, require improvement, or are inadequate. The CQC ratings must be clearly visible, such as in waiting rooms or entrances, and must be published on an organisation s website with a link to the inspection report. The CQC will test public awareness of the ratings by asking patients if they know the CQC rating of their provider as part of their inspection programme. The law is expected to come into force on 1 April 2015, subject to parliamentary approval. Action Hampshire, 30 January 2015 Page 8
Policy & practice News from West Hampshire CCG: West Hampshire CCG wants to hear from you about their end of life strategy refresh The CCG is refreshing its plans around helping all local residents with advanced, progressive, incurable illness to live as well as possible until they die. The input from local communities and voluntary groups will help to plan and shape local services appropriately for the future. You can find the draft strategy here. Please email your thoughts to info@westhampshireccg.nhs.uk (Also, see end of life events above) Please join West Hampshire patient involvement network The CCG is always looking for the views and experiences of local people. As one of the ways to do this, they would like to establish a network of patients and individuals who could share their thoughts about health services in West Hampshire, either by email, telephone or in focus groups or face to face meetings it would be your choice. If you would like to be more involved in their work and help to make healthcare the best it can be for patients, you can sign up to the network here. Improving wheelchair services Dr Sarah Schofield, Chair of West Hampshire Clinical Commissioning Group (CCG) and a local GP, has been appointed a national champion to help improve the provision and quality of wheelchair services. This means she is now a member of an NHS England led network of clinicians and leaders from CCGs across the country, who are committed to transforming services for people with complex and changing needs so they get the right wheelchair quickly, along with the appropriate and ongoing support. Sign up for West Hampshire CCG letter The CCG is keen to engage with as many organisations and individuals as possible. To make sure you keep in touch with what they are doing, just drop them an email to sign up to receive their newsletter. New figures estimate smoking rates among young people in local areas Commissioned by Public Health England (PHE) and NICE, and modelled by the Universities of Portsmouth and Southampton, the figures are estimates of youth smoking rates for every local authority, ward and local NHS level, based on factors known to predict smoking in young people. The data should help local organisations to respond to high levels of smoking within their areas and is available on the PHE Local Health website. Nationally an estimated 12.71% of 15 year olds are regular or occasional smokers, but the data shows considerable variation between areas. What s new? Green care for dementia Age Concern Hampshire tries new approach More older people with dementia will be able to interact with the natural outdoors environment, thanks to a brand new new project launched by Age Concern Hampshire. Taking place at community farm, Down To Earth, in Millbrook, participants will be able to take part in a range of activities on the farm, from feeding and caring for animals, to wood work, gardening activities and crafts using natural materials all supported by specialist staff in a safe setting. Action Hampshire, 30 January 2015 Page 9
This project was inspired by the innovative Green Care Farming model which is being increasingly used across Europe to improve health and social care outcomes, and result in better nutrition, sleeping, confidence, and general wellbeing. Funded by a grant of just over 8,000 from a partnership between Southampton City Council and the city s Clinical Commissioning Group, this pilot project is the first of its kind in the city, and is open to referrals from local mental health teams as well as self referrals from anyone in Southampton over 50 with dementia for a small means tested fee. A practical guide to healthy ageing NHS England has published this new guide with Age UK, to help people improve their health and general fitness, particularly those aged 70 or over with mild frailty. The evidence-based guide covers key areas that have been identified as the main risk factors for older people living at home, but if they are proactively managed, they can help people stay well for longer and improve their quality of life. BBC Cost of Care project The BBC has set up some very useful webpages exploring different aspects of care, including whether the cap on care costs is really what you might think it is. Improving Male Health for the Next Generation NCB (National Children s Bureau) has published a new report, Improving Male Health for the Next Generation, presenting findings from its survey of 138 men. The 2014 survey asked men about their approaches to getting help and advice on health issues, and what they think might help boys and young men growing up now to look after their health as they get older. These survey findings - for example, that over 90% of men surveyed by NCB felt that social expectations and how males talk about health need to change - suggest priorities for further investigation and point to steps that may improve male health for future generations. Action Hampshire, 30 January 2015 Page 10