Agenda item

Medway’s Council Plan 2017/18 sets out the Council’s three priorities. This report sets out the end of year and quarter 4 2017/18 performance summary against the Council priority relevant for this Committee: Supporting Medway’s people to realise their potential.

Discussion

The Committee was given an overview of performance against the indicators relevant to the Committee’s terms of reference under the Council priority ‘Supporting Medway’s People to realise their potential.’

The percentage of long term packages that were placements had improved from 33% to 31.4% during 2017/18. This indicator was a measure of how well people were supported to remain in their own home. It was noted that development of the Three Conversations model was the principle way in which the delivery and support of Adult Social Care provision in Medway would be strengthened.

In relation to the percentage of clients receiving a direct payment for Adult Social Care services, performance had improved slightly but remained below the target of 32%. Performance had remained at around this level in recent years and it was acknowledged that service transformation was required to improve the figure significantly. There were plans to create a deeper pool of personal assistants, strengthen employer support training and to launch pre-paid cards. As part of the re-procurement of Homecare provision, there was a move towards a model which would utilise individual support funds. This would enable clients to access personal budgets through other providers.

Performance against the indicator for the percentage of adults with learning difficulties in settled accommodation had improved significantly from the 41.5% shown in the report to 67.5%. While this remained below the Medway target of 75% and national average of 76%, it represented significant improvement compared to the figure of 58% for the previous year. It was noted that individuals would only be included in the figures if they had received a review in the previous 12 months, with some clients having not had one during the year. This was something that the service would be looking to address.

In relation to the proportion of adults in contact with secondary mental health services, who were in settled accommodation, performance had improved between Q2 and Q3 from 60% to 64%. This was below the target of 70% but was above the national average of 61%.

One area of particularly good performance was for hospital Delayed Discharges of Care. Significant and sustained improvement had been achieved through joint working between the Council, Medway Foundation Trust and Medway Clinical Commissioning Group.

A Committee Member emphasised the need to keep the system for applying for direct payments simple and to engage service users to clearly explain the advantages. The Assistant Director, Adult Social Care agreed that there was a need to simplify processes and to ensure that there was a staff culture of promoting direct payments and explaining them in a simple and straightforward way.

Another Member said that there would be some people who would not want the responsibility of direct payments, particularly in the case of older people who may not have someone to support them. The Member considered, therefore, that a target of 32% was quite high. She also felt that, given the total population of Medway, it should be possible to provide a reasonable standard of care to the 3,000 people currently in receipt of Council services. The Member emphasised that replacing personal visits with, for example, Skype calls, was often not appropriate, particularly where social worker or carer visits were the only human interaction that the person had .

The Assistant Director said that technology had a role to play but was not considered to be a replacement for care and support in the community. However, it could play an important role in supporting people to remain independent in their own homes and in helping families to stay in touch.

It was acknowledged that winter had been challenging, particularly in relation to safeguarding performance. Demand for services had increased during winter and levels of staff sickness had also increased. There was a need to ensure service sustainability and that performance was sustained throughout the year.

In relation to the targeted review team, which has been created to support the Council’s statutory duty to undertake reviews for all clients every 12 months, it was questioned whether  an impact assessment had been undertaken before deciding to disband the previous team, how it would be ensured that vulnerable adults still received a review and what had happened to the staff that had been part of the team. The Member was also concerned that the data presented for the proportion of adults in settled accommodation in contact with secondary mental health services was six months old.

The Assistant Director advised that the Council had a statutory responsibility to undertake reviews with all clients on an annual basis. Delivery of this had been a challenge over the last year. A key aim for the current year was to make the service more sustainable. It was clarified that there had not previously been a permanent dedicated review team but that time limited teams had previously been established to undertake outstanding reviews. A new time limited team is currently in place in order to undertake the outstanding reviews. In relation to the concern raised relating to the age of data, the Council did not hold this data but the possibility of obtaining provisional data would be investigated.

Decision

The Committee:

i)     Considered the quarter 4 and end of year 2017/18 performance of the measures of success used to monitor progress against the Council’s priorities.

ii)    Requested that further information be provided to the Committee in relation to the following:

a)    Confirmation of whether being in receipt of direct payments would have an impact on eligibility for universal credit.

b)    Confirmation of whether the figure for the percentage of adults with learning difficulties in settled accommodation includes people who are homeless.

c)    Clarification of the figures presented in the report in relation to the number Depravation of Liberty Safeguards (DoLS) assessments outstanding over the last four months.

d)    Details of what employer support training involves, how it is being targeted and its impact.

e)     A written update to be provided on the work of Task and Finish Group established to investigate hospital readmissions.