Agenda item

Medway’s Council Plan 2016/21 sets out the Council’s three priorities. This report summarise how the Council performed in quarter 2 2018/19 on the delivery of the delivery of the priority relevant for this committee: Supporting Medway’s people to realise their potential.

Discussion

Performance remained good in relation to Delayed Transfers of Care. However, there were areas for which performance was more challenging. This included the percentage of adults with learning disabilities in settled accommodation. Performance was below target for the proportion of adults in contact with mental health services in settled accommodation, although it was 7% above the national average for this indicator. Performance had improved from the previous to the current quarter. Quarter two performance was also below target for permanent admissions to care homes for the older population, although performance across the first six months was on track to be better than target. It was acknowledged that further improvement was needed in relation to the percentage of clients receiving direct payment for social care services.

Committee Members raised a number of questions which were responded to as follows:

Concerns in relation to overall performance – The Assistant Director, Adult Social Care advised that there were nine performance measures within the Council Plan for which performance was reported to the Committee. Performance against three was above target, two showed amber performance and four were below target.

In relation to the target for percentage of adults with learning disabilities in settled accommodation, performance for quarter 2 stood at 59%, compared to a target of 75%. Detailed analysis of this measure had been undertaken and mechanisms identified to get performance close to 70% by the end of the year. This included ensuring that a client’s accommodation status was accurately recorded and ensuring that all clients received a review each year. Clients had to be recorded as not being in settled accommodation where there had been no contact with them for 12 months, irrespective of whether they were actually in settled accommodation or not. Improvement beyond 70% would require a more strategic approach that considered how to support people with learning disabilities more effectively by ensuring that there were a range of options available as alternatives to residential and nursing care and that people were supported to live as independently as possible.

Work undertaken so far had included appointing transitions workers to support people in the transition from children’s to adult services. Work had recently started to promote and grow the Shared Lives Service as an alternative to residential and nursing care, with further promotional activity planned for early 2019. There was also a need to ensure the provision of adequate supported living accommodation as an alternative to residential or nursing care. Extra Care accommodation currently had a lower age limit of 55. Discussion was taking place with Housing Services to consider removal of this limit for future schemes to enable younger adults to be supported in this type of accommodation. It was acknowledged that making and sustaining significant improvements would take time.

Challenges making improvement difficult – The Assistant Director said that clients with learning disabilities often had complex needs, some of which were best met in a residential care or nursing care setting. Adult Social Care was planning to increase the capacity of the Shared Lives Service, which was already successful and well regarded. Service growth would be dependent on the success of marketing activity. The availability of appropriate supported accommodation locally was also a challenge as was the need to work closely with the Housing service to ensure sufficient supply was available in the local area. This process would take time.

Settled Accommodation and Extra Care provision – A Committee Member expressed concern about the availability of settled accommodation and Extra Care housing and that performance of Medway was behind that of some comparator authorities. The Assistant Director said that there was a need to consider vulnerable groups, their needs and how can best to support them. This necessitated providing the correct mix of accommodation. Fully addressing this would take time, but it was important to put the correct foundations in place to enable future improvement. The Director of People, Children and Adults Services said that some concerns had been identified in relation to validity of some Kent and Medway NHS and Social Care Partnership Trust (KMPT) data and that work was being undertaken to address this. Housing Services had jointly funded, with Adult Social Care, a mental health practitioner post. This would help to identify people at risk of homelessness due to mental health needs. The Department for Education had also provided funding for a Personal Advisor to specifically target care leavers at risk of homelessness due to a long term mental health problem.

Support for people leaving residential care – A Member said that there was a need to better consider the support offer for people leaving residential care. The Member questioned whether there might be capacity to provide some support as part of the proposed Britton Farm development, which was due to include housing and some KMPT mental health services. The Assistant Director of Adult Social Care acknowledged that there were a number of ways in which people could be supported towards independence. The Flight service assisted people in supported living for a fixed period, with the aim of supporting them to manage on their own in a more independent setting. The service currently only had two places but consideration was being given as to how this could be increased. The Shared Lives scheme also helped to provide people with skills to enable independent living. The Assistant Director undertook to investigate opportunities in relation to Britton Farm.

Direct Payments – In response to a Member’s concern that the Direct Payments systems was too complicated, the Assistant Director said that the concept of individual support funds was being investigated. This involved a broker acting on behalf of a client to manage their personal budget. This removed some of the complexity while still providing the client with choice and control.

Decision

The Committee considered the quarter 2 performance of the measures of success used to monitor progress against the Council’s priorities.