Archived decisions

Hampshire's 'Investigate Urgently' ratings

This is an update of Hampshire's work on the four PAF performance indicators rated as 'investigate urgently'.

C19 Health of Children Looked After

The difficulty here was the creation of a database which could be interrogated. Without such a database Hampshire could not respond with statistics for this indicator, and was accordingly rated as 'investigate urgently'. Historically health details for individual children have been kept on paper records/files, usually with their foster carers or in their residential homes. To respond to this indicator an electronic means of collating and analysing this data was needed, which did not require any major adaptation of our existing computer system (which is earmarked for replacement in the next few years). Hampshire sought the help of local Health Authorities who, it is believed, already hold much of this data electronically. Unfortunately none of them felt able to help, either for technical and resource reasons or because of their understanding of the Caldicott Guardianship rules. Discussions are ongoing and look optimistic for the data being available for the QP MAP in January 2002.

C29 Adults with Physical Disabilities helped to live at home and C32 Older People helped to live at home

Investigations into both of these indicators have revealed similar problems. Initial contacts with other authorities are showing that we all have a different understanding of the definition 'simple services provided at or near the point of contact', which are specifically excluded from this indicator. Responses so far are indicating that Hampshire has been excluding many clients that other authorities count. Work on this is ongoing through ADSS-SE sub-group members and the Social Services Research Group. David Vowles from the SSI and Gemma Trim of the Department of Health Statistics Section have also been requested to contribute to a harder definition of such services. Hampshire has been informed that some other authorities have raised similar issues and that, as part of an attempt to ensure greater conformity of approach, the Policy Branch are also being involved.

Discussions with Service Managers have also confirmed suspicions that some users are not having details of their care entered into Hampshire's care management system (ACMS). This problem is most frequent for users of services covered by bulk contracts; where clients are allocated to the service by phone and no formal 'order' is required. Management action is being taken to size this problem and subsequently to correct this situation. It may be that results for 2001-2 will have to be calculated using survey techniques, rather than through correcting data in the system, due to the proximity of the financial year end.

Once these issues have been 'solved' Hampshire will have a better understanding of its real performance in comparison with other authorities.

These recording issues alone are not expected to solve our poor performance. Workgroups have been set up comprising of senior managers, performance management staff, practitioners and statisticians. These groups are tasked to take appropriate actions to identify issues, initiate improvements and make recommendations should any changes in policy be felt to be required.

D39 Percentage of people receiving a statement of their needs and how they will be met

Historically Hampshire has provided a statement of needs for users receiving a care managed service for the first time and for those having a significant change in their requirements for social care following a review. Users having unchanged services, and those receiving equipment as part of an OT or sensory assessment, were not provided with statements. This was mainly because it was felt that to issue a formal statement of needs for these users was an unnecessary bureaucracy.

Following the PAF results Hampshire is implementing changes to facilitate the provision of a statement of needs for OT and sensory services. The OT work has already been completed; a new form DP23 has been prepared including a top copy which can be torn off the pad and given to the 'user' at the end of the assessment. Training on this was undertaken in December, followed by immediate implementation. It is intended to follow a similar strategy for sensory services in the coming months.

The task group set up to look at this problem has also identified a possible action for users not receiving a significantly altered service following their annual review; involving computer generated letters. This is in the early stages of investigation, but may provide an interim solution until a simple systems solution can be found.

One further difficulty with this indicator has recently been highlighted. As the numbers of users in the 'helped to remain at home' category is increased, partly through better activity recording, all these clients will also require 'statements of need' on an annual basis. This will significantly impact on the numbers of statements required, perhaps by almost 100%, making a simple systems solution even more important.