Archived decisions

Mr Terry Butler CBE

Director of Social Services

Hampshire County Council

Social Services Department

Trafalgar House

The Castle

Winchester

Hants

SO23 8UQ

19 September 2003

Dear Terry

ANNUAL REVIEW OF PERFORMANCE

Thank you for arranging our recent annual review meeting. This letter sets out the Inspectorate's view of the performance of social services in your area during the last year and comments on improvements planned for the year ahead.

The recommendations made in this letter and its annexed report are intended to help the council improve outcomes and the quality of service to service users and carers. They are also intended to improve the prospects of improved performance ratings in the future.

In assessing performance, SSI reaches judgements about performance against a set of standards and criteria, as published in February 2002, drawing on evidence from a number of standard sources. These include:

    · the published PAF performance indicators and other statistical data up to 2002-03, plus data supporting planned targets for 2003-04;

    · monitoring information from the Position Statement completed in June and October 2002, and the Delivery and Improvement Statement completed in May 2003;

    · the audit of services to children in need carried out in response to the report of the Victoria Climbie Inquiry;

    · the report of an SSI evaluation of the council's response to children in need, carried out in July 2003; and

    · the draft report of an SSI Inspection of Children's Services carried out in January 2003.

Details of the standards and criteria have been published, are available from SSI, or may be seen on the Department of Health's website. A summary of the evidence used has also been sent to you separately.

The Annex to this letter summarises the strengths of performance over the last year and highlights priorities for improvement in the year ahead. The annual review does not attempt to review all aspects of performance. It focuses on the performance issues for which SSI has current information.

This report will form part of the SSI's performance record for the Council and will be published on the Department of Health's website in November. You are asked to present it to an open meeting of the relevant executive committee of the council within two months of the date of this letter, and to advise me of the date on which this will take place. The document must be made available to members of the public at the same time.

Progress will continue to be monitored during 2003-04 through our usual processes, and a further Annual Review meeting will take place during the first quarter of 2004-05.

Performance (Star) ratings will be confirmed in November, based on an assessment of overall performance using all admissible evidence. The evidence summarised in this letter will be used to help arrive at the rating.

Yours sincerely

Lynda Hoare

Director

Social Services Inspectorate - South East

cc: Council Chief Executive

    Appointed Auditor

Chief Executive StHA

Area Manager, NCSC

PERFORMANCE REVIEW REPORT 2003: HAMPSHIRE

SERVICES FOR CHILDREN & FAMILIES

Assessment has highlighted the following improvements to service since the last Annual Review.

    · the SSI evaluation of the council's initial response to children in need (July 2003) found that the council served most children well, with sound and effective management of the referral process, and rigorous and timely decision-making. The council accepts that assessments are not always carried out within the Department of Health Assessment Framework timescales, and that some improvements need to be made to the reviewing and auditing of case. These matters are being addressed. (Standard 3);

    · the council and its partners have achieved Children's Trust pilot status for a county-wide CAMHS. This strategy has been developed by an effective Children and Young Persons Strategic Partnership, which relates to the Local Strategic Partnership. The CYPSP provides a focus for robust partnership working on a range of initiatives including: a 3rd Wave Children's fund plan (which was commended by the Government Office for the South East and Children and Young Persons Unit; and preparation for a Local Preventative Strategy. (Standard 1);

    · the major re-modelling is now demonstrating improved arrangements, including a new Children Looked After Unit, integrated Children with Disabilities Teams, Care Leavers Teams, Permanence Teams and a Reviewing Service for Looked After Children and Child Protection work. A particular strength is the focus on local needs and capacity, which enables the council to work to best effect with local partners to match local needs with appropriate staff skills and services. The final stages of the re-modelling will be implemented following a Best Value Review of Services to Children and Young people in the Community. (Standards 1, 2, 4);

    · a comprehensive action plan has been developed in response to the findings of the draft report of the SSI Inspection of Children's Services that was carried out in January. Actions to address shortfalls in respect of Lord Laming's recommendation following the Victoria Climbie Inquiry and PAF PIs where performance is poor or concerning are also monitored systematically (Standards 1, 3)

    · all service developments are subject to comprehensive and effective consultation with children and their carers. There are some exciting user-involvement initiatives, including a Care Action Team which funds individual young people to provide a consultation and involvement mechanism for children and young people who are looked after or leaving care. (Standard 4);

    · joint working with education continues to improve, and includes Inclusion Social Workers in schools and a corporate unit for the education of looked after children. The council performs better than most comparative councils on the rate of looked after children who are absent from school (PAF PI C24), and the percentage of children leaving care at 16+ with at least one GCSE at grade A*-G or GNVQ (PAF PI A2) has improved to a good rate. The council's Local Public Service Agreement includes two targets relating to educational achievement of looked after children. (Standard 3); and

    · performance indicators for aspects of child protection work (PAF PIs A3- registrations; and C21 - duration on the CP register) are good or very good, although there continue to be . (Standard 3).

Assessment has highlighted the following concerns about performance:

    · assessments of need are not always carried out within the Department of Health Assessment Framework timescales: only 21% of initial assessments are completed within 7 days, compared to an average of 48.1% in similar councils; only 33.7% of core assessments are completed within 35 days, compared to an average of 53.2% for similar councils. The rate of repeat referrals is significantly higher than the average for similar councils. Action is in hand to review business processes and staff awareness, and the council anticipates that the current Best Value Review on Services for Children and Young People in the Community and the planned development of a single (inter-agency) initial assessment will have a positive impact. (Standard 4);

    · the SSI Inspection of Children's Services found a number of shortcomings in the assessment, case recording, case review and transfer of children in need and child protection work, with inconsistencies between geographical areas. The council is implementing an action plan to address these. (Standards 3, 4)

    · variations in the rate of child protection activity (numbers of Section 47 enquiries, new registrations, and number on the register) across the county cannot be fully explained by demographic differences, and further action is required to ensure that thresholds and practice are consistent and of high quality. The rate of reviews of child protection cases that are completed within required timescales (PAF PI C20) remains unacceptable. (Standard 3);

    · the health of looked after children is not adequately assured through health checks and dental checks (PAF PI C19) - the council's performance is the lowest of its comparator group. Action is in hand, in partnership with the seven Hampshire PCTs, to address this. (Standard 3);

    · the rate of care leavers who are in education, training or employment (PAF PI A4) is very poor, although the council considers that this reflects a shortfall in contact arrangements during 2002/03. The new care leavers teams mean that contacts with care leavers has now improved, and a recent audit showed that 51% were in education, training or employment. (Standards 1, 3);

    · the rate of final warnings and convictions of children looked after (PAF PI C18) remains high, although performance is better than many similar councils, and Hampshire is taking action to address the situation. (Standards 1, 3); and

    · improvements need to be made to assure permanent and stable placements for looked after children and to improve performance on the rate of children placed for adoption (PAF PI C23) and the rate of children looked after for four years or more who have been in their foster placement for 2 years or more (PAF PI D35). (Standard 3).

Capacity for improvement (Standard 6)

Assessment has highlighted the following improvements to capacity:

    · the SSI evaluation of the council's self-audit in response to the Victoria Climbie Inquiry, and the SSI visit to evaluate the council's response to children in need both found that capacity for improvement in relation to the areas looked at was promising. This suggests an improvement since the SSI Inspection of Children's, although the scope of the latter was much wider. (Standard 6);

    · the council has made significant new investment in Children's Services (£2.5M in 2003/04) to enable existing services to be sustained and new services to be developed in response to national priorities and local strategic objectives. The commitment of the council is also demonstrated in strong Member involvement and effective corporate working. (Standard 1);

    · performance management arrangements have been developed to include a departmental performance information team, divisional Performance Action Groups, and a Reviewing Service for child protection and looked after children cases. A new Information System is being implemented. Service planning is being developed at council level. (Standard 6); and

    · a rigorous recruitment campaign, supported by a recruitment and retention strategy, has resulted in a good number of new appointments. Well-regarded induction programmes, effective departmental communication mechanisms and specific incentives all contribute to staff retention, and the council anticipates that the comparatively poor position of staff vacancies and staff turnover in 2002/03 will be improved in 2003/04. Investors in People status has been achieved. (Standard 6).

Assessment has highlighted the following concerns about capacity:

    · the improvements to capacity noted above are relatively new and are being implemented at a time when the new structure is still not fully completed and bedded in. In addition, factors such as further development of PCT Local Delivery Plans, and lack of certainty about recruitment raise potential risks, which will need to be effectively managed.

SERVICES FOR ADULTS

Assessment has highlighted the following improvements to service since the last Annual Review:

    · the council has responded proactively to the SSI Inspection of Social Care Services for Older People that was carried out in 2002, with an action plan to address its recommendations, which is incorporated into a Commissioning Strategy Action Plan. This aligns strategies for activity, performance and budgets in relation to national priorities and local strategic objectives (Standard 1);

    · £2M in-year investment was made to tackle a continuing high level of delayed transfers of care, and this has contributed to significant improvement in the overall level, and in particular in the proportion of delays that are attributable to social services. The Department of Health Change Agent Team has supported the council and its partners. (Standards 2, 3)

    · The council is implementing a major programme to increase the availability of nursing home beds in the county. The rate of supported admissions of older people to residential and nursing home care continues to be very good (ie low) (PAF PI C26), in line with the policy to promote independence. This is supported by some innovative work with housing partners to develop extra care housing, "active care technology" and Supporting People solutions, along with continuing development of intermediate care. There is an effective funded Agreement in place between the council and the Hampshire Care Association. (Standards 2, 3);

    · the council continues to support higher rates of people through Direct Payments than similar councils, and supported a high number of people with physical disabilities to access Independent Living Fund (Standards 3, 4);

    · for people with learning disabilities, all Valuing People framework expectations were completed on time (one of only two councils achieving this in the South East). The Partnership Board, and a post of County Manager which is jointly funded with a Section 31 Pooled Budget are working to modernise day services, and a good number of people have moved into supported living. (Standards 1, 2, 3);

    · for people with mental health problems, there is single line management with the NHS provider (West Hampshire NHS Trust), and significant progress has been made on all of the NSF objectives. Savings achieved through the integration have been invested in front-line services. A very good rate of people supported to live at home has been sustained. The council received a positive report following a recent visit from the Mental Health Act Commission (Standard 3); and

    · there is a strong user and carer focus across all adult user groups, with effective advocacy, involvement and consultation mechanisms in place. Some exciting and well-received conferences have been held to promote user empowerment. A Social Services Direct service provides a base for a number of specific direct-access services (eg Equipment Direct and OT Direct) (Standards 3, 4, 5).

Assessment has highlighted the following concerns about performance:

    · the rate of households receiving intensive homecare (PAF PI C28) continues to be comparatively low, although there is some improvement since 2001/02. It is noted that the data collection excludes people whose services are arranged through Direct Payments (of which there are high numbers in Hampshire). The rate of older people helped to live at home (PAF PI C32) is also low. (Standard 3); and

    · the proportion of people who receive a statement of their needs and how they will be met (PAF PI D39) continues to be very poor. Action is in hand to address this. (Standard 3).

Capacity for Improvement (Standard 6)

Assessment has highlighted the following improvements to capacity:

    · the council has made significant new investment in Adult's Services (£7M in 2003/04) to enable existing services to be sustained and new services to be developed in response to national priorities and local strategic objectives. The commitment of the council is also demonstrated in strong Member involvement and effective corporate working. (Standard 1);

    · performance management arrangements have been developed, with a new departmental performance information team based in the Performance Management Unit. A new Information System is being implemented. Service planning is being developed at council level. (Standard 6); and

    · Investors in People status has been achieved. Adult Services has been able to recruit high quality new staff. The induction programme and communication mechanisms are well-regarded, and corporate objectives are included in job targets (Standard 6).

Assessment has highlight the following concerns about capacity:

    · the improvements to capacity noted above are relatively new. In addition, factors such as lack of capacity in the independent sector, a shift towards non-chargeable services, further development of PCT Local Delivery Plans, and lack of certainty about recruitment, raise potential risks, which will need to be effectively managed.