Hampshire County Council

Social Care Policy Review Committee

Item: 8

19 March 2004

Monitoring of Best Value Reviews (exception report)

Report of the Director of Social Services

Appendix 1

Name:

Children and adolescent mental health services (CAMHS)

Proposed improvements

Improve leadership and management

Increase user involvement

Clarify expectations between Health and Social Services

Provide regular supervision, support and development to staff

Develop identity for the service and staff

Make the resourcing and model of delivery of service more equitable

Develop and monitor performance data

Progress in implementing the Improvement Plan

Hampshire has been selected by the government to run a three year Children's Trust pilot.

The new Children's Trust will be formalised under section 31 of the Health Act.

The new trust will focus on integration and co-ordination of social services, education and health services for children and adolescents with mental health difficulties. Social Services and Education departments along with the county's seven Primary Care Trusts will pool resources and work together with providers, the voluntary sector, users and carers, to commission services for children and young people and establish a county-wide planning structure to inform commissioners.

The aim of the Trust is to improve services and outcomes for children and families, to ensure greater equity in services across the county, co-ordinated development and joint working that makes the best use of available resources across all agencies.

Future Plans

In addition to the evaluation of the CAMHS Children's Trust pilot, future continuous improvements and planning for these services will be addressed by the overall Children and Families service plan.

Phase 2 of the children's trust is planned for 2005, which will include comprehensive joint commissioning amongst partners for all CAMHS commissioning.

This review is therefore completed.

Contact for further information

Mary Killick on 01962 847177

Natalie Trentham on 01962 847166

Appendix 2

Name:

Mental Health provider and contracted services

Proposed improvements

Service quality: to develop a service specification to ensure all services meet minimum requirements, and introduce regular monitoring and reviewing of directly provided services.

Each service should develop specific objectives and measurable outcomes that demonstrate effectiveness.
Priority of access to highest level of eligibility, but within available resources to allow access for those of lower eligibility who need continuing support.
Services should be available at times required by service users, including evenings and weekends.
Ensure systematic involvement of user involvement in the planning and running of services.
Efficiency improvements through combining smaller contracts; improved unit costing; and feasibility of externalising a support work service.
Ensure consistency of remuneration and support for professionally non-affiliated staff.
Improve collection and use of management information so that all service activity is recorded.

Progress in implementing the Improvement Plan

Services aim to prioritise access for those with greatest need but also to allow access to those with lesser needs where resources allow.

Day Service Specification has been developed and to be used as a template for all future in house and contracted services.

Joint management of mental health services with West Hampshire NHS Trust and Surrey Hampshire Borders NHS Trust was achieved in April 03.

A project has begun to strengthen joint commissioning of mental health services with PCTs through the Local Implementation Teams (LITs)

LITs have subgroups which address service improvement for day opportunities and employment. Membership includes users and the voluntary sector.

Managers in the integrated service have received training on tendering, contract management and market development in the voluntary sector

Review of staff grades is being undertaken within the County Council's ongoing Pay and Benefits project

3 conferences on the `Recovery' model for mental health were held in Hampshire during 2003 and 2004 involving all stakeholders to raise awareness of the need to incorporate this into service delivery. A steering group has been established to take this work forward.

Reviews of services in North and North East Hants and the New Forest have been completed and tendering processes are underway for 04/05.

A draft Women's Strategy has been completed.

West Hampshire Trust and Social Services have been selected to pilot the implementation of Support Time and Recovery (STR) workers in mental health services.

Future Plans

Reviews of provider and contracted services are underway in all remaining localities to be completed by mid 04 to reflect user need and requirements of the Mental Health National Service Framework. Local review groups and workshops will ensure broad consultation with local stakeholders, including the voluntary sector, service users and carers. These reviews will address the need for modernisation of services with particular attention to:

· Access and eligibility for services

· Women's issues

· The means by which STR workers can be incorporated into the design of future services. A West Hampshire Trust STR Steering Group has been formed with a project manager working across the Trust and Social Services

· Review of contracts with the voluntary sector to enable externalisation of some services, redesign and improved Best Value

· The need to extend out of hours services having regard to the impact of the development of new teams for Assertive Outreach and Crisis Resolution/Home Treatment

· The need to incorporate the `Recovery' model in all services.

· The need to address Black and Minority Ethnic issues

· Training needs arising from the need for modernisation for both statutory and voluntary sector staff.

The above improvements will be incorporated into the mental health service plan. This review is therefore completed.

Contact for further information

Graham Collingridge on 01962 847277

Appendix 3

Name:

Receivership service

Proposed improvements

The services of the Receivership Unit should continue to be provided as a service of last resort when no suitable alternative person could be found to undertake the duties
Feasibility of whether it should become a business unit should be carried out
Work should continue to systems to improve financial and management information
The Unit's business with Southampton and Portsmouth Cities should continue, and in the longer term to consider other business opportunities
Access to information about the Unit was improved
Various steps be taken to improve the management of staff through staff performance reviews, and additional staff and additional accommodation
The County Council review its policy on appointeeship (assistance with the management of the financial resources of people with mental disorder who have very limited assets) with a view to providing an improved level of service.

Progress in implementing the Improvement Plan

A pilot project for the Receivership Unit to manage appointeeships is underway. The pilot is expected to be concluded by June 2004. Learning from the pilot is expected to inform the roll out of a centralised County Wide service, funded from the income from additional activity

Business Unit status will not be taken forward for the foreseeable future (the service has been reviewed by County Treasurers).

Discussions with agencies to work in partnership with the Receivership Unit continue. The service to Portsmouth City users has been transferred successfully.

Receivership Unit staff have contributed to the development of a national network with the Public Guardianship Office, and to the consultation on the draft Mental Incapacity Bill that has been subject to Parliamentary scrutiny.

Future Plans

Future continuous improvements and planning for the service will be addressed within the Mental Health service plan. This review is complete.

Contact for further information

Graham Collingridge on 01962 847277

Appendix 4

Name:

Day Care for Older People

Proposed improvements

Work at a strategic level to put systems are in place to ensure day care services are more effectively commissioned, from a sound knowledge base;
 

Work at an operational level that can run concurrently or subsequently, dependent on the status of specific services in localities.

Progress in implementing the Improvement Plan

Since January 2003 the following progress has been made:

· The Day Care Forum hosted a Day Care Stakeholders Meeting in June 2003 to bring commissioning and provider staff together

· A meeting was held in November with representatives from commissioning, care management and provider staff to identify issues in day services. This included the issue of training for in-house and voluntary sector staff

· A Day Services Action Plan is currently in draft form and will be signed off in February 2004. One of the action points is regarding training

· A Day Services Steering Group has been formed and has its first meeting in February 2004

Future Plans

Future continuous improvements and planning for these service will be addressed within the Older Peoples Service Plan and Day Services Action Plan. This review is complete.

Contact for further information

Vincent Oliver on 01962 845720

Claire Foreman on 01962 847127

Appendix 5

Name:

Occupational therapy, equipment & technician services

Proposed improvements

The current national performance measure for all three services is the percentage of equipment costing under £1000 delivered within 3 weeks. The County Council is within 3% of the top quartile for performance by similar shire counties and has set itself to achieve this target by 2003.

Average waiting times were found to be equal to the national average of 10 weeks but still unacceptably long for some users and it was proposed that waiting times should be reduced to existing County target levels by 2005. Pressure on OT teams is intense. Hampshire Social Services OT staff have the highest number of cases per OT by comparison to other similar sized counties. Many of the recommended actions were therefore largely aimed at managing demand to try to maintain and improve performance on waiting times for assessment without further restricting eligibility criteria or the range of services offered. 

There was a strong message from users that given trustworthy, independent advice and information about equipment and adaptations, many people with simple needs would prefer to take the initiative to meet their own needs rather than access Social Services. It was proposed to introduce a county-wide self-assessment form and better information to enable such people to do so, enabling OT resources to be refocused upon those with higher levels of need. 

Equipment services in Hampshire were found to be in line with the Audit Commission's recommendations for community equipment services (`Fully Equipped' - March 2000). Two out of three JES exceed the Commission's suggested 70% target for recycling of equipment, by over 20%.

Users are generally satisfied with the delivery time for equipment which currently averages 90% of all equipment delivered in 3-7 days but would like more choice as to colour, style and quality of equipment supplied. 

There was some concern about the delivery and collection performance of the JES in SW Hampshire . It was therefore to be monitored and benchmarked against the best performing JES. 

The Technician Service was found to be well run and well received, with the potential to trade as an independent business unit. It was proposed to exploit this potential subject to further advice from the County Treasurer. 

A pilot project to operate a combined OTA/Technician service providing simple assessments, fitting of equipment and grab rails in one visit, was to be pursued as a possible model for an improved fast track service. 

Health and Housing partner agencies and service users regard improved integration of community based services for people with disabilities as highly desirable. The NHS Plan may enable such integration and pooling of resources and this would be explored via strategic joint planning.

Progress in implementing the Improvement Plan

The new Occupational Therapy helpline Social Services Direct - OT(OT Direct), went live on 3 November 2003. The helpline is part of Social Services Direct and is both for professionals who want to make a referral and for members of the public who want advice about equipment or an assessment of their needs. The new helpline means that referrals/requests can be screened centrally and simple requests dealt with quickly. Early indications are that OT Direct is helping to reduce waiting lists and make it quicker for people to get pieces of simple equipment.

Performance information 2002/2003:

Hampshire's performance against BV156/PAF D38 indicators was better than most shire counties with 91% minor adaptations and items of equipment costing under £1000 being delivered within 3 weeks

This indicator has been replaced by a new indicator measuring delivery within 7 days and removing the £1000 limit. As yet, no data has been collected nationally for performance against the new indicator.

The department is restructuring the technicians service which together with some process change should help meet the new indicator.

Targets for waiting times of 4 weeks to see an OT are now set as part of the single assessment process (see below)

Future Plans

Future continuous improvements and planning for these services will be addressed within the service plan for Physical Disability services and joint planning with Health. In addition, these services are part of care management and the single assessment process and will, therefore, be monitored through the national strategic framework.

Contact for further information

Glyn Jones on 01962 847257

Appendix 6

Name:

Day and resources centres for people with a physical disability

Proposed improvements

To implement the strategic direction in community support for physically disabled people

All key staff to receive training on independent living

Support users to access employment services

To enable a more flexible support service for carers

To promote direct payments as an option to maximise user control

To identify suitable performance indicators to benchmark services against

To clarify unit costs to enable comparative analysis.

Progress in implementing the Improvement Plan

Individuals attending day services have individual programmes tailored to meet their needs which has furthered links with colleges and community facilities.

Work is being undertaken with voluntary sector providers and service users to further develop Day Services

Future Plans

Future continuous improvements and planning for these service will be addressed within the service plan for Physical Disability services. This review is complete.

Contact for further information

Glyn Jones on 01962 847257

Appendix 7

Name:

Day activities for adults with learning disabilities

Proposed improvements

Social Services providers of day activities will make £15,000 available in 2001/2 for direct payments, to allow an increase in the number of people with learning disabilities who arrange their own day/evening or weekend activities. By the end of March 2003, costed plans will be prepared for the redevelopment of day activities across Hampshire, based on the needs and aspirations of people with learning disabilities and designed to provide more flexible and responsive services. This work will form the basis of reports to the Social Services Committee to gain approval for the implementation of plans. 

Links will be established with employment agencies and leisure services across Hampshire that will work pro-actively to support people with learning disabilities to have greater access to employment and leisure opportunities.

Progress in implementing the Improvement Plan

The modernisation of day services is being progressed through four subgroups, linked into Locality Implementation Groups that report to the Hampshire Learning Disability Partnership Board. Links are being established with local colleges, leisure services, employment organisations and other providers of day activities.

The White Paper, Valuing People, requires planning and development of services to be based on person centred planning or person centred approaches. To support this requirement the Hampshire Learning Disability Partnership Board has established a small team, of five people, to promote and develop the use of person centred approaches across all aspects of learning disability services. This work will feed into the detailed plans for day activities for each locality.

Progress on the development of plans and ongoing implementation of the modernisation of day services is being monitored through the Hampshire Learning Disability Partnership Board, on a quarterly basis.

Future Plans

Future continuous improvements and planning for these service will be addressed within the Learning Disability Service Plan and monitored through the Hampshire Learning Disability Partnership Board. This review is complete.

Contact for further information

Claire Bruin on 01962 847219

Appendix 8

Name:

Complaints service

Proposed improvements

The review identified an action plan to achieve the following improvements to be made to the service.

· Publication of clear service objectives and performance measures and a revised complaints procedure.

· New complaints information leaflets to be produced and published 

· Support to and supervision of Independent Persons to be consistently given. 

· The staffing structure of the service to be amended to include additional staff time and changes to roles and responsibilities.

Progress in implementing the Improvement Plan

Children's Participation Officer accountability statement, person specification and role profile completed. Recruitment material drafted. Post included in PMU Work Force Plan. Recruitment for post suspended indefinitely owing to budgetary constraints

Ongoing work to secure funding.

Future Plans

Future continuous improvements and planning for the service will be addressed within the Performance Management Unit service plan and in the annual complaints report presented to PRC. This review is complete.

Contact for further information

Irene Unwin on 01962 847256

Appendix 9

Name:

Information analysis service

Proposed improvements

The Best Value review found that a step-change in the performance of the service was necessary if it was to fulfil its crucial role in helping the Department meet the mounting demands of Best Value, Social Services Inspectorate monitoring and other modernisation initiatives.

With the additional funding of £28,000, phase one improvements included:

· Central Government will receive complete and accurate sets of statistical data from Hampshire County Council Social Services Department within the specified deadlines

· 100% returns will be complete and delivered on-time by the end of 2002/3 (from a level of 45% in December 2000).

With the proposed funding of £108,000 remaining, Phase one improvements expected are:

· a report analysing current and past performance against an agreed set of standard indicators/targets will be regularly provided for the department's managers and for elected members

· 100% planned reports will be delivered by the end of 2002/3 (from a level of 28% in December 2000).

· requests for management information received by the Information Analysis service will be met in a timely fashion

· 80% customers will be very satisfied with the completeness of information by the end of 2002/3 (from a level of 37% in December 2000)

· 50% customers will be very satisfied with the timescales that are achieved by the end of 2002/3 (from a level of 29% in December 2000).

Progress in implementing the Improvement Plan

Three Performance Information Officers were appointed in November 2003 and are supporting Performance Action Groups, which are being cascaded throughout Social Services. This was the final action outstanding and the review is therefore completed.

Future Plans

Future continuous improvements and planning will be addressed by the service plan for information services. This review is complete.

Contact for further information

Ken Howard on 023 8068 7332

Appendix 10

Name:

Employment services

Proposed improvements

Two key objectives were identified for both service user groups

1. to assist the maximum number of service users into open employment 

2. to assist the maximum number of service users moving into useful and meaningful activity such as training or voluntary work.

Other objectives included:

· improved contract monitoring

· gain a better understanding of the costs of the service

· improved consultation with service user

· develop the department's work with other agencies

· the County Council to use its strong position as an employer in order to ensure that more people with disabilities are employed by the County Council

Progress in implementing the Improvement Plan

Learning Disability

The Hampshire Learning Disability Partnership Board completed the strategy on employment required by the White Paper, Valuing People, in the winter 2002/3. The feedback from the Valuing People Support Team on this strategy was positive.

Work has been undertaken during 2003 to learn from best practice within the field of learning disabilities and locally, from Mental Health colleagues. This information is being used to develop a new service specification as part of the tendering process for supported employment services that will be undertaken in 2004/5, with new contracts being let from April 2005. Performance information, as specified within the Best Value Review will be incorporated into the quarterly monitoring of the new contract(s).

Updated performance information:

· Number of service users helped into open employment (minimum target January 2003 15% users on a scheme)

· Number of service users helped into useful and meaningful activity such as training or voluntary work

· % employment schemes using satisfaction surveys (80% minimum target January 2003)

Mental Health

· All employment services in Hampshire are being remodelled to enable individuals to move into open employment. As contracts are renewed or retendered this model is specified.

· Services in Eastleigh/Romsey, New Forest and E Hants now operate a supported employment model using Vocational Advisers.

· Service specifications require services to move towards the goal of a minimum of 15% of users moving to open employment, to monitor the numbers in other voluntary or training activities, and to employ user satisfaction surveys (80% by 2003)

· Where services have been redesigned these targets are being met. (eg in E Hants since April 03)

· Elsewhere by contract monitoring processes we are reviewing practice in the services to move the maximum number of users into open employment, training or voluntary work (eg in Fareham/Gosport 100% of users are undertaking training, 8% doing voluntary work, 3% volunteering)

· West Hants Trust and Social Services have appointed a Development Manager for Employment Services in mental health

· A Mental Health Employment Strategy has been developed and consultation was completed by Feb 04, key elements of which are outlined below . This will provide the framework for future improvements.

· 3 conferences on the theme of Recovery in mental health services were held end 03/beginning 04 and this model will influence service development in employment services

· All Local Implementation Teams (LITs) have subgroups addressing employment issues and membership includes service users, carers and the voluntary sector

Future Plans

Learning Disability

Future continuous improvements and planning for these services will be addressed within the Learning Disability Service Plan, and monitored through the Hampshire Learning Disability Partnership Board.

Mental Health

The key elements of the Mental Health Employment Strategy 2004 developed in partnership with West Hants Trust and Southampton City Council are:

· To develop employment opportunities for those who have experienced mental health problems within West Hampshire Mental Health Trust and partner organisations such as Hampshire Social Services, and develop retention services to support staff

· Develop the Vocational Advice model across Hampshire

· Ensure service users have access to a range of mainstream employment, education and training by building effective partnerships and enable day services via their own service reviews to support users to access these services

· Collate the necessary information to support the Strategy

· Promote the Recovery model within employment services in common with all other mental health services

· Develop job retention services with links to primary Care in order to prevent people experiencing mental distress or emotional difficulties at work from losing their jobs.

· In common with other parts of the mental health service, employment services will address cross cutting issues such as the needs of women and people from Black and Minority Ethnic groups, and carers.

The improvements identified in the review for both sectors were all undertaken by January 2003. The review is therefore complete.

Future continuous improvements and planning for these services will be addressed within the Mental Health service plan and the above Employment Strategy.

Contact for further information

Claire Bruin on 01962 847219 (Learning Disability)

Graham Collingridge on 01962 847277 (Mental Health)

Appendix 11

Name:

Looked after children services

Proposed improvements

The review identified 6 outcomes in its improvement plan.

1. Looked after children gain the maximum life chances from education, health and social care provision.

2. Through appropriate care placements looked after children are securely placed with carers capable of providing safe and effective care for the duration of their childhood.

3. There is a competent and committed workforce within a participative and supportive management culture.

4. Looked after children's individual needs and choices are met through maximising resources to deliver effective services that demonstrate value for money.

5. Users and carers are involved in planning their individual care packages and the delivery of services.

6. Services are planned to meet strategic objectives through accurate management information.

 The main performance targets are in relation to improvement generally in the areas of care placements and staffing. For

care placements, they cover more children looked after

reported as having appropriate health services provided, improvement in statutory reviews being completed on time, improvement in the long term stability of placements for looked after children, improvement in children and parents participation in planning and improvement in contracting with external providers. For staffing they relate to improvement in recruitment and retention generally and specifically in vacancy levels, sickness, morale, staff communication and training.

Progress in implementing the Improvement Plan

· Recruitment to participation posts has been delayed by budget pressures and the need to take on board implications of government programmes e.g. Children's Fund which contain participation elements. Options to use economies of scale are under investigation. The revised target for achieving this objective is April 2004

· The Children's Green Paper proposals and the new advocacy requirements, are also being assessed for impact on plans. The revised target date is August 2004

· Software improvements are under implementation as part of the SWIFT programme (Phase 1.1 is current and Phase 2.2 is planned for July 2004).

· Work as part of central government requirements for `Information Sharing'(IRT) and for ICS is underway; the IRT protocol with effect from April 04 in outline phase and ICS in 2005

· The website for children looked after is underway with government grant fully committed.

Other improvements now implemented are:

· Contracts support manager now in post

· Care Management manual published 2003

Future Plans

Future continuous improvements and planning for looked after children's services will be addressed by the overall Children and Families service plan. This review is complete.

Contact for further information

Graham Wright on 01962 847263

Appendix 12

Name:

Adult residential and accommodation services encompassing older people, mental health, learning and physical disabilities

Proposed improvements

For older people:

The key outcomes that are expected are;

· Address gaps in the market regarding types of provision;

· Respond rapidly to changing agenda;

· Improve market capacity to enable timely appropriate placements;

· Meet user aspirations and values;

· Secure value for money on behalf of residents of Hampshire;

· Achieve market sustainability for the future within available resources.

For people with disabilities:

The key outcomes that are expected to be achieved through the implementation of the action plan are:

· A strengthening of the Adult Placement Scheme with a mix of registered care and Supported Living.

· Flexible use of vacancies in in-house services.

· Options appraisals carried out for all in-house services in response to the standards set by the National Care Standards Commission.

· Joint working with NHS colleagues and providers to identify gaps in services and progress new service developments within Hampshire.

· Purchasing co-ordinated across the County, to ensure most effective use of resources.

· Collaborative approach to providing appropriate services for people with health and social care needs, within the framework of the Continuing Care Eligibility Criteria.

· Increased number of Supported Living arrangements.

· Use of benchmarking tool for comparison of residential services.

For people with mental health problems;

The key outcomes are:

Development of a range of residential care and housing with support in each locality informed by the needs analysis in the ROCC report.

Development of integrated planning processes incorporating the NSF and Supporting People agendas

Development of robust joint financial and management information

Improved housing practice in mental health services through joint training

Services are responsive to specialist needs

There is effective user and carer involvement

Revenue and capital resources are maximised across agencies to meet need and promote independence

Services have clear, jointly owned and published care standards

Progress in implementing the Improvement Plan

Supporting People came into operation on 1 April 2003. It brings together into one pot the money used to provide support services for people living in a variety of special housing schemes and hostels previously paid through housing benefit. There are around 25,000 users of support services in Hampshire, 75% of whom are older people in sheltered housing. The Supporting People fund (around £35m) is now administered by Social Services on behalf of the County Council through contracts with a large number of providers of support services.

The Supporting People team began reviewing the contracts for the 1,200 support services that are currently being provided in Hampshire in May 2003. The team is looking at their relevance to the overall provision of support services, their value for money, and how they fit into the government's Quality Assurance Framework (QAF).

The Supporting People partnership will decide which services should be funded with Supporting People money and will be managing the contracts for the services.

Future Plans

Future planning will be addressed by the relevant service plan. This review is complete.

Contact for further information

Claire Foreman on 01962 847127

Glyn Jones on 01962 847257

Graham Collingridge on 01962 847277

Claire Bruin on 01962 847219

Appendix 13

Name:

Care management for adults and older people

Proposed improvements

1. Progress towards implementation of care brokerage across the county

2. Progress towards achieving performance targets:

a. the proportion of people whose assessment of need is completed within 6 weeks of their first contact with a care manager (target = 10% improvement over 2 years)

b. the proportion of people in receipt of care who have their needs and services reviewed (target = 15% improvement over 2 years)

c. the proportion of people in receipt of care who receive written details of the care they receive (target = 45% improvement over 2 years)

3. Progress towards achieving mental health targets:

a. Development of an integrated training programme for care co-ordinators

b. Improvement of recruitment and retention of Approved Social Workers

c. Responsive integrated out of hours services

d. Effective services for carers

e. Involvement of service users and carers in service delivery

f. Development of an integrated race equality plan

g. Development of joint performance management

Progress in implementing outstanding improvements

1. Care brokerage schemes implemented in Eastleigh, Fareham & Gosport and New Forest (joint with Health)

2. Performance targets:

a. Information for 2002/2003 not yet available (currently being examined by performance information team)

b. As above

c. 100% service users on ACMS received a written statement of their needs in 2002/2003

3. Mental Health targets:

a. Joint training programmes in place.

b. Senior Practitioner posts established; joint Approved Social Worker (ASW) rota in place between North East Hampshire and Surrey Heath; opportunities for ASWs to work in Out of Hours Service.

c. Primary Care Trust (PCT) funding identified for Crisis Resolution and Home Treatment teams in all localities

d. Additional posts in all localities for Carer Support Workers

e. Training programme for service users and carers in North Hants; Delivery of mental health awareness training by service users; systems to involve service users and carers in place in all locality implementation teams

f. Plans to implement Department Race Equality Plan jointly with Local Implementation Teams (LITs)

g. Information sharing agreement in place; Client information data shared with West Hampshire Trust to develop joint information collection processes.

Future Plans

Future continuous improvements and planning for these services will be addressed within the single assessment process and will, therefore, be monitored through the national strategic framework.

Mental Health continuous improvements will be addressed within the Mental Health Service Plan through annual joint audits of Care Programme Approach.

Contact for further information

Sandra Grime on 01962 847274

Margot Mottershead on 01962 847133

Appendix 14

Name:

Services to carers and respite care

Proposed improvements

The improvement plan for this review contains seven outcomes:

1. Improved access for carers and professionals to information about help and services available to carers

2. Improved communication with carers from hard-to-reach groups and wider recognition of their needs

3. Improved access to assessment for carers to ensure recognition of their needs

4. A cohesive, consistent network of carer support services across the county

5. An increased range of flexible services to enable carers to take a break when they need it

6. Improved efficiency of in-house resources providing respite care

7. More responsive services to support carers of people with mental health problems

Progress in implementing the Improvement Plan

This review obtained final approval from the Executive

Member for Social Care in January 2003. Progress in

implementing the improvement plan includes the following

actions:

_ Secured resources from each sector to fund ethnic minority development worker posts (co-ordinated by the race policy advisor)

_ Held an open meeting of key stakeholders to consider the future direction of carer support services across the county

_ Responded to the needs of carers of people with mental health problems through;

- carer representatives on each local implementation team with a number having a user/carer consultation group

- introducing payments to carers for attending meetings

- carers clinics in several localities

- funding an information pack (400 already distributed)

- developing and implementing joint eligibility criteria between health and social services

- 7 new Carer Support Workers appointed

- new ICPA paperwork in place which will increase the number of recorded carer assessments

· Engaging carers of adults with learning disabilities in planning processes through inclusion on the Hampshire Learning Disability Partnership Board, Locality Implementation Groups and associated subgroups

· Jointly commissioned, with Health, resources to provide residential respite care for children with severe disabilities in the south east and north of the county.

Future Plans

The following actions are required to ensure future continuous improvements and planning for the service:

_ Explore with other provider possibilities for setting up a database and website links to access information about resources for carers

_ Contract with an independent consultant and expand the steering group to produce a detailed plan to progress the development of carer support services across the county

_ Contract with carer support services to promote the needs of gay carers and carers from ethnic minorities

_ In response to the care group focus, Assistant Directors to devise plans for utilising carers grant flexibilities to benefit carers

_ Review the success of the joint Health/Social Services assessment and of the carers' training programme with carers of people with mental health problems

_ Commission a survey of carers' views one year from implementation of the review.

Future planning for this review will be addressed in the carers support strategy and service plan. This review is therefore completed.

Contact for further information

Claire Bruin on 01962 847219

Appendix 15

Name:

Meeting the social care needs of people with sensory impairment

Proposed improvements

Outcome 1: Reduction in waiting times for people with recently diagnosed sensory loss through the creation of the "First Focus" approach

Outcome 2: Improve the efficiency and quality of the service offered through reorganising into larger, dedicated teams

Progress in implementing the Improvement Plan

1. Planning the `First Focus' (Early Sensory Intervention Service) approach is well advanced and there is a phased implementation programme phasing the service in over the next 2 years.

2. Dedicated Sensory Services teams are now in place across Hampshire and this is already had a positive impact on the on the service in terms of quality and efficiency and links with other organisations.

Future Plans

The implementation of these outcomes together with the service developments identified by the Review process is being led by the Best Value Review Implementation Group

Future continuous improvements and planning for these services will also addressed within the service plan for Physical Disability services and joint planning with Health. In addition, these services are part of care management and the single assessment process and will, therefore, be monitored through the national strategic framework.

Contact for further information

Glyn Jones on 01962 847257