Archived decisions
Hampshire County Council
Adult Social Care Policy Review Committee Item 7
20 January 2006
Adult Social Care Performance
Report by the Director of Adult Services
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Contact: : Barbara Sorkin Ext: 5985 email: [email protected]
Kevin Peers Ext: 7182 email: [email protected]
3 |
Consultation with Local Members |
3.1 |
No consultation has taken place with local members, as the information is all compiled on a county wide basis. |
4 Overarching assessment
4.1 The full Adult Performance Review Report from CSCI is attached at Appendix B, but the significant points are quoted below:
4.2 Summary of improvements Adult services are demonstrating good sustained progress in implementing their strategies for responding to national and local priorities for all client groups. These improvements are reflected in the fact that this year they achieved a higher band rating for nine performance indicators. The planning and delivery of services reflects well-developed joint working, effective financial arrangements and the active involvement of service users and carers. There is evidence of sound commissioning and that the delivery of quality services, which promote independence and are responsive to individuals' needs and preferences, is undertaken in a effective and efficient manner. Work is being undertaken to build on the success of ground-breaking pilot projects such as the innovation project and to ensure that there is equality of service provision across the county, including actions to increase take-up of services from under- represented groups. During 2004-05 social services has had good support from the chief executive and Councillors. A major reorganisation of social services is planned for 2005-06. This is underpinned by a strong implementation plan for adult services, based on an agreed vision and clear strategic direction, which is owned by both Councillors and managers. Performance management and quality assurance have both improved considerably since the implementation of the new IT system (SWIFT) and there is good evidence of success in relation to management action on performance improvement. 4.3 Summary of areas for improvement |
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The good progress that has been made in enabling service users their families and other supporters to access and receive good quality services needs to continue with improvements being made in the time it takes to complete assessments and set up packages of services. The council needs to build on and extend the work that it is undertaking to secure fair access to and provision of services that meet the assessed needs and preferences of their diverse local communities, and its disparate BME residents. There are a range of agreed plans, including the restructuring of social services, the remodelling of some of the adult services' teams and building on the success of a number of pilot projects a wider implementation of a range of services. Together these should further facilitate the council in modernising its services; this will require close monitoring and evaluation against SMART criteria. Hampshire has a good record of partnership working but the pace of taking forward some areas of work has been hampered by the difficulties that health agencies have been facing. It is committed to creating a strategic alliance with the SHA, reconfigured PCTs and Acute Trusts to develop LAAs and LPSA2. These are areas of work that will need clear implementation plans and close monitoring if local stretch targets are to be met, particularly in light of the SHA serious debt problems, which could result in personnel and unit/service reductions. |
4.4 There are no aspects of this written judgement that Adult Services would significantly disagree with.
5 Detailed summary of performance
5.1 As performance reports have been presented to members for several years now, this report will not cover the history, detail or logic of the annual Performance Assessment Framework (PAF) scheme under which social care operates and is inspected. Instead it will present the information in a summarised way, drawing out themes used by the Commission for Social Care Inspection(CSCI) when looking at Hampshire's performance.
5.2 Data on individual PAF indicators :
Red denotes a low score, and the bandings rise to orange, yellow and light green with dark green being the highest banding.
There are some exceptions, such as D40, where yellow is the highest banding possible for an indicator. The column on the right indicates the highest banding possible for each indicator.
Performance Indicator |
2002/3 HCC |
2003/4 HCC |
2004/5 HCC |
2004/5 England |
2004/5 Shires |
Excellent | |
National strategies |
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A6 Emergency Psychiatric Admissions |
15% |
11% |
13% |
10.3% |
10.0% |
0<6.5% | |
A60 Participation in drug treatment programmes (new for 2004/5) |
37% |
31.0% |
29.0% |
89.7% | |||
Cost and efficiency |
|||||||
B11 Intensive Care as % of intensive and residential/ nursing care |
18% |
23% |
24% |
25% |
24% |
27<45 | |
B12 Cost of intensive social care per week |
£489 |
£529 |
£478 |
£480 |
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B13 Cost of older person's residential/ nursing care per week |
£396 |
£415 |
£405 |
£401 |
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B17 Cost of home care per hour |
£13.00 |
£14.30 |
£15.90 |
£13.60 |
£14.00 |
Performance Indicator |
2002/3 HCC |
2003/4 HCC |
2004/5 HCC |
2004/5 England |
2004/5 Shires |
Excellent | |
Effectiveness and outcomes |
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C26 Admissions of supported residents aged 65+ to nursing/ residential care |
91 |
98 |
94 |
91 |
86 |
70<100 | |
C27 Admissions of supported residents aged 18-64 to nursing/ residential care |
2.4 |
2.1 |
1.8 |
2.2 |
2.1 |
2<3 | |
C28 Intensive Home Care |
6.5 |
8.0 |
8.3 |
11.5 |
9.3 |
16+ | |
C29 Adults with physical disabilities aged 18-64 helped to live at home |
4.0 |
4.8 |
4.7 |
4.2 |
4.1 |
5+ | |
C30 Adults with learning disabilities aged 18-64 helped to live at home |
2.0 |
2.2 |
2.3 |
2.7 |
2.7 |
3+ | |
C31 Adults with mental health problems aged 18-64 helped to live at home |
2.9 |
2.6 |
10.8 |
3.7 |
3.7 |
2.3+ | |
C29 Older people aged 65+ helped to live at home |
62 |
75 |
83 |
80 |
72 |
100+ | |
C51 Direct Payments |
61 |
68 |
102 |
57 |
58 |
150+ | |
C62 Carers services (new for 2004/5) |
13 |
9 |
11 |
Performance Indicator |
2002/3 HCC |
2003/4 HCC |
2004/5 HCC |
2004/5 England |
2004/5 Shires |
Excellent | |
Quality of Services |
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D37 Availability of single rooms |
81 |
81 |
87 |
94 |
93 |
95<100 | |
D39 Statement of needs |
75% |
92% |
93% |
91% |
90% |
100% | |
D40 Clients receiving a review |
65% |
72% |
63% |
65% |
60<90 | ||
D41 Delayed transfers of care from hospital |
105 |
81 |
70 |
33 |
33 |
0<20.12 | |
Performance Indicator |
2002/3 HCC |
2003/4 HCC |
2004/5 HCC |
2004/5 England |
2004/5 Shires |
Excellent | |
D54 Equipment delivered within 7 days |
73% |
72% |
82% |
79% |
85%+ | ||
D55 Waiting times for assessments |
41 |
79 |
72 |
75 |
85+ | ||
D56 Waiting times for packages of care |
79 |
86 |
84 |
85 |
85+ | ||
D59 Practice Learning (SW training) |
16.8 |
13.3 |
10.1 |
10.1 |
17+ | ||
Fair Access |
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E47 Ethnicity of older people receiving assessments |
0.98 |
0.82 |
1.38 |
1.11 |
1.15 |
1<2 | |
E48 Ethnicity of older people receiving services following an assessment |
1.19 |
0.63 |
1.02 |
1.02 |
0.9<1.11 | ||
E50 Assessments leading to provision of services |
5 |
25 |
46 |
45 |
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E61Assessments of new clients aged 65+ |
149 |
57 |
59 |
59 |
30<100 |
6 National Strategies
6.1 It will be seen that Hampshire had a higher than average level of emergency admissions to psychiatric beds, although still being at an acceptable level. This indicator is expected to improve as the modernisation of local mental health services concentrates on services delivered in the community; switching investment from in-patient beds to outreach and crisis services delivered to people in their own homes.
6.2 Increased participation in drug and alcohol treatments, arranged through the DAAT partnership with Hampshire County Council, are above national and Shire levels; but still only judged as acceptable by CSCI. Looking on the CSCI site http://www.csci.org.uk/council_performance/paf/paf_2004_2005_full.pdf
it is clear that this new indicator is open to interpretation as it measures percentage change over previous years rather than actual provision: for example, are increases high because historic levels were too low? Until this indicator becomes established, it is probably better to be average than an outlier.
7 Costs and Efficiency
7.1 When looking at intensive care in the home as a percentage of all intensive care packages, Hampshire is consistent with the Shire averages and is considered to be good. This indicator is closely linked to C28 Intensive Care, which continues to improve.
7.2 The low weighting given to unit costs by CSCI is best exemplified by the fact that over half of them have been deleted from the PAF suite of indicators. This was done as CSCI felt unable to judge whether a low cost showed good purchasing ability, the provision of low quality services or just reflected local market conditions. The three that are left suffer less from this difficulty than the ones deleted. All the unit costs show Hampshire as being significantly above national levels - but interestingly, with the exception of Home Care, they are consistent with those for Group 3 which includes Surrey. Even so, the Home Care costs are only just above average for what many consider to be similar cost authorities.
8 Effectiveness and Outcomes
8.1 We have excellent performance for admissions of older people to nursing and residential care, with good performance for younger people. As we are following the national agenda to promote people's ability to remain in their own homes through the use of intensive home care packages or direct payments, we were effectively marked down in our performance rankings for making too little use of residential care.
8.2 Intensive care (C28) grew slightly during 2004/5, reaching acceptable levels by September 2004. The September 2005 return, just submitted, shows that the number of intensive care packages supplied has risen by almost 10% to 9.1, close to the 2004/5 Shire average.
8.3 Increasing numbers of people are being helped to remain at home. We are above the Shire and national averages for people with physical disabilities, mental health and older people. We are just under the average for people with learning disabilities, and we believe this is linked to the way some services are currently being provided. This is being investigated with colleagues in other authorities to verify we are all counting in the same way.
8.4 We remain a national leader for Direct Payments; an indicator highly regarded by the audit commission. Although only considered by CSCI as good, we are the 12th highest nationally.
8.5 The information on Carers was collected for the first time, on a trial basis, in 2004/5. As a result bandings have not been set for this indicator.
9 Quality of Services
9.1 When judging quality of services, Hampshire is acceptable for 5, good for 2 and excellent for 1.
9.2 We have poorer performance than many other authorities in providing single rooms to people permanently entering nursing and residential care. This was believed to reflect the type of private provision available for purchasing; with the ENHANCE nursing beds coming on line we expect this indicator to continue improving.
9.3 Although only regarded by CSCI as acceptable, we are outperforming national and Shire averages for the provision of statements of need - and CSCI rate no authority at above this level.
9.4 Delayed transfers of care are still too high, but have improved to a level considered as acceptable. This indicator measures whole system delays, not just those attributable to social care. When viewed alone, social care delays have decreased significantly. As at the end of March 2005 there were, on average, 30 social care delays compared to 60 eighteen months earlier. Whole system delays, monitored by CSCI, averaged 100.
9.5 Equipment delivered within 7 days has shown a small decline in performance, but is still considered to be acceptable. Several changes have been made during 2005/6 to the way this service operates, so we are expecting improved performance for the current year.
9.6 Acceptable waiting times for care management assessments, and the provision of services following assessment, have both improved significantly. Both of these items remain under close scrutiny by the Adult Services management team as they have a very high profile nationally.
9.7 The practice learning indicator measures the involvement of Hampshire social care in providing assessed workplace training days to trainee social workers. The fall in 2004/5 was due to decreased take up of places offered, rather than Hampshire offering fewer placements. This is believed to be a temporary effect mirroring the change of SW Qualification from a Diploma course, often undertaken on a post graduate basis, to a normal 3 year first degree.
10 Fair Access
10.1 All of these gradings only have two levels, acceptable and low. Hampshire was acceptable for two, low for one and no gradings were offered for the fourth as results fluctuated significantly between authorities.
10.2 Despite the performance indicator scores under this heading, Adult Services is developing strong links with hard to reach groups to ensure they have fair access to services.
11 Recommendation(s) | |
That: |
That the PRC considers the performance information provided and makes any recommendations to the Executive Member for Adult Social Care on policy matters. |
Section 100 D - Local Government Act 1972 - background papers
The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.
NB the list excludes:
1 Published works
2 Documents which disclose exempt or confidential information as defined in the Act
None
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Ref/Initials/11-Jan-06