Archived decisions

Contact: Rea Mattocks, Ext (01962) 847200, [email protected]

1. Summary

1.1 This paper proposes the setting up of a Hampshire Commission on Adult Social Care to explore how to move towards a more personalised service for people in need of support and care. The Personalisation agenda (also known as `Putting People First', Individualisation, Self Directed Care, Total Transformation) is likely to be a fundamental change to the way social care services for adults are being delivered and it is expected that it will bring about much better outcomes for service users and their carers and will ensure that service users are afforded choice, dignity and control in the way they lead their lives. As is often stated by service users, they would like a `life' rather than a set of `services' that lead them into greater dependence on the social care systems, and the Commission will hear evidence on how this can be best achieved and the financial, resourcing and structural implications. It is also imperative to understand the effects that Personalisation will have on the market place and on our commissioning intentions.

1.1.1 Hampshire is already engaged in small pilot projects with people with Learning Disabilities to see how they benefit from `self directed care' and a few case examples are described in Appendix 1.

1.1.2 The moves towards a more personalised service need to take into account the growing pressures in Adult Social Care, including demographic changes, changes in health care and changes in user expectations. We also need to take into account the desire of service users to access a range of resources provided either privately or by the other County Council Departments or by other public sector organisations - for example, taxi services, holidays, care by neighbours, work opportunities, library and recreation services

1.1.3 The outcomes of the Commission will inform the modernisation of Adult Services in Hampshire and inform the Green Paper on the future of Adult Social Care.

1.2 The Commission will support the Corporate priorities:-

Hampshire Safer and more secure for all.

Maximising Wellbeing

2. Recommendations

2.1 The following decision is sought:

That Cabinet:

a) approve the setting up of a Commission on Adult Social Care which will hear evidence and involve leading experts with a view to informing Hampshire (members, staff and citizens) on how social care services for adults can be made more relevant to individuals' needs and how this should be funded into the future.

b) That the following members be nominated to serve on the Commission (name to be determined by Cabinet) as County Council nominated Commissioners:

The Executive Member for Policy and Resources (Chairman)

The Executive Member for Adult Social Care (Vice Chairman)

The Executive Member for Children and Families

The Executive Member for Recreation and Heritage

The Leader of the Liberal Democratic Group (or nominee)

The Leader of the Labour Group (or nominee)

c) That the Chairman, on behalf of the Commission, be authorised to co-opt additional Commissioners, or Special Advisers, to support the Commission as appropriate

d) Other Commissioners, who may be co-opted onto the Commission will be drawn from a variety of potential external organisations and interests, including academia, national organisations, and community stakeholders.

e) Receive a report on the findings of the Commission in November 2008.

f) Ensure that the findings of the Commission inform the Green Paper on the future of Adult Social Care.

3. Background

3.1 Adult Social Care Services nationally are faced with rising numbers of people with increasingly complex care needs. At the same time the public have different and higher expectations of how those needs will be met. As a public sector organisation, the duties to achieve good value and efficiencies, to remain within cash limits, and achieve best possible outcomes are paramount.

3.2 Traditionally, services have developed to meet the needs of groups of people. Inevitably people have been matched to the services available, rather than ensuring their individual needs and choices are met. As a result less than optimum outcomes for individuals and their families have been achieved.

3.3 Personalisation (or individualisation or self directed care) means starting with the person as an individual with aspirations as well as needs and a circle of family, friends and other resources and support mechanisms around them. It introduces the requirement for greater personal responsibility and for individuals to exploit all their own resources, as well as those available through statutory services to meet their needs in the best way possible. The individual is at the centre of the process of identifying their needs and making choices about who, what and when regarding the support and care required to achieve their aspirations.

3.4 Personalisation is at the heart of modernising our service to deliver choice and control and meet the new Outcomes Framework on which our performance will be measured.

3.5 Hampshire County Council is one of the authorities invited to influence the thinking behind the new Comprehensive Area Assessment which will replace the Comprehensive Performance Assessment, and this provides a real opportunity to be at the forefront of modernising Adult Services to improve outcomes for vulnerable people.

3.6 Hampshire County Council has also been invited to influence the thinking on the proposed Green Paper on Funding for Adult Social Care (to be launched in early Spring with a proposed completion date of late summer/early autumn). The Green paper is expected to reform the system of Adult Social Care and support to ensure

· that an affordable system is in place for the 21^st century,

· that state resources are targeted effectively,

· that people have choice and control over the way they live.

3.7 On December 10^th 2007 a Social Care Reform Concordat was signed by:

Secretary of State for Health

Secretary of State for Work and Pensions

Secretary of State for Communities and Local Government

Secretary of State for Children, Schools and Families

Chief Secretary to the Treasury

Secretary of State for Innovation, Universities and Skills

Chair, Local Government Association

President, Association of Directors of Adult Social Services

Chief Executive, NHS

Chief Executive, NHS Confederation

Chair, Society of Local Authority Chief Executives

Chair, Commission for Social Care Inspection

Chair, Social Care Institute for Excellence

Chair, General Social Care Council

Chair, Skills for Care

English Community Care Association

National Care Association

UK Home Care Association

Executive Director, National Care Forum

setting out a shared vision and commitment to the transformation of Adult Social Care. This Concordat is attached at Appendix 2

4. The Hampshire Commission

4.1 The Commission will be chaired by the Leader of the County Council Cllr. Ken Thornber and will have up to thirteen Commissioners drawn from the County Council, and other eminent and expert persons. The Commission will meet four times to hear evidence and there will be a fifth session to review all the evidence and draw conclusions. A report will be published at the end of the Commission.

4.2 The timing of the Commission will be managed to ensure the findings of the Commission can be used to inform the Green Paper as well as identifying a way forward for Hampshire's Adult Services

5. Conclusion

5.1 Personalisation of Adult Social Care Services (also called `Putting People First', individualised services, self-directed care or total transformation) signals a fundamental change in the relationship between people needing support and care and local authorities delivering services. Also subject all services to market forces as people make their own decisions about what services they want. This also brings opportunities and challenges for all departments of the County Council which need to be explored and managed.

5.2 The Commission will hear evidence and involve leading experts with a view to informing Hampshire (members staff and citizens) about the move towards personalisation and begin to change culture. At the same time a greater understanding of the implications of the necessary changes will emerge and actions to maximise opportunities and manage challenges will be developed in response to the findings of the Commission.

5.3 The timetable for the Commission will be managed to ensure that findings will influence and inform the Green Paper on the future of Adult Social Care. It will also identify a way forward for Hampshire's Adult Services.

Section 100 D - Local Government Act 1972 - background documents

The following documents discuss facts or matters on which this report, or an important part of it, is based and have 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.

Appendix 1

Case study examples

Jo - is a 19 year old man with severe learning disabilities, he lives with his mum and dad and younger siblings. 3 years ago he received traditional care managed services - his mum relates how he might have had up to 10 different people support him in one day (to help him get up, to go to school, support at school etc) . Jo had challenging behaviour. His mum decided to try an individual budget when one morning a new carer who had come to help Jo get up rushed into her room when she was still in bed and tried to help her instead (the carer got the wrong bedroom!). Now Jo's mum employs 6 personal assistants. They are all Jo's age (before he was being looked after by mostly middle aged women). He has combined money from the Learning Skills Council (LSC) and Adult Services and his new care package has saved 40k per annum. He has less instances of challenging behaviour. His mum says that prior to the new package she was frightened to help care for Jo in case support was withheld, now she offers to help Jo get up at the weekend knowing that she can use the money saved by doing this, on him going out on a Saturday afternoon, extra activity for him and respite for her. This is a very well-known national case study.

SH - a young woman with learning disabilities living in Hampshire. SH used to go to HCC in house day services. She was depressed and although she lives with her mum and dad they were feeling the strain of caring, especially her mum who would have to leave work early to get back in time for SH (as our in-house day services are open until 3.30). SH decided to take part in the Dynamite Project, a small pilot we ran in Hampshire for young people to receive an individualised budget. SH chose to go to the day services a couple of days a week and receive support from a personal assistant the rest of the time. She has flourished since she has done this, she is no longer depressed and her mum and dad say they feel a burden has been lifted as SH is now able to choose the times she receives support which means her mum does not have to worry about returning home early from work.

IC - a young man with learning disabilities living in Hampshire. He was at a residential school and was due to go to a residential college funded by the LSC and Adult Services. His father helped him develop a support plan and his support plan emphasised how much he enjoyed being with his family and loved seeing them. The residential college was not local and would have meant he got to see his family rarely. The LSC and Adult Services agreed to combine funding to enable him a have a personalised package of care at home. He is really happy and enjoying his teenage years and his family are delighted and able to have him live at home with the support they now get.