Archived decisions

HAMPSHIRE COUNTY COUNCIL

Decision Report :

EXECUTIVE SUMMARY

1) Summary of Decision Area:

1.1. The annual performance assessment rating for the County Council's Adult Services Department as determined by the Commission for Social Care Inspection (CSCI).

2) Issues Covered in Report:

2.1. The 2008 performance rating for councils with adult social care responsibilities was announced by CSCI on 24 November 2008 and is requested to be taken to a public committee of the Council within two months of publication.

2.2. The County Council has been awarded 3 stars, the highest rating, for its adult services for the second year running. This retains the Council's position in the top quartile.

2.3. This reports sets out the key factors which led to the two judgements and how the proposals for Hampshire Model for Personalisation also presented to Cabinet today will encompass several of the `areas for development' identified by CSCI. The judgements which form the overall star rating are:

Delivering Outcomes: Good - a service that consistently delivers above minimum requirements for people, is cost effective and makes contributions to wider outcomes .

Capacity to Improve: Excellent - the council has a clear vision and ambitious strategic direction, communicates this effectively and organises the necessary resources required for delivery and meets value for money requirements

2.4. The Delivering Outcomes judgment contributes to the Comprehensive Performance Assessment rating for the County Council.

2.5. This report includes as Appendix 1 the CSCI Performance Summary Report of 2007/08 for Hampshire.

2.6. Set out in Appendix 2 are the Council's 2007/08 outturn results for the Performance Assessment Framework (PAF) performance indicators.

3) Recommendations:

It is recommended that Cabinet:

3.1 Agree to the publication of the CSCI Star Ratings and Summary report on the County Councils' website.

3.2 Commend the sustained level of performance which is at the highest level; and the contribution of elected members and staff across the Council in this achievement.

3.3 Support the development of an Improvement Plan for submission to CSCI in January 2009.

MAIN REPORT

1) Purpose of the Report:

1.1 To inform Cabinet of the Commission for Social Care's (CSCI) Annual Performance Assessment rating for Adult Services for 2008.

1.2 To set out how The Hampshire Model for Personalisation will address the medium term `areas for development' identified by CSCI.

2) Context

2.1 The 2008 performance rating for councils with adult social care responsibilities was announced by CSCI on 24 November. Council's are requested to present the CSCI Summary Report to a public committee within two months of publication.

2.2 The County Council has been awarded 3 stars, the highest rating, for its adult services for the second year running. The two judgements that form this overall star rating are:

Delivering Outcomes: Good - a service that consistently delivers above minimum requirements for people; is cost effective and makes contributions to wider outcomes.

Capacity to Improve: Excellent - the council has a clear vision and ambitious strategic direction, communicates this effectively and organises the necessary resources for delivery and meets value for money requirements.

2.3 The Delivering Outcomes judgement contributes directly to the Council's Comprehensive Performance Assessment rating awarded by the Audit Commission in February 2009.

3. Key Issues

3.1 Delivering Outcomes: Strengths.

3.1.1 The Council is judged to be `good' in delivering 6 of the 7 outcomes for adult social care and `excellent' in enabling Hampshire residents to make a positive contribution (maintaining involvement in local activities and being involved in policy development and decision-making). Examples include: Adult Services User Survey - 83% satisfaction, consultation on the Council's Wellbeing Strategy for the 84% of people who do not intensively use health and social care services, user workshops and public engagement events run or commissioned by the department to enable contributions to policy and practice development e.g. Older Person's Mental Health Strategy, Carers Strategy and the review of Safeguarding processes.

3.2 Delivering Outcomes: Areas for Development

3.2.1 CSCI identified 48 `key strengths' and 14 `key areas for development' in this area based on the department's self-assessment and additional evidence, for example service inspections. Nine of the areas for development, such as Extra Care Housing and Direct Payments, are brought forward from the 2007 assessment as CSCI recognise action is planned over two or more years. However three of the areas for development are concerned with the Council's performance in increasing the number of Adult Services clients who use Direct Payments and significant improvement is required in 2008/09. Others require specific actions such as improving data quality and all are on course for achievement to plan. There is strong resonance between several of the CSCI areas for development and the Hampshire Model for Personalisation contained in the Commission of Inquiry Report presented to Cabinet today. Examples of outcomes and services where the Hampshire Model will deliver improved performance include:

(i) Implement a Single Assessment Process between Health and Social Care. The Model proposals include person centred needs assessment as part of the universal offer, access to self-assessment and a commitment to single point of access and Common Assessment Framework across Health and adult social care services in Hampshire.

(ii) Advocacy Services. Access to free good quality information, self-assessment, advice and advocacy is also proposed under The Model, together with partnership work to support and encourage the development of self help groups

(iii) Telecare. This area is carried forward and is on course to achieve its 2008/09 plan. The Hampshire Model supports targeting Telecare through the proposal to offer free urgent care for up to 8 weeks for people discharged from hospital and to avoid hospital admission

3.3 Capacity to Improve: Strengths

3.3.1 The Council is judged to be `excellent' in both domains of Leadership

and Commissioning/Use of Resources. 18 key strengths are identified including ambitious and competent leadership by elected members and senior managers who deliver objectives within budget. CSCI commented "The council successfully achieved their two-year financial recovery plan and ended the year slightly under budget. Although the plan was ambitious this was achieved through strong leadership and a clear link between financial stability and modernisation". Further strengths noted include corporate and external partnerships, reduced staff absence levels in adult services - now lower that the average of similar councils, training for independent sector delivered through the PACT programme and performance management which is well embedded with effective arrangements in place. Commissioning and Use of Resources strengths include the Joint Strategic Needs Assessment; use of resources clearly reflecting local and national priorities. CSCI noted in particular "Total cashable efficiency gains achieved during the year equate to £5,237,000, which is significantly higher than the comparator average". Further strengths identified include: advice and information to self-funders including the award winning Care Choices website.

3.4 Capacity to Improve: Areas for Development

3.4.1 Of the three areas for development, two are brought forward from 2007/08. Delivery of the Electronic Social Care Record will be completed in 2008/09. Two development areas are key components of the Hampshire Model:

(i) To enhance and support the developing personalisation agenda, the council must continue to embed countywide successfully trialled local services. The Hampshire Model is for personal budgets and Self Directed Support to be offered to all people eligible for Adult Services support. It also includes proposals to develop or extend other services including Community Innovations Teams, the Wellness Recovery Action Plan (WRAP) and the OPAL project, a partnership between the Council's Older People's Well-Being Team, Age Concern Hampshire and Hampshire Voluntary Care Groups Advisory Service.

(ii) The Council continue to engage in discussion with the local PCT about priorities for joint working and acknowledge there is a need to further develop joint working countywide before extending any further pooled budgets. The Council and PCT already have a number of partnership arrangements in place where these best meet the needs of local residents including mental health services, the ENHANCE nursing homes and learning disability integrated services. As demonstrated through other examples in this report The Hampshire Model includes many examples of how joint working with the PCT will be progressed across the County.

4. Performance Assessment Framework (PAF) National Indicators

4.1 The national PAF indicators for adult social care were used to assess performance, for the final time in 2007/08. They have been replaced by the National Indicator Set. The corporate half - year performance report presented to Cabinet today provides information about NIS performance in the current year, including Adult Services.

4.2 With regard to the PAF in 2007/08, in Hampshire, 91% had improved performance on the previous year with 55% achieving the highest CSCI banding. As a high proportion of PAF's are already in the top band ensuring continued improvement was a challenge and some were no longer consistent with local priorities for adult social care. For example C28 Intensive Care at Home is inconsistent with the reablement model developed and provided by the Council's Community Response Service Consequently any improvements needed to meet the following criteria:

· Where advancement was in line with the Council's priorities for adult social care

· To keep pace with population growth. For example approximately 250 additional older people needed to be supported to live at home just to maintain performance

· Where `smarter' working was identified. For example ensuring best practice is shared between teams to help improve performance and outcomes for clients

· Where advancement to the next performance `band' is affordable.

4.3 The departments 2007/08 outturns against the PAF indicators are set out in Appendix 2.

5. Conclusions:

5.1 The Council has sustained its Adult Services performance at the highest level and now needs to focus on implementing the Hampshire Model for Personalisation to ensure that it remains amongst the top performing councils in the country.

5.2 Focusing on delivering better outcomes and quality services will best meet the needs of Hampshire residents. Offering Direct Payments to all clients to purchase their own care and support is the highest short to medium term performance priority.

6. Recommendations:

Please see Executive Summary for recommendations

CORPORATE OR LEGAL INFORMATION: