Archived decisions
Report on Commission of Inquiry into Personalisation and the proposed model for adult social care in Hampshire
1. The future of adult social care presents great opportunities and challenges to society, the government, all local authorities, health services and every individual across England. The publication in December 2007 of "Putting People First; shared vision and commitment to the transformation of Adult Social Car"e, a ground breaking concordat, outlined a shared vision for the transformation of adult social care and called for central and local government and the NHS to make a strong commitment to the personalisation of care services over the next three years.
2. "Putting People First" made manifest a commitment to transforming care services by 2011. Transformation involves moving to a more person-centred or `personalised' adult social care system which emphasises the individual's dignity, right to self-determination, choice, control and power over the support services they receive. In response to these issues and with strong cross-party support, Hampshire County Council set up the Commission of Inquiry into Personalisation and the future of adult social care in January 2008. Commissioners from a range of backgrounds and from different parts of the care and political spectrums were then invited to participate to ensure a balance of views, perspectives and expertise.
3. A general call for evidence was made through a press release, a Commission website was established and extensive use was made of Hampshire County Council's publications and the press to raise awareness and encourage participation. Publicity given to the Commission's investigations resulted in detailed evidence being received from members of the public, a wide range of organisations and members of staff in Local Authorities, including HCC. In addition, two pieces of evidence on demographic change and economic diversity in Hampshire were commissioned.
4. Work of the Commission was divided into four main subject areas which became the basis of public sessions held in April, June, July and September covering:
· People and carers
· Funding and partners
· The care market
· The local authority.
5. The Commission concluded its work in early November 2008 and published its report on
25 November 2008. Key findings included a recognition of personalisation being the right way forward but the need for national measures to be implemented to ensure its maximum benefit; an acknowledgement of the pressure on local authority budgets and increasing demographic pressures, the need for fairness in the system; the differences between health care being free at the point of delivery but social care being means tested; the relatively low level of savings and capital `disregard'; the particular problems for older carers and the differing allocations and charging regimes between authorities along with the lack of portability of entitlement.
6. The Hampshire Model : a model for the future of adult social care in Hampshire was evolved and formulated upon the learning and recommendations from the Commission, some of which can only be implemented once there is national acceptance and relevant policy changes. Such recommendations include the following proposals:-
o That there should be an increase in the threshold for means testing from the current level of £22,250 to £50,000 for people with savings and capital.
o That there should be a review of the relationship between eligibility and the tax and benefit system to include removing the overlapping benefits rule for carers who lose their entitlement to Carers Allowance once they reach 65 and receive the state pension.
o That the performance targets for Primary Care Trusts should be reviewed to incorporate measures that give them an incentive to invest in preventative services.
7. Other recommendations that can be implemented without national policy changes include a universal offer of help with information and advice regardless of where people live, how much money they have and whether they are assessed as being eligible for social care and free urgent social care, for up to 8 weeks, for all those at risk of admission to hospital or who are being discharged from hospital and are in need of urgent social care.
8. Action will now be taken on issues within the power and financial capacity of the County Council and its local partners that were raised during the work of the Commission. The direct actions Hampshire County Council will take include:
o Ensuring that personalisation is offered to all, including people who use mental health services and people with drug and alcohol problems.
o Establishing with its partners a joint choice, empowerment and risk policy which promotes transparent practices, incorporating a light touch in relation to audit and an explicit approach to balancing risk with the promotion of choice.
o Moving to a transparent model for all in-house services.
o Supporting service users to lead and undertake monitoring and quality assurance through user-led organisations in order to improve the quality of services available.
o Facilitating provider forums and a stakeholders working group to lead the development and shaping of new services.
o Promoting use of integrated health and social care personal budgets for older people with dementia.
o Through the new Hampshire Senate local authorities at all levels will seek to strengthen the integration of all relevant county and district services.
9. The Commission's report and findings received a positive response at both local and national levels. It will inform and influence the Green Paper and forthcoming legislation on the future direction and funding of adult social care. The proposed Hampshire Model builds on the current self directed support project and further roll out will commence from April 2009 with staggered implementation throughout 09/10 and future years. Implementation will be influenced by resources available, as well as the outcome from the Green Paper but an implementation plan with detailed transition activities, longer term changes, timescales, implementation dates and communications plan is now being formulated.
10. On 22 December 2008, the Cabinet considered a report /decisions/decisions-docs/081222-cabine-R1215103356 detailing the Commission's findings. In welcoming the Commission's findings and noting its recommendations, the Cabinet also approved the Hampshire Model as set out in the Commission report (see Appendix E of the full report contained in the link below). The County Council's response to the consultation `The Case for change - Why England needs a new care and support system' that had been submitted was also acknowledged.
11. The Commission's full report can be accessed on http://www3.hants.gov.uk/getting-personal.pdf