Archived decisions

HAMPSHIRE COUNTY COUNCIL

Report

1. Purpose of Report

1.1. The purpose of this report is to give an update on the transformation of Adult Social Care and progress on the Hampshire Model. Specific reference is also given to the work around the Free Crisis Care pillar of the Hampshire Model and the early intervention work being undertaken through Community Innovations Teams

1.2. There are two fundamental parts to the transformation of Adult Social Care:

· Personalisation - helping people to live their lives as they choose, the way all public services are shaped to suit the individual's needs [Hampshire Model]

· The Green Paper

o The funding debate - a fairer and more sustainable approach to the funding of adult social care

2. Contextual Information

2.1 The concordat "Putting People First - a shared vision and commitment to the transformation of Adult Social Care", made manifest a commitment to transform social care in this country by 2011. This involves moving to a more "personalised" system which emphasises the individual's dignity, right to self determination, choice, control and power over the support they receive. The vision gives greater recognition to the importance of prevention along with building community capacity and requires a whole system change.

2.2 In 2008 HCC undertook its own investigation into the future of a personalised social care system through a wide ranging consultation process. As a result it developed the Hampshire Model of Personalisation and this now frames the work of the Adult Services Department and the County Council.

2.3 The Hampshire Model is a holistic and practical model to `put people first'. This is not just about adult services or social care; it is designed to stretch across all county council departments covering everything from transport, to recreation, culture and other services. In this way the model creates the opportunity for more integrated services and builds on the benefits of working in partnership.

2.4 Following the recommendations made by the Hampshire Commission six key areas were identified in order to address the areas of concern raised by the citizens of Hampshire. These 6 key areas are:

· Universal Offer - Access to Information and advice

· Free Crisis Care - To offer free crisis care for those who meet our eligibility criteria and who are at risk of admission to hospital or long term residential and nursing care, and at point of hospital discharge, when the risk of loss of independent and re-admission are high.

· Self Directed Support (SDS) - People will be able to make choices about how they want to live their life and the social care they need to have to help them to do that.

· Carers - To position Hampshire County Council's cares support and information solutions at the forefront of best practice

· User Involvement - to engage with service users throughout this process through their own user led organisations at a local and national level.

· Market Development - developing the care market to support individual choice

2.5 Alongside these 6 pillars, there are two additional transformation streams which are:

· Learning Disabilities Transformation - to transform the services we deliver to people with a learning disability and their carers.

· Process and Efficiency - to create a modern business which provides responsive customer focussed and efficient services.

3. Free Crisis Care - Community Innovations

3.1 As well as providing an update on the Hampshire Model and progress being made in relation to the transformation of social care, this report also gives a specific update on the Free Crisis Care pillar and the work being undertaken around early intervention and the role of the Community Innovations Teams.

3.2 Community Innovations is a key element of free care that is about targeted intervention to prevent crisis. This early intervention work has already been piloted through the LAA Flagship Community Innovations Project. The Community Innovations teams are multi-disciplinary and multi-agency in nature and include staff from Adult Services, health and the voluntary sector.

3.3 The teams explore ways of promoting well-being of older people at risk of losing their independence but who are not yet in crisis. The teams strengthen people's links with local communities, and aim to reduce their need for emergency and other services such as emergency hospital admissions and home care by intervening when problems first start to emerge rather than waiting for a crisis to occur.

3.4 The Community Innovations teams also help strengthen the capacity of the community to respond, and provide opportunities for older people to stay active and independent. Seven teams are already in place throughout the county and a further nine are planned. It is anticipated that the nine new teams will be in place by April 2010 in line with the objectives stated within the Commission of Inquiry into Personalisation and the Hampshire Model.

4. Making the Transition

4.1 Across all the workstreams, the way in which existing services are delivered and ways of working will need to be developed to extend the personalisation of services across all aspects of social care. Work programmes reaching across all areas of service delivery are focussing on Governance and risk, Finance and resources, Quality and performance, Workforce and practice, Partnerships, Engagement and communications, and Infrastructure.

4.2 Developing personalisation in existing services

4.2.1 Personalisation must include people already in existing services such as residential care and day centres, and people who want to keep getting traditional care services must be able to choose that if they wish. People will have choices, and this includes people in community based settings with a personal budget and people in residential care. All service users will be offered a choice of traditional and new-style services. The costs of services provided by Hampshire County Council itself will be clear to people.

4.3 Workforce and culture

4.3.1 Personalisation will bring important changes to social care work and this will mean more of a variety of working roles. There will be a shift away from traditional care management to new ways of working. Hampshire County Council will involve the social care workforce at every stage of this process and widely promote understanding of Personalisation. The following new style support roles will need to be developed:

· People who pay for their own care will need to be able to gain advice and information.

· More people will want to have a Personal Assistant, and we will look at ways of making it easier for people to employ PAs, which may include the local authority being the employer.

· Different styles of brokerage and advice services will need to be developed both within the local authority and in the community so that people have choices.

· Training and organisational change will need to be supported within the local authority workforce and in the wider social care sector.

4.4 Funding

4.4.1 Hampshire County Council will need to talk to other organisations involved in funding social care, and review available funding to ensure the implementation of Personalisation is successful. Recommendations have been made at national level by the Commission about funding for adult social care. The costs of making all the changes to do with Personalisation will need to be worked out, including the effects of the changes, and will make a plan of how the costs can be met.

4.4.2 Under the Hampshire model there will be a clear process for people to find out what money they are entitled to for their social care, including money from the local authority and from other sources such as the Independent Living Fund, Disabled Facilities Grant, Supporting People, and Continuing Health Care. An individual who is eligible for some money will know clearly what money is available to them and how to access it. They will be offered a personal budget where it is clearly set out.

4.4.3 The way of working out the care someone needs, the financial costs of the care and any financial entitlement is through a process called RAS (Resource Allocation System). This process will be clearly set out so that people know what is involved. Everyone, including people who will pay for all of their own care, will be able to use a RAS to work out what care they need, what it will cost, and how much they will have to pay.

5. Green Paper: Shaping the Future of Care Together

5.1 The Green Paper sets out the Government's vision for a new care and support system in recognition of the fact that the system needs to be made fairer, simpler and more affordable for everyone. Feedback in Hampshire confirmed overwhelmingly that local people feel the system is unfair, particularly penalising those people who have managed their money well and saved for the future. The three key areas covered in the consultation are:

· The proposal for a new `National Care Service' with feedback invited about how the service would work

· How to ensure that choice over quality and joined-up services are achieved in a new National Care Service, and what the barriers to success might be

· Options for funding the National Care Service and whether funding decisions should be made at national or local level

5.2 Hampshire County Council's response to the Green Paper was presented to 26 October Cabinet and builds on Hampshire's public Commission of Inquiry into Personalisation held in 2008. the work of the Commission has since been followed up with consultations on the Green Paper with service users and carers including a Service User and Carer Conference and presentations to Older Peoples Forums around the County.

5.3 Many aspects of this funding Green Paper echo the findings and recommendations of the Commission. For example, ahead of the Green Paper, the Commission's report last year called for:

· 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.

· Free social care for a set period for all those at risk of admission to hospital or those people being discharged from hospital, and in need of urgent social care.

· An increase in the threshold for means testing from the current level (now £23,000 at April 2009) to £50,000 for people with savings and capital.

· The replacement of the current charging regime with a personal contribution model that supplements the individual budget that a person will receive.

5.4 The Green Paper focuses heavily on the older people population and does address issues relating to the care and support issues facing people with learning and physical disabilities and mental health issues. Although the population of older people is by far the largest of the care groups, hence the Department of Health's focus in this consultation on their needs, there are also significant demographic and cost pressures in Learning and Physical Disabilities. People in these care groups are living longer with much more complex care needs, and the paper does not adequately address how their care will be funded in the future.

5.5 Please see attached link to the Cabinet Report: /decisions/decisions-index/index-docs-7132

6. Conclusions

6.1 This is the first of a series of briefings on the Hampshire Model and the progress being made for the transformation of social care in Hampshire.

IMPACT ASSESSMENTS:

1. Equalities Impact Assessment:

1.1 An impact Assessment has either been completed or is in the process of being completed for each element of the Hampshire Model and account has been taken of the requirements of the Corporate Equalities Plan and Race scheme.

2. Impact on Crime and Disorder:

2.1. The County Council has a legal obligation under Section 17 of the Crime and Disorder Act 1998 to consider the impact of all decisions it makes on the prevention of crime.

3. Climate Change:

3.1. How does what is being proposed impact on our carbon footprint / energy consumption?

a) How does what is being proposed consider the need to adapt to climate change, and be resilient to its longer term impacts?

No impact has been identified, since this report is an update and no recommendations are being proposed.