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Improving services

Action relating to the Care Act 2014

A headline priority for adult social care in the last year has been to follow the passage of the Care Act and the associated Statutory Guidance through to implementation.

 Update

In particular we have:

  • Commissioned a social care service for prisons commencing in April 2015
  • Prepared for and implemented the new statutory framework for our Safeguarding Adults Board and appointed an independent chair
  • Introduced care accounts
  • Prepared for the implementation of new duties to carers
  • Prepared for the implementation of the new national eligibility criteria for social care

Other priorities include:

Personalisation

Recognising people as individuals who have strengths and preferences and putting them at the centre of their own care and support, whatever the setting.

Action:

Procure a new framework of Direct Payment support providers.

Update:

We completed this procurement and launched the new framework of providers, enabling service users to choose from a range of providers as to who they would like to appoint to provide them with this support.

Action:

Complete and implement the design of a new 0-25 service.

Update:

We launched our new integrated 0-25 service from 1 September 2014 introducing unified education, health and care plans. Since the launch in September 2014 the service has continued to implement the new reforms including the more recent duties placed on us by both the Children & Families Act and the Care Act.

Action:

Implement the next phase of the Better Support for Older People Programme with the closure of one of the council’s two remaining residential care homes.

Update:

In November 2014 the council’s Adults & Housing Committee reviewed the position in relation to the next of the two remaining council care homes scheduled for closure. After considering a range of factors including current supply and demand for care homes, the committee decided that the homes would not close within the following two years.

Action:

Review and improve people’s initial access to information about their options and eligibility for care and support. The aim is for people to be given clear, prompt advice to decide the best route to take and that they are directed to an appropriate assessment or signposted to community and voluntary services. This action is supported by staff as a priority in their day to day work.

Update:

Our customer services officers, adult social care practitioners and health colleagues are continually making improvements in the way they advise and signpost people enquiring about services and their eligibility. We have supported this by implementing Care Act information in a new accessible online format. A review programme of existing information will lead to further improvements.

Action:

Review how we meet the needs of people with mental health needs.

Update:

An adult mental health and wellbeing needs assessment is nearing completion and a strategy and action plan are currently being developed in close partnership with key stakeholders in the Clinical Commissioning Group (CCG) and other statutory and voluntary agencies

Equitable access

Making access to health and social care easily accessible to everyone, no matter where they live, their age or circumstances.

Actions:

Assess the intensity of day care services to individual service users, but not the availability, to ensure that the extent and balance of service intensity is appropriate, using benchmarking data for other local authority areas,

and

Review our decision making criteria for determining the type, extent and setting for the delivery of care packages to ensure an appropriate balance is achieved between the care and support needs of an individual and its cost to the community.

Update:

This work was ongoing as at 31 March 2015. Research undertaken during the year showed that in South Gloucestershire there are greater numbers of older people and people with physical and sensory disabilities receiving day services that in other comparable council areas. Research also suggested that to an extent this was due to historic, rather than current, patterns of undertaking and responding to needs assessment. Finally the cost of day services for people with learning difficulties appear higher in South Gloucestershire than in other local authority areas.

We are continuing and will complete this work in 2015/16.

Action:

Adopt a more generic model for people seeking accommodation via HomeChoice to be supported and to make the transition into their new home.

Update:

We implemented change to improve the support from social care practitioners whose service users require and seek supported housing.

Value for money

Working with partners and communities to make best use of available resources in a climate of demographic and financial pressures, so that people have choice from a wide range of high quality support and services to achieve better outcomes

Action:

Introduce a payment card system for direct payments.

Update:

We implemented the new payment card system for all current and future service users who receive their personal social care budget as a direct payment.

Action:

Implement approved changes to the council’s in-house day services following completion of the ‘What people do in the day’ service review.

Update:

We completed the review of our in-house day services which demonstrated falling attendance levels through new service users making alternative choices other than attending traditional buildings-based day services. We addressed the issue of over-capacity and built upon existing expertise, focusing improved services in Yate and Kingswood whilst closing Downend Day Centre.

Action:

Implement the outcomes of Children, Adults and Health Integration Projects, including:

  • Commissioning Hub
  • Information Systems and Performance Management.

Update:

As part of our work to build a new single department for Children, Adults & Health we completed both of these integration projects – bringing together into single teams most commissioning staff and staff whose role delivers information systems and performance management support.

Skilled workforce

Working together to continue our whole-sector approach to workforce planning and development, understanding the impact of personalisation and self-directed care to shape a workforce skilled to meet new and future demands.

Action:

Commence a project to ensure our adult social care workforce is balanced in its ratio of qualified and non-qualified staff.

Update:

The agreed actions to support initial implementation of the Care Act have been completed. The next stage is to design the shape of the future service that moves towards greater integration with health, provides extended access to service and refines pathways and uses resources effectively.

Strong partnerships in a developing local market

Exploring and agreeing with our stakeholders “what sort of lives do people who need support or services want to live?” and “what services should we provide to help them achieve that?”

Action:

Complete the re-procurement of community based support services, including home care and day care.

Update:

We implemented a new framework for all community based care and support services (other than housing related support) in 2014.

Action:

Re-procure short break capacity.

Update:

We postponed this work into 2015/16 to ensure sufficient capacity to undertake it and to provide the opportunity to engage and work with a nominated local carers’ group to understand the issues they encounter.

Action:

Re-procure carers’ support services.

Update:

We agreed a new service with the Carers’ Support Centre in 2014, bringing together a series of previous arrangements across adults’ & children’s services.

Action:

Procure a new expandable Shared Lives service capable of meeting demand to maximise benefits.

Update:

In September 2014 our Adults & Housing Committee agreed to commission an external partner to deliver an expanded Shared Lives service, exploring the possibilities of a social enterprise model. We are still working towards a new service to launch in 2015/16.

Action:

Begin the re-commissioning of our framework for care home placements.

Update:

We have commenced work on a new care home framework and remain on course to implement this is the second half of 2015/16.

Action:

Finalise our Better Care Fund proposals, submit to NHS England, and commence implementation of our plan for Integrated Health and Social Care Services.

Update:

In partnership with South Gloucestershire Clinical Commissioning Group (CCG) we finalised our Better Care Fund Plan, achieved sign-off by NHS England, and agreed governance structures for implementation from April 2015.

Action:

Publish and implement our service quality framework for domiciliary/home care services. Start development of an equivalent quality framework for care home and day care services.

Update:

We implemented a new service quality framework for domiciliary/home care services and commenced development of an equivalent quality framework for care homes are part of our work to procure a new framework agreement with care home providers

Action:

Publish a market position statement setting out our analysis of the local market for care services and our future commissioning intentions.

Update:

We published our first market position statement in April 2014 and in preparation for a market engagement event for providers of care homes and extra care housing on 24 April, we undertook further market analysis. Planning commenced for Working towards approval of the statement at committee in March 2016. A refreshed market position statement is planned for April 2016.