In 2022-23 we laid the foundations for a two-year programme of improvement which commenced in April 2023. By the end of March 2023 we had made significant progress with a number of key objectives.
- The publication of a Market Sustainability Plan 2023-25. The plan summarises the challenges facing the care market and identifies the way that providers and the County Council will work together to address these.
- Progress towards an improved model of intermediate care to provide a joint NHS and social care reablement service which will support people to be discharged from hospital to their home. The service will also help to prevent unnecessary hospital or residential care admissions. (Intermediate care is short-term support to help people recover and regain their independence, for example, after a stay in hospital).
- Mapping business processes across the service to identify areas for improvement to be delivered through 2023-24 and beyond.
- Progressed work to deliver a new pathway and protocol to support children and young people with mental health needs.
- Continued work to extend engagement and co-production across the service.
Looking ahead and what’s happening now
In April 2023 we began a two-year improvement programme which comprises six workstreams and two overarching areas of work.
Commissioning – The planning, purchasing and monitoring of services to meet people’s needs.
- Development of a modern and cost-effective commissioning strategy and to build on our Market Sustainability Plan to shape, manage and support the care market.
- Collaborative working with partners and stakeholders to:
- strengthen our information, advice and guidance offer with a focus on early support and signposting to preventative services and making best use of information technology and artificial intelligence (AI)
- increase the range of options to support people’s wellbeing and independence to prevent an escalation of their needs, and to increase people’s choice and control
- piloting the use of Individual Service Funds. This is where a person’s personal budget is paid to a provider who manages the money on their behalf and works with the person to plan their support to meet their goals or outcomes.
- Reviewing our 30 year contract with Shaw Healthcare for residential and nursing care home beds to ensure that it meets current needs.
Practice and operational
- Embedding a strength-based approach to delivering social care support which involves working with people to identify their capabilities and existing support networks to help them remain as independent as possible and to prevent or delay the development of their needs. This approach places people at the centre of the assessment process.
- Reviewing all staff practice guidance documents to ensure they reflect changing policy and legislation.
- Working with Children’s Services to improve the experience of young people transitioning from Children’s to Adults’ Services.
Finance and systems
- Increasing the number of people receiving direct payments and the uptake of pre-paid cards which is a more efficient way to make payments for both the person and the County Council.
- Development of an online payment platform (portal) for domiciliary care providers to submit invoices and view the status of payments.
- Exploring more opportunities to integrate digital technology into our work, including AI and online assessments. Mindful of the challenges related to digital access for some people in our communities, we will take account of feedback from people we support and other stakeholders.
Workforce and organisational development
- A workforce strategy which references how we support, develop, recruit and retain staff.
- Being clear about the roles and responsibilities of our workforce.
- In preparation for social care reform in October 2025, we will be exploring trusted assessor approaches. This is where another organisation has responsibility to undertake assessments on our behalf under a formal agreement.
Performance and intelligence
- More widespread and consistent use of quality data and intelligence to inform service developments, for example, increased use of the Joint Strategic Needs Assessment and a focus on analysis and research to support the development of our market position statements.
- Ensuring effective financial reporting for budget management oversight.
- Further development and embedding of performance frameworks to manage how information is used and to monitor performance levels.
Systems and partnership working
- Working with the NHS to extend intermediate care (providing short-term support to help people recover and regain their independence, for example, after a stay in hospital).
- Strengthening our hospital discharge service.
Overarching workstreams
Care Quality Commission (CQC) Assurance (2023-25) readiness – The CQC has a duty to review and assess local authority performance in delivery of their adult social care duties.
There are four areas of focus.
1. Working with people - Assessing needs, supporting people to live healthier lives, prevention, wellbeing, information and advice
2. Providing support - Markets (including commissioning), integration and partnership working
3. Ensuring safety - Safeguarding, safe systems and continuity of care
4. Leadership - Governance, learning, improvement, innovation
We have been analysing our compliance with our duties under the Care Act 2014 and the ‘I’ statements that CQC will evaluate us against. These statements are based on the Think Local Act Personal’s ‘Making It Real’ framework which reflects what people expect from their services. We have developed our self assessment which will be subject to regular review in preparation for submission to the CQC when the Assurance process begins.
Communications and change – Managing all communications and change for the Improvement Programme.