Agenda item

Members were provided with a presentation illustrating the objectives and progress made on Community Led Support as a part of the Adults Transformation Programme. 

Members were asked for their comments on the following vision statement that was presented to them;

‘Community Led Support is about Doncaster residents coming together to shape community services; working alongside teams, across the whole social care and health sector and beyond to build capability, understand local need and develop solutions using existing strengths, assets and resources to maximise community independence and wellbeing’

It was outlined that the focus for Community Led Support will be on 4 hubs (one per locality) and no fixed location had been identified yet as the Council was trialling them in different areas first.  It was recognised that there should be an all age approach.   Members were informed that they would be kept up-to-date about the hubs.

Members raised concern that there had been little progress made with Community Led Support during the last 2 years, since it was first introduced.  Members were informed that the approach had been reviewed in last 6 months to test the vision. 

Concern was raised that residents would face certain upheaval through the changes to be made and may have to travel further to reach their local facility.  Members were reminded of the savings and cuts the Council had made in addition to the investment undertaken to address demographic growth through the Transformation Programme.  It was further explained that the Council was looking to design services specifically to meet needs, and that some positive initial steps had been made.  It was stated that the understanding would be derived through the engagement of what was achievable and what was not.

In response as to whether consideration had been given for a co-location for delivery in youth service provision, it was explained that the hubs will be placed where there is an integrated base delivery and the biggest outcome can be achieved.

Members were informed how in Mexborough, the Youth Club that would have been sold had been taken over through funding and now owned and run by the community.  It was explained that the youth club was being used by day as a day centre and at night as a youth provision. 

During the second part of the report, Members considered the Adults Health and Wellbeing performance results as at Quarter 3 2017/18.  It was acknowledged that despite increasing pressure on Adults Health and Wellbeing (AHWb) services at a particularly challenging time of the year, overall performance had been positive during this quarter.

Some of the performance highlights included;

·         Delayed Transfers of Care

·         Residential Care

·         Direct Payments

·         Learning Disabilities

·         NHS Health Checks

·         People Feeling Safe and Secure

Members stated that the results were impressive

It was explained that progress had been made through looking at the whole system, for example, from how patients were admitted to hospital to being discharged.  It was outlined that the process was very lengthy and it was about getting the patient into it at an earlier stage and seeing what was needed to prime the market.  It was felt that more of an emphasis was needed by looking at risk and what needed to be put in place for the patient to be at home.

Members questioned how many patients returned back to hospital and were informed that this was being scrutinised.  Members were informed that monitoring had taken place through an exercise which tracked 600 individuals after one month, three months then finally after twelve months.  Members were reminded about the work being undertaken through intermediate care with a great deal of work being done with health colleagues.

It was explained that through intermediate care area, (that was contained within the Place Plan) more was being done to consider a sensible challenge around bed based occupancy rates.  It was explained that the Place Plan was focusing on the back end of the problem not the front end and when the Council does intervene, this would be built through a collective of partnerships.

Members stated that they would like to see figures of how many re-referrals took place.  A comment was made that many individuals received care within the home by a carer who was often on a tight time schedule.   Concern was raised that when an accident occurred, an ambulance might be called in response and then the individual became lost in the system.

Members were informed that a great deal of work was being undertaken with Home Care providers and assistive technology

Reference was made to how Doncaster was now amongst the top quartile performers nationally, having previously been ranked in the bottom quartile. Furthermore, Doncaster was highlighted as a “beacon site” for improvements made within Delayed Transfers of Care (DToC) and had featured in the monthly iMPOWER DTOC index.  It was recognised that this was a key example of Health and Social Care Integration working well working together with health colleagues.

Residential Care

It was reported that 1342 of Doncaster adults lived in residential care against a target of 1372.  It was added that people continued to be admitted into residential care, although there was now more of a focus of whether that was the right type of care.

Reference was made to the Resource Panel process which met weekly and looked at individual cases of those put forward by Social Workers.  The cases it considered was for residential and other packages of care through the resources allocation system that went above a certain amount of money and if the client was not admitted to residential care then other types of alternative care would be looked at.  It was agreed that numbers of those admitted could be presented with the next update.

Direct Payments

That in 2015, 15% of social care users on direct payments increased to 27% (760) people.  It was explained that 52% (395) of those individuals employed a Personal Assistant to assist with the delivery of their care and support (this was in addition to the Council and external providers undertaking this role). Members raised concern about safeguarding in respect of financial abuse.

Learning Disabilities

It was reported that there had been a big increase in the proportion of adults with learning disabilities who live in their own home or with their family, increasing from 56.1% in 2015/16 to 84.4% in 2016/17 which was above the target of 78.6%.

Health Checks

Members heard that a promotional campaign during the early part of 2018, may have contributed to figures that had increased in recent months.  It was explained that work had being undertaken with GP practices to ensure that people from more deprived areas were better engaged with.   In respect of the diabetes prevention programme, it was explained that there had been some initial numbers around December time which would pick up in time.

A Member suggested the use of advertisement cards being left out in well attended places to increase the uptake of this. Members were informed about the ‘Safe and Well Checks’ undertaken by the South Yorkshire Fire Authority.

People Feeling Safe and Secure

It was explained that the number of people who said that services had made them feel safe and secure had steadily increased since 2013 to the current level of 87.3% (524 people out of 600 people responded therefore represented example). 

RESOLVED that the Panel note the presentation and report provided.