Agenda item

Phil Holmes, Director of Adults, Health and Wellbeing (DMBC) gave a presentation to the Board explaining the steps being taken to improve access to, experience of, outcomes from and value for money of Adult Social Care, which would both directly improve health and wellbeing for people who came into contact with it and also enable better use of wider resources to support the health and wellbeing of others.

Phil explained that it was intended to try and develop an approach to Adult Social Care that felt like it was more research and data driven, but also critically more about ‘voice’ and talking to people in day to day work.  He stressed that when he stated that services needed improving, he was not being critical of staff who were doing a brilliant job, but that he was being more self-critical, as it was about improving the system within which staff were having to operate.

With regard to the vision and purpose of the Adult Social Care service, Phil stated that the vision needed to start by focussing on the people we are serving and ensuring that the service was right for them.  It was acknowledged that the present system did not always meet expectations and achieve the outcomes that people wanted.  He added that it was hoped to invite people with lived experience to a future meeting to speak to the Board.

He explained that other aspects of Adult Social Care delivery that were being re-framed included:-

• A focus on community prevention and having better conversations when people were in crisis;
• Removing bureaucracy – the best Councils were moving away from red tape and bureaucracy which, for example, meant having appreciative enquiry conversations with people about their specific needs instead of filling out 20 page assessments;
• Ensuring that Adult Social Care was engaged with locality working, with staff who were connected to their local communities;
• Adopting the national ‘Making it Real’ framework which set out a range of ‘I’ and ‘We’ statements which helped set out obligations of service providers and expectations of how people should be treated.

During subsequent discussion, Dr Rupert Suckling referred to the making it real ‘We’ statements and felt it would be useful to incorporate some of these in the next Health and Wellbeing Strategy as an aid for partners to hold themselves to account.  He also asked how the issue of homes and housing was being addressed.  In reply, Phil Holmes confirmed that ‘home’ featured strongly within the vision, and he explained that this was picked up in two of the Making it Real statements, namely ‘The Place I live in feels like home’ and ‘My house has been changed to suit me’.

Lucy Robertshaw suggested that it would be good to have a detailed conversation at the Health and Social Care Forum on this topic at some point in the future.

In reply to a question by the Chair as regards next steps, Phil Holmes explained that as a result of recently changing the case management system used by his service, a number of issues had been highlighted such as why certain forms were being filled out, so there would be a focus on working practices and administration.  A further piece of work currently being undertaken was concerned with looking at flows and hospital discharge, which was related to people’s rights, so that people were more aware of their rights and responsibilities in hospital, and then streamlining the way people were dealt with to increase capacity for getting people home and supporting them.  He also emphasised that these were challenging times and that stress levels were currently high amongst the workforce.

Dr David Crichton stated that he would take away some actions from the Commissioning Group’s perspective having heard Phil’s comments today, as he felt that it was also important that health partners showed their commitment to helping the Adult Social Care service with these processes and proposed changes to how services were provided.  He commented that partners had been forced to work together differently during the pandemic in supporting people and he felt it was important that this new way of working continued in the future.  He also stressed the need to inject more pace in integrating the neighbourhood teams more with health partners to help develop the neighbourhood approach.

            RESOLVED:-

1)        To endorse and give a commitment to supporting the vision and statement of purpose for Adult Social Care in Doncaster;

2)        To endorse the Making It Real framework and work already underway alongside / accountable to people with lived experience to turn the vision into reality;

3)        That Board members note and actively pursue the opportunities provided within the Adult Social Care vision for joint working across the health and care partnership on shared goals e.g. Locality Working / Primary Care Networks, Preparation for Adulthood, Home First / Discharge to Assess, Transforming Care / Mental Health Transformation; and

4)        That Officers liaise with the Chair of the Board to determine any further reporting required, perhaps incorporating time for direct feedback from people with lived experience.