Agenda item

A presentation was made to the Panel around Doncaster's Strategic Health and Social Care.  The Panel received a verbal update on progress made on the Councils’ Adults Health and Wellbeing Transformation Programme alongside Quarter 2 of the 2017/18 performance information.

Members were informed how the programme was about enabling people to stay independent through providing a very different and more personalised offer.  It was explained that this was something that needed to be achieved through integrated services involving health colleagues, as well as building up additional community capacity. 

After consideration of the report and details presented, the following areas were highlighted;

Day Care Services – It was outlined that this was about presenting a range of alternative community led day opportunities for people.  It was stated that there needed to be best interest meetings starting with the individual, looking at their personal needs and that of the wider family to ensure the most appropriate offer.

It was commented that previously there had been concerns about centres in Mexborough that provided a combined service to individuals with learning disabilities alongside the elderly.  Members were also informed that there had been reservations around facilities available to support adult’s with higher dependency needs. 

A Member who had recently visited the centre, commended staff and expressed that there was real warmth present, with happy people being well supported by staff who had an enthusiasm and willingness to embrace change.  The Member praised the community involvement, engagement and interaction that were taking place with local groups using the facilities.  It was recognised that this had been a big change which had resulted in a highly regarded model, with users receiving a better and more personalised service.

Short Stay and Respite Care - Members were informed that a focus was being placed on preventing admissions and there was an opportunity for this within the Place Plan.  Members were told how there were currently four different admission routes to Intermediate Care and how they could be brought together was being reviewed.  It was stated that sometimes individuals were placed in hospitals when they didn’t need to be.  It was added that there should be more of a focus on the outcomes of people to receive the necessary care and respite before being moved on appropriately dependent upon their needs.

Concern was raised regarding those with dementia who had been left and had found themselves in the emergency ward alone. Members were informed that the Rapid Response Services offered a chaperone facility which provided a mechanism for those in hospital at risk of harming themselves.  It was commented that an effective handover point could be when someone was being transported over. 

Home Care – Members heard that this was an area of challenge, where contracts were being looked at to see whether the right provision was in place moving forward.

Supported Living – Members were told that steps were being taken to review the current Supported Living offer to develop a more effective demand management led approach.  It was added that the Council was looking to re-procure this offer by next August and were considering new ways of doing this.

Learning Disabilities – Some expressed that there was a need for a Learning Disability and Autism Strategy.   Members were informed that this needed to be procured in a way that enabled the strategy to be more flexible.

Veterans – Concern was raised that there had been no mention of Veterans, a group that was at particular risk of mental health problems.  Members were informed that there was a specific action plan for veterans who were classed as an equality characteristic.

Carers – Members were informed that significant pieces of work were being done around carers.

Your Life - Reference was made to Your Life Doncaster, supporting a new approach to adult social care, through the development of a website which aimed to provide the necessary resources for Doncaster’s residents to stay independent within their community.   It was questioned whether this could be more localised and branded by town.

Members were informed that powers of general competency would need to be used when the market failed to pick up certain areas.  It was added that interest had been expressed by staff to look at social enterprise models offering an alternative delivery model to provide extra support for a voluntary and community model.  Reference was made to voluntary and community organisations who currently did not charge for their services and it was questioned whether this could be done differently, for example, using direct payments. 

Members were informed that there was work being undertaken which could be brought back to the Panel in the future.

Performance Management - A presentation was provided to the Panel setting out the latest progress on Adults Health and Wellbeing transformation and quarterly performance highlights for Quarter 2.  Areas covered included:

• Financial Position – projected Q2 overspend of £401K (£900k 2016/17, Q1 £469K)
• Residential Care Places
• Admissions To Residential Care (Over 65s)
• Direct Payment Agreements
• Staff Sickness
• Contracts
• Social Care Reviews

Members were informed that there had been 30 positions that had been vacant within adult social care and as a result, systems had not been where they should have been.  Members were assured that that situation had been addressed and wouldn’t be allowed to happen again.

Delayed Transfer of Care – Members considered information presented around delayed transfers of care where performance hadn’t met set targets.  Representatives from the NHS Clinical Commissioning Group commented that this was an issue that would be looked at collectively. 

RESOLVED That the Panel;

1.    Notes the information presented and that consideration should be given to; and

That consideration be given to;

A secondary cooperative being established to support voluntary groups with administration functions.