Adult Social Care Business Plan. 2020/2021

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Adult Social Care Business Plan. 2020/2021

“Together we can deliver a better quality of life

in Southwark”

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Our Vision for Adult Social Care

“Members of our community can access high quality information, advice and coordinated

community services that prevent, reduce and delay their needs for social care support. Adults with

eligible support needs and their carers have access to services which maximise independence and

choice, and enable them to live healthy, safe and fulfilling lives in their community”.

In the previous Business Plan my predecessor noted the unprecedented financial challenges that

the council has had to weather. We can be proud of how we have navigated these challenges. We

have continued to invest in our communities, our workforce and also our infrastructure.

The majority of my tenure as Director for Adult Social Care so far been spent leading the division

through the COVID-19 pandemic. For many of you these have been both professionally and

personally challenging times. I have been immensely impressed (although not at all surprised) by

the commitment of our workforce. It is telling that we are still able to deliver the range of services

that we do, to continued high levels, even during these difficult times. We know our services make

a real and positive impact on the lives of our service users because they tell us so. Adult Social

Care interventions save lives and make lives better.

The pandemic has presented opportunities as well as challenges. Like local authorities up and

down the country we have had to work in new ways. We have had to consider how we can utilise

technology to achieve better outcomes. We have had to be innovative. Where we have achieved

positive outcomes through these new ways of working it is important that we maintain the positive

momentum once things return to ‘normal’.

This document sets out our vision and priorities for the period April 2020 to March 2021. Many of

the goals set out in this business plan have been carried over from the 2018/19 – 2019/20 plan so

the document will have a familiar look and feel. We plan on undertaking a larger scale review for

the period 2021 and beyond, we will use this review to consider the lessons from the pandemic,

and also learn more from residents and staff about their priorities. We will also take the opportunity

to more closely align our business plan to the soon to be revised Council Plan.

I want to thank you for the invaluable work that you do and your ongoing efforts. We are only able

to carry on, to realise the council’s vision, and that of adult social care, through your hard work and

commitment.

Pauline O’Hare. Director Adult Social Care

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Adult Social Care – Vision and Strategic Priorities

Together we can

deliver a better

quality of life in

Southwark

Workforce. Establish a Workforce

Strategy which promotes a

strengths-based culture spanning

all levels of staff structure and

covering all areas of work across all

service areas, supported by

continuing professional

development as steered by Social

Work and Occupational Therapy

Professional Leads.

Preventative Services. Develop

hub model to be delivered via

Southwark’s voluntary and

community sector, in order to

enable people to remain

independent, improve or maintain

their wellbeing, and to prevent/

reduce the need for the provision of

statutory support by the council.

Community and Accommodation

Based Support. Utilise effective

and efficient community and

accommodation based services

that improve and maximise

people’s independence in

collaboration with placements and

commissioning.

Ensure value for money and

quality is at the heart of service

provision. Deliver services within a

reduced budget while ensuring high

quality, effective and efficient

services worthy of Southwark

residents.

Service Redesign. Work with our

partners to develop pathways

across the whole health and social

care system to improve and

maximise independence, maintain

and/or improve wellbeing, and

reduce the need for hospital and

long term care.

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Goal Deadline Why this goal is important Sponsor Lead

1. Workforce. Establish a Workforce Strategy which promotes a strengths-based culture spanning all levels of staff structure and

covering all areas of work across all service areas, supported by continuing professional development as steered by Social Work and Occupational Therapy Professional Leads.

1.1 Embed a strengths-based model across all areas and all levels of work including management, supervision, practice and all contacts with service users and carers.

Dec 2021 Delivering the ASC vision requires a confident, capable and well-trained

workforce which is at the forefront of empowering people to have

independence and choice, and enabling them to stay healthy and active.

Recruitment and retention will continue to be a priority to ensure that

people with the right potential are recruited to adult social care, and are

retained. The development of a workforce with the right skills, knowledge,

values and attitudes to provide high quality social care is a priority.

Wendy McDermott

Annie Ho/ Hannah Moorhouse

1.2 Promote and maintain oversight of workforce development including comprehensive learning and development offer for staff, staff progression and retention, and practice development

Dec 2021 Wendy McDermott

Annie Ho/ Hannah Moorhouse

2. Preventative Services. Develop a hub model to be delivered via Southwark’s voluntary and community sector, in order to

enable people to remain independent, improve or maintain their wellbeing, and to prevent/delay/reduce the need for the provision of statutory support by the council.

2.1 Develop and launch the disability hub delivered out of Southwark Resource Centre

Oct 2021 The Care Act places an express duty on local authorities to ensure that

information and advice is available to local people, including information

about the care and support system locally, how to access care and

support, the choice of types of care available in the area and with

information about how the care system operates. The Hub model is well

placed to meet the wide ranging issues that Southwark residents have,

and also provides a more connected and sustainable model than is

currently being delivered. We believe that it also provides a better model

for preventing, delaying and reducing the need for care and support, and

also meeting some needs (including building based day services) with the

delivery of joined up information, advice and support.

Pauline O’Hare

Cynthia Davis

2.2 Develop and launch the older persons hub

Sept 2021

Pauline O’Hare

Cynthia Davis

Adult Social Care – 2020/2021 Strategic Plan

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2.3 Develop a clear carers pathway to support healthy and lasting carer/cared for relationships and – Prevent, delay and reduce the

onset of needs.

ensure timely access to

information, advice & support;

deliver timely & appropriate

interventions and reviews.

Jan 2021 Under the Care Act, the council has a duty to -

Prevent, delay and reduce the onset of care and support needs of

Southwark residents

Meet carers eligible needs

We recognise the valuable contribution that carers make in Southwark.

We are committed to supporting carers in their role. This can delay or

reduce the need for intensive long term support for the cared for person

and help to maintain carers health and wellbeing.

Simon Rayner

Sam McGavin

3. Community and Accommodation Based Support. Utilise effective and efficient community and accommodation based

services that improve and maximise people’s independence in collaboration with placements and commissioning.

This objective is primarily being led on by colleagues in the Commissioning division. We will work alongside our commissioning colleagues to deliver several significant objectives set out in their business plan, including projects focused on –

Mental Health Accommodation and Support re-design Nursing care for adults Learning Disability Accommodation & Support Redesign and Procurement

Residential (accommodation-based) care for adults Review of Telecare The dementia care pathway

For more information you can view the Commissioning business plans here.

3.1 Design and commission health,

social care, other council and 3rd

sector services to deliver an

improved pathway for adults

leaving acute care for community

placements.

We want to do things differently with and for our local communities.

Collaboration through Partnership Southwark (as part of a South East

London Integrated Care System) will enable us to reduce growth in

demand through better integration and by shifting resources to invest in

prevention, self-management and early action.

Partnership Southwark will also include voluntary sector organisations so

that we can tackle the causes of health inequalities and prevent illness.

You can find more information about Partnership Southwark here

Pauline

O’Hare/

Jo Kent

Haley

Ormandy

https://proceduresonline.com/trixcms/media/4414/commissioning-combined-business-plan-2018-19.pdf

https://www.southwarkccg.nhs.uk/our-plans/partnership-southwark/Pages/default.aspx

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4. Service Redesign. Work with our partners to develop pathways across the whole health and social care system to improve and

maximise independence, maintain and/or improve wellbeing, and reduce the need for hospital and long term care

4.1 Full implementation of the

Intermediate Care Southwark

model bringing together all urgent

response, short term

rehabilitation and reablement

functions to create one co-

ordinated health and social care

delivery model.

Note: The Reablement service in question refers to

OPPD/not MH Reablement

Mar

2021

The Intermediate Care Southwark service is being developed in order to –

Improve people’s personal outcomes and experience.

Better co-ordinate care around the person.

Streamline the pathway, simplifying access, avoid duplication and

reduce handoffs.

Improve integrated working and provide connectivity across the

whole system.

Build on what works well and develop a shared and robust working

culture.

Align with the developing Local Care Networks and work towards

becoming population rather than service focused.

Increase the number of people accessing short term rehabilitation

and reablement.

Improve outcomes to enable more people to live independently at

home.

Victoria Nestor

Suzanne Roberts

4.2 Redesign the current reablement

service (which includes the RSW

contract) to ensure a flexible

reablement service to deliver the

new integrated model (linked to

4.1 above)

Note: The Reablement service in question refers to

OPPD/not MH Reablement

Jun 2021 In May 2015, work commenced on developing an integrated health and

social care urgent response, short term rehabilitation and reablement

delivery mode (see 3.1). A critical part of the model is access to a pool of

Reablement Support Workers (RSWs) who can provide support across all

client groups and conditions. RSWs will work jointly with therapists and

social workers to enable people to maximise their independence or

recover from illness or injury. As the current reablement model does not

‘fit’ with the new service design, a transition plan is required to move from

the current way of working in reablement to ‘new reablement’ and

supporting Southwark’s new integrated model. As well as different

contractual arrangements, there is a need to develop a new culture of

practice, quality measures, structures, process, and procedures, also

introduce an E-Rostering system.

Victoria Nestor

Wendy McDermott

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4.3 Fully realise the council’s vision

for Flexi-care, requiring a shift

from traditional Extra Care to a

modern Flexi-Care housing and

support model.

Southwark has 3 extra care schemes for people aged 55+ with care

needs. Planned developments (Tayo Situ phase 2 and a fourth scheme on

the Aylesbury estate) will provide approx. 100 additional flats by 2021.

We want to ensure that our residents receive the best services possible

from these schemes. Services that enrich their lives and which enable

them to thrive and remain as independent as possible for as long as

possible. We also want to ensure that voids are managed effectively and

capacity is fully utilised in order to offer our residents value for money.

Our vision for flexi-care requires that residents:

have access to physical environments, services and technologies at the right time in their lives to prevent, delay and reduce the onset of significant care and support needs;

are able to maintain and/or improve their situations for as long as possible, preventing or delaying or the need for them to be moved into higher needs nursing/residential care.

Wendy McDermott / Cheryl Russell

Dean Thomas

4.4 Preparations for implementation

of Liberty Protection Safeguards

arrangements

Mar

2022

Following recent changes to the Mental Capacity Act, the current

framework for managing Deprivation of Liberty Safeguards will be

replaced by the Liberty Protection Safeguards framework. This work will

focus on ensuring that the council is ready to meet its responsibilities in

readiness for the launch of Liberty Protection Safeguards in October 2020.

Wendy McDermott

Annie Ho

5. Ensure value for money and quality is at the heart of service provision. Deliver services within a reduced budget

while ensuring high quality, effective and efficient services worthy of Southwark residents.

5.1 Manage limited and reducing

resources in an efficient, effective

and economic way to protect our

valuable services and maximise

outcomes for service users.

Mar

2021

We spend over £120m each year providing vital services to our residents.

We are all responsible for spending every penny as our own and for

safeguarding the finances of our service users and our organisation. We

will work closely with finance, procurement and commissioning colleagues

to understand, plan and manage our budgets to ensure we deliver the very

best service we can in a sustainable way.

Pauline

O’Hare /

Genette

Laws

Eniko Nolan

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5.2 Undertake a whole system review

of the income and debt functions

Mar

2021

The purpose of this work is to put an effective and sustainable system in

place at every step of the ASC client contribution process, ensuring that –

Service users experience consistent and high levels of customer

service

Financial assessments are carried out in a timely fashion

Service users are aware of their responsibilities and required

contributions at any given time

Effective systems are in place to ensure monies owed to the council are

collected

Suzanne Barcz

George Roscoe

Last updated 07/10/20

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Appendix A: Previous Priorities – From project to business as usual


3. Community and Accommodation Based Support. Utilise effective and efficient community and accommodation based services that improve and maximise people’s independence in collaboration with brokerage and commissioning.

3.1 Use the assessment and review

process to:

inform brokerage and

commissioning activity;

ensure suitable care and support

is sourced to maximise

independence.

Mar 2019 We are statutorily required under the Care Act to use the assessment and review

process to identify and deliver personalised information, care and support to meet

eligible needs (and non-eligible needs the council agrees to meet). We are

committed to using the intelligence gathered during assessments/reviews to

commission appropriate services and to link to universal services where

appropriate. Through these means we aim to empower and support adults with

care needs to remain as independent as possible, and also delay and reduce their

need for care and support.

Pauline O’Hare/ Simon Rayner

All managers

3.2 Ensure effective monitoring and

management of Extra Care and

Step Down accommodation options.

Mar 2019 Effective management of step-down and extra care accommodation will:

reduce delayed discharges from hospital;

support individual’s to return to their previous accommodation where

possible;

ensure that referrals to extra care accommodation identify those who

would most benefit from the accommodation.


All managers

3.3 Utilise funding panels to ensure that

a community asset approach is

championed, and -

Universal services are effectively

utilised

Community and accommodation

based resources are arranged

when suitable

Mar 2019 We must continue to focus on developing an asset/strength based approach in

line with best practice and the Care Act to understand and meet the needs of

adults with care needs in this challenging environment. A broad operational

understanding of the wide range of universal services available to Southwark

residents will enable staff to signpost/refer to services that can meet the needs of

service users, ensure personalised budgets are employed where they are most

needed, and that appropriate community support/accommodation is

commissioned as/when required (see goals 3.1 & 3.2)


All managers

3.4 Use reviews to ensure that services

received correspond with service

users current level of needs and

offer value for money.

Mar 2019 We aim to increase individual’s ability to remain independent and reduce their

need for intensive/long term care and support. Timely reviews and a ‘strengths’

based approach are essential to ensure that –

we do not disempower the individual by providing too much or

inappropriate care that increases dependency too early on in their lives;

we are able to keep under review the most appropriate options for support

to ensure that the individual receives an appropriate package of care and

support.


All managers

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3.5 Review out of borough placements

with a view to arranging appropriate

Southwark based accommodation.

Mar 2019 Southwark has a significant number of out of borough accommodation

placements. Such placements risk isolating individuals from their support network,

and often do not represent good value for money compared to the expanding

provision of Southwark based commissioned accommodation.

We will focus on moving residents who are ordinarily resident of Southwark back

to local accommodation in order that they can better benefit from local community

assets.


All managers

4. Service Redesign. Work with our partners to develop pathways across the whole health and social care system to improve and maximise independence, maintain and/or improve wellbeing, and reduce the need for hospital and long term care

4.3 Develop an All Age (0-25)

Disabilities pathway through the

establishment of an All Age

Disabilities service.

Dec 2019 A transitional service structure will provide an opportunity to fully review, design

and deliver an all age disabilities pathway and progress the 0-25 pathway design

and implementation (as recommended within the IPC options appraisal of July

2016).

Once best practice and standards are established there will be an opportunity to

share these across all divisions with the prospect of a standardised approach

across the Children’s and Adults’ Division, including opportunities to extend the

service area and responsibilities to Children and Young People (CY) with Special

Educational Needs and Disabilities (SEND).

Simon Rayner

Robert Skipwith

5 Ensure value for money and quality is at the heart of service provision. Deliver services within a reduced budget while ensuring high quality, effective and efficient services worthy of Southwark residents.

5.3 Work with the Clinical

Commissioning Group (CCG) to

ensure that Southwark residents

with adult social care needs can

access timely and appropriate

continuing health care (CHC)

funding to meet eligible CHC needs,

and also to ensure equitable joint

funding arrangements between the

council and the CCG.

2020 To -

tackle ongoing issues with regards to the frequency of cases turned away

by the CHC panel, and also the lack of formal arrangements for jointly

funded packages. Both issues continue to contribute to overspend from

ASC budgets at a time when the council must realise significant savings.

Ensure people are able to access funding for the care/support that they are

eligible to receive

Jay Stickland Cynthia Davis

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5.4 Implement improvements to Mosaic

work flows and processes and Develop

and implement a strategy and action

plan to maintain excellent data quality

across the division.

March

2019

Good quality data and a streamlined and easy to use case management system

are critical enablers to good performance management, budget monitoring

(allowing the dept. to stay within budget) and reduced administrative burdens on

staff.

The implementation of a data quality strategy and action plan for the division will

result in excellent data quality in the longer term.

Wendy McDermott

Sandra Hickey

5.5 Implement the outcome of the -

5.5.1 ASC Client Finance and

Personal Budget Pathway

function review (Brokerage and

Direct payment Functions)

5.5.2 Appointee and Deputy

work/functions Pathway review

Mar 2019

5.3.1 In order to simplify the Personal Budget management options and

workflows (including financial assessment and income collection), and to

reduce duplication and increase operational efficiency.

5.3.2 To ensure appropriate referrals and case holding for the Client Finance

appointee and deputy function (with a secondary aim of reducing the

overall number of cases held by the service).

Suzanne Barcz

George Roscoe

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Appendix B: Meeting Council Plan priorities that impact on vulnerable adults via the business planning process

Council plan commitment Adult Social Care strategic priorities

Adult Services Commissioning

Protect adult mental health services

Preventative services

Service redesign

Ensure value for money is at the heart of service provision

Better use of Council and NHS resources and asses so that we spend our limited money well

Ensure we buy and deliver quality, outcome focused, value for money services

Deliver a loneliness strategy


Community and accommodation based support

Service redesign

Work with divisions to support delivery of their strategies and plans

Train mental health first aiders

Workforce


Better use of Council and NHS resources and asses so that we spend our limited money well

Work with divisions to support delivery of their strategies and plans

Open two nursing homes

Community and accommodation based support Work with divisions to support delivery of their strategies and plans

Build extra care housing

Community and accommodation based support Work with divisions to support delivery of their strategies and plans

Raise standards with a Residential Care Charter

Community and accommodation based support Ensure we buy and deliver quality, outcome focused, value for money services

Documents

Adult Social Care Business Plan. 2020/2021