REGIONAL DSF ISSUES - Southern Health and Social Care Trust 11ic. DFS Appendix 1 SHSCT ACTION... · agreed to lead a working group to consider all viable and objective options for

SHSCT DSF Action plan for period 1st April 2018 – 31st March 2019

T = Trust action; B = Board action Updated: 30 April 2019

Southern HSC Trust Delegated Statutory Functions Monitoring For Period: 1st April 2018 – 31st March 2019

Actions to be taken forward 1st April 2019 – 31st March 2020

REGIONAL DSF ISSUES



LOCAL ISSUES

FAMILY & CHILD CARE POC

Originating date

Issue

Action

Outcome Action

by

Date completed

(if not completed,

carry forward)

June 2017 LAC – increase in nos

SHSCT reported significant pressures remain given the a) increase in admission to foster care and b) the difficulties in recruiting sufficient foster carers to meet the need.

The Trust is involved in the regional scoping and marketing initiative being undertaken to inform and enhance recruitment.

This issue is being dealt with on a regional basis. Report has been completed and analysed. However plans are now in jeopardy as a consequence of withdrawal of Transformational funding which was going to be used to enhance recruitment of foster carers. Therefore this has not progressed and challenges remain more acute than ever.

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June 2018

June 2017 Post Adoption Support

SHSCT reported ongoing challenges in relation to support needs of adoptive families. There is a need to

SHSCT have a draft model however funding is not available to take this model forward.

This issue is being dealt with on a regional basis. Mater has been progressed in this trust with the establishment

B/T

June 2018




Originating date

Issue

Action

Outcome Action

by

Date completed

(if not completed,

carry forward)

highlight that adoption support is required post order/post 18 years old.

HSCB has undertaken work in terms of gathering information re disruptions to inform regional need / regional Pathway. Bid made by the HSCB for funding (Transformation monies) Regional Post Adoption Pathway to be developed Confirmation awaited re Transformation funding. Task and Finish Group to be convened re Pathway.

of post Adoption Support Service and an associated Service Pathway. However this is based on transformation funding and the trust will not be able to mainstream this service post March 2020 without recurrent funding.

Achieved

Achieved

Commenced

June 2017 Children with Disability Complex Needs

Increasingly complex needs of some children with disabilities

A regional workshop is scheduled for the 15/6/18. This is a precursor to a wider review of service

This issue is being dealt with on a regional basis This has not progressed for

B/T

June 2018




Originating date

Issue

Action

Outcome Action

by

Date completed

(if not completed,

carry forward)

needs. various reasons. There remains a need to agree a CWD strategy. There remains a serious lack of suitable care options/placement options for CWD requiring full time and specialist care away from family and who cannot be cared for in Foster care setting

June 2017 Domestic / Sexual Violence

The volume of work resulting from Domestic / Sexual Violence is a key challenge facing the Trust. Changes at a Departmental/ strategic level have not proved positive. Domestic violence is a key factor in admissions to care and inclusion on the child Protection Register.

Domestic Violence remains a significant issue within the Trust/regionally with interventions especially for no adjudicated perpetrators very limited. This needs to continue to be raised with the DoH.

This issue is being dealt with on a regional basis Funding has been secured to deliver 5 DV group work programmes – 60 places across the 5 Trusts. 3 social workers are receiving training to complete DV & SV risk assessments.

B

June 2018




Originating date

Issue

Action

Outcome Action

by

Date completed

(if not completed,

carry forward)

June 2018 Transition to Adult Services for Children with a Disability

The transition to adult services remains based on IQ as opposed to needs based. The HSCB has consulted with DLS and provided a clear view to Trusts, highlighting the need also to ensure compliance with new legislation.

There continues to be some challenges associated with thresholds in transitions for Children to Adult services

T



MENTAL HEALTH AND LEARNING DISABILITY POC –

MENTAL HEALTH

Originating date

Issue Action Outcome Action

by

Date completed

(if not completed,

carry forward)

June 2018 Uptake of Carer Assessments

Uptake of Carer Assessments remain relatively low.

Further work required on regional basis. (see specific question under Older People’s poc)

Trust notes that more offers of an assessment are made than recorded. New data return in place to capture data more effectively, however uptake is lower than target. Clickpoint tool is helping to identify problem areas. To be reviewed mid year.

Carer’s assessments are raised at all governance meetings. Carer’s assessments continue to be highlighted and prioritised across all MH teams. Recent QI project in Bluestone unit which focussed on the identification of young carers. (carers over 18yrs are routinely identified) Work continues on developing a Standard operating procedure for staff to enable accurate recording of Carers Assessments offered on PARIS. Current recording difficulties are affecting the accuracy at this time. Continued promotion of carers champions within all teams Development of the Good

T

January 2019



Practice in Carers Assessment

Information Booklet for Trust

staff now available on

SharePoint and circulated to

members of Carers Reference

Group (CRG) for cascading to

teams

June 2018 Article 15 Payments

SHSCT Adult PoC has made unusually low use of Article 15 (in comparison to other Trusts. Can the Trust comment?

Trust advised they need to unpick this re how other measures such as use of foodbanks etc are impacting. Criteria have been re-issued recently to staff to promote awareness. Clear that this is last resort.

Trust noted very low usage of Article 15 payments, preference is to access community resources wherever possible Article 15 Guidance and application form circulated to MH SW staff for information.

June 2018 April 2019

June 2018 Cross-Trust Placements

SHSCT noted emerging issues with other Trusts placing residents in specialist facilities within SHSCT, at above the agreed tariff. This adds to already challenging process of securing appropriate placements for very

Concerns noted. To be reviewed mid year.

Being addressed through A/D Group and DoH meetings.

B/T

January 2019



complex cases.




LEARNING DISABILITY

Originating date


by

Date completed

(if not completed,

carry forward)

June 2018 Bed based short breaks

HSCB note SHSCT unsuccessful efforts to secure additional beds for short breaks through procurement processes. Is there an update / alternative plan?

The Trust will be undertaking a new full options appraisal of short breaks and will be engaging with the wider carer community to explore what options might be available. In the interim the Trust continues to spot purchase beds from the independent sector however the availability of beds for short breaks is decreasing. This piece of work will require the setting up of a new working group to examine all possible options. The group will consist of Trust staff and a representative number of carers.

The Trust will be undertaking a new financial options appraisal commencing May 2019. 6 carers from the Trusts learning disability forum will be sitting on the working group. Several workshops and direct contact with carers currently using bed based short breaks have taken place since February 2019 to help inform the new service. It is hoped that the preferred option will be selected by the autumn of 2019.

T

June 2018 Scoring Tool for allocation of short breaks

Innovation commended. Is there any potential for

The Scoring Tool although welcomed by some carers, was

Pat Mc Ateer specialist services manager has been asked to




LEARNING DISABILITY

Originating date


by

Date completed

(if not completed,

carry forward)

regional learning? considered too harsh a method by others for determining the level of short breaks a carer would qualify for. The Scoring Tool has been shared with the other four Trusts Short Break Leads with a view to examining how the other Trusts determine their levels of short breaks for carers and whether this Tool would have regional potential. The difficulty with the Tool is that it does introduce the notion of a cap on the number of nights available to carers and this is perceived as being unfair to those carers who have an historic high number of bed based nights. Scoring Tools to date have not been actively adopted by the Board as a means to introduce

lead on the development of a regional scoring tool and one meeting has taken place to date. A workshop has been planned for 3rd June 2019 to look at all possible models which might inform a future model.




LEARNING DISABILITY

Originating date


by

Date completed

(if not completed,

carry forward)

a fair and equitable allocation of short break nights and it would be beneficial if the Board agreed to lead a working group to consider all viable and objective options for assessing levels of short breaks.

June 2018 Transitions

Range of issues noted in relation to transitions, including underspend in an area previously identified as under severe pressure; and risk of non-compliance with DDA legislation

HSCB to write to SHSCT setting out the issues and requesting a formal response and separate meeting to discuss the issues more thoroughly. To be reviewed mid year.

The SHSCT are currently waiting on a formal response to their latest communication from the HSCB.

B/T



ADULT SAFEGUARDING

Originating date


by

Date completed

(if not completed,

carry forward)

June 2016 How is the Trust managing the migration of adult safeguarding activity data to the PARIS system?

Preliminary discussions have taken place on how and when migration will happen. Trust has decided to migrate in stages. Final plans depend on new procedures November 2016 – Still using SOSCARE module/manual return Final arrangements still to be agreed Work is progressing to cleanse the SOSCARE module prior to implementing the PARIS adult protection system. This work will effectively close all historic cases and where there are cases ongoing to adult protection they will be referenced under a different code. This will mean that

Update now using NISAT and SOSCARE no longer in use. The Trust aim to develop a safeguarding module on Paris. A date for commencement of migration will be set in Q1 with aim of completing migration to Paris by December 2019.

T

January 2019



there will only be current open cases to be migrated across.

June 2017 What is the timescale for the completed transition of all adult safeguarding services to PARIS?

See above Confirmation of regional final data set required Plan to roll out by Directorate, but recognition that this may pose problems for a cross-programme initiative such as adult safeguarding The Trust continues to await the final regional data set. However, work has been ongoing in liaising closely with colleagues in BHSCT re the development of the regional forms for PARIS. However, this cannot be finalised until the data set is confirmed. Update 1/11/18 The Trust continues to progress with an exercise to cleanse the SOSCARE system in preparation for migration to PARIS. The Trust has begun the mapping process with the PARIS team and liaison with

Update 27/03/19 As per NIASP decision in December 2018 the SHSCT no longer input adult protection data onto SOSCARE. Community Information is presently working through bulk closure arrangements for all remaining adult protection cases on the SOSCARE system. It is anticipated that this will be completed by autumn 2019 Due to corporate priorities the implementation of the PARIS system has been delayed to May 2019. Preparation work has begun and the PARIS team have been involved with the OBA work undertaken to consider how safeguarding uses data to inform future service development and delivery. The OBA model devised will be piloted in the next quarter with a view to the scorecard being built into the

B/T

January 2019



the developers has commenced. It is anticipated that the PARIS team will be in a position to progress implementation in January 2019.

PARIS reporting system.

June 2018 The report notes the challenges associated with the application of the new thresholds for adults at risk and adults in need of protection. What actions is the Trust taking to manage these challenges?

Trust noted important culture shift in managing situations of adults at risk, and associated pressure on Gateway to assist in that change. Consideration being given to the development of an ASC Network to support colleagues in community, voluntary dn independent sectors., with the independent sector seen as a priority for 2018/19. To be reviewed mid year.

The Trust and the Southern LASP continue to work closely with statutory, independent and voluntary sector groups to consider thresholds for protection intervention and / or alternative safeguarding responses. The LASP has established an ASC support network and interest and participation has been overwhelming to date. Due to the extensive waiting list for places at the events a further event is being arranged. Further events specifically for those involved in delivering training and development in adult safeguarding have been arranged and in light of the emerging regional learning the Southern LASP opted to

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consider how agencies can work better together to integrate Human Rights within training. Bespoke shared learning and information sessions have been provided by the Adult Safeguarding team on request to partner organisations to explore how the new definitions and thresholds are identified and responded to in various aspects of care delivery. Ie with partners such as Women’s Aid; acute Mental Health teams; Palliative care; Dementia in patient services etc. The SHSCT practitioner support fora continue to be a place to promote shared learning opportunities to explore new practice requirements and to nurture a shared understanding of appropriateness of intervention in real case circumstances. These 3 practitioner fora are well



attended across the Trust and are led by the Adult Safeguarding team. Furthermore the team have been proactive in engaging with PPU and CRU to explore threshold issues for Joint Protocol. Understanding of agency strategic direction and practice responsibilities have been shared and preparatory work developed to share at the regional JP review day in June 2019.



OLDER PEOPLE, PHYSICAL DISABILITY & SENSORY IMPAIRMENT POC –

OLDER PEOPLE

Originating date


by

Date completed

(if not completed,

carry forward)

June 2018 Day Opportunities for Persons over 65 years

Day Opportunities should be promoted over centre based day care if possible. It works very well for other POCs (Mental Health, Learning Disability and PDSI). Why are Day Opportunities not available to older people within SHSCT?

Older People’s Services actively support individuals accessing day opportunities through attendance at Luncheon clubs etc. There has not been any additional investment made in respect of promoting Day Opportunities within Older People’s Services.

Service has been reviewed. Attendees are very physically frail, more able users avail of Day Opportunities

June 2018

June 2018 HSC Funded Placements out of Trust area

Why are people being placed outside NI? Are these ECRs? How and when are these cases reviewed?

In a very small number of cases, individuals request that they are placed outside of N Ireland, usually to allow them to reside near to their family members who have moved outside of NI. At one point, this type of placement would have been discussed/ agreed with DOH

Only 2 such placements for SHSCT area. Both moved to be closer to family. Arrangements in place with relevant Local Authority to manage day-to-day issues re placement

June 2018



prior to proceeding and regarded as an ECR. However, this is no longer a DOH requirement on Trusts. These placements are subject to the same Care Management expectations that apply to all placements. Therefore individuals should be reviewed at least annually or more often if required. In the case of individuals placed outside of our NI jurisdiction, the Trust agrees with the Local Authority SW Provider an arrangement to ensure the annual review and any potential safeguarding arrangements is delivered.

June 2018 Learning Disability and Dementia

How does the Older People’s programme engage with the LD programme to ensure that persons with a learning disability and dementia have access to services and that there is shared learning across teams?

The Memory Service liaises with the LD Dementia Services Manager in relation to referrals received for persons with a learning disability. There are opportunities to interface however they are adhoc in nature therefore in order to improve this, regular meetings between LD Dementia Services Manager and the Dementia Co-ordinator in Memory Service

LD Project Manager in place to develop the Pathway, strong links with the LD PoC. Developing a data base of adults with LD who are living with dementia and those at risk of early on-set dementia.

Interface meetings are taking place between LD Dementia

June 2018



Does the Trust have a system for identifying the numbers of people with a learning disability and dementia within the Trust area?

have been arranged to promote shared learning. The LD Dementia Services Manager has compiled a database detailing people with a learning disability and dementia.

Services Manager and the Dementia Co-ordinator in Memory Service to promote shared learning and best practise. A Trust wide database is being

maintained by the LD Dementia

Services Manager. A database

has also been compiled in

relation to those with Down’s

syndrome however this requires

further development to enhance

the data. A regional data

analytics bid has been

successful in order to support

the development of consistent

data sets for use across the

region.

June 2018 Carer Support – Trust performance around the offer and uptake of carers assessments

Can you describe the steps your Trust is taking to improve its performance around

(a) the offer of carer

In an effort to improve Trust compliance with both the offer and completion of Carer’s Assessments, the Trust has: • Provided increased training opportunities for staff • Introduced access to

Information provided

Performance during 2018/19 up

to December 2018

demonstrates an increase of

B/T January 2019



assessments

(b) improving on the acceptance and uptake levels when the offer of assessment and support is made?

Whilst the Trust offer of assessment is comparable with other Trusts over the past 4 years, the uptake/ acceptance levels have been quite low (under 40% in some cases). Seek Trust comment on this.

SHSCT has expressed interest in adding Marie Curie activity data to its carers’ data. Trust has been asked for more detail around this and are yet to provide this. If raised, note - Carer Short Breaks must be funded by the Trust and have a primary aim of supporting carers.

weekly reports in respect of the numbers offered and completed in terms f Carer’s Assessments • Initiated work to provide staff with access to the most up to date electronic carer’s assessments within the PARIS system. At the June 2018 DSF meeting the Trust made colleagues aware of the role played by Marie Curie in respect of supporting individuals and families to care. The majority of this involvement takes the form of Marie Curie staff providing a night-sitting service, to allow families to take a break from their caring roles and often to have an opportunity to get a sleep at night.

+638 (+25%) above the

apportioned objective level for

2018/19 therefore the Trust, at

end of Q3 is well on track

against the 2018/2019

objective. With an increase in

offers the service is now

monitoring its ability to meet

this increased demand and

ensure assessments

completed.

June 2018 Service User Annual Reviews



The BSO audit of Domiciliary Care makes one recommendation in relation to Service User Annual Reviews as follows: 1. Trust Management should review the process for conducting service user annual reviews to make it more efficient and ensure all professionals within the ICT contribute to improving the completion rate of annual reviews in those teams that have higher levels of reviews overdue (Priority 2) What progress is the Trust making towards compliance with both this recommendation?

The Trust continues to make efforts to further improve the integration of the annual review process within the business of the whole Integrated Care Team. Improved use of the Trust Community Information System, including better analysis of the available data, is supporting teams to identify who is best placed to complete reviews. This along with some investment in additional staff will see further improvements. OT now recruited and assessing and joining up processes with SW.

April 2019 – There have been noticeable differences in relation to integrated working within ICTs in regards to annual reviews. Professionals undertaking uni-professional assessments are now recognising the contribution their assessments can make to an individual service users’ holistic annual review and there is a shift in culture. Nevertheless it has been recognised that further work needs to be undertaken to address the issues with overdue annual reviews. Therefore currently a Social Work pilot is being undertaken in two ICTs which is an opportunity to embed and implement the newly devised processes referenced in last years’ DSF report. A business plan has been presented to and endorsed by SMT in Southern Trust to invest further in SW and Social Care Workers in ICTs to ensure that the newly developed harmonised processes can be fully

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implemented in a meaningful way. A temporary Project Lead has also been endorsed by our Director for OPPC which has provided a focused opportunity to implement the changes and effectively manage them. The pilot area has already demonstrated increased ability to meet annual review targets in the last 8 weeks and it is envisaged that roll out across all ICTs with the increased resources will ensure compliance with our statutory functions.

June 2018 Non Acute Hospitals

It is noted in the period that there were 490 referrals for non-acute hospital social workers. Within the DSF return there was limited information regarding the service, information provided being alongside Intermediate Care. Please can the Trust provide a more detailed

Non Acute Hospital SW in an integral part of MDT that provide Social Work intervention to adults in need of rehab or future care planning. Non Acute SW also provide support within palliative and end of life to patients carers and families Non Acute hospital Staff aim to meet patients within 24-48 hrs of admission and begin an

APRIL 19 - Delayed discharges continue to be challenging due to the lack of dom care and nursing and residential placements. An escalation process has been agreed from ward level and interface meeting with community and other trusts to explore the issues. Direct payments and self-directed support are also

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update on the service and the issues which are delaying discharge from non-acute hospitals?

assessment and explain the role an function of SW and the ethos of Non Acute hospitals. SW also liaises with the Community services if patients have already been known. With consent an initial MD Meeting is arranged with the carer or family with 3-5 days. This allows for the sharing of information on the patients presenting care needs, it allows the gathering of information form carers and families shares allows carers to share any issues or concerns, EDD is shared and discusses the care plan and future objectives SW staff works in partnership with patients and families to identify discharge pathways service provision referral to community and voluntary and complete relevant documentation to support the transfer from hospital. On ward identification of ongoing SW intervention is passed to the relevant community service Carer’s assessments are not completed within the hospital

options that are explored



environment but advice and support is provided. Carer’s assessments are offered and if appropriate referred to community for completion. Within the MDT through daily whiteboard and weekly MD meetings delay’s in discharge are discussed. Issues that can affect discharge are homes of choice not being available for service users and delayed packages of care. Were patients have very complex needs such as cognition issues ,brain injuries or on going delirium if can be challenging to find suitable homes to meet the patients’ needs with the families choice of area. Information provided. Regional work on narrative for HSW on-going

June 2018 Domiciliary Care

The Trust advise that they “now hold a waiting list for those needing a care package.” Can the Trust provide more detailed information as to

Once an assessment has identified an eligible need for the provision of a domiciliary care package the Trust’s Care Bureau manage a system of offering the work to either the

Management/Review of the Waiting List Once an assessment has

identified an eligible need for

the provision of a domiciliary

T



how this is managed and reviewed?

in-house service or Independent Sector Providers. Each day, newly identified individuals are identified alongside any outstanding requests.

care package the Trust’s Care

Bureau manage a system of

offering the work to either the

in-house service or

Independent Sector Providers.

If the care package is not

accepted within the day of

decaff the package is normally

transferred to the waiting list on

the following day. This unmet

need list is forwarded by e-mail

to all in house and Independent

Sector Providers on a daily

basis to encourage package

uptake and is then

subsequently updated by the

care bureau and forwarded to

Trust senior management for

review at the end of each

working day. On an adhoc

basis the Care Bureau contacts

In house and Independent

Providers by telephone or e-

mail to check if they have

availability for urgent packages

on the list.

Detail on in house OT



Perhaps further clarification required on the SHSCT advising that they use as Outcomes Based Domiciliary Care Model – no detail in the body of the report, OPPC narrative.

The Trust is implementing an Occupational Therapy outcomes based model into the Trust domiciliary care service. This approach is bringing forward a reablement ethos to individuals whose package of care has been in place for a longer period of time. The approach included the establishment of a goal plan in each house, to provide clarity for dom care staff in respect of how they enable clients.

Outcomes Model The Trust is currently rolling out the Armagh and Dungannon in house domiciliary care OT service to the C&B locality. The current model has been extended as a proven way of ensuring that the package in place is right for the individual service users need/goals at any point in time. The model also offers the appropriate tools eg goal plans and THCW training in order to ensure that the service user goals can be fully realised and that changes in subsequent need are escalated and package of care tailored appropriately throughout the service users journey.

June 2018 Palliative Care

How does the Trust support service users facing end of life and requiring Palliative Care? How does the Trust meet the post-qualifying training needs of SW

In line with regional direction, the Trust views the provision of Palliative and End of life care as being the responsibility of all health and social care staff who are involved in a service users care. In order to support staff to develop their knowledge, skills

Trust has a Palliative Care Programme Board with associated workplan in place. A range of training opportunities is available NB Trust did not rank the PiPs course on Palliative Care as a priority.

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staff? How does the Trust meet the training needs of staff working in specialist palliative care roles?

and confidence in the delivery of generalist palliative care, the Trust provides a range of Palliative and End of Life Care training including: Palliative Care Awareness, Communication skills training and bespoke Palliative and End of Life Care Conferences and Masterclasses. A multidisciplinary specialist palliative care team is available to offer additional support where a service user presents with complexities beyond the scope of core services. This community based team includes: Palliative Medicine Consultant, Specialist Palliative Care Nurses, Specialist Palliative Care AHPs (dietitian, speech and language therapist, physiotherapist, occupational therapist) and a specialist palliative care social worker. The specialist social worker is involved in the delivery of training for staff across the Trust, including the delivery of palliative care training as part of the Trust Social Work induction programme.

Part of the role of the specialist palliative care team MDT is direct work with patients and service users. In addition, the team provides advice, guidance and opportunity to co-work direct care in oder to enhance the quality of palliative care service provision to the person and those important to them. Training continues on a rolling basis on general palliative care also communication skills as well as some bespoke training for eg staff providing bereavement support to people with a learning disability. Consideration is currently being

given to writing and delivering a

bespoke ACP training for SW

across all programmes of care.



Staff employed in Specialist Palliative Care roles are encouraged and supported to avail of a range of post graduate training opportunities as applicable to their roles. This may include: undertaking a postgraduate programme, membership of regional profession-specific specialist palliative care fora and completion of a post qualifying specialist award.

June 2018 Hospital Social Work

All Trusts would appear to be recording fewer referrals – what would the explanation be? SHSCT (managed within Acute) - as usual SHSCT provides very comprehensive narrative (12 pages + stats.) which conveys depth and breadth of work undertaken although the emphasis does seem to be weighted in terms of discharge planning. Referrals figures have been declining over 5

2/11/18: Review of referrals received for Acute Hospital Social work from April 18-Oct 19: 4928( 7 month period) which is in line with referrals received over the last 2 yrs with a slight increase at present. 3/7/18: On reviewing the referral figures over the past 5 vrs there appears to be a difference in Client Referrals: which is only counted as 1 for multiple admission’s for the same person versus “Referrals” which counts each separate referral to Hospital social work. 2013/14 - Number of referrals

All referrals to HSW are recorded as referrals , The data for this reporting year will reflect this and client referral’s will cease.

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years would this be correct and is there an explanation?

to CAH and DHH were reported for DSF 2014/15 - Report was amended to meet the requirement of adults referred to CAH and DHH, therefore number of clients referred was reported. 2015/16 - reported consistently as per 2014/15: No of clients referred was reported 2016/17 - Non acute hospitals included separately in DSF in addition to acute hospitals. Through validation I have noticed that referrals were counted instead of clients referred for both areas. 2017/18 - PARIS was implemented for acute hospital SW and clients referred was reported. Referrals received, 2013-2014; Referrals :9172 2014-2015 Referrals: 8340 2016-2016 Referrals: 7488 2016-2017 Referrals: 8126 2017-2018 Referrals: 8154



As you can see from this analysis, the SHSCT reporting has not been consistent in reporting on all Referrals received or Client referrals received (this does not include re-admissions). I personally feel the report should be on Referrals as this is the accurate report on activity as every new admission requires a new assessment, intervention and discharge pathway. It would be helpful if this could be confirmed.

June 2018 Self Directed Support

What measures is the Trust putting into place to encourage uptake of SDS across all POC’s to be inclusive of the spectrum of all 4 SDS options and to collect data more effectively? What Measures is the Trust implementing to increase recurrent

The Trust has dramatically up-scaled its SDS Implementation Plans, with Directors from each Programme Of Care giving a strong SMT endorsement through targeted and global emails, tailored Memorandums for staff at all levels, representation at regional SDS Meetings and endorsement through speeches at SDS Staff Engagement Events

Building on progress made in 2018, the SDS Team continues to ensure that advice delivered via SDS Level 1, 2 & 3 Staff Training is clear and succinct in relation to encouraging the uptake of SDS across all POC’s and revising and delivering Direct Payment Training to underpin the importance of professional analysis and decision making based on

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March 2019



packages? How does the Trust intend to redress this issue, particularly recurrent SDS Carers Packages?

The Trust has invested significantly in replacing all previous Direct Payment Rates with the 2018-19 Regional Rate to not only make SDS recurrent Options more attractive but alleviate previous confusion caused for individuals, families and staff alike. An extensive training programme has also been facilitated so all Trust Staff can advocate for SDS as the only way of receiving social care support. Alongside this, the Trust’s SDS Team has been facilitating a separate Scheme to support ‘Individual Budgets for Carers of Older People’ and in working closely with the Trust’s Carers Co-ordinator takes every opportunity to present at Carers Forum and engage with Carers Support Groups though-out the Trust’s area of benefit.

assessment of need when approving individual outcomes.

Whilst the Trust’s SDS Team continues to review and explore suitable models of practice that would support the delivery of Managed Budgets - greater regional clarity on acceptable procurement and contracting arrangements are needed to allow individuals to avail of the Managed Budget option within the full spectrum of 4 SDS options available. Despite this however, the Trust continues to work towards increasing the number of recurrent SDS cases in place through establishing an SDS Practitioners Forum which aims to support staff to enhance good governance arrangements and follow-up team specific SDS Practitioner Clinics and support for carers via the Trust SMT approved ‘Short Breaks Factsheet’ which has an Addendum for Staff to determine how to equitably calculate clear individual budget



allocations. Further, in order to enhance and capture the development of SDS Support Plans across all teams for both Carers and individuals alike, work has also been boosted by:

Issuing Paris guidance to Trust Staff re: scanning individual SDS Support Plans onto Paris and through working in partnership with the Trust’s Paris Team, illustrating how best to utilise existing electronic records kept by the Trust to provide clarity of purpose to best monitor expenditure - learning from which is being shared across all teams and other HSC Trusts in NI.

Establishing a SharePoint Site for Trust Staff to not only centralise all SDS resources but ensure staff continually access updated templates and guidance informed by local and regional best practice.

Updating SDS information



already available by devising and publishing a user-friendly ‘Personalised Approaches’ Booklet and ‘Carers Guide’ designed to guarantee that individuals and carers have informed choice and control over what kind of support they receive.

Revising the Trust’s existing Direct Payment Agreement Form to provide clarity on individual, Carer and Trust roles and responsibilities.

Facilitating an SDS User Engagement Group to

provide ongoing co-production opportunities for SDS Service users to share their experience of personalised support in both adult and children’s services.

June 2018 Direct Payments

The Trust following clarification from the HSCB, advised that they do not collate information as to the number of

The reason for refusal of Direct payment when offered is recorded on Monthly returns. If Direct payment is requested and refused by Trust as a way

Information provided

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January 2019



requests and approvals for Direct Payments in year. What action does the Trust plan to take going forward to capture this data?

to meet assessed need, this would only be due to the capability of the person wanting to manage this. This may be linked to Safeguarding concerns or previous mismanagement of finances. We do not keep a record of this currently.


SHSCT Adult PoC has made unusually low use of Article 15 (in comparison to other Trusts. Can the Trust comment?

The community teams look to all other community options before Article 15 would be considered.

Trust noted very low usage of Article 15 payments, preference is to access community resources wherever possible

June 2018



OLDER PEOPLE, PHYSICAL DISABILITY & SENSORY IMPAIRMENT POC –

PHYSICAL DISABILITY & SENSORY IMPAIRMENT

Originating date


by

Date completed

(if not completed,

carry forward)

June 2015 Care Management Review

Report charts progress on implementation of changes emerging from review and indicates on track for completion (p64); what actions are required before Compliance Check in Autumn 2015?

Autumn 2015 was an internal milestone set by Trust, which confirms that all outstanding actions will be completed by this deadline.

Roll-out progressing with a training needs analysis process completed and delivery on this as next step to full implementation Trust provided an update on the impact of its review of care management arrangements and the impact, in particular, on staff grades and responsibilities. They confirmed there were no staff side problems. Training implications to be followed up in interim meetings. November 2016 – Full implementation achieved.

Case management review under way. This was delayed due to issues raised by Staffside which are now resolved. Appointing independent person and to commence by March 2019.See below

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Review of implementation currently underway. Trust to share findings.

June 2017 Review of Care Management approach: Implications are noted across the PoC, particularly in relation to the Nurse Case Manager and the Case Manager, Addictions. Evaluation to be completed in-year, please share findings when available

Challenges in recruitment process noted

Evaluation to be shared when available

Review of case management underway and will be concluded by March 2019

To be reviewed June 2019.

As above. T

June 2017 Early Intervention Social Worker (Brain Injury Rehab)

Note concern re potential capacity for 1 worker to carry out required tasks. Has the trust done any kind of demand/capacity analysis to assist future planning?

Trust to share evaluation of post when available Outcome of evaluation available March 2019. To be reviewed June 2019.

The early Intervention Social Worker post has developed and evolved since clinician was first in post in 2010. Evaluation of this post revealed that due to the time constraints of a 20 hour post across the entire trust area, the early intervention brain injury team developed a concussion pathway.

This has resulted in a significant increase in referrals from

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hospital , Emergency Department and GP’s for people with mild TBI (i.e. concussion). The pathway has developed into a group intervention in order to maximise service delivery. The role of the early intervention social worker has changed to ensure maximum efficiency of time and impact on service users (e.g. communication with acute hospitals through email and telephone rather than attending meetings in person).

June 2018 PSD – The PSD Strategy and Action Plan (36 Actions) 2011 will be formally closed by end of September

How does the Trust plan to mainstream and carry on the work initiated within the Strategy?

The SHSCT have been very actively involved in all of the Work Streams associated with the development of services for individuals with a sensory disability. The Sensory Disability Teams will continue through Regional Sensory Forums to implement the recommendations coming out of the Strategy. The Trust have obvious concerns that the Board should continue to host regional forums

Trust has a plan to roll out remaining actions through various Task and Finish Groups Information supplied

June 2018



to examine the implementation and development of the Strategy and this has been raised at various RSIG meetings. Strategy and Action Plan closed. Internal review to be convened to consider the needs of Phy Dis etc rather than Sensory Disability. DOH guidance is awaited. Communications contract work is being progressed by HSCB.

June 2018 Emergency Planning and Response

How does the Trust plan to address these ongoing and increasing requirements?

Supporting ESCs beyond the initial 48 hours in the event of long-term displaced of large numbers of people

Trust has an Emergency Planning Group in place. Programme of Care carries out monthly review of most vulnerable to ensure that they are given priority in any emergency situation. Relevant assurances provided

June 2018


SHSCT Adult PoC has made unusually low use of Article 15 (in comparison to other

Trust noted very low usage of Article 15 payments, preference is to access community resources wherever possible.

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June 2018



Trusts). Can the Trust comment?

Documents

REGIONAL DSF ISSUES - Southern Health and Social Care Trust 11ic. DFS Appendix 1 SHSCT ACTION... · agreed to lead a working group to consider all viable and objective options for