Programme Management Board

Adult Social Care - Personalisation and Efficiency

Draft Terms of Reference

Objective

1.1To consider the Transformation of Adult Social Care in Poole and to ensure that this is achieved in a way which is both timely and in line with the aspirations of both Poole residents and Government.

1.2In particular:

  • To approve the priorities in the Programme Definition Report, and review them annually
  • To approve progress of the Programme against strategic objectives
  • To consider the implications and consequences of the Programme for the Council and for residents of Poole
  • To approve investment in the Programme
  • To monitor progress on individual projects within the Programme
  • To advise and support the Senior Responsible Officer
  • To confirm successful delivery and signoff closure of the Programme

Background

2.1In December 2007, Government published a concordat entitled “Putting People First”. Signatories included relevant Secretaries of State but also the LGA, the Chief Executive of the NHS, regulators, professional bodies and organisations representing independent sector care providers. The concordat sets out a vision of a fully-integrated Health and Social Care system achieved not by structural reform but by organisations coming together to re-design local systems around the needs of citizens. In particular, the paper (and the more detailed circular ‘Transforming Social Care’ published in January 2008) envisages a personalised Adult Social Care system of which the key elements are:
  • Local Authority leadership accompanied by authentic partnership working with the NHS, other agencies and providers to create a high-quality care system which is responsive to the individual needs of those who use services and their carers.
  • The care system will be based on shared outcomes which ensure that people are supported to live independently, exercise maximum control over their own lives and participate as active and equal citizens. They will have the best possible quality of life and retain dignity and respect.
  • System-wide transformation, covering the following objectives:

-A Joint Strategic Needs Assessment with PCT and NHS providers, accompanied by an integrated approach to achieve specific outcomes on particular issues, including fall reduction; hospital discharge; intermediate care; management of long-term conditions; Community Equipment Services; and universal information, advice and advocacy.

-Commissioning which incentivises and stimulates quality provision.

-A locally-agreed approach which informs the Sustainable Community Strategy, a Common Assessment Process with great emphasis on self-assessment and with Social Workers spending less time on assessment and more on support, brokerage and advocacy.

-Person-Centred Planning and self-directed support as a mainstream service delivery framework.

-Personal budgets for everyone eligible for publicly-funded Adult Social Care support.

-Direct Payments utilised by increasing numbers of people.

-Creation of a transformed Community Equipment Service which is much more responsive to people’s needs.

-Support for at least one local user-led organisation.

-Coordinated local Workforce Development Strategies.

2.2Timescales

The concordat makes it clear that such transformation of Adult Social Care, because it is so radical, will require time. It expects by the end of the current Comprehensive Spending Review period in March 2011 significant progress in all Local Authorities. Incremental progress should be evident over a shorter period of time and will be confirmed via the new National Indicator set which contains measures designed to monitor progress.

2.3Programme scope

The key elements that need to be in place to deliver the strategy are:

  • A Customer Service Centre which incorporates a specialised knowledge base which can deliver answers wherever possible to information requests and service requests, without further recourse to Adult Social Care officers.
  • Development of website to incorporate regularly-updated information on a wide range of social care services.
  • A web-based Self-Assessment Tool for relevant services.
  • A guided Self-Assessment process, to be delivered either through the Customer Service Centre or face-to-face.
  • Development of the existing Poole Intermediate Care Service (PICS) to ensure that synergy exists between the Customer Service Centre and PICS. Robust processes must be in place to make sure that there is no possibility of people falling through gaps, either between these two services, or between PICS and any long-term Complex Care services.
  • Services which are personalised and person-centred, and commissioned by individuals themselves (with support where necessary) following application of a Common Assessment Framework.
  • Development of a Resource Allocation System which enables people to calculate for themselves the financial resources available for their care. They can then (again with help if necessary) devise a care and support package to meet their own objectives, and receive an Individual Budget (which may be delivered as either a virtual budget or as a Direct Payment).
  • Development of Brokerage services offering direct specialised advice to Individual Budget holders and their support teams, as well as a direct Brokerage and information/advice service to people funding their own residential and domiciliary care.
  • A workforce which is fully committed and trained to deliver customer-driven, personalised services.
  • Modernised provider services, both in-house and independent, which are focused on flexibility and adaptability. Management of those services to be located in the most appropriate sector to deliver the required outcomes. In particular this requires the agreement of a contract with Care South for the provision of residential dementia care in the new Heathlands, the outsourcing of the management of the new Fourways Wellbeing Centre, and the outsourcing of the Supported Living Service for people with Learning Disabilities.
  • A re-defined and re-specified long-term Home Care Service which is commissioned on the basis of outcomes rather than tasks and which is charged for on a “per minute” basis via electronic home care monitoring rather than on a time block basis.
  • New services to be commissioned as a result of customer demand.

2.4All the above will initially comprise twelve individual projects, some with a number of sub-projects, and others will be added or removed from the Programme as time goes on. At present they comprise:

  • Cultural change in Adult Social Care
  • Universal Information, Advocacy and Advice
  • Delivery through Customers First
  • Universality of service through work with the Third Sector and PCT
  • Information quality and availability
  • Advice quality and availability
  • Advocacy quality and availability
  • Direct Payments
  • Individual Budgets
  • Resource Allocation System
  • Personal Budget processes
  • Care Management IT system
  • Heathlands Contract
  • Source Management of New Fourways
  • Modernise Supported Living Service
  • Ashmore
  • Christopher Crescent
  • Eligibility Criteria framework
  • Modernised management of longterm conditions
  • Modernised commissioning of longer-term home care
  • Electronic Monitoring of Home Care
  • Retail Model of Community Equipment

2.4Each of these will be formally project-managed, each with its own project timetable and mechanisms for accountability and sign-off. Each project will need to consider training and other HR issues, financial control and legal matters as part of the project planning; relevant Service Units will need to be involved in the development of these project plans.

3.Direct Payments and Personal Budgets

3.1Members have monitored the development of Direct Payments for some years by means of a Working Party, and it is proposed that this work continues by way of a sub-group reporting to Cabinet via the Programme Management Board. It is proposed that the subgroup comprises three elected Members, and representatives of informal carers, service users and voluntary organisations directly involved with Direct Payments such as ProDisability. The subgroup will also interest itself in the development of practical arrangements for Personal Budgets.

4.Membership and Working Arrangements

4.1The Board shall consist of:

  • Three elected Members (two Conservative and one Liberal Democrat)
  • Service users representing Older people; People with Disabilities; People with Learning Disabilities and People with Mental Health Needs
  • Two carers
  • Strategy Director responsible for Adult Social Services
  • Heads of Adult Social Services (Commissioning), Adult Social Care and Wellbeing, Customer Services and Financial Services
  • Integrated Commissioning lead, Bournemouth and Poole Teaching Primary Care Trust
  • Programme Manager

4.2 Board members shall be provided with all necessary support to enable them to play a full part in its work.

4.3 The Board will elect a Chair at its first meeting, and annually thereafter

4.4 The Board will meet at least quarterly, and will continue until the programme reaches its target date of March 2011. At this point, it will review progress and consider whether and in what form it needs to continue to meet.

4.5 An agenda will be approved by the Chair and, with supporting papers, be distributed to all members (including those requiring accessible formats) before the meetings in accordance with normal Council timescales.

4.6 The Board will be overseen by, and required to report on progress to, Cabinet.

Nick Molland

Programme Manager, Personalisation and Efficiency

August 11, 2008

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