Hertfordshire Adult Social Care Local Account 2011

Adult Social Care

LOCAL ACCOUNT 2010/11

Foreword from Colette Wyatt-Lowe, Executive Member for Health and Adult Care

I am pleased to introduce our first Local Account, which I hope will give you an overview of howHertfordshire’s adult social care services have performedover the last year.

As you will be aware, financial pressures in the public sectorcontinue to be high on the news agenda and Hertfordshire County Council is undergoing a major transformation programme ‘Council for the Future’ to identify savings of £200m a year by 2014/15. Protecting front-line services, particularly for Hertfordshire’s most vulnerable people, is a key priority for the council so wherever possible savings are being made by delivering services in more cost-effective waysbyreducing our internal and management costs and by redesigning services.

In 2009/10, Hertfordshire adult social care department was given an ‘excellent’ rating by the Care Quality Commission. The star rating system has now been phased out and the Coalition Government have asked councils to product a ‘local account’ instead - and be accountable to its elected members and citizens.

We have been able to build onour final star rating and have continued to increase the choice of care and support available to help people stay as independent as possible. Much of this work has been innovative and delivered in partnership with NHS organisations, the voluntary sector and other councils.

I know that we face further challenges, both in financial terms, but also in terms of the demographic changes ahead. I am committed to ensuring that we take bold and imaginative steps to meet these challenges head-on, whilst protecting or indeed improving, the quality of care and support available to people in Hertfordshire.

I hope you find this document provides a useful overview of our performance and our plans for transforming and improving our services in the future.

Cllr Colette Wyatt-Lowe

Executive Member, Health and Community Services

Introduction

The purpose of this report is to provide citizens and elected members with a local account of how adult social care services performedin Hertfordshire between April 2010 and March 2011.

This covers the services undertaken by the County Council directly - and those provided by independent care homes and care agencies to meet people’s care needs.

In November 2010, the Government published a new vision for adult social care called ‘Capable Communities and Active Citizens’ which sets out how it wishes to see social care services delivered for people. The key themes are:

  • Prevention: empowered people and strong communities will work together to maintain independence for service-users. Where the state is needed, it helps people to retain and regain their independence;
  • Personalisation: Individuals not institutions take control of their care. Personal budgets, preferably as direct payments, are provided to all eligible people. Information about care and support is available for all;
  • Partnership: Care and support delivered in a partnership between individuals, communities, the voluntary sector, the NHS and councils;
  • Plurality: the variety of people’s needs is matched by diverse service provision, with a broad market of high quality service providers;
  • Protection: there are sensible safeguards against the risk of abuse or neglect. Risk is no longer an excuse to limit people’s freedom;
  • Productivity: greater local accountability will drive improvements and innovation to deliver higher productivity and high quality care; and
  • People: we can draw on a workforce who can provide care and support with skill, compassion and imagination, and who are given the freedom and support to do so.

In addition, a partnership agreement called ‘Think Local, Act Personal’ was signed up to by a consortium of public sector bodies and private care providers to implement the vision.

Hertfordshire County Council has a corporate plan which sets out its approach to delivering council services. ‘Maximising people’s independence’ is a key objective in that plan. The plan also sets out a number of conditions of wellbeing which people in Hertfordshire should expect. These include services which should:

  • Create confident citizens;
  • Catch problems early;
  • Provide personalised services; and
  • Ensure safe and secure neighbourhoods.

Inform, advise and prevent…

A

pproximately 21,000 people contact adult social care every month in Hertfordshire, either by calling the council’s Customer Service Centre or through a referral from a family member orhealth professional.

Method of referral / 2010/11
Referred by GP or health worker / 15%
Referred throughacute hospital / 23%
Referred by family / spouse / 23%
Referred by other concerned person / 12%
Self-referred / 27%

Hertfordshire has had one telephone number for people to call to get access to advice and information about social care and support for over 10 years. The Customer Service Centre (CSC) currently receives 150,000 calls a year relating to adult social care, two thirds relating to individual cases, 25,000 general enquiries and 22,000 Blue Badge enquiries.

The CSC advisors taking calls about adult social care are currently being trained in greater depth, so that they can answer more enquiries at the first point of contact. This will also help social work staff who may later work with individuals to provide the support that they need, and will mean callers do not have to repeat information.

People working in our Customer Service Centre have access to good quality local information to pass on to callers / people. This might be letting people know about voluntary groups or services in their locality which could help them stay independent, or more information about health and social care services which can help them if their needs are more significant.

Every year, a number of people who use adult care services conduct a ‘mystery shopping’ exercise. They call the Customer Service Centre and pretend to be callers with different types of queries to see how the calls are dealt with by staff. In 2011, the mystery shoppers said there was an improvement on the same exercise the year before and the call centre staff are professional, polite and friendly.

Of the 64 ‘mystery shopper’ calls made to the CSC over 51.6% achieved an overall experience rating of excellent. Improvements will made to address those areas the panel identified where calls handling could be better.

Information and advice is also available to people in a number of other ways. The council prints 48 different publications which are displayed in our libraries, in local GP’s surgeries and from district council offices throughout the county. Information can also be found on the County Council’s website can also be made available,upon request, in different languages and other formats including large print, Braille and audio tape.

In 2010, we started a scheme called ‘In Touch’ which is run on our behalf by Age UK. If people call us who are independent at the moment, but who are worried that they might need assistance in the near future, we call them back every few months to see how they are. We give them advice and signpost them to local community groups who could help. The idea is to keep people independent for as long as possible.

Community agents and the First Contact Check-list

First Contact is a strand of the Information, Advice and Advocacy Strategy. The service has part-time Community Agents working across the county to provide short term one-to-one support to people who need it. The First Contact Checklist is a 12-question checklist designed by HCC to help a range of partners who visit vulnerable people in their homes to identify whether someone needs a home fire safety check, help to stop smoking, or to know more about community groups and local clubs. The checklist can also be filled in by Community Agents. People are then put in touch with organisations that can provide the services they need or advise them on services available locally including local social events and activities. First Contact is being built into the new Herts Help information network.
In partnership with Public Health, First Contact is also piloting three health trainers supporting older people (50+) who wish to improve their health. Facilitated by a health trainer, individuals can agree a health plan in which they set their own goals around diet, physical activity, alcohol abuse and smoking. As members of the communities they work in, health trainers also engage with local community groups, volunteers and health professionals to help support residents.

Blue Badge Scheme

In addition to the social care calls, Hertfordshire County Council administered requests for 19,300 blue badges in 2010/11. This scheme allows disabled people to park in priority places and benefit from other concessions including not paying the London congestion charge. Around 5,000 people get their badge automatically through their benefit entitlement but the remainder must provide evidence of their disability. There were some delays at various points during the year because of peaks in demand and this caused complaints. Additional staff were employed to deal with backlogs and a new management structure is in place to deal with future demand. Some changes are proposed to the Blue Badge scheme this year which may increase the numbers of people eligible for a blue badge.

We have also recently started a scheme called ‘Herts Help’. This is a single point of access that anyone in Hertfordshire can call to find the practical support, guidance and information they need to get the most out of life.

Call us:0300 123 4044

Email us:

Look us up: scheme itself is a network of organisations who can ‘signpost’ people and their families to community organisations or services that can best assist them. This might be the local Citizens Advice Bureau, another voluntary organisation like the Alzheimer’s Society, Carers in Hertfordshire or Age UK – or a specialist providerthat people may not know about within their locality.

Support from the Voluntary Sector

Hertfordshire County Council funds over two hundred voluntary organisations and groups to help people remain independent at home. These include luncheon clubs, countywide charities and small community groups. Grants range from £1m per year to Age UK through to £250 for a small local group. We collect information about whether people enjoy and value these services and we review the grants we provide every year to ensure we’re getting the best value for money. During 2010/11 we reviewed the services we commission from the voluntary sector and have been able to work with them to reduce the overall spend but maintain the services we receive.

Hertfordshire voluntary organisations funded / People benefiting from their services / Annual local authority spend
204 / 15,158 / £7.34m

Information and advice about autism

Hertfordshire Autistic Resource Centre (HARC) – the Hertfordshire branch of the National Autistic Society - isa very close and important partner, theytrain teaching assistants in Severe Learning Disabilities, Mild Learning Disabilities and mainstream schools. In partnership with HARC and the National Autistic Society we have held a number of awareness raising conferences for professionals and those with autism.

We fund an information advisory post that is hosted and managed by theNational AutisticSociety: the aim being to create a one-stop point ofContact/information for FairAccess to Care eligible and non-Fair Access to Careeligible individuals and theirfamilies. C4A is a support group for parents/carers of people with Asperger’s/High functioningautism run by HARC and based in Welwyn Garden City. They are actively involvedwith HARCand are key to moving the Autism Strategy forward with our otherpartners.

Falls Response Car

Hertfordshire County Council has worked in partnership with the East of England Ambulance Service on a new service which is the first of its kind in the country. The Falls Response Car is a 999 vehicle which responds to emergency calls when someone has fallen at home. The car is driven by a paramedic who is accompanied by a social worker. They can immediately get equipment or services to the person’s home to make sure they are safe – and prevent the person being taken to hospital. Previously, 90% of people who fell at home were conveyed to hospital and often stayed overnight. Two vehicles now respond to 999 falls calls in Hertfordshire. During January – March 2011,only 12% went to hospital and 88% of people were NOT conveyed to hospital.

Hospital Social Work Teams

A team of social care professionals is located at each of Hertfordshire’s main hospitals to quickly assist people being discharged home. They can assess whether any care and support is needed to ensure the person is safe to return home and their family carers are supported. In 2010/11, hospital teams assessed 4,400 people being discharged (an average of 85 people per week). The council is measured on whether it delays people’s discharge from hospital because it does not assess or arrange

services in time to make sure the person will be safe at home. In 2010/11, an average of 5 people per week were delayed across all hospitalsused by Hertfordshire citizens because of the time it took to arrange safe social care services to enable them to be discharged. This is one of the best rates in the country.

The Health Liaison team

This nurse led team that is integrated within the Community Learning Disabilities Service works across primary, secondary and tertiary services promoting equitable access to health care for people with learning disabilities (LD). This involves promoting awareness of health needs, tackling health inequalities, changing attitudes and developing skills and competency in supporting vulnerable groups. A regional survey highlighted that the council worked well with Hertfordshire GPs to the benefit of local citizens.

The team continually develop initiatives that improve health outcomes. Examples include the Purple Folder, a health portfolio & health action plan used during consultations that support health professionals to meet individual needs; a unique E-learning Programme that aims to raise awareness amongst health and social care professionals; and specialist communication tools. Initiatives developed in partnership with others include an award winning Prison in Reach Programme, an End of Life Care Project and the Health Champions Group (a service user led group) using creative arts to promote and address health priorities.

People who fund their own social care

The council charges people for the cost of their social care if they have savings or income above certain amounts. There is a different charging system for people who need a residential care place from people who have assistance in their own home. Information is available on the council website or through the Customer Service Centre for people on how this system works.Everyone is entitled to a free care assessment from the council, irrespective of their means. Our professionals will give information, advice and assistance in arranging services for people who will fund their own care.

Money advice

Advice and information on managing their money is accessible to all, through the CitizensAdvice Bureau, a network of voluntary groups, and the council’s own Money Advice Unit (MAU) for vulnerable adults. The number of people was reduced in the team on 1 April 2011 and additional monies given to the Citizen’s Advice Bureau to support more people in the community. The target of £4m in extra benefits received by our clients was exceeded in 2010/11, helping them achieve financial security and independence. Over 2,500 clients were assisted on the new money advice helpline. This year additional money was given to local CABs for debt advice services, which is particularly important given the difficult economic climate. Five new full time specialist debt advisers have been employed, helping over 1,000 new clients.

Recovery, re-ablement and rehabilitation

I

f people need more help than information and advice,adult social care have teams of professionals who can phone or visit people in their own homes. They assess them and decide whether someone’s needs are high enough to meet the council’s criteria to be eligible for social care services.

National eligibility criteria for social care exists called ‘Fair Access to Care Services’ (FACS) - which councils use to assess people and determine whether their social care needs can be met. FACS describes people’s needs in four bands – ‘low’, ‘moderate’, ‘substantial’ and ‘critical’. Hertfordshire County Council will meet the care needs of people assessed as of ‘substantial’ or ‘critical’ need – although these people may have to financially contribute towards the cost of their care depending on their savings and income.If people are not eligible, care professionals will sign-post to other organisations which can help them.