Appendix 2
Outcome Agreement Year One Evaluation – WrexhamCounty Borough Council
Strategic Theme – Improved quality and length of life with fairer outcomes for allOutcome – Reduced Inequities in Health
What we are trying to achieve
- PREVENTION - help to prevent young people from starting to smoke and increase awareness of the dangers associated with smoking and tobacco use.
- CESSATION - support smokers to give up and increase motivation to quit through raising awareness of services available.
- ENVIRONMENTAL ACTION - actions to encourage non-smoking as the norm through smoke free policies, protecting against exposure to second hand tobacco smoke, restricting youth access to tobacco and enforcement of legislation (sales of tobacco, advertising)
Current Strengths
Respiratory Health together with Tobacco Control has been identified by the Caring for Our Health2008-2011, the Health, Social Care and Well-being Strategy for Wrexham County Borough, as a public health priority area for Wrexham. The Respiratory Health and Tobacco Control (RHTC) Programme Group have developed an Action Plan which supports the delivery of the Health, Social Care and Well-being (HSCWB) priorities with regard to improving Respiratory Health mortality and morbidity in Wrexham. The group comprises of partners from Wrexham County Borough Council, Public Health Wales, Betsi Cadwaladr University Health Board and the Association of Voluntary Organisations in Wrexham (AVOW)
Areas for Improvement
- Prevention Activity for Children and Young People
- Improving links and increasing referrals to the Smoking Cessation Service.
- Actions which encourage a smoke free environment as the norm.
- Use of social marketing and publicity regarding the above areas to increase awareness and impact.
- Particular emphasis should be placed on reducing inequities.
Improvement Planned and Evidence
- Increasing effective prevention activity and training (e.g. ASSIST, ASH training, Smokebugs, Smoke free Class) in schools and youth services.
- Increasing referrals and awareness of Smoking Cessation services, including mainstreaming Brief Intervention Training for front line service staff particularly those who work with individuals and groups who are more likely to smoke (e.g. targeting Social Services, Communities First, Voluntary Sector and Manual Workers) – thereby helping to reduce inequities.
- Supporting environmental action on Tobacco Control through policies, enforcement and environmental action (to include linking with national initiatives regarding implementing smoke free homes and cars).
- Use of social marketing and publicity regarding the above areas to increase awareness and impact (Health Challenge Wrexham, Change 4 Life, National No Smoking Day, Get Well Sooner Project, Availability of Smoking Cessation Services).
- Demonstration of the use of evidence based practice to inform activity.
- Demonstration of the use of monitoring and evaluation to determine impact and improve activity.
- Demonstration of carrying out activity which aims to reduce inequities.
Actions / Deadline / Result 2010-11
A / Help to prevent young people from starting to smoke and increase awareness of the dangers associated with smoking and tobacco use
- Ensure effective prevention activity and training in schools and youth services (e.g. ASSIST,ASH training, Smokebugs and Smoke Free Classes)
- Mainstream brief intervention training for frontline service staff, particularly those who work with individuals and groups who are most likely to smoke.
B / Support smokers to give up and increase motivation to quit through raising awareness of services available.
- Support environmental action on Tobacco control through policies, enforcement and environmental action
- Increase awareness of Smoking Cessation services
C / Actions to encourage non-smoking as the norm
Use social marketing and publicity to increase awareness and impact / Ongoing throughout the agreement / Ongoing/ On Track
Evidence based practice to inform activity / Ongoing throughout the agreement / Ongoing/ On Track
Monitoring and evaluation to determine impact and improve activity / Ongoing throughout the agreement / Ongoing/ On Track
Activity to reduce inequities, including improving access to services / Ongoing throughout the agreement / Ongoing/ On Track
Reduce the illegal sale of cigarettes to minors / Ongoing throughout the agreement / Ongoing/ On Track
Measures / Target / Outturn / Comments
2010/11 / 2010/11
A / Help to prevent young people from starting to smoke and increase awareness of the dangers associated with smoking and tobacco use
- Number of referrals to smoking cessation services
- The percentage of those referred to smoking cessation services who are smoke free at 4 weeks
- The percentage of those referred to smoking cessation services who are smoke free at 12 months
- The percentage of frontline staff attending Brief Intervention Training
- The number of prevention activity events/training sessions held each year in Wrexham County Borough;
-ASH
-Smokebugs
-Smoke Free Classes / - 6 Schools
- 1 Training Event
- 12 Primary Schools
- 2 schools / - 6 schools
- 1 training event
- 12 Primary schools
- 2 schools / Met
A,B
&C / Prevention - help to prevent young people from starting to smoke and increase awareness of the dangers associated with smoking and tobacco use, Cessation - support smokers to give up and increase motivation to quit through raising awareness of services available and Environmental Action - actions to encourage non-smoking as the norm through smoke free policies, protecting against exposure to second hand tobacco smoke, restricting youth access to tobacco and enforcement of legislation (sales of tobacco, advertising)
The number of community events attended by Health Challenge Wrexham in order to increase the awareness of the impacts of smoking and the cessation services that are available / 15 / 18 / Met
C / Actions to encourage non-smoking as the norm
The percentage of underage purchase attempts for cigarettes/tobacco which result in a sale / Baseline to be established / 13% / Met
Reasons for shortfalls
1 / Differing reporting timelines in partner organisations has meant that full year information is not available until Quarter 2 2011-12. (We have been informed that the Non Smoking Day campaign in March led to large number of referrals to cessation services.)
Overall self-assessment of performance for this outcome: / Fully successful
Strategic Theme –The Environment Is Protected and Sustainable
Outcome –Enhancing the quality and enjoyment of the natural environment
What we are trying to achieve
a. Protect and enhance the natural environment
b. Encourage more people to enjoy the Natural Environment, CountryParks and public open spaces in Wrexham
Current Strengths
The protection and enhancement of the natural environment is currently delivered through the Wrexham Unitary Development Plan 1996-2011 (adopted 2005) supported by a range of supplementary planning guidance. A review of this Plan, the Wrexham Local Development Plan 2006-21, is currently progressing through its Deposit stage. When adopted (September 2012) this strategy will continue and will strengthen policies designed to protect and enhance the natural and built environments.
Areas for Improvement
1. Deliver a sustainable land use pattern that protects and enhances peoples’ quality of life and aids regeneration
2. Designating and protecting quality landscape including maintaining favourable conservation status for European protected species
3. Formulate conservation area character assessments and management plans and saving listed buildings of historical/architectural importance
4. Encourage more people to enjoy the natural environment, CountryParks and public open spaces in Wrexham
5. Work with other regional Authorities to devise new ways to ensure effective protection and enhancement of the natural environment
6. Engage regularly with the people of Wrexham to ensure their involvement in the development of policy documents that ensure the quality and enjoyment of the natural environment.
Improvement Planned and Evidence
Success will see the delivery of a sustainable land use pattern in Wrexham to ensure the protection of the natural environment, European protected species and buildings of historical importance, the completion of conservation area character assessments and the designation of a Local Nature Reserve at Plas Power. We also aim to engage regularly with the people of Wrexham to ensure their involvement in the development of policy documents, guidance notes, assessments and plans.
Actions / Deadline / Result 2010-11A / Protect and Enhance the Natural Environment
Designating a Local Nature Reserve at Plas Power in conjunction with Groundwork and the local Wildlife Trust
-Action Completed
-Progress Monitoring / - Year One
- Year Two / Slightly Off Track – Reason 1
N/A
Formulate conservation area character assessments and management plans in collaboration with public, private and voluntary organisations and local communities / Ongoing throughout the agreement / Slightly off track, 5 conservation area character assessments and management plans completed - Reason 2
Formulation of supplementary planning guidance and planning application procedures to protect European Species in conjunction with Countryside Council for Wales, COFNOD and local community and interest groups
-Supplementary guidance and application procedures completed and approved
-Annual progress monitoring / - Year One
- Year Two and Three / Action Complete
N/A
Transfer the responsibilities of the Mineral Officer at WCBC to a central specialist function for North Wales in Flintshire County Council and ensure that the effectiveness of this arrangement is monitored as necessary on a regular basis
-Duties transferred
-Monitoring meetings/report / -Year One
- Year Two / Action Complete
N/A
Engage regularly with the people of Wrexham to ensure their involvement in the development of policy documents, guidance notes, assessments and plans (e.g. Public consultation on the LDP, targeted consultation on Public Open Spaces, Conservation Management Plans etc) / Ongoing throughout the agreement / Ongoing/ On Track
Reduce the number of listed buildings of historical/ architectural importance at risk in WCBC in conjunction with CADW and landowners / Ongoing throughout the agreement / Ongoing/ On Track
B / Encourage more people to enjoy the Natural Environment, Country Parks and public open spaces in Wrexham
Through the use events encourage more people to visit Wrexham’s Country Parks / Ongoing throughout the agreement / Ongoing/ on Track
Measures / Target / Outturn / Comments
2010/11 / 2010/11
A / Protect and Enhance the Natural Environment
Number of conservation area character assessments and management plans formulated / 6 / 5 / Reason 2 (as above)
The number of listed buildings of historical/ architectural importance at risk in WCBC / 83 / 83 / Met
Engagement with the people of Wrexham to ensure their involvement in the development of policy documents, guidance notes, assessments and plans / LDP deposit, LDP Alternative sites, 7 local planning guidance notes and 6 conservation area character assessments and management plans / All LDP consultation on track
3 Local PlanningGuidance Notes complete and published
3 drafted and being consulted upon
1 being drafted and consulted upon with two other Local Authorities
5 Characterassessments/management plans complete / Slightly Off Track - Reason 2 and Reason 3
Percentage of designated Special Landscape Area lost to development / 0% / 0% / Met
B / Encourage more people to enjoy the Natural Environment, Country Parks and public open spaces in Wrexham
Volunteering in the parks - Number of volunteer hours spent in the parks carrying out voluntary activities / 4500 / 4890 / Met
The number of people who attend events in Wrexham’s Country Parks / 26,287 / 28,687 / Met
Reasons for shortfalls
1 / Work well advanced in discussions with Groundwork and Local wildlife trust and draft management plan worked up prior to Ecologist going on maternity leave in 2010. No further work was undertaken prior to her return in March 2011. Work now recommenced and designation report and Management Plan scheduled to be reported to Committee in June 2011.
2 / The target of 6 was missed by one character assessment/management plan – we accept that this is within our control and that progress is less than we would have liked.
3 / Local Planning Guidance for Welsh Language and Welsh Communities, Biodiversity and Development and Trees and Development were all completed and published this year.Substantial work has been carried out on the remaining four.Draft guidance for Affordable Housing, Public Open Space and Green Networks has been prepared and subject to internal consultation but cannot be finalised until the LDP is submitted to WAG/PINS this summer.There have been various drafts and extensive internal and external consultations on the Pontcysyllte Aqueduct, which is being drawn up in conjunction with Denbighshire and Shropshire, but it has not yet been finalised largely due to some disagreements with Denbighshire.
Overall self-assessment of performance for this outcome: / Fully successful
Strategic Theme – Good Social Care allows people a better quality of life
Outcome – Support is provided so that people can live independent lives
What we are trying to achieve
A. Enabling older people to live in their homes for as long as possible
B. Assisting older people to make active and informed choices for suitable housing and care
C. Assisting older people to maximise independence and quality of life
Current Strengths
There is strong member support for this outcome as this area is one of the WrexhamCounty borough Council’s key Improvement Priorities.
A number of key initiatives taking place in Wrexham will contribute to the achievement of this outcome;
- The Telecare service has, since its launch in 2008, supported over 550 new service users to live independently in their own home. The service includes mobile response to assist and support service users in the event of an emergency, for example lifting after a fall.
- A home adaptations review is currently taking place within the authority in order to ensure that any adaptations required, to ensure that people can remain living in there own homes for longer, are carried out as quickly and efficiently as possible.
- The hub and spoke warden service is currently being piloted and malnutrition toolkit training will be provided to people who are responsible for assisting in the care of the elderly, including sheltered wardens, to ensure that less older people are admitted to hospital with illnesses relating to malnutrition.
- The Falls Pathway, which helps to encourage increased mobility in older people, has been developed to decrease the number of people who are suffering from falls resulting in serious injury and broken bones.
Areas for Improvement
1. An increase in the number of people who are supported to live in their own homes
2. A wider variety of quality accommodation available for older people
3. An increase in the level and quality of support given to the significant number of unpaid carers of older people in Wrexham
4. Better general health and wellbeing of older people
Improvement Planned and Evidence
Success in this area would see more older people reabled to live independently, in suitable accommodation, and saying that they are satisfied with the quality and level of support they have received. The number supported in care homes will be maintained against a rising population (improved performance) and carers of older people will receive support to ensure a better quality of life.
Actions / Deadline / Result 2010-11A,B&C / Enabling older people to live in their homes for as long as possible, assisting older people to make active and informed choices for suitable housing and care and assisting older people to maximise independence and quality of life
Work with the independent sector and Betsi Cadwaladr University Health Board
In order to re-focus Re-ablement into a front-line assessment service provided to all people assessed as requiring support at home;
- Re-allocation of In-house domiciliary service workload to independent sector
- Scoping exercise undertaken on required capacity of the service
- Ongoing training provided to Re-ablement Staff
- In-house domiciliary Care Service converted into and assessment and re- ablement Service / Year one / Project on track overall – final action point slightly off track Reason 1.
Review and revise processes for assessment of carers’ needs;
- Complete the piloting of a revised carers needs assessment process
- implement the recommendations from this pilot across all service areas / Year One
Year Two / Complete
N/A
Continue with the implementation of the Falls Pathway in collaboration with Betsi Cadwaladr University Health Board and the Third Sector / Year One / Complete
Implement 20 point action plan, following the full review of the adaptation process / Year One / Complete
Develop Local Performance indicators to be used to gauge effectiveness of the implemented adaptations action plan / Year One / Complete – indicators to be inserted into the agreement for year two and three reporting
Monitor and report the key local performance indicators that will monitor the individual stages of the adaptation process. / Year Two and Three / Not reporting in year one
Review and Implement revised model for provision of domiciliary care services in collaboration with the independent sector
- Agree Strategy
- Map internal and external services
- Plan development
- Complete tender exercise / Year One / Complete
Work with Betsi Cadwaladr University Health Board and the Third Sector to ensure that individuals’ needs can be met within their local communities;
- Evaluation of the Locality Project Pilot
- Implement findings of the evaluation and extend the Locality Project to cover the whole of Wrexham County Borough by 2013 / Year One
Year Two and Three / Slightly Off Track – Reason 2
N/A
Hub and Spoke Warden Service Pilot Completed in collaboration with the Third Sector / Year One / Complete
Hub and Spoke Warden Service Pilot Evaluation Carried Out and Recommendations of the Evaluation Implemented/actioned / Year Two / Not reporting in year one.
Review the Volunteer Befriending Scheme to support socially isolated older people to confirm the future commissioning Programme in collaboration with the Third Sector / Year One / Complete
Measures / Target / Outturn / Comments
2010/11 / 2010/11
A,B&C / Enabling older people to live in their homes for as long as possible, assisting older people to make active and informed choices for suitable housing and care and assisting older people to maximise independence and quality of life
Reablement Service - The percentage of;
a)new users provided with Reablement / 50-60% / 91.75% / Met
b) Users requiring no ongoing purchased service / 30-40% / 46.07% / Met
The percentage of carers of adults who had an assessment or review of their needs in their own right during the year / 50-60% / 91.4% / Met
Percentage of carers who said that their needs were being met / 55-65% / 85% / Met
Number of carers joining Wrexham carers Leisure Scheme / 20 / 28 / Met
Number of Carers attendances at Wrexham County Borough Council Leisure Facilities / 200 / 30 / Reason 3
Percentage of clients (aged 65 plus) who are supported in the community during the year / 81% / 81.04% / Met
The rate of clients whom the authority supports in care homes per 1,000 population (aged 65 or over at 31 March) / 23.46% / 21.63% / Met
Adaptations Local Measures (to be established during Year 1) / Reporting in Year Two and Three / N/A / N/A
The number of additional people outside of sheltered housing receiving a warden service / 10 / 12 / Met
The percentage of Sheltered Wardens undertaking the malnutrition toolkit training / 60% / 30% (10 out of 37 wardens) / Reason 4
Average wait for domiciliary care provider to be identified / under 15 working days / 7 days / Met
Number of new ‘Enhanced’ Telecare packages / 100 / 128 / Met
Number of new ‘Basic’ Telecare packages / 300 / 437 / Met
Percentage of users who express overall satisfaction with support arrangements / Baseline to be established / 90% / Met
The rate of delayed transfers of care per 1,000 population aged 75 or over / 26 people / 25 people (2.38%) / Met
Reasons for shortfalls
1 / All on track except the staff consultation process which is now expected to be complete by 1st June 2011 and is not expected to impact on the identified service efficiency savings for 2011/12.
2 / Itwas intended that the locality model be more developed by Q4 but the joint-working with health,including the presentation to the Executive Board, were delayed from the Health side. The Head of Adult Social Care has updated SMT and ASIG on this.
3 / We are working with AVOW and their dedicated Carer’s register to raise awareness of the opportunities available to Carers. This is a difficult group to capture as their time as a carer leaves them little time to access physical activity. Their time away from caring is very precious, therefore the fact that they choose to exercise in that time, makes it more likely that they will continue to exercise in the future. This was a new PI for 2010-11 and we recognise that we were over ambitious when setting the target.
4 / Timescales and workloads did not allow for greater numbers to attend the training; priority for training was therefore given to those Wardens involved in the Hub and Spoke pilot. Further training in this area has not been identified for 2011/12 as no longer available, however, consideration will be given to said training should it become available again in future.
Overall self-assessment of performance for this outcome: / Fully Successful
Strategic Theme – Public Services are efficient and provide value for money
Outcome – More efficient and effective procurement
What we are trying to achieve
A. Adopting a new P2P System