Contents

Glossary 3

Introduction 5

Vision, Aims and Objectives 8

National Drivers 9

Local Drivers10

Current Position11

Gaps in Provision13

Local Demand15

Developments17

Commissioning Intentions19

Ways Forward23

Appendix 1 – NHS Lincolnshire Strategic Plan for LTC24

Glossary

This section gives brief definitions of some of the terms used within this document.

Carer – An individual or individuals who support someone with a need without being paid

Changing Places – A type of public toilet or changing facility that is specially designed to be accessible for people with profound or multiple needs that has as a shower, bed, and hoist as well as toilet facilities

Commission for Social Care Inspection (CSCI) – The body responsible for inspecting all social care services including Adult Social Care within LCC

Commissioning – Finding out what people want, need and should have,and making sure it is available

Community Strategy – An overarching document that pulls together all local long term plans

Day Services – The things that people want to do during the day. This has traditionally meant Day Centres but now covers all opportunities for people in the day, evening and at weekends

Direct Payments – The method for passing payment to an individual in lieu of social care services

District Councils – The organisations that are responsible for delivering local services within areas of a larger local authority. This often covers housing, household waste, etc.

In-house Services – The services that are provided directly by Lincolnshire County Council

Individual Budgets– The nationally used term for bringing together a collection of funding streams used to buy services and allocating it directly to individuals rather than services

Job Coach – A person who will support an individual in the work place so they can gain the skills needed to do and maintain employment

Joint Strategic Needs Assessment (JSNA) – A document that looks at the health and social care needs of an entire population

LincolnshireCounty Council – The local authority responsible for delivering services within Lincolnshire that includes Adult Social Care among others

NHS Lincolnshire (NHSL) – The local National Health Service responsible for delivering health services in Lincolnshire (formally Lincolnshire Primary Care Trust)

Local Area Agreement (LAA) – An agreement between a number of local organisations that agrees the priorities for that area

Local Operating Plan (LOP) – The plan that states how local health services will be improved and financed

Local Strategic Partnership (LSP) – The local partnership that is responsible for the Community Strategy and LAA

Personal Budgets– Adult Social Care funding that is assigned to an individual based on their needs and which can be spent on meeting that individuals needs

Personalisation– The method for changing services so that individuals have more choice and control on their services and funding

Person Centred Plan – A plan that is drawn up by an individual (and those around them) to demonstrate their wants, needs and aspirations and to look at ways of meeting them

Preventative Services – Low level services that aim to stop people having the need to require more long term services – e.g. community groups

Putting People First – The document put out by Central Government that sets forward the future of Social Care

Resource Allocation System (RAS) – The system that allocates funding from assessed need via a Personal Budget

Respite – A break (normally in a residential facility) for an individual or a Carer

Short Breaks – The new term for respite which allows for greater flexibility

Supported Living – The name given to accommodation with support where the two are separated and an individual has a separate support agreement to their tenancy agreement (or house ownership)

Supporting People – A Central Government funding stream that is administered by local authorities that pays for housing related support to enable individuals to remain in their own home

Transformation – The term given to the change that is taking place within Adult Social Care as part of the Putting People First Agenda

Introduction

Lincolnshire County Council is embarking on a significant period of transformation within the Adult Social Care agenda. Central to this transformation is the development of a set of commissioning strategies that will detail the way forward for Adult Social Care across Lincolnshire. Full commissioning strategies will be developed over the coming year, along with more detailed analysis, but in order to support transformation and development interim commissioning plans have been developed. This document covers the Physical and Sensory Impairment agenda.

These commissioning plans are an important stage in Lincolnshire’s long term strategy to become a commissioning led authority. The agenda for change and transformation of Social Care is significant. Social Care Services will change beyond recognition within the next decade. How services are commissioned, delivered and accessed will be influenced by the impact of personalisation in relation to a greater emphasis on personal choice and control. The challenges of a greater focus on prevention, preventing dependence and outcomes will all take place within the context of putting people and their communities at the heart of the decision making process.

Lincolnshire County Council is listening and is responding to the expressed wishes of the people it serves. These plans are an expression of the need to move forward through a structured and cohesive approach to the specification, co-ordination and procurement of services at a strategic level. The need to joint commission services with Health colleagues and to work in partnership with providers will and should ensure greater value for money and the efficient use of resources.

All these aspirations for future services will be framed by an understanding of individual needs and how collectively, through appropriate provision of services, they can be met. For this to be achieved these commissioning plans will be formulated through mapping existing services and demographic profiles and then calculating what is needed against what is available. This equation will then form the basis of the development and the strategic commissioning of new services and the decommissioning of services that are no longer required.

These plans will need to reflect market trends and manage the change agenda, whilst maintaining the levels of service that are available at a strategic level through a gradual redistribution of resources via a current centrally controlled system to a more community focussed and person centred approach. The transitional commissioning plans that arise from the impact of transformational change are designed to ensure that there is sufficient capacity, robust structures and the systems in place which will be able to deliver effective and efficient Adult Social Care Service to all eligible people within Lincolnshire. The service commissioning plans are designed for a rolling three year period and will be renewed annually.

Lincolnshire is the fourth largest County in the UK, with a total area of almost 6000 square kilometres. It has a predominantly rural based population of around 650,000. In terms of population growth the County is expanding faster than most other comparative authorities in the East Region with increases in both birth rates and inward migration. The County has a mix of some large conurbations, sparsely populated rural areas and coastal communities that have seasonal variations in their profiles through issues of migrant workers (national and regional) and inward retirement migration. The population profile varies significantly across the County.

Although there has been an influx of migrant workers into Lincolnshire the levels of diversity within the Lincolnshire population are significantly lower than across the East Midlands.

A more detailed analysis of the profile of Lincolnshire- in relation to its demography and resources - has been undertaken and will be used to formulate specific local plans within a commissioning framework. The Joint Strategic Needs Assessmentwas completed in March 2008. The idea of a Joint Strategic Needs Assessment (JSNA) was first introduced by the Department of Health’s report Commissioning for Health and Well-being. Subsequently the Local Government and Public Involvement in Health Act (2007) has made JSNA a requirement for which Directors of Public Health, Adult Social Services and Children and Young People’s Services are jointly responsible. We will use the information we have from the JSNA and a report commissioned from Laing and Buisson - ‘The Supply and Demand for Care Services in Lincolnshire’ February 2008 to justify strategic decisions to either commission or de-commission services in a particular area, in order to meet the needs of people within a particular group or their community.

All strategic commissioning decisions will go through a communication and consultation process as identified within this document.

It is clear that the local authority through its commissioning arrangement with partners will need to change how it commissions services. A needs led re-modelling of services is seen as the most effective approach, with the advantages of:

  • An ability to respond to people’s expressed choice and desire to control the services they use.
  • The ability to de-commission those services which are no longer appropriate.
  • Managing the change agenda with the minimum of impact on service continuity.

There are however risks associated with the need to reconfigure the commissioning arrangements for service which are:

  • Stability of the market as it changes from a centrally commissioned to more localised consumer directed arrangements.
  • The move to more preventative, needs led services from the current acute and intensive forms of care and support.
  • Financial implications of a transition stage where some services may need short term support while they respond to the changing market needs.

Communication and stakeholder engagement will be a continuous process, in which stakeholders are engaged as active partners in determining the commissioning requirements for adult social care. The various communication activities have been designed to ensure this two-way communication process.

  • Provide key messages explaining the work being undertaken to meet the current and future needs of the County’s population through commissioning plans which ensure a mixed economy of care.
  • To keep key stakeholders informed of the decisions and progress regarding the strategic commissioning intentions of LCC.
  • Provide specific information as part of the wider Transformation of Adult Social Care programme, particularly how the commissioning plans begin to incorporate the step changes necessary to achieve the vision for Individual Budgets, Self-Directed Support and putting choice, power and control in the hands of service users and carers.
  • Through engagement with providers begin to influence the market to provide a more flexible range of services to meet service user expectations, through future contracting arrangements.
  • Provide stakeholders with information about services that are to be commissioned and decommissioned.
  • Ensure transparency in detailing how we will engage with service users and carers and other stakeholders. This will involve building on and/or incorporating findings/recommendations of consultation/engagement undertaken as part of recent best value options appraisals, service reviews, visioning events, and deliberative events for other strategies such as carers’, LAA, LSP etc.

Vision, Aims, and Objectives

Every organisation is driven by its core values. These values are supported by principles that underpin their behaviour. The values of Lincolnshire County Council are captured by the word PERFORMS, this stands for:

  • Putting Customers first
  • Encouraging innovation in a learning organisation
  • Results and successful outcomes matter most
  • Focussed on the needs of the citizen, customer and community
  • Openness and honesty, welcoming of challenge and being accountable
  • Respecting and including everyone, with equality of opportunity and celebration of diversity
  • Making a difference through community leadership
  • Setting challenging standards; always striving to improve services

Supplementary to these values the Commissioning services also aims to:

  • Have the right services available, which are in the right place and are provided at the right time
  • Improve the well being of the County’s adult community
  • Have clear standards and commission services providing high quality care
  • Improve access to a range of services
  • Improve the service user experience through greater choice and control
  • Ensure fairness and equity in service delivery through putting people first.

In addition, Lincolnshire through its recent consultation with service users and carers have identified a series of eight aspirations. These expressed service priorities will form the basis for service delivery and will be reflected in the mapping of existing services and the commissioning of new services.

  • Transport & Accessibility. (e.g. making places easier to get to)
  • Support services to help reduce isolation. (e.g. Drop-in centres)
  • Respite Services. (e.g. providing a break for carers)
  • Flexible support. (e.g. 24 hour care)
  • Access to daytime opportunities and employment. (e.g. help to get out and about and get a job)
  • Access to information. (e.g. helping you to get the information you need)
  • Supported Housing. (e.g. providing supported accommodation and helping people to live independently in their own homes)
  • Carers support services.(e.g. providing training, information and support for carers)

The aim of this plan is to ensure that services and opportunities for people with Physical and Sensory Impairments are what people want, what they need, and are both cost and quality efficient. We will do this by carrying out a brief analysis of current service provision and examining where and how transformation is needed to enable improvement. The objective of this plan is that we will produce a document that gives us and our partners a clear and defined way forward to develop services and opportunities in Lincolnshire.

National Drivers

The Government’s White Paper, Our Health, Our Care Our Say, identified a number of key outcomes for communities and individuals being served by health and social care agencies.

These are:

  • Improved health
  • Improved quality of life
  • Making a positive contribution
  • Exercise of choice and control
  • Freedom from discrimination or harassment
  • Economic well-being
  • Personal dignity

There are also two additional outcomes identified for Health and Social Care Agencies which relate to Commissioning / Use of Resources and Leadership.

The ‘Putting People First’ agreement signed in December 2007 establishes Department of Health funding for the next three years to deliver a system wide transformation of social care. With the emphasis on every area having a single community based support system focussed on the outcomes above. The monies are intended to be spent on systems and processes that will deliver the self directed support/personalisation agenda.

We are also nationally led by a series of national performance indicators and targets. Both Performance Assessment Framework (PAF) and Public Service Agreement (PSA) targets have been set nationally and prioritised at a local level. These along with Health and Supporting People targets need to be considered in how we prioritise our local resources.

Local Drivers

Lincolnshireis - like all local authorities are through the Local Government Act 2000 - under a duty to produce a Community Strategy to improve the economic, social and environmental well being of their area. The Sustainable Community Strategy for Lincolnshire 2006 – 2021 was agreed by the Lincolnshire Assembly in 2006. The Assembly is a partnership of organisations and agencies who work together in order to provide services across the County. They have agreed four priority areas: Safer Stronger Communities: Children and Young People: Health and Social Well-Being: Economic Development; which they seek to deliver through a Local Strategic Partnership (LSP). The Local Area Agreement LAA is an action plan agreed between the Assembly, central and local government to deliver genuinely sustainable communities through better outcomes. This is a three year agreement, which is refreshed every year to ensure that is relevant and up to date with the needs of the people of Lincolnshire.

For more details please refer to

Other local drivers include the suite of corporate plans that this document will feed into and will be fed by. For Lincolnshire County Council this will be the Corporate Business Plan, and the Communities Directorate Service Plan. Prioritisation of resources will be affected by the direction of travel agreed within these documents, and will reflect the direction of the Council, its priorities, and those of elected members.

This will be added to through our integrated way of working with the corporate plan of NHS Lincolnshire (NHSL). The Local Operating Plan (LOP) will contain the ways forward in terms of health funding, and we will be able to work with colleagues within NHS Lincolnshire to submit towards joint projects within this document. It will also give us the ways forward of NHS Lincolnshire and its Board.

The Supporting People Strategy is a document covering the intentions for resource allocation from within the Supporting People funding stream for a five year period. This document gives the direction of travel for the Supporting People Commissioning Body and will influence how and what we can develop, and commission jointly.

Finally, local priorities are influenced by the Commission for Social Care Inspection (CSCI) who act as the Social Care regulating body, and are responsible for assessing Lincolnshire County Council’s Adult Social Care rating. Within the work they take on with us they will support us in prioritising areas that need improvement, and resources will be utilised in areas where it has been highlighted or that we have noted that we need to improve our services to the people of Lincolnshire.

Current Position

Population

Lincolnshire Total Population
Year / Total
2001 / 646,646
2008* / 703,600
2010* / 721,600
2014* / 757,600
2020* / 811,400
2031* / 902,400

* 2008 – 2031 are projections from Lincolnshire Research Observatory