- Strengths and
improvements during the year.
Assessment
has highlighted the following strengths and improvements to services
for adults during the last year.
Long-term
care for older people
Intensive
homecare as a proportion of intensive homecare and residential care
has improved to 25% (Source: PAF B11), and is higher than average for
Shires and England. The rate of admissions of supported residents aged
65 to residential/nursing home care remains low at 95/10,000 (Source:
PAF C26). These figures demonstrate that Oxfordshire is promoting the
independence of older people and enabling them to remain in their own
home rather than move into residential settings. The actual number of
people supported to live at home is relatively low but has improved
since the previous year. (PAF C32). This is within the 1999/2000 context
of a relatively low rate of 18.6/1,000 of the population older people
permanently supported in residential care (Source: Key Stats AC15a)
The
rate of intensive homecare has improved to an acceptable level of 8.5
(Source: PAF C28). and a relatively low rate of households receiving
lower intensity homecare (Source: Key Stats AC15a)
A
major programme of commissioning of services for older people, with
a pooled budget of £40M, and Social Services as lead commissioners has
been agreed
Long-term
care and support for adults aged 18-65
The
number of people with learning disabilities helped to live at home has
improved, and is now at a good level of 2.6. (Source: PAF 30). This
is complemented by a good rate of supported admissions of adults aged
18-65 to residential and nursing home care. (Source PAF C26)
Carers
The
council supports three carers’ centres, and a relatively high number
of carer assessments are carried out (Source: PAF D42)
Mental
Health services
An
SSI inspection of mental health services in December 2000 found a number
of strengths, with an overall conclusion that Oxfordshire provided a
responsive service. The directorate has drawn up an action plan to address
the SSI’s recommendations.
Inspections
of residential care for adults and older people
There
was very good performance on PAF PI C34, the inspections of residential
homes completed as required.
Percentage
of items of equipment and adaptations costing less than £1000 delivered
within three weeks
Although
the percentage of pieces of equipment costing up to £1,000 delivered
within 3 weeks has deteriorated, performance on this indicator (PAF
D38) is still good
Asessments
and Reviews for users
There
was a high rate of assessments of older people per head of population,
although of these, a low rate went on to receive services (see below).
A high proportion of people said that get help quickly (PAF D36)
- Areas for development
Assessment
has highlighted the following concerns about performance during the
year:
Availability
of single rooms
The
proportion of people in single rooms in their residential accommodation
has deteriorated, and is very low at 66% (Source PAF D37). This is a
consequence of high fee levels and constrained budget
Assessment
and reviews
Data
for the percentage of people receiving a statement of their needs and
how they will be met is missing, and it therefore difficult for the
directorate to assure the quality of assessment. (Source: PAF D39).
90%
of assessments of adults and older people lead to provision of service.
(Source: PAF E50). This indicates that people with lower levels of need
do not receive assessments. It is important that the relatively high
threshold for social services intervention is complemented by good preventative
community services. Conversely, there are low numbers of people from
ethnic minority groups whose needs are assessed (PAF E47), and a high
proportion of these go on to receive a service (PAF E48), suggesting
that these people do not have access to social care until they have
high levels of need.
The
number of clients receiving a review met is relatively low (Source:
PAF D40).
Costs
of services
In
common with other councils in the South East, the cost of intensive
social care for adults and older people, the unit cost of residential
and nursing care for older people, the unit cost of residential and
nursing care for people with learning disabilities, and the unit cost
of homecare for adults and older people are all high. This clearly places
a strain on the difficult budget position.
Interface
with Health
The
proportion of emergency psychiatric readmissions has increased and is
now relatively high.
Delayed
transfers of care in acute hospital beds have not been as great a problem
in the Oxfordshire Health and Social Care system as in other parts of
the South East. However, the whole system is under strain, with: significant
pressure on community hospital beds; increasingly limited absolute capacity
in the independent sector residential and domiciliary market; funding
constraints which limit support to people at an early stage, with the
potential risk of deterioration and greater service needs. It will be
important for Social Services to build on the success of its new Commissioning
service for older people, through a stronger plan for "Building Capacity
and Partnership in Care". The national Change Agents Team will work
with Oxfordshire in 2002/03.
- Prospects for
Improvement in 2002 – 03