Agenda item

10:30

Contact: Alan Sinclair, Programme Director – Transforming Adult Social Care (01865) 323665

It has been agreed that a report on transforming Adult Social Care will be brought to every meeting of this Committee (AS5) and will include detail on self directed support.

The above report includes a short update on progress in relation to the policy for the operation of personal budgets for Adult Social Care in Oxfordshire (the Resource Allocation Policy), together with the Quarterly Milestones self assessment report (Refer Annex 1).

Mr Sinclair will attend to answer any questions the Committee may wish to ask.

The Self Directed Support Task Group is also invited to give its progress update to the Committee as part of this item.

[Task Group comprises Councillors J. Hannaby, S. Hutchinson & L. Sanders].

The Committee is invited to track progress and conduct a question and answer session.

The report before the Committee (AS5) included a short update on progress in relation to the policy for the operation of personal budgets for Adult Social Care in Oxfordshire (the Resource Allocation Policy), together with the Quarterly Milestones self assessment report (Annex 1).

Mr Alan Sinclair (Programme Director – Transforming Adult Social Care) attended before the Committee, together with the Cabinet Member for Adult Services, in order to answer any questions which the Committee wished to ask.

The Committee noted the update from Mr Sinclair as detailed in report AS5.

Mr Sinclair reported as follows:

In relation to Social Capital/Community Building the work undertaken by the Institute of Public Care was now completed and a revised approach would be taken in this area. A document had been produced which identified characteristics where communities were and were not supporting people well and the Directorate wanted to devise a checklist based on this evidence for communities to use.

Issues challenging TASC were:

• transferring existing long term service users (c 3000) to personal budgets by April 2010. There was a large number of people to be transferred, all of whom would need reviewing and  were likely to  be given a smaller budget than the current cost of the services they were receiving (although it was anticipated that they will be able to purchase services more cheaply in future);
• revamping the ICT system – this is the area of TASC where the least progress was being made. The required capital investment was still to be confirmed in the current financial climate, which was appropriate given the circumstances. (Capital investment was agreed shortly after this meeting);
• officers were struggling with implementing the workforce strategy. However, they were right to stall, as this too needed to be re-examined in light of less money.

The Committee then conducted a question and answer session. A selection of the Committee’s questions, together with Mr Sinclair’s responses, is listed below:

• In relation to Milestone 3: Prevention and cost effective services – the document states that by April 2011 there should be evidence that cashable savings have been released as a result of the preventative strategies and that overall, social care has delivered a minimum of 3% cashable savings. The likelihood of achieving the milestone by this date has been assessed as ‘fairly likely’. Surely this should say ‘very unlikely’, won’t it take years to be quantifiable?

The overall impact will be longer term, but we need a system where we can record soon that an intervention has led to an outcome and to a reduction in expenditure. In terms of falls prevention and continence services, work here has an immediate outcome and payback. Careful monitoring needs to take place so that we can see where the financial savings occur.

• How fundamental is a properly functioning ICT system for self directed support – such as assessments and record keeping – surely this must be dependent on a properly functioning system? When are you going to get it and what are you going to do?

There are a number of solutions that can help us with ICT. The current ICT system which we are using is not fit for purpose now and will not be adequate to administer self directed support in future. We are having to bolt on “add ons” to enable administrative type functions to be performed.  Developing the Resource Allocation System (RAS) does require some upfront investment but once the model is running it will be relatively straightforward  and cost effective. The issue is whether the allocations are recorded on paper or electronically.

• Personal budgets are an area that is supposed to deliver efficiency savings. Are there still more savings to find in this area?

We won’t know until October the extent of the overall savings that we have to make (Comprehensive Spending Review).  The RAS can deliver as many savings as you want it to but the issue is can people still buy the care and support that they need with the personal budgets they are given. Officers will need to test the average unit costs as the market changes in response to personalisation. In six month’s time we will need to see if people have managed to buy the level of services that they need. Managing demand will be based upon eligibility criteria and prevention activities.

• There has been a lot of coverage in the national media about people using their personal budgets to purchase sexual services. How will this be mitigated against in Oxfordshire?

The Directorate will not be producing a list of “do’s and don’ts” but people will only be allowed to spend their personal budgets on services that are safe, legal and affordable.

• How many personal assistants (PAs) are there at the moment in Oxfordshire?

We don’t know the number of PAs in Oxfordshire. People have been employing neighbours and friends for a number of years. About 60 people are going through the Council’s ‘Support with Confidence’ scheme now, but this will still not be a sufficient number of PAs to meet the expected demand. We are looking at how many people we think we will need in future.

• If people are going from council assistance to non council PAs will you be monitoring the quality of care provided?

All aspects of self directed support are currently being monitored, eg the number of assessments carried out, the number of people with a care plan, whether people are using council approved PAs or not and which services people are purchasing. People are being advised to purchase services that are safe and certified. If officers thought that a vulnerable person wanting to employ their neighbour was at risk they would check that everything was ok before approving their budget and depending on the circumstances be reviewing them more often.

This Committee then AGREED to advise the Cabinet that it endorsed the requirement for a new ICT solution and agreed that a new system with the right requirements to meet the changing needs of adult social care would make a significant difference to personalisation and help to deliver subsequent efficiencies.

The Committee also noted:

• that Mr Sinclair would focus on the Adult Social Care Information and Advice  (and Advocacy) Strategy as part of the next TASC report to Scrutiny;
• the progress update from the Self Directed Support Task Group and AGREED to nominate Councillor Don Seale to join the Group.

The Committee noted that the Self Directed Support Task Group would be monitoring all of the changes over the next few months, including:

• monitoring the impact and outcome of changes on service users, carers and staff;
• meeting with brokers and user-led organisations to find out how it feels to go through the process;
• looking at the sustainability of the changes once the TASC team is disbanded.