Agenda and minutes

Resolved:-  That the minutes of the previous meeting held on 10^th March 2008 be approved as a correct record.

Green Lane Centre

The Cabinet Member was informed that letters from two volunteers who had sought information on matters relating to the Talking Book Service had been responded to by the Director of Health and Wellbeing.

Consideration was given to a report of the Director of Commissioning and Partnerships which outlined the progress being made to improve on the areas of weakness identified by the Commission for Social Care Inspectorate (CSCI) in the 2007 Annual Performance Assessment of registered Adult Services.

The 2007 social care Annual Performance Assessment (APA) identified that Rotherham is a ‘2 Star’ (Good) Authority with ‘Promising Prospects for Improvement’.  The report identified 60 areas of strength, which far outweighed the 29 areas of weakness.  This meant that the Authority had a platform on which to improve services and raise the standard of services towards excellent next year.

The Neighbourhoods and Adult Services Performance Assessment Excellence Plan, as set out in Appendix A, captures each of the identified areas of weakness made by the CSCI into an action plan.  This plan provides the Directorate with a focus on addressing the areas which will contribute to achieving a ‘3 Star’ (Excellent) rating.  Each weakness has been assigned to a Director with clear timescales for delivery including milestones to measure progress.  Progress is performance managed through the Directorate Management Team and reported quarterly to Members.

This is the first progress report since the plan was presented to the Cabinet Member for Adult Social Care and Health on 10^th December, 2007 and the Adult Services and Health Scrutiny Panel on 10^th January, 2008.

Of the 29 actions that are contained within the excellence plan, 26 (90%) are rated ‘complete’ or ‘on target’ and 3 (10%) are rated ‘off target’.

The following actions are rated ‘off target’:

·        Progress recommendations of the review of the intermediate care service.

A remedial action plan is in place performance managed through the Directorate Management Team to address areas of slippage

·        Raise awareness of services, the help available for older people from black and minority ethnic groups, and to improve access to services for BME post assessment, achieving targets for E47 and E48

      The hospital study of BME take up of service has now commenced and findings will be reported in April 2008

·        Implement electronic social care records

Delays have been due to problems with IT interfaces which are being addressed area by area. A successful ESCR pilot was run in Maltby on 17^th March.  A programme is in place to ensure that over the next 8 months ESCR will be implemented across Rotherham. 

The plan also identifies recent improvements to services and key achievements to date.  These are:-

v     Health and Wellbeing

Increased level of reviews from 45% to 75%

v     Improved Quality of Life

331 more assessments have been undertaken, and a reduction made of the backlog of assessments from 300 to 0, and 374 more older people helped to live at home this year compared to last year – and reduced waiting times for major adaptations from 183 days to 52 days

v     Making a Positive Contribution

The Authority has become Standard Bearers for Cabinet Office Customer Service Excellence Standard

v     Increased Choice and  ...  view the full minutes text for item 107.

This item was deferred for consideration on 21^st April, 2008.

Consideration was given to a report presented by the Director of Commissioning and Partnerships which gave an update on the implementation of Electronic Social Care Records in Adult Social Care Services.

The implementation of Electronic Social Care Records will mean that customer case records will no longer be held on paper, enabling greater agile working by Social Workers and other Staff providing services to Adults and Older People.

Phase One of the Project has now been completed.  This has included the full installation and configuration of the system, resulting in a fully working Electronic Document and Record Management System linked to SWIFT.

Full evaluation and detailed testing of the system will take place from April onwards with the first teams going ‘live’ on the system from July 2008.

A successful ‘live’ pilot was held between 14^th and 18^th March, 2008 within the Maltby Social Work Team.  This will be one of the first teams to go ‘live’ in July 2008 in the Maltby Customer Service Centre.

Phase 2 Implementation of the system will be:-

April 2008                 User Acceptance testing and process review

May 2008                  Local office PC set up and resolve issues list

June 2008                 Develop training materials and train the trainers

July 2008                  Commence end user training and first teams go live

Aug-Nov 2008           Review and roll out to remainder of services

Capital funding of £761,000 has been allocated and the majority utilised for software, hardware and professional services to implement ESCR across both Neighbourhoods and Adult Services and Children and Young People’s Services.

An element of this funding, approximately £100,000 has been earmarked for the scanning solution and further work is required with RBT to achieve best value for money.

The meeting discussed future work to improve the access and linking of customer case records by Rotherham Primary Care Trust.

Resolved:-   (1)  That the report be received as an update on ESCR implementation.

(2)  That a further update report be submitted to a future meeting in September 2008.

The Strategic Planning and Commissioning Manager presented the submitted report which set out the commissioning intentions and analysis of local need, described services that currently exist and highlights gaps in provision.  It identifies those service areas where a joint approach would be most effective and sets out proposals on joint commissioning arrangements, service reconfiguration and resource allocation.

The Joint Commissioning Strategy, which has been subject to a comprehensive consultation programme, replaces the current joint strategies for Long Term Conditions, Intermediate Care and Older People’s Mental Health, and enmeshes the content of the Adult Services Strategy.

Service users and partners have all endorsed the direction of travel set by the strategy.  There is strong support for identifying specific priorities and building the joint planning framework around these.  The consultation process has highlighted gaps in coverage of the strategy, specifically in relation to mental health and learning disability.  The Adults Board intends to update the strategy over the next year to include these communities of interest.

The overarching vision of the Joint Commissioning Strategy is to:-

v     Maintain people in independence for as long as possible

v     Develop community-based services, which provide choice and improve quality of life

v     Make sure that health and social care services are working closely together

v     Maintain mental well-being well into later life

The Joint Commissioning Strategy proposes that, over the next three years, Rotherham MBC and Rotherham PCT will work together to:-

·        Improve the quality of health and social care services to people who have a long term condition.

·        Develop effective rehabilitation and support services to ensure people can maintain their independence.

·        Make significant improvements to services which focus on the mental health needs of older people.

·        Reduce hospital admissions and admissions to residential or nursing care by helping people to stay at home for longer.

Over the next fifteen years Rotherham MBC and Rotherham PCT will:-

·        Develop fully integrated health and social care services in the community for people with long term conditions.

·        Develop a fully integrated specialist service for older people with mental health problems, which is co-located within a purpose-built unit and incorporates relevant inpatient and community-based services.

·        Develop a new service structure based on enablement rather than delivery of direct care.

·        Fully integrate the commissioning function for community based health and social care services. 

Resolved:-  (1)  That the Joint Commissioning Strategy be endorsed.

(2)   That a progress report on the implementation of a Joint Commissioning Strategy be submitted in September 2008.

(3)  That the report be submitted to the Adult Services and Health Scrutiny Panel.

Consideration was given to a report of the Service Performance Manager which outlined the 2007/08 key performance indicator 3^rd quarter results for the Adult Services elements of the Directorate.

At the end of the quarter, 17 (68%) key performance indicators are currently on track to achieve their year end targets and improve upon their position last year.  Seven indicators are rated ‘off target’, which again is an improvement from the last quarter when 9 indicators were rated ‘off target’.

Currently, it is projected that 4 areas of the service will have delivered ‘step change’ improvement by the end of the year.  These relate to doubling the number of reviews that have been undertaken (D40), increasing the help given to carers (C62), improving the number of people that are given a statement of how their needs will be met (D39) and the reduction in the time people now have to wait for an assessment from 12 weeks to 1 week (D55).

There are 7 indicators that are rated ‘off’ target, and are shown as a red triangle alert in Appendix A.

The report set out exceptions, and the recovering actions in place for the following indicators that are rated as ‘off’ target.  These are:-

-                       D40 – Reviews completed of those on service

-                       C28 – Intensive Home Care

-                       C62 – Services for carers

-                       C32/C29 – Older people and those with physical disabilities helped to live at home

-                       D54 – Equipment delivered in 7 days

-                       C72 – Permanent admissions of older people to residential/nursing care

-                       E82 – Adults (over 18’s) assessments leading to a provision of service

-                       E47 – Ethnicity of older people receiving an assessment

-                       LPI 102 – Number of protection plans in place

Members raised questions with regard to:-

-                       Range of benchmarking opportunities and performance with statistical neighbours

-                       Need for more resources from both the Local Authority and Rotherham Primary Care Trust  in order to “shift the balance” from Hospital provision to provision in the community

-                       Local Area Agreement and impact on indicators

-                       Delayed Transfer Charges

-                       Repeat Admissions

-                       Services for Carers

Resolved:-  (1)  That the results and remedial actions in place to improve performance be noted.

(2)  That the Strategic Director write to the Interim Director of Assessment and Care Management thanking him for the service he has given to the work of the Directorate and to pass on the Cabinet Member and Advisors’ best wishes for his future.

The Service Accountant (Adult Social Services) submitted a budget monitoring report, informing of the latest projections and commitments against the approved Adult Services capital programme for the 2007/08 financial year.

The capital monitoring report provides detail of the approved capital programme for the Adult Services department of the Neighbourhoods and Adult Services Directorate, actual expenditure for the period April to mid February 2008, and the projected expenditure for each scheme to the end of March 2008.

The approved 2007/08 capital budget for Adult Services has been revised to take account of slippage in a number of schemes reducing from £15.6m to £12.5m, the main revision being in respect of the two new residential care homes which are experiencing some delays on completion. 

Actual expenditure to mid-February 2008 was £6.1m.  The approved schemes are funded from a variety of different funding sources including unsupported borrowing, allocations from the capital receipts, Supported Capital Expenditure and specific capital grant funding.  Appendix 1 shows actual expenditure to date against the approved budget, together with projected expenditure to the end of the financial year.

The report set out a brief summary of the latest position on the main projects within each client groups, as follows:-

-                       Older People

-                       Learning Disabilities

-                       Mental Health

-                       Management Information

Particular reference was made to an increase in costs in relation to the construction of the two new residential care homes.  It was noted that the Strategic Director, Environment and Development Services had been asked to monitor the situation.

Resolved:-  That the latest capital expenditure monitoring report for 2007/08 be received and noted.

The Service Accountant (Adult Social Services) presented the submitted report which provided a financial forecast for the Adult Services Department within the Neighbourhoods and Adult Services Directorate to the end of March 2008 based on actual income and expenditure to the end of February 2008, and highlighted the main areas of change since the previous monitoring report.

During the year there have been a number of budget pressures within the service, mainly in respect of the non-achievement of a number of savings proposals, built into the 2007/08 budget, for reducing service level agreements with voluntary and community sector providers, in addition to demand pressures on domiciliary and residential care budgets.  These have been reported throughout the year in previous budget monitoring reports.  A number of management actions to reduce these pressures were also identified, however subsequent to implementing these actions, a significant pressure remained.  As part of the Revised Estimates process the Cabinet approved an additional one-off budget allocation of £974k to reduce the projected overspend in 2007/08. 

The current forecast position for the year shows a projected balanced budget.  All management actions have now been incorporated into the financial projections.

There still remains underlying budget pressures within Domiciliary Care services, including a shortfall in income from charges against the approved budget plus pressures within Physical and Sensory Disabilities mainly within residential care due to increased demand and an increase in the average cost of care packages.

These pressures are being reduced by:-

v     Projected underspends in independent residential care and extra care housing within Older Peoples services,

v     Slippage in developing supported living schemes within Learning Disability services and further additional income from continuing health care funding and

v     Management actions identified from budget performance clinics

The meeting discussed:-

-                       recent one off budget allocation and current budget pressures in terms of possible impact in 2008

-                       Social Care Reform Grant and conditions attached to spend

-                       additional budget pressures – construction of two new residential homes/Residential Care Packages/Demographic issues

Resolved:-  That the latest balanced financial projection against budget for the year based on actual income and expenditure to the end of February 2008 for Adult Social Services be noted.

Further to Minute No. 99 of a meeting of the Cabinet Member, Adult Social Care and Health held on 25^th February 2008, the Director of Commissioning and Partnerships presented the submitted report in respect of a proposal to introduce charges for transport to day care.

A consultation exercise carried out with customers had been via a questionnaire and through meetings held in day centres.

The report outlined the results of the consultation exercise and provided a recommendation for decision.

It is understood that people do not like to be charged for services which they have received free previously.  The service will endeavour to ensure that everyone who should receive transport related benefits (Disability Living Allowance – Mobility Component) and free bus passes, are able to make a claim.  Transport is seen as a daily living charge, in the same way as meals, for which people should be expected to pay.

On balance, a significant number of people are in favour of such a charge.

Members raised questions with regard to the consultation process.

Resolved:-  That, subject to the outcome of a meeting between the Cabinet Member and carers, a £1 per day transport charge be implemented for people using day services, one month’s notice to be given from effect from 7^th April, 2008.