Agenda item

Councillor Roche, Cabinet Member for Adult Social Care and Health, introduced the agenda item highlighting that all local authorities had to produce annual statutory returns.  The performance indicators had to be viewed in the wider context where RMBC was in the top quarter/third of Adult Social Care directorates nationally and ranked second in Yorkshire and Humber on the national statistics.  There were concerns over some measures and for some individual measures Rotherham did not compare so well with the national figures.  Overall the outcomes were mixed and the majority of measures that had declined were the perception measures. Perceptions were important as the Service needed to take users with it in light of some of the other changes that would be brought in to Social Care.

AnneMarie Lubanski, Strategic Director of Adult Care and Housing, and Scott Clayton, Performance & Quality Team Manager, presented a report outlining the provisional year end 2016-17 Key Performance Indicator results for the Adult Social Care elements of the directorate.

The Council had implemented a new case management recording system, Liquid Logic in year, with a go live date in December 2016. Migration and recording onto the new system highlighted some operational and performance reporting challenges.  All national reporting requirements were met in relation to 2016-17.

Performance overall had been mixed with approximately one-third of measures improving and two-thirds declining. Perception results from Service User and Carer surveys accounted for most of the declining performance indicators. Some Indicators, for example the Service user surveys, had declined since last year but not necessarily over the last two years. 

Continued improvements to pathways, embedding of user data recording, plus enhanced reporting functionality during 2017/18 were being delivered.

Year-end benchmarking data would be available later in the year and not all the Adult Social Care Outcome Framework (ASCOF) measures had a provisional result at this stage as mental health data was awaited from RDaSH.

It was important to note that in terms of local waiting times performance measures the data had become unreliable as it was not now reported in the same way.

Discussion ensued with the following issues raised/highlighted:-

·                    Was any KPI data collected monthly? – Reporting periods varied with a mixture of monthly, quarterly (including RDaSH) and annual reporting, such as for reablement.

·                    Where was data recorded regarding people who drop out of the system, possibly homeless people or people no longer with us? – We work actively with some people so they did not need an ongoing personal budget from the Council as they regain independence. If people did not meet Service eligibility criteria they should be signposted elsewhere, such as to the voluntary sector. The Data Protection Act limited data that could be held with stringent record procedures.  Data was held for people who had passed away.  If people had chosen to move away from Rotherham our involvement stopped and hopefully it could also be through greater independence and no longer being in service. This would be captured in reablement data.

·                    Measure No. 14 permanent admissions to residential care (18-64) covered a large age range, could this be broken down further by age, bearing in mind differences in needs at different ages? – The indicator was a national one reported to the DWP because of benefits.  We would be able to drill down into our data and provide the Commission with information on sub-cohorts by age and Service user group.  In total for Rotherham this referred to approximately 20 people, so a very small actual number.

·                    Survey sample sizes and response rates as smaller samples would be more sensitive to change – Requirements were set nationally calculated from the number of people on Service. There had probably been some changes in the number of carers recorded on the system since the Care Act.

 
Service users 2015-16 1016 surveys sent out and return rate 41%.

            Service users 2016-17 1000 surveys sent out and return rate 39%.

            Carers 2014-15 896 surveys sent out and return rate 46%.

            Carers 2016-17 702 surveys sent out and return rate 47.4%.

·                    Although the survey sample sizes were small and the final figures were not yet available, there had been a decline on a number of measures at a time of ongoing service reconfiguration, such as the measures for people with learning disabilities on long term service and for social contact. Similarly for the measures for ease of access to information about support, suggesting people were encountering barriers to accessing information - Councillor Roche commented that he was concerned but not surprised by some of the responses given that questions were asked about Services that people know were in a state of flux and transformation. From conversations with carers it was known that some opposed the proposed changes for Learning Disability Services, others agreed with them and some agreed but wished to wait until their family member had been through the system.  Results were likely to decline again next time in this time of uncertainty and many false rumours were circulating about Learning Disability Services when no decisions had yet been made.

·                    Did surveys go to people in private care homes? – The survey sample had to include people in the community and those in receipt of 24 hour care with no distinction made between local authority or privately operated care.

Following discussion on the report a short presentation entitled Adult Social Care – Thematic review of provisional year end performance report 2016/17 outlined four key themes and how the Performance Indicators linked into these. This enabled the Commission to have an overview of areas that were doing well and areas where the challenges remained, by means of a type of traffic light system.

Theme 1 Prevention & Delay

With regard to the Community Connectors that was interesting in terms of the performance measures discussed earlier and further work would be needed to get the messages out there.

Performance on delayed discharges from hospital was a challenge nationally and although this measure had declined it remained good as previously Rotherham had been in the top 20.

Rotherham was doing well on the effectiveness of reablement measure (91 days) but the numbers offered the service were low - bottom quartile ranking.

Theme 2 Independence

One challenge was to move the people from the bottom right quadrant using traditional services, including for learning disability, into the top left quadrant, resulting in a double benefit.

Theme 3 Personalisation

Theme 4 Perception and Experience of Care and Support

Resolved:- (1) That the content of the provisional summary ‘high level’ year-end performance results be noted.

(2) That a further report be presented to the Health Select Commission January 2018 meeting, showing the final submitted detailed results and analysed benchmark comparisons against regional and national data due to be published from late Autumn 2017.