Agenda item

Cabinet Portfolio: Adult Social Care and Health

Strategic Directorate: Adult Care, Housing and Public Health

Consideration was given to an update in respect of the Adult Social Care restructure and pathway, which was implemented on 21 October 2019. The main aims of the new structure and pathways were to ensure a more customer focussed and responsive offer to the residents of Rotherham resulting in less waiting times at point of contact; a stronger reablement offer enabling more people to regain independence; increase the continuity of council staff involved; a simpler structure for residents and partners to understand and to raise practice standards and overall performance.

Members noted the following developments:

·       Adult Social Care had been successfully completed with a very small number of compulsory redundancies.

·       The Reablement service had been able to increase the number of people who it supported at any one time, which had resulted in more people having access to vital reablement, regaining independence and confidence for the future.

·       More people could contact the council and inquire about adult social care services without waiting.

·       Extensive workforce development programme was in place, increasing competence and improving practice in line with the objectives of the new Pathway.

·       The Coaching programme had been successful in building leadership skills and had resulted in a new ‘Operating Rhythm’ for teams that included daily ‘huddles’, assisted by technology that enabled key information and actions to be shared and freed up time in the day to respond to people’s needs and enquiries.

·       Overall performance had improved since implementation.

It was reported that a Sector Led Improvement Regional Peer Challenge had taken place in early February and had identified the following strengths:

·       Leadership was strong throughout the directorate

·       very clear evidence around partnership working (internally and externally)

·       strong investment in workforce

·       culture had changed in a positive way

·       coherent performance management framework

The challenge had also identified the following areas for further consideration:

·       Pathway clarity

·       Sufficient capacity

·       Sustainability

·       Celebrating successes

·       Improving the Carers offer

Attention was drawn to the fact that this restructure and development of the TOM had been a major piece of work that affected nearly 400 staff over a period of months.  The overall planning and engagement with staff about what the vision needed to be formed a key element of this before the formal restructuring process and the new pathway came into being in October.  Specialist teams had been replaced with more generic teams which meant the breadth of knowledge and competence required by staff now was much broader but this was felt to be appropriate for social workers.

A formal six month review of the restructure was approaching to look at its impact, the benefits and any areas that still needed to be worked on and improved.  Whilst it was a very positive message the service was in the middle of a change programme, with the restructuring and the new pathways just one part of that.   Embedding the new practices and new ways of working would take some time to actually deliver. A change programme had been needed to organise and improve services but as it also came with a significant saving in resources the concern was in relation to not only wanting to maintain performance but wanting to improve it and the offer. Monitoring showed signs of progress but not every element was quite where it was wanted to be yet.  For example, there was work needed on the digital offer, website and encouragement for people to self-help.

Work had gone in to supporting the change through providing coaching and leadership development to managers and changes in the day to day management, such as big screens/digital platforms around Riverside House and at Maltby for daily team huddles.  It kept the momentum and was about visibility and what people did as a manager and had been received positively.

Improvements in performance were acknowledged by Members but they asked about feedback from social workers about the changes.  Some really positive comments had been received, with staff reporting that they had never felt so invested in, including some long serving members of staff.  That was also echoed by other stuff picked up as part of the peer review challenge.  Significant time had been invested in the training offer, including bringing in experts for areas such as strength based practice and safeguarding, with a lot of positivity amongst the workforce. The Liquid Logic review of the assessment tools would soon conclude and this would drive social work practice very much in that strengths based direction and allow for a greater degree of exercising professional judgement and autonomy for social workers.  As managers and social workers were involved in co-production it should result in the tools to determine eligibility in the right way and to be proportionate and flexible.  Strong emphasis was placed on the reablement pathway as the default position wherever possible as the first step.

The fact that the service had now succeeded in reducing sickness absence levels after going through a major change programme might indicate there was learning that could be shared across the Council.  At a challenging and emotive time the engagement with staff had been a key aspect but clearly there were stresses.

The Chair inquired whether the wider more generic role for social workers was used in other local authorities.  Debate was always occurring around specialist teams and generic social work, with the latter sometimes viewed in a lesser way than specialist. The view in Rotherham was that roles and places for specialism and specific knowledge had their place with champions in certain areas.  Experts in the Principal Social Worker’s team provided support around continuing healthcare and safeguarding and still retaining a smaller amount of specialist knowledge would help to inform practice of the wider social workers.

Members asked about ensuring equality for service users across the pathways and making sure each person received a specific service.  Around reablement, far more people were getting the opportunity to be re-abled at an earlier stage and if their circumstances changed at any point they could have further reablement, it was not a one-off.  This was much more flexible and more in tune with what people were saying they needed, as feedback was that people wanted to remain independent for as long as possible but they did need the support, advice and guidance to do that.

In terms of any major challenges from the restructure it was a sizeable staff group, therefore organisationally and resource wise it had taken a lot out of the system to actually deliver it.  The workforce development programme was very robust but as it would take time for everyone to go through that process not everybody was operating exactly as desired yet and there had been delays due to competing priorities.  Undoubtedly in any change programme some people would take a bit longer to feel comfortable and confident with the work they were doing. Certain parts of the pathway were also interdependent on other parts of the Council, such as some of the supporting elements around the website design and the digital offer.  It was anticipated that by October 2020 the service would be where it needed to be but things might change and there could be statutory changes within that time frame.

Members took the opportunity to ask about improving communication about the offer following the restructure as there seemed to be a lack of information for some services, such as Shared Lives.  Shared Lives was a good example of a service that was growing in demand but it was agreed more people did need to be aware of it, both staff and the public.  There could also be misinformation as well as no information about how beneficial a certain service is.  Community Connectors helped teams with local information and there were close links with the Neighbourhood Strategy to try and get the information out there but more could be done in terms of promoting certain services.

The officers were thanked for their attendance and although it was pleasing to see things progressing well a further update was requested.

Resolved:-

1)    That the information in the briefing be noted.

2)    That Overview and Scrutiny Management Board receive a further update on implementation of the Target Operating Model and new pathways in Adult Care in October 2020.