Agenda item

To consider a report of the Strategic Director of Adult Care, Housing and Public Health outlining proposals for a new model for the Council’s Adult Social Care mental health provision across the Borough.

Recommendations

That Cabinet:

1.             Note the proposals for a new Adult Social Care mental health model of provision for the Borough.

2.             Approve the development of a co-designed Council Mental Health Strategy for Rotherham, with the strategy being presented back to Cabinet for approval in 2025, prior to publication.

The Chair invited the Strategic Director for Adult Care, Housing and Public Health and the Head of Safeguarding and Mental Health Services to introduce the report. It was noted that in February 2023, Cabinet approved a recommendation to review the Council’s Adult Social Care Mental Health model which included a period of consultation with people with lived experience, their families and carers. The review was delayed due to the impact of the pandemic on adult social care. If approved by Cabinet, a staff consultation exercise would be undertaken.

The proposals outlined in the report were intended to enhance the benefits of continued joint working between health and social care whilst defining and developing the social care offer to best effect. Research and evidence supported that such approaches provided the best opportunities for personalised support to maximise recovery and independence. A recent policy paper published by the Department of Health and Social Care in 2022 focussed on shared outcomes through partner collaboration and set out how person-centred care should be central to reform.

Working with other relevant local organisations, the Integrated Care Board (ICB) was responsible for planning and delivering joined up health and care services to improve the lives of people in their area. The proposed model recognised the importance of continued commitment to partnership working and identified collaborative, co-located approaches.

It was outlined that the demographics of the borough were a key consideration in developing the proposed model. It was noted that Rotherham was one of the 20% most deprived authorities in England which impacted on the prevalence of mental health related needs.

Based on the outcome from the consultation, and collaboration with partners during the review period, a new personalised mental health pathway had been designed. The pathway focused on the person and set out the core component of the model to deliver the statutory social care duties. These included:

·      A new information and guidance offer.

·      Early Solutions (the adult social care front door and enablement offer).

·      Care Act social care assessment.

·      Mental Health Act duties.

·       Crisis care and recovery.

The key change in the proposed model was an alignment of Council employed adult social care staff to deliver roles and responsibilities that met the requirements of the Care Act 2014, the Mental Health Act 1983, the Mental Health Capacity Act 2005, as well as associated statutory guidance and codes of practice.  It was proposed that this would better balance the clinical and social models to provide a collaborative model of delivery which would further strengthen co-location and integration. Details were provided in the report of how this would be achieved. It was noted that the proposed changes would provide evidence for the Care Quality Commission.

The Chair invited questions and comments from Board Members and a discussion on the following issues ensued:

·      The proposals outlined were welcomed. Clarification was sought about how people’s mental health needs would be triaged to ensure that they were referred to the most appropriate service. Details were provided on the assessment process which was dependent on presenting need.

·      It was noted that people with mental health often presented in crisis at accident and emergency departments. It was outlined that there was a liaison and diversion team located within the hospital that could work with individuals. Swallownest Court was identified as a place of safety. Work was also underway with South Yorkshire Police on the ‘right care, right person’ programme, to identify responsibilities and how health, social care and the ICB can work together.

·      Further details were sought on the potential impact of the proposals on other services. There was a commitment across the partnership to ensure that prevention of unnecessary mental ill-health was a priority and people received the support they needed. It was noted that health partners and the voluntary sector were working collaboratively to design services to make sure the referral pathways aligned. It was clarified that the proposals redirected resources to the areas where it was believed they could have the most impact.

·      Further details were provided on employment support to people in mental health crisis.

·      Clarification was sought if there would be any changes to out-of-hours access. It was confirmed that the local authority would continue to respond in line with its statutory mental health and safeguarding duties.

·      An example was given of “mental health ambulances” pilot, whereby a mental health professional was available with first responders. It was outlined that police officers were aware that it was not always appropriate for them to undertake mental health well-being checks. Work was underway with ICB colleagues to identify which organisation was best to respond to those in crisis.

·       Details were sought about access to services for non-Rotherham residents. It was outlined that if the individual was in extreme risk, they would receive appropriate services under the Mental Health Act and safeguarding provisions. The level of support would be dependent on their presenting need. It was highlighted that information would be shared with the individual’s home authority or health care professional.

Resolved:

1)    That Cabinet be advised that the recommendations be supported.

That Cabinet:

1.    Note the proposals for a new Adult Social Care mental health model of provision for the Borough.

2.    Approve the development of a co-designed Council Mental Health Strategy for Rotherham, with the strategy being presented back to Cabinet for approval in 2025, prior to publication.

2)    That an update be provided to OSMB (or nominated Select Commission) on the impact of the review, 12 months after its implementation.