September 2014 Welcome to the Managers Update Session … · 2016. 3. 9. · September 2014 Stuart...

Welcome to the Managers Update Session September 2014

Stuart Cowley, Director of Adult Social Care and Health

Confident Place, Confident People.

By the end of this session you will:

• Received up to date information on Transforming Adult Social Care and Health plan on a page

• Have a clearer understanding of how we think ‘the Deal’ for adult social care and wellbeing changes the way we work

• Understand the new management structure

• See evidence that we have listened and put previous staff suggestions into action

• Understand the expectation and behaviours of the workforce

• Contribute your ideas, to influence ‘the deals’ we will make with our service users, staff, carers and providers.

• Make a pledge around your contribution to transforming adult social care and health

State of the Borough

Wigan’s population is aging faster than the national average. Although major gains have been made in terms of life expectancy, this has not been matched by a healthy life expectancy, with the result that people tend to live for a longer period with a limiting long term condition. This is more pronounced in deprived areas.

Wigan Council – The size of the Financial Challenge:

Current & Estimated Future Savings Requirements

The Council and the Directorate in context

• Council: circa 4500 employees, 6 Directorates, diverse functions, overall budget circa £275million

• Adult Social Care & Health Directorate responsible for a Budget of £94m (over 30%) and 1150 employees for 2014/15

• In 2013/14 services provided to 8818 service users via hundreds of organisations including ours

-2663 service users of working age, 6155 over 65 year

• Health improvement and protection services for whole population

• £17.8m reduced from the Adult Social Care & Health budget between 2011/12 and 2013/14 - £7.8million last year

Key achievements 2013/14

• Early intervention investment reducing the dependence on long-term social care services.

• Fundamental review of day services and supported living

• Significant shift to locality based working.

• Public Health joined from April 2013 onward. : integration and transformation around ‘Start Well’, ‘Live Well’, ‘Age Well’ and lead on civil contingencies /health protection

• Focused work to improve rates of physical activity, reduction in obesity and smoking.

Budget Strategy

• 3 year strategy to 2016-17

• Face up to tough choices

• Look to the future

- Investment

- Transformation

• Political Priorities

New Approaches

• Transformation Programme to deliver £25m

• Adult Social Care and Health integration

• Public Service Reform

• Building Self Reliance

• Wigan Deal

Transformation Plans 2014-17

•Modernisation Programme £11.6m

•Transforming Adult Social Care & Health £4.2m

•Transforming Children’s Services £4.5m

•Transforming Environmental Services £3.6m

•Transforming Economy & Skills £1.3m


Adult Social Care and Health Transformation programme – 2014-2017


Transforming the Public’s Health

•Live Well

•Age Well Live Well and Age Well programmes the aim is to increase healthy life expectancy within the borough and to reduce the internal health inequalities gap, by efficiently targeting opportunities, programmes and interventions to the higher risk groups within our communities

(NB Start Well is also part of this agenda – priorities: early years & reducing under 18s alcohol admissions)

•Health Protection & Civil Contingencies ReformFocuses on immunisation, protecting the population, community resilience and infection prevention control (tackling antibiotic resistance)



Live Well priorities include:

•Health improvement

•Drugs and Alcohol

•Mental Wellbeing

•Redesigning and recommissioning of services to reduce duplication, maximise impact and improve targeting of key population groups



Age Well priorities include:•Development of the Wigan deal for warmth

•Healthy lifestyle – e.g. Physical activity and weight management

•Review of existing Age well provision e.g.. Home improvement Agency service

•The establishment of an integrated approach to falls prevention and bone health across a range of providers

•Roll out of dementia friendly communities, dementia Action Alliance plans and early diagnosis

•Redesigning and recommissioning of services


Accommodation and Support Key Principles:• Embed the Deal for Adult Social Care and meet

peoples changing expectations and aspirations• Transformational shift from traditional,

segregated services to better connection with local communities and use of mainstream services

• Increased choice and control for customers• Fit for the Future, specialist In House Service• Diverse and vibrant external market


Accommodation and Support Key workstreams:

• Modernisation of Day Opportunities for Adults

• Housing with Care Programme – Supported Living and Out of Borough Projects


Care Act 2014▪ Received royal assent in May 2014 and bring together

over 60 years worth of legislation.▪ Introduces the care cap cost cap of 72k from 2016▪ Place a duty on local authorities to assess the needs of

carers and provide personal budgets by 2015.▪ Places a duty on local authorities to asses the needs of

self funders and procure services.▪ A focus on early intervention and proportionate

assessments, personalisation, well-being and market shaping.


Care Act ImplementationWork to date:

5 work streams; Prevention, Workforce, Finance (charging & market shaping), Assessments & Transforming through Technology

▪New deal for Carers, RAQ, Third Sector, Assessment.▪Care logic – new IT system.▪Workforce re-design with focus on roles of the workforce being proportionate and the right.▪Development of diverse community resources and workforce starting to focus on asset based outcomes.▪Mapping of advice and information to co-ordinate local offer.


Challenges

▪ Understanding and planning for the increase in demand.▪ Market changing, development and sustainability.▪ Understanding the impact on our own and partners

workforce.▪ Communicating the changes.▪ New policy decisions.▪ Cost / ? Financial impact


Principles of Health and Care Reform agreed by Wigan Leaders (Council and NHS)

People will be supported to be independent and well and take control of their own life and care

Health and Social Care Services should be provided at home, in the community or in primary care if possible

All services should be safe and of high quality and part of an integrated system led by primary care

National Patient Voices’ definition of Integrated Care:

My care is planned with people who work together to understand me and my carers, put me in control, co-ordinate and deliver services to achieve my best outcomes.

Integrated Care as a principle, not a project


What would an integrated care and well being system look like

• IT systems that talk to each other• Teams from different agencies working together at the interests of

the patient not the organisation• Co-located teams?• A shared view of patients/residents at risk of unnecessary or

premature admission to institutions• A focus on connecting people to communities, that is shared by all

agencies (e.g. primary care)• Jointly commissioned services (CCG and Council) that complement

not duplicate• More accessible/consistent primary care• A hospital system of high quality treating people that need hospital

treatment• A shift of investment from reactive and unplanned spend (50% of

people in hospital don’t need to be there?) to planned and targeted spend


Individual Programmes (Start and Live) Programme Update RAG

Start Well (Update report provided on monthly basis to TPB)

Childrens Integrated Care Programme Board Established

(including Council, CCG, and Education)

Community Paediatrician Development

Due to commence December 2014

Implementation of AGMA Early Years model

On going

Live Well (Update report provided on monthly basis to TPB)

Whole Public Service Reform Approach to Live well

Reported to TPB and HWBB September 2014

Alcohol Joint Investment in primary care based alcohol harm prevention services agreed by JCG

Domestic Violence New operational multiagency integrated team working in place - ISAPP

Heart of Wigan Phase II Further roll out of Wigan Borough CVD prevention strategy

Learning Disabilities Agreed joint approach and learning disabilities strategy


Individual Programmes (Age)

Programme Update RAG

Age Well (Update report provided on monthly basis to TPB)

Integrated Hospital Discharge Team

Progressing and subject to accommodation will be operational by November

Falls Whole System Stocktake of falls prevention pathway convened

INT Roll out in context of AUA DES

NWAS Pathfinder Implementation

Due to commence October 2014

End of Life Care Practioner borough wide group (not social care) group in place Agreement for joint strategic approach, and recognise EPACC potential of MIG available imminently

Fuel Poverty Joint investment proposed in roll out of Wigan model (based on Oldham) – joint approach to target prevention

Care Home Quality Assurance Joint approach to care home quality assurance by CCG and Council

Telehealth/ Telecare stocktake Agree to scope potential alignment of programmes and procurement

Personal Budgets Provisional discussions about extension of current system to cope with wider personal health budget roll out


Individual Programmes (Generic) Programme Update RAG

Generic

“Real Time Urgent Care Dashboard”

Under development

Housing with Care Establishment of jointly managed sub group between council and CCG from the formal housing with care board

7 Day Working Wigan as national pilot site – linked now to the System Resilience Group and recognition of 7 day working for whole system

RAID + Implementation progressing, although some concerns to be reported to Wigan Leaders Group

Carer Support CCG and Council Agreement to single carers strategy. New architecture in place to implement

GMFRS CRIT Team implementation

Due to commence autumn

GMFRS roll out of Home Safety assessment linked to INT and including falls assessment

Implementation plan under development

Boston House – Perfect Week To informally test what good looks like. Week commencing 13th October.


Better Outcomes As was (Pines) As is (Upper Dicconson Street)


Sunshine House Community Hub

Transferred from in house to community use, improved offer to people with health & social care needs - dementia reading group, mental health friendship group.

Vibrant community hub - strong local knowledge & flexible provision.


Mission Statement for In House Provider Services

• In house services are a role model of quality• In house services are the foundation stone for a

diverse and expanding personal budget market• In house services are delivered by a highly

trained, competent, consistent and committed workforce, with clear and accountable leadership

• In house services are designed and delivered through co-production with customers, carers and citizens


Transforming Through TechnologyWork to Date:• Contract awarded for new case

management system to Core Logic including:– Case management system– Software to support remote working– Personalisation and self service– Dashboard reporting– Integrated care records moving forward


Transforming Through Technology• Project plan in development and task and finish

group established

• iPAD’s being piloted with Support Planners

• Communications across all teams to start October 2014

• Bid submitted to Integrated Digital Care fund to support the development of a single Health and Social Care Record.

• Freeze Council Tax

• Help communities to support each other

• Cut red tape and provide value for money

• Build services around you and your family

• Create opportunities for young people

• Support the local economy to grow

• Listen, be open, honest and friendly

• Believe in our borough

• Recycle more, recycle right

• Get involved in your community

• Get online

• Be healthy and be active

• Help protect children and the vulnerable

• Support your local businesses

• Have your say and tell us if we get it wrong

• Believe in our borough

Signed Signed

Lord Peter Smith of Leigh, Leader of Wigan Council

• Offer an assessment that fits with your needs and provide support that is tailored to you in a timely fashion

• Enable you to continue in your caring role • Provide you with information and advice • Help you to access knowledge and services • Understand and value your caring

contribution • Provide choice and control over budget and

the support you access.• Give you access to new opportunities

• Take care of your health and well being so you can be the best possible carer

• Be open and honest with our staff - before crisis point

• Be open to new ideas and doing things differently

• Get the support you need to enable you to continue in your caring role

• Share your ideas and be honest • Promote the independence of the person

your care for • Engage in support available • Advance planning to avoid crisis calls

Signed Signed


Carers

• Share information and intelligence concerning future demands.

• Support you to maintain standards and provide high quality services.

• Provide you with a robust safeguarding framework

• Be clear about expectations of service provision.

• Acknowledge, value and promote the contribution of providers.

• Think differently and creatively about how you provide services

• Work in partnership with us to maintain high standards and put people at the heart of your service.

• Co-operate on safeguarding procedures

• To maintain and provide information that can be viewed on a regular basis or as required

• Maintain positive working relationships with the Council and other Providers

Signed SignedLord Peter Smith of Leigh, Leader of Wigan Council

Providers

• Listen to what is important to you

• Support you to achieve greater independence

• Give you support that is unique to you

• Provide you with greater menu of choice

• Give you more control

• Share your ideas and be honest

• Be open minded to our new approach

• Get involved in planning your care

• Think differently about what you need.

• Maintain your health and well being and consider the affects of your lifestyle choices.

Signed Signed


Service Users

•Share your skills gifts and talents with others to make a contribution to your community, no matter how big or small

•Help to shape the future of the Wigan Borough by highlighting needs

•Find out what’s available, be a good neighbour and ‘pass it on’

•Work together with one another to support great ideas

•Turn an idea or hobby into an opportunity to improve the lives of local people

•Get involved and support your local community

Signed SignedLord Peter Smith of Leigh, Leader of Wigan Council

• Invest in developing skills, talents and assets of local people and groups

• Listen to your feedback to help improve health, wellbeing and independence of local people

• Make it easy for you to find out about, and connect to, local support , advice and community activities by coordinating information in one place

• We will encourage existing and new community groups to thrive by unblocking barriers that inhibit innovation and developments

• We will support great ideas and solutions that improve local lives and strengthen our communities

• We will provide a value for money solution when investing for you

Community

• Enable you to understand and empower your customers

• Reduce bureaucracy and support new ways of working

• Provide sufficient resources for you to do your job well

• Listen to your views and act on them

• Support your healthy worklife balance

• Enable you to develop personally and professionally

• Reward your commitment and hard work

• Be ‘One Team, One Council’

• Empower your customers to take control of their lives

• Embrace new ways of working

• Use resources efficiently and effectively

• Give positive, constructive feedback

• Maintain your health and worklife balance

• Take opportunities to develop yourself and your professional skills

• Be committed to working hard

• Work as part of a team and support each other

Signed Signed


Staff


The Deal: adult social care, health and wellbeing

Two key pillars

1.‘Different conversations’ with residents to better understand need, revealing insights about how to enrich their lives

2.Building community capacity to respond and meet this need:

• Mapping and utilisation of community assets

• Community hubs and micro enterprises

• Use of new technology and value exchange

• Step change in volunteering


A familiar picture?


The Deal for Adult Social Care & Wellbeing

Overarching shift from dependence on formal health and social care services to independence and self reliance

•‘Different conversations’ with residents to better understand individual assets, revealing insights about how to enrich their lives and recognising strengths, gifts and talents.

• Building community capacity to respond and meet this need:

- Mapping and utilisation of community assets

- Community hubs and micro enterprises

- Use of new technology and value exchange

- Step change in volunteering


Your visit was different to others, as you talked about what is important to me

What I am good at or interested

in…

Deeper conversations- what does it really mean for individuals?

Helped me feel active and

healthy

Opportunities to make friends and talk to others who live nearby, who I would never have met.

Time to get to know me and build trust…

Suggestions and ideas I wouldn’t have thought of..

Me, still being me


The importance of knowing a

person’s story

Providing something meaningful

Deeper conversations- what does it really mean for frontline staff?

Understanding what the

community can offer

More activities that people can get to, something they actually want to do

Allowed us to think differently

Having permission to have time to get to the root cause

Opportunity to highlight carers , I wouldn’t have done that in the

past


Adult Social Care and Health Management Structure


So what are the benefits of the new approach?


Approach and principles

• Integration of early intervention commissioning and delivery with incoming PH function

• Designing the functions around the customer journey: a workforce without silos

• A shift to meaningful locality working in all parts of the service, with roles also carrying strategic leads on whole borough issues

• Removal of ‘commissioner / provider’ split


What did the recent staff survey tell us?

• Staff are generally feeling happier about working for the council despite the challenges we face.

• Significant improvements across all eight engagement themes, particularly around leadership and my company.

• Best Companies have placed us in their ‘Ones to Watch’ category which recognises the great levels of engagement we’ve achieved.

• Results highlighted some areas where we need to improve, for example, wellbeing and fair deal.

• We need to keep up the energy, and work harder to develop and improve relationships within and between teams


Importance of staff

• Key asset

• Difficult period

• Reduced sickness levels

• Respect

• Thanks

Types of employees

Our Leadership behaviours


You said… we did

• Contract agreed with Core Logic, in place by October 2015.

• Support planners now using IPads

• Regular newsletter to be produced to update all staff on the implementation of new IT system

• Briefing sessions by Assistant Directors

• Service managers in place and building relationships with teams

• Recruiting for staff vacancies to ensure all teams are working at the right level


You said… we did

• Multi skilling of all staff in Early Intervention and Prevention.

• Career development opportunities currently being made available in Early Intervention

• Exploring new options for online directory to support agile working

• Deal for Communities Investment Fund exploring opportunities for developing community transport


You’ve listened to me, now over to you

✓ Further information on the Transforming Adult Social Care and Health plan on a page

✓ Have a clearer understanding of how we think ‘the Deal’ translates into changing the way we work with partners and with communities

✓ Understand the new management structure

✓ See evidence that we have listened and put previous staff suggestions into action

✓ Understand the expectation and behaviours of the workforce

✓ Contribute your ideas, to influence ‘the deal’ we will make with our service users, staff, carers and providers.

✓ Make a pledge around your contribution to transforming adult social care and health

Thank you for your timeand attention

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September 2014 Welcome to the Managers Update Session … · 2016. 3. 9. · September 2014 Stuart...

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