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www.hertsdirect.org
‘New Ways’Transformation Programme
Health and Adult Care Cabinet Panel 6 December 2011
www.hertsdirect.org
New Ways: Four main projects
• ‘Social Care Access Service’ with Serco
• ‘Lean review’ of Older People’s Teams
• ‘Lean review’ of Learning Disability Teams
• Assessment and care management of older people with dementia
www.hertsdirect.org
Consultation to date
• Consultation event with service users and carers, local groups and vol orgs
• Second event for people with learning disabilities, their carers and vol orgs
• Workshops with people and carers using dementia services and GP consortia
• Staff consultation events and feedback
www.hertsdirect.org
Government vision for social care
• More informed people and families through better information and advice
• People told if they are eligible quickly
• People empowered to take control
• Choice in the care and support available
• People are safe and providers high quality
www.hertsdirect.org
Project 1:Social Care Access Service
Health and Community Services
New Ways Programme
www.hertsdirect.org
Project 1: ‘Social Care Access Service’
• Partnership with Serco as part of HCC’s shared and managed services contract
• Quality advice at first point of contact
• Eligibility assessments and options
• ‘Channel shift’ and new ‘eMarketplace’
• Service finding and care reviews
www.hertsdirect.org
Project 1: Social Care Access Service
Calls to the Customer Service Centre 44,000
Number of new referrals per year 15,500
Eligibility assessments per year 8,000
Care package changes per year 20,000
Scheduled care reviews per year 5,000
www.hertsdirect.org
Social Care Access - Social Care Access - from the way we do it now …from the way we do it now …
CSC
Referral Management Teams
Service Solutions
Unscheduled Reviews
Scheduled Reviews
Other professionals
Social Work
Locality TeamsEnablement
TIER 1
WebServicesSERCO
Increasing access to direct support Increasing access to direct support and self-help opportunitiesand self-help opportunities Reducing the need for Reducing the need for
longer term provisionlonger term provision
Slide 9Slide 9
Enablement
Social Care AccessInformation
Advice
Triage
Service Finding & Brokerage
Reviews
Extended Involvement
Other professionals
TIER 2
SERCO/HCS SERCO/HCS PartnershipPartnership
Goldsborough Goldsborough PartnershipPartnership HCSHCS
Hos
pita
ls
Hosp Teams /
HCT
www.hertsdirect.org
Project 1: ‘Social Care Access Service’
Web-based services fit for 21st Century
• …for use by service users and their families – a web portal with user account
• New ‘eMarketplace’ – allows people to buy care and support services directly
• IT system integration to improve back–office efficiency – linked to SAP etc
www.hertsdirect.org
www.hertsdirect.org
www.hertsdirect.org
Project 1: ‘Social Care Access Service’
Housing Solutions Service:
• Adaptations to people’s homes (inc DFG)
• More consistent OT assessments
• Working with Serco and 6 Districts• Shorter and simpler processes
• Standardised electronic applications
• eMarketplace for builders
www.hertsdirect.org
Project 1: ‘Social Care Access Service’
Monitoring quality and safeguarding:
• Partnerships & Quality Unit• Key performance indicators agreed
• Activity levels agreed and staffing matched
• Interfaces with other teams automated
• Audit mechanisms in place
• Satisfaction levels monitored
• Budget levels monitored
www.hertsdirect.org
Assistant Director Older People and Physical Disabilities
Head of Partnerships and Quality
County OT Development
Manager
Performanceand Quality
Manager
Performanceand Quality
Manager
InformationQualityOfficer
SERCO Goldsborough
Project 1: ‘Social Care Access Service’
Monitoring quality and safeguarding
www.hertsdirect.org
Project 2:‘Lean review’ of Older
People’s Social Work Teams
Health and Community Services
New Ways Programme
www.hertsdirect.org
Project 2: Lean review of OP Teams
WHAT IS A LEAN REVIEW?
• Reduce duplication and waste
• Appropriate delegated authority to spend
• Eliminate bureaucracy
• Shorten forms and paperwork
www.hertsdirect.org
Project 2: Lean review of OP Teams
Success of enablement – key stats:
• Of 1,708 people into enablement this year, 50% needed no on-going service
• Homecare population fell by 700 last year with a further reduction projected
• This has led to a 40% reduction in the number of personal budget assessments by Older People’s Teams
www.hertsdirect.org
Project 2: Lean review of OP Teams
Processes made lean:
• ‘Trusted assessors’ – budget authorisers• New universal assessment process• New pathways for enablement services• Review of caseload expectations• Design new operational structure• Define roles and responsibilities
www.hertsdirect.org
Project 2: Lean review of OP Teams
Efficiency drivers:• Success of enablement services• More streamlined assessments• Target reduction in managementBenefits:• Financial savings of £1.6M per annum• Headcount reduction of approx 70 – trying
to avoid compulsory redundancies
www.hertsdirect.org
Project 3:‘Lean review’ of Learning
Disability Teams
Health and Community Services
New Ways Programme
www.hertsdirect.org
Project 3: Lean review of LD Teams
Processes made lean:• Universal assessment• Expectations at care review• Alternative sources of care and support• Authorisations and approvals
Review of team structures:• Maintain community teams• Changes to transition team
www.hertsdirect.org
Project 3: Lean review of LD Teams
Older Family Carer’s Workers (4 posts):• Staff who provide support to family carers
over the age of 70 caring for an adult with LD at home
• This work has been mainstreamed into the community social work role
• Support managed through teams• Named team lead for older family carers
www.hertsdirect.org
Project 3: Lean review of LD Teams
Efficiency drivers:• Better throughput required in teams• More streamlined assessments• Reduction in specialist postsBenefits:• Financial savings of £0.5M per annum• Headcount reduction of approx 15 – trying
to avoid compulsory redundancies
www.hertsdirect.org
Project 4:Assessment and care management of
older people with dementia
Health and Community Services
New Ways Programme
www.hertsdirect.org
Project 4: Older People with Dementia
Current arrangements:• HPfT have provided assessment and care management for
all older people with mental ill health in integrated teams since 2005
Perceived problem:• Whilst integrated health and social care input works well for
older people with functional mental illness (e.g. depression or schizophrenia) it does not work well for older people with dementia
• Care purchasing budget was never given to HPfT
www.hertsdirect.org
Project 4: Older People with Dementia
Drivers for change:• Delays to appropriate social care interventions• Delayed transfers of care• Slow uptake of enablement services• Relatively high permanent admission to care homes• High numbers of complaints
Proposed solution:• Transfer back the care management responsibility
for older people with dementia and Alzheimer’s
www.hertsdirect.org
Project 4: Older People with Dementia
Detailed proposals:• Transfer approx 40 social care staff who work in the
Specialist MH Teams for Older People (HPfT) back to HCC via TUPE
• Integrate the workers into newly configured locality social work teams to support all older people
• Ensure that any older person who is referred to HPfT navigates the system quickly
• Transfer the care purchasing budget for older people with functional MH problems to HPfT
www.hertsdirect.org
Equality Impact Assessments
• Have been developed iteratively for impact on both service users and staff
Impact Mitigation
Web services inaccessible to some group
Use accessibility technologyContinued use of other channels‘Assisted’ access to technology
Reduction of support to older carers of individuals with LD
Maintain support through CLDT
Staff restructures could negatively impact on certain groups
Maintain flexible working, monitoring workforce profileTransparent change processes
www.hertsdirect.org
Decision-making and next steps
Health and Adult Care Panel – Presentation on consultation
6 Dec 2011
Formal staff consultation ends 19 Dec 2011
Health and Adult Care Panel – Recommendation to Cabinet
31 Jan 2012
Cabinet Decision 20 Feb 2012
Changes Go Live 2 April 2012