Agenda item

The Strategic Director of Social Care and Education submits a report to provide an overview of social care reviews including the legal framework, Leicester’s approach and the current financial and performance context.

The Director for Adult Social Care & Safeguarding highlighted that the Commission had expressed an interest in reviews and the report was intended to provide Members with detail of the service approach to undertaking reviews and challenges. As part of the presentation, it was noted that:

·       The Care Act 2014 places a statutory duty on the Local Authority to undertake reviews. Statutory guidance states reviews should be completed once every 12months or earlier if providing care for the first time or if there has been a substantial change in care. Reviews should be proportionate, and strength based, not prescriptive and therefore can vary in approach and may be planned or unplanned. 

·       Reviews follow a conversation model by gathering information and revisiting outcomes to understand whether they are being achieved, if anything needs to be altered or opportunities for change can be explored.

·       The CQC assessment will consider the Local Authority approach and wait times. It was highlighted that every area is likely to have overdue reviews and will need to articulate what is being done to address waiting times.

·       The service became aware that individuals felt anxious about the review process and therefore worked with co-producers, Making it Real Group, to develop and share materials to explain the new review process, which has been well received. The Director for Adult Social Care & Safeguarding expressed thanks to co-producers for their time and input.

·       Outcomes are assessed as part of a review to determine if they are being met, partially met or not met; and where they are not being met officers will review what may need to change. Outcomes are monitored to assess whether individuals can receive support available in the community and reduce the need for statutory care which is viewed as positive to reduce reliance on services and provide individuals with greater freedom and control in their lives and may also reduce financial contributions.

·       The number of individuals waiting for a review has increased with a range of attributing factors such as capacity to conduct reviews, particularly during the pandemic, complexity of needs and priority of new assessments and safeguarding work. Improvement plans have been established to reduce overdue reviews and additional grant funding has been secured.

·       A steering group has been established to oversee work on reviews and how ongoing work may capture a review. The service speaks with individuals about support and needs which is often reflected through support case change notes and could provide sufficient information for a review.

  
In response to questions and comments from Members, it was noted that: 
 

·       The earlier a change of needs is identified the sooner there is an opportunity to positively alter the support to ensure individuals are receiving the correct size care package.

·       Prioritisation of reviews is generally determined on risk and safeguarding. Individuals often request a review when they feel their needs aren’t being met. Factors that are considered when prioritising include whether there has been contact with the individual within 12months; if they live alone or support is provided by others such as carers or family; if they live in a residential setting and there are concerns about the provider etc. These factors are tracked on a management system that will alert officers to a risk rate and support the use professional judgement.

·       The Local Authority is responsible for identifying eligible needs and defining outcomes for a support plan. Independent providers generally support individuals to achieve outcomes and can provide information for a review to determine if outcomes are being met or need to be adjusted.

·       Capacity has been an issue impacting overdue reviews, but the service has increased officer numbers and additional funding to grow the workforce will enable a dedicated team to support reviews.

·       Significant work takes place by officers in communicating with individuals about their needs which is illustrated through support change case notes. This is not always captured as a review and figures may therefore be underreported. The service is exploring how detailed notes could be utilised to evidence a review, but assurance was provided that minor changes and notes will not be classified as a review or used to simply improve figures.

·       The concerns regarding conflicts of interest on provider led reviews were acknowledged though assurance was given that they would not be an option for review if the Local Authority had concerns about providers. Pilots had been carried out in residential settings and domiciliary care where feedback indicated more natural conversations occurred in residential settings.

The Chair thanked officers for their continued honesty regarding figures and openness to address the challenges.

The Deputy City Mayor for Social Care, Health and Community Safety suggested that a previous report on the strength-based approach be circulated to Members.

AGREED:  

·       The Commission noted the report.

·       Additional information to be circulated to the Commission.