Agenda item

The Strategic Director for Social Care and Education submits a report on Adult Social Care Performance Monitoring 2023/24 (for Q1).

Members of the Commission are recommended to note the report and pass any comments to the Strategic Director for Social Care and Education.

The Director of Social Care and Safeguarding presented the report to update on performance monitoring for Q1 of 2023/24. It was noted that:

·       The department continues to be very busy and there are lots of pressures as highlighted to the commission previously in terms of backlog of reviews but there is also much good practice.

·       Areas of strength include advice and guidance provided to individuals to be able to address their own needs and do not make further contact with the service within twelve months; providing short-term support to individuals who are then able to manage independently without ongoing long-term support; and numbers of individuals who remain at home 91 days after reablement.

·       The department has an ambition to support people at home where possible and have a higher benchmark to national and East Midlands of people being supported at home and smaller number in residential and nursing care.

·       Data in relation to integration of health and social care is relatively new. Attention is being focused on reducing individuals on Pathway 2 – short term bed on discharge from hospital - and increasing Pathway 1 – getting individuals home. The recovery, reablement and rehabilitation model is being rolled out and having a positive impact on the numbers of people going home and the timeliness of discharge within 24 hours when informed they are ready to leave hospital.

·       The number of complaints received is small in totality. The department has approximately eighteen thousand contacts and supports five thousand individuals. If the service is not adequate and there is cause to complain, then it is right for residents to do so and will be dealt with appropriately.

·       It is important to ensure people are supported to live the life they want and therefore the department regularly ask individuals at assessment and review for comments. A substantial proportion agree or strongly agree that the service offer does enable them to live the life they want. This positive impact was also reflected in the annual conversation.

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

·       There are various data sets available in relation to the workforce at a regional and sub-regional level across health and social care that will be illustrated in a report for discussion at the next meeting. The organisation also undertakes exit interviews to understand why officers leave roles. Generally, across social care and education officers talk positively about working in Leicester and feel supported.

·       A reflective workforce is very important to support residents. The organisation has data for employed male carers within the reablement service but the vast proportion of support to people is provided by the independent sector. Skills for Care collate data externally which will be reviewed for further understanding.

·       There are two provisions for short term care; enablement who work with individuals with learning difficulties and mental health issues for up to twelve weeks, and reablement who work with individuals that have physical needs, for example following a hospital admission or a fall within the home, for up to six weeks. Multidisciplinary meetings occur three times a week to monitor the needs of individuals to understand whether the objectives have been met or ongoing care is required and by who.

·       The national delayed transfers of care metric has been discontinued. People who remain in hospital with no clinical reason to reside is now reported and the department continues to monitor people awaiting social care support to leave hospital. The recovery, reablement and rehabilitation model is having a positive impact and Leicester is recognised nationally as a strong performer with usually no more than 25 people waiting at any given time and often for less than one or two days.
Further information and a metric will be provided to the commission in relation to the average number of people waiting to be discharged from hospital and on length waiting to be discharged.

·       Safeguarding concerns should be reported to the department but it should also be proportionate. Reports are often made by providers to ensure they are being transparent about incidents, but they do not meet safeguarding thresholds for investigation and are better managed via contract and quality support.

·       We benchmark well with approximately 45% of support in the community is provided as direct or part direct payment. This tends to be balanced and comparable across working age and older people.  Utilisation of direct payments within BAME communities slightly higher, a recent project with IMPACT supported by the University of Birmingham looked at experience of direct payments within the BAME community and interesting findings shared nationally is that people find them more flexible.

AGREED:

·       The Commission notes the report.

·       The Commission recommends a metric be provided on performance monitoring in relation to discharges from hospital to social care.

·       The information requested in relation to the workforce be noted and included in the report proposed for the meeting on 30 November 2023.