Agenda item

(To receive a report by Carolyn Nice, Assistant Director Adult Frailty and Long Term Conditions, which provides the Committee with details of the current Adult Frailty and Long Term Conditions Commissioning Strategy 2016 – 2019)

Consideration was given to a report which contained the key strategic aims of the Adult Frailty and Long Term Conditions Commissioning Strategy 2016 – 2019 and set out what had been achieved since the implementation in 2016.  It was reported that the Strategy and associated activities supported people with eligible needs as outlined by the Care Act 2014.  The customer groups supported by this strategy were Older People, People with Physical Disabilities and People with Sensory Impairments.  It was noted that this Strategy was due to be refreshed and officers were keen to receive feedback on what the Committee would like to see included going forward.

It was noted that there were a number of areas where there had been some success and good achievements.  There was a need to ensure that the strategies linked together, as people will pick up one strategy but not necessarily another.  Members were advised that the home care contract had been re-procured since the strategy was introduced, and personal budgets had been introduced which were to help people make more informed choices about their care.  It was also noted that pre-paid cards had also been introduced to make the personal budgets easier for people to manage.

Members were provided with the opportunity to ask questions of the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         It was clarified that in relation to personal budgets, a person would have an assessment and the results would then give an indication of what their personal budget would be.  A social worker would then go through the support plan with the person and the personal budget may then increase or decrease based on the person's needs.  The personal budget would cover the cost of the care and the person would then have a number of options on how to spend it, they could either opt for commissioned services or a direct payment.  A person receiving a direct payment was able to spend that money in a way that met the outcomes of their support plan.  It was noted that they did have to submit receipts and the receipts would be audited, as the authority tracked what people were buying with their direct payments.  A lot of people would purchase agency support.  There was a need to look at whether people were getting the best they could for their direct payment.

·         There was a need for balance between the choice of direct payment and commissioning responsibilities.

·         There was a need to ensure that the care provided was suitable for a person's needs.

·         In was considered important that when people came out of hospital they were able to return to independence.  Members were advised that there were teams based within hospitals who would assess patients as to whether they would require any adaptations or home care.  In relation to adaptations It was noted that people would not stay in hospital whilst these were carried out if they were able to be discharged.  There were various things that health colleagues needed a person to be able to perform before they could be discharged. 

·         It was commented that Pendrells seemed to be a key player in terms of care, and members were advised that they tended to be the favoured choice for most local authorities, it was suggested this maybe because they have many years of experience.

·         It was queried why there had been a decrease in convalescent homes, and it was noted that most people did not want to go into care and wanted to receive care in their own home.  Now there was a need to determine how to put a team around a person in order to support them to the level they need. 

·         Reablement provided a level of control over demand, and enabled the support to be front loaded, so a person would receive more care visits for example when they first came out of hospital, and gradually reduce the number or frequency of visits to get someone back to independence as much as possible.

·         It was commented that there were a lot of opportunities around day care, and they could be more focused around certain issues e.g. cooking.  It was suggested that people wanted to engage with like-minded people.

·         It was noted that work was underway with the Director of Public Health and the Assistant Director Specialist Adult Services on how the authority could make better use of its assets (buildings).

·         It was noted that there were very few homes suitable for people with disabilities, and so it was essential that the Strategy linked in with housing.

·         There were some people whose needs were so complex that they would need specialist care.

·         There was a need for more creative options to ensure people remained independent, for example it was commented that in Cambridgeshire, supermarkets were sponsoring buses to pick people up so they could do their shopping.

·         Rurality was key factor as the cost of getting into town if there were no or limited bus services could be prohibitive for some people.  It was noted that in Somerset, micro commissioning of services was taking place, which enabled a few people to get together to jointly commission a service.  There was a need to look at how the authority could help people to be more creative.

·         There was also a need to incorporate more digital engagement as well as the promotion of self-care and supporting people to look after themselves.

RESOLVED

            That the content and feedback on the current Adult Frailty and Long Term Conditions Commissioning Strategy be noted.