Agenda item

Adult Care and Community Wellbeing Performance Report - Quarter 3 2018/19

(To receive a report by Katy Thomas, County Manager – Performance & Intelligence, which presents performance against Council Business Plan targets for Adult Care and Community Wellbeing as at the end of Quarter 3 2018/19)


Consideration was given to a report which presented performance against Council Business Plan targets for the Directorate as at the end of Quarter 3 2018/19.  A summary of performance against target for the year had been provided in Appendix A of the report.  It was also reported that a full analysis of each indicator over the year had been provided in Appendix B to the report.


It was noted that there were 26 measures across five commissioning strands.  Of these, 16 measures were achieving or exceeding target, three were reported annually, and of the measures not being achieved, five fell within the community wellbeing strategy.


In relation to the measures which had not met target the following was reported:

·         31 - % of alcohol users that left drug treatment successfully who do not re-present to treatment within 6 months – this had fallen slightly but there was a 3 month reporting time lag.  There had been some staffing issues, but these had started to improve and the performance was expected to stabilise between 35 – 37%.  A paper would be presented to Executive Departmental Management Team outlining further options.

·         34 – Chlamydia diagnoses per 100,000 15 – 24 year old – there was an action plan in place.  This measured the number of young people who had had the diagnostic test and the proportion of positive test results.  The rate of positive test results at 10.4% indicated that the targeted work was working well.  Even though Lincolnshire was below target, it was noted that the current performance was the third best in its CIPFA group and was also below the regional and national target.

·         109 – Number of Health and Social Care staff trained in Making Every Contact Count (MECC) – 662 staff had now been trained, and there were no concerns that the target would be missed at the end of the quarter.  It was confirmed that for 2019-20 this target would only reported annually.

·         111 – People successfully supported to stop smoking – it was noted that this had a three month time lag.  The Service was continuing to target the hardest to change groups.  There were some other issues with the service that had been recognised, but there would be a switch to the integrated lifestyle support service in the summer.  It was important that people were ready to change when they came to the service.  With the right support, it was possible to double the numbers of those successfully quitting.


Members were provided with the opportunity to ask questions to 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 noted that smoking was not always linked with obesity as some used it as a substitute for eating.  It was suggested whether this group could be targeted through their vanity for example how it could age them and have negative effects on their skin.

·         In terms of smoking, with 20 – 23 year olds, guidance tended to talk about the costs involved and participants would be asked to put the money they would have used to buy cigarettes into a separate account and then seeing the amount go up reinforced the behaviour to quit.

·         112 – People accessing Housing related support that are successfully supported to access and maintain their settled accommodation – the reasons behind this not meeting target were being discussed with the contract provider through the contract monitoring process as it was not clear why this target had not been met and further investigation was required.  Members were advised that this target was very aspirational, and there may need to be some work on how better to monitor this measure going forward.

·         114 - % of safeguarding enquiries where the 'Source of Risk' is a service provider i.e. social care support – it was noted that this indicator was not really the right measure to determine whether the work was effective.  A new indicator was in the process of being agreed by the Departmental Management Team.

·         63 - % of clients in receipt of long terms support who receive a direct payment – it has been queried whether this is the correct measure and it was planned that a paper on this would be going to the Executive Departmental Management Team.  It was commented that for some older people direct payments would be too complicated for them.

·         There had been a government push to move more people to direct payments, but this was not suitable in every instance.

·         It was commented that drug and alcohol misuse services were at capacity and it was thought that this would only get worse, and it was queried whether there was a need to increase the service provision.  Work was ongoing with the contract provider to monitor this situation.  It was noted that a lot of audit work had been done and it was a very good provider.  Due to the nature of the client group there were very regular contract management meetings.  It was a challenge to meet to the target but it did not mean that the service was not good.  There had been previously a question of capacity and issues with resources.  There were also overlaps with mental health and the criminal justice system, therefore a more integrated approach could be beneficial.

·         There was support for the idea of making every contact count.

·         The issue of direct payments was a complex one, for example not everyone used the internet, and there was a need to make it as simple as possible.

·         It was noted that people's conditions could change dramatically over a short period of time and it was queried whether there was any mechanism to pick up these changes.  If things did change the family could ring the social worker who would reassess the care being provided and make changes if necessary. 

·         Permanent admissions to residential and nursing care homes aged 65+ - it was confirmed that the target was to keep as many out of residential care as possible and support people to stay at home.  The service worked on the assumption that people wanted to live at home for as long as possible.  However, if people were not safe at home a move into residential care would be recommended.

·         It was noted that when the authority had to place someone in residential care, it would be in competition with those accessing it themselves.  Members were advised that 40 – 45% of places were being filled by people funded by Lincolnshire County Council. 

·         If the plan was to reduce the numbers in residential care, it was queried whether in order for care homes to maintain occupancy levels, would they need to find additional ways to fill spaces.  It was noted that a couple of homes had gone out of business but this was not due to placements, and the executive councillor commented that she could not remember the last time a residential home went out of business due to capacity.  The need for adult social care was increasing.

·         The authority had a statutory duty to maintain and manage the market.  Occupancy was at 90% around the county.  There was an aim to reduce the target, but the demand would increase.

·         It was queried whether the authority promoted anything like day care facilities in residential homes.  Members were advised that there were activities such as lunches or tea and cake afternoons.

·         34 – Chlamydia diagnoses per 100,000 15-24 year old – it was highlighted that there were changes in culture and there were now increases in STI's in the over 60's being reported.  It was queried how responsive the indicators were to these changes.  It was noted that this indicator had come from a national priority, and was still a valid target.


The Chairman concluded by observing 16 of the 23 indicators were on target and recognised the efforts of all staff in delivering these targets




            That the performance information received be noted and the efforts of all staff in meeting the performance targets me recorded.



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