Agenda item

(To receive a report by Caroline Jackson, Head of Corporate Performance, which summarises the Adult Care and Community Wellbeing Service Level performance for Quarter 4)

Consideration was given to a report which summarised the Adult Care and Community Wellbeing Service Level Performance for Quarter 4.  The report only summarised the measures which were either above or below the target range.  Members were advised that 11 measures had achieved target, four had not achieved their target and five could not be reported at this time.  The report set out the explanations for the measures not achieving target.

The Committee was 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:

·         People in receipt of long term support who have been reviewed – it was queried what this review included, and members were advised that this was a compliance measure.  It was commented that reviews were seen nationally as a good thing to do as it was recognised that people's needs changed over time.   Lincolnshire wanted its frontline practitioners to be more innovative where there were changes that would help people to become more independent.

·         Requests for support for new clients, where the outcome was no support or support of a lower level – it was clarified that low level support did not mean an inferior level of support.  If people were able to access lower levels of support sooner, it was more beneficial than them only coming to the attention of the service when they were in need of a higher dependency package of care.

·         Percentage of alcohol users that left specialist treatment early – it was commented that it was understandable why it was very difficult to achieve this target as it required a lot of personal determination from the individual receiving treatment.  It was also noted that some other authorities did not have the rural challenges that Lincolnshire did.

·         It was noted that there would be times when people would be oversubscribed care and support, usually when there was a pressure, such as leaving hospital.  This could give them a level of dependency which was not beneficial in terms of longevity.  A lower level of care and support could help people to retain their place in their community.

·         Adults who receive a direct payment – it was queried whether this achieved a better outcome for people and the authority, and members were advised that typically yes, there would be better outcomes for the individual.  It was also highlighted that people who received direct payments tended to spend less, and had more flexibility about how they used their resources.  There were also providers who an individual could approach that the Council was unable to as they were not Care Quality Commission regulated.

·         Adult Safeguarding concerns that lead to a Safeguarding enquiry – it was queried whether more training was needed in some agencies to reduce the numbers of safeguarding concerns being referred which did not progress to enquiry.  Members were advised that there could be up to 15 agencies supporting an individual.  A concern was logged when someone called to say they were worried about an individual, it became an enquiry if it was followed up.  Approximately two thirds of concerns did not lead to an enquiry.  It was commented that training was critical, and the Care Act had made adult safeguarding a statutory duty.  However, adult safeguarding was more complicated as adults had resources and assets and items that could be stolen.  Compared to safeguarding children, safeguarding adults was still a relatively new service.

·         Safeguarding cases supported by an advocate – it was queried how this could be at 100%.  It was commented that this target had been at 100% for a while and it could be re-examined.  It was noted that this was an assurance measure to ensure that this activity was taking place.

·         Percentage of alcohol users that left specialised treatment successfully – it was queried whether the target for this was too low.

·         Percentage of people supported to improve their outcomes following Wellbeing intervention – it was queried where this opinion came from and if it was the view of the client or the clinician.  It was reported that this opinion was formed through conversations with the individual, and what outcomes they wanted to achieve and if they felt they had achieved them.

·         In terms of safeguarding, if there was a significant proportion of safeguarding contacts that did not lead to an enquiry, there could be a gap in training.

·         In terms of assessments, it was queried whether there were going to be additional cases and additional assessments, and would the service be able to manage in future with an increase in workload.  It was commented that social care in general was finding it more difficult to cope with increasing workloads, and additional resources and a long term financial plan.  The Council had a medium term financial plan, which did not assume that it would receive additional funding from government.

·         In relation to hospital re-admissions, it was queried whether people received the care they needed when they left hospital.  In relation to occupational therapy, it was noted that a backlog had been identified a few years ago and so resources were increased within the service.  However, there was a national difficulty in recruiting occupational therapists.

·         Data in relation to timescales for assessments was being examined, and it was noted that assessments were carried out in a very timely manner.

·         It was commented that it would be useful to know the actual numbers for some of the measures rather than just percentages.  It was confirmed that the numbers could be incorporated into future reports.

·         It was queried what was being done to help those carers who were socially isolated.  Members were advised that a social isolation strategy had been developed, and work was underway to explore how this could be linked in with the Digital Strategy, and it was also part of the Housing Strategy.  There was more work to do, not just with this Council, but also working with the voluntary sector.  Specifically in relation to carers, it was noted that a significant amount of work to support carers had been undertaken over the past 16 months.  The data in the performance measure was from a national survey.

RESOLVED

            That the performance of the measures that were either above or below the target range be noted.