1. ‘New Ways’ Transformation Programme Health and Adult Care Cabinet Panel 6 December 2011

2. New Ways: Four main projects • ‘Social Care Access Service’ with Serco • ‘Lean review’ of Older People’s Teams • ‘Lean review’ of Learning Disability Teams • Assessment and care management of older people with dementia

3. Consultation to date • Consultation event with service users and carers, local groups and vol orgs • Second event for people with learning disabilities, their carers and vol orgs • Workshops with people and carers using dementia services and GP consortia • Staff consultation events and feedback

4. Government vision for social care • More informed people and families through better information and advice • People told if they are eligible quickly • People empowered to take control • Choice in the care and support available • People are safe and providers high quality

5. Project 1: Social Care Access Service Health and Community Services New Ways Programme

6. Project 1: ‘Social Care Access Service’ • Partnership with Serco as part of HCC’s shared and managed services contract • Quality advice at first point of contact • Eligibility assessments and options • ‘Channel shift’ and new ‘eMarketplace’ • Service finding and care reviews

7. Project 1: Social Care Access Service

8. Social Care Access - from the way we do it now … Other professionals Service Solutions Referral Management Teams Service User Social Work Locality Teams CSC Unscheduled Reviews Enablement Scheduled Reviews

9. Slide 9 SERCO/HCS Partnership Hosp Teams / HCT Goldsborough Partnership HCS Increasing access to direct support and self-help opportunities Reducing the need for longer term provision Web Services SERCO Service User TIER 1 Social Care Access Information Advice Triage Service Finding & Brokerage Reviews TIER 2 Extended Involvement Hospitals Other professionals Enablement

10. Project 1: ‘Social Care Access Service’ • Web-based services fit for 21st Century • …for use by service users and their families – a web portal with user account • New ‘eMarketplace’ – allows people to buy care and support services directly • IT system integration to improve back–office efficiency – linked to SAP etc

13. Project 1: ‘Social Care Access Service’ • Housing Solutions Service: • Adaptations to people’s homes (inc DFG) • More consistent OT assessments • Working with Serco and 6 Districts • Shorter and simpler processes • Standardised electronic applications • eMarketplace for builders

14. Project 1: ‘Social Care Access Service’ • Monitoring quality and safeguarding: • Partnerships & Quality Unit • Key performance indicators agreed • Activity levels agreed and staffing matched • Interfaces with other teams automated • Audit mechanisms in place • Satisfaction levels monitored • Budget levels monitored

15. Project 1: ‘Social Care Access Service’ Monitoring quality and safeguarding Assistant Director Older People and Physical Disabilities Head of Partnerships and Quality County OT Development Manager Performance and Quality Manager Performance and Quality Manager Information Quality Officer SERCO Goldsborough

16. Project 2: ‘Lean review’ of Older People’s Social Work Teams Health and Community Services New Ways Programme

17. Project 2: Lean review of OP Teams • WHAT IS A LEAN REVIEW? • Reduce duplication and waste • Appropriate delegated authority to spend • Eliminate bureaucracy • Shorten forms and paperwork

18. Project 2: Lean review of OP Teams • Success of enablement – key stats: • Of 1,708 people into enablement this year, 50% needed no on-going service • Homecare population fell by 700 last year with a further reduction projected • This has led to a 40% reduction in the number of personal budget assessments by Older People’s Teams

19. Project 2: Lean review of OP Teams • Processes made lean: • ‘Trusted assessors’ – budget authorisers • New universal assessment process • New pathways for enablement services • Review of caseload expectations • Design new operational structure • Define roles and responsibilities

20. Project 2: Lean review of OP Teams • Efficiency drivers: • Success of enablement services • More streamlined assessments • Target reduction in management • Benefits: • Financial savings of £1.6M per annum • Headcount reduction of approx 70 – trying to avoid compulsory redundancies

21. Project 3: ‘Lean review’ of Learning Disability Teams Health and Community Services New Ways Programme

22. Project 3: Lean review of LD Teams • Processes made lean: • Universal assessment • Expectations at care review • Alternative sources of care and support • Authorisations and approvals • Review of team structures: • Maintain community teams • Changes to transition team

23. Project 3: Lean review of LD Teams • Older Family Carer’s Workers (4 posts): • Staff who provide support to family carers over the age of 70 caring for an adult with LD at home • This work has been mainstreamed into the community social work role • Support managed through teams • Named team lead for older family carers

24. Project 3: Lean review of LD Teams • Efficiency drivers: • Better throughput required in teams • More streamlined assessments • Reduction in specialist posts • Benefits: • Financial savings of £0.5M per annum • Headcount reduction of approx 15 – trying to avoid compulsory redundancies

25. Project 4: Assessment and care management of older people with dementia Health and Community Services New Ways Programme

26. Project 4: Older People with Dementia • Current arrangements: • HPfT have provided assessment and care management for all older people with mental ill health in integrated teams since 2005 • Perceived problem: • Whilst integrated health and social care input works well for older people with functional mental illness (e.g. depression or schizophrenia) it does not work well for older people with dementia • Care purchasing budget was never given to HPfT

27. Project 4: Older People with Dementia • Drivers for change: • Delays to appropriate social care interventions • Delayed transfers of care • Slow uptake of enablement services • Relatively high permanent admission to care homes • High numbers of complaints • Proposed solution: • Transfer back the care management responsibility for older people with dementia and Alzheimer’s

28. Project 4: Older People with Dementia • Detailed proposals: • Transfer approx 40 social care staff who work in the Specialist MH Teams for Older People (HPfT) back to HCC via TUPE • Integrate the workers into newly configured locality social work teams to support all older people • Ensure that any older person who is referred to HPfT navigates the system quickly • Transfer the care purchasing budget for older people with functional MH problems to HPfT

29. Equality Impact Assessments • Have been developed iteratively for impact on both service users and staff

30. Decision-making and next steps