Care and Support White Paper

Overview The Care and Support White Paper was published alongside the draft Care and Support Bill and a progress report on finance The White Paper aims to set out a vision, principles and legislative framework for the care and support system In many ways the White Paper is in line with the current objectives of Hampshire County Council Adult Services

Care and Support White Paper The vision is underpinned by five service user statements: “ I am supported to maintain my independence for as long as possible” “I understand how care and support works, and what my entitlements and responsibilities are” “I am happy with the quality of my care and support” “I know that the person giving me care and support will treat me with dignity and respect” “I am in control of my care and support”

“I am supported to maintain my independence for as long as possible” Support for people within communities Duty to commission and provide preventative practice –Village Agents, Community Independence Teams New approaches encouraged such as time banking and social impact bonds New care and support housing fund –Extra Care Housing Strategy Further roll out of telehealth and telecare – –Widespread use of telecare and planned step change by procuring a strategic partner for delivery

“I understand how care and support works, and what my entitlements and responsibilities are” Improving information and advice –Hants Direct, Care Choices Consistent eligibility criteria Portability of assessments from one authority to another Increased support for carers –Cares strategy and partnership. take a break scheme

“I am happy with the quality of my care and support” Improving regulation provided by the Care Quality Commission (CQC) –Care Governance and Quality Outcomes and Contract Monitoring in place Care providers subject to new standards to be developed by the National Institute for Health and Clinical Excellence (NICE) –Partnership Training Local Safeguarding Adults Boards to have statutory basis. –Appointment of Independent Chair of the Hampshire Board Duty to promote diversity and quality in the provision of services –CDW team and Equalities Impact assessments

“I know that the person giving me care and support will treat me with dignity and respect” National code of conduct and minimum training standards for social workers Chief Social Worker 100,000 apprenticeships in social care over the next five years

“I am in control of my care and support” Aim for a more personalised and integrated social care system Legislation to give everyone eligible, a personal budget Duty to inform people which of their needs could be met through a personal budget –Full review of our approach to personalisation and direct payments based on feedback from Service Users – year on year increase in number of direct payments £100 million in 2013/14 and £200 million in 2014/15 to support integration –Development of Integrated Care Teams working in partnership with CCGs and Community Health Services

Conclusions The White Paper does not address the critical funding issues –Pressure of the cost of care on individuals and families – Dilnot proposals –Underlying structural deficit in the funding of care and support However it is welcome in that its emphasis is on many areas where the County Council has already made good progress and reflects the voice of service users

Winterbourne View Winterbourne View services for people with a learning disability / Autism and behaviour which challenges

Winterbourne View Review Concerns were highlighted in the media after warning signs were ignored and a whistleblower went unheeded The review, overseen by the Department of Health went beyond Winterbourne View drawing on: –A criminal investigation with 11 individuals prosecuted and sentenced –The CQC review of all services provided by Castlebeck Care and a programme of inspections of 150 learning disability hospitals and homes –NHS South of England reviews of serious untoward incident reports and commissioning at Winterbourne View –Independent Serious Case Review commissioned by South Gloucestershire –Experiences and views of people with learning disabilities or autism and mental health conditions or behaviours described as challenging, carers, care staff, commissioners and care providers A national programme of action has been agreed that will be overseen by the NHS Commissioning Board

Winterbourne View - Key Points The review revealed: Abuse that was criminal. Weaknesses in the systems ability to hold providers to account and a gap in the regulatory framework overall Many people in “hospital” did not need this level of care and their right to receive care and support in other settings near their friends and family was not being respected and their voices were not being heard. The response requires health and social care partners and the respective regulatory bodies to take co-ordinated action at strategic policy, strategic commissioning and tactical levels immediately. By June 2014 individual reviews need to have been enacted

The action we are taking Safeguarding Policy –The Hampshire Safeguarding Adults Board are working with multi-agency partners to refresh and refine our approach. This will build on our current work to develop a culture that does not tolerate abuse; awareness raising; prevention; intervention where abuse does happen to support and safeguard the rights of people who are harmed Strategic Commissioning for the Health and Care System –We are working with NHS commissioning partners to develop a joint commissioning approach for Hampshire to establish more individualised local solutions which provide a good quality of life to people with a learning disability and autism with additional complex needs Operational Commissioning for Individuals –We have established a working group that includes commissioners and providers to identify all the people affected; prioritise the review programme to meet the required timescales; address provider market issues and embed the quality and safeguarding demands. Consideration of the value for money is also included

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