Management Forum April 2013 John Bolton Interim Executive Director

Management Forum April 2013 Evaluation

Who am I …? John Bolton – Qualified Social Worker Director of Joint Review Team Director at Coventry City Council 2001–07 Strategic Finance Director at Department of Health including responsibilities for delivery of Putting People First Freelance consultant and visiting professor at the Institute for Public Care – Oxford Brookes University Interim Director in Warwickshire 2010 and Westminster 2011 Local Government Association Efficiency Programme 12/14 – work with LAs on effective use of resources in England Wales and Scotland – written many publications

… and what am I doing here? Build on the success of Adult Social Care in Walsall and make it fit for the future Deal with any fallout arising from the suspension of Paul Davies et al Ensure that the Directorate is running efficiently and effectively Move forward on the journey to personalisation Develop the programme of preventive interventions Assist the Directorate to identify its contributions to corporate savings I expect to be here for at least 6 months – probably longer

What is good about Walsall?  Has a good range of services and strategies that ought to be fit to assist with getting the right outcomes for local people  Partner organisations that want to work with us  Good investment in some preventive services  A group of competent managers for their own services  Streets Corner as a hub for new contacts – build on it  Progress in thinking about personalisation  Focus on quality  Financial stability (at present)  Generally a good environment in which to work

What might need to improve?  Managers who can work together across divisions and service lines –commissioners and care managers and providers –Focus on shared outcomes –Clarity about roles and responsibilities and overlaps  Service users need fewer hand-offs, fewer assessments  Personalisation – less bureaucratic, more outcome focused  Getting the flow of people in and out of the care system  Focus on promoting independence and prevention  Clarity on the care market that we need  Using PARIS properly at all levels –Performance and outcomes for every intervention –Using the data to help manage the business

Introducing some new developments Personalisation A focus on outcomes that promote independence Personal Budgets (not Individual Budgets) Either a Direct Payment (support available) or a Managed Account – straight choice Support Plan Focus on the outcomes to be delivered Assessment – only carried out when preventive interventions have failed – should lead to a support plan Hospital – not the place to do an assessment for a long-term service – need no delays Prevention

What is prevention? Universal provision Community based services which people need assistance to access Preventative provision Services that are for people who have some needs but not critical enough to warrant an assessed social care intervention – Supporting People Recovery-based Services Services that are supporting recovery, rehabilitation, recuperation and rehabilitation which are offered people for whom, if they are successful, they will reduce the need for high intensity care – Reablement or Recovery Therapies Deferred interventions Services that are preventative in that they defer people for a time from a poorer outcome and for the need for more intensive care. Dementia Care FOCUS ON OUTCOMES THAT PROMOTE INDEPENDENCE

Prevention Services All Services that address issues that assist people in being diverted away from any direct help from social care. Includes supporting people services/ neighbourhood and community teams with community alarms et al. Interventions that help people short term who are in a crisis – the aim of these services is to help people short term to regain as much independence as is possible. Includes intermediate Care/ Reablement/ IAPT – counselling services/welfare rights/rehabilitation/ promoting independence and employment/ telecare. Main skills are OTs and some social workers Hospital Social Work Service is in this area e.g. Helping Older People and carers in living with dementia. Safeguarding is an intervention. Assessments For those people who are deemed to need an assessment because they may be eligible for longer term support and other interventions have not (yet) worked. Some of the interventions may be assessed as continuation of Short-term Intervention Service. The RAS operates here and only option is a PB – the brokerage function First place where residential care can be assessed. The front end of the Directorate …

Long term Care People who need long term help including those with complex needs – includes reviews of any person who receives an existing care package. Reviews should always consider whether the initial intervention has achieved its set outcome and whether there are better ways of delivering any further needs. Access to longer term provision all of which has been commissioned and procured by JCU and is contract managed for outcomes delivered. Personal Budgets Direct Payments – supported by external bodies. Managed Accounts – brokered and managed in- house. … and the back end

Social care has a legal duty to assess people’s needs and decide if they are entitled to services. Advice and signposting are available to people who are not eligible. Eligible people complete a self assessment which helps them to work out for themselves what support they need to achieve their outcomes. Together with an assessment completed by a social worker, this generates an individual budget - the sum of money people can have to meet their needs and outcomes.

 Questions and Discussion

The financial strategy ahead  Likely scenario of £15 million+ less in 3 years’ time  We can manage demand better (prevention)  If prevention works – what will demand look like?  We can manage costs better (the level of care or the costs of care)  Reduced use of residential care could save money?  Can we save money from H21 contract or res care?  Should we out-source current in-house services?  We can increase charging (transport) or collection of charges  If this doesn't deliver, from where would we reduce staffing?

Group Exercise  From where might you find savings for the next 3 years? Managing demand Managing costs Raising income Reducing staffing and infrastructure costs

Evaluation