1. Overview – Adult Social Care and Better Care Fund update People Directorate Stoke-on-Trent City Council

2. Purpose Understand what we do How we are responding to the challenges we face Better Care Fund update

3. Activity - Quiz Question 1 In 2013, how many contacts did we receive from people who needed help or advice? A. 5,000 B. 10,000 C. 15,000

4. Activity - Quiz Question 1 In 2013, how many contacts did we receive from people who needed help or advice? A. 5,000 B. 10,000 C. 15,000

5. Activity - Quiz Question 2 In 2013, how many assessments did we carry out? A. 6,000 B. 9,000 C. 12,000

6. Activity - Quiz Question 2 In 2013, how many assessments did we carry out? A. 6000 B. 9,000 C. 12,000

7. Activity - Quiz Question 3 What proportion of people we assessed went on to receive services? A. 65% B. 50% C. 80%

8. Activity - Quiz Question 3 What proportion of people we assessed went on to receive services? A. 65% B. 50% C. 80%

9. Activity - Quiz Question 4 The 2011 census suggested that there were 20,000 unpaid carers in the city. What proportion of these do you think we currently provide support to? A. 12% B. 20% C. 28%

10. Activity - Quiz Question 4 The 2011 census suggested that there were 20,000 unpaid carers in the city. What proportion of these do you think we currently provide support to? A. 12% B. 20% C. 28%

11. Activity If Cabinet were all aged 65 +, one and a half of you would have received a service from us in the year: - We provided services to 6,265 people aged 65 + in 2012-13 - This is 15% of the 65 + population in the city The Census indicates one of you will be an unpaid carer To be able to deliver all of the domiciliary (home) care provision, we would need 31 times your number each week - We provide 600,000 hours of domiciliary care per year (more than 1 million contacts) - This is an average of 11,538 hours of care per week - Assuming 37 working hours per week, we need the equivalent of 311 people

12. What we do Statutory Responsibilities for the City Council to provide ASC: Include a range of legislation e.g. 1948 National Assistance Act, 1990 Community Care & NHS Act Duty to assess need People with need for community care services Carers need for support Duty to provide Residential Accommodation and Community Services for: Older People Disabled People People experiencing mental ill health Carers Make direct payments to allow people to pay for care Safeguarding vulnerable adults and older people After care services for people detained under the MHA

13. Making a difference Case Example 1 (Reablement) Mrs B ages 55 years MS Rigidity in limbs, fall, broken leg, hospital admission 10 weeks reablement Case Example 2 (Safeguarding) M aged 42 Learning Disabilities – suffered bullying and harassment Became very nervous and struggled to regain her previous confidence. Intensive programme at Riverside Case Example 3 (Direct Payments) V aged 19 years RTA – brain injury – impacting on behaviour, cognition and memory DP for 2:1 support and DP for carer

14. Challenges National policy reform – care bill reform and BCF Public service reform – demand vs resources Maintaining quality Commissioning and delivery footprints Distressed local NHS economy Greater efficiency

15. The Care Bill Very significant legal reform to the way care and support is accessed and funded New specific duties for authorities and health to work together - prevention, promotion, co-operation Additional responsibilities and demands - new carers rights(same as people they care for) - self funders - Shaping the wider care market - new statutory framework for Adult Safeguarding - provides legal basis for personalised budgets - changes to charges to people for their care costs Significant impact on how we work – finance, operations, commissioning, IT, communications and marketing

16. Better Care Fund Pooled budget of up to circa £47m between LA and CCG to progress transformation (lead commissioner locally agreed). National requirement. 5 main areas - Integrated Local Care Teams / Community Team + (joint assessment and care management, accountable professional, assessment in home) - Frail / Complex (named GP over 75s, clinical support) - Support to live at home (equipment, telecare, homecare, housing) - Intermediate care / reablement (integrated model) - Carers Key Objectives - Reduce pressure on acute and long term care - Joined up approach with shared responsibility to address local issues/demands - Protection of adult social care - Improved efficiency (reduce duplication) with opportunity to reinvest in right services, right place - Improved community provision to support people at home

17. Better Care Fund - update Have paper that summarises latest position Developments since we last briefed you: ―Section 256 agreements will wrap up existing financial arrangements for 2014-15 ―The requirement for 25% of Better Care Fund to be dependent on performance has been changed (no withholding of funds) ―We have agreed a definition of “protecting social care”, with a figure of £6m health funding for 2015-16 ―Need to work on Section 75 agreements and risk management / governance for 2015-16

18. What needs to happen going forward? Consolidate our current approach Scale up integrated approaches with new delivery model design - demand management Maximise opportunities for self management and self care - culture Introduce new ways of working – new staff new roles – co production Create sufficient leadership and resource capacity to support implementation Strong system leadership is needed not market driven Strengthen demand/ activity / financial modelling/ outcomes – cost benefit analysis

19. What outcomes do we need to deliver? It’s not just about national reform and meeting requirements but about improving customer experience Treating people with dignity and respect Providing the right care in the right place, first time Cultural shift - focus on person centred care and support Assessment and care at home wherever possible Joined up approaches with health Increased independence and reduced demand for acute services

20. Outcomes from this session Greater insight into Adult Social Care Understand the challenges and approaches being used to deliver improved outcomes Recognise the challenges and uncertainties around the Care Bill and Adult Social Care generally Sign off BCF at stage 1, and give authorisation to proceed to stage 2 Develop member engagement around adult safeguarding

21. Thank you