1. RCPA Ltd Annual Conference
Welcome
RCPA Ltd Annual Conference
Tuesday 15th November 2016

2. 09.30 Registration
10.00 Opening address; Richard Brice, Chair, RCPA
10.05 Stephen Chandler, Director, Adult Social Services, Somerset CC
10.35 Lisa Smith, Research and Development Manager, Research in Practice for Adults
11.00 BREAK

3. Richard Brice
Chair RCPA Ltd
“Welcome & Introduction”

4. Vision of Adult Social Care
Please welcome our first speaker
Stephen Chandler, Director
Adult Social Services, Somerset CC
Vision of Adult Social Care

5. Service Transformation
“What does it mean for me?”
‘Doing the right things, well’
Stephen T Chandler
Director of Adult Services

6. Is it all about the money ?

7. Remember the analysis The inescapable truth… Outcomes Demand Cost
Budget
Social care the ticking time bomb at the heart of local government
ADASS suggesting a 25 billion pound funding gap
Barnet’s now famous graph of doom

8. “ADASS October 2016 financial review”
Somerset Council
Adult Social Care Budget
£ ,000 or £383,000 per day
“ADASS October 2016 financial review”
“74% of councils are now predicting an overspend within their Adult Social Care Services”

12. Are we doing the right things – and well?

13. Source: ASCOF 2014/15

14. Source: ASCOF 2014/15

15. Source: SALT 2014/15

16. But what else matters ? Personalisation Co-production Innovation
Technology enabled
Workforce
…………….

17. So what could it / will it be about ?
There must be a clear story line,
a clear strategy, a clear narrative

18. What will it all be about ?
Changing the expectation and understanding of ASC
Aspirational rather than paternalistic
Shifting from an “assessment for service” to “being part of joined up community based ‘system of support’ based on helping people to get on with their lives”
“at every interaction with a person, a local authority considers whether or how the person’s needs could be reduced or other needs could be delayed from arising”
Care and Support Statutory Guidance 1.14c p.3
A relationship that is co-produced, the council is the glue rather than the whole

19. What will the norm become ?
A good starting point for a discussion that helps develop resilience and promotes independence would be to ask “what does a good life look like for you and your family and how can we work together to achieve it?” Giving people choice and control over the support they may need and access to the right information enables people to stay as well as possible, maintain independence and caring roles for longer” Care and Support Statutory Guidance 2.21 p.13

20. Conversation 2:
Wider community resources are also expected to be part of the overall offer, “including local support networks and facilities provided by other partners and voluntary organisations”
Care and Support Statutory Guidance 2.27 p.14
Conversation 1:
It will require “consideration of the role a person’s family or friends can play in helping the person to meet their goals” Care and Support Statutory Guidance 2.5 p.8
Conversation 3:
..and the involvement of a wider range of services than adult social care alone, including “those responsible for public health, leisure, transport, and housing services…’
Care and Support Statutory Guidance 2.23 p.13

21. Conversation 2: Conversation 1:
When people are at risk – ‘What needs to change to make you safe?
How do I help make that happen?
What offers do I have at my disposal, including small amounts of money and using my knowledge of the community to support you?
How can I pull them together in an ‘emergency plan’ and stay with you to make sure it works’?
Conversation 1:
‘How can I connect you to things that will help you get on with your life – based on your assets, strengths and those of your family and neighborhood.
What do you want to do?
What can I connect you to?
Conversation 3:
What is a fair personal budget and where do the sources of Funding come from?
What does a good life look like?
How can I help you use your resources to support your chosen life.?
Who do you want to be involved in good support planning?

22. --Eligibility Assessment --
Offer 2
Help When You Need it
Immediate short term help,
intensive support
to regain independence, Minimal delays,
No presumption about long-term support, goal focused, integrated
Success = Regaining an
independent life
where possible
Offer 1
Help to help yourself
Accessible, friendly, quick, universal services,
connecting you to your community
Available to the whole community
Success = Enabling you to get on with your life
--Eligibility Assessment --
Offer 3
Ongoing support
for those that need it
Self-directed, personal budget based,
choice and control, highly invidualised.
Success = Helping you to get
on with your life,
with the support that
works for you
Safeguarding
We will enable as
many people
as possible
to live their lives
at offer 1 and 2

23. How will we get there ?

24. Performance Improvement
Place shaping
A systematic approach to managing both business and transformation
Performance management focused
Zero tolerance of poor practice
Outcome focused
Engaging the broader council and system

25. Questions

26. Personalisation; Where are we now?
Please welcome our Second speaker
Lisa Smith, Assistant Director,
Research in Practice for Adults
Personalisation; Where are we now?

27. Personalisation: Where are we now?
Lisa Smith Assistant Director Research in Practice for Adults

28. www.ripfa.org.uk Personalisation:
Background and current policy context i.e. Care Act
Personalisation is about person-centred approaches- not just about personal budgets- sometimes we conflate the two.
 What is the Care Act?
The Care Act 2014 is the most significant change in social care law for 60 years. It applies to England and replaces a host of out-of-date and often confusing care laws.
'A long time coming': Social workers have their say on the Care Act
Read more
The legislation sets out how people’s care and support needs should be met and introduces the right to an assessment for anyone, including carers and self-funders, in need of support.
What is the most important change?
The act’s “wellbeing principle” spells out a local authority’s duty to ensure people’s wellbeing is at the centre of all it does. There will be more emphasis on outcomes and helping people to connect with their local community. Also, for the first time, people’s eligibility for services will be the same across England. Another first is that councils are now allowed to contract out social work functions such as assessment.

29. www.ripfa.org.uk What underpins a personalised approach?
Outcomes focused conversations- the disco shower
Strengths-based: What matters to you? not what’s the matter with you?
What does the evidence tell us?

30. www.ripfa.org.uk What does the evidence tell us?

31. www.ripfa.org.uk https://blog.scope.org.uk/tag/personal-budget/
Personal budgets as an approach to personalisation?
History… case studies… where are we now? Where is Somerset?
Challenges for the market of PA
Messages for practice
Personalisation is not just about personal budgets, but about achieving choice and control in many ways and in different settings, including basic needs such as being able to access public transport if you are disabled.
Personalisation is about the dignity and well-being of the individual.
Delivering personalised services will mean different things to different people – it’s about self-determination and self-directed care.
The relationship between social workers/PAs and service users should be based on respect and a recognition of equality.

32. www.ripfa.org.uk Is it a cultural shift?
Whose culture are we shifting?
Commissioners?
Providers?
LA social workers?
Our community?- how do we work with the community to enable people to have different expectations of what social care should look like

33. Contact @ripfa https://www.ripfa.org.uk help@ripfa.org.uk 33

34. COFFEE BREAK
Please return at
11.25am
Thank you

35. 11.25 Mei-Ling Huang, Partner,
QualitySolicitors Burroughs Day
11.55 Our Partners: QualitySolicitors Burroughs Day, Albert Goodman, Natwest, Redlink Alliance, Acacia Training and Development,
12.20 Workshops (1)
13.20 LUNCH

36. Implications of Service Transformation
Please welcome our third speaker
Mei-Ling Huang, Partner
QualitySolicitors Burroughs Day
Implications of Service Transformation

37. RCPA Conference
15th November 2016
@QS_BurroughsDay

38. Social care specialists
Challenging CQC inspections and enforcement
Negotiations and disputes with local authorities
Recovery of care fees
Safeguarding
Mental capacity and Court of Protection
Employment law
Business sales and acquisitions
Commercial property, leases and tenancies

39. How we can help Services for Businesses: Services for Individuals:
Commercial Law
Residential Property
Commercial Property
Employment, HR & Discrimination Advice
Advice for Business Start-ups
Family & Relationships
Charity Law
Lasting Powers of Attorney
Debt Recovery
Litigation
Medical Negligence
Employment Law
Mental Capacity
Health & Social Care Law
Personal Injury
Legal Costs
Probate
Pharmacy Law
Wills and Tax Planning

40. CQC Inspections and enforcement
Mei-Ling Huang
Partner

41. Overview
Inspections
Ratings
Ratings reviews
Enforcement

42. SSP Health Limited
If you can prove that CQC have got it wrong in your draft report but they ignore you, what can you do about it?
“We didn’t see it, so it doesn’t exist.”
An independent review of the factual accuracy process is required if the provider requests it

43. New Factual Accuracy Logs
Section A – Typographical errors
Section B – Accuracy of the evidence in the report
Section C – Completeness of the evidence
You may make a separate complaint regarding the conduct of the inspection
Important: Include everything at this stage!

44. Factual Accuracy Log Steps
Draft report to provider;
Submit factual accuracy log with all your arguments;
Inspector responds to log;
Log internally reviewed by someone else in CQC;
CQC sends responses to the factual accuracy log and final report;
Report is published.

45. 2015/16 State of Care 596 services rated inadequate as of July 2016
Some were re-inspected
139 achieved a “good rating” (23%)
316 achieved “requires improvement” (53%)
This leaves 141 unaccounted for – perhaps closed.

46. State of Care 2015/16 Many services were caring.
Performance flows from management.
Most of the regulatory compliance action taken related to management, safety and staffing.

47. New Ratings (1)
Residential homes that have been rated under the new system as of September 2016:
0.8% outstanding
69% good
26% require improvement
3% inadequate
1% not rated

48. New Ratings (2) Nursing homes (as of September 2016): 0.6% outstanding
58% good
35% require improvement
5% inadequate
2% not rated

49. New Ratings (3) Home care agencies (as of September 2016):
1% outstanding
73% good
21% require improvement
2% inadequate
2% not rated

50. Is there too much variation in ratings?
“We will be clearer when services are good with outstanding features and where the rating of requires improvement does and does not entail a breach of regulations”.

51. Changing your rating
Factual accuracy logs are still the most effective way to obtain a change
Add in positive points omitted from draft report

52. Changing your rating (2)
Request for ratings review
Procedural argument
500 words!
Low chance of getting the rating changed

53. Ratings reviews July 2016 Reviews requested - 290 No grounds - 178
Paused due to external factors - 17
Under investigation by CQC team - 31
Under consideration by reviewer - 4

54. Ratings reviews July 2016 Outcomes of 236 completed cases:
Not reviewed due to “no grounds” - 193
Ratings increased - 14
Ratings decreased - 2
Ratings increased and decreased - 2
No change to ratings - 25

55. Enforcement Fewer warning notices Embargoes
Cancellation of managers’ registration

56. Help is at hand!!! Call us if… Your draft report is not accurate
You are on the cusp of a rating (e.g. 2 ‘requires improvement’ and 3 ‘goods’)
You have any ‘inadequate’ ratings
You receive a warning notice, notice of proposal or notice about special measures

57. QUESTIONS

58. Thank you for listening
For a free initial consultation please contact
Our Social Care Team

59. QualitySolicitors Burroughs Day Acacia Training and Development
Our Partners;
QualitySolicitors Burroughs Day
Albert Goodman
Natwest
Redlink Alliance
Acacia Training and Development

65. WORKSHOPS SESSIONS 1 1 2 3 4 5 6
Please return at
1.20pm
Thank you

66. LUNCH &
VISITING TRADE
STANDS
Please return at
2.30pm
Thank you

67. 14.30 Workshops (2)
15.30 Simon Blackburn, CEO and Guy Wolfenden, Marketing and Development Manager, RCPA: Closing Plenary and RCPA Service Offer
16.00 Close

68. SECOND WORKSHOP SESSION1 2 3 4 5 6
Please return at
3.30pm
Thank you

69. Marketing Manager RCPA Ltd
Guy Wolfenden
Marketing Manager RCPA Ltd
“Our Service Offer”

70. Who we are:
Since the 1981, the RCPA has worked within the health social care sector to support care providers and promote good practice. We have established a reputation as a reliable source of support, advice and provided services to members as a force for change.
We have forged and maintained respected relationships with key stakeholders in the local authority and the NHS.
RCPA works with providers, commissioners and other stakeholders, often in times of challenge and uncertainty, to develop, sustain and deliver high quality services to individuals.

71. What we do:
Support: we provide services that support member organisations towards sustainable growth, ensuring that they have the necessary infrastructure to meet the needs of their business.
Influence: we represent our members through a collective voice, to influence and collaborate with key strategy and policy makers, including commissioners, service planners and other stakeholders.
Quality: we support our members to be able develop and deliver high quality, evidence based care and support.

72. @rcpaltd
Care Providers Forum
Closed Group

73. Chief Executive Officer RCPA Ltd
Simon Blackburn
Chief Executive Officer RCPA Ltd
“Closing Plenary”

74. Thank You
“have a safe
journey home”