1. Assistant Director - Older People and Physical Disabilities Services
Karen Jackson
Assistant Director - Older People and Physical Disabilities Services

2. Financial overview
National cuts to public sector funding since 2008 has meant HCC has needed to deliver £340m in savings by end March 2017
Adult Services will have saved in excess of £100m in this period
By 2019, HCC will need to achieve a further £140m of savings – adult social care will have to achieve a further £55m
Council tax and social care precept in 2016/17 raised approx. £20m (3.99%) and for 2017/18 approx. £25m (4.99%) of which £15m identified to directly support adult social care

3. Adult social care – a little more detail
Net budget of £302m in 2017/18, reduced from £325m in 2016/17
Over the period 2016 /18 total of £43m to be saved on a recurring basis. That will be followed by a further saving requirement from 19/20 of £55m
Each day we support 15,000 people – with short-term or long-term support, carers support – all in a variety of settings - in the community and in care homes, etc. - 70% are older people
Significant pressures exist across the county; supporting transfers of care from acute hospitals, capacity and sustainability of the care market, for example
Imperative we change our approach to how we support residents and how we operate
Communicate frequently and consistently with the public, engaging, involving and co-producing with service users and their families
Be ambitious and confident about what people can do to help themselves
Manage people’s expectations, to provide a realistic view of what we should and will provide within our statutory duties and responsibilities
Ensure people are able to access information about the support available wherever they live in the county, in a way that is accessible to them
Be clear and knowledgeable about what support is available to enable people to support themselves
Encourage people to share their stories and improve our practice

4. Strengths Based Approach

5. How will the Care Offer be delivered?
Application of the Statutory Framework at all times
Using a Strengths Based Approach to Social work
Adopting a Tiered Approach to care and Support Planning
The new Personal Budgets Policy
A simplified process for Direct Payments
Increasing use of Assistive Technology
A new Information and Advice Directory

6. Adults’ Health and Care Reablement Service
Reablement is the active process of an individual regaining the skills, confidence and independence to enable them to do things for themselves, rather than having things done for them
47% of service users during the period were discharged from Service with no ongoing commissioned support i.e. re-abled
Maximising an individual’s potential and independence by making best use of accessible resources
The integrated re-ablement service brings together four distinct service functions, each of which support reablement
Occupational Therapy
Community Response Teams (CRT)
Sensory Services
Equipment Services

7. Adults’ Health and Care Reablement Service
It provides a sustainable service that is able to respond to the ever- changing challenges that the sector faces, including delivering cost- effective services within the resources available
The focus is on positive outcomes for service users; this means that we have to support service users and staff in positive risk taking. Delivering strength based approaches
Short-term:- This element of reablement service forms part of Hampshire County Council’s non-chargeable care offer and is based on The Care and Support (Charging and Assessment of Resources) Regulations 2014, which includes:
Up to 6–week’s reablement support under intermediate care funding
support people to use prescribed equipment or adaptations
support for safe moving and handling transfers to achieve social care outcomes.

8. Support to live at home continued enablement and long-term care
Remains the preferred option
We need to embed strength based ways of working
Home Care sector well placed to work with us to ensure people’s care needs met appropriately
Jointly working together to make sustainable care sector

9. Assistive Technology and Innovation
HCC Started with normal ‘Telecare’ now developing beyond this
Partnership with PA Argenti allows innovation and testing of new approaches such as the Amazon Alexa
Complementary to other services that maintain people in their own homes
Part of our Strength Based Approach
Opportunity to work with Home Care providers in enhancing our care technology offer.

10. Carers
Carers Strategy Group established to develop a new joint strategy for Hampshire launching later this year
Estimated 133,000 carers in Hampshire (approximately 10% of the population)
Who is a carer and what is the role of a carer?
Information and advice
Health and wellbeing
Employment, education and leisure
Carers assessments
Support and services
End of life
Young carers

11. Working with NHS partners
One of the major themes from the review of winter 2015/16 is the problems created by hospital discharge delays, caused by poor internal processes and external constraints. To combat this, all systems should implement best practice models to support their discharge processes and optimise patient flow.
Key actions
Technical Guidance
Embed ‘home first’: discharge to assess ways of working
Embed ‘trusted assessor’ ways of working
Implement policy on supporting patients’ choices to avoid long hospital stays (if existing policy not in use)
Reduce the number of NHS continuing health care screenings and full assessments taking place in an acute location
Increase proportion of patients receiving RRR (rehabilitation, recovery and reablement) care in home or community settings
Focus on simple discharge. Expediting routine (simple) discharges can be more effective in releasing beds than only concentrating on complex discharges.

12. Home First: what this means for patients, staff, system
Reduced waits for patients – improving flow, improved patient experience
Enablement and care provided in a comfortable and familiar home environment
Reduce confusion for hospital staff by limiting the number of available community pathway options
Improved care pathways: standardised discharge processes and forms between HHFT and SHFT
Positive outcomes for the patient, carers and the whole system
Reduction in ‘over-prescription’ of care from an acute bed
Effective utilisation of the limit care capacity
Ability to manage patients and family expectations
Ensuring consistent messages from staff working in a multidisciplinary team (acute, community and social)
Positive approach to risk - how can we support this person home?

13. Connect to Support Hampshire
Recently been updated – new look and new website address – independent of the Council’s website
We have listened to feedback and made improvements to the Community Directory based on what you, our stakeholders, the public and our staff have told us.
Future key developments will include; a Hampshire wide PA finder, professional zone and an offline App
Public marketing campaign commences in 2018 aiming to double the number of hits on the site
Notes; 
Bullet point 1; The website is still accessible via the Adults’ Health and Care homepage on Hantsweb and the old web address will still work for 6 months.
Bullet point 2 – continually welcome feedback – you can feedback on every page (tab at the bottom of each page) and we ask that you please do this – it will continually be improved and shaped based on user opinion.
Bullet 3 – Over the next 1 -2 years we are developing a PA finder – this will allow PA’s to register on the site and for people to search for a PA by geographical area and by interest eg. I want a PA who lives locally and likes outdoor activity. The offline App is being developed now which means you can access all the info without having to worry about wifi – you don’t need to be online to be able to access it.
Bullet 4 – Marketing campaign will be a rolling programme focusing on 2 district and boroughs at a time using customer insight tools to really target key demographics and using most effective marketing approaches for each location.

14. Hospital Workstream
Working with health colleagues to provide the most effective service to our customers.
The main aims of this workstream are to:
enable the making of timely, appropriate decisions
clarify and improve routes out of hospital
reduce re-admission rates
The focus on maintaining flow will support to reduce harm due to prolonged hospital stays, decrease delays to patient discharge, utilise the benefits of the Strengths-Based Approach, give a single view of capacity and resourcing across all beds and maintain simple referral routes with consistent specifications.

15. Hospital Workstream Hospital Offer Reablement Team Improvements
Staffing
Creating information in relation to Hampshire County Councils ‘Offer’ to residents who become a patient in a Hospital setting
New Service User Leaflet
Health Communication Pack
Implementation of Connect to Support web tool
Create active, sustainable working links and processes between Hospital and Reablement Hubs/Teams
New referral process across Hospital and Community Teams using the Wellbeing Check Tool
New reablement link role for D2A
Local link meetings
Identify and provide support to encourage and implement equity and practice
In house standardisation of reporting with a new DTOC (Delay Transfers of Care) tool.
Supporting the STP (Sustainability and Transformation Plan)
Improvements.
Joint working with Learning Disabilities and Mental Health
Improved working with Community and outlying Acute Hospitals
Innovative design and implementation of a new Hospital Operating Model including staffing changes
Triage and Case work function to support smarter working and more rapid, safe discharge
Trusted Professionals Model - written and offered to all Acute Hospitals with aim to review and expand.