1. The Social Issues in South Lincolnshire: an Adult Social Care Perspective Pete Sidgwick Lincolnshire County Council

2. Governance for Adult Care Key Decisions Pete Sidgwick Assistant Director (Interim) Transformation/Integration Pete Sidgwick Assistant Director (Interim) Transformation/Integration Justin Hackney Joint Assistant Director Learning Disabilities & Mental Health Commissioning Justin Hackney Joint Assistant Director Learning Disabilities & Mental Health Commissioning Glen Garrod Director of Adult Social Services Glen Garrod Director of Adult Social Services Executive Adults Scrutiny Committee Adults Scrutiny Committee Health & Wellbeing Board Informal Executive Executive Councillor Optional

3. Adult Social Care in Lincolnshire We directly support – 1,800 LD (all ages) – 1,000 MH (18-64) – 2,000 PD (18-64) – 12,400 OP (65+) – Overall 17,200 very vulnerable people across the County Council Expenditure £526m pa (net) gross is over £1.1 Billion – ACS Services £143m pa 4,600 Residential/Nursing Placements 6,000 people receiving Domiciliary care (80,000 visits a week)

4. Lincolnshire County Council Expenditure Budget 2012/13 (£m)

5. Overview of Health and Social Care demand in Lincolnshire A rise in the 65 – 84 age group of 31% by 2022 A rise in the 85 years of age group of 55% by 2022 A significant rise in the older population with dementia An ageing population with Learning Disabilities

6. Overview East CCG 30 GP practices covering Boston, East Lindsey, Skegness and cost covering 1060 sq miles Supporting 241,246 people Key challenges -Large geographic, sparsely populated area -Significant health issues – health disease, cancer, diabetes and COPD -Lowest life expectancy for both men and women in Lincolnshire South CCG 15 GP practices covering Welland and South Holland Supporting 157,000 people Key challenges -Rural poverty

7. Adult Social Care Net Expenditure 2011/12 4261 clients 4974 clients 2174 clients 2008 clients

8. Source: www.apho.org.uk/PracProf/Profile. Source: http://www.research-lincs.org.uk/, data as at December 2012 South Lincolnshire CCG

9. Source: www.apho.org.uk/PracProf/Profile. Source: http://www.research-lincs.org.uk/, data as at December 2012 Lincolnshire East CCG

10. 2013 A raft of welfare reforms Housing benefit reform- size criteria reductions ( bedroom tax) Social Fund reform local welfare provision Social Fund reform short term benefit advice advance Localised Council Tax reduction scheme Benefit cap Benefits on line Child maintenance reform Universal job match Personal Independence Payments (PIP) Conditionality and sanctions Employment and Support Allowance ( ESA) Universal Credit

11. 2013 welfare reforms introduced Universal Credit Introduction from April 2013- 2017 Designed to always make work pay Will introduce monthly payment and a household payments On line Claimant Commitment Payment to be based on Earnings not hours worked Housing Costs to be paid to Claimant Personal Independence Payments ( replacing DLA For people aged 16-64 Claims started by phone but eventually online. Paper claims by exception only Special rules remain for terminally ill PIP claims in Lincolnshire will involve a face to face consultation with a health professional– Capita. 2 components ‘Daily Living’ and Mobility with 2 payment rates ‘standard or enhanced’ using a point score for each activity.

12. For people in Lincolnshire ( source DWP) Overall figures 13.6% number 60,290 claiming benefits in Lincolnshire in November 2012 6% 26,500Job seekers allowance 1.1% 4,670 Employment and support allowance & incapacity benefits 1.1% 4,670 Lone parents 1.5% 6,470 Carers 0.4% 1,940 Other income related benefits 1.2% 5,540 Disabled 0.2% 900 Bereaved Existing people with Disability Living Allowance (DLA) South Holland 4.7% ( 4,200) of population Boston 8.7% (3,540) West Lindsay 5.2% ( 4,760) East Lindsay 8.2% (11,250) South Kesteven 4.7% (5,420) North Kesteven 4.8% (5,270) Lincoln 6% ( 5,700) www.dwp.gov.uk/PIP

13. Community Care Grants and Crisis Loans Part of the DWP Discretionary Social Fund payments Analysis of claims and payments made in Lincolnshire in 2011/12 shown below Total spend in Lincolnshire in 2011/12 = £1.5m Welfare Reform Act 2012 ceased these payments and passed responsibility to upper tier LA’s to provide local assistance to vulnerable groups DWP continue to provide Budgeting Advances and Short Term Advances to benefit claimants

14. Lincolnshire Community Assistance Scheme (LCAS) DWP did not require LA schemes to try and replicate theirs Lincolnshire’s Community Assistance Scheme introduced April 2013, providing assistance rather than loans LA received a grant of £1.5m from DWP to deliver the scheme Focus is on people in crisis being brought into getting support to avoid future crisis, providing goods and services rather than cash Partnered with the Voluntary Sector to develop a delivery network of goods and services Working with Lincolnshire Credit Union and Citizens Advice Bureaux, to help people become more financially resilient

15. Healthwatch Lincolnshire is the independent consumer champion created to gather and represent the view of the public. Healthwatch Lincolnshire will represent the views of both health and social care for children and adults living in Lincolnshire. Healthwatch Lincolnshire will play a role at both local and national level and will make sure that the views of the public and the people who use the services are taken into account. Healthwatch Lincolnshire will have a countywide network of local groups for you to get involved in. These groups will be there to support your local community in having a say and influencing services. Contact email : info@healthwatchlincolnshire.co.ukinfo@healthwatchlincolnshire.co.uk Next South Lincs Healthwatch Forum Tuesday 15th October 2013 at 12.30pm - 2.30pm - The Woodlands Hotel, Pinchbeck Road, Spalding, PE11 1QF

16. Adult Social Care Priorities Prevention and Early Intervention Intermediate Care Integration with Health Case Management Partnership Programme (CMPP) Future Delivery of Support Services (FDSS)

17. Key drivers of change Care Bill Social care funding Increasing cost of care Demographic growth Comprehensive spending review & central government settlement Increased funding via the NHS National policy developments supporting integration between health and social care

18. The five principles set out for the Adult Care Directorate Change Programme are that: