1. Hertfordshire County Council Health and Community Services Plan 2012-15

2. Health & Community Services Plan Most families in Hertfordshire will call upon Health and Community Services at some point in their lives. Whether this be using their local library, getting information about local services, returning home safely from a stay in hospital or receiving a personal budget for social care to help them live independently. People have told us that they want to be given access to good advice about what is available to them so they can make an informed choice. They want to feel well and stay in their own homes for as long as possible and they want to feel safe in their local community. The Government has published its vision for social care in the future called ‘Capable Communities, Active Citizens’. It sets a challenge for councils to provide a personal budget, preferably as a direct payment, for everyone who is eligible for social care services by April 2013. The vision also calls for an increase in local services which prevent needing health and social care in the future. ‘Future Libraries’ is a government strategy which gives expectations around running a modern public library service. The government has also announced that Primary Care Trusts in the NHS will hand responsibility for public health initiatives to local authorities from April 2013 and this plan will be refreshed at that time to reflect those new responsibilities.

3. Health & Community Services Plan What we want to do: Inform, advise and prevent: Our first objective is to ensure that people can access the information and advice they need to live full and independent lives and to enhance their wellbeing. We also want to ensure that there is a community infrastructure and a set of universal and preventative services that people can readily access to support independence and wellbeing. Reablement and recovery: For people that need some specific social care support following an illness or other life event, our objective is to enable them to recover as fully as is possible and to regain their independence. Personalisation: Where people have benefited as much as possible from short term reablement and recovery services and need ongoing support, our objective is to ensure that this support is personalised and that an enabling approach is continued. People will choose how they want their care needs to be met using an allocated personal budget. How we want to do it: We want to do everything we do as efficiently as we can, ensuring value for money for taxpayers. We will aim to do things in partnership where this adds value for citizens in terms of lower costs and / or better outcomes We will seek contributions from citizens both in terms of care, support and activity within communities, engagement in developing, commissioning, delivering and reviewing services and sometimes financially, through means tested contributions.

4. 1. Inform, advise and prevent From the council’s objective of maximising independent living we will: Lead on public health from April 2013, promoting the health and wellbeing of citizens through the Health and Wellbeing Board Encourage volunteering in the county, including using our buildings to assist local groups to take the initiative in their communities Use the Hertfordshire Adult and Family Learning Service to improve the wellbeing of citizens, particularly hard to reach groups Give excellent information through a range of access points, including the internet, resolving people’s enquiries to their satisfaction first time Assist other health professionals to get the right advice to people at the right time and work with GPs to promote better health outcomes Continue to fund the third sector to deliver schemes which evidence how they make a positive difference to people and carers Promote ‘universal services’ available to everyone in Hertfordshire through our libraries to maximise people’s independence

5. THE THIRD SECTOR… …is another name for the voluntary sector. These are not- for-profit and non-governmental organisations who undertake social activity in communities. They are not solely run by volunteers – and are often run by paid professionals who are specialists in their field. eMARKETPLACE A website which allows the public to access information about different goods and services – and buy them online through a transactional payment system. WHAT IS ‘PUBLIC HEALTH’? Public health is about helping people stay healthy and avoid getting ill, so this includes work in a whole range of areas including immunisation, nutrition, tobacco, eating healthily, sexual health, pregnancy and children’s health. How we will measure our success:2012/132014/15 People who get information from our website, via the Customer Service Centre or through Herts Help are ‘satisfied’ with that assistance. 90%95% Numbers of visits to libraries and ‘virtual visits’ increases by a percentage each year +5% People who fund their own services or have Direct Payments transact via our online eMarketplace 100 people 2,000 people The proportion of people who use services who “find it easy to get information and advice about services”, measured by the ASCOT survey 90%95% Provide carer’s assessments, services and carer’s direct payments to family carers to help them sustain their caring role at home 40%46% The proportion of carers who report that they have “been consulted in discussion about the person they care for”, measured by the Carer’s Survey 90%95% Number of individuals directly benefiting from grants to the voluntary sector or volunteering 6,0007,500 Proportion of GPs who report that they are ‘satisfied’ with the support from HCS measured by a survey 90%95%

6. 2. Re-ablement and recovery From the council’s objective of maximising independent living we will: Minimise the number of people whose discharge from hospital is delayed because social care services are not arranged in time Assess people for intermediate care services and enablement services jointly with the NHS to get the best outcome quickly Provide Telecare and TeleHealth devices to give people and their families confidence and independence Identify the family carers who would benefit from extra support and put this in place - an enhanced ‘core offer’ for carers Use peer support schemes to aid people’s recovery and provide on-going care and support Make new accommodation schemes like Flexicare Housing and Supported Living widely available around the county Develop ‘progressive’ services to help people with a disability to learn or re-learn skills and live independently

7. FLEXICARE HOUSING Accommodation for older people which has 24 hour support on site in case of emergencies. How we will measure our success:2012/132014/15 Very low numbers of Hertfordshire people are delayed in hospital because of social services 12 per week A high percentage of people eligible for social care services use enablement services 80% People who have accessed enablement services do not need social care after up to 6 weeks 50%54% Improve on the current ratio of volunteers (no of people) to HCC grant (£s) funding +5% people High numbers of people are given access to Telecare and TeleHealth devices 550 people 4,500 people Number of people with learning disabilities moved from residential care into housing tenancies 50 in year Family carers reporting “a good quality of life”, measured through the ASCOT survey 90%95% Number of new Flexicare Housing places available in the year 160 places 180 places Number of people who use new “progressive” services to learn life skills and get tenancies 15 people 20 people TELECARE & TELEHEALTH These are electronic devices which can be installed in people’s homes that alert a professional or family member if something is wrong. This could be someone falling or someone’s blood pressure being of concern, for example. ENABLEMENT SERVICES These are care and support services which last for up to six weeks either in people’s homes or in a care home setting. They allow people to fully recover, learn how to cope and become independent again. ASCOT SURVEY A short annual survey sent out to people who use services asking people whether they are receiving the help they need and whether this is making a difference.

8. 3. Personalisation From the council’s objective of maximising independent living we will: Provide a personal care budget to everyone who is eligible for on-going social care services Show that people’s social care has improved their quality of life Increase the number of people receiving a Direct Payment and improve the amount of training given to personal assistants Improve our care services and support to people who have dementia and their families Reduce the number of older people and people with learning disabilities living in residential care homes Explore the development of advocacy and independent brokerage services and support to families who self-fund Promote life skills and literacy along with IT skills in our libraries and through the Hertfordshire Adult and Family Learning Service Work with care providers of all sizes to deliver a vibrant and diverse market and give real choice to people and carers

9. ELIGIBILITY CRITERIA The council can only meet people’s social care needs if they meet the national Fair Access to Care eligibility criteria at ‘substantial’ or ‘critical’ level only. DIRECT PAYMENTS People may take all or part of their personal budget as cash to buy their own services or employ a personal assistant. PERSONAL BUDGETS A notional amount of money allocated to person who is eligible for social care services after they have been assessed. The person has choice about how this budget is spent to meet their needs. TRANSITION PLANNING Every young disabled person who will be eligible for social care when they become an adult must have a transition plan prior to becoming 18. How we will measure our success:2012/132014/15 The percentage of people eligible for on-going social care who have a personal budget 65%80% The proportion of people who use services who say they have “control over their daily life”, measured through the ASCOT survey 90%95% Numbers of people in receipt of a Direct Payment for their care on the last day of the year 2,1002,900 A high ‘quality of life’ response from people who answer the national ASCOT survey 90%95% People who are eligible for social care and their families use the eMarketplace and a ‘virtual wallet’ to choose their social care services 100 people 2,500 people Number of older people in permanent residential or nursing care funded by the county council 2,0681,804 Number of people with learning disabilities living in their own home supported by the council 2,250 people 2,650 people Numbers of people with disabilities helped into work or volunteering opportunities increases 120 people 195 people All young disabled people have a personal transition plan at age 17 100%

10. 4. Safeguarding people From the council’s objective of ensuring safe neighbourhoods we will: Pro-actively work with care providers to prevent safeguarding issues occurring and improve the overall quality of care Work with the NHS, communities and other agencies to prevent, detect and report neglect and abuse Take immediate action to protect vulnerable people from abuse where this has been reported Balance people’s freedom and choices with risk and protection Invest in learning and development for the health and social care sector including all public sector staff and care providers Support all care providers in the county to achieve good ratings Treat people and carers with dignity and respect and support them to participate in the safeguarding process, where possible Promote schemes like ‘Keep Safe’ for people with disabilities

11. DIGNITY & RESPECT People should expect high standards from social care professionals within the council, from care providers and from other partners. Everyone should feel they are treated with dignity and respect at all times. HAVING YOUR SAY A short survey that is sent out to people who have come into contact with adult social care to ask how satisfied they were with the service they received. PROTECTION PLANS People who need to be safeguarding must have a plan that is agreed with the relevant professionals and family members to co-ordinate keeping them safe from abuse. SAFEGUARDING ADULTS The county council is responsible for keeping vulnerable people safe from harm or abuse. If it is reported that someone is at risk, we must act immediately to safeguard them. How we will measure our success:2012/132014/15 Percentage of safeguarding referrals where people were protected on the same day 100% Percentage of safeguarding referrals with protection plans in place within three days 100% People with a protection plan who, when surveyed, reported that they were included in decisions about their care and protection 100% Percentage of care homes in Hertfordshire rated as ‘good’ or better on the eMarketplace. 90%95% People through ‘Having Your Say’ who reported being ‘satisfied’ they were treated with dignity and respect by HCS 90%95% The proportion of people who use on-going social care services who say they feel safe, measured by the ASCOT survey 90%95% Percentage of professionals in Hertfordshire who have received learning and development in safeguarding vulnerable adults in the last 2 years 70%90%

12. 5. Be a leading council From the council’s objective of being a leading council we will: Build on existing partnerships with the NHS and other stake- holders through the new Health and Wellbeing Board Create a new strategy for Library and Heritage Services Promote volunteering as a valuable and important activity for the county council as an opportunity for citizens Encourage localism and community participation in all of the services we deliver or commission Engage people who use our services when we redesign them Invest in our staff and keep our talented people in times of change through a co-ordinated workforce strategy Champion the equalities agenda for older or disabled people who use our services and their family carers Lead on commissioning the voluntary sector for the council

13. WORK TASTERS A period of time spend employed in particular team or field of work to see if you suit the job and if the work suits you. CARER FRIENDLY TOWN A nominated town in the county where support services are enhanced for people who provide informal care for another person including their spouse or family members. HEALTH & WELLBEING BOARDS A new partnership meeting with elected members and officers from health, county council, district councils and other key stakeholders who will take the strategic lead on health and social care. MICRO-BUSINESS A small business, employing fewer than 5 people, who operates locally and delivers services – often at better value for money and better outcomes. How we will measure our success:2012/132014/15 Increase the number of apprenticeships and work tasters being offered by HCS 50 per year 100 per year Reduce the average number of days of sickness absence in Health and Community Services 11.9 days 8.0 days Voluntary staff turnover maintained at low levels5% Improve the percentage of the workforce which is trained to NVQ level 3 and above +5% Percentage of our staff satisfaction with working for Hertfordshire County Council 70%80% Develop a Health and Wellbeing Strategy for the county, incorporating the accompanying action plan into the HCS plan when agreed By Sept 2012 Review annually Achieve sustained citizen satisfaction with the council’s Customer Service Centre 95% Reduce expenditure on library services per 1,000 population through use of online services and new innovations, whilst maintaining user satisfaction -3% (£s) Pilot a ‘carer-friendly town’ in Hertfordshire in partnership with Health and the voluntary sector evaluate pilot Demonstrate growth in sustainable micro- businesses delivering care and support +5+25

14. Health & Wellbeing Board Hertfordshire’s New Shadow Health and Wellbeing Board In anticipation of the government’s vision for each area to have a forum to lead on the strategic direction for health, social care and public health in their locality - a shadow board is now meeting in Hertfordshire.This will be the key partnership for promoting the health and wellbeing of residents. Its focus will be on securing the best possible health outcomes for all local people. Membership of the Board has been taken from locally elected councillors, senior managers from the statutory organisations in the county – and elected leads from the new Clinical Commissioning Groups who represent GPs and other clinicians in Hertfordshire: This plan has been endorsed by this Board as well as by county councillors. Cllr Richard Roberts (Chair), HCC Cabinet Member Children’s Services Cllr Colette Wyatt-Lowe, HCC Cabinet Member Health & Adult Care Cllr Lynda Needham, Leader North Herts District Council Cllr Dorothy Thornhill, Mayor of Watford Council Cllr Chris Hayward, HCC Cabinet Member Hertfordshire Local and Libraries Sarah Pickup, HCC Director of Health & Community Services Jenny Coles, HCC Director of Children’s Safeguarding & Specialist Services Dr Raymond Jankowski, Deputy Director Public Health, Hertfordshire PCT Dr Tony Kostick, Chair of the East & North Herts Clinical Commissioning Group Dr Nicholas Small, Chair of the Herts Valley Clinical Commissioning Group Kenneth Spooner, Practice Manager - The Red House Group of Practices Henry Goldberg, Chair of the Hertfordshire LINk Jess Lievesley, Assistant Director Community Commissioning for HCC

15. Health and Community Services Plan 2012-15