To consider what the Council has achieved, what challenges lie ahead and what areas will be the focus for improvement.  A report is attached.

Contact:  Stephen Chandler, Director of Adult Services, 01743 253704

The Portfolio Holder for Adult Social Care introduced the Adult Social Care Account for Shropshire 2013 – 2014 and explained that it was designed to provide a snapshot of the past year, and outline the challenges expected in the coming year.  (A copy of the report is attached to the signed minutes).

Jon Hancock, the Co-Chairman of the Making It Real Board, reported that he and the Making It Real Board had encouraged a different, lighter approach to the Annual Account in order to demonstrate performance in adult social care using real life stories and people.  The report was designed to be more accessible and interesting to read than previous versions, was user-focussed, and highlighted the quality aspects of services provided, rather than focusing solely on quantitative information.   

In response to questions from Members of the Committee arising from the account and from the national performance measures included within it, officers explained that:

·       There were two measures related to the proportion of adult social care users in employment and Shropshire Council was either the best or second best in the West Midlands and in the top 5% in the country. 

·       The drop in 2013-2014 figures regarding proportion of service users who found it easy to find information had been addressed through improved information available online and the commissioning of an information, advice and advocacy service.  The 2013 – 14 figures did not reflect the position now that the First Point of Contact had been established and there was confidence that the 2014/15 would show improvement.

·       Loneliness had been clearly linked with poor health and work was being undertaken to identify people who were at risk of this as part of resilient communities work. 

·       Community resources were being utilised within the New Operating Model and the GUSTO project was now a mainstream activity delivered by the Community Council.

·       Let’s Talk local meetings were held at 18 different localities on a weekly or fortnightly basis and provided an opportunity for people to plan to meet their needs in community buildings, in recognised communities.  18 was not a fixed number and might increase in future. 

·       Where appropriate technologies would be used to help meet people’s needs but this was being implemented carefully and slowly on a sustained basis.

·       The IT support capital budget being rolled forward to next year related to the re-tender of the Care First system, not the use of assistive technology which was still being rolled out as planned.

·       Shropshire spent the lowest amount of money on over 65s in the country with a good variety in the market place utilising the voluntary and business sectors.   

In response to further questions from Members about the location of Let’s Talk meetings, and the distance people might be required to travel to attend one, officers explained that locations did vary, although they tended to be held in Market Towns.  The majority of calls were concluded successfully through the First Point of Contact but if that was not possible a visit to the nearest Let’s Talk meeting would be offered, or a home visit arranged if needed, such as in the case of a vulnerable or elderly caller who was unable to travel.

A Member from a rural electoral division emphasised the importance of work in tackling loneliness, particularly in very rural areas where it would be more difficult to put into practice.  Efforts appeared to be focused on Market Towns.  She thought it would be interesting to see data related to geographical spread and success in relieving pressure on the health service.     

The Director agreed that this was an important issue.  Initial work had been focused on the Shrewsbury area and was now being rolled out across Shropshire.  Exploring the impact of the roll out would be useful in addressing concerns about the potential of missing people, particularly in the most rural areas.  Members suggested such a piece of work should be all encompassing and cover craft groups, WIs, GP liaison services, theatre groups, lunch groups. 

A Member representing a rural division expressed reservations around use of technology particularly where broadband connections were less well developed.  She went on to compliment the First Point of Contact Service in relation to cross border working with Worcestershire, citing a recent example of a transfer of a patient from an acute Worcestershire setting back to Shropshire for home care effectively. 

In answering further questions from Members, the Director explained that:

The significant drop from 2012/13 to 2013/14 in permanent admissions into residential or nursing care homes had resulted from significant work in developing alternatives, particularly those that were home based and made use of assistive technology and domiciliary care. 

The current year had seen increased confidence in quality of reablement data.  Consistency of data had been variable previously as it was provided by a number of different systems and organisations.

A recent national radio broadcast had drawn attention to Shropshire having the lowest spend on over 65s in the country and best performance on quality with good variety in the market place including the voluntary and business sectors.    However, this good performance made it harder to reduce expenditure further.  

Some Members referred to reports due to be considered by Cabinet showing savings required and still to be made, whether these were achievable and what areas would be affected.  As the Committee did not have the reports before it, the Director offered to meet individually with the Members raising these questions to explain the figures in detail.  

In the meantime, he explained the significant pressures on financial performance from in year pressures and referred to the higher than ever number of people who had been self funders now approaching the Council.   He reiterated how the new operating model focused on avoiding people coming into the system with 73% of calls were successfully diverted at the First Point of Contact.  Although there was knowledge of some self funders approaching the threshold most people were reluctant to share their financial details before they needed to.  The Council was working with Shropshire Partners in Care (SPIC) in an attempt to map self funders.   

The Director also referred to the pressure from increased costs, and unattained savings, for example, the lack of success in re-negotiation of the PFI contract. Pressures faced year on year were substantial.

The Director thanked members of the Making It Real Board, who had been driving forces behind putting the report together, provided constructive challenge and helped develop the report in its new dynamic format. 

In response to queries around the recommendation to note the report, the Director explained the status of the Account.  All Adult Social Care Services were required to produce one to be  presented to Cabinet and Scrutiny but not for revision or amendment.  It was an evolving document that would improve year on year and would be presented to the Committee again in the Autumn. 

The Committee expressed its appreciation to the Making It Real Board and Jon Hancock for attending the meeting.  In noting the Account, the Committee said it had stimulated valuable questions and debate, and highlighted areas for further work.  In particular,  the Committee had agreed on the need to look at work in the most rural parts of the county and asked for more context to be presented around the comparative information in the report.