Following its consideration of the Adult Social Care Local Account at the last meeting, the Health and Adult Social Care Scrutiny Committee requested a further update on the Adult Social Care Outcomes Framework (ASCOF) measures contained within it to assess how the Council compares with other local authorities.  A report is attached marked 7

Contact:  Tom Dodds, Performance and Design Team Leader, 01743 252011     

The Performance and Design Team Leader presented a report produced to address the request of the Committee for information on the Adult Social Care Outcomes Framework (ASCOF) measures, direction of travel, and how Shropshire Council compared with other authorities.

The report gave Members the opportunity to review comparisons over time, with England averages and the average for other similar local authorities.  Members discussed where they felt clarification was needed and potential topics for future scrutiny consideration. 

Seven ASCOF measures were based on the annual nationally prescribed survey of people who receive Adult Social Care services.  The 2014/15 survey was currently being completed and the published results would be available from Autumn 2015.  For five out of these seven measures, performance was lower than the average for England and other similar authorities, and was in the lowest quartile.  These were:

1A Social Care related quality of life score

1B Proportion of people who use services who have control over their daily life, as a percentage of respondents

1I Proportion of service users who reported they had as much social contact as they would like

3D Percentage of users who find it easy to find information about services

4A Percentage of users who feel safe

Overall, the comparison of the ASCOF measures reported in the Local Account showed that the significant majority had shown improvement over the three years of the data, with more than half comparing favourably both against the England and other similar local authorities averages.

Discussion of the measures particularly focused on the following:

‘proportion of service users who reported that they had as much social contact as they would like’, this was a new measure for 2013/14 and it was likely that Shropshire’s bottom quartile ranking might be linked to the rural nature the county, which might increase peoples sense of isolation.  A Member representing a rural electoral division emphasised that this was likely to stem from difficulties around accessing both information and services which could have a major impact on  mental and physical health. 

Permanent admissions of older people age 65 + into residential/nursing care homes, per 100,000 population.  Members felt that there was a gap in between hospital and residential care where accommodation was needed.  In referring to personal experience, a Member said he had felt a reluctance to send someone into a care setting who really needed to be there, which had ended up meaning a longer stay in hospital.  Members discussed how the ICS project would address this sort of circumstance and the spike in care home admissions in January 2015.

Proportion of older people who were still at home 91 days after discharge from hospital into reablement services

Members noted that the latest figures should show an improvement, reflecting the Integration Community Services now in place in Shropshire.

 ‘Social Care related quality of life score’ Members noted that this was a little lower than the England average and felt that Shropshire’s performance should be comparable with the family average.  They noted that the expectations of people in Shropshire might be different in terms of quality of life and that it was important to look at this indicator alongside other qualitative data.

‘Proportion of people who use services who have control over their daily life, as a percentage of respondents’

The Committee felt that performance was surprising and should be better due to the extent of personalisation in Shropshire.  The Performance and Design Team Leader advised Members to consider this result alongside others.  Although an improved result was anticipated for 2014/15, it was suggested that the Committee establish a working group including the Healthwatch representative to look into this particular issue in more depth.  The Portfolio Holder said he would welcome work to understand this apparent anomaly.  The Head of Social Care Efficiency and Improvement questioned if service users were relating the questions to the services they were receiving from Adult Social Care.

It was agreed to establish a group following the June Meeting of the committee and the following members indicated that they would like to participate in this work:  Cllrs:  Dakin, Jones, Shineton, Mullock and Vanessa Barrett, Healthwatch Representative.

Officers agreed to bring draft terms of reference for the work to the June meeting of the Committee. 

It was agreed that the Committee should re-visit the performance in the ASCOF measures derived from the User Survey in the Autumn, when the most recent survey results would be published.  

It was confirmed that the Committee’s Working Group on Performance indicators would be reconvening shortly to continue work with officers in developing reporting dashboards and presentation of data which would be made available at the 29 June meeting of the Committee.