Promoting Independence EDMT update May 2019 Serving the people of Cumbria
Past Rising each month Historic £120m legacy demand £45m Historic legacy demand Reviews – Reviews – Mental health, business as usual older adults, learning disabilities, younger adults. Children looked after, SEND
> Approaches to promoting independence (decision making) new demand Controlling Reviewing historic and legacy demand (existing clients ongoing commitments) Culture and practice change (strength based) Serving the people of Cumbria
Achievements To Date New Demand • Practice development – process implemented to Audit and gather customer feedback. • Project group setup to support strength based practice to develop practitioner toolkit and customer charter. • Development of reasonable offer • Developed a new assessment tool to support strength based practice- to be launched • Improved financial gate keeping Serving the people of Cumbria
Achievements To Date – Legacy Demand • Identified cohort 500 + people to review • changing packages of care so that support is more inline with level of need • Increase in NHS funding for those people with a primary health need • Providing evidence to commissioning to assist in shaping the provider market • Improved financial decision making and management oversight for those customers who have the highest level of needs • Working with health colleagues to improve partnership working to improve the outcome for those people who need to use our services. Serving the people of Cumbria
Achievements in 2018 - 2019 • Significant financial savings towards the target of £12.5m • Completed 167 reviews of the highest cost packages, with 231 ongoing • Identified those cases which pose the highest risk to the Council in terms of financial impact and or potential to cause harm to themselves or others. • Continue to develop the Promoting Independence Team • Developing future work streams that links to the wider Promoting Independence Transformation Programme • Addressing challenges of recruitment, retention, partners, policy, procedures and systems Serving the people of Cumbria
Next Steps- Phase 1 • Continue to identify and prioritise the review activity of the team to maximise efficiencies and improved outcomes. • Support the review and development of practice guidance and policies and procedures to embed strength based practice as the norm. • Progress and develop improvement plans from the action learning and skills gap identified as part of the review activity with colleagues in Learning & Development. • Explore opportunities to work with providers and partners to reshape and commission services that promotes positive risk taking to prevent the likelihood of over provision resulting in efficiencies and cost avoidance. Serving the people of Cumbria
Promoting Independence Phase 2 Culture and Practice Serving the people of Cumbria
Why do we need to transform? • Life expectancy vs health expectancy • Increasing citizens independence and resilience • To provide an even better service to the people of Cumbria • Improve outcomes for the people of Cumbria • Financial sustainability
A new structure for ASC Aim of the review: • To create an Adult Social Care structure with capacity for transformation: – Consistently promoting independence, ensuring best outcomes for all our people – Managing demand – Keeping our customers at the heart of everything we do – Working with stakeholders to support communities to thrive – Focus upon the most vulnerable – Embedding strength based culture and practice as the way we work in Cumbria – Adopting and embedding a ‘think family’ approach across People – Making best use of resources - financial sustainability – PREVENT, REDUCE, DELAY STRUCTURE ALONE WILL NOT FIX CULTURE!
Mid-point Structure
What will it mean for Citizens? There’s no bed Improved The right services and Lived like your own support available when experience bed people need them Everyone can Experts by achieve their full Adds to experience - potential whatever what is good for rather than that looks like you ? Choice replaces and control Strength Based
What will it mean for the workforce? Valued and Better supported through recognition of improved supervision, peer Get involved support and appraisals impact they have in shaping the future Intelligent allocation Access to quality Reclaim and manageable information, Professional case loads guidance and tools roles to do their job Strength based approaches – learning culture!
Progress so far • Genuine consultation – structure is evolving • Mid- point meetings last week • Over 100 1:1s • 200+ separate feedback responses • 1:1s this week • Consultation window is open • Aiming to have final structure by end of June • Mental Health, Learning Disabilities and Support Services out of scope Serving the people of Cumbria
Next Steps • Complete restructure and join PI phase 1 and phase 2 together • Redesign all age service, mental health service • Redesign front door • Redesign support services • Continue to work together to improve!
It’s about the people of Cumbria
Questions Serving the people of Cumbria
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