Adult Social Care and Community Safety Scrutiny Committee |
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Date: |
19 March 2015
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By: |
Director of Adult Social Care and Health
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Title of report: |
RPPR savings plan: Care Package reductions |
Purpose of report: |
The Committee is recommended to consider the impact on users and carers of reducing care packages by an average of 30%
1. Financial Appraisal
1.1 There are no additional financial implications arising from this report.
1.2 The 2013/14 to 2015/16 Reconciling Policy, Performance and Resources savings plan set out how Adult Social Care and Health would deliver the required £27.8m savings as part of the East Sussex County Council Reconciling Policy, Performance and Resources (RPPR) process. Given the spend profile of the department, significant savings were identified from the community care budget. These included reducing peoples care packages by an average of 30%.
2. Background and Supporting Information
2.1. In March 2013, Adult Social Care carried out an Equality Impact Assessment to consider how the changes to Adult Social Care services required as part of RPPR savings would be likely to affect people and as far as possible, to put in place mitigations against negatives effects. This Equality Impact Assessment was reviewed in July 2014 and will be reviewed and updated again in March/April 2015.
2.2. Since the savings plan commenced in 2013, a range of qualitative and quantitative data sets have been monitored to understand impact of reducing peoples care packages.
3. Carers
3.1. At the November 2014 Scrutiny Committee requested a particular focus on Carer satisfaction levels from the 2014/2015 Carers survey. This is a national survey introduced in 2012/2013 and is undertaken every two years. The results from this survey and a comparison with the previous survey results can be found in Appendix 1.
3.2. Following changes to national data returns as part of the Zero Based Review, we recently introduced a number of local measures to ensure close monitoring of the numbers of carers we are assessing and supporting:
· The number of carers known to Adult Social Care has increased from 6288 (April-August 2014) to 6703 (April ‘14 - Jan ‘15).
· Of the carers known to Adult Social Care, the percentage receiving a service (includinginformation / advice and signposting) has increased from 65.6% (April-August 2014) to 77.4% (April ‘14 - Jan ‘15).
3.3. Since August 2013 carers have been able to use their personal budgets towards the cost of respite care, either home based, day or residential care. During January–December 2014 there were 250 Carers Personal Budgets approved.
3.4. Carers have been asked whether various areas of their life had changes since receiving the service. Improvements were most likely to be noted around help with taking a break (64% believed this aspect had improved); meeting the needs of the person being cared for (48%); and the carers’ own emotional health and wellbeing (44%). Where matters had worsened, this was most commonly in relation to carers’ emotional health and well-being (12% rated this as worse) and their own physical health (10%).
3.5. Examples of how budgets were used:
4. Impacts on other areas
5. Conclusion and Reasons for Recommendation
5.1. Monitoring the impact on clients and carers and the effectiveness of additional mitigations will continue. This monitoring will extend to incorporate the effect of Care Act changes on service delivery.
KEITH HINKLEY
Director of Adult Social Care and Health
Contact Officer: Samantha Williams Tel No. 01273 482115
2014/2015 Carers Survey
The 2014/2015 Carers survey was undertaken between 14 October 2014 and 21 November 2014. Nine hundred and twenty seven people were surveyed and 534 (57.6%) responded.
The Adult Social Care Outcomes Framework (ASCOF) is a set of performance measures that all authorities are obliged to monitor and report against. The results of the Carers survey are used to inform five of these ASCOF measures:
· Carers reported quality of life
· Overall satisfaction of carers with social services
· The proportion of carers who report they have been included or consulted in discussions about the person they care for
· The proportion of people who use services and carers who find it easy to find information about services (this report focuses on the carers element of this measure)
· Proportion of people who use services and their carers who reported that they had as much social contact as they would like (this report focuses on the carers element of this measure)
These ASCOF measures in relation to carer’s experiences were introduced in 2012/13.
Please note: all results shown in this report are based on respondents to each question, therefore excludes non responses to the individual question or those where the response was “not applicable”.
Carers reported quality of life
The result for Carers reported quality of life is taken from an amalgamation of the results of six questions, each scored between 0 and 2. The maximum that can be scored for this measure is 12.
The questions used are:
Results from the 2014/15 Carers Survey shows carers reported quality of life has dropped slightly from 8.1 in 2012/13 to 7.9 in 2014/15.
Provisional benchmarking for 2014/15 against this measure will be available later in 2015. Performance in relation to carer reported quality of life in 2012/13 was in the upper middle quartile, and was in line with both the national and south east averages.
Overall satisfaction of carers with social services
This measures the proportion of respondents to the Carers Survey who state they are extremely satisfied or very satisfied with social services.
Results from the 2014/15 Carers Survey shows overall satisfaction of carers with social services has dropped from 45.3% in 2012/13 to 40.7% in 2014/15.
Provisional benchmarking for 2014/15 against this measure will be available later in 2015. Performance in relation to overall satisfaction of carers with social services in 2012/13 was in the upper middle quartile, and was above both the national and south east averages.
It should be noted, that if those respondents who stated they were “quite satisfied” is included, performance increases to 72.6%, this compares to 77.6% in 2012/13.
The proportion of respondents who stated they were quite, very or extremely dissatisfied with social services was 12.1%, compared to 8.4% in 2012/13.
The proportion of respondents who gave a neutral response (those who stated they were neither satisfied nor dissatisfied) with social services was 14.9%, compared to 13.9% in 2012/13.
Analysis of any comments provided will be undertaken in relation to this and the other four ASCOF measures, to understand key themes underpinning respondent’s dissatisfaction.
The proportion of carers who report they have been included or consulted in discussions about the person they care for
This measures the proportion of respondents to the Carers Survey who state they “always felt involved or consulted” or “usually felt involved or consulted”.
Results from the 2014/15 Carers Survey shows the proportion of carers who report they have been included or consulted in discussions about the person they care for has dropped from 73.3% in 2012/13 to 71.0% in 2014/15.
Provisional benchmarking for 2014/15 against this measure will be available later in 2015. Performance in relation to the proportion of carers who reported that they had been included or consulted in discussion about the person they care for in 2012/13 was in the upper middle quartile, and was above the national average, but was slightly below the south east average.
It should be noted, that if those respondents who stated they “sometimes felt involved or consulted” is included, performance increases to 90.7%, this compares to 94.7% in 2012/13.
The proportion of respondents who stated they “never felt involved or consulted” was 9.3%, compared to 5.3% in 2012/13.
The proportion of carers who find it easy to find information about services
This measures the proportion of respondents to the Carers Survey who stated that information about services was very easy or fairly easy to find.
Results from the 2014/15 Carers Survey shows the proportion of carers who report that information about services was very easy or fairly easy to find has dropped from 70.5% in 2012/13 to 68.3% in 2014/15.
As at the middle of September 1,756 services were registered on 1Space across 1,626 organisations. This is an increase of 193 from 2013/14, against a target increase of 300. We are working with the police looking at adding community safety services to 1Space. Free registration workshops continue to be offered to providers.
Between October and December 17th a total of 10,178 visits were made to 1Space. 73% of which were new visitors and 27% were repeat visitors. Work continues on the ongoing development of the dictionary and thesaurus. Designs are in development to update the site to be fully responsive design for improved usability on all size mobiles and tablets and to improve our ranking in search engine optimisation (SEO).
Proportion of carers who reported that they had as much social contact as they would like
This is a new measure for 2014/15. This measures the proportion on respondents to the Carers Survey who stated that they had as much social contact as they want.
Results from the 2014/15 Carers Survey shows 37.5% of respondents stated they had as much social contact as they want. It is not yet known how this compares with other authorities performance. Provisional benchmarking against this measure will be available later in 2015.
If those respondents who stated they have “some social contact with people but not enough” is included, performance increases to 85.1%.
Further information
The information below is taken from surveys received by organisations which have ESCC and NHS funding through the Commissioning Grants Prospectus to support carers. The information below covers surveys received between 29th October 2013 and 22nd January 2015.
The information below shows responses in relation to the question “Which areas of your life have improved since you received the service”
Complaints
Overall complaints for the last 7 years
Latest figures continue to support the downward trend in complaints. The total number of complaints received between October and December 2014 was 91, compared to 122 the previous quarter; a 25% decrease.
The biggest area of complaints related to assessment, which equalled 31 and equated to 34% of all complaints received. 20 (65%) of these complaints were disputing the decision or outcome of an assessment. The next biggest proportion, 5 complaints (16%) were in relation to a delay in the assessment process.
The top three assessment types were in relation to:
7 complaints (23%) were upheld or partially upheld in relation to assessment, which equates to 25% of all complaints upheld or partially upheld. This is the highest percentage of complaints that had some basis. It is worth noting that in Quarter 2 of 2014/15, 16 complaints were upheld or partially upheld in relation to assessment, this equated to 38% of all complaints upheld or partially upheld.
Of the 7 complaints upheld in full or in part this quarter:
Again, this continues the theme from 2013/2014 data when 41% of all complaints received during the year related to different kinds of assessment (155 complaints).
Since the last update report in November 2014, only two more appeals have been reported. A total of 39 appeals had been received from April to November.