Agenda item

Purpose: To conduct a review of the Council’s Fair Access to Care Services Policy.

Councillor Webb introduced the Adult Social Care Eligibility Criteria review report to the Commission. The task group conducted the in-depth review over the course of 12 months which included an independent public consultation.

Councillor Webb talked the Commission through the report and directed them toward the task groups recommendations which they would be asked to consider;

1.      The Head of Adult Social Care should keep the Council’s Fair Access to Care Services eligibility criteria at ‘critical’ and continue to ensure that appropriate levels of funding remain for the provision of preventative services outside of that required for assessed care packages (currently £700,000 per year).

2.      The Head of Adult Social care should ensure, through annual review, that in its operation of the Fair Access to Care Services Policy the Council continues to comply with its statutory duties. In addition to any required policy changes, the reviews should incorporate an assessment of equality impact.

3.      The Head of Adult Social Care should monitor the effectiveness of the steps that have been taken to reduce both the time taken to complete Section 47 assessments and the backlog of those cases awaiting assessment. Additionally, a further action might be a cessation of the practise of the Access for All team fielding telephone calls for other social care teams and the allocation of more staff time for the completion of assessments.

4.      The Head of Adult Social Care should evaluate the operation of the Access for All team to ensure that its position within the organisational structure provides the most effective operational environment. Any changes to the role, formation or positioning of it should ensure that staff in this crucial team are appropriately trained, resourced, focussed and supported.

5.      The Head of Adult Social Care should continue to review and evaluate the effectiveness of the Multifunctional Assessment/Review Document to further improve its effectiveness and ensure that the administrative burden it necessarily imposes is kept to an absolute minimum.

6.      The Head of Adult Social Care should ensure that those completing the Multifunctional Assessment/Review Document understand that the information it contains will be used by the Resource Panel to make decisions on the provision of care. If necessary, training should be provided to ensure that the delays caused by incomplete or poorly completed forms are reduced.

7.      The Head of Adult Social Care should ensure that all staff undertaking social care assessments understand the need to keep those undergoing the process fully appraised of progress. This should ensure that expectations are managed and that dissatisfaction is resultantly kept to a minimum.

8.      The Head of Adult Social Care should ensure that the lessons drawn from the Transitions Project (which examined the period when people move from children’s social care to adult social care) are widely communicated and fully understood both by those going through it and the staff supporting them.

9.      The Head of Adult Social Care should undertake further work to test the perception of some stakeholders that some groups, regardless of the level at which the eligibility criteria are set, are being disadvantaged. Specifically on the grounds of their

·        Age, particularly older people or those not receiving care from a particular and specific age-related service provider (eg Age UK)

·        Disability, particularly those with

§         remitting or relapsing conditions

§         sensory impairment

§         a condition on the autistic spectrum

·        Gender, particularly women who may have a societal expectation that they should act as a primary carer

·        Religion, particularly those with a cultural requirement for hygiene or washing routines.

Should a disproportionate adverse effects be determined to be present then measures should be introduced to mitigate them.

10.The Head of Adult Social Care should review and then re-issue the guidance to staff about the necessity to ensure a holistic assessment is carried out in line with the ‘Cross team working protocol’.

11.The Head of Adult Social Care should give consideration to the introduction of measures to meet the needs of carers, especially

·        Their capacity to provide care and the impact that it may have on the effective delivery of support packages

·        The beneficial effects of preventative respite care

·        The widespread and early provision of the Carer’s Handbook

·        The production of a newsletter or bulletin

12.The Head of Adult Social Care should strengthen the links between their service and GPs to ensure that the unique and trusted status of GPs is used to identify an early need for social care or the provision of support for carers.

13.The Head of Adult Social Care should disseminate widely to their service the report on the findings of the public consultation in order that improvements in operational systems, processes and practise might be further identified.

The Commission heard that the Strategic Support team stored a copy of the agendas, minutes and reports produced and considered during the course of the review.

Councillor Quentin Webb passed his appreciation to David Lowe, Charlene Myers, Leigh Hogan and Jan Evans for their support during the review. The Commission extended their thanks to the task group.

Jan Evans was asked to provide her comments on the recommendations, she advised that she had reviewed the recommendations prior to the meeting and was content that each one was achievable locally.

Councillor Beck requested clarity around the costs associated with the change from ‘Critical’ to ‘Substantial’. David Lowe advised that the Council would incur a one off fee of £1.2 million, followed by an estimated annual cost of £1.9 million.

Councillor Hunneman raised his concerns about the suggested waiting times for an eligibility assessment. He requested that the item was revisited at future meetings to monitor the backlog. The Commission agreed that recommendation three would be amended to incorporate a request to review the waiting time for assessments on a quarterly basis.

Councillor Bryant asked what the associated costs would be to implement the recommendations. David Lowe advised that it was not for the Commission to consider.

Councillor Garth Simpson asked what comparisons had been made against other Local authorities in respect of residents being signposted to alternative services if deemed not to meet the eligibility criteria.  David Lowe advised that the consultation responses suggested that residents were generally highly satisfied with the service. The Commission heard that the Adult Social Care service provided £700,000 of funding to preventative services and an annual survey established feedback from the users of those services.

Councillor Simpson asked whether the struggle to establish NHS Continuing Health Care funding impacted on the Council’s capacity to manage the demand on services. Jan Evans advised that the Council had a duty of care to conduct an assessment on any person over the age of 65 years old and, through various avenues, residents outside this age group could be referred for an assessment. Jan Evans explained that the service was resource intensive.

Councillor Vickers expressed his concern that it appeared as though the NHS and West Berkshire Council utilised stringent frameworks when assessing local residents. Jan Evans informed the Commission that the process of delivering care, from volunteer services aimed to provide preventative measures, through to the use of end of life services for those residents with the most significant presenting needs. Jan Evans explained that the process could include regular reviews in order to ensure the individuals needs were being met, the agency providing those services would change dependant on the complexity of the case.

Councillor Goff asked whether residents could be assessed within alternative local authorities. The Commission acknowledged that due to the differing levels of eligibility criteria within local authorities, it was possible that a resident could be deemed eligible for care if assessed outside of West Berkshire.

Councillor Brian Bedwell proposed acceptance of the task group’s recommendations, subject to the amendment being made to item three. The Commission unanimously agreed to accept the recommendations.

Resolved that

• Recommendation three would be amended to read:

The Head of Adult Social Care should monitor the effectiveness of the steps that have been taken to reduce both the time taken to complete Section 47 assessments and the backlog of those cases awaiting assessment. Additionally, a further action might be a cessation of the practise of the Access for All team fielding telephone calls for other social care teams and the allocation of more staff time for the completion of assessments. Reports on effectiveness and progress should be made quarterly to the Overview and Scrutiny Management Commission.

• The recommendations were accepted and the report noted by the Commission.