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Agenda item

Scrutiny Review of Adult Social Care Transformation - Witness Evidence

The Committee is due to receive evidence related to the council’s reablement services.

Minutes:

The Committee received a presentation from Stephen Taylor, Interim Director of Adult Social Care Transformation, and Michel Murphy, Assistant Director of Adult Social Care. The presentation focused on reablement and the Councils commitment to working with residents in Islington.

 

The following points were noted in the discussion:

 

·       In 2021 the council carried out a strategic review of the Reablement Service to ensure it continued to meet the needs of vulnerable residents and respond to the challenges presented by COVID 19.

·       In January 2022 the council undertook work to transform the service and develop an enhanced model of Reablement that supports more people in our community 

·       This involved aligning the response with the integrated offer being developed with colleagues from Whittington Health.

·       The review looked to improve efficiency, value for money and increase the amount of direct support delivered without compromising quality ?

·       Officers were looking at how best to support staff to have the skills, capacity & resources they need to do their jobs effectively.?

·       In September 2022 the new model of Reablement was implemented, and officers were now exploring how to expand this further with a 7-recovery day model. This will allow better use of staff capacity, resources and more targeted decision making. The service is piloting this initially with independent providers with a view to potentially providing this service in house. 

·       ?Effective reablement is about working intensively with people in a time of short-term crisis, to support them to regain the skills, confidence, and social networks to return to their previous levels of independence. The service is provided free for up to 6 weeks and is delivered by a range of skilled professionals and carers all working with the resident to maximise independence where they can. 

  • In terms of the impact of effective reablement, the effective reablement reduces the need for long term homecare by an average of 22% after 1 year and 30% after 2 years. Also, effective reablement can reduce homecare expenditure by 40%.
  • Our Council’s new reablement offer will deliver reablement to a wider group of residents, coordinate our responses with community and mental health services, improve efficiency, value for money and increase actual hours delivered, significant reduction in long-term homecare and the overall homecare spends. The offer will also utilise resources in a more flexible way and have better target support to increase people’s potential to regain lost skills.
  • It was explained to the committee that the 7-day plan is to be viewed as running alongside the reablement offer, it is not replacing this.
  • The main challenges included the assessment of needs when residents are discharged as well as continuity of care.
  • The committee noted suggestions to freeing up capacity in the workforce through possible consideration of reviewing staff rotas considering the low traffic neighbourhood schemes, and the introduction of e-bikes.

·       The chair suggested that there should be a focus on rebranding care work to emphasise that this was skilled work. This may assist with attracting applicants to the role, as would improving the transport journeys for carers. 

·       The committee was informed that in cases where the 7-day recovery service is insufficient it still allows the service to develop capacity and tailor a bespoke approach within that time.

·       The 7 Day Recovery Service will be delivered initially as a 6-month pilot and will aim to enable the person time to settle back into their home routine after time in hospital. The recovery service is different to Reablement as it aims to provide basic daily living support, providing up to 22.5hrs support over the 7 days. The 7 Day Recovery Service also allows the professionals time to complete a more detailed assessment of reablement potential in the persons own home rather than on a hospital ward. Other Local Authorities using this approach found that the model reduced the time it took to reach reablement goals from 25 to 18 days, helped managed the demand and flow from the hospital, delivered reductions to the long-term home care budget by targeting the right support at the right time and maximised the capacity and effectiveness of the Reablement Service.

·       This service will be initially delivered as a pilot with our local care agencies to ensure this new way of working is effective. At the end of the pilot period, the council could potentially provide this service in house. 

·       Some councils had a mixture of both in-house and outsourced reablement provision, and this may be a model to look at in future. The Committee would be hearing from Kent and Camden Councils about their services at an evidence session scheduled for early March. The newly developed Reablement Service now has all staff in place and is fully operational and it has increased available capacity by 53% while maintaining high quality care. The service now forms part of an integrated pathway alongside services provided by Whittington Health Care. This ensures a joined up and coordinated experience for residents.

·       The proposed 7 Day Recovery Service, if successful, will allow us to further increase this capacity to support more residents to live independently with a view, if successful, to assessing the longer-term viability for delivery, including the option to commission and work with external providers, to deliver an In-House service offer (alongside our new reablement service), or as a mixture of both.

·       The Chair highlighted points raised in evidence from service users, including the timeliness of carers’ arrival, making the charging policies easier to understand, and having a clear plan of care after the initial 7-day period, if required. 

 

·       ACTIONS: To organise a separate session with representatives from Kent and Camden councils to find out more about their 7-day model.

·       To present the committee with a report on the pilot after 6 months.

·       The Chair thanked those who attended the virtual session with reablement service users, and it was requested that officers organise a further session for committee members to meet service users in future.

Supporting documents: