Transcript Insert main title here - Local Government Association

Implementing the care and support reforms
– progress and challenges
Martin Caunt, Head of Care and Support Reform
Programme, DH/
Andy Hughes, Head of Implementation LGA
Headlines from the latest stocktake
• Carried out 13 Jan-3 Feb 2015
• Confidence that councils will be ready for 1 April continues to
increase
• (To supplement the stocktake we have spoken direct to a small,
random sample of councils )
• Concerns remain about cost pressures and difficulties in predicting
and managing demand from carers and self-funders
• Support in a number of areas (including IT systems, workforce,
market sustainability) will require continued focus throughout
2015/16
• It s clear that work to establish fit for purpose systems eg
information and advice, will need to continue through 2015-16
• A very small number of councils may require more intensive hands
on support and we will work with ADASS in regions and the LGA’s
sector led improvement colleagues to put this in place
Key activities from April 15
Readying systems and
approaches for 1 April
Monitoring impact during
2015-16
Embedding longer term
change and behaviours
Preparing for 2016-17
Key dates and phases of work
External
factors
Spending Review
NHS Budget setting
Awareness
Campaign
Awareness Campaign Phase 1b
Awareness Campaign Phase 2
LA Budget setting
Joint cost-modelling for 2016/17
Local work
ADASS 15/16 cost monitoring work
Policy and procedures implemented
Training
staff
Final Part 2 regulations
and guidance
10/2015
Key dates
Care Act Part 1:
Commences
Allocations for 2016/17
12/2015
01/4/2015
Care Act Part 2:
Commences
General Election 2015
07/5/2015
Feb
2015
Apr
Jun
01/4/2016
Aug
Oct
Dec
Feb
2016
Apr
Jun
Preparing for 2016
• It isn’t long till October, the publication of the next
set of regs and guidance and the final lead in to
April 2016
• Changes will impact beyond adult social care –
finance and IT
• Systems will need to be ready for day one
• But there is an opportunity to build in more long
term change: prevention and more contact with
self funders, on-line self assessments, stronger
ties and sharing data with health and other
partners
Modelling costs of funding reforms
• New simpler model to be co-produced – fed with consistent
council data and based on clear assumptions
• Testing to take place during March – April across a sample
of c. 30 councils
• Additional capacity to be provided to support data collection
• Single transparent model that is endorsed by DH and
ADASS
• Credible, robust data available for local and central
government to plan implementation of funding reforms
• Thorough sense check of ‘ assumptions’ (eg number of
self funders, daily living costs)
• Exercise to be concluded prior to election in May
Public awareness
Radio
advertising
PR & media
partnerships
Door
drops
Digital
communications
Our support offer so far….
■ Care and Support Reform Programme
■ Wider system support
£125k Care Act
Implementation
Grant
Providers’
guides to
elements of
the reforms
Towards
Excellence in
Adult Social
Care
Regional
programme
offices + AIAs
‘Deep
dives’
£4m Regional
training and
support fund
Secondary
legislation and
impact
assessments
Legal literacy
training
Informatics
support
Comprehensive
suite of practice
guides and
toolkits
Learning and
development
suite
Communication
resources
SCIE, TLAP, TCSW,
Skills for Care
wider resources
Centrallyagreed cost
models for
local use
LGA Peer
Challenge
offer
*For a comprehensive list of resources in each of the areas covered by statutory guidance – please visit the
‘Implementing your programme’ section of www.local.gov.uk/care-support-reform
7/20/2015
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Top priorities for implementation support in
2015-16
1. Supportive public awareness campaign – consistency of message and expectation
management
2. Development of peer-to-peer networks and expert support – at the appropriate
level (e.g. regional or sub-regional)
3. E-learning materials – free to access resources as the best way raise awareness and
train at scale on social care reform and funding reform.
4. Skills and knowledge for system leaders – expanding the reach and scope of
existing offers to support senior staff to drive culture change.
5. Commissioning – Mapping existing support, gaps, and supporting skills development
at the frontline.
6. Help to access the tools you need - A better ‘front-door’ to existing resources and
support and improved mechanisms for sharing exemplar plans.
7. Practice guidance – A limited amount of new material focused on independent
personal budgets and appeals for example, along with selective refreshes and
promotion of the material already produced.
7/20/2015
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Questions and comments?
Views and enquiries
[email protected]
Further information
http://www.local.gov.uk/caresupport-reform
Social care reform – potential areas for support
Support networks
•Local learning networks need a pool of those who are
steeped in current practice
but also completely
understand the new
legislative context
•Authoritative voices on
transformation – wellconnected amongst peers
(whichever staff group)
•Offer practical advice and
challenge on local areas’
work and ‘permitted
variability’ – not training.
Improved information
sharing
•‘Front-door’ or roadmap to
navigate existing tools
•Increased sharing of
implementation plans /
solutions via new Knowledge
Hub.
7/20/2015
Culture change for the
whole-system
•Examples of how wellbeing
approach has made a difference to
individual cases
•Counterfactuals – negative impact
of not changing
•Prevention duty in practice – for all
roles
Integration
•Communications and engagement with specific staff groups
within health – e.g. hospital staff and GPs – on specific Care Act
issues and linkages to the wider integration agenda.
•Support system-wide leadership through senior staff and
councillors – enabling them to explain clearly the relationship
between BCF, Care Act, Integration and personalisation.
Support for commissioners
Smarter, better assessment
• Role of staff who are not
qualified social workers in
assessment?
• Systems thinking
• Role of tech
•Map alignment (CCGs and councils) – to support a
collaborative approach
•How everything fits together “strategic route map”
•Share learning from CBO pilots
•Skills for market shaping are different from procurement – we
need to support both elements
•Co-production using community-based organisations
Workforce learning & development
•E-learning / digital the only way to reach the whole workforce at
pace
•From knowledge to skills – tools and follow-up (“Help to work
through the tools, show us how to use them”)
•Collective or regional procurement of trainers where appropriate
– to make best use of limited capacity
•Ensuring specialist staff are ready: mental health services, drug
and alcohol services, forensic social workers
Informatics –
requirements vs
possibilities
•Online self-service
•People-centred citizen services
•NHS Number / Integrated
Digital Care Record
Supporting implementation of the Care Act 2014
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Funding reform – potential areas for support
Demand-management / triage
•Self-assessment tools – including tools which allow individuals to
understand their eligibility
•Digital care cost calculators
•Filtering – first contact services, 3rd sector partners in the area, NHS and
others all will play a role in signposting and referral – including to
preventative services.
•Principles for designing Care Accounts – needs a human element
Appeals
•Training assessors in time for
the provisions taking effect.
•Important for DH to support
councils to ‘hold the line’ re
interpretation of the duty to
arrange.
•Consistency of operation is
important for efficiency and
protection
•Need good, robust legal advice
within councils on appeals /
metering.
•Assessors need to know where
the challenges are likely to be.
•Practice guidance on what a
good appeal system should look
like
7/20/2015
Managing relationships with Care Providers
•Need to build skills amongst councils’ commissioners in line with
Commissioning for Better Outcomes - reflect the cost of providing
quality care
•Explore concept of ‘Business relationship manager’
•Providers want consistency across councils where possible
•What is the ‘appropriate’ level of profit for providers?
•Care providers are looking for consistency from councils in terms
of expectations, systems / procedures
•Centre needs to reach smaller care providers
Public awareness campaign
•Consistent, standard messaging
•Must work in interest of individual –
but not generate unrealistic
expectations for councils and
providers
•Help self-funders understand context
of decisions
Market equalisation
• Share DH research (inc. scenario
modelling)
• Supply-side offer for providers
• Support to plan and mitigate
the effects for local authorities
Workforce learning & development
•Face-to-face where possible – products and roadshows
•Legal literacy important
•Distinct target groups and levels:
o First contact staff – enabling new conversations
o Financial assessors – specialist knowledge e.g. managing people’s
finances & equity release
o Commissioners – shaping the new market and understanding the impact
•How to train a transient workforce efficiently?
•New skills to have 1:1 conversations with self-funders and families
Accelerating
planning
• Development of
exemplar plans with test
sites
• Simulation events
• Generic local programme
plan
• Self-assessment
framework v2
IPBs
•Practice guidance – set
assumptions and a
common framework
•Share practice examples
•Local experts
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