Outcome 1: Improved health and well being The council is performing: Excellently

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1 Annual Performance Assessment Report 2008/2009 Adult Social Care Services Council Name: Croydon This report is a summary of the performance of how the council promotes adult social care outcomes for people in the council area. The overall grade for performance is combined from the grades given for the individual outcomes. There is a brief description below see Grading for Adult Social Care Outcomes 2008/09 in the Performance Assessment Guide web address below, for more detail. Poorly performing not delivering the minimum requirements for people Performing adequately only delivering the minimum requirements for people Performing well consistently delivering above the minimum requirements for people Performing excellently- overall delivering well above the minimum requirements for people We also make a written assessment about Leadership and Commissioning and use of resources Information on these additional areas can be found in the outcomes framework To see the outcomes framework please go to our web site: Outcomes framework You will also find an explanation of terms used in the report in the glossary on the web site. Delivering Outcomes Assessment Overall Croydon council is performing: Outcome 1: Improved health and well being Outcome 2: Improved quality of life Outcome 3: Making a positive contribution Outcome 4: Increased choice and control Outcome 5: Freedom from discrimination and harassment Page 1 of 9

2 Outcome 6: Economic well-being Well Outcome 7: Maintaining personal dignity and respect Well Click on titles above to view a text summary of the outcome. Assessment of Leadership and Commissioning and use of resources Leadership There are good rates of recruitment and retention and vacant posts are low The Council s planned restructuring of social care is on target to support more personcentred support and self-directed services. The Council have published an economic development plan and are producing a social economic plan. Information and advice with regards to the recession is made available on the Croydon Crunch website. Continue to implement the ambitious transformation programme and evaluate the results from the first phase of the self directed support pilot Commissioning and use of resources Joint commissioning arrangements are in place with the PCT The Council are using the views of older people and carers across all areas to influence commissioning decisions and ensure the outcomes most important to the public are prioritised. Continue the work to achieve their target of 200 people choosing personal budgets by Page 2 of 9

3 Summary of Performance Brief overview of performance and progress The Council s planned restructuring of social care is on target to support more person-centred support and they are progressing with their roll out of self directed support. Progress has been made in implementing the transformation programme and whilst this is a long term programme examples of achieved outcomes to date show an increase in the number of people with learning disabilities living in supported housing; the creation of Social Enterprise has started and the overall number of residential placements for adult mental health has reduced. Recruitment and retention rates and vacancy rates appear good. The Council is keen to share learning with other councils across England from the different projects it has taken part in the In Control pilot to extend personalisation for people who use substance misuse services. Croydon is taking part in the Surrey and Borders transfer project for residential care services for adults with learning disabilities to independent providers which is on target for completion in The council has a committee structure which facilitates Member oversight of health and social care in Croydon. Councillors on the committee work flexibly, for example holding additional public meetings where concerns have been raised about specific issues, and through informal meetings with health partners. The joint strategic needs assessment has influenced the Council s Mental Health Commissioning Strategy particularly in the new focus on cognitive talking therapies. Restructuring of the department has created increased capacity to deliver joint commissioning with the PCT. Joint commissioning arrangements have been in place with the PCT for learning disability, mental health, drugs and alcohol. Commissioning arrangements for older people and physical disability have been aligned for many years. The council are using the views of people and carers to influence commissioning decisions across the full range of services. Page 3 of 9

4 Outcome 1: Improved health and well being People in Croydon are provided with a range of information to improve their health and well being. The council has an improving health and well-being plan for a Healthy Croydon and this is support by health and wellbeing campaign events for service users and carers held throughout the year and there has been positive feedback following these events. Information regarding healthy living is made available to people in a variety of ways including the POP bus which tours the borough, and a new contact centre, established in April 2009, enabling older people to gain advice and support without the need for a full social care assessment. The council continues with its work to support carers. A review of carer s assessments has been carried out and a new carer s assessment review document has been introduced and there has been an increase in the number of carer s breaks. A new response service for carers has been launched and is contributing to a decrease in attendance at the accident and emergency department. The council has refreshed the meals on wheels service and subsequent feedback from service users is good. People who use services are helped to remain independent and the council is working to reduce hospital stays. There are virtual wards throughout the borough and delayed transfers of care are below the target. There have been improvements to the integrated adult mental health service such as improved access to physical health checks for people with schizophrenia. The council has recommissioned the substance misuse services following feedback from service users and is taking part in the In Control pilot to extend personalisation for people who use substance misuse services. There is increased access locally and an outreach service has been introduced. Services for people with learning disabilities are managed jointly by the primary care trust and social services. Support is provided locally by the joint team and easy read information and advice on health issues is provided. The number of short term assessment and treatment beds required for people with learning disabilities has reduced with fewer people needing admission and length of stay has reduced. The council is working with the PCT to deliver an End of Life care strategy to improve end of life support in Croydon to improve choice for people. There is a wide range of healthy living campaigns for the public A new response service for carers and increased number of breaks Responding to evaluations by users and former users of services to provide improved services for people who have substance misuse treatment. Continue with their work to address the seven health improvement priorities identified within the Healthy Croydon plan Page 4 of 9

5 Outcome 2: Improved quality of life The Council continues to provide support and early intervention services to help people maintain their independence. Measures are in place for older people and people with physical disabilities to access a social life, learning and development opportunities, culture and leisure in line with the council s policy of an ordinary life. Croydon has set a firm foundation for further development of self directed care, has consulted people about the proposed self assessment questionnaire, and is sharing knowledge gained during the pilot with other London councils and stakeholders. The Council has opened up self-service options including the equipment shop and the Aztec Centre where people can view and try out equipment that may help them live independently. People with disabilities have easier access to try out and choose equipment at the Aztec Centre. The council aims to develop further services to give greater choices to people with disabilities longer term. Waiting times for minor adaptations have increased during 2008/09 however these remain lower than the London average. The wait for major adaptations has increased and the number of people waiting is above the London average the Council is investigating the use of prefabricated bathrooms and other methods to expedite delivery of equipment. Data for 2008/09 indicates that the number of people receiving Telecare has decreased however the Council s expenditure has increased. The outturn for all adults supported to live independently through social services was higher than the London average and clients with profound learning disabilities and multiple physical and sensory impairments are benefiting from the new supported housing projects. In Croydon developed and consulted on the new carers strategy and has a means to implement and review it, as well as ways of linking with other partnership groups. The strategy will embed in , when its impact can begin to be evaluated. The Council has demonstrated a keen interest in using information and research to identify people at risk, plan and predict future demands for care, and is working effectively with health partners to share information for this purpose. Consultation on the carers strategy Establishment of the Aztec Centre equipment shop Progress on supporting people to live independently Increase uptake of Telecare Improve waiting times for both minor and major adaptations and reduce the number of people waiting for major adaptations. Continue with plans to implement and evaluate the carers strategy Page 5 of 9

6 Outcome 3: Making a positive contribution The Council provides opportunities for service users and carers to provide feedback on services and are using feedback to enhance their transformation programme. The Council engages with key partners on self directed support. Third sector provider organisations have been represented on the programme steering group, and a consortium of third sector providers is managing the implementation of the Croydon Small Sparks scheme. In October 2008 the Council was short listed for a beacon award for positive engagement of older people. A service user and carer reference group has been established to strengthen user and carer participation and add a user perspective to quality assurance. The Council are pro-actively engaging with service users for alcohol and drug misuse and carers were consulted in the development of the carer s strategy through the use of the Open Space events with over 140 carers and professionals. Members have shown a high level of interest and engagement in social care. The LINK, and all consultation groups feed into the Council s political process. The Council is increasing ways people to make choices through self assessment, and responds quickly to contacts from people by telephone. Croydon is a pilot site for Social Enterprise and are implementing kiosk information points across the borough. Croydon Voluntary Action plays a lead role in encouraging local people to volunteer and promotes and brokers volunteering and runs a number of volunteering programmes. Positive engagement with older people Consultation with carers To continue to increase ways people make choices via self-assessment Outcome 4: Increased choice and control The Council provides a wide range of information through a variety of mechanisms to support choice and control. Croydon s self directed support is well established and the Council has the management framework and infrastructure to support further development of self directed care and increase the numbers of people using direct payments. The Council is working with south west London councils on personalisation to shape market development. Its work with In Control puts the council in a strong position to promote self directed care and direct payments in the coming year. The first phase test lasting 3 months has 60 recruits of which, to date, 41 have opted for personal budgets. The second phase will include an evaluation of the pilot scheme for personal budgets. The Council introduced a new complaints system in December 2008 and has effective systems to track and follow through all kinds of feedback. There has been an increase in the number of complaints received. The Council provided examples where complaints had resulted in changes Page 6 of 9

7 to practice a specific example related to the use of independent advocacy services when best interest decisions were being made. The Council continues to provide support for carers and have developed an emergency response scheme aimed at all carers including parent carers and young carers. An independent advocacy service has been commissioned specifically to support people using mental health day care services throughout the individual review process. There are trained advocates for clients with learning disabilities support them when making choices about care. The Council are now paying a market supplement for adult mental health and adult social worker posts and this has enabled them to recruit more permanent staff. The numbers of people choosing direct payments has increased in comparison to last years figures with the exception of carers. Croydon should identify factors which are making Direct Payments less attractive to carers and work out a strategy to overcome this. The Council is moving to a more person centred support model for users of day services Improvements to the complaints process has led to an increase in the number of complaints received. Uptake of direct payments is improving across all client groups (except carers). Increase the uptake of direct payments for carers. Should raise awareness of direct payments amongst staff and ensure people are supported in their uptake. Outcome 5: Freedom from discrimination and harassment The Council has measures in place for promoting equality and has self assessed adult social care at Level 5 of the Local Government Equality Standards. The Council is working actively with local black and minority ethnic (BME) communities to improve access to social care services and raise awareness of safeguarding. There is increased BME representation at the mental health forum and improved equality of access to services. There is evidence of improved uptake of carers breaks and involvement by carers from black, Asian and minority ethnic groups. There are specialist teams in place to address the needs of people subject to immigration controls. The teams provide support in accommodation, subsistence and care and support services. The Council continue to monitor the ethnicity of those they support in the community; through access to interpreting and translation services and signposting to community organisations which offer support to refugee and asylum seeking communities. The Council has arrangements to signpost clients who fall outside of the FACs criteria to appropriate support. Older people s services and physical disability services have created selfservice options and the Council have supported alternatives, such as the Croydon Small Sparks a scheme managed by a consortium of third sector organisations, for people in the community who are not FACS eligible. Page 7 of 9

8 The Council has evidence of equality impact assessments carried out in on all strategies and has plans to extend these to self directed support. Uptake of breaks by carers from BME communities has increased. There is evidence that the council are working actively with BME communities Croydon has established specialist teams to meet the needs of people subject to immigration controls Continue to review the access to services where care falls outside the FACs criteria. Progress action plans to fully implement the recommissioned mental health day services Outcome 6: Economic well - being Well The Council is working in adult social care and at a corporate level to develop greater employment opportunities the council and in the local community for people with disabilities. This is supported by the Delivering an Ordinary Working Life (DOWL) project which has been agreed and a project proposal is in development. The Council have set a target to increase by 3% the number of people with disabilities directly employed by the council by the end of The Council have set up a website the Croydon Crunch to provide advice and information regarding the recession. The Council provides advice and carries out benefit checks to ensure people receive their full entitlement and commission Mind in Croydon to provide a specialist mental health welfare benefits service. Support is provided for carers to find employment and to access training opportunities. The Council are working to help disabled people and others with support needs to move into work providing support to individuals, arranging work experience and liaising with employers to resolve any problems. The Council report that they have recently contacted all adults with learning disabilities, known to the Council, to reiterate the availability of support for those who are not in employment and who require assistance. The Council are taking positive action to address concerns for older people who are self-funding residential and nursing home care in particular within the recession and have identified those potentially at risk. The Council are providing information and advice to the public in regards to the economic down turn via a Croydon Crunch website The Council are taking positive action to address concerns for older people who are selffunders within the recession. Continue to provide support to increase the number of adults with learning disabilities in employment Ensure opportunities for employment continue during the economic down turn. Page 8 of 9

9 Outcome 7: Maintaining personal dignity and respect Well The Council has taken steps to raise awareness of safeguarding this has been through a range of activities and events as well as providing information and training for independent providers. The number of safeguarding referrals has increased in 2008/09. Work is in progress to improve safeguarding and the council has identified five key learning points from their own safeguarding audit and are taking practical steps to improve areas for the areas identified for development. The Council has explored safeguarding issues affecting the black and minority ethnic and faith communities and identified ways of improving safeguarding practice. The Council held a conference in November 2008 for Family Faith and Safeguarding attended by representatives from statutory, voluntary and faith groups to identify barriers to disclosing abuse from black and minority ethnic and faith communities in Croydon. The Council has reported a good response to e-learning training on its website and has run other training courses which are well attended, advertised widely, and mostly free. The Council has a Care Home Support Team that works to improve quality of care and safeguarding in residential and nursing care homes. The Council has identified where there are gaps in formal training and suggested ways of filling gaps in learning by other means. Staff receiving safeguarding training is higher than the London average however, the number of staff from the independent sector undertaking protection of vulnerable adults training is lower than the average. The Council is using information from their safeguarding audit to identify priorities, training needs and consistency of approach. The number of safeguarding referrals and training for directly employed staff is above the London average. The Council have explored safeguarding issues affecting BME and faith communities. To continue to implement the key findings from their safeguarding audit To increase the number of staff from the voluntary sector accessing safeguarding training Page 9 of 9