INDEPENDENCE, WELL-BEING AND CHOICE

1. INDEPENDENCE, WELL-BEING AND CHOICE VISION FOR THE FUTURE OF SOCIAL CARE FOR ADULTS

2. HEADLINE POINTS • Closing date for consultation on Green Paper is 28.7.05 • 10-15 year vision • No new money • No prescribed structural changes • Requirement to have a statutory post of Director of Adults Social Services (DASS) but Councils free to decide local structures

3. Requirement to have a lead Member whose portfolio mirrors DASS responsibilities • Focus on improving and increasing availability and range of universal preventative services • Framework to achieve 7 key outcomes • Focus on putting people in control over their own lives • Balancing risks : Individual choice and control - v - expectations of a protective stance

4. BACKGROUND AND CONTEXT • An ageing population • Proportion of people living alone will increase in next 20 years • An increase in the number of over 85’s • 10% increase in people aged 60+ with mental health problems • 1% increase each year in adults with learning disabilities

5. More middle aged people choosing to move from towns to rural areas, therefore more older people in rural areas • Closure of local shops, pubs, banks and emphasis on out of town shopping malls (Living in a car orientated society without a car can be a problem) • The need for Social Care will increase over the coming years

6. DEFINITION OF SOCIAL CARE “The term Social Care describes the wide range of services designed to support people in their daily lives and help them play a full part in society. It includes practical services (Home Care, Day Centres, Residential Care etc) and practical assistance to overcome barriers to inclusion (supported entry to work for people with mental health problems, personal assistants) and support services to those in emotional distress”.

7. THE 7 KEY OUTCOMES • Improved health: enjoying good physical and mental health (including protection from abuse and exploitation). Access to appropriate treatment and support in managing long-term conditions independently. Opportunities for physical activity. • Improved quality of life: access to leisure, social activities and life-long learning and to universal, public and commercial services. Security at home, access to transport and confidence in safety outside the home.

8. Making a positive contribution: active participation in the community through employment or voluntary opportunities. Maintaining involvement in local activities and being involved in policy development and decision making. • Exercise of choice and control: through maximum independence and access to information. Being able to choose and control services. Managing risk in personal life.

9. Freedom from discrimination or harassment: equality of access to services. Not being subject to abuse. • Economic well-being: access to income and resources sufficient for a good diet, accommodation and participation in family and community life. Ability to meet costs arising from specific individual needs. • Personal dignity: keeping clean and comfortable. Enjoying a clean and orderly environment. Availability of appropriate personal care.

10. SPECIFIC ISSUES • Supporting and enabling individuals to take control of their lives. • Move away from a system where people have to take what is offered, to having control over the type of help and support they want, and more choice about, and influence over, the services on offer. • Information is the key to decision making - ensuring people have all the information on what help and support is available, and how to access it.

11. Introducing “the right to request not to live in a residential or nursing care setting”, requiring providers to state their reasons if they recommend this option. • Introducing client self assessment. • Confining social worker assessments to those with more complex needs. • Streamlining assessments across agencies (SSD/DWP). • Introducing “Individual Budgets” • Introducing “Care Navigator”

12. Extending the range of support to carers • Providing training and support in the caring role. • Providing information on available (universal) services • Support from a care manager/care navigator in identifying and accessing services. • Preventative Services • Early, well-targeted interventions should be developed to reduce the need for intensive, more costly services. The local authority well-being agenda can be used to improve health, social inclusion and quality of life. The wider resources of the community, including universal services, should be deployed to support individuals.

13. Service Redesign • Innovative flexible services that have been shown to work should be developed. These include new technology, extra care housing, homeshare, adult placement, connect care centres. • Strategic Commissioning • A local `community-wide’ strategic commissioning framework should be developed by all partner agencies to provide the right balance in investment between: • Services for the general population aimed at promoting health and social inclusion:

14. Preventative services that meet low level needs: and • Intensive support for higher level and complex needs. • Local Authority to undertake regular strategic needs assessments to plan ahead for 10-15 years, to include • care and support needs of whole population, including those who can pay for services themselves

15. Partnerships • The government will explore mechanisms for improving collaboration between local authorities and the NHS. It does not want to impose solutions to improve joint working, however `doing nothing will not be an option’. Local Area Agreements are an opportunity to improve public services. A `strong and vibrant’ voluntary and community sector is an essential part of the vision, and the government wants to encourage capacity building in the sector to help them engage with local public sector commissioning authorities.

16. Regulation and Performance Management • Regulation, inspection and performance management frameworks will be modernised to support the vision for social care. The merger of the Commission for Social Care Inspection and the Healthcare Commission will reflect shared objectives. Headline targets will be aligned across services. • Creation of “well-being” targets • Local Strategic Partnerships can establish local agreements on cross-cutting issues.

17. Workforce • The workforce is critical to delivering improved services. The government is working to improve leadership, capacity and skills. Local workforce initiatives should include training and employment for carers.

18. SO WHAT WILL IT MEAN IN PRACTICE ………….. • Councils will not be expected to direct clients to particular providers, but will need to ensure that they have all the help and information they need to make choices - the role of a “Care Navigator”? • In future, funding for all providers (Local Authority and Independent Sector) will be decided by client choice - individual budgets.

19. Commissioning will be the key lever to manage the risk of “Supply Induced Demand”. • Implications and challenges for a model of service commissioning and delivery based on fixed roles, fixed timetables, fixed budgets. • Commissioning capacity and infrastructure implications. • Clients likely to demand more flexible services, with greater use during evenings and weekends.

20. Service levels and budgets will need to be flexed much more quickly to respond to fluctuations and demands. • Changing the way the system operates is essential for quality and client control, but at the same time commissioners will have to secure value for money.

21. AND FINALLY ……………….. “SHARED VALUES ARE NOT ACHIEVED BY STATING THEM, BUT BY LIVING THEM”.