Report of the Executive Director of Adult Social Services

This report focuses on adult social care performance activity as well as external commissioning and market capacity. 

The Committee considered the report of the Executive Director of Adult Social Services that provided information on adult social care performance activity as well as external commissioning and market capacity.  

Key points and themes in the report and accompanying presentation included:

·         Providing the context in which Adult Social Care were delivered;

·         Better Outcomes Better Lives transformation programme and key headline activity;

·         An update on key areas of adult social care that related to community capacity, including key performance information;

·         An overview of the care market, with reference to market sustainability and in-year supplementary funding;

·         Supporting discharge through the Manchester Integrated Control Room; and

·         New arrangements for placement finding via the Brokerage Team.

Some of the key points that arose from the Committee’s discussions were:

·         Welcoming the report and recognising the outstanding work that was delivered on behalf of Manchester residents;

·         Thanking the Executive Member and officers for their continued dedication and hard work;

·         Whilst welcoming the use of technology to support residents, it was important to recognise the importance of face-to-face support;

·         Noting and welcoming the recent inspection by the CQC of the Central Reablement Team and the awarding of an “Outstanding” rating;

·         More needed to be done to raise the prestige of the caring profession;

·         Commenting that there still existed many unrecognised unpaid carers in the city;

·         Was the intention to roll out the described pilot that had been taking place with an existing homecare provider around delegated responsibility;

·         Noting the significant impact the closure of a care home could have on both the residents and their families; and

·         Welcoming the information provided regarding the Real Living Wage paid to carers, however there was a need to support care staff on other issues, such as the cost associated with work visa applications. 

The Assistant Director, Early Help, Hospitals, Reablement and Manchester Equipment and Adaptations Partnership (MEAP) said the major adaptations were defined as works exceeding £1000 and minor as less than. She said that major works were administered in conjunction with assessment officers and Occupational Therapists.  She commented that the demand for these services was increasing year on year and there was a national challenge regarding the recruitment and retention of qualified Occupational Therapists. In regard to a discussion relating to wheelchairs and highways she commented that highways was not within her remit and wheelchairs could either be supplied via the MEAP or health providers. She further provided a description of the Disabled Facilities Grant process where individuals could apply for funding for major adaptations that helped people stay as independent as possible, for as long as possible, in their home. She addressed the discussion regarding the use of technology. She said the intention was to deliver the most appropriate and safe support for residents, assessed by adopting a person centred, strength-based approach and it was not the intention to replace the role of the social worker. In accordance with the Care Act, support would be reviewed annually to ensure the individual continued to receive the correct and appropriate support.

The Executive Director of Adult Social Services stated that the Hospital at Home model of care was a model that was supported by multi disciplinary teams (MDTs). She added that discussions were ongoing with providers and health colleagues to extend this model into care homes. She reiterated that people were at the heart of these discussions. She further stated that the intention was to roll out the delegated responsibility pilot, with the appropriate level of clinical oversight and that an update on this could be provided to the Committee at the appropriate time.

The Executive Director of Adult Social Services noted and acknowledged the comments expressed regarding the impact care home closures had. She said that in the event of such a closure staff would work with residents and families to secure the best outcome for residents and their families. She added that the local care home sector was monitored to identify early warning signs and where appropriate support would be offered to sustain the provision. She made reference to the new framework rates (uplifts to providers) that had been completed through the MLCO Commissioning Board and various MCC governance routes to further stabilise the care market. The large increases to older people’s care homes provision were significant and would have a direct impact on reducing the fragility in the market, hopefully preventing care home closures and improving recruitment and retention in the sector.

The Executive Member for Healthy Manchester and Adult Social Care stated that in the event of a closure of a care home the relevant ward Members would be briefed at the earliest opportunity.

The Assistant Director (Commissioning) informed the Committee that reablement led flats were part of the Extra Care programme that had been routinely reported to the Committee. She advised that there were currently 30 such properties across the city, all supported by Reablement Teams with wrap around care. She stated that this model had been recognised as good practice by the Care Quality Commission. She commented that the challenge was to meet ongoing demand.

The Executive Director of Adult Social Services recognised the comments made regarding the perception of caring as a profession. She made reference to the establishment of the Greater Manchester Social Care Academy and suggested that a report on this work could be provided to the Committee at the appropriate time.

The Head of Commissioning for Care Homes, Homecare and Quality informed the Committee that the reported strength-based assessments and reviews that continued to exceed the BOBL performance indicator for the past 12 months was a result of improved identification with people being directed to the most appropriate care pathway. He further advised that a Greater Manchester pilot scheme had been launched that was designed to financially support providers help support staff with work visa applications, he further commented that recent communication with the Home Office had greatly improved to support this activity.

The Assistant Director (Commissioning) addressed the comments regarding paid and unpaid carers and drew Members’ attention to the Greater Manchester Support for Carers Programme, an exemplar model for carer support. She added that this area of work was regularly reviewed and audited with best practice being shared.

Decision

To note the report.