Agenda item

Agenda item

Risk Review Item: Adults Assurance Update

The report of the Director of Adult Social Services is enclosed.


The Committee considered a report of the Executive Director of Adult Services which provided an update on the actions taken to address risk in respect longstanding and partially implemented audit recommendations in relation to Adults Mental Health safeguarding and transitions from Children’s to Adults social care.


The report therefore focussed on:


  • Actions Taken to Develop the Social Work Transitions in Care Service and a summary of Next Steps; and
  • Actions to support the reconciliation of mental health casework records across the Adult Service function and the Greater Manchester Mental Health Trust (GMMHT), as well as additional measures taken to provide added assurance


With regard to Social Work Transitions, significant progress across the system in respect of planning and preparation for the transition to adulthood was reported, which formed part of a wider programme of improvement activity. This included the development of new practice forums, an invigorated multi-agency focus to deliver an impactful and joined up approach to referrals and care delivery. Additionally, a service delivery improvement in respect of Care Act assessments for young people before or within their 18th year instead of at or following a young person’s 18 birthday was reported. The Committee was also invited to note external assurance had been provided for the service following an OFSTED inspection of Special Educational Need and Disability (SEND) services in November 2021. The inspection had found leaders’ clear vision for improving outcomes for children and young people with SEND; that appropriate and timely interventions were provided and good oversight of delivery including priorities for action had been maintained. Further priorities were also outlined in the meeting regarding earlier identification of young people approaching the transition to adult services and earlier assessment and review functions of young people with an Education Health and Care Plan to support the management of future demands on services. An expansion of the team was also reported in the form of two additional staff members who would be specifically recruited to deliver person focused planning arrangements.


With regard to the reconciliation of mental health casework and safeguarding referrals between social work and health colleagues, reference was made to the challenges of infection control measures arising from the pandemic on service delivery and the impact of GMMH’s COVID business continuity plans to manage significantly increased demands on services. The Deputy Director of Adult Services spoke about time that had been invested in actions and resources to mitigate the complexities of reconciling records across two different recording systems, which was at the heart of the issue and was a common feature nationally across integrated health and care forums. Weekly and monthly reporting arrangements outlined in the report underpinned the process of record reconciliation, resulting in confidence that there were no gaps in the data and that the risks of omissions or errors had been addressed. In addition, further steps were being introduced around GMMHT staffing, which included additional training input with regard to case-management recording as well as the development of the Council’s own systems processes which were outlined in the report.


The Committee welcomed the work that had taken place around transitions in care services and stressed the importance of consistent oversight. With specific reference to the impact of the pandemic, a member commented that further efforts may be necessary to address the needs of those young people who had either reached or passed their 18th birthday during that time. In response, the Service Manager - Transitions confirmed that this had been identified as a priority for the service and a proposal was in place to deliver focussed activity to address those gaps, using the input of the newly expanded team as sufficient capacity would exist in the initial stages. Efforts would be made to work with affected families to rebuild a relationship of trust in service provision, including (as an example) the offer of input about their experiences as part of the ongoing journey of service improvement.


Noting that improvements had been reported in respect of timeliness of the first assessments, more detailed performance information was requested. The Service Manager - Transitions confirmed that referrals were prioritised on a needs-led basis and that whilst numbers had initially been low at the time of the introduction of monitored  performance indicators, they had since doubled indicating a positive and healthy trajectory. Targets would be determined with the input of the Transitions Board, mindful that pathway planning often required a multi-agency focus where some challenges existed (e.g. the age at which a young person became eligible for a particular health services). With regard to the timeliness of follow up assessments, inter- agency service inputs were highlighted as crucial to the process leading up to those assessments. Further work was therefore planned to enable capacity to meet demand as part of planned practice-led improvement activity. Discussions moved to how future demands on services were determined. The Committee was informed that the Transitions team worked closely with colleagues in the Performance, Research and Intelligence Directorate to gather rich, high quality data on young people with an EHCP to establish whether input from adult social care or health services needed to be arranged to ensure care delivery at the best possible time, adding that feedback indicated that a lack of information, advice and guidance was the biggest source of anxiety for service users as they prepare for adulthood. In response to a question around capacity to deliver a whole system approach, the Deputy Director of Adult Services described the two predominant referral routes into adult social care services, namely transitions from children’s social services and adults in later life experiencing levels of frailty. Therefore the service had adopted a range of collaborative interventions to develop an effective demand management strategy, supported by cross – directorate information sharing (which included population modelling) to better understand where and how demand will change in the future.


There was a discussion about the role of parents and carers, the Manchester Parents and Carers Forum and the Parent Carer Board which was co-chaired by the Transitions Service. The Committee was informed that whilst this was not specifically referenced in the report, input from the Forum sat at the very heart of service improvement in recognition of their crucial role.


On the subject of mental health casework, assurance was also sought in respect of lessons learnt about the reconciliation of care systems as the move towards integrated care delivery continued. The Deputy Director of Adult Services referred to a range of developments that were underway to underpin future data sharing and systems integration in a safe and secure manner. In response to a question about safeguards and the mitigation of potential risks in relying on the manual transfer of casework records, the Deputy Director of Adult Services made reference to end to end safeguarding measures, which involved multiagency and clinical staff at referral meetings, which had been given external assurance following the recent audit. Information about that process would be circulated to the committee for information, in due course. The Deputy Director also agreed to share with the Committee, further statistical performance information  on the delivery of staff training for social care and health colleagues, including scope, implementation and it’s evaluation.


There was a discussion about the delivery of Care Act responsibilities. The Deputy Director of Adult Services explained that those responsibilities had been delegated to GMMH so that multidisciplinary and clinical support to people with a mental health issue was available as part of a coordinated approach to care delivery. She asked the Committee to note that whilst this model provided the best service for the service user, it provided a degree of complexity in terms of the Council’s own infrastructure.


The Deputy Leader with responsibility for Adult Services thanked the Committee for its input and spoke about the Service’s ongoing transformation, adding that whilst that transformation had not yet concluded, she was reassured by the positive steps that had taken place, acknowledging the strong commitment that existed across the partnerships to deliver the highest quality care.




To note the assurance updates provided

Supporting documents: