This report sets out the last twelve months progress of the Adapt programme and what is planned through to March 2020.
The Head of Innovation and Change introduced the item, and reminded Members that this would be the third update on the Adapt programme. The last update to the Panel had been in June 2018, and this report covered the 12 months following.
There had been some delay in implementing the new e-marketplace, although through the new Croydon Digital Service, the issues were being resolved. In response to questions about the timeline for completing this work, the Panel heard that the target had been November 2019, with testing on the e-marketplace, information and advice and community directory taking place in September 2019. It was planned to be a ‘one-stop shop’ for services, and Members would be shown how it worked to enable them to help residents.
There had been an improvement in provider engagement events, which had been attended by over 200 different suppliers. A key intention discussed was, where appropriate, to enable more people to live in supported accommodation, rather than unnecessarily being placed in residential care. Forecasts had suggested there needed to be an additional 280 units of supported living stock before 2024, and work would be done to figure out how best to deliver this; 38 units had been secured since June 2018.
Members learned that a consultation on a new Direct Payments policy had begun, and residents could give their views and get involved at the following link: www.croydon.gov.uk/directpayment_consultation. Carers, families and residents had been encouraged to engage with the consultation.
A Virtual Wallet system had been procured for direct payments, and would allow users to buy care and support services. The advantage of this would be that providers could be paid faster, which the market had been responding to. Testing would be done with managed accounts first, before being rolled out to the remaining direct payment users.
Members expressed concern about direct payments, with many elderly people not being online or using emails. Members had witnessed multiple launches of other direct payment schemes, and stated this caused them some scepticism in regard to this one. The Head of Innovation and Change responded that direct payments user groups, amongst other service user groups, had already been engaged following an equality impact assessment, and would continue to form a key element of the user testing for the virtual wallet before it went live. All direct payment users had been written to asking for comments on the current direct payments policy.
Following this, Members discussed whether the programme had engaged widely enough with the public on consultations, and cited the new charging policy engagement. Members were concerned that the letters that had been sent had discussed removing a subsidy, without enough information on what it meant for them, which had caused some residents to panic, as the communications had not kept the audience in mind. The Chair responded that a review of the letters would be undertaken, to ensure that they would be properly tailored to vulnerable people.
Members felt that there had not been enough engagement with the Croydon Adult Social Services User Panel, and that there had been a lot of concern from residents, some with dementia, over the new charging policy. Members stressed the importance of engaging with the right people, and for making it personal with engagement from family members or carers. Regarding the charging policy, the Head of Innovation and Change agreed to make sure phone numbers and email addresses were available to the affected residents.
The Head of Innovation and Change highlighted that direct payments were not being forced upon service users, with managed accounts and other support services still in place to reduce risk; it was agreed that the availability of telephone and in person contact was important. The council would also be going to the market for a Croydon adult support service, to work with current Personal Assistants, to develop new ones, and to support people who wanted to use direct payments for employing a Personal Assistant. There would be a Personal Assistant register on the e-marketplace and through direct payments, but also information and advice though the Croydon adult support service.
The Cherry Hub had been opened, and would be used as the benchmark for Active Lives, with the Autism Service located separately next door. The Hub would deliver sessional services on life skills and employability; the Brit School and National Autistic Association had been involved, and some users had been linked up with the Croydon Voluntary Services.
A new Outreach Service would be available from July 2019 to help move service users out of day services, where appropriate; the Transitions Team would be involved, and the service would help to move residents to supported living and teach them life skills.
Liquid Logic would be implemented by autumn 2020, with the aim of providing an improved client record system, and supporting health and care to achieve an integrated care system. This would link in with Community Led Support, and ensure the council had access to quality practice and data to direct services and workforce development. In response to questions from Members about whether Liquid Logic would integrate information from Croydon Health Services, the Panel learned that data from the health information exchange would be used to allow these systems to talk to each other. Members expressed frustration that the data from Liquid Logic was not as granular and informative as it could be, and learned that the localities work being done would assist in correcting this, and that a new financing system would feed data into the system to show how budgets should be split. The building blocks for achieving more detailed data were in place, and should produce the desired results soon.
Exit plans were being made from the current Special Sheltered Housing contracts, with the option of bringing this service back in-house being considered. This had been in the business planning stage.
The Panel praised the volume of work taking place, but queried what difference service users and residents would experience in their interactions with the council. The Head of Innovation and Change responded that in the past there had been a fractured service with many different teams who did not always communicate with each other, and these had been restructured into the Croydon Adult Support Team to start reflecting the Multi-Agency Safeguarding Hub (MASH); this would be part of the whole family approach and the work to provide a local offer.
Talking points in the Thornton Heath locality innovation site, which included social care, welfare benefits advice and local voluntary colleagues, had been available at Parchmore Church on Mondays and Thursdays as part of community led support; lessons learned here would be taken to the next locality site to see if they were effective in other localities. This would show the value of testing models in the community.
The Director of the Alliance Programme informed the Panel that there were plans to add a section to reports on ‘what it meant for Doris’. There was acknowledgement that more engagement could be done across health and social care, and that the market for direct payments users needed to be developed.
Members reported incidents of residents not being able to get through to the right services when contacting the council by phone, and heard that there would be a dedicated line, with an emergency team on duty after 16.00. There would be efforts to ensure that staff were logged into their phones, and to promote longer phone calls which could gather more information and result in more actions taken. Members heard that there would be an effort for that same people to stay in touch with the resident, and that the good conversation model, along with localities and community led support, would reduce waiting lists and improved outcomes for people. The Head of Adult Safeguarding and Quality Assurance added that there had been a day in Thornton Heath where the waiting list had been zero, and Members noted that there had been a drop in GP waiting lists.
Members queried whether locality work had only been undertaken in Thornton Heath, and learned that this was the pilot site for community led support, but that the older peoples workforce had been restructured across all six localities, and that the wider disability service would be, where appropriate, restructured to the model. Once the community led support pilot had proved successful, it would be introduced across the other five localities. The Chair commented that the evidence from the sites where locality work had begun indicated that these projects would be successful.