This report provides an update on the implementation of new adult social care Direct Payments arrangements for Croydon residents in support of the Council’s priority to help people live long, healthy, happy and independent lives.
The Category Manager introduced the report and presentation which provided an update on the council’s progress towards extending Direct Payments (DP) to more residents which supported the council’s priority to enable Croydon people to live long, healthy, happy and independent lives. They noted that Croydon was behind to implement Direct Payments (DP) comparatively to other authorities.
The Category Manager explained that many people in Croydon wanted a PA, however they were low in number and Personal Assistant (PA) training was difficult to access. Policy and guidance for DP was dated, the last update being in 2010, and processes had changed which meant the system was in need for refreshing and modernising. The Panel noted that 56% of parents of children with a disability used DP therefore it was necessary to try and replicate this success for services to help adults live at home.
The council aimed to be in a position where they managed a lower number of adults by encouraging greater flexibility and choice to users enabling them to find care and support locally using the new directory. There would also be the Contract Personal Assistant Support Service which supported users to recruit and to employ PAs, therefore retaining their service. DP moving forward aimed to reduce red tape and would introduce an online system which would mean people could manage their own direct payments online paperlessly, without the need to retain receipts. This agency system had been tried and tested in other local authorities and was delivered by Independent Lives, a user led charity, who had won awards for their results. The agency commission was the council in partnership with the Croydon Clinical Commissioning Group (CCG) which meant that there was one market for PAs, removing competition and promoting integrated care.
The strategies would be implemented through a community led approach where residents would be supported in their individual choices by social workers working on a case-by-case basis. DP in the past had been working alongside the central service and the new scheme would enable integration of the whole process enabling continued relationships through each stage, particularly with social workers.
In response to a Panel Member asking where the Croydon Personal Assistant Support Service would operate from, the Category Manager stated that a face-to-face service could be offered homebased or in the Community Support Office, Cherry Hub. The service would initially use Crawley based staff, however throughout the transition period staff would be recruited from Croydon and would eventually lead to the employment, training and accredited status of 200 Croydon residents.
The Category Manager described the consultation for DP which was in effect widely through meetings and surveys from the guidance produced and respondents predominantly focussed opinions on the implementation of policies. Themes raised from the consultation would be incorporated in to the policy guidance and developing the implementation plan.
The online payment system was due to be introduced which would be connected to the directory and users were able to carry out cashless transactions using the Virtual Wallet. In response to Members asking how pre-paid cards would be integrated in to the system and whether users would be able to monitor their own balance, the Executive Director for Health, Wellbeing and Adults stated that the account would be connected to the online systems enabling users to check their accounts. Using the new system the council was better able to audit usage and officers were able to restrict transactions in particular circumstances, whereas currently with the pre-paid card users were able to overspend and the council would only be aware afterwards when receiving a statement. The Virtual Wallet was seen to be a user friendly platform however there were still further tests to be completed and this would be an optional service for users.
Members asked who would be managing the Virtual Wallet and the Category Manager responded that beyond January 2020 the support would be predominantly community led and social workers would set up the user profiles for residents. Members asked if there would be social worker audits and they replied that they would be included in part of the review to additionally include annual audits. The Executive Director for Health, Wellbeing and Adults told the Panel that resulting from the flexibility for residents to choose services suited to their needs, approximately £250,000 would be saved.
The Category Manager told the Panel that the Adults Social Services Users Panel (CASSUP) had the view that residents should have the choice in making a financial contribution towards the service and the Executive Director for Health, Wellbeing and Adults stated that lawfully there must be a financial assessment. There were other concerns raised that the council and DP needed to operate on a level playing field which would be reviewed.
Panel members commended the recent work to plan and implement the new arrangements, in comparison to previous years, by increasing the level of choice to complex groups. In response to a Panel Member asking whether Respite Centres were connected to DP, the Executive Director for Health, Wellbeing and Adults stated that they were, however the Centre was meant for residents who were not suited to mainstream services. There needed to be a culture change for more people to use mainstream services and normalise their requirements. A Panel Member agreed and stated that people should be supported in a complete capacity only when absolutely necessary. This was part of broader conversation about care provision and in their opinion a good model facilitated by the community was required, which would also consequently save costs.
The Category Manager described the ability to commission more creative activities for users. It was noted that Mencap residents were able to organise exciting trips or holidays that were an alternative to old fashioned institutional homes. A Panel Member added that there had been a mental cultural shift in recent years in what activities were deemed safe, secure or appropriate for vulnerable people. The Category Manager explained that the DP was researched and developed throughout the 1990s-2000s and was already common practice in countries such as Australia and New Zealand.
In response to the Vice-Chair asking whether social workers were familiar with DP, the Director of Operations Adult Social Care stated that at this stage the system as it currently stood was too clunky and that they were still in the testing phase. The community led support was to encourage and inspire.
The Executive Director for Health, Wellbeing and Adults stated that in the past there was distrust between the council and providers which caused undesirable outcomes, the whole system needed a culture change to bring back the key aim to improve outcomes for users which would be supported by introducing new staff. In response to a Panel Member asking where carer centres fit into the picture, the Category Manager stated partner centres were in favour of the new system but supported the opinion that more ground work would be needed to perfect it. There was training planned for council staff which would be rolled out externally at a later stage; this meant that knowledge and advice provided to residents would be standardised across care providers.