Agenda item

County Councillor Graham Gooch, Cabinet Member for Adult Social Care, Mark Howe, Director of Quality Improvement and Principle Social Worker and Kerry Ross, Head of Service Quality and Improvement, Elaina Quesada, Deputy Executive Director of Adult Services attended the meeting to provide information and partake in a discussion on Living Better Lives in Lancashire.

The report and presentation circulated in the agenda pack provided information on the Adult Social Care vision for the Living Better Lives in Lancashire operating model. The report also included information on the strength-based model utilising a three step conversation approach to prevent and delay social care needs.

The Chair invited questions from committee members and a summary is outlined below:

·  The committee queried when the Living Better Lives strategy would be fully implemented. Members were informed that the first and key stage would begin on 1 July 2024 with the Wellbeing and Early Support Function and that the updates to the Liquid Logic System would also be implemented from 1 July 2024. It was reiterated to members that some teams were already working to the strength-based practice model, the date of 1 July 2024 referred to when this model would go County wide.

·  Regarding the Living Better Lives workforce model, it was queried what the workforce's reaction had been to the model. It was explained to the committee that this report specifically applied to the social care services (e.g. social workers, social care support officers etc) and the training being delivered was in partnership with the Social Care Institute of Excellence (SKIE), who had rolled out strength-based practice training on a national scale. It was further explained to members that the training was not new, and strength-based practice training had been in place since 2021 and from this, the feedback already received was largely positive and changes made to the model as a result of workforce feedback. It was confirmed the training offered from SKIE was accompanied by managerial supervision, training for the system to be utilised by social care staff and the training programme up to the launch date was significant.

·  The committee raised concern regarding savings required within the Adult Social Care budget and queried how much was needed to be saved. Members heard that the implementation of the strength-based practice model attributed to specific savings, and from information regarding national strength-based practice models, it was a positive way of working for both the individual and the authority, as savings were made without affecting the individual requiring the service.

·  Concern was raised regarding implementation of the model, and an impact on staff morale. Further concern was raised by members regarding whether the workforce was equipped to deliver the model effectively and in a timely manner. It was explained to the committee that initially the authority was partnered with Partners4Change.It was explained to members that the first 5 pilot sites were largely successful however when the model was then rolled out across Central Older Adults and People with Physical Disability Services, staff feedback highlighted the need for more structure and support. Members were informed that as a result, the Living Better Lives in Lancashire model was developed. It was confirmed to the committee that staff engagement has been good, and from feedback professional practice had been enhanced to ensure staff have the time and support to implement this model effectively and this support would continue past implementation.

·  Regarding 'Conversation two' (Wellbeing and Early Support), it was queried which staff would be delivering this level of service and their level of qualification. Further to this, it was queried if the model expected service users to stay on the lower levels of support. The committee were informed that existing staff would be used to deliver every level of the model. Members were informed 'Conversation one and two' referred to individuals not previously known to Adult Social Care and was the 'front door' support, which would be delivered by mental health, learning disability, older people, and physical disability Social Workers alongside unregistered staff (Social Care Support Workers, Occupational Therapy Support Officers etc). In terms of 'Conversation one and two', this delivered the local authorities Care Act duty. The model ensured those who needed lower level of support (e.g. mobility equipment) would not wait for a Care Act assessment to receive this, however those who needed long term care would move through the Conservation model quickly to an assessment.

·  Members queried if there was a different assessment model for individuals in hospital care, opposed to the 6-week response timeline highlighted within the report. It was confirmed the assessment was different for an individual in hospital care, and the timeline for this type of assessment was 72 hours after an individual is discharged into an intermediate care bed or to their home.

·  The committee raised concern regarding the recurring mention of the involvement of the Voluntary, Community, Faith and Social Enterprise (VCFSE) sector to support this model of working and queried if investment was being made into this sector to support their involvement in community care. It was confirmed to the committee that no commissioning plan for the VCFSE sector had been made however Adult Social Care had been involved in discussions with umbrella organisations on how to commission the sector. It was acknowledged to members that district councils had a very strong relationship with the VCFSE sector and did commission their services already, as well as Lancashire County Council (e.g. care services and advocacy services). It was explained to members that in 2024, funds had been set aside to invest in the VCFSE sector however links needed to be made between health services and district councils to ensure commissioning was done properly to prevent inundating voluntary sector organisations beyond their capacity. Further to this, the committee heard that work was being carried out with the Integrated Care System to maintain regular contact with the 12 district councils' Chief Executives to discuss how to commission the VCFSE services as one. Members were informed that it was agreed that the district councils would coordinate a single interface of services for the North, East and Central Lancashire and from this interface, Adult Social Care could commission services. It was highlighted to the committee that the focus on commissioning the sector was to fill any gaps within Adult Social Care and to ensure services were not duplicated, and Senior Operational Focus Groups were in place to oversee this work with the district councils, county council, Health sector and VCFSE sector.

·  The committee raised concern regarding how Adult Social Care would ensure undue burden was not placed on other organisations, families, or carers specifically with non-commissioned services. It was acknowledged that organisations, families, and carers were vital to deliver community support on every level. It was explained that within the Senior Operational Focus Groups, there was a focus on supporting carers. The committee were informed it was a complex work area on both the preventative side, and end-of-life.

·  The committee commented that the public may not be aware of VCFSE sector organisations within their area. Members were informed that the purpose of creating the online directory of services was to inform the public of what support was available to them, however the challenge with a directory was to prevent small organisations within the community from being overwhelmed.

·  Regarding a directory of services, the committee commented if directories of this nature did exist, how the Health and Adult Services Scrutiny Committee and councillors could raise awareness. It was confirmed that directories of this nature did exist within certain areas of Lancashire and Adult Social Care were aware of some of these directories, and it was explained to the committee that creating a County wide database of this size was challenging, and ensuring the Social Care workforce and residents were aware of this resource was difficult. Members were assured that the creation of a database was a service objective, and Adult Social Care were hoping to partner with Childrens' Social Care and Public Health to create a robust list of services to meet a variety of needs. It was acknowledged to the committee that councillors were essential in spreading awareness of services within their divisions.

·  The committee commented that the University of Central Lancashire were currently working with the VCFSE sector to create an online directory to allow the public to search local organisations.

·  It was confirmed that the Living Better Lives in Lancashire practice model was compliant with the Care Act 2014.

Resolved: That the:

  i.  Introduction of the Living Better Lives in Lancashire Practice Model through adoption of a strengths-based approach and the Wellbeing and Early Support operating system be supported.

That the following recommendations be considered by the Cabinet Member for Adult Social Care in the implementation of the Living Better Lives in Lancashire Practice Model:

  ii.  Concerns raised as part of discussions, and as outlined in the body of the minutes, be incorporated.

  iii.  All county councillors be provided with opportunity to feed into existing work being undertaken to identify services available from VCFSE sector across Lancashire.

  iv.  A system of notification for councillors be identified and implemented to further support information sharing on VCFSE services to adult social care services.

  v.  Discussions be held with UCLAN on work currently being undertaken to create directory of VCFSE services.

  vi.  A review of implementation of the Living Better Lives in Lancashire Practice Model be undertaken at a future meeting of the committee.