Agenda item

Ian Crabtree presented a report in response to questions about entry CR21 on the Quarter 4 Corporate Risk and Opportunity Register, which had been raised at the last Cabinet Committee meeting.  Papers in relation to the following were circulated to Committee Members:

• LCC Safeguarding Report for the quarter ending 31 March 2018 for the

Lancashire Adults Multi Agency Safeguarding Hub

• Delayed Transfers of Care Analysis – Lancashire February 2018

Details were provided to the Committee of the five broad approaches to managing excess or increasing demand across adult social care.

At the last Cabinet Committee meeting, concerns had been raised about the waiting times for assessments and reviews for safeguarding, hospital discharge and occupational therapy, and further information was provided to the Committee on these.

Safeguarding

In addition to the 28 social workers and four social care support officers, agreement to 6 agency staff (2 per area) being appointed was reached, on a temporary basis, to ensure elimination of backlogs and reduction in waiting times.  It was noted that there was no difficulty recruiting staff for the safeguarding teams. 

The criteria as to what was a safeguarding case, and what response was required, was made by the Multi Agency Safeguarding Hub.  Details were provided to the Committee on the following 4 priorities:

• Priority 1 - To be allocated immediately as an urgent response is required
• Priority 2 - To be allocated within 24 hours
• Priority 3 - To be allocated within a 2 week period
• Priority 4 - To be allocated within a  4 to 6 week period

Generally, the response times were showing major improvement over the last few months, due to improved management grip and the additional temporary staffing.  However, it should be noted that there were, at times, significant weekly fluctuations, due to routine staff absences and/or unusual surges of new referrals.

Hospital Discharge

The Committee noted that substantial additional resources from the Improved Better Care Fund and significant redesign of the system for managing hospital discharge had been underway for several months in Lancashire.  Overall, there had been a gradual but sustained improvement in reducing delayed transfers of care over the last 6 months, with some short periods where problems escalated, due to flu outbreaks or severe weather.  The Committee noted that Preston and Chorley accounted for 60% of the delays and that this needed to improve

A query was raised about working with registered social landlords where individuals due to be discharged required adaptations to their home.  It was confirmed that the County Council held the funds for Disabled Facilities Grants and administered the scheme.  However, it was for the District Councils to work with the social landlords to discuss the best use for the grant funding for individuals.  It was the county council's responsibility to ensure that discharge was not delayed and that the funds were spent on what aids/adaptations were required.  It was reported that interim arrangements could be put in place whilst any adaptation work was being completed.  Ian Crabtree would provide further information to the Committee on how the County Council worked with social landlords.

Occupational therapy

Over the last year, new posts had been established and recruited to, resulting in the occupational therapy workforce being doubled to 40 qualified Occupational Therapists.  In addition, there had been a further campaign aiming to recruit nine newly qualified therapists, which would enhance the career pathway for staff wishing to work for the local authority.  The Committee noted there had also been a major increase in posts of Social Care Support Officers working in this field.

Reablement

There was a lack of Occupational Therapists in the Reablement Service which was creating significant operational challenges.  The county council's guidance stated that all individuals in reablement should be seen within 72 hours.  Due to the current volume of referrals, and the speed of flow outstripping staffing capacity, initial visits were currently taking five to seven days to arrange across all localities.  .

Community - Equipment

It was reported that average waiting times had come down considerably for community occupational therapy assessments and that this trend continued to improve across the county.  However, improvements still needed to be made.  Referrals for community assessments were prioritised according to a decision making framework which meant that those in greatest need and risk were seen much more quickly, and a copy of the framework was set out at Appendix 'A' to the report.

Resolved:  That the Cabinet Committee note the mitigations in place for managing this Corporate Risk relating to Adult Services demand.