Agenda item

To receive the report.

Mel Lock, Executive Director of Adult Social Care, presented on this topic. She highlighted the work Newton have done and that they are slowly decreasing the support they are providing, that the transformation is on track to deliver £10m savings and a minimum of £10m year on year savings with additional expected, that they have improved reablement services and supported people to become more independent and stay in their home longer, as well as support for young people in transition and the progression model. The results of the work were shown in the staff survey where staff now agree their work makes a difference to the life of people in Somerset.

During the discussion, the following points were raised and responded to:-

• If Newton have been working with our staff, how is it going to be impacted by redundancy programme?
  • We are having to make cuts to our staffing, we are also looking at technology that can aid us. We are looking at all sorts of ways to do this as the council goes through ‘rightsizing’ to balance our budget. We can’t say that there will be no impact, we will have to change.
• What steps are we taking to ensure the necessary corporate support from digital and IT teams are still in place? It’s clear this is delivering results.
  • We can’t discuss the wider council restructure today. Newton have a good tool around sustainability, they will not leave us until we are all at silver sustainability, some will be at gold. Newton will review every 3 months and if things aren’t working they will come back. This sustainability matrix is working well. We have been able to upskill other parts of the services and other parts of the council. Downsizing the organisation will inevitably have an impact.
• Pathway 1 – Discharge from hospitals – aware of issues from other councillors, and want to ensure that our staff is knowledgeable on what is up to patients and that they can go home.
  • This isn’t just about us in Adult Social Care – health staff are also involved in this. A multi-agency team prescribes to individuals. There needs to be a cultural shift and the hospitals are aware of this, Peter Lewis (CEO – NHS Somerset Foundation Trust) is working to help cultural change happen ward by ward.
• Is there anything we can do to pressure the Integrated Care Board (ICB) to do this properly?
  • We can do our best to influence but we can’t change behaviour. We have a joint post starting with us that will be linked with the hospital to look at this. Nowhere has cracked it totally, the whole system has recognised the need for behavioural change.
• Should we as a committee be writing to the ICB and central government to stress this point?
  • Yes, we will take that away.
• I would like to see examples of how this transformation is improving the lives of people in Somerset?
  • We do have many stories – once a month ASC puts out a newsletter with lots of positive stories about people and how people work.
• Do we have feedback on the reablement service from service users?
  • Yes, we do. We also have a case record audit system, which can provide feedback immediately and after 6 months has passed.
• Could we have a briefing paper on hospital discharge?
  • Not everybody can stay at home – everybody is an individual, and for some people home isn’t the right place or it is much more expensive. We offer families options.
  • Rather than an additional report, we would bring people from the team that works on hospital discharge to the committee.
• Some of these are rural issues, where what you can do in a town easily is more difficult and expensive in rural areas. Would welcome some thought on how this can be improved in rural areas.
• We have been having conversations about this for 3-5 years. How have Newton helped us with that?
  • Newton have allowed us the capacity and the skills. They brought new techniques and analysts to get a better understanding of us and helped us to look nationally. They have provided skill transfer and a different way of looking at things.
• Will there be a tipping point after people have stayed at home for a while? As their health needs become more complex, may need residential or nursing care.
  • What we know is about flow, flow in and flow out. We will always need nursing homes, but there are other models, like extra care housing. In five years’ time we will have different models of care. Demographic growth will be in the budget. The rates of people going into nursing care are static and the rate of people who die in our services and new people who need our services are roughly balanced.
• How will you keep the new way of working sustainable as new staff come in?
  • We are using a bottom up rather than a top down approach – it has become part of culture.

The Chair thanked officers for the presentation, summarised the actions, and the Committee noted the report.