Adult Social Care

John Jackson Director of Adult Social Services,

Oxfordshire County Council and Director of Strategy & Transformation, Oxfordshire Clinical Commissioning Group

2nd October 2014

Overview • Introduction

• Our strategy – including with NHS partners

• The challenge of demography

• What we currently offer

• Improving Adult Social Care

• The Care Act 2014

• Working with health

Introduction • Personal care is helping people get dressed, washed, going to

the toilet, eating and providing psychological support

• People must meet our eligibility criteria before they can receive services: their needs must be at least “substantial”. 86% of local authorities apply the same standard as us.

• Adult social care is not free – nearly everyone pays something

• Whilst we support relatively few people (just over 12,000) most older people will need personal care at some point in time (67% men; 85% women)

• People get a personal budget which allows them to choose how their care needs are met. In 2013/14, we were in the top quartile of authorities offering personal budgets and had the 4th highest use in the country of direct payments

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Our Strategy • Keeping people well through investment in prevention and

early intervention • Supporting people who provide care for their families,

friends and neighbours • To ensure people can live a life free from abuse and the

fear of abuse • Ensuring people have more choice and control over the way

they are supported • To develop long term support options that reduce the

number of people admitted to care homes • To create a market of good quality services that can be

used by everyone • To work ever closer with health given that we are providing

services to the same small group of people

Our joint strategy with the NHS to reduce the need for services

• Stop or reduce the number of people needing care - through services like reablement, providing equipment, information and advice

• Early intervention when people need care to reduce care needs – eliminating waiting lists, free or cheap universal

services (day services, assistive technology, dementia advisers, carers’ services), stopping people going into hospital and getting them home from hospital more quickly

• Range of alternatives to care homes – extra care housing;

housing options for people with dementia; modern attractive sheltered housing (rented and owner occupied); bed based respite care

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The challenge of demography • Increasing demand reflecting our ageing

population. Those aged over 85 will increase by 69% in Oxfordshire between 2011 and 2026

• There are also more younger adults with increased care needs

• Affects both the NHS and adult social care: increased pressures on GPs, ambulance services, accident and emergency and social care

What does adult social care offer?

• Prevention

• Recovering Independence

• Long term care

Prevention

• Information and advice

• Carers assessments and low-level support

• Assistive technology

• Equipment

Recovering Independence

• Rehabilitation: health professionals such as physiotherapists and speech and language therapists, work with individuals to help them regain physical and mental functions that they have lost due to an illness or injury

• Reablement is the provision of personal care by a care worker who also teaches the individual how to provide the care for themselves

• The objective is either for them to achieve full independence or to have more independence than they would have had without the input

Long term care

• Support and care at home

• Direct Payments – where the person gets money which they use to pay for their care which they have chosen

• Extra care housing/supported living – intensive support but the person is still able to live in their own home

• Care Homes

Ensuring Quality

• Targeted monitoring of service providers

• Quality and work with providers • Partnership with providers –Market position statements –Development of Oxfordshire

Association of Care Providers

Improving adult social care

• LEAN processes to improve the customer service and reduce costs

• Improved local working (with health) focusing on the needs of individuals

• Developing the adult social care workforce (again in partnership with health)

• Improving information and advice

• Introducing self-service so that people can assess their own needs and qualify for help

• “Trip adviser” for adult social care

What does the Care Act do?

• Brings together law on adult social care that has grown incrementally over the years

• Makes key changes to the way the care and support system works: promote people’s wellbeing, prevent and postpone needs for care and support; put people in control; support carers

• Introduces funding reform

• Aims to develop a person-centred, clearer and fairer system

Three parts, Part 1 on reforming care and support:

A shift in the care and support system

The Care Act Timescales

• Received Royal Assent on 14th May 2014

• Majority comes into effect (Part 1) April 2015, with funding reform (Part 2) in April 2016

• Draft guidance and regulations on Part 1 consulted on over the summer, with final regulations expected in October

• Part 2 (Funding Reform) draft guidance in November / December

Working with health

• 19% take up 62% of the time of GPs and 70% of the resources of hospitals

• Most of the people who need adult social care will be part of this group

• They don’t differentiate between health and social care

• They want seamless services from us

• What are we doing jointly in response?

Joint work with health

• Oxfordshire Health & Wellbeing Board bringing together local politicians and GPs

• Oxfordshire Health & Wellbeing Strategy based on the Joint Strategic Needs Assessment

• Joint strategies aimed at particular groups: those with mental health problems, adults with learning difficulties, frail older people, adults with physical disabilities, autism

• Pooling money between health and social care - £330m: the largest pooled budgets in England

• Joint posts to reflect our shared commitments • Commitment to integrated working