Putting People First Transforming Adult Social Care

Part I: TRANSFORMING ADULT SOCIAL CARE

INTRODUCTION

3. Social care is the wide range of services designed to support people to maintain their independence, enable them to play a fuller part in society, protect them in vulnerable situations and work with complex relationships. Advances in public health, healthcare and changes in society mean that people are living longer and as communities become more diverse, the challenges of supporting the increasing demand and diversity becomes more apparent.

4. People have higher expectations of what they need to meet their own particular circumstances, wanting greater control over their lives and the risks they take. They want dignity and respect to be at the heart of any interaction, so that they can access high-quality services and support closer to home at the right time, enabling them and their supporters to maintain or improve their wellbeing and independence rather than relying on intervention at the point of crisis. Social care cannot meet these challenges without radical change in how services are delivered.

5. In the longer term, the Department of Health (DH) is committed to publishing a Green Paper this year on reforming future Care and Support services in England. In the meantime, to address the challenges we face now and to make best use of resources available to us, Puffing People Firsf (2007) sets the direction for adult social care over the next 10 years and more.

6. Putting People Firsf confirms that reform can only be delivered through partnerships across central and local government and signals a sector-wide agreement on the direction of travel, and the commitment to delivering significant change by April 201 1. At its heart is a pledge to ensure that all public bodies work together towards a society that enables individuals to have maximum choice and control over their lives and values the contribution that all citizens can make, whether they need support from others now or in the future. This is reinforced in Lord Darzi's Next Stage Review (2008) which makes it clear that only through working in partnership, and focusing on people will the NHS and local government help improve peoples' health and wellbeing. It also underpins the implementation of other DH priorities such as the national carers' strategy5 , Valuing People NOW' and the Dementia strategy7.

7. The Government has recognised that to meet this goal, the system will need to undergo further significant redesign in process, practice and culture to ensure people have access to high quality information and advice, appropriate early interventions and can exercise choice and control over the services and support they need. It will also

High Quality Care for All- NHS Next Stage Review Final Report, pp 43, Depariment of Health, 2008 hti~:/iw.dh.qov.uWenipublicationsandstatisti~/~ublications/~ublications~olicvandquidance/DH 085825 ' Carers at the head of 21'' centow families and communities, HMG, 2008 hti~:liw.dh.aov.uk/eniPublicationsandstatistics/Publications/PublicationsPolicvAndGuidanceiDH 085345

Valuingpeople now: a new three-yearstrafegy forpeople with learning disabilities, DH, 2009 hti~://w.dh.qov.uk/en/PublicationsandstatisticsiPublicationslPublicationsPolicvAndGuidance/DH 093377 Living well with dementia: a National Dementia Strategy, DH, 2009

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require investment in training and support for the workforce to enable them to meet the challenges of this new way of working. To support this transformation the Social Care Reform Grant, worth £520 (£435 million (including E6m top slice) over the next two years, 2009110 and 2010111), has been made available for councils to invest in the necessary system and process development.

8. In the first year of the Grant, significant progress has been made by some councils. A number have developed new preventative services working with PCTs to target resources on those most at risk of high health or social care needs. Some councils now offer a self-directed support assessment to all new referrals, whilst others have developed stronaer universal information and advice services. The expectation is that this will accelerate and that all councils will show real progress towards the transformation of adult social care in 2009110.

9. This progress, as well as dissemination of best practice will be supported by the:

regional improvement and efficiency agencies appointment of the local government National Director of Social Care Transformation

= DH's Deputy Regional Directors for Social Care and Partnerships.

DELIVERING PUTTING PEOPLE FIRST

10.Over the last year, the Department of Health (DH) and its partners, at all levels, have been working together to start the process of transforming adult social care into a system capable of delivering support tailored to individuals and local populations.

11. Recognising the size of the challenge, all partners have been working collaboratively with those involved with social care, including people who use services, their carers and their organisations, to develop, produce and start to evaluate the programme of implementation work and support capacity building at a local level. As a starting point, the Association of Directors of Adult Social Services (ADASS) and the Local Government Association (LGA) will be conducting their own appraisal of current progress in relation to Putting People First during March 2009.

Transformation at a local level

12.This second year sees a very significant increase in the ring fenced Social Care Reform Grant, rising from f85million in 2008109 to fl95million in 2009110. With this, and through ensuring improved value for money, we are confident that each council should be able to make real and measurable progress to achieve the system changes necessary to achieve the outcomes of Puffing People First by March 201 1. Councils may wish to consider working with others, to combine resources and planning and use this as an opportunity to share learning and development.

13.The Appendix to Annex A of this document sets out the resources available for the year 2009110 for councils to undertake the ongoing redesign of systems, processes and transactions to transform delivery. The allocations are made on the basis of the Adult Social Care Relative Needs or mu la. The Grant will continue over the final year of the CSR07 settlement and indicative allocations for 201011 1 are included for planning purposes.

3 LAC (DH) (2009) 1

The Social Care Reform Grant

14.The DH is making available, through the Social Care Reform Grant, monies to support councils in this transformation. The Grant is additional to the monies provided through the Personal Social Services funding and is specifically for the range of process reengineering, capability and capacity building activities required to redesign the entire system. This will include work to:

(i) Change the social care system away from the often complex, bureaucratic traditional service provision towards a more straightfotward, flexible approach, which delivers the outcomes people want and need and promotes their independence, well-being and dignity.

(ii) Create a strategic shift in resources and culture from intervention at the point of crisis towards prevention and early intervention, focusing on promoting independence and improved wellbeing in line with the needs of the local population, reaching out to those at risk of poor outcomes.

(iii) Ensure that people and their organisations are much more involved in the design, commissioning and evaluation of services and how their needs are met. This choice and control should extend to individuals in every setting and at every stage; ranging from advocacy and advice services, prevention and self-management to complex situations where solutions are developed in partnership with professionals.

(iv) Remodel systems and processes so they are not only efficient and equitable but also recognise the ability of individuals to identify cost effective, personalised solutions through wider community networks and innovation.

(v) Join up services to provide easy to recognise access points, which coordinate or facilitate partner organisations to meet the needs of individuals. Systems should be put in place to identify hard to reach people and strategies developed to meet their needs.

(vi) Raise the skills of the workforce to deliver the new system, through strengthening commissioning capability, promoting new ways of working and new types of worker and remodelling the social care workforce.

(vii) Develop leadership at all levels of local government and communities to enable this change to happen.

15.ln practice, what this means is that by 201 1 all 152 councils will be expected to have made significant steps towards redesign and reshaping their adult social care services (in the light of their JSNAs), and have most of the core components outlined below in place:

An integrated approach to working with the NHS and wider local government partners. Moving to harness resources from across the whole system, with a strategic shift in the focus of care and support away from intervention at the point of crisis to a more holistic, pro-active and preventative model centred on improved well-being. This might include focus on specific outcomes such as hospital discharge, intermediate care, transition to adulthood and co-location of services.

LAC (DH) (2009) I

A commissioning strategy, which includes incentives to stimulate development of high quality services that treat people with dignity and maximise choice and control whilst balancing investment in prevention, early interventionlre-ablement and providing intensive care and support for those with high-level complex needs. Evidence of how councils might approach this is available in the DH homecare re- ablement work8. This should have the capacity to support thirdlprivate sector innovation, including social enterprise and where appropriate be undertaken jointly with the NHS and other statutory agencies such as the Learning and Skills Council.

Universal, joined-up information and advice available for individuals and carers, including those who self-assess and fund, which enables people to access information from all strategic partners. Councils could do this using the learning from the Partnership for Older People pilotsg and LinkAge Plus ~ro~rammes" . Links to advocacy and support services will need to be considered where individuals do not have a carer or in circumstances where they require support to articulate their needs andlor utilise the personal budget. Equally, this type of support may be necessary where there are potential conflicts of interest between the needs of the user and the family carer andlor other family members.

A framework for proportionate contact and social care needs assessment to deliver more effective, joined-up processes. Greater emphasis on (assisted) self- assessment, enabling social workers to undertake more appropriate assessments and spend more time on support, brokerage and advocacy to ensure users experience a 'no wrong door' service.

For people eligible to receive council-funded support:

o Person centred planning and self-directed support to become mainstream, with individuals having choice and control over how best to meet their needs, including through routine access to telecare.

o A simple, straightforward personal budget system, which will lead to maximum choice and control being in the hands of people who use services as well as support to increase the uptake of direct payments, where people choose to take their personal budget as cash. The Personalisation ~e fwork" provides a range of resources, tools and examples gathered from councils across the country.

= Mechanisms to actively involve family members and other carers as expert care partners, with appropriate training and practical support to enable carers to develop their skills and confidence.

An enabling framework to ensure people can exercise choice and control with accessible advocacy, peer support and brokerage systems with strong links to user led organisations. Where user led organisations do not exist, a strategy to foster, stimulate and develop these locally.

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LAC (DH) (2009) 1

An effective and established mechanism to enable people to make supported decisions built on appropriate safeguarding arrangements, eg risk boards and corporate approaches to supporting individual choice and risk management. Supported by a network of "champions", including volunteers and professionals, promoting dignity and respect in local care services for both service users and their carers.

Effective quality assurance and benchmarking arrangements. This will include active membership of the locallregional networks to support transformation to ensure access to the latest information, advice and support. Effective local information systems to capture inputsloutputs and outcomes for individuals to support local quality assurance.

16.Councils will also be expected to have started, either locally or in their regions, to develop:

A market development and stimulation strategy, either individually or on a wider regional basis with others, with actions identified to deliver the necessary changes. This may include a transformed community equipment service, consistent with the retail model.

A local care workforce with the capacity and capability to deliver choice and support individual control, with staff who are appropriately trained and empowered to be able to work with people to enable them to manage risks and resources and achieve high quality outcomes.

An approach that demonstrates an effective use of the available resources and meets the 3% efficiency targets.

17.ln the longer term, all 152 councils with adult social services responsibilities should take a balanced approach to prevention and early intervention and deliver personalised services, enabling individuals or groups to develop solutions that work for them. Key components should include:

Everyone eligible for statutory support should have a personal budget - a clear, up-front allocation of resources. The council or a third party may manage this on behalf of an individual. Alternatively, people may choose to take all or part of this budget as a direct payment, with access to appropriate support to enable real choice and control.

A strategic balance of investment between enablement, early intervention or prevention whilst ensuring suitable provision of intensive care and support for those with high-level complex needs.

Responding to the developing national approach, a move to wider information sharing through the common assessment framework.

An established mechanism to ensure that views and experiences of users, carers and other stakeholders are central to every aspect of the reform programme.

18. Councils will be expected to:

(i) work with regional consortia and improvement agencies to start to develop and identify local actions needed for service transformation.

S LAC (DH) (2009) 1

(ii) Engage with other partners, including disabled people and their organisations to ensure this priority contributes to and is properly represented in discussions on Local Area Agreements.

19.The DH will work with partners in Government and across the sector to develop and improve outcome-based indicators around all aspects of the transformation of adult social care.

Regional support

20.The establishment of regional Joint lmprovement Partnerships (JIPs) and the appointment of DH's Deputy Regional Directors for Social Care and Partnerships (DRDs) provide strong foundations to build on.

21.Though the role of the DRDs encompasses the breadth of DHs interests in the regions, they are responsible, in relation to transforming adult social care, for working with councils and their partners to ensure delivery of Puffing People First. In particular by:

Promoting social care transformation and preparing to take forward the new Green Paper on care and support when it is published this year.

= Leading DH relationships with the nine Regional Efficiency and lmprovement Partnerships (RIEPs) with regard to each regional JIP and other local partners to facilitate local activity and meet DH's aims for social care transformation.

Ensuring that strong links are maintained between the work of regional partners and national policy leads to ensure good communication of new developments.

= Working with councils and partners to support progress towards transformation and achieving key milestones and targets.

Working with councils and partners to measure progress towards better outcomes for people, as demonstrated by national indicators and Local Area Agreement targets.

Working with councils to achieve DH's adult social care Public Service Agreements (including those that are part of the cross-government PSAs), promoting action on achieving them, identifying drivers of performance and any blocks.

Ensuring the social care efficiency agenda is part of all planning for delivery of Putting People First as part of the regional JIP programme and is delivered alongside wider RlEP priorities.

22.The national programme, supported by the National Director and the DRDs, continues to work to integrate the JlPs in each region with the work and governance structures of the RIEPs, emphasising that system reform on this scale cannot be achieved by focusing solely on adult social care. At a regional level, the RIEPs will, through the JlPs, facilitate regional implementation and local activity, and provide local leadership. This will support the goals of our framework for the National lmprovement and Efficiency Strategy (NIES).

7 LAC (DH) (2009) 1

23.To support this regional facilitation role, in 2009110 DH will expect the DRDs to agree priorities for a f2million top-slice of the Social Care Reform Grant to be spent on regional improvement initiatives in consultation with the RIEP and JIP in their region.

24.This f2million will be in addition to existing resources in the system for implementation and improvement activity, to support a coherent regional strategy for transformation. It is anticipated that, taking account of local priorities, all councils in each region will be supported to ensure there is:

close working with DH's regional teams in each Government Office to align and join up policy delivery.

= dissemination of tools and technologies to support excellence in delivery and transformational change.

work to shape and develop local and regional markets with the capacity and the variety to offer the range of options that are accessible to both those entitled to public support and self-funders.

support for local leadership, for example through ADASSllDeA programmes on leadership academy, peer review and mentoring, for both elected members and senior managers.

facilitation of information exchange and improvement work, bringing together groups of councils and their partners where shared priorities have been identified.

an agreed strategy for the commissioning of specific regional support and facilitation to build workforce capacity and capability to:

o use the tools of personalisation (eg resource allocation systems) o make the strategic shift to prevention and early intervention o manage change through project management, business case

development and benefits realisation.

* a joined-up approach with the work of the DH efficiency programme which will also be working to align its support with the RIEPs.

support for councils in developing performance management systems to measure the outcome benefits for people and communities of personalisation, prevention and early intervention and cdllect other types of robust evidence, which can be used for performance assessment processes, to inform commissioning.

proactive identification of under performers to engage them in developing strategies and key areas for investment (eg change management) either individually or at a regional level.

At a National Level

25.The Local Government Association (LGA), the Association of Directors of Adult Social Services (ADASS) and the Improvement and Development Agency (IDeA) remain critical in delivering the outcomes for individuals, as are set out in Puffing People Firsf. Their unique position, in terms of raising awareness and engaging with local government leaders at all levels, is key in developing both strategic leadership and

8 LAC (DH) (2009) 1

leadership capacity and capability across councils. They continue to work together as a sector-led 'consortium' at national level to support the change agenda through the sharing of information across the regions, to maximise the learning from any local and regional investment.

26.Other partners including Social Care Institute for Excellence (SCIE), the inspectorate and the regional improvement agencies are also essential to delivering the changes set out in Puffing People First. To ensure this is a coherent and coordinated process, the DH has established a cross-sector Transforming Adult Social Care (TASC) Programme Board, chaired by the DH Director of Social Care Strategic Finance. This brings together the key stakeholders including representatives of a User Reference Group drawn from a wide range of individuals of all ages, to embed the experience of people who use services, carers and the wider population in every aspect of the work.

27. LAC (DH) (2008) 1 recognised the lead role local government needs to take in the change agenda. To facilitate this, the consortium has appointed a National Director for Social Care Transformation to lead their contribution to delivering Puffing People First. Jeff Jerome took up this appointment on lS' October 2008.

28.An additional f l m top-slice from the Social Care Reform Grant will be used in 2009110 to enable DH and the TASC Board to jointly commission and undertake activities at a national level to facilitate reform where they are best placed to do so. This includes:

Commissioning and developing key tools and technologies (including e-learning), which will be required by all councils.

= Facilitating a range of national mechanisms to support implementation, in particular the interface of policy and statutory issues and cross-government agenda.

Providing strategic advice, in particular on the key areas identified in Puffing People First to deliver social care transformation.

- Continuing to develop, with SCIE, a national information network supported by a good, and emerging, practice library to facilitate the roll out of the transformation agenda, including lessons learned.

Supporting the development of commissioning capability and capacity.

Supporting the provider market to meet the challenges of transformation.

Working with the regulator to ensure their roles and functions support the transformation agenda.

29.There are a number of programmes of work currently underway to address some of the anomalies which exist in the system including contributions to care and the review of eligibility criteria. These are outlined in the paragraphs below.

Contributions to care

30.The issue of charging, or collecting a personal financial contribution from the individual budget holder, was identified as a key issue during the Individual Budgets Pilot Programme in 2006107.

9 LAC (DH) (2009) 1

31. DH has undertaken a review of the Fairer Charging guidance in relation to personal budgets as part of the work to help local authorities transform their social care systems. A twelve-week national consultation on a proposed contributions system is due to end in rill^. The aim is to issue revised guidance to local authorities as soon as possible after the consultation ends. Local authorities will continue to have the option not to charge for any non-residential services if they so wish.

Fair Access to Care Services

32. In response to concerns about the tightening of eligibility criteria for social care, in January 2008 DH asked the Commission for Social Care Inspection to lead an independent review of eligibility criteria for access to social care services. We are now working with sector partners to consider the report's recommendation^'^. In particular, to ensure that the Fair Access to Care Services framework fully supports the aspirations of Putting People First and provides for fair, transparent and effective implementation of eligibility criteria.

MEASURING PROGRESS

33. Ultimately the measure of success will be, as set out in Putting People First, that everyone will be able to:

live independently stay healthy and recover quickly from illness exercise maximum control over their own life and, where appropriate the lives of their family members sustain a family unit which avoids children being required to take on inappropriate caring roles participate as active and equal citizens, both economically and socially have the best possible quality of life, irrespective of illness or disability and retain maximum dignity and respect.

34.The approach continues to focus on building the strengths and capacity of individual councils to make local decisions on priorities reflected though improvement targets in Local Area Agreements (LAAs). Councils will need to continue to work with health partners in their Local Strategic Partnerships to undertake Joint Strategic Needs Assessments (JSNAs), which will in turn be informed by, and support other needs assessments and plans (eg the Sustainable Community Strategy and local housing strategies). This reflects the shared responsibilities for health and wellbeing of citizens, families and communities as set out in the NHS Operating ~rarnework'~.

35.The success of this whole-system change is predicated on engagement with communities and their ownership of the agenda at a local level. The Public Service Agreements (PSAs), the Local Government National Indicator sett5 (NIS) and LAAs provide the incentives and framework to make local delivery a reality.

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36.Councils will be supported to make substantial progress on transforming their services over the next two years, with performance across health and social care measured against relevant indicators in the NIS (and any relevant LAA improvement targets). This information will inform the Care Quality Commission's assessments of PCTs and councils across health and adult social care which in turn contribute to the Comprehensive Area Assessment (cAA)'~. The prize is huge, transforming the areas in which we live, the lives of our citizens and creating self-improving public services, which can provide personalised support to all.

37. In addition to the existing performance and information mechanisms, there are two significant areas being co-produced by the DH and partners in 2009110. These are:

(i) building on the lessons learnt from the current National Indicator Set and the first round of the Local Area Agreements (LAAs), we are working to improve the adult social care indicators for future spending cycles. These indicators are likely to form part of the evidence base for both future assessments by the Inspectorates and the foundation for the next round of LAAs. DH is now taking initial development work forward in partnership with ADASS regional networks, JlPs and other local sector stakeholders and as part of a wider government review of the indicator set for the next CSR period.

(ii) a new Improving Social Care Information work programme to enhance and develop the use of information held locally and support delivery of Puffing People First. This strategic programme aims to respond to the specific needs of different parties in the system, whether those of service users planning their own support or councils sharing benchmarking information. It will combine technical and policy solutions to change the way information is collected, held and used by councils.

Amongst other things, this will incorporate work to provide public-facing information resources on social care, and to develop whole-systems approaches to information sharing between local councils and with the NHS and DH. The development and use of data standards, starting with the roll-out of the NHS Number in adult social care, will be an important factor in enhancing the way information is used. This work is led by the newly established Strategic information Programme Board, led by the Director for Leadership and Performance.

OPPORTUNITIES AND CHALLENGES

38.There are a range of opportunities to make connections with the wider policy arena and to ensure that the principles and concepts set out in Puffing People Firsf are supported, these are summarised below. There are also a number of challenges, in particular workforce development and resources, faced by local authorities, at regional and national levels. Current work on addressing these issues is set out here, with information on what action is being taken to address them.

Personal health budgets

39. Lord Darzi announced in High Qualify Care for all that in 2009 the DH would start piloting personal health budgets, as a way of giving people greater control over the

11 LAC (DH) (2009) 1

services they receive and the providers from which they receive services. The pilots 17.18 will draw on the experience in social care and will run for three years, supported by

a learning community and a robust evaluation.

40.Some ways to deliver personal health budgets, including notional budgets and real budgets held by a third party, for example by setting up an Independent User Trust, are already possible. To enable pilot sites to test the possibility of direct payments for healthcare, we have introduced proposals in the current Health Bill. There is significant potential for people to benefit from personal health budgets - not least that it could help the integration of health and social care - but there will be challenges in making it effective. We have published a first steps document inviting expressions of interest in piloting1g. We will be looking for evidence of genuine partnership with local authorities when assessing pilot proposals.

Integrated care pilots

41 .Following the publication of the integrated care pilot programme prospectus in October 2008, over 100 initial applications were received. Thirty seven have reached the final stage of the selection process for the integrated care pilot programme, focusing on clinically-led change and improved outcomes for patients and clients.

42.Of those short-listed, almost two thirds explicitly propose partnerships with social care, as well as secondary care, the voluntary and private sectors. Further information on the integrated pilot programme, including a list of short-listed bids are available on the integrated care website''.

Welfare Reform White Paper

43.The Welfare Reform White Paper, Raising expectations and increasing support. reforming welfare for the future was published on 10 December 2008. It announced the government's intention to introduce legislation to give disabled people a right to control certain public funds spent on their support. This right will be tested in a small number of trailblazing public authority areas from 2010'~.

New Opportunities White Paper

44. Published on 13 January, the New Opportunities: fair chances for the future White pape?' indicates the Government's intention to publish a new cross-government strategy focused on helping people with moderate to severe learning disabilities to access employment opportunities. This will be facilitated by the introduction of 'support brokers' into existing pilot programmes to help the people they work with use their social care personal budgets, alongside appropriate disability employment funding.

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45.The NOWP also included a commitment to encourage the use of personal budgets to fund employment support for those with severe mental health problems and reiterated the commitment to publish a mental health and employment strategy in spring 2009.

Transition Support Programme

46.As part of the joint DHlDepartment for Children, Schools and Families Aiming High for Disabled Children programme23 we are seeking to transform services for families of disabled children and young people. A key part of the programme is to improve the transition of disabled young people into adulthood and the National Transition Support Team is working with local authority children's services and PCTs to improve joint working with adult social services. The principles of choice, control and independence are as important for disabled young people as they are for adults. The reforms provide an opportunity to move to a system where support is based on the needs of individual young people and their families, rather than on organisational boundaries.

Resources

47. Personalisation must be delivered in a cost effective way, this is even more important in the current economic climate. It is vital that councils recognise that personalisation, early intervention and efficiency need to be strongly aligned in the future. Effectively delivered personalised systems can be a route to efficient use of resources, offering people a way to identify their own priorities, and co-design and focus the support they need.

48. The Pre-Budget Report in December 2008 set out a challenging economic and fiscal outlook. Public Sector spending is forecast to slow to 1.1% real growth from 201 1. Councils will need to plan to meet their increasing pressures within this envelope. The additional monies from the Social Care Reform Grant should assist councils in preparing for the future. They should make investments in areas which will deliver transformation and build services that are cost effective and efficient.

49.The monies from the Social Care Reform Grant must be used to support this purpose. For some Councils there may be a temptation when resources appear to be tight to use this additional resource to help meet current priorities. The money has been allocated by the Treasury specifically for the purpose of delivering the transformation required. Failure to use the resources available to drive this transformation is not acceptable and the Grant monies may have to be paid back if this happens.

Workforce

50.The vision for a personalised approach to adult social care has huge implications for the workforce of the futurez4. It is clear that given population and workforce demographics as well as rising expectations of people who use services, the current and future workforce need to change radically to meet the challenges it will face.

51. In June 2008, the Department of Health, in partnership with key stakeholders, published an interim statement on the workforce strategy development, Puffing People First - Working to Make it Happen. The report mapped the enablers in Putting People First and identified the key priority areas for workforce as:

23 Details on the Aiming High for Disabled Children programme are at: w.even/childmatters.qov.uklahdc '' independence, weiibeing and choice: Our vision forthe future of social care foraduits in England, Department of Health, 2005 13 LAC (DH) (2009) 1

Leadership , Management and Commissioning Skills; Workforce Development; Recruitment, Retention and Career Pathways; Remodelling the Workforce; Regulation of the Workforce (Quality Improvement) and Integrated and Joint Cross-Sector Working.

52.The role of the Director of Adult Social Services will be key to planning services and ensuring commissioning strategies reflect and recognise the contributions of all service providers.

53.The Adult Social Care Workforce Strategy will be published in the spring, building on the earlier interim statement. Additionally, the National Skills Academy for Social Care is developing programmes across the workforce aimed at improving skills in the key areas (highlighted in the interim statement) of leadership, management and commissioning as well as the broader task of workforce develop~ent, for example developing a social care training scheme.

Cancellation of this circular

54.This circular should be cancelled on 1" April 2010.

Enquiries

55.Any queries about this document should be addressed to Helen Tomkys, Department of Health, Social Care Policy and Innovation Team, Wellington House, 133-155 Waterloo Road, London SE1 8UG. You can email: Helen.Tomkvs@dh.~si.gov.uk

56.This Circular may be freely reproduced and, in addition to other information on social care policy, can be found at http://www.dh.qov.u klen/SociaICare/Socialcarereform/Personalisation/index. htm

57.Current circulars are now listed on the Department of Health website on the internet at: http://ww.dh.~ov.uk/lac O Crown copyright 2009.

LAC (DH) (2009) 1

ANNEX A: DETERMINATION UNDER SECTION 31 OF THE LOCAL GOVERNMENT ACT 2003 OF THE SOCIAL CARE REFORM GRANT FOR 20091201 0

Introduction

1. This Determination is made by the Secretary of State for Health ("the Secretary of State") under section 31 of the Local Government Act 2003'~ ("the 2003 Act"). It specifies grants that the Secretary of State proposes to pay to certain local authorities in England.

2. Before making this Determination, the Secretary of State obtained the consent of the Treasury in accordance with section 31 (6) of the 2003 Act.

Amounts payable to authorities

3. Pursuant to section 31 (3) of the Act the Secretary of State hereby determines that the local authorities to which grants are to be paid, and the amount of each grant, are the local authorities listed in column 1 of the Appendix and the corresponding amounts set out in column 2 of that Appendix. The indicative allocations for 2010/11 are included for planning purposes only in column 3 of the Appendix.

Definitions

4. In this determination:

(a) "Capital expenditure" has the same meaning as specified in section 16(1) of the 2003 Act.

(b) "Financial year" means a period of twelve months ending with 31st March.

Purpose o f the grant

5. Pursuant to section 31 of the 2003 Act, the Secretary of State hereby determines that the grants shall be paid towards revenue or capital expenditure incurred or to be incurred by local authorities in the financial year 2009/2010 for the purpose of social care modernisation and reform, as described in paragraphs 14-18 of LAC (DH) (2009) 1 attached to this determination.

Payment

6. The grants shall be payable to local authorities in one instalment on or before 30th April 2009.

Grant conditions

7. Local authorities must be able to identify expenditure against the grant monies for the purposes set out in paragraphs 14 -18 of LAC (DH) (2009) 1 (attached to this determination) if required by the Secretary of State to do so. Apart from this, there are no specific audit requirements for the grant.

LAC (DH) (2009) 1

8. However, subject to paragraph 8, the Secretary of State may request the repayment of the whole or any part of the grant monies (less any monies carried over in accordance with paragraph 8), to the extent that they are not used for the purposes for which they are given, as set out in paragraphs 14 -18 of LAC (DH) (2009) 1.

9. Local authorities may carry monies over to the financial year 2010/11 if they are reasonably of the view that there are compelling business reasons to do so, but only for the purposes for which the grant is made.

Signed by authority of the Secretary of State 3 March 2009

LAC (DH) (2009) 1

Appendix

Local Authority Social Care Reform Grant ( £ 4

2009-10 2010-11

Principal Metropolitan Cities 15.367 18.823 Other Metropolitan Districts 32.670 40.218 Metropolitan Sub Total 48.037 59.041

Inner London Outer London London Sub total

Shire Counties 79.231 98.300 Shire Unitary Authorities 35.022 43.226 Shire sub total 114.254 141.526

England Total 192.000 237.000

LAC (DH) (2009) 1

Local Authority

Principal Mefropolifan Cities

Birmingham Leeds Liverpool Manchester Newcastle upon Tyne Sheffield

Sub-Total

Other Metropolitan Districts

Barnsley Bolton Bradford Buly Calderdale Covently Doncaster Dudley Gateshead Kirklees Knowsley North Tyneside Oldham Rochdale Rotherham Salford Sandwell Sefton Solihull South Tyneside St Helens Stockport Sunderland Tameside Trafford Wakefield Walsall Wigan Wirral Wolverhampton

Sub-Total

Metropolitan Sub-total

Social Care Reform Grant (Em)

2009-10 2010-11

LAC (DH) (2009) 1

Local Authority

Inner London

City of London Camden Greenwich Hackney Hammersmith and Fulham lslington Kensington and Chelsea Lambeth Lewisham Southwark Tower Hamlets Wandsworth Westminster

Sub-total

Oufer London

Barking and Dagenham Barnet Bexley Brent Bromley Croydon Ealing Enfield Haringey Harrow Havering Hillingdon Hounslow Kingston upon Thames Merton Newham Redbridge Richmond upon Thames Sutton Waltham Forest

Sub-total

London Sub-total

Social Care Reform Grant (Em)

2009-10 2010-11

LAC (DH) (2009) 1

Local Authority

Shire Counties

Buckinghamshire Cambridgeshire Cornwall Cumbria Derbyshire Devon Dorset Durham East Sussex Essex Gloucestershire Hampshire Hertfordshire Kent Lancashire Leicestershire Lincolnshire Norfolk North Yorkshire Northamptonshire Northumberland Nottinghamshire Oxfordshire Shropshire Somerset Staffordshire Suffolk Surrey Warwickshire West Sussex Wiltshire Worcestershire

Sub-total

Social Care Reform Grant (f m)

2009-10 2010-11

M C (DH) (2009) 1

Local Authority

Shire Unitary Authorities

Bath & North East Somerset0.677 Bedford Blackburn with Darwen Blackpool Bournemouth Bracknel Forest Brighton & Hove Bristol Central Bedfordshire Cheshire East Cheshire West and Chester Darlington Derby East Riding of Yorkshire Halton Hartlepool Herefordshire Isle of Wight Council Isles of Scilly Kingston upon Hull Leicester Luton Medway Middlesbrough Milton Keynes North East Lincolnshire North Lincolnshire North Somerset Nottingham

Social Care Reform Grant (Em)

2009-10 2010-11

LAC (DH) (2009) 1

Local Authority

Shire Unitary Authorities

Peterborough Plymouth Poole Portsmouth Reading Redcar and Cleveland Rutland Slough South Gloucestershire Southampton Southend-on-Sea Stockton-on-Tees Stoke-on-Trent Swindon Telford and The Wrekin Thurrock Torbay Warrington West Berkshire Windsor and Maidenhead Wokingham York

Sub -total

Shires Sub-total

Social Care Reform Grant (Em)

2009-1 0 2010-11

LAC (DH) (2009) 1

Putting People First Transforming Adult Social Care

Not only do these early interventions make sure For example, they can make their own plans for people can stay in their own homes for as long services with the money from the council. They as they want, but are also the best way of can also get together with friends to make the keeping the costs down in the future. plans together, or they can ask an a ~ e n t or the . -

Louncil to arrange things for them. They must Success would mean people were to show that the money they have been given is get the right exercise and equipment following a making the difference it was supposed to make fall so they would not have to go into hospital, (the agreed outcomes). and could stay at home without significant risk of falling again. klternatively, thr~u~keffect ive use Success would mean people in the commun~ty f telecare people with dementia are routinely who need support and their families a ble to stay at home with their families, who are feeling empowered to come up with f e - , ble to continue their everyday lives. solutions to meet their needs, individually o

collectively. They would understand what is third part of Putfing People First is about available and be confident the services availa

self-directed support. This means having to buy were suitable, safe and reliable. P services available to meet people's needs rather feel they have a life rather than a set of than people having to fit in with the things on offer. People who need support should be able The fourth part of Puffing People Firsf is ab to choose'who orovides t h i t suooort. and how socieg works to m'ke su're evervone has the

the Make ~t Easy Group - Wawlckshrre, October 2008.

66

ITEM NO: 31.02

Wokingham Borough Council's Officer response to the

'REPORT OF THE COUNCIL'S SERVICE DEVELOPMENT OVERVIEW AND SCRUTINY PANEL ON THE IMPLEMENTATION OF PUTTING PEOPLE FIRST AND RECOMMENDATIONS'

Date of report 24 June 2009

Date of Response 14 July 2009

Response Authors - Stuart Rowbotham (General Manager, Community Care & Housing) and Matthew Pope (Putting People First Project Manager)

The Council's Community Care Service is pleased to accept the general outcome and content of the above report. we would like to thank the panel for its effort and attention to what is an important and complex subject. The service will be happy to report back to the panel in January 2010 as recommended by the Overview and Scrutiny Management Committee on 15 June 2009.

Officers to cover the following areas as part of their report back to the Panel in January 201 0, (Recommendation 8 of the report) :

0 the effect of Self Directed Support on the voluntary sector particularly with regard to any evidence that voluntary organisations were prepared to provide social care services o r offer brokerage;

e data on the number of organisations offering brokerage services as of January 201 0;

0 high level financial data setting out actual versus budgeted costs to date o f the role out o f Self Directed Support to specific social care groups;

e Information to provide assurance that vulnerable people are continuing to receive appropriate support as a result of exercising choice.

In addition to the above the Council's Community Care Service would like to make more detailed comments below on the recommendations made in the report.

Recommendations

1 That the implementafion and development of self directed support as part of Puffing People First should continue within Wokingham Borough, but on a phased basis and following further piloting.

Reason: Given the potential risks to the Council and service users it is essenfial fhaf these risks are taken account of and caution exercised so that any lessons learnt can taken on board prior to the full implementation of self directed support across all uses groups.

Response

We are pleased that the panel and committee endorse the continued implementation of self directed support in Wokingham and the benefits that this is and will bring to its residents. We generally agree with phased approach and the current work programme already facilitates this. Targets for numbers of people receiving self directed support are described as a percentage of those people receiving community based social care support (performance indicator NI 130). They are 15% Sept 2009, 25% March 2010 and 50% March 2011. As of the date of this report we are at 12%. We have feedback mechanisms in place from all of the projects major stakeholders and will review our approach in light of this.

2) That robust monitoring and safeguarding procedures be put in place to protect services users and ensure qualify of oufcome.

Reason: The welcome increase in choice and flexibilify that self directed support has the potential to provide, comes with the disadvantage fhat if will be harder for the Council to monitor the qualify of provision in a fragmenfed market, rather than through the provision of traditionally based care arrangements. This is fundamental given the Council's statutory responsibilifies.

Response

Agree with the above and that this is important. We reassure the panel that current monitoring and safeguarding procedures will be adhered to. It is important to remember that this is a long term change programme and that all current safeguarding measures remain in place for all the people we support and in our recent CSCl inspection in June 2008 we

were rated as 'good' in this respect. It is true though that as more people use self directed support we will need to modify and develop our safeguarding and monitoring approaches. An initial revision to our procedures and practices will be completed by Dec 2009.

3) That robust financial procedures are put in place to monitor the financial aspects of the move to self directed suppott and individual budgets including brokerage cosfs, administration and safeguarding cosfs.

Reason: Monitoring of all processes is key, so as to ensure that as self direcfed support is implemented, the underlying assumptions made regarding cost effectiveness are delivered in practice and that any problems can be identified in good time.

Response

Agree that this is important. It is important to note that individuals can only directly receive cash for their support via our current Direct Payments framework so are subject to the monitoring that this brings. The other choice is that we at the council hold the budget on their behalf or a mix of the two. The third option is that we pay to a third party. This route is still in development and will be piloted soon, then reviewed. Reassurance can be given though that a prudent but flexible and proportionate approach will be taken to financial monitoring. The total costs of the new system approach will be analysed in a financial modelling exercise that will be undertaken this financial year as take up for self directed support increases.

4) That the level of funding allocafed as part of an individual assessment should be sufficient to cover needs, but not so much as to encourage wastage by paying too much for services.

Reason: It is essential that procedures and processes are developed to ensure that service users can achieve value for money on the funds allocafed to them and that the Council does not allocate more than is needed.

Response

Again agree that this is important. The method that we use to allocate funding against need is called a resource allocation process. This consists of a community care assessment confirming FACS eligibility and a self assessment questionnaire, as part of a resource allocation tool, which gives us a benchmarked allocation of funds against need. This information is then considered at a management forum where a moderated decision is taken as to an allocation of money. Part of this process considers what is enough to meet need (our duty of care) but not so much as to be wasteful. Once the person is informed of this decision then a support plan must be drawn up detailing how this money is to be spent. At this point the council is able to have a further check before sign off and release of funds. Crucially however, the

funding allocation does not of itself discharge our duty of care - we are duty bound to ensure arrangements are in place to meet critical need regardless of cost. We will have safeguards in place to verify that the personal budget allocation is sufficient to fund the support plan, or we will step in to make the necessary arrangements. It should be noted that this has not been necessary to date.

5). That as a priority, the Council continues to do all within its power to stimulate and encourage a social care market based upon individual self directed support, both at local and national level. Locally where the Council can have the greatest impact, but also through national organisafions where those organisafions might potentially provide services to services users.

Reason: This is fundamental given that the aspiration of greater choice for individual services users can only become a reality if there are enough small and medium sized organisafions offering services.

Response

Agreed, i f the market is not offering the services in a way that people want it would be impossible for individuals to exercise choice and control. The ultimate aim of the programme is that the residents of Wokingham who receive social care support and their families will drive the market. The council will take a new role in supporting the development of this market. As we roll out self-directed support we will gather intelligence as to the type of support that people want and ensure that these supports are available. We have begun this work already by

Talking to our current providers about the changes they will need to make

0 Launching a 'Micro-enterprise' scheme which will deliver 5 new small providers this financial year and a support service to them Launching a new signposting service which will manage an information service so that people can find out what is available

6) That consideration should be given to the establishment by the Council of a voluntary accreditation system for brokerage services and service providers.

Reason: If is not intended fhat this would amount to a recommendation for particular providers on the behalf of the Council or fhat there would be any prohibition on individual service users opting to a use a broker or service provider not on the accredited list as this would be contrary to the principle of choice. In the Panel's view, the Council, in encouraging a system of self directed support does have a moral responsibility to provide service users with information and should go as far as possible in reassuring service users that those they might purchase services from operate to approved standards.

Currently we manage brokerage services that are external to the council via contract and therefore will have made appropriate checks on these

organisations. Service providers are currently regulated by the Care Quality Commission, where they provide registerable services, so as a council we would not seek to replace or duplicate this. However, as take up of self-directed support increases and people exercise choice by using less traditional services we will need to support them to make informed choices about services. To this end we will develop a customer guide to understanding how to select safe and effective supports and we will give consideration to a voluntary accreditation scheme. We will need to be sure that this is voluntary and has proportionate regulation so as not to be counter intuitive to choice and market development.

7) Thaf sufficient contingency provision is given to allow for additional costs to the Council in the event of a breakdown in an individual's support plan.

Reason: With any sysfem there is an element of risk of things going wrong and fhe Council needs to plan for this. The Panel does not wish to be proscriptive in how this might be achieved, but felt fhaf a contingency could be held through a central budget, as an elemenf of the individual's budget or through insurance provision.

We will ensure that funds for emergency or crisis intervention are included in the financial modelling exercise referred to in the responses to recommendations 3 and 4. We will give consideration to a separately identified contingency fund

8) Thaf fhe Overview and Scrutiny Management Commiffee delegate ongoing monitoring of Puffing People First fo the Service Development Panel and fhaf Officers be asked fo report back fo the Panel in January 2010.

Reason: Throughout the review, the Panel was aware thaf the Council along wifh ofher local authorities across the country was af fhe very beginning of a process of reform for social care provision fhat will fake decades to achieve. Given the uncertainfies around the development of self direcfed support, the Panel felt fhaf regular monitoring was necessary.

We agree to this and will report back as detailed at the beginning of this response.

ITEM NO: 31 .OO

REPORT OF THE COUNCIL'S SERVICE DEVELOPMENT OVERVIEW AND SCRUTINY

PANEL ON THE IMPLEMENTATION OF PUTTING PEOPLE FIRST

Panel Members:

Chairman Councillor Tim Holton Vice-Chairman Councillor Gerald A Cockroft Councillor Abdul Loyes Councillor Malcolm Storry Councillor Claire Stretton

Section 1

Section 2

Section 3

Section 4

Section 5

Appendix 1

Appendix 2

Appendix 3

CONTENTS

Introduction

Background

Information Gathering

Conclusion

Recommendations

Review Terms of Reference

Glossary of Terms

List of Witnesses Interviewed

Page 3

Page 3

Page 4

Page 12

Page 13

Page 15

Page 18

Page 20

REVIEW OF THE PUTTING PEOPLE FIRST INITIATIVE

Report by the Service Development Overview and Scrutiny Panel

Introduction

3.1 At its meeting on 18 November 2008 the Overview and Scrutiny Management Committee requested that the Service Development Overview and Scrutiny Panel consider a review of the role of the VoluntaryIThird Sector. Following the request the Panel received a presentation by Stuart Rowbotham, Interim General Manager Community Care, on the implementation of the Putting People First initiative within the Borough at its meeting on 5 January 2009.

1.2 After receiving the presentation the Panel discussed the initiative and agreed there were a number of matters Members wanted to explore further and that a full scrutiny review of the Putting People First Initiative was warranted.

1.3 At its meeting on 16 March 2009, the Overview and Scrutiny Management Committee authorised the Service Development Overview and Scrutiny Panel to undertake the review and agreed the review's terms of reference. A copy of this document can be found in Appendix A. The key objectives of the review were:

a) To find out as much as possible about the initiative and its implications for service users;

b) To look at what other local authorities are doing in this area, relevant Government advice and examples of best practice.

Background

2.1 Putting People First - what is it?

Putting People First was an agreement signed in 2007 between the Government, the Local Government Association and other key organisations setting out an intended direction of travel for adult social care over a ten year period. Building upon the 2006 White Paper 'Our Heath, Our Care, Our Say', the agreement aimed to establish a set of shared values that would act as a guide for the transformation of adult care services. A key concept is that people's experiences of local support and services would be improved by putting in place a personalised approach to the delivery of the adult social care.

2.2 The principles set out within Putting People First are underpinned by four key themes':

a) Access to universal services such as transport, leisure and education as well as information, advice and advocacy - planning for these to consider the implications for disabled and older people;

' Taken from 'Social Care Transformation: Elected Member Briefing' IDeA 2009

b) Prevention and early intervention - helping people early enough or in the right way, so that they can stay healthy and recover quickly from illness;

c) Choice and control - People who need support can design it themselves, understanding quickly how much money is available to fund the support, have a choice about how they receive the support and who manages it;

d) Social Capital - making sure that everyone has the opportunity to be part of the community and experience the friendships and care that can come from families, friends and neighbours.

2.5 The Panel's terms of reference focused upon the practical implementation of the choice and control aspects of the Putting People First Agenda through the move to greater self directed support. Therefore the other themes of Putting People First have not been covered in great detail although the Panel was conscious throughout the review of the close linkages and relationships between the themes.

2.6 Every effort has been made within the report to use plain English and reduce the use of acronyms and technical language. However, a glossary of terms referred to within the report is included as Appendix 2.

Information Gathering

3.1 The Panel met on 19 March 2009 to consider background information on Putting People First and self directed support supplied by Officers and to interview a number of service users in order to seek their views. Members were provided with the following information as part of the Agenda which was considered:

Putting People First - Transforming Adult Social Care - briefing paper published by the Department of Health setting out the four areas of the Putting People First Concordant; Social Care Transformation - Implementing the Putting People First Concordant - report to the Council's Executive dated 27 March 2009 which set out details of the social transformation process and asked for authorisation that the project be treated as a major piece of work; Putting People First Newsletters -copies of various newsletters to Council social care staff regarding social care transformation and Putting People First.

3.2 Phillip Pearce, a service user with learning disabilities attended the meeting and went into detail regarding his experiences of the social care system both before and after he had been asked to take part in the pilot of self directed support and brokerage services. The Panel was informed that Phillip had spent the majority of his life in residential care, but at the end of his stay had decided that he wished to move back to the Wokingham area. Phillip had been supported in taking his own decision's regarding his future care by an external care broker, contracted by the Council as part of the pilot of brokerage services. The broker had supported Phillip in helping him to live as independently as possible including helping with finding a shared flat, employment, selecting a care worker and further education.

3.3 It was explained to the Panel that prior to the implementation of Putting People First; Phillip would not have had the same degree of control or choice over the care options available to him which he now had as a result of an individual budget being allocated to him Phillip commented that he had found the principle of being involved very rewarding.

3.4 Tim Holland, Manager Director of Support Horizons and Alice Richmond, a social support broker employed by Support Horizons, attended the meeting in order to provide the Panel with general information of the role of brokers and specific information on the role of Support Horizons in providing brokerage services.

3.5 Tim Holland explained that Support Horizons was a community owned social enterprise company and as such traded on a not for private profit basis. The main area of the company's business was in the provision of trained and vetted temporary workers to the social care sector, but following a tendering process, the company had won the contract for the piloted provision of brokerage services to service users with learning disabilities. Two brokers had been trained and employed for this purpose.

3.6 The Panel was informed that once an individual had been assessed as eligible for services from the Council and the individual's care manager had agreed a personal or individual budget to organise that support, they would be referred to the Support Horizons brokerage service. However, the choice of whether to use a broker was the individual's and it was possible to opt not to use a broker.

3.7 If the individual did opt to use the brokerage service, the role of the broker was to help the individual service userplan and organised any support they needed to be independent. The role was to ensure that the service user was fully involved, and in control throughout the process of choosing a care package and its delivery. Part of the role included trying to ensure that any agreed services offered the best value for money. A broker did not necessarily have to coordinate all of the support a person needs, but only the aspects the person said that they needed support with. Tim Holland commented that the aim was to think creatively in order to get the best possible outcome for the service user.

3.8 It was stressed that the role of broker did not replace that of the individual's care manager, who retained on behalf of the Council the statutory responsibility for an individual's care and who would still be involved in many day to day issues.

3.9 The Panel was informed that the development of brokerage services was ground breaking with early indications of success for service users in terms of improved outcomes, and savings to the Council. However, the pilot so far had related to service users from the learning disabilities spectrum and there would be different challenges as self directed support was taken up by a larger group of service users. For instance, service uses with a single physical disability might require no or only very limited assistance in organising their support provision whereas other groups would need a high degree of guidance and assitance in managing their support, including the use of a broker.

3.10 The Panel was concerned that there was not enough small to medium sized service providers within the social care market to make choice for individual service users a realistic prospect. The Panel was informed that the market for individually based service providers was very small and there were only a small number of organisations capable of competing to

deliver services to individual service users. However, the Council was doing all it could to develop and stimulate the market.

3.1 1 A change of culture was also required within existing larger service providers who although very experienced in providing social care staff, were not used to having direct contact with individual services users. The Panel was informed that in Phillip's case, the two service providers approached regarding the supply of care to him had been unprepared for the eventuality of being personally interviewed by Philip.

3.12. Members of the Panel expressed some concern that the time and resources spent by service providers in developing and marketing their services might result in an increase in fees for individual service users.

3.13 The Panel was informed that a characteristic of the current system of centrally planned and organised provision of social care services was that in many cases individuals did not come to the attention of social services as needing support until a point of crisis had been reached. The level and cost of intervention required to rectify a person's needs in response to an emergency situation was significant and it was expected that if support for an individual could be provided at an earlier point, and as part of a planned care plan, costs would reduce.

3.14 Members of the Panel were very concerned about arrangements for the safeguarding of the individual and ensuring that public funds allocated to personal or individual budgets were spent in the best way. The Panel was informed that individual service users would receive their budgets on a phased payment schedule to minimise the potential financial risk of budgets being spent inappropriately. In addition, the Council would be able review arrangements if it was felt that they did not meet the needs of the individual. However, there was a need to balance measures designed to ensure proper safeguarding with the key direction of self directed support - that the individual needed to able to make real decisions on the care provided to them.

3.15 The Panel was informed that in order for individuals to be able to purchase services, potential service providers, (be they from the Council, private or voluntary sectors), had to provide charges based upon unit costs rather than on an aggregate basis. This would require a different way of working and changes in thinking. As a Council, Wokingham had already started the process of indentifying unit costs for the social care services it provided, and as such was further forward in developing the necessary processes to create a market for the provision of social care services than many other local authorities. This was important given that an individual would in future be able to buy their care from a number of providers and would not be limited to buying provision from their home Council.

3.16 The Panel met again on the 6 April 2009 to continue to seek the views of a wider group of service users, carers and Council Officers. Members were provided with the following information together with the Agenda for the meeting:

0 Details of national performance indicator N130 which from 200912010 would directly measure level of service users in receipt of self directed support as a percentage of service users receiving social care services;

Paper from the Association of Directors of Adult Social Services setting out a suggested framework for adult social care services that local authorities could use to ensure vulnerable adults remained safeguard as self direct support was implemented across the country; Details of a workshop hosted by the Council set up to consider the building in of safeguards into the Putting People First process;

e A draft paper on possible Brokerage Options for the Council; e Background information on the Council's current contract with Support Horizons for

the piloted delivery of brokerage services and number of referrals and services users using Support Horizons;

r Project brief on the development and support of smaller social care enterprises;

3.17 Mr. Brian Leeminq attended the meeting and provided the Panel with an account of his experiences of the social care system as a carer for his wife. He explained that his wife's needs had increased progressively over a 40 year period and that in 2006 he had been offered the opportunity of receiving a direct financial payment to cover the costs of his wife's social care needs. The service provider he used invoiced him directly and he paid the invoices direct from a bank account set up specifically for this purpose.

3.18 Rather than simply being informed who his wife's carer would be as would have been the case under a traditionally based care package, he had been supported by the Council to personally interview potential care providers from a list of providers given to him.

3.19 Mr. Leeming commented that he had found the experience to be very positive and he had considered it especially beneficial to make a decision on a choice of carer as he needed to be personally comfortable with the person undertaking his wife's care. When asked by the Panel whether being given opportunity to make decisions relating to his wife's care had made a difference he replied that it had because as an individual carer he was in a position of real control over the form of his wife's care.

3.20 Mr. and Mrs. Thompson attended the meeting and provided the Panel with an account of their experiences of the social care system as the parents of a child born with a mental handicap through to adulthood and how they felt the introduction of self directed support had been a positive development in their daughter's care.

3.21 Historically, Mr and Mrs Thompson had had some concerns regarding the standard of home support available to their daughter. Encouraged by a briefing and general information they had received regarding greater involvement by carers in decision making, they had wished to pursue matters further and had also been interested in an opportunity for carers to take control of their housing options by investing in property with support from the Council.

3.22 At the time Mr and Mrs Thompson had expressed an interest in taking decisions regarding their daughter's care budget, the brokerage system had not yet been established and a consultant had been appointed on a one off basis who had worked with them to develop a care plan. Their experience in recent years had been that they had received very good support from social care staff in setting up their daughter's support package and it's on going operation.

3.23 The Panel was informed that whilst Mr and Mrs Thompson were fully supportive of the principles of self directed support they did have some points they wished the Panel to be aware of. In their view, the individual budget allocated to them was insufficient to cover the level of support necessary for their daughter and they had used their own resources to top up the care plan. As a more general point, they commented that they had become hands on managers of their daughter's care and had the advantage of being personally assertive and articulate in arguing their case. They did have a concern that other carers, perhaps not so articulate or assertive might find it more difficult to navigate and obtain what they wished to achieve from the social care system, even though in principle self directed support would give them greater control. Mr and Mrs Thompson also felt that they had needed a sound grasp of the basics of financial management in order navigate the bureaucracy involved as part of the move to self directed support.

3.24 Frances Brewer and Phillip Pearce attended the meeting as Directors of the Caring Listening and Supporting Partnership, an organisation that supported people with learning disabilities and as individuals with learning disabilities themselves. Julie White, a support officer working at the Caring and ~istening and Supporting Partnership also attended the meeting.

3.25 The Panel was informed as an organisation, the Caring and Listening Partnership had supported the 'Take Notice' campaign which aimed to provide people with learning disabilities with the right set of skills to represent themselves. The principles of self directed support for people with learning disabilities was therefore consistent with the aims of the organisation and it had been involved by the Council in the development of direct payments and individual budgets as part of the implementation of Putting People First within the Borough.

3.26 The Panel noted that Francis and Phillip made a number of general comments regarding their impression of services currently provided or facilitated by the Council which the Panel felt needed to be considered seriously given the choice that individuals would have in the future under self directed support, to shop around for the facilities and services that. they wished to use. For instance, a comment was made that day centre services for people with learning disabilities were not something all people with learning disabilities would necessarily always wish to use. In the Panel's view comments of this kind underlined the importance of the Council making sure that the facilities and services it offered remained attractive to service users so that they would choose to continue using Council services even though their individual budget would allow them to take their budget elsewhere if they wished. This mattered because if significant amounts of services users choose to stop using services provided by the Council, those services could become financially unviable.

3.27 The Panel was informed that in Phillip's case he had received support from a broker when he had wished to move house via house transfer.

3.28 Matt Pope, Puttina People First Proiect Manaaer attended the meeting in order to provide the Panel with information on the development of the Putting People First Project.

3.29 The Panel was reminded that the term Putting People First encompassed a range of measures that had the objective of increasing choice and putting service users in the control through self directed support, but also gave a high priority towards the use of preventative

measures as a means of reducing future needs. It was a ten year vision of the direction the Government saw social care services moving towards.

3.30 The Panel had expressed concern that there was a need to ensure that support plans whether they arose directly from services users, their carers or had been developed with the assistance of a broker met suitable quality standards. Whilst greater choice offered opportunities, it also increased potential risk to service users and the Council. The Panel was informed that all support plans would need to be signed off as suitable by the Council and would be subject to regular review in the same way that traditionally arranged support plans had been.

3.31 Members of the Panel were informed that work was in progress to forecast the number of brokers that might be required to meet the demand for brokerage services once demand for self directed support and personal/individual budgets increased. Service users with learning disabilities had been chosen for the pilot of the brokerage service as this was an area where service users had a long standing record of wishing to be involved in decisions regarding their care and Officers had the most knowledge and experience.

3.32 Members of the Panel were concerned that the administrative costs of rolling out self directed support and brokerage services might be higher than the administrative costs of providing the present centrally based traditional care packages. It was noted that within the lbsen report it had been estimated that the cost of brokerage costs would add approximately £200-£800 to each support plan. Eventually, costs for brokerage would be included within an individual's personal budget. Members were informed that the cost of providing support services to enable people to put self directed support into practice needed to be balanced against improvements in the quality of provision and the avoidance of crisis situations.

3.33 Members of the Panel whilst fully supportive of the principle of services users exercising choice on who they wished their broker to be were concerned that there seemed to be a lack of qualifications for brokers or set of approved standards, given that they would be in a position of considerable influence over public funds. The Panel was informed that the specific issue of qualifications as well as safeguarding as a whole was being given a high priority and that both issues and had been flagged up within the draft Brokerage Options Appraisal document supplied to the Panel. The Panel noted that whilst it was important to put safeguards in place it was also important to preserve the over-riding principle of service user choice.

3.34 The Panel met on the 28 April 2009 to discuss the implementation of Putting People First with Stuart Rowbotham, Interim General Manager Community Care. It had been the Panel's intention to have a discussion with Councillor Chris Edmunds, Executive Member for Social Care, but he was unable to attend the meeting because of illness. Councillor David Lee, Leader of the Council attended the meeting. The Panel expressed regret that it had not been possible within the timescale of the review to seek Councillor Edrnunds' views or ask questions.

3.35 The Panel was supplied with the following additional written information together with the Agenda for the meeting:

0 Details of the number of the full time equivalent social care practitioners working directly to operate the social care management system and current ratios of clients per social care practitioners;

0 Details of financial modelling as part of the lbsen report anticipating costs of administering individual budgets in comparision to traditionally based care packages; List of questions and answers concerning Putting People First and Self Directed Support produced by the 'In Control' organisation; Concerns raised regarding self directed support and individual budgets;

0 lbsen Report - a national evaluation of the Individual Budgets Pilot programme;

3.36 The Panel was reminded that the whole of the national Putting People First vision and self directed support was in its infancy and that the Government was yet to issue guidance on how to implement the totality of the programme. The onus was on local authorities to come up with best practice in implementing self directed support and share it with other local authorities and the ~overnment. In the absence of a~direction, the Council had taken a pragmatic and 'bottom up' approach to the develo~ment of self directed sup~ort. . - Stuart Rowbotham informed the Panel that service users had a right to receive direct payments in lieu of services so changes in the system were going to happen.

3.37 The Panel noted that there were two main drivers for change to the social care system. Service users wanted to take more control over decisions affecting their care and the affordability of traditionally based social care packages in the medium to long term because of demographic changes. The demographic changes meant that in the future more people would be requiring social care services and their needs would have to be met without large increases in expenditure.

3.38 In light of the anticipated future costs of social care, the Panel noted evidence supplied to it which indicated that from the pilot of self directed support for service users with a learning disability, the costs of providing care through personal/individual budgets was less in four of the examples than what it would had been if a traditional package had been used. Stuart Rowbotham commented that in relation to the learning disabilities, care costs had been contained and in fact reduced from E9OOk to E300k. It was noted that national research undertaken as part of the lbsen report indicated that on average costs of individual budgets varied considerably depending on the needs of the service user. Cost were lower for mental health service users (average £ 150 per week); middling for older people (£230) and physically disabled people (£310); and highest for people with learning disabilities (£360)'. The Panel noted that it was accepted by Officers that it was less certain that the relatively high degree of savings arising from the pilot within learning disability would also apply to other categories of service users, in particular within the Older People's budget.

3.39 In light of the lack of definitive figures, but taking into account that reductions in costs were unlikely to be as significant as those made in within the learning disabilities budget, the Panel was concerned that a prudent and measured approached needed to be taken to the expansion of the self directed support programme.

3.40 The Panel also expressed continued concern over the robustness of arrangements to check the suitability and aptitude of persons employed by services users to provide care

* 'The national evaluation of the Individual budgets pilot programme' page 2 Ibsen Report October 2008

services paid for from within their individual budget. Stuart Rowbotham commented that the Council was not a regulator of social care services and did not have the statutory powers of such regulators. Within the concept of self directed support it was conceivable and reasonable to assume that a proportion of service users would choose to commission members of their family or family friends to provide personal support and in effect become personal assistants. The Panel was informed that it might not be possible or advisable to undertake Criminal Records Bureau check on a personal contact; a judgement would need to made as part of the formulation and agreement of a service user's support plan. The Council had the right to veto any support plan it did not feel was suitable although the guidance that was available indicated the Council should use a light touch whenever possible. The Panel noted this, but remained concerned over the issue of safeguarding and monitoring.

3.41 In light of concerns expressed by the Panel regarding how the Council intended to ensure that its service users would take up its services, Stuart Rowbotham informed the Panel that in general service users were happy to buy into the Council's day services and that he was confident they would continue to do so in the future as self directed support was expanded. The Panel was informed that the following issues were being examined.

In the future consideration would be given to whether the Council continued to provide services itself or whether they could be provided by independent concerns; If services were not taken up the Council would need to consider whether to reduce provision of that particular service or stop providing it if it became financially unviable; The Council was in an-advantageous position in so far as it already had infrastructure and services in place that other service providers would find hard to replicate;

3.42 Members of the Panel whilst welcoming the development of self directed support expressed the view that implementation was going too fast in light of the immature nature of the marker for social care provision and risks attached to the process. In response, the Panel noted the comments of Stuart Rowbotham that the conundrum was that service providers would not enter the self directed support market unless there was a demand for services. As part of the development of the project an Officer had been employed specially to work with providers across the commercial and voluntary sector to develop the market.

3.43 The Panel was informed that traditional centrally organised care packages involving residential care were an expensive way of meeting people's care needs, whereas if people were supported as part of the process self directed support to either remain in their own homes or to live in sheltered housing the Council would only be paying for care costs, not residential costs.

3.44 Members of the Panel questioned what arrangements were being developed to develop the brokerage services that would be required to make self direct support a reality, as well as what safeguards would be in place to ensure the quality of brokerage services offered. The Panel was informed that the Council had begun the process of developing an 'arms length' in house brokerage service by splitting the functions of the Learning Disability Team into statutory assessment and support plan review on the one hand and care brokerage on the other so that there was a clear separation of roles. This in principle could be extended into other social care teams. The Council had also held preliminary discussions with Age Concern as a voluntary agency that could potentially be supported in developing brokerage

services. The ideal was for a broker that had a good knowledge of the local community and both the free and chargeable services available that their clients might wish to access.

3.45 Members of the Panel whilst very encouraged by the success of the self directed support pilot, noted from the examples given to them that not every individual budget support plan would work out and that if they did not, the Council retained the statutory responsibility to intervene and ensure the person received services they were entitled to. The Panel expressed concern that in these circumstances the level of intervention required could be expensive and that some kind of provision was needed to mitigate against the financial risk of having to intervene. The Panel was informed that the Council was aware of the issue, but was looking at what would be the best option. One option was into include a contingency within each individual budget, but alternatively a contingency could be held internally.

3.46 The Panel also received comments from John de Mierre, Cabinet Member for Adult Services of West Sussex Council, a leading authority in the development of self directed support, concerning issues they had encointered and which they felt Wokingham Borough Council miaht want to consider as it im~lemented Puttina Peo~ le First. These centred on the need to work to develop and stimulate ihe provider market; thk need to continue to accommodate service users who did not want a personal budget; and the overriding need to communicate effectively with those affected, so that they could find out what services were available to them and how those services could be accessed. The Panel was informed that all of these issues had been considered as part of the development of self directed support within Wokingham.

3.47 The Panel noted written comments made by Councillor Diane King, Executive Member for Community Development concerning the impact of self directed support on the voluntary sector. It was recognised there was a great deal of uncertainty about the affects on the voluntary sector, but that in her opinion ;t was likely that service users would perceive that areater value for monev could be ~rovided bv the voluntarv sector. It was im~ortant that the ;oluntary sector be fully briefed regarding seif directed support and likewise that individual service users were briefed on the range of services offered by the voluntary sector.

4.0 Conclusion

4.1 On the 30 April 2009, the Panel met to consider its findings and draft recommendations.

4.2 The Panel concluded that on the evidence available, the piloted introduction of self directed support within Wokingham Borough as part of Putting People First initiative has been very successful, leading to real improvements-to the quality of lives of service users. The service users who experienced self directed support were very positive about their experiences. In the Panel's view the fundamental principles of Putting People First in terms of enabling individual service users to take control of decisions about their own care through self directed support and of providing them with the necessary support to achieve this were correct and the represented the right way of developing social care services in the future. Self directed support also showed signs of mitigating against the underlying growth pressures on social care budgets arising in the future.

4.3 Balanced against the opportunities that self directed support in social care offers are the very real challenges and risks of ensuring adequate safeguarding of the individual service user's interests and that of the Council and council tax payers in ensuring outcomes and costs are closely monitored.

Recommendations

5.1 The following policy recommendations are put forward

1) That the implementation and development of self directed support as part of Putting People First should continue within Wokingham Borough, but on a phased basis and following further piloting.

Reason: Given the potential risks to the Council and service users it is essential that these risks are taken account of and caution exercised so that any lessons learnt can taken on board prior to the full implementation of self directed support across all uses groups.

2) That robust monitoring and safeguarding procedures be put in place to protect services users and ensure quality of outcome.

Reason: The welcome increase in choice and flexibility that self directed support has the potential to provide, comes with the disadvantage that it will be harder for the Council to monitor the quality of provision in a fragmented market, rather than through the provision of traditionally based care arrangements. This is fundamental given the Council's statutory responsibilities.

3) That robust financial procedures are put in place to monitor the financial aspects of the move to self directed support and individual budgets including brokerage costs, administration and safeguarding costs.

Reason: Monitoring of all processes is key, so as to ensure that as self directed support is implemented, the underlying assumptions made regarding cost effectiveness are delivered in practice and that any problems can be identified in good time.

4) That the level of funding allocated as part of an individual assessment should be sufficient to cover needs, but not so much as to encourage wastage by paying too much for services.

Reason: It is essential that procedures and processes are developed to ensure that service users can achieve value for money on the funds allocated to them and that the Council does not allocate more than is needed.

5). That as a priority, the Council continues to do all within its power to stimulate and encourage a social care market based upon individual self directed support, both at local and national level. Locally where the Council can have the greatest impact, but also through national organisations where those organisations might potentially provide services to services users.

Reason: This is fundamental given that the aspiration of greater choice for individual services users can only become a reality if there are enough small and medium sized organisations offering services.

6) That consideration should be given to the establishment by the Council of a voluntary accreditation system for brokerage services and service providers.

Reason: It is not intended that this would amount to a recommendation for particular providers on the behalf of the Council or that there would be any prohibition on individual service users opting to a use a broker or service provider not on the accredited list as this would be contrary to the principle of choice. In the Panel's view, the Council, in encouraging a system of self directed support does have a moral responsibility to provide service users with information and should go as far as possible in reassuring service users that those they might purchase services from operate to approved standards.

7 ) That sufficient contingency provision is given to allow for additional costs to the Council in the event of a breakdown in an individual's support plan.

Reason: With any system there is an element of risk of things going wrong and the Council needs to plan for this. The Panel does not wish to be proscriptive in how this might be achieved, but felt that a contingency could be held through a central budget, as an element of the individual's budget or through insurance provision.

8) That the Overview and Scrutiny Management Committee delegate ongoing monitoring of Putting People First to the Service Development Panel and that Officers be asked to report back to the Panel in January 2010.

Reason: Throughout the review, the Panel was aware that the Council along with other local authorities across the country was at the very beginning of a process of reform for social care provision that will take decades to achieve. Given the uncertainties around the development of self directed support, the Panel felt that regular monitoring was necessary.

ITEM NO: Appendix 1

OVERVIEW AND SCRUTINY REVIEW

TERMS OF REFERENCE

REVIEW OF THE PUTTING PEOPLE FIRST INITIATIVE

Purpose of Review:

1. To inform the implementation of the Putting People First Initiative.

2. To ensure continued high standards of adult social care across providers.

Key Objectives:

1. To find out as much as possible about the initiative and its implications for service users.

2. To look at what other local authorities are doing in this area, relevant Government advice and examples of best practice. I

Scope o f the work:

1. To ascertain what facilities and services are currently provided to service users by the Council and look at whether these services offer service users what they want and so can be used to full potential.

2. To ascertain how many ProviderslBrokers will be available to service users, who they will be and how they will work with both the Council and service users.

To ascertain how the ProviderslBrokers will be monitored. I 4. To ascertain how what the financial cost of the services would be to service users

and how much the resources of this initiative would cost the Council.

To ascertain how service users will cope with the process and how they feel about the changes.

6. To ascertain how individuals will be safeguarded, including making sure personal budgets are used to get them the best care for their requirements.

Background:

The Overview and Scrutiny Management Committee at its meeting on 18 November 2008 referred the consideration of any changes to the VoluntaryRhird Sector to the Service Development Overview and Scrutiny Panel to ascertain if a review of any aspect was required. At the Panel's meeting on 5 January 2009, a presentation on the Putting People First Initiative was given and the Panel proposed that a full review was needed.

A request to carry out a full review will be put forward to the Overview and Scrutiny Management on 16 March 2009.

INFORMATION GATHERING:

Witnesses to be invited

I Council / People First Initiative To be confirmed with I Provider Oraanisations I To ascertain how thev feel

Name Stuart Rowbotham

Matt Pope

-- . -- OrganisationlPosition I Reason .. .- for lnv~t in lnter~m General Manaaer for To orov~de the Pan21 wlth Community Care servyces, Wokingham Borough Council Putting People First Project Manager, Wokingham Borough

Panel Chairman and Management Committee Chairman Service Users

Councillor Chris Edmunds

Councillor Dianne King

Tim Holland

Starting: March 2009 Ending: May 2009

infdrmation on the Putting People First Initiative To provide the Panel with information on the Putting

lnforrnation to be obtained from

Referred by the Management Committee to: Service Development Overview and Scrutiny Panel

.,

To be confirmed with Panel Chairman and Management Committee Chairman Executive Member for Social Care, Wokingham Borough Council

Executive Member for Community Development, Wokingham Borough Council

Managing Director, Support Horizons CIC

Organisation

Other Local Authorities

Terms of Reference to be agreed by: Overview and Scrutiny Management Committee on

16 March 2009

about the changes/hiw they propose to deliver services.

To ascertain how they feel about the changes.

To ascertain the Executive Member's views on issues relating to the Putting People First Initiative. To ascertain the Executive Member's views on issues relating to the Putting People First Initiative, particularly in relation to the voluntary sector. To provide the Panel with information about the role of a

Information to be Requested How they are dealing with the Putting People First initiative. Examples of best practice.

Panel Members involved in Service Development Overview and Scrutiny Panel: the review: Councillor Tim Holton (Chairman)

Councillor Gerald Cockroft Councillor Abdul Loyes

Panel Lead Member: Executive Member:

Councillor Malcolm Storry Councillor Claire Stretton

Councillor Tim Holton Councillor Chris Edmunds

Appendix 2

Putting People First: A Glossary of Common ~ e r m s ~

Direct Payments These are local authority payments to people who are eligible for help from social services. and who would like to arrange and pay for their own servikes instead of getting them from the Council. One of the aims of Putting People First is to make Direct Payments the model for all adult social care.

Personal and Individual Budgets A personal budget is an allocation of social care funding from the local authority to a person. This can be managed by the person, (as a Direct Payment) or by the Council or another organisation on their behalf. An Individual Budget is similar, but can include money from other funding streams.

In Control/Self Directed Support In the Wokingham Borough an In Control pilot scheme has been running to offer individual budgets to people with a learning disability. In Control is a campaigningnational organisation that has pioneered self directed support for people with a learning disability.

Person centred planning The process of planning that puts individuals at the centre of the planning process. It is the key to Putting People First.

Circle of support This is the group of people, (often family members or friends) who meet regularly to help a . .

person make decisions about their support and make sure they are gettincthe right helb and the services they are entitled to receive. Such a function can could also be delivered by a broker.

Fair Access to Care Fair Access to Care, (FACS) is the criteria used by all local authorities to decide whether a person's needs are critical, substantial, moderateor low. Wokingham Borough Council pays for support for critical needs only.

Resource Allocation System This is the process of determining a person's Personal Budget by assessing their eligible needs and calculating what it will cost to meet them. Wokingham Borough Council now has a resource allocation system for all services.

Self-assessment This is an assessment completed by an individual, (with help where necessary) that is used to identify the support they need. This is then feed through the Resource Allocation System to determine their personal budget.

3 Taken froin 31d Edition Putting People First Staff Update.

Support Plan This defines what a werson wants to chanae or maintain in their lives and how thev will use their personal budget to achieve those aims. They can be drawn up by individuals with appropriate help, (perhaps with the help of a broker) and are then sent to the Council for approval.

Support Broker If an eligible person does not wish to manage their own personal budget, another person could do so on their behalf. This could be a family member or friend or a Support Broker who are independent advisors who can help people think about how and where they can get the support they want.

Self-directed support This is a support system that allows everybody who is eligible for social care support to know what money they are entitled to and to control how that money is spent and to get the support that they need in the way that they want. This is the fundamental aim of Putting People First.

Appendix 3

List of Witnesses Interviewed by the Panel

Frances Brewer -Service user

Tim Holland, - Managing Director, Support Horizons

David Lee, - Leader of Wokingham Borough Council

Brian Lemming, - Carer

Philip Pearce, - Service user

Matt Pope, - Putting People First Project Manager, Wokingham Borough Council

Alice Richmond, -Social Support Broker, Support Horizons

Stuart Rowbotham - General Manager for Social Care, Wokingham Borough Council

Mr & Mrs Thompson, - Carers

Julie White, - Support Officer, Caring and Listening and Supporting Partnership

Further Appendices - available on request.

Appendix 4 - minutes of the meeting of the Service Development Overview and Scrutiny Panel held on 19 March 2009;

Appendix 5 - background information and minutes of the Service Development Overview and Scrutiny Panel held on 6 April 2009;

Appendix 6 - background information and minutes of the Service Development Overview and Scrutiny Panel held on 28 April 2009.

ITEM NO: 35.00

TITLE Staffing Implications of the Transformation Programme

FOR CONSIDERATION BY Personnel Board on 28 September 2010

WARD None specific

GENERAL MANAGER Graham Ebers, General Manager Business Services

OUTCOME

Effective and efficient services through re-shaping staffing structures and operating processes.

RECOMMENDATION

Personnel Board are invited to: 1. Endorse the overarching staffing principles behind the Council's Transformation

Programme; 2. Consider and note progress on centralising Council Wide functions (in

accordance with the overarching staffing principles); 3. Note the key staffing risks and mitigation; 4. Recommend to the Constitution Review Working Group proposed changes in

terms of reference for the Personnel Board as set out in Annex A, (paragraph d time limited to 31 March 2012).

SUMMARY OF REPORT

Staffing Principles

The overarching staffing principles behind the Council's Transformation Programme are 3s follows

* Fewer staff - not just as a result of moving activity outside WBC but also from streamlining and automating processes Fewer managers & fewer tiers of management - clear management accountability and spans of control Forward planning -workforce planning, re-deployment, vacancy management, turnover and retirement will reduce the need for redundancies

e Structured around functions /activities not departments (e.g. commissioning, service delivery and internal support). Commissioning involves clearly identifying and championing customer /client needs. Service delivery involves championing service improvemetlt and innovation and can be delivered internally, externally or in partnership with other public bodies and the 3rd sector Streamlining - simplify, standardise, share and centralise /consolidate processes common to all services, removing duplication

0 New models of service delivery - e.g. more automated where possible, delivered on a shared service basis with other authorities I organisations, delivered by wholly owned companies etc.

0 "Future proofingn- to ensure flexibility to respond quickly to any future financial

pressures as well as current ones "Smart workingv- i.e. working from home, flexible locations, hot-desking etc. tl drive down the cost of providing office accommodation, offer services at more flexible times and improve recruitment and retention

e Local flexibility to determine appropriate, and tailored, pay and benefit levels il /when this becomes necessary and affordable

These overarching principles support the Council becoming more financially viable an( sustainable by allowing for streamlined processes, economies of scale and greater automation, each allowing for more to be achieved with less. They will support the Council to achieve f6m savings p.a. by 31 March 2013. Not re-shaping the Council, or following the above staffing principles, would not achieve this scale of savings over the required timescale.

Future Shape of the Council As agreed by the Executive, the overall shape of the Council will look like this:

r Corporate Core & Strategic Commissioning - Corporate Core supporting tk overall direction and policy of the Council and Strategic Commissioning assessing needs, commissioning activity to meet these needs and identifying future shape of services

r Service Delivery Units -providing services direct to customers, either deliverec in-house or by external organisations - Support Units (set up as internal shared service business units delivering clea~ outcomes and with transparency of costs and revenues)- transactional support corporate core and service delivery units as required

Service Delivery Units and Support Units may operate as shared services with other organisations (e.g. Trading Standards) where this provides at least as effective service at less cost, pooling resources, skills and expertise

The Review of Administration and Support is under way and proposed structures are being worked up in line with the ran sf or mat ion staffing principles above. Given that tl new structures are designed to generate efficiencies, and where possible improve services, it is imperative that new structures are approved and populated as expeditiously as possible. The proposed structure will be presented to Personnel Boar to note and consider.

A review of Policy & Strategy and Contracts & Procurement is also being undertaken c a similar basis to Administration & Support and will be reported to Personnel Board in due course.

Key staffing risks These are as follows :

e Service Performance and Customer satisfaction during interim 0 Staffing capacity to deliver such large scale change r Reduced morale & increased staff turnover

These risks will be mitigated by: e Back fill staff seconded to Transformation activity where critical for maintaining

i i b u ~ i n e ~ ~ as usual" Stronger focus on change management and communications: managers brief

staff regularly and engage them on the "what, why, how, when" of change "Next Steps Programme" to support staff to prepare to fill new roles, operate new processes and use new IT

Personnel Board Terms of Reference Amendments to the Personnel Board Terms of Reference were supported in principle in August 2010, with the exception of any revision to;

d) To make recommendafions to fhe Council in relafion to major re-organisafions within deparfments which affect more fhan 20 sfaff

It is recognised that Personnel Board are keen to be engaged in significant organisational developments and are reluctant to have this removed. However, during the period of Transformation, staff are being 'affected' frequently (whether it be through the introduction of new IT or new reporting lines for example). Furthermore Executive has (and will be) agreeing to significant staffing re-organisations in discharging their Budgetary responsibilities. In recognition of these issues it is suggested that the Terms of Reference be amended to the below during the significant time period of Transformation (to 31 March 2012);

d) To receive Transformation Staffing updates and make recommendations to fhe Council, when considered necessary, in relafion to major re-organisafions wifhin the Council which would put at risk of redundancy more fhan 20 sfaff

Transformation staffing updates will include; I l a Principles of any restructuring I I 0 Draft Management Structures (prior to consultation) I l Finalised Structures and recruitment process I

0 Implementation Progress

A full set of terms of reference taking account the points raised at Personnel Board on 24 August 2010 is attached as Annex A.

( Reasons for considering the report in Part 2 1 None

List of Background Papers I None I

Contact Geoff Munday Telephone No 01 18 974 6526 /

07770700762 Date 17.09.10

Service Transformation Email geoff.munday@wokingham.gov.uk

Version No. 1.0

9 5

ANNEX A

Proposed revised Terms of Reference of the Personnel Board

8.6.1 Function and Composition of the Personnel Board

The Personnel Board's functions shall be as follows: a) To deal with the appointment of, and terms and conditions of service of, the Head of Paid Service and General ~ a n a ~ e r s . In relation to the Head of Paid Service, the Personnel Board shall make a recommendation to the Council:

b) To discharge the Council's functions relating to the appointment, dismissal, or disciplinary action in respect of the Head of Paid Service, or General Managers;

c) To determine the Terms and Conditions of service of all non-teaching staff (including procedures for dismissal);

d) To receive Transformation Staffing updates and make recommendations to the Council, when considered necessary, in relation to major re-organisations within the Council which would put at risk of redundancy more than 20 staff

e) To determine requests for early retirement and redundancy in respect of all staff directly employed by the Council where

there is a request for the Council to exercise its discretions to enhance pension benefits andlor enhance redundancy compensation payments ;

and/or 0 where there are financial implications for which budgetary provision has not been

made, and in which case make recommendations to the Executive for a Supplementary Estimate as appropriate.