The Social Issues in South Lincolnshire: an Adult Social Care

Perspective

Pete SidgwickLincolnshire County Council

Governance for Adult Care Key Decisions

Pete SidgwickAssistant Director (Interim)Transformation/Integration

Pete SidgwickAssistant Director (Interim)Transformation/Integration

Justin HackneyJoint Assistant Director Learning

Disabilities & Mental Health Commissioning

Justin HackneyJoint Assistant Director Learning

Disabilities & Mental Health Commissioning

Glen GarrodDirector of Adult Social

Services

Glen GarrodDirector of Adult Social

Services

ExecutiveExecutive

Adults ScrutinyCommittee

Adults ScrutinyCommittee

Health & Wellbeing

Board

Health & Wellbeing

Board

Informal ExecutiveInformal Executive

Executive CouncillorExecutive Councillor

Optional

Adult Social Care in Lincolnshire• We directly support

– 1,800 LD (all ages)– 1,000 MH (18-64)– 2,000 PD (18-64)– 12,400 OP (65+)– Overall 17,200 very vulnerable people across the County

• Council Expenditure £526m pa (net) gross is over £1.1 Billion– ACS Services £143m pa

• 4,600 Residential/Nursing Placements • 6,000 people receiving Domiciliary care (80,000 visits

a week)

Lincolnshire County Council Expenditure Budget 2012/13 (£m)

Overview of Health and Social Care demand in Lincolnshire

• A rise in the 65 – 84 age group of 31% by 2022• A rise in the 85 years of age group of 55% by

2022• A significant rise in the older population with

dementia• An ageing population with Learning

Disabilities

OverviewEast CCG

• 30 GP practices covering Boston, East Lindsey, Skegness and cost covering 1060 sq miles

• Supporting 241,246 peopleKey challenges- Large geographic, sparsely populated area- Significant health issues – health disease, cancer, diabetes and COPD - Lowest life expectancy for both men and women in Lincolnshire

South CCG• 15 GP practices covering Welland and South Holland• Supporting 157,000 people

Key challenges- Rural poverty

Adult Social Care Net Expenditure 2011/12

Spend and activity By CCG Area£m

£46.9

£42.9

£20.6

£18.7

Lincolnshire West

Lincolnshire East

South Lincolnshire

South West Lincolnshire

4261 clients

4974 clients

2174 clients

2008 clients

Source: www.apho.org.uk/PracProf/Profile.

Source: http://www.research-lincs.org.uk/, data as at December 2012

South Lincolnshire CCG

Source: www.apho.org.uk/PracProf/Profile.

Source: http://www.research-lincs.org.uk/, data as at December 2012

Lincolnshire East CCG

2013 A raft of welfare reforms

• Housing benefit reform- size criteria reductions ( bedroom tax)• Social Fund reform local welfare provision• Social Fund reform short term benefit advice advance• Localised Council Tax reduction scheme• Benefit cap • Benefits on line• Child maintenance reform• Universal job match• Personal Independence Payments (PIP)• Conditionality and sanctions• Employment and Support Allowance ( ESA)• Universal Credit

2013 welfare reforms introduced

• Universal Credit• Introduction from April 2013- 2017• Designed to always make work pay• Will introduce monthly payment and

a household payments• On line• Claimant Commitment• Payment to be based on Earnings

not hours worked• Housing Costs to be paid to Claimant

• Personal Independence Payments ( replacing DLA

• For people aged 16-64• Claims started by phone but

eventually online. Paper claims by exception only

• Special rules remain for terminally ill• PIP claims in Lincolnshire will involve

a face to face consultation with a health professional– Capita.

• 2 components ‘Daily Living’ and Mobility with 2 payment rates ‘standard or enhanced’ using a point score for each activity.

For people in Lincolnshire ( source DWP)

Overall figures•13.6% number 60,290 claiming benefits in Lincolnshire in November 2012•6% 26,500Job seekers allowance•1.1% 4,670 Employment and support allowance & incapacity benefits•1.1% 4,670 Lone parents•1.5% 6,470 Carers•0.4% 1,940 Other income related benefits•1.2% 5,540 Disabled• 0.2% 900 Bereaved

Existing people with Disability Living Allowance (DLA)

•South Holland 4.7% ( 4,200) of population•Boston 8.7% (3,540) •West Lindsay 5.2% ( 4,760)•East Lindsay 8.2% (11,250)•South Kesteven 4.7% (5,420)•North Kesteven 4.8% (5,270)•Lincoln 6% ( 5,700)•www.dwp.gov.uk/PIP

Community Care Grants and Crisis Loans

• Part of the DWP Discretionary Social Fund payments • Analysis of claims and payments made in Lincolnshire in

2011/12 shown below

Lincolnshire Analysis for 2011/12 Lincoln

North Kesteven

South Kesteven

South Holland Boston

East Lindsey

West Lindsey

Crisis LoansTotal Expend £ £142,100 £29,500 £80,300 £34,600 £46,400 £110,500 £67,600Number Of awards 2,470 510 1,390 510 820 1,860 1,180

Community Care GrantsTotal Expend £ £258,900 £62,400 £150,700 £67,500 £78,600 £295,200 £145,700Number Of awards 500 140 290 140 180 550 260

• Total spend in Lincolnshire in 2011/12 = £1.5m• Welfare Reform Act 2012 ceased these payments and passed

responsibility to upper tier LA’s to provide local assistance to vulnerable groups

• DWP continue to provide Budgeting Advances and Short Term Advances to benefit claimants

Lincolnshire Community Assistance Scheme (LCAS)

• DWP did not require LA schemes to try and replicate theirs• Lincolnshire’s Community Assistance Scheme introduced April

2013, providing assistance rather than loans• LA received a grant of £1.5m from DWP to deliver the scheme• Focus is on people in crisis being brought into getting support

to avoid future crisis, providing goods and services rather than cash

• Partnered with the Voluntary Sector to develop a delivery network of goods and services

• Working with Lincolnshire Credit Union and Citizens Advice Bureaux, to help people become more financially resilient

• Healthwatch Lincolnshire is the independent consumer champion created to gather and represent

the view of the public.

• Healthwatch Lincolnshire will represent the views of both health and social care for children and

adults living in Lincolnshire.

• Healthwatch Lincolnshire will play a role at both local and national level and will make sure that

the views of the public and the people who use the services are taken into account.

• Healthwatch Lincolnshire will have a countywide network of local groups for you to get involved in.

These groups will be there to support your local community in having a say and influencing

services.

• Contact email : info@healthwatchlincolnshire.co.uk

• Next South Lincs Healthwatch Forum Tuesday 15th October 2013 at 12.30pm - 2.30pm - The

Woodlands Hotel, Pinchbeck Road, Spalding, PE11 1QF

Adult Social Care Priorities

• Prevention and Early Intervention

• Intermediate Care

• Integration with Health

• Case Management Partnership Programme (CMPP)

• Future Delivery of Support Services (FDSS)

Key drivers of change

• Care Bill• Social care funding• Increasing cost of care• Demographic growth• Comprehensive spending review & central

government settlement• Increased funding via the NHS • National policy developments supporting

integration between health and social care

The five principles set out for the Adult Care Directorate Change Programme are that:

Any development will maintain or improve the customer experience In developing new ways of working, reducing transaction and

operating costs will be central Appropriate services will be integrated with those commissioned by

the NHS Technology will be exploited to increase productivity and improve the

customer's experience, whether the service is directly provided by the council or by a third party supplier

Developments will reflect the strategic commissioning council ethos and Lincolnshire centric solutions