To receive a report on the Annual Inspection by the Commission for Social Care Inspection (CSCI).

The Committee received a report from the Business Relationship Manager on the Commission for Social Care Improvement (CSCI) Annual Assessment and Performance Rating for 2007/08.

She reported that overall there had been a steady improvement in Adult Social Care over the year. A baseline to modernise services for Herefordshire had been created and the Directorate had been prioritised by the Council in order to improve the rating of ‘adequate’ from the previous year. 

Areas for improvement that had been outlined were the intermediate care provision, where support needed to be more robust, and more needed to be done in order to bring this area within the joint commissioning framework.  There were opportunities to build on what had already been achieved, and improvements in data collection for intermediate care would allow the Service to understand what was happening in the field, and how well the Service was working.

She went on to say that improvements in the area of Learning Disabilities had taken place, and the culture of adoption agendas had changed:  residential care was not offered as the first and only option and telecare options were regularly and usefully being used.

Work had been started with carers, but this was coming from a very low base and was an area that did need improvement. As a result it had been prioritised, and as more Carers’ were engaged with the Council’s agenda, then outcomes would improve. Whilst there was no obvious plan to improve areas such as the implementation of major and minor adaptations to homes, the Centre for Independent Living had been offering to provide training for Council staff to enable a greater understanding as to the problems of living with a disability.

The Business Relationship Manager went on to say that the reduction in waiting time for assessments was an important step forward, but that improvements should continue to be made.  The Council was pioneering in its use of individualised budgets, and the momentum for the use of these should be kept up.  The Service was a local one for local people, and the commissioning structure would need to ensure that the broadest range of services possible were in place. She remarked that the spend on advocacy had failed to reach target for the year, but CSCI had been reassured that people could access advocacy.  This was an area that needed to be addressed.

Strong leadership of the Service was vital, and it was important that sufficient people were in place to ensure that the change agenda could be delivered.  It did appear that the appropriate arrangements were in place at the moment, and staff had been re-energised over the last few months.  The change of culture that had been seen had meant that the visibility of Officers had improved and the role of elected Members had become more important.  Improvement had been seen in both the business planning and performance management processes.

The overall impact of the changes made by the Directorate in the implementation of new structures has provided an improvement of service across all user groups.  The commissioning and use of resources had improved.  The commissioning issue was a major part of ensuring that the Service improved performance, and a clear baseline had been laid out by the joint commissioning plan.

The Interim Director of Adult Social Care said that it was helpful to have feedback from the Business Relationship Manager.  She pointed out that the assessment was up to April 2008, and was therefore two thirds of the way through the year that the Directorate was assessed on. There were anomalies, in the way the assessment was reported.  Personalisation of budgets had been at a very low base during most of the assessment period, but had been addressed in a very positive way during the year, and would be taken on by Wendy Fabbro in her role as Head of Integrated Commissioning.

In reply to a question from a Member, she went on to say that the domiciliary care was in the process of being re-commissioned, and one of the issues that was being considered was that of the right options that would be available for staff in order to prevent the sort of disillusionment of seconded staff to which the Member referred. 

She went on to say that the care assessments were outdated, and these had been re-examined with the view to replacing them with another means of assessment.   In answer to a further question, she said that there was currently a transition period that affected individualised budgets in that the Council was moving away from block contracts.  The bureaucracy associated with direct payments would be reduced with the new system. 

In reply to a question about migrant workers, the Interim Director went on to say that currently this group did not seek help at an early stage of mental illness, and ways would have to be found to offer help at the appropriate juncture.

RESOLVED: That the report be noted.