To provide an updated report on progress in achieving  national performance indicator targets and other local performance indicators in Adult Social Care within the Integrated Commissioning Directorate.

The Committee noted the updated report on progress in achieving national performance indicator targets and other local performance indicators in Adult Social Care within the Integrated Commissioning Directorate. 

The Interim Director of Adult Social Services reported that Herefordshire continued to perform “well” according to the annual Assessment of Performance by the Quality Care Commission (CQC).  Whilst the CQC concluded that the capacity to improve in Herefordshire was uncertain, a robust plan was being developed that would respond to the technical proposals in the assessment and would ensure that an outcomes based  framework was in place.  A consultation exercise would be undertaken on these plans, and it should be clear how the Council would be assessed in 2011/12 by March 2011.  It had been expected that CQC would come to Cabinet in January, but in light of the changes that were in hand, nationally from CQC, this was no longer possible.

The Interim Director went on to say that whilst there had been a slight increase in the performance of NI 130 (The number of clients receiving self directed support) to 5.9%, there was an expectation by central government that 30% of clients should be receiving a personalised budget by 2013.  A radical reconsideration as to how the initiative was implemented was required, and the resource allocation was being reconsidered.  Work to address the shortfall had included increasing the emphasis on offering personal budgets for new service users, which was expected to increase the number of personal budgets by around 25 per month; an increment of 150 by March 2011.  This was supported by a short-term central review team which would focus on existing case reviews for 3 months from January 2011. It was estimated that this would deliver an additional 350-400 users with personal budgets by March 2011.  She believed that more progress had been made in the previous month in this area than had been achieved for some time.

The Interim Director went on to report that outturns continued to exceed targets for NI136 (The number of people supported to live independently through social care) and the Council was performing both above target and better than national comparator councils

She went on to say that a detailed look at care governance would be undertaken as part of the adult safeguarding agenda.  There was concern over the level of safeguarding referrals, and the matter would be reviewed.

In the ensuing discussion, the following points were made:

• That it was unlikely that any clients who felt they were not capable of managing their own affairs and were unwilling to take up personalised budgets would not lose support, as it had always been assumed that personalised budgets would not be appropriate for all clients.  There were a number of incentives that could be built into the system however and, in the final instance, the Local Authority would be able to administer a budget on behalf of a client.  This is knows as a “managed account”.  The aim was to reduce dependency and promote as much independence as possible.

• In reply to a question from a Member, the Interim Director said that safeguarding referrals should be acted on as quickly as possible, and that the screening process that would be introduced in January would greatly reduce waiting times.

• It was unclear as to why NI 131 (rate of delayed transfers of care per 100k of population) had been so high in August, but work was in hand to bring transfer times down.  The recent cold weather had not helped the situation.

RESOLVED

THAT:

(a)               progress in managing performance towards achieving targets be      noted; and;

 (b)      areas of concern should continue to be addressed.