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Mr G Garrod
Director of Social Services & Housing
Social Services
Headquarters
17 Fairlee Road
Newport
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Dear Mr Garrod
ANNUAL REVIEW OF PERFORMANCE
Thank you for arranging
our recent annual review meeting. This letter and report set out the Commission
for Social Care Inspection’s (CSCI) view of the performance of social services
in your area during the last year, and comment on improvements for the year
ahead.
The report is intended to
help the council improve outcomes and the quality of service to service-users
and carers. It is also intended to improve the prospects for improved
performance ratings in the future.
In assessing performance,
CSCI reaches judgements about performance against a set of standards and
criteria, drawing on evidence from a number of standard sources. These include:
¨ The published PAF performance indicators and other
statistical data up to 2003-04, plus data supporting planned targets for
2004-05.
¨ Evidence agreed in the course of our monitoring
meetings that have been formally recorded.
¨ Monitoring information from the Delivery and
Improvement Statements completed in October 2003 and May 2004.
¨ The
report of an inspection of Children's Services published in July 2004.
Details of the standards and
criteria have been published, and are available from CSCI, or may be seen on
the CSCI’s performance website. A
summary of the evidence used has also been sent to you separately.
The report is in two
parts. The first is a summary of improvement recommendations that highlights
the strategic issues for the council. The second part summarises the strengths
of performance over the last year, and the priorities for improvement in the
year ahead. These are organised around 6 standards against which the council is
assessed. The annual review does not
attempt to review all aspects of performance, but focuses on the main
performance issues for which CSCI has current information.
This report will form part
of the performance record for the council, and will be published on the CSCI
website in November. You are asked:
¨ to present it to an open meeting of the relevant
executive committee of the council, within two months of the date of this
letter, and to inform me of the date on which this will take place.
¨ to make the report available to members of the
public at the same time.
¨ to copy this letter and report to the council’s
appointed auditor, and to NHS and education partners.
Progress
will continue to be monitored during the year through our usual processes, and
a further Annual Review meeting will take place during 2005-06.
Performance (Star) Ratings will be confirmed in
November, based on an assessment of overall performance using all admissible
evidence. The evidence summarised in this letter
will be used to help arrive at the rating, but may be updated where further
evidence becomes available.
Yours
sincerely
Mrs S
A Turner
Business
Relationship Manager
Copy: Council Chief Executive
Social Services: 2004
Summary
of improvement recommendations
The review of social
services on the Isle of Wight has highlighted the following performance issues
that need to be addressed over the next twelve months. Further information
about the standards against which social services are assessed is contained in
the detailed report.
Child and family services
·
The council needs to
address the recommendations in the January 2004 inspection of children’s
services.
·
The council needs to
seek to achieve adoption for more of the
looked after children who need it (C23).
·
An evaluation of the
unit cost of foster care (B10) should be carried out.
·
Further joint work with
Education is expected to improve the performance of the educational
qualifications of looked after children (A2), which is at band 1. This is also
an LPSA agreed target.
·
Re-registrations of
children on the child protection register (A3) were too high last year and they
are now too low while the duration that children remain on the register (C21)
remains at band 2. It would appear that
children are being kept on the register for longer which has reduced the amount
of re-registrations. The council needs
to achieve the right balance to ensure the needs of children are being met.
·
Further discussion
and an evaluation of the escalation of final warnings/reprimands and
convictions of looked after children
(C18) with other councils is planned, this indicator will be monitored
during the year.
Services for adults and older people
·
Intensive home care
as a percentage of intensive home and residential care (B11) and the percentage
of people receiving intensive home care (C28) are in need of improvement in order
to help people to remain in their own homes as long as they want to.
·
The council needs to
review and monitor the unit cost of residential and nursing care for older
people (B13).
·
There were 229 emergency admissions (A5) in the last year. The council
needs to continue to monitor this performance indicator.
·
Improved recording
procedures with the introduction of SWIFT IT system is required to improve data
on people receiving a statement of their needs (D39).
·
The council needs to
review data collected from the recent mapping exercise looking at race and
faith issues on the island, to meet the ethnic needs of the community (E47).
Performance Review Report 2004
Isle of Wight
SERVICES FOR CHILDREN AND FAMILIES
An inspection of the council’s children’s services
was undertaken in January 2004 by the then Social Services Inspectorate. The inspectors judged that the council was
serving some children well with a promising capacity for improvement.
The inspection report concluded that the council was
providing a good standard of service and in some areas achieving a very good
level of service but that there were also some things that required serious
attention (including the referral and assessment team) and that the council was
starting from a relatively low base in a number of areas. One of the other areas drawn attention to
was that there were several committees involved in services to children and
young people. Since the inspection the
council has completely reorganised
senior management and political structures so that as from the beginning
of September 2004 there is now one Strategic
Director responsible for all Children’s services, one
portfolio holder and one select committee.
The Isle of Wight Social Services also incorporates
Housing and Community Services which has direct benefits for some aspects of
children’s services. There has been an
allocation of 10 housing units per year in the housing strategy for children
leaving care. The strategy also identifies
an allocation of 2 units per year to foster parents. The council also report that it has achieved the government
target of no families in B&B at the beginning of this financial year.
The Government’s
performance indicators for 2003/04 informed us about the council’s improvement
momentum over the year compared to 2002/03 and in relation to other councils.
The percentage of all children’s indicators in band 3 in 2003/04 had gone down
from 77.8% to 64.7%. The average band score for 2003/04 remained the same at
3.4 compared to 2002/03. Relative to other councils, this percentage and this
average banding for 2003/04 for the Isle of Wight was not as good as in
2002/03.
1. National priorities and
strategic objectives
Areas for
improvement
·
Adoptions of looked after children (C23) have
fallen from band 4 to band 2. The council has facilitated a support group for
adopters, with a regular newsletter and training workshops. The council
reported that the cohort numbers of children at the right age for adoption had
contributed to the low level of performance. The council needs to evaluate the
adoption process in order to improve their performance and meet the needs of
looked after children.
·
The number of looked after children receiving final
warnings or reprimands (C18) have dropped from band 3 to band 2. The number of
looked after children over 10 years old receiving reprimands or convictions has
increased from 2.3% to 11.9%. The
council is developing a strategy to deal with this however the council’s planned
figure does not indicate that there will be any improvement. This should be given priority and monitored
to ensure improved outcomes.
2. Cost and efficiency
Improvements
observed since the previous annual review
·
There has been improvement to the unit cost of
children's residential care (B9) from band 2 to band 4, with the council
developing a range of placements on the island to reduce the number of children
placed off the island.
·
The council have managed to produce a balanced budget
at the end of 2002/03 and again in 2003/04
Areas for
improvement
·
The unit cost of foster care (B10) has risen, resulting
in a drop from band 3 to band 2. The
council reports that it is facing difficulties due to limited resources on the
Island. However, the children's
inspection highlighted that there was an effective system of budget monitoring
and accountability with a joint commissioning manager and strategy in place. The council will need to continue to monitor
this area of expenditure.
3. Effectiveness of service
delivery and service outcomes
Improvements
observed since the previous annual review
·
The council is meeting the
needs of the health of looked after children (C19). This has been achieved
through the development of an interagency protocol with plans to appoint a
specialist nurse to carry out holistic health assessments of looked after
children.
·
Children
looked after who were absent from school for 25 days or more (C24) has improved
from band 3 to band 4 and the council plans to sustain this level of
performance.
·
The
council has sustained a good performance with the stability of placements of
looked after children (A1) negotiations are underway with an independent fostering
agency to block contract placements and support services, which will continue
to sustain this performance at band 5.
·
The
percentage of looked after children who were in foster placements or placed for
adoption (B7) has also improved from band 4 to band 5.
·
The
council is meeting the needs of looked after children on the child protection
register and has achieved 100% of reviews of children (C20). The child
protection co-ordinator role has further strengthened the number of reviews being
carried out within 6 weeks.
Areas for
improvement
·
The percentage of younger people leaving care aged 16
or over with at least one GCSE (A2) has dropped from band 2 to band 1. The council plans to improve partnership
working to address this poor performance.
This downward trajectory raises concerns and the council’s performance will be monitored as they have
identified educational attainment as a priority improvement area for the coming
year.
·
Improvement
is required in respect of
re-registrations of children on the child protection register (A3) which
remains at band 2. The figure for last
year was at 22.9% and the council planned to come in line with the national
target, however the outturn figure dropped too low to 4.6%. The council has an action plan in place to
achieve 8% following the children's inspection and this will be monitored.
·
The
council has also dropped from band 4 to band 2 in respect of the duration
children spend on the child protection register (C21). A recovery plan is in place to address this
and the council is intending to improve this indicator to band 3.
4. Quality of services for users
and carers
Improvements
observed since the previous annual review
·
The council has published its local preventative
strategy for 2004-2006. It plans to review and revise the looked after children
packs in consultation with children and young people themselves.
·
A survey is being conducted on children's views about
services. Personal interviews will be carried out.
·
There is a youth council on the island into which
looked after children can comment and make representation.
Areas for
improvement
·
There
has been a slight decline in the number of initial assessments of looked after children
within 7 working days of referral completed within timescales. This was due to staffing difficulties and
the re-organisation and process changes. The council will need to improve on
this performance through the action plan to increase initial assessments from
72% to 85%. The council has informed us that their performance since April 2004
has improved.
·
The
percentage of core assessments completed within 35 days has increased from
20.8% to 35%, however this is below their comparator group who have an outturn
of 62.1%. The council acknowledge that there can be variation in how local
authorities collect this data and it has an action plan in place to increase
this performance indicator to 40%.
5. Fair access
Improvements
observed since the previous annual review
·
The performance indicator concerning the ratio of
children in need from ethnic minority groups is indicating that the council’s
performance has not been banded this year however the council is in line with
its comparator group. Following the BME
mapping exercise undertaken by the Head of housing the council are liaising
with faith champions regarding the needs of these faith groups.
Areas for
improvement
·
The
children's report highlighted areas for development regarding needs analysis of
the Island’s minority ethnic residents and that there was little action taken
to identify, consult and engage minority ethnic children and their families on
the Island. The council has addressed
this in a number of ways and have set up a diversity-working group who will
address the issues of black and minority ethnic children. There is a children's involvement and
consultation strategy in place to consider the needs of black and minority
ethnic children. The outcomes from
these initiatives should be monitored by the council.
·
The
children's report highlighted that there was only one complaint from a child in
the last 3 years. The council has
addressed this by the appointment of a children's rights officer. The council
should monitor the effectiveness of this plan and ensure that the complaints
procedure is widely publicised. The
council have informed us that since the children’s inspection and the
appointment of the children’s rights officer they have now received 3
complaints from children and an increased representation that has been resolved
at an informal level.
·
The
children's inspection recommended that
action should be taken in relation to information provided to foster carers
about children prior to placement.
Support workers will be asked to spend additional time with foster
carers. The council has informed us that they now have a policy in place
regarding information sharing prior to placement, which is being monitored by
the Service manager.
6. Capacity for improvement
Improvements observed
since the previous annual review
·
The children's report showed that the council
demonstrated a strong strategic commitment to the integration of children's
services at different levels between the key statutory agencies.
·
The council has responded positively to the green paper
‘Every Child Matters’ and is undertaking steps to create a children's trust
with the appointment of a children's director.
·
The council has a number of multi-agency services and
arrangements which promote effective joint working within service
delivery. There is a new joint
intensive support service between education, health and social services working
intensively with children at risk of family breakdown, education, exclusion and
mental health problems.
·
The council are negotiating block contracts and longer
term service level agreements with providers to develop capacity and cost
efficiency.
Areas for
improvement
·
The
children's report highlighted that the council was slow to realise its role as
corporate parents, and the absence of mechanisms to enable contact between
members and looked after children.
Having revised their corporate parenting policy, the council anticipates
an increased involvement of councillors.
·
The
inspection report commented that there was a need of a more corporate approach
to staff recruitment and retention. The council plans to continue with member
and officer collaboration on maintaining improved childcare recruitment and
retention levels. They are aiming to improve the profile of social care work
though the workforce development strategy. A sustained improvement on this
performance will need to be demonstrated.
·
The council has taken action following an independent
review and the CSCI children's inspection to address high levels of stress and
low morale within the referral and assessment team. The council has reported to us that since the children’s
inspection they have monitored this team and revised and reduced the tasks,
changing the manager with reported improvement to morale. The council will need
to review and monitor the levels of staff absence and turnover.
·
The council, together with education, has developed a
looked after children education centre, which is expected to deliver
improvements in performance of the educational attainments of, looked after
children. Performance will need to improve on these educational indicators.
·
The council are currently taking steps to improve the
performance of D59 Practice learning, which is a new indicator. The Council is a key partner in the Hampshire/Isle
of Wight bid for a learning resource network and they are hoping this will
contribute to the development of high quality placements across the
region. The council are planning to
have 1100 student learning days during the coming year.
SERVICES FOR ADULTS AND OLDER PEOPLE
The council sees itself as a
learning organisation and there have been many changes over the last two
years. Strategic planning has been a
fundamental part of these changes with several key senior management appointments. This has resulted in a strong management
incorporating a broader range of professionals with a diverse skill mix. The council envisages an improvement on
collection of performance management data, which will be, captured through the
new IT system, due to be implemented over the course of the year. The council is proactively working
collaboratively with the Primary Care Trust and the Strategic Health Authority
and there are a number of successful joint working initiatives.
1. National priorities and
strategic objectives
Improvements
observed since the previous annual review
·
The council is
meeting the needs of service users wishing to have a single room by 100%.
·
The percentage of
items of equipment and adaptations delivered within 7 working days (D54) is
currently at band 3. The council has in
place an integrated community equipment service with plans to introduce a new
software programme to integrate equipment supply.
·
Joint work with the
primary care and acute trust has ensured that the levels of delayed transfers
(D41) for which the council is responsible are kept to a minimum. The council
has a housing renewal strategy with an objective to use resources (grants &
expertise) specifically to limit hospital discharge delays where property condition
is an issue.
Areas for
improvement
·
Intensive
home care as a percentage of home and residential care (B11 – new definition)
has increased by 2% only and remains at band 2 as has the percentage of people
receiving intensive home care (C28) which is a key indicator. The council plans to improve these
indicators with the joint commissioning strategy and block purchasing of
intensive beds within the private sector.
·
There
were 229 emergency admissions (A5) in the last year. The Primary Care Trust have carried out an
analysis of emergency admissions and the council is addressing this in a number
of ways; such as strengthening the intermediate care team, partnership with the
private hospital to provide 40 nursing home beds and the appointment of a falls
co-ordinator with local media coverage on the prevention of hypothermia. The
council also plans to use two of their own establishments to include
rehabilitation for chronic disease and acute exacerbation episodes. The council
needs to continue to monitor the effect on this performance indicator.
2. Cost and efficiency
Improvements
observed since the previous annual review
·
There
has been a considerable improvement to the numbers of older people helped to
live at home (C32) increasing the numbers from 69 at band 2 to 117 at band 5.
Further developments and negotiations with domiciliary providers are currently
being discussed which should enable more service users the choice to remain
within their own homes.
·
With
regard to the admissions of supported residents aged 65 or over to
residential/nursing care (C26), the council has sustained the numbers of
service users to 88.
·
The council has worked effectively in reducing the unit
cost of residential and nursing care for adults with learning disabilities
(B14). The council was performing
consistently at band 2 and have now improved their performance to band 4.
·
The
difficulties experienced last year, negotiating an agreement of contracts and
costs with the independent sector providing residential care has now been
resolved. The council have made capital investments in intermediate care beds
which will enable market growth.
·
The council has managed to produce a balanced budget at
the end of 2002/03 and again in 2003/04
Area for
improvement
·
The council needs to review and monitor the unit cost
of residential and nursing care for older people (B13). The council has dropped from band 4 to band
2 under the new definition. The council needs to ensure that outcomes are in
the best interests of the service users and value for money.
3. Effectiveness of service
delivery and service outcomes
Improvements
observed since the previous annual review
·
The
focus and the performance of the council is consistent with the Government’s
agenda on promoting independence for older people, people with mental health
problems, and people with physical and learning disabilities helping them
through choice to remain at home.
·
The council has performed well in terms of direct
payments to service users (C51) moving from band 2 to band 3. Direct payments
will be further promoted and the council have included targets for care
management teams. Numbers of people receiving direct payments has increased and
a bid has been made to the direct payments development fund for a further 120K.
Areas for
improvement
·
The number of carers receiving an assessment (D42) has
dropped from 61 to 32. The council suggested that a number of assessments have
been offered but refused. There is no way of noting how may carers refused
assessments this is a recording issue for which they are hoping SWIFT will help
to achieve their target of 45.
4. Quality of services for users
and carers
Improvements
observed since the previous annual review
·
There
has been an improvement for Clients receiving a review (D40) this is a new
definition and the council has increased from 48 to 62 band 3. The council
recognise assessment and review as the cornerstone of good care management and
have created 4 new review officer posts.
·
Waiting
times for assessments (D56) is at 80 with the acceptable waiting time for the
delivery of care packages (D56) being at 77 this indicates that service users
are not waiting long from assessments to delivery. The council’s commissioning
strategy should enable a more localised domiciliary service.
Areas for
improvement
·
The
council needs to improve on the percentage of people receiving a statement of
their needs and how they will be met (D39) as this is at band 2. The council plans to improve these figures
from 80.8% to 90%. The council report that they are currently reviewing the
format of care plans which includes the statement of needs to make them more
outcome focussed.
5. Fair access
Improvements
observed since the previous annual review
·
The
numbers of older people from an ethnic background living on the island who are
receiving services following an assessment (E48) has shown an increase.
Area for
improvement
·
The
council will need to review data collected from the recent mapping exercise
looking at race and faith issues on the island, to meet the ethnic needs of the
community. The council have reported that service managers have been allocated
identified faith champions from the recent mapping exercise
·
The
council has appointed a diversity officer, who they intend will address
services to black and minority ethnic communities on the island and the
effectiveness of this post will need to be reviewed.
6. Capacity for improvement
Improvements
observed since the previous annual review
·
The
council, together with its partners, has a clear vision and ambition to work
towards establishing a care trust.
Health and Social Services are working in close collaboration and have
established a number of section 31 agreements. The council have single
management of a joint Health and Social care occupational therapy service and
plan to have a further Section 31 agreement for this by the end of the calendar
year.
·
The council are negotiating block contracts and longer
term service level agreements with providers to develop capacity and cost
efficiency.
·
The
configuration of housing services has changed; they have a brief to integrate
Health and Social Services occupational therapists on one site. A comprehensive housing needs survey is
about to be undertaken which will provide a better strategy framework.
·
There
has been a service manager appointed which is a new post, who will be
responsible for the safer communities initiative.
·
The chief executive has chaired a joint strategy
group, out of which came the Price Waterhouse Cooper commission to review
services on the Island. Their report is
due out shortly and entails the creation of a care trust linking Health, Primary
Care and adult services with an aim for implementation by April 2006.
·
The
Directorate over the last year has taken a more strategic approach and has
engaged with the department of health change agent team to facilitate a more
productive joint working strategy.
Areas for
improvement
·
The
council has a number of the elements required to sustain strategic improvement.
Performance management and quality assurance should be improved with the
introduction of the new IT system SWIFT. This will have mandatory fields to
collect the relevant data in a more systematic approach, which will enable
quality assurances and more accurate information for managers.
·
The council are currently taking steps to improve the performance
of D59 Practice learning, which is a new indicator. The Council is a key partner in the Hampshire/Isle of Wight bid
for a learning resource network and they are hoping this will contribute to the
development of high quality placements across the region. The council are planning to have 1100
student learning days during the coming year.
Mrs
S.A. Turner
Business Relationship Manager
7 October 2004
