PAPER C

 

Committee:      SOCIAL SERVICES, HOUSING AND BENEFITS SELECT COMMITTEE       

 

Date:                14 JANUARY 2003

 

Title:                CARE MANAGEMENT AND COMMISSIONING BEST VALUE REVIEW IMPROVEMENT PLAN

 

REPORT OF THE ACTING STRATEGIC DIRECTOR OF SOCIAL SERVICES AND HOUSING

 

 

1.                  SUMMARY/PURPOSE

 

To monitor progress made against the improvement plan previously presented to the Social Services & Housing Select Committee.

 

2.         BACKGROUND

 

2.1       A Best Value Review of Care Management and Commissioning was undertaken by the Isle of Wight Councils Social Services and Housing Directorate, starting in May 2000 with the final report being produced in March 2001. The Councils Executive Committee agreed the subsequent report and action plan on the 10th May 2001.

 

2.2       A project team supported this review and consisted of council staff, representatives from the health service, voluntary and independent stakeholder organizations. Council Members were reported to at key stages of the review. The Social Services Inspectorate (SSI) later evaluated the review.

 

2.3       The context of the review included the findings of the 1999 Joint Review of Social Services that drew attention to the need to improve the care management process as well as improving the commissioning and contracting arrangement for adult care services. The review was also mindful of the governments programme for modernising health and social care services and emerging legislation such as the Health and Social Care Bill 2000 and “Supporting People” arrangements; which continues to have a significant impact on how the council supports, both practically and financially, people in the community. The review took note of the changes already taking place under the Partnership in Action agenda; in commissioning, with lead commissioning for mental health moving to the Primary Care Group (now Primary Care Trust), and the merging of mental health services, with the exception of the Approved Social Work Service, under the general management of the Isle of Wight NHS Trust. Future population projections were taken into account with demographic trends indicating a significant rise in people over 65.

 

2.4       The review applied the Councils and Best Value review framework, including challenging the role and nature of the service, consultation with key stakeholders, comparison with the performance of other councils and examining the options for competition. The scope of the review was to:

 

Ø       Identify and challenge care management and the commissioning of adult social care.

Ø       Investigate and influence objectives, strategies and standards.

Ø       Consult with service users, carers and other key providers.

Ø       Compare service quality and costs.

Ø       Ensure improvement where required and effective future provision.

 

2.5       The review was also influenced by and reviewed against, the Department of Health’s Social Services Inspectorates standards:

 

Ø       National Priorities and strategic objectives.

Ø       Cost and efficiency.

Ø       Effectiveness of service delivery and outcomes.

Ø       Quality of service for users and carers.

Ø       Fair access.

 

2.6       As the review progressed areas were identified where there was scope for improvement, in particular the need to have a more accessible and consistent care management service. The main areas reviewed were as follows:

 

Ø       Arrangements for providing access to services for adults.

Ø       Assessment of need.

Ø       Care planning.

Ø       Review and maintenance of care plans.

Ø       Commissioning arrangements.

Ø       Contracting.

Ø       Performance and equality of access.

 

3.         OUTCOME OF REVIEW

 

3.1       The following is an extract from the Best Value Review of Care Management and Commissioning 2001:

 

1.1   Key Points

                       

“The review finds that care management and commissioning services (including contracting) provided by the Isle of Wight Council Social Services and Housing Directorate are well regarded and generate favorable national measures for the provision of adult social care. There are however aspects of the reviewed services which will benefit from improvement and change.

 

Ø       Variations in access to information and staff, care management practice, application of process and service management.

Ø       Care management retains many inefficient processes which do not directly benefit staff, service users and other stakeholders.

Ø       Care management and commissioning services operate relatively inefficient information systems and insufficiently adequate performance management.”

 

3.2       The Best Value improvement plan details the issues that require addressing to meet the service improvements identified in the main body of the report. Members will note that there is an extra column added to this report, the “current situation” column notes the actions taken against each heading since the report was last presented to members. Whilst most of the action points have been addressed members will note that some have been not yet been addressed or been addressed in part only. The reasons for this are outlined against the particular improvement item.

 

4.         SOCIAL SERVICE INSPECTORATE REPORT

 

4.1       The SSI reviewed the Best Value Review on Care Management and Commissioning in September 2001. They felt that the scope of the review was complex and comprehensive and that “the review clearly identified options, gaps and scope for improvement.”

 

4.2       They judged the service to be a fair 1 star service with scope for improvement. It is worth noting that the Directorate is now judged to be a two star service with this star rating being maintained following the Spring Position Statement.

 

5.         FINANCIAL IMPLICATIONS

 

Most of the recommendations contained in the report were achievable by service efficiencies however the need to upgrade our client database system remains a challenge to the council due to the lack of sufficient financial resources, although there is a possibility of gaining a significant, but not entirely adequate, sum of money from the Public Service Agreement currently being negotiated with central government.

 

6.         LEGAL IMPLICATIONS

 

None

 

7.         ACTION PLAN

 

The Best Value Improvement Plan is appended to this report.

 

8.         RECOMMENDATIONS

 

That the select committee note the action taken against the action plan.

 

9.         BACKGROUND PAPERS

 

i)        Best Value Improvement Plan, Care Management and Commissioning, (attached to this report).

 

ii)       Social Services and Housing Directorate Best Value Review of Care Management and Commissioning March 2001, (in members library).

 

iii)     Social Services Inspectorate, Inspection of Best Value Review September 2001, (in members library).

 

 

Contact Point: James Lowe 2228, F 520600

 

J DOYLE

Acting Strategic Director of Social Services and Housing