Agenda item - Adult Social Care: Future Vision

Rob Persey, BHCC Executive Director, Health and Adult Social Care, will present on his priorities for services (verbal presentation)

18.1    Rob Persey, Executive Director Health & Adult Social Care (HASC), presented on his vision for HASC.

18.2    Mr Persey told members that, on his arrival in 2016, he inherited relatively few issues that caused him serious concern. The most worrying matters were: social care reviews, staff sickness levels, and some issues concerning direct payments (particularly their uptake). Also, the council was and is being stretched by the number of Deprivation of Liberties Safeguarding (DOLS) assessments it is now required to undertake: around 190 per month rather than approximately 130 per annum which had been the figure before the outcome of a court case forced social services departments to change procedures. However, this is a national rather than purely a local problem.

18.3    On a more positive note, Mr Persey inherited a history of positive co-working between social care and the local NHS. This provides a good building-block for further integration. There were also very close working relationships between social care and public health. There has been more work in this direction, and public health is now firmly embedded in everything that social care does.

18.4    Mr Persey also explained his statutory responsibilities as Director of Adult Social Services (DASS); as well as outlining the 3 year directorate plan and HASC’s priorities for 2017/18. Health inequalities are a particular priority, as in recent years inequalities have been increasing.

18.5    In response to a question from Colin Vincent on whether a breakdown was available showing how money collected via the social care Council Tax precept has been spent, Mr Persey replied that the precept funding and monies that come via the Better Care Fund (BCF) are ring-fenced to three areas: Adult Social Care (ASC) assessment and delivery; co-working with the NHS on reducing hospital admissions and Delayed Transfers of Care from hospital; and sustaining the ASC provider market. Mr Persey agreed to circulate further information on this.

18.6    Caroline Ridley told the committee that the recently announced tender for supporting Direct Payments is flawed as it demands that potential providers have specific direct experience of this work rather than just being able to demonstrate that they are competent to undertake it. This limits the number of local providers who will be in a position to bid. Mr Persey agreed to look at this issue.

18.7    In answer to a question from Cllr Ann Norman on sickness rates in HASC, Mr Persey told members that social care sickness rates are high everywhere due to the innate stresses of the job. However, BHCC is an outlier in terms of its rates. There are several plans to tackle this. They include running a council-wide wellbeing programme; ensuring staff take proper lunch breaks; encouraging front-line workers to get flu jabs; and the introduction of ‘First Care’, a new absence reporting system which requires staff to call a helpline rather than their line-manager to report illness. Clinically trained call-handlers are on hand to provide support and advice in addition to registering the absence.

18.8    Cllr Allen made the point that he was eager to see HASC performance reported to HOSC, not dealt with solely at the quarterly joint HOSC/HWB HASC performance workshops. Mr Persey replied that he was happy to bring performance information to HOSC where the data is available (the KPIs for health and social care integration are still being determined). He did not bring performance to this meeting because he had been briefed not to.

However, HASC performance is currently strong. For example, there has been a concerted focus on placements into residential care, where performance has historically been poor. This has been very effective, with the year-end target for reductions already exceeded. Social care reviews remain a real concern, but they are now being processed by priority which should help address the problem.

18.9    Fran McCabe echoed the call for more HASC performance reporting at HOSC, noting that although performance may be reported at other council committees, HOSC co-opted members were unable to scrutinise it there. Ms McCabe also expressed concerns that rising health inequalities might be linked to problems with city GP practices. Mr Persey responded that this was an understandable concern. However, the key factor here was probably the number of GPs working in Brighton & Hove rather than the number of practices, as long as there was a spread across the city. HASC is now working more closely with city GPs: social care has been split into three localities which each align with two of the six city GP clusters.

18.10  In answer to a query from Cllr Janio on the benefits of integration, Mr Persey told members that integration would give the CCG a better understanding of council responsibilities that constitute the broader determinants of health, such as housing and culture. Integration will also help drive a greater focus on prevention. The challenges of integration should not be underestimated, as the council and the NHS are culturally quite different, but this work is very important.

18.11  The Chair thanked Mr Persey for his presentation.