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Our Local Account of services 2014 - 2015

Our Local Account of services 2014 - 2015

Local account image

What is the Local Account?

Each year we produce a local account to tell people what their adult social care services are doing. The report explains:

  • What we have been doing to make people’s lives better
  • How much we spend
  • What we spend money on
  • What our plans are for the future

Our priorities

You can find out more about our vision and priorities on our adult social care vision page.

We provide Adult Social Care services to thousands of people each year, including:

  • Statutory support services to vulnerable adults
  • More general support to help improve health and wellbeing of all

Who contacted us?

In 2014 - 2015 we were contacted by 4,600 people. Of these people:

  • 0.1 percent came from what is known as planned entry. These are young people who have received social care services as children
  • 18.5 percent came from discharge from hospital
  • 81.4 percent came from the community or other sources
  • 20.3 percent were passed on for further assessment
  • 79.7 percent didn't go onto to have an assessment. They were given advice or signposted to serves
 

What happened following requests for support?

Short term support

285 people received Short Term Support to Maximise Independence. Of these:

  • 25 were aged 18 - 64 (8.8 percent)
  • 260 were aged 65 and over (91.2 percent)

The most common reasons were:

  • Physical Support: Personal Care Support (52.6 percent)
  • Physical Support: Access and Mobility Only’ (33.3 percent)

See the graph below:

Short term support - primary reason

Of the 285 clients who received this support:

  • 50 went onto receive long term support
  • 15 ended early
  • 5 went onto receive low level ongoing support
  • 5 had identified needs but were funding their own care and support
  • 5 declined the support offered
  • 5 were signposted or went onto receive universal services
  • 190 had no services offered because they had no identified needs
  • 10 went onto other short term support

Long term support

1770 clients accessed Long Term Support. Of these:

  • 705 clients were aged 18-64 (39.8 percent)
  • 1065 were aged over 65 (60.2 percent)

As of March 2015, 650 people aged 18-64 and 720 people aged 65 and over were still receiving services, making a total of 1370.

The most common reasons were:

  • Physical support: personal care support for people aged over 65
  • Learning disability support for people aged 18 - 64

See the graph below:

Long term support - primary reason

Residential and nursing care

Of the people receiving long term care 330 accessed residential care of which:

  • 210 were aged over 65
  • 120 were aged 18 - 64 

260 people accessed nursing care of which:

  • 250 were aged over 65
  • 10 were aged 18 - 64

The rest of the people receiving long term support were supported in the community

Autism and Asperger's  syndrome

As of 31 March 2015 there were:

  • 55 clients with autism
  • 45 clients with Asperger's syndrome

They were all aged 18 - 64 and accounted for 7.3 percent of all clients receiving long term support.

Carers

Carers have a right to receive an assessment of their own needs and may be eligible for services to support them in their caring role.

In 2014-15, there were 950 requests for carer support. Of these:

  • 545 had support provided directly to them (57.4 percent) 20 of which (2.1 percent) related to carers under 18
  • 225 were helped by respite or other forms of support being given to the person they care for (23.7 percent)
  • 180 received no direct support (18.9 percent). Nationally, this was 24 percent

We provide services to people in a wide range of circumstances. The main aim of these services is to promote and maintain the health and wellbeing of vulnerable adults by enabling them to live safely in their own homes. 

To do this, people might need: 

  • Information and advice 
  • Short-term support to get them back on their feet 
  • Intensive, long-term services

Below are some examples of the support we provide:

Case study A: personal budget and becoming an adult

A is a very vulnerable young man who attends a special school and lives at home with his mother:

  • When he reached the age of 17, he was supported by a social worker during his transition from children’s services to adult social care
  • The adult assessment highlighted that his mother was responsible for supporting him in all aspects of his life
  •  A personal budget was arranged that would allow him to meet new people and develop a sense of independence while giving regular short breaks to his mother allowing her to make plans for herself
  • A support plan was drawn up which detailed how he wanted to spend his budget and how he would be supported safely
  • He was able to choose his support worker himself and has been able to plan more and more what he would like to do and when he would like to do it
  • He, with the help of his support worker, fulfilled a long-held dream by travelling to a rock concert to see his favourite band
  • He made a video of the whole day which he presented to the Learning Disability Partnership Board
  • This has made a huge difference to his confidence and he is now thinking about going to college next year

Case Study B: how a personal budget allowed a lady to stay in her own home

Mrs B suffers from a number of serious medical conditions: 

  • Mrs B has been paying privately for full-time, live-in care without which she would have to go into a care home
  • When her funds depleted, she approached us
  • After assessment, a personal budget was set up to fund Mrs B's care needs. This is paid in the form of a direct payment which is managed by a member of her family
  • This has enabled Mrs B to have choice and control over her care
  • All her needs are met by carers with whom she has a close relationship
  • Mrs B is happy that she can carry on living in her own home with all its fond memories
  • Her family are happy as they can see that Mrs B is well cared for and safe

Case Study C: how a personal budget helped a resident fulfil their choices

Mr C has a rare degenerative illness and, after an active life, was forced to retire as the illness took its toll upon his physical abilities: 

  • He feared being moved out of his beloved home. 
  • We first became involved by altering aspects of Mr C's home to allow wheelchair access and to make adaptations designed to help him make the most of his home. 
  • For the tasks that Mr C couldn't manage, a Personal Budget was agreed which would pay for support carers to visit and he made the most of his abilities to remain independent. 
  • To do the heavier domestic tasks Mr C had come to rely upon a person he had known for many years. 
  • After a period of time, we became involved again when it was suspected that this person had been taking advantage of the relationship for their own financial gain. 
  • Our adult protection team worked with Mr C to ensure his safety, and looked again at his personal budget. 
  • His needs had changed because he could no longer trust this person in his home. 
  • Mr C’s personal budget was increased to pay for his support carers to undertake all of those domestic tasks that he could not manage. 
  • This freed Mr C of his dependency on volunteers and friends furthering his opportunities to live in his own home safely and to continue to enjoy making his own choices in life.

Case Study D: how support allowed a carer to continue in her caring role

D was referred to the assessment team for a Carers Assessment: 

  • D is the main carer for her son who has extremely high care needs and is unable to meet any of these needs independently
  • D provides full support
  • D’s assessment recognised that there are aspects of her day to day living which have been exacerbated due to caring for her son such as the expense of shopping and the amount of laundry she has to do for him
  • D has said she is happy to continue to support her son despite the impact. However, the washing machine was ‘on its last legs’ and it would be very difficult for her to take the washing to the launderette
  • This was causing her stress. A one-off personal budget payment allowed D to buy a new washing machine which meant she could continue her caring role

The Step-Up /Step-Down scheme

This service is a comprehensive reablement and social care package which:

  • Helps prevent people being admitted to hospital unnecessarily 
  • Enables people to be discharged earlier than would otherwise be possible. 

Following assessment, trained reablement workers will work with the individual, slowly reducing the level of support they need to carry out the tasks of daily living as they become more independent.

The Adult Social Care Outcomes Framework (ASCOF) is a way of looking at outcomes (or end results) for people who use social care. 

You can look at any authority in the country and see how outcomes for the key measures compare with other areas.

Enhancing quality of life for people with care and support needs

The social care-related quality of life measure within the ASCOF gives an overarching view of the quality of life of users of care and support. 

In 2014-15, social care-related quality of life for Wokingham was 19.4 out of a maximum possible score of 24. This is:

  • Up from 19.2 in 2013 - 2014
  • The same as the average for South East region
  • Higher than the average for England which is 19.1
 

Any decisions about a person’s care and support will consider their wellbeing and what is important to them and their family. 

One measure of this is the proportion of people who use services who have control over their daily life. For Wokingham this was 82.1 per cent in 2014-15 which is:

  • Up from 76.9 percent in 2013 - 2014
  • Higher than the average for the South East region (80.1 percent)
  • Higher than the average for England as a whole (77.3 per cent)

Carers reported an average quality of life score of 7.8 out of a maximum of 12. This is similar to the scores for:

  • The South East region (7.7)
  • England (7.9)

To give people more flexibility and choice about the type of service they want, we have continued to increase the number of people receiving personal budgets and direct payments.

See the graph below:

Proportion of people using social care who receive a personal and direct payment

Delaying and reducing the need for care and support

The number of older people admitted to residential and nursing care homes in Wokingham has continued to reduce in line with our policy of enabling people to stay living independently in their own homes. 

The rate of admissions for 2014-15 was:

  • Lower than rate in 2013 - 2014
  • Lower than the average rate for the South East region
  • Lower than the average rate for England as a whole

The reablement service aims to support people to relearn lost skills. It promotes independence and enables them to continue with their life. 

One measure of this is to see how many people who have been given reablement services when they leave hospital are still at home 91 days later. 

For Wokingham, the figure for 2014-15 was 77.9 per cent. This is:

  • Up from 65.6 percent in 2013 - 2014
  • Lower than the average for the South East region which is 79.4 percent
  • Lower than the average for England as a whole which is 82.1 percent

Some people who contact us for help will only need short-term support to get them back on their feet. 

We can see how effective this is by measuring what percentage of the people required no further support (or only support of a lower level) after they received short-term support. 

For Wokingham this was 81.2 per cent in 2014-15. This is:

  • Higher than the average for the South East region (74.5 percent)
  • Higher than the average for England as a whole (74.6 percent) 

Find out more

For more about the indicators see the Adult Social Care Outcomes Framework on the UK Government website

You see the full list of results by reading Measures from the Adult Social Care Outcomes Framework (ASCOF): Comparator Report 2014-15 (PDF document).

Everyone has the right to live in safety, free from abuse and neglect. You can find out more about this on our personal safety web page.

Safeguarding Adults Board

The Safeguarding Adults Board is made up of local organisations which work together to protect adults at risk of abuse or neglect and keep them safe.


How safe do you feel?

In 2014 - 2015 the proportion of people who use services who felt safe was 72.4 percent. This was:

  • Up from 66.2 percent in 2013 - 2014
  • Higher than the average for the South East region (70.7 percent)
  • Higher than the average for England as a whole (68.5 percent)

Of people who use services, 87.2 percent said that the services they use have made them feel safe and secure. This:

  • Up from 85.6 percent in 2013 - 2014
  • Higher than the average for the South East region (85.5 per cent)
  • Higher than the average for England as a whole (84.5 per cent)

Carers survey

The results of the carers survey show that:

  • 86.4 percent of carers had no worries about personal safety
  • 12.5 percent had some worries about personal safety
  • 1 percent were extremely worried

These results are similar to the national and regional figures. Nationally:

  • 84.9 percent of carers had no worries about personal safety
  • 13.7 percent had some worries about personal safety
  • 1.4 percent were extremely worried

Regionally:

  • 83.8 percent of carers had no worries about personal safety
  • 14.8 percent had some worries about personal safety
  • 1.4 percent were extremely worried

See the graph below:

Carers views about their personal safety 2014 - 2015

Safeguarding

There were: 

  • 400 referrals to the safeguarding team during 2014-5, with 
  • Only 68 percent of these referrals being for people already known to Wokingham’s Adult Social Care service; 60 per cent of these referrals were for females believed to be at risk. 

The age breakdown of the people referred to the safeguarding service was:

Safeguarding referrals 2014 - 2015

None of these referrals resulted in a serious case review.

In 2014-15 £42.9 million of gross current expenditure was spent on long and short term support combined. Of this: 

  • 47.3 per cent (£20.3 million) was spent on people aged 65 and over
  • 52.7 per cent (£22.6 million) on people aged 18 to 64

Total expenditure on type of support by age

Total expenditure was

  • £0.6 million on short term support for people over 65
  • £19.7 million on long term support for people over 65
  • £22.6 million on long term support for people 18 - 64

Total expenditure on type of support by age

Total number of people supported in 2014-15

The total numbers were:

  • 530 people over 65 received short term support
  • 710 people 18 - 64 received long term support 
  • 1070 people over 65 received long term support

Total number of people supported in 2014-15

Expenditure on people aged 18-64 in 2014-15

Expenditure was:

  • £0.4 million (2 per cent) on long term sensory and memory and cognition support
  • £1.6 million (7 per cent) on long term mental health support
  • £3.1 million (14 per cent) on long term physical support
  • £17.5 million (77 per cent) on long term learning disability support

 

Expenditure on people aged 18-64 in 2014-15

Expenditure on people aged over 65 2014-15

Expenditure was:

  • £0.5 million (2.5 per cent) on long term sensory support
  • £0.5 million (2.5 per cent) on long term mental health support
  • £0.6 million (3 per cent) on short term physical support
  • £1.3 million (6 per cent) on long term support with memory and cognition
  • £1.6 million (8 per cent) on long term learning disability support
  • £15.8 million (78 per cent) on long term physical support

 

Expenditure on people aged over 65 2014-15

Adult Social Care Survey

Each February, as part of a national survey, we send out a questionnaire to people over 18 who use social care to find out what they think about their services. 

In 2015, 775 surveys were sent out and 303 people responded (39.1 per cent).

Overall, 67.8 per cent of users reported that they were extremely or very satisfied with the care and support services they received in 2014-15. This is:

  • Up from 66.9 per cent in 2013 - 2014 
  • Higher than the average for the South East region (64.6 per cent)
  • Higher than the average for England as a whole (64.7 per cent)

To find out more see the Personal Social Services Adult Social Care Survey 2014 - 2015 Report (PDF document)

Carers survey

Every two years a survey is sent out to carers. In 2015, 520 surveys were sent out and 277 people responded (53.3 per cent).

Overall, 39.7 per cent of carers reported that they were extremely or very satisfied with the support services they received in 2014-15. This is:

  • Down from 42 per cent in 2012-13
  • Lower than the average for the South East region (41.2 per cent)
  • Lower than the average for England as a whole (41.2 per cent) 

To find out more see the  Personal Social Services Survey of Adult Carers 2014-2015 Report (PDF document)

Complaints

If you are unhappy about something, it is important to let someone know:

  • Most issues are dealt with straight away by Adult Social Care staff but 
  • If the complainant remains unhappy, the complaint will be passed to the Council’s Complaints Team 
  • If everything has been done to resolve the complaint and a person is still not satisfied, they can ask the Local Government Ombudsman to review the matter

In 2014 - 2015 we received 13 formal complaints. The reasons for the complaints were:

  • Appropriateness of Service - 1 complaint
  • Quality of Food - 1 complaint
  • Delay in Arranging Service - 4 complaints
  • Financial Assessment - 2 complaints
  • Quality of Service - 1 complaint
  • Other - 1 complaint

12 of the complaints were dealt with at Stage 1 and the other is still with Local Government Ombudsman. 

Learning from complaints

We were made aware of a client who had been moved into residential care funded by us but who had not subsequently had an Annual Review of her care: 

  • Unfortunately, the placement wasn’t suitable in the longer term but we hadn’t made contact with the family to check all was well. 
  • As a result of this complaint, which was upheld, we made an unreserved apology to the client and her family and have ensured she is now in suitable accommodation where she is happy and settled and being well cared for. 
  • To ensure this will not happen again, changes have been made to our recording processes to electronically transfer this information to our Reviewing Team, and we have also put in place some additional reporting tools so that this can be checked for accuracy on a regular basis.

The Integrated Hub

We have listened to our residents and customers and, in conjunction with Berkshire Health Foundation Trust during the course of 2016 we plan to have an integrated health and social care hub or Single Point of Access for new referrals for adult social care and NHS services. 

This will change the current model of two points of contact for WBC and NHS services respectively into a single integrated service. As we develop this towards April 2016 more information will be made available to service users, carers and professionals.

Pre-Paid Cards for Direct Payments

Some people feel that the administration involved in receiving a Direct Payment is not worth the benefit as you need to open a special bank account and send in regular bank statements and receipts. 

Work is going on to introduce Pre-paid Cards for Adult Social Care direct payments. The cards: 

  • Are a simple electronic bank account that we can monitor online. 
  • Will be used in any location or transaction process where a typical credit or debit card can currently be used. This includes shops, banks, ATMs (if allowed), over a telephone or via the internet. 

You will be able to set up direct debits or standing orders. If you are required to contribute to the costs of your care, you will be able to add your contribution to the card account, keeping all funding in a single place.

We expect to have a contract in place in the final quarter of this financial year. We will then carry out a trial with a small number of current Direct Payment recipients before introducing them to all new and existing customers sometime during the first half of 2016-17.

Go to the direct payments page to find out more.

Joint working across the wider health community – the Frail Elderly Project

A report published by The King's Fund has set out a plan to reduce hospital admission rates, release resources for patients to be cared for at home and stem the growing demand for hospital beds. The plan is based on community services working much more closely with groups of general practices and building multidisciplinary teams to care for people with complex needs.

Across the West of Berkshire the hospitals, GPs, Clinical Commissioning Groups and Local Authorities are working together to deliver on these recommendations. The “Frail Elderly Project” is designed to provide better, more joined-up services to people living in the community as their needs increase with age. Our aim is to develop a health care pathway that responds to the needs of individuals rather than one shaped by the organisational structures, whilst using our combined resources more efficiently to improve the experiences of older people and their families. To take this project forward we are currently:

  • Mapping services across organisational structures
  • Looking at the costs of services provided and desired
  • Sharing details on the types of people we currently support

We are expecting that this analysis will have been finished by spring 2016, so we can make progress towards implementation of the changes during the coming year.

Service Developments

Older People's Housing – Extra Care:

  • Making sure we have the right mix of housing and sufficient provision for older people 

See the Housing Strategy 2015 - 2018 (PDF document) to find out more.

Dementia services:

  • Ensuring we have a range of providers with a skilled workforce which can deliver care with compassion and maintain customers dignity
  • Ensuring there is appropriate support for younger people with dementia

Supported Living options for working age adults:

  • Continuing our aim to provide care for people in the local community rather than in regulated care homes and outside of the borough 
  • Working with health partners to meet the needs of those with challenging behaviour 

Carers - ensuring there is a range of services available to support carers:

  • In their caring role
  • To have a life outside caring
  • To maintain their health and wellbeing

This  will include services to provide:

  • Information and advice
  • Emergency support
  • Specialist support 

Visit the support for carers web pages to find out more.

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