Agenda item

Report of the Director of Adults

The Board considered a briefing note and presentation of the Director of Adults and Housing, on the progress made over the last 12 months to manage increasing demand in Adult Social Care and to advise how risk was monitored across all service areas.

Managing risk within a high volume and dynamic environment was part of the daily business of Adult Social Care.  Although the numbers of people waiting for an assessment across the services had reduced, additional risk management approaches were in place to support and enable people waiting for an update on their situation.

Some people waited longer than others for interventions and the average days waiting for assessment was not on target.  To mitigate risk and ensure those with the greatest need had an assessment completed in a timely manner, robust risk assessments and escalations were in place and a process had recently been introduced to monitor the risk which involved proactively contacting people to update on their situation and review risks.

Over the past year, improvements had been seen in many areas and a reduction seen in those waiting for further assessment as well as an increased number of positive change in a number of key Adult Social Care Outcomes Framework (ASCOF) indicators.

Increased casework complexity impacted on capacity and throughput of cases although cases deemed lower risk would wait longer for an assessment or review.

Overall levels of risk are monitored by Heads of Service.  Escalation processes were in place to monitor level of risks and response times to ensure cases were appropriately risk assessed and allocated accordingly.  Managers reviewed the priority cases on the list for allocation to a worker weekly.  Handover meetings were in place to support the handover between shifts for AMHP.  Heads of Service would also take action to mitigate risk by moving staffing resource to meet demand and reallocation of cases.

There were approximately 3600 people in receipt of ongoing care and support in Coventry, 2700 of which were in long term support for 12 months or more.  Overall referrals into intake Teams were 210 referrals per week (900 per month), 46% of which were Safeguarding referrals, significant numbers of which were resolved at source with only 40% requiring intervention from a Social Worker or Occupational Therapist.

The hospital social work team received an average of 700 referrals per month, all of which were allocated on the same day due to the timely nature of hospital discharges.

Increased demand on ASC meant waiting times are longer for some and were likely to be an issue of challenge in the forthcoming CQC Inspections.  Following the introduction of 2 new staff in January 2024, a positive impact was being seen.

Members of the Scrutiny Board, having considered the content of the briefing note, verbal update and presentation, asked questions and received information from the officers on the following matters:

·  Year on year increases were being seen in DoLS cases.

·  Referrals to ASC was a staged process.  A good proportion of patients did not go on to require an assessment however, some patients went on to long term support.

·  General referrals had seen a 17% increase.

·  Colleagues were responsive to training requirements however, the budget was limited.  Expertise within the directorate was utilised for training purposes.

·  A 24/7 emergency team to support all crisis cases and a 24 hour AMPH rota was in place.

·  Tools for managing risk included a workload waiting tool which was being trialled in some areas and sometimes a video call was used however, in many cases visits were necessary due to patients mental health ability.

Members requested information on the Disabled Facilities Grant levels.

RESOLVED that the Health and Social Care Scrutiny Board (5) review the work of Adult Social Care, to understand the approaches and mechanism that are in place to manage demand on Adult Social Care.