Agenda item

The Committee received a report presenting an update on the integration of community health and adult social care services delivered by the Community Health and Adult Social Care Service (Community Service) which held the commissioning responsibilities for all the statutory adult social services ensuring all requirements of the Local Authority including safeguarding, are enforced and also provided leadership for and operation of all the adult community health and statutory social care services operating in the Borough delivered through an alliance of several employers.  The Community Service was a critical mechanism to realising the shared vision for the wider health and social care economy and it was therefore essential that the service is focussed on wellbeing and prevention, enabling people to regain independence whilst targeting long-term support at those people with the most complex needs.

The emphasis for Phase 2 of integrating community services has therefore been focused on design and implementation of an integrated community service that would enable practitioners to focus on supporting people in their communities, avoid acute interventions and long-term community service dependency, reinforce a new culture of self-care, place and strength-based support, drive financial and demand efficiencies, and deliver better outcomes for residents and the economy as a whole.  The high level care and support pathway that it was envisaged would deliver this vision was illustrated, and support to provide a clear understanding of where the organisation needed to be to deliver this vision was being sought.

Alongside this work, the following were key areas of development –

·         Community enablement – to design and deliver an enablement model that building on the partially integrated crisis enablement team and further improve the referral pathway into enablement services;

·         Embedding integration – developing and embedding standard operating procedures for the integrated neighbourhood community teams;

·         Adults Targeted Model – designing and implementing a model for prevention and resident engagement to support people to self-care;

·         Streamlining governance and decision-making – while ensuring that the governance arrangements and requirements of each of the organisations involved were still met; and

·         Operational reform of services with known high risk concerns to ensure that we have strong and stable services are in operation ahead of transforming them to meet the refocused vision.

Other work being undertaken was the review of community health contracts transferred from Pennine Care Foundation Trust to the Oldham Care Organisation following recognition that the specifications were out of date, and the implementation of a redesigned safeguarding adults system.

A Member queried how changes to service delivery are communicated to service users and what feedback was received.  It was accepted that more work on communication needed to be done, in part because information governance and data sharing issues needed to be resolved, and in part in developing an identity for the new structure which Phase 2 would seek to resolve.

The role that the North West Ambulance Service (NWAS) might play within this service model was queried.  Members were advised that early work seemed to be going well, NWAS being made aware of the community enablement provision and the quick responses possible, and they were keen to work with and develop this model.

Noting the complexity of the issue of integration generally, a Member made reference to the agreed development of a glossary of health and social care terms at the Development Session held on 15^th October 2019 (and reflected in the submitted Committee Forward Plan elsewhere on the agenda).  In this regard it was suggested that future submissions might contain some explanation of the boxes within the organisational and governance structures at Appendices 2 and 3 to the submitted report, and show how the diagrams at paragraph 3.5 to the submitted report emphasising a shift to self-care, preventative and place-based practice approaches, and at paragraph 4.1 illustrating the Community Health and Adult Social Care Services high level care and support pathway, related to those organisation and governance structures.  In this regard, the Director advised that efforts to simplify were being made, and invited the Chair and Vice Chair to join him and the Strategic Director (Commissioning) to contribute to a piece of work in this regard.

With regard to the projected Adult Social Care overspend, there was an acknowledgement that budget availability was not going to change soon and so service redesign was about managing resources effectively and identifying different ways of working.  Going forward, there would be a consideration of funding availability, what the Service can do within that funding in terms of care delivery and how this might be enhanced, including a consideration of different patterns of demand across different geographical areas.  The split of the five geographical areas was advised.  Within the geographical areas, no particular approach had been made to Parish Councils, but leading Members were being kept updated on progress.

A Member suggested that references to older people needing care because of falls tended to presume a fall within the home, querying whether any record was made of falls on footpaths and whether Highways were notified accordingly.  Confirmation as to whether falls data was recorded in this way could not be given, but the issue raised would be considered further.

RESOLVED that

1.            the update on the integration of Health and Adult Social Care Services be noted; and

2.            a further update on the progress of Health and Adult Social Care Services integration be provided to the Committee in a Development Session to be provided in/around September 2020.