Community Impact Assessment Form For a summary of this Community Impact Assessment, click here Note: A Community Impact Assessment must be undertaken before and at the time that a decision is being considered Title of Community Impact Assessment: Commissioning Review of Services for Carers Directorate: Community, Health and Social Care Directorate Date of assessment: 19th September 2011 Names and roles of people carrying out the community impact assessment. (Please identify Lead Officer): Lead Officer: Jennifer McGovern – Assistant Director, Joint Commissioning; Deborah Siddique – Principal Officer, Commissioning Section A – What are you impact assessing? What are you impact assessing? (please tick which applies):o A decision to review or change a service o A strategy o A policy or procedure A function or service Are you impact assessing something that is?:o o New Existing Being reviewed Being reviewed as a result of budget constraints Describe the area you are impact assessing and, where appropriate, the changes you are proposing? 1 CHSC commission a range of services for vulnerable adults from Third Sector providers, including advocacy; advice and information; day care; and support for:older people, disabled people, people with HIV/AIDS, people who experience mental ill-health, cares and people with conditions and / or diseases such as stroke and cancer. These services help people to live in the community and maintain their independence, preventing or delaying their need for specialist interventions. The health and social care services provided by these Third Sector organisations were reviewed in 2010/11 in response to the Comprehensive Spending Review, which necessitated efficiency savings equivalent to 8%. Whilst this meant that most organisations had to make adjustments to the way they carried out their services the actual level of services received by vulnerable adults was largely unaffected in 2011/12. However the continuing requirement for efficiencies means that the level of service provision is likely to be affected in 2012/13. This impact assessment is considering services commissioned for Carers. The Commissioning cycle involves a continuous activity of assessing need, identifying provision, identifying gaps, specifying service requirements, identifying a budget, agreeing the contract, monitoring performance and reviewing the service. As all the contracts with Third Sector organisations were coming to an end on 31st March 2011 it was agreed that a strategic review of services was necessary. In order to facilitate this all contracts were extended to 31 st March 2012. The review involved: Individual meetings with providers Analysing review forms completed by providers to establish strategic relevance and identify the full scope of their activity Stakeholders contacted for their views to input into the review and recommissioning process Questionnaire and focus group with service users In addition the review has been informed by the: Joint Strategic Needs Assessment Client group specific commissioning strategies Commissioning Strategy for Personalisation Gap analysis based on the Adult Social Care / NHS Outcome Frameworks Analysis of policy, commissioning guidance and legislation The outcome of the review is that three priorities have been highlighted for commissioning services. These are: 2 Personalisation Services delivering advice, information and support; services providing advocacy; services which can be purchased by individuals with their own resources, including personal budgets Rehabilitation and Prevention Services delivering specialist rehabilitation and preventative support designed to maintain independent living and prevent the need for admission to secondary care or intensive social care Infrastructure Support Services which contribute to the infrastructure required to deliver effective partnership working It has been determined that there will be 5 single contracts commissioned from 1st June 2012: General Information, Advice and Support Advocacy Services Dementia Support Carers Services Delivering Direct Payments Hospital Discharge and Stroke Services will continue to be provided by the existing providers. This means that the City Council will continue to directly commission a specific contract for support services for carers. In addition carers will be able to access a Carers Personal Budget to purchase breaks. Section B – Is a Community Impact Assessment required? Consider what you are impact assessing and mark “x” for all the statement(s) below which apply Service or policy that people use or which apply to people (this could include staff) Discretion is exercised or there is potential for people to experience different outcomes Concerns at local, regional or national level of discrimination/inequalities Major change, such as closure, removal or transfer 3 X X X X Community and regeneration strategies, organisational or directorate partnership strategies/plans Employment policy – where discretion is not exercised Employment policy – where discretion is exercised, e.g., recruitment or disciplinary process X If none of the areas above apply, you will not be required to undertake a community impact assessment. Please summarise why a CIA is not required and send this form to your directorate equality lead officer Equality Areas Indicate with an “x” which equality areas are likely to be affected by the proposals Age X Religion and/or belief X Disability X Race X Gender (including pregnancy and maternity) Gender reassignment X Sexual Identity X X People on a low income X Race X Other (please state) (For example carers, ex offenders) Carers If any of the areas above apply, you will be required to undertake a CIA. You will need only to consider those areas which you have indicated are likely to be affected by the proposals. 4 Section C – Information Please provide a list of the information (monitoring and consultation) used to inform your CIA and what this information tells you. If there are any gaps in information, explain how you will address this. Equality area Age List of information What does this information tell you? How will gaps be addressed? (This should also be detailed in the action plan at section E) Mid-Year Census data There are approximately 33,200 people over There are no gaps in the age of 65 in Salford (15.4% of the information Service User data population. This is expected to rise to from providers 17.2% by 2025. It is predicted that 35.8% (11,893) of people over 65 live alone, 10.7% Service Provider (3,581 are carers and 32.4% (10,780) are Review Forms unable to manage at least one self-care activity on their own. Stakeholder In Salford 13% of the 16 – 74 population are consultation carers which means there are approximately 20,600 carers in Salford. The current provider organisations engage with a large number of carers in Salford – over 4,450. Where age has been recorded the indication is that a large number of carers are over 65 - 50% of carers using 4 of the current providers services are 65+. The information tells us that carers are accessing the current services in line with expectations 5 Disability Census data Service User data from providers Service Provider Review Forms Stakeholder consultation Gender (including Census data pregnancy and maternity) Service User data from providers Service Provider Review Forms It is predicted that 32.4% (10,780) of the 65+ population in Salford are unable to manage at least one self-care activity on their own. There were 14,999 people on the Chronically Sick and Disabled Persons Register in June 2008 and 18.5% of these were under 65. 1,034 are registered with a hearing loss, 220 are profoundly deaf, 989 are registered blind and 1,055 are partially sighted; 175 people are deaf and blind. Whilst many disabled people have a carer it should also be noted that a significant proportion of carers also have a disability. Records produced by 4 of the current providers show that 34.5% of their carers are disabled. The premises of the current provider organisations are all physically accessible and each produces a range of information in accessible formats. This information tells us that carers with a disability are accessing the services they need In 2008 there were 68,400 (38.6%) men and 108,985 (61.4%) women aged18 – 64 and 14,400 (43.2%) men and 18,900 (56.8%) women over the age of 65 in Salford. Women generally live longer than men and it is the very elderly that are more likely to need services. Women are also much more 6 There are no gaps in information There are no gaps in information Stakeholder consultation Gender Reassignment No data available Race Census data Service User data from providers Service Provider Review Forms Stakeholder consultation Religion and/or belief Census data likely to be carers. Of those receiving services from 5 of the current Third Sector providers 30.7% are men and 69.3% are women. This information tells us that men and women are accessing the services in the proportions expected It is estimated (by the Gender Identity Research and Education Society) that the prevalence of gender dysphoria is 20 per 100,000 population. This would equate to 43 in Salford. This is an area of growing demand for medical treatment (doubles every 5 years) It is known that the BME population has grown since 2001 and according to the 2007 ONS population estimate 7.98% of the population in Salford is from a BME community. Of the individuals accessing current 4, not BME specific, services approximately 4.3% are from BME communities. Two services are BME specific. This information tells us that, given the demographics of the BME population the communities in Salford are accessing services in line with expectation The 2001 census indicated that 76.46% of the population in Salford was Christian, 2.4% Jewish, 1.22% Muslim. It is known 7 Data on gender reassignment is not collected by the providers. This will be required of providers in future There are no gaps in information Data on religion is not collected by all providers. This will be required of Sexual Identity Government data Service User data from providers Service Provider Review Forms People on a low income Stakeholder consultation Service Provider Review Forms that these figures have changed – for example it is believed that the Jewish population is now 5.5%. The people accessing the services of the BME specific providers are doing so because they are sensitive to their religious needs. Of the not BME specific service providers two have recorded religion and this indicates that 6.75% are from faiths other than Christian Information on sexual identity was not collected in the 2001 census but the Government figure is that 5.7% of the population is lesbian, gay or bisexual. Most services for older people are targeted at heterosexuals. Information on sexual identity is not collected by the current service providers providers in future Whilst the employment status / income level of people using carers support services is not recorded all have access to welfare benefits checks through the providers. Whist some carers will manage to work as well as undertake their caring role many do not – 14% of carers provide 20 -49 hours of care each week and 24% provide over 50 hours. The employment status of carers has only been recorded by one provider – this Data on income level / employment status is not collected by the providers. This will be required of providers in future 8 Data on sexual identity is not collected by the providers. This will be required of providers in future Other (please state) (For example carers, ex offenders) Service User data from providers Service Provider Review Forms Stakeholder consultation indicates that 20.3% are unemployed. Health inequalities are also closely linked with levels of deprivation and carers often have additional health problems – 15% describe themselves as not being in good health It is estimated that there are 20,000+ carers There are no gaps in in Salford of whom approximately 3,500 information receive a service from Community, Health and Social Care Directorate. Over 4,400 carers receive a service from Third Sector providers (NB: many carers will receive a service from both CHSC & the Third Sector). A significant number of carers will be older people looking after a partner or their learning disabled offspring. Overall this indicates that carers are accessing services appropriately Section D – Potential impact and how this will be addressed The Equality Act 2010 requires public bodies to have “due regard” or to consciously think about the three aims of the Equality Duty as part of the process of decision-making, in the following areas: Eliminate unlawful discrimination, harassment and victimisation Advance equality of opportunity between people who share a protected characteristic (link) and those who do not 9 Foster good relations between people who share a protected characteristic and those who do not Indicate below how you will meet the Equality Duty. Eliminate discrimination Equality area Age Advance equality of opportunity Based on information What changes will you detailed in Section C above, make to the function to who is not, or may not be maximise positive getting the outcome they outcomes for all groups? need from the function? Explain why. Carers are accessing current The new contracts for: services as expected in terms General Advice, of the age demographics of Information and Support population Advocacy Dementia Support As the older population Carers Services increases in size and Delivering Direct becomes more frail services payments will need to ensure they Will have service reflect the needs of a wider specifications that include age range of service users provision for older carers. Providers will be expected to demonstrate that their service is appropriate to carers in different age groups. In addition it is expected that carers will also be able to purchase a range of services 10 Foster good relations Is there potential to foster good relations between different equality groups? Explain how you will do this. Third Sector provider organisations are being encouraged to diversify and work in partnership to provide services that are appropriate to different equality groups and reach as many vulnerable adults as possible Disability from providers of their choice using their own resources, including carers personal budgets Disabled carers are accessing The new contracts for: the current services General Advice, appropriately. Information and Support Service providers will need to Advocacy ensure that their services are Dementia Support accessible to people with Carers Services physical and/or sensory Delivering Direct impairments. payments Services also need to take Will have service action to combat attitudinal specifications that include barriers provision for disabled carers. Services should provide information in formats other than English. Providers will be expected to demonstrate that their service is appropriate for physically and sensory impaired carers. In addition it is expected that carers will also be able to purchase a range of services from providers of their choice using their own resources, including carers personal budgets 11 Third Sector provider organisations are being encouraged to diversify and work in partnership to provide services that are appropriate to different equality groups and reach as many vulnerable adults as possible Gender (including pregnancy and maternity) Gender Reassignment Carers are accessing current The new contracts for: services as expected in terms General Advice, of the gender demographics Information and Support of the population. Advocacy Providers will need to ensure Dementia Support that services are appropriate Carers Services to the needs of men and Delivering Direct women as the demographics payments of the carer population Will have service changes specifications that include provision for men and women carers. Providers will be expected to demonstrate that their service is appropriate for men and women. In addition it is expected that carers will also be able to purchase a range of services from providers of their choice using their own resources, including carers personal budgets No data available to indicate The new contracts for: whether or not carers who General Advice, have changed gender are Information and Support accessing current services Advocacy Dementia Support Carers Services Delivering Direct 12 Third Sector provider organisations are being encouraged to diversify and work in partnership to provide services that are appropriate to different equality groups and reach as many vulnerable adults as possible Third Sector provider organisations are being encouraged to diversify and work in partnership to provide services that are appropriate to different equality groups and reach as many vulnerable adults as possible Race Carers from different BME communities are accessing the services as expected according to the demographics of the population. Given the size of the BME population providers need to ensure that their services are inclusive and can adapt as payments Will have service specifications that include provision transgender carers. Services should be also be sensitive to carers who are in the process of gender reassignment or have changed gender. Providers will be expected to demonstrate that their service is appropriate for carers who have changed gender. In addition it is expected that carers will also be able to purchase a range of services from providers of their choice using their own resources, including carers personal budgets The new contracts for: General Advice, Information and Support Advocacy Dementia Support Carers Services Delivering Direct payments Will have service specifications that include 13 Third Sector provider organisations are being encouraged to diversify and work in partnership to provide services that are appropriate to different equality groups and reach as many vulnerable adults as possible the population increases Religion and/or belief Not all current providers record the religion of service users. Carers access the BME specific providers services because they are religiously and culturally sensitive. All service providers will need to ensure data on religion / belief is captured and that they provide appropriate spiritual welfare services provision for BME carers. Services should be culturally sensitive and provide information and support in languages other than English. Providers will be expected to demonstrate that their service is appropriate for carers from all BME communities. In addition it is expected that carers will also be able to purchase a range of services from providers of their choice using their own resources, including carers personal budgets The new contracts for: General Advice, Information and Support Advocacy Dementia Support Carers Services Delivering Direct payments Will have service specifications that include provision for carers from different faiths and beliefs. Services should be sensitive to carers religion / beliefs and 14 Third Sector provider organisations are being encouraged to diversify and work in partnership to provide services that are appropriate to different equality groups and reach as many vulnerable adults as possible Sexual Identity support their spiritual welfare. Providers will be expected to demonstrate that their service is appropriate for different religious / belief communities. In addition it is expected that carers will also be able to purchase a range of services from providers of their choice using their own resources, including carers personal budgets No data available to indicate The new contracts for: whether or not carers of General Advice, different sexual identities Information and Support access services. Providers Advocacy need to collect this data and Dementia Support ensure that the environment Carers Services and information is appropriate Delivering Direct for communities of all sexual payments identities Will have service specifications that include provision for carers of different sexual identities. Services should be sensitive to individuals of different sexual identities. Providers will be expected to demonstrate that their service is appropriate for different 15 Third Sector provider organisations are being encouraged to diversify and work in partnership to provide services that are appropriate to different equality groups and reach as many vulnerable adults as possible People on a low income Current providers do not record income level or employment status of carers using their services. Many carers are older people on low income or state benefits and experience higher levels of deprivation and therefore health inequalities. Service providers will need to ensure data on income level / benefit status is recorded and that carers are supported to maximise their income sexual identities. In addition it is expected that carers will also be able to purchase a range of services from providers of their choice using their own resources, including carers personal budgets The new contracts for: General Advice, Information and Support Advocacy Dementia Support Carers Services Delivering Direct payments Will have service specifications that include provision for carers. Services should help individuals to maximise their income. Providers will be expected to demonstrate that their service helps to reduce socioeconomic inequality. In addition it is expected that carers will also be able to purchase a range of services from providers of their choice using their own resources, 16 Third Sector provider organisations are being encouraged to diversify and work in partnership to provide services that are appropriate to different equality groups and reach as many vulnerable adults as possible including carers personal budgets Other (please state) (For example carers, ex offenders) Carers are accessing the current services as expected. Service providers need to ensure that their services are carer friendly. The new contracts for: General Advice, Information and Support Advocacy Dementia Support Carers Services Delivering Direct payments Will have service specifications that include provision for carers. Services should support people in their caring role. Providers will be expected to demonstrate how their service has benefitted carers. In addition it is expected that carers will also be able to purchase a range of services from providers of their choice using their own resources, including carers personal budgets Cross cutting themes (If your responses cover all equality 17 Third Sector provider organisations are being encouraged to diversify and work in partnership to provide services that are appropriate to different equality groups and reach as many vulnerable adults as possible areas, state here) Could making the changes in any of the above areas have a negative effect on other groups? Explain why and what you will do about this. None of the above should have an impact on other groups. The service specifications are intended to make services inclusive to all communities / groups . 18 Section E – Action Plan and review Detail in the plan below, actions that you have identified in your community impact assessment, which will eliminate discrimination, advance equality of opportunity and/or foster good relations. Impact (positive or negative) identified Proposed action Collection of data to Lack of data on: be included in new Gender reassignment service specifications Religion / belief Employment status One new contract for Carers Support is being tendered to replace the 6 current Third Sector Provider contracts One new contract for New specification for Carers Support Services will incorporate appropriate services for carers within all equality groups require evidence that services are accessible to carers within all equality groups Encourage Third Sector organisations Person(s) responsible Integrated Commissioning Managers Target date Required outcome Inclusion in Specifications: October 2011 Collection: from July 2012 Data will be available from April 2013 Integrated Commissioning Managers Inclusion in Specifications: October 2011 Contracts in operation: from July 2012 Redesigned, inclusive services available from July 2012 Commissioning Team December 2011 then (in partnership with on-going 19 Redesigned, inclusive services available Carers Support is being tendered to replace the 6 current Third Sector Provider contracts to diversify and work in partnership to provide services that are appropriate to different equality groups and reach as many carers as possible Enable Third Sector Services not covered organisations to by the new contracts make the transition will have to be from block contracts purchased by to providing services individuals using their that individuals own resources purchase with their personal budget Salford CVS) from July 2012 Commissioning Team March 2014 (in partnership with Salford CVS) Wide choice of services available for people to purchase Review Your CIA must be reviewed at least every three years, less if it has a significant impact on people. Please enter the date your CIA will be reviewed: September 2014. You should review progress on your CIA action plan annually. 20 Section F – Summary of your CIA As your CIA will be published on the council’s website and accessible to the general public, a summary of your CIA is required. Please provide a summary of your CIA in the box below. Summary of Community Impact Assessment How did you approach the CIA and what did you find? This CIA has been based on information gathered during individual meetings with provider organisations, review forms completed by the provider organisations, stakeholder questionnaires, current service user questionnaires and focus groups. The CIA also takes into account the JSNA, appropriate commissioning strategies, a gap analysis based on the Adult Social Care / NHS Outcome Frameworks. The three priority areas identified: Personalisation; Prevention and Rehabilitation; Infrastructure Support mean there will continue to be a contract specifically for carers from June 2012. The information indicates that carers are accessing current services as expected, according to the demographics of the population in Salford, in relation to age, disability, gender and race. There is a lack of data in relation to level of income / employment status, religion / belief, sexual identity and gender reassignment. What are the main areas requiring further attention? The redesigned services will form five new contracts which organisations, including existing providers, can tender for as sole provider or as a partnership arrangement. These are: General Advice, Information and Support Advocacy Dementia Support Carers Services Delivering Direct Payments The new Carers Support contract will have service specifications that: incorporate appropriate services for carers in all equality groups require evidence that services are accessible to carers in all equality groups Some areas of current service provision may not be covered by the new contracts e.g. day care, carers breaks. These will need to be purchased by individuals using 21 their own resources, including carers personal budgets. Organisations will be worked with to ensure they are able to make the transition to this new purchasing model. The new contracts will require providers to collect data on employment status, religion / belief, sexual identity and gender reassignment. Summary of recommendations for improvement Services will be redesigned under 5 new contracts incorporating all equality groups Organisations will be supported to operate successfully in the new Personalisation model Data on all equality groups will be collected by providers Section G – Next Steps Quality Assurance When you have completed your CIA, you should send it to your directorate Equality Lead Officer who will arrange for it to be quality assured. It is important that your CIA is robust and of good quality as it may be challenged “Sign off” within your directorate Your directorate Equality Link Officer will then arrange for your CIA to be “signed off” within your directorate. Your CIA will be returned to you if more work is required. Your directorate Equality Lead Officer or other senior manager within your directorate should “sign off” your CIA. Publishing When your CIA has been signed off within your directorate, your directorate Equality Link Officer will send it to the Equalities and Cohesion Team for publishing on the council’s website. Monitoring Your directorate Equality Link Officer will also send your CIA to your directorate Performance Officer where the actions identified within your CIA will be entered into Covalent, the council’s performance management monitoring software so that progress can be monitored as part of your directorate Business Plan. 22