Best Value in Salford
Review of Services to Disabled Adults and
People in Need of Sensory Services
May 2004 - June 2005
Final Challenge Report
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Contents
1.
Introduction to Review
2.
Why are we providing this service
-
National & Local Context
Community Plan & Salford Pledges
3.
Service Context
4.
Best Value Review
5.
Challenge
6.
Consultation
-
7.
Consultation Events
Staff Consultation
Partnership Board
Stakeholders Workshop Priorities
Compare
-
Best Practice Examples
Learning from Inspections
8.
Compete
9.
Options Appraisal
10.
Risk Assessment
11.
Change Management
12.
Improvement Plan
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Appendix
References
(1) SSI Report : Independence Matters
(2) Green Paper ‘Independence, Wellbeing and Choice’
1.1
Legislative Duties
1.2
National Guidance
2.
Pen Pictures
3.
Key Stakeholders
4.
Types of Services, their usage and costs
5.
Budget Paper
6.
Review Team Members
7.1
Improving Service Action Checklist
7.2
Outcome of the Checklist and Scoping Paper 29 June 2004
8.
Consultation Events
8.1
Service Users Events
8.2
Service Users Priorities
9.
Performance Indicators
10.
Best Practice Examples
11.
Progress on Issues from Inspections
12.
Options Appraisal
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1.
INTRODUCTION TO REVIEW
This Best Value Review has focused on the services being provided through
Community and Social Services Directorate to disabled people and people with
sensory needs. The main focus has been on adults aged 18-65 but Sensory &
Community Equipment Services provide a service to all age groups.
The needs of these citizens are far ranging and impact on all Local Authority
Services. Their social care needs are inextricably linked to their health needs.
People are affected by a range of universal services that, through their disability,
they may have difficulty in accessing.
In conducting the review the review has adopted the Social Model of Disability(1) .
This accepts that disabled people have fewer opportunities and a lower quality of
life than non-disabled people. There are two different ways of explaining this
disadvantage.
●
An individual (medical) model of disability where disabled people’s inability to
join in society is seen as a direct result of having an impairment. Efforts are
concentrated on ‘compensating’ people with impairments for what is ‘wrong’
with their bodies, and providing ‘special’ segregated services.
●
The social model of disability distinguishes between the individual
‘impairment’ and the ‘disability’ that is inflicted by society through the loss of
opportunities to take part in society on an equal level because of social or
environmental barriers.
These barriers may be prejudice and stereotyping, inflexible procedures, access to
information, buildings, transport etc. These barriers have nothing to do with
individual peoples bodies, they are created by people which means it is possible to
remove them. Organisations can take a social approach to disability by identifying
and getting rid of the disability barriers within their control.
In conducting this Best Value Review the Disabled People of Salford have
challenged us to adopt this social view of disability. This has also challenged the
way we deliver a whole systems approach to peoples needs.
The services under review in Community and Social Services, start by working
with the individual in seeking to ‘compensate’ for their disability by offering through
assessment, access to a range of services to help enable people to live an
‘independent’ life.
Disabled citizens welcome the individualised help, but want to use this to equip
them to live as equal citizens, not to be dependent on services designed by other
people.
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They want to access the range of opportunities other citizens have, eg:
employment, education, leisure transport to get around the City, adapted housing,
access to information in an accessible format, to be in control of their own lives
and to have the financial resources to do this.
In completing this review Community and Social Services Directorate have looked
into the services they provide for disabled people and recognised the changes that
can be made, but it is apparent that this in itself will not provide the quality lives our
citizens deserve.
During extensive consultation with people, they constantly referred to issues
outside the scope of Community and Social Services Directorate that the City as a
whole, with its Partners through the Local Strategic Partnership, will be better
placed to address.
The implementation plan will focus on what Community and Social Services
Directorate can deliver, but may make recommendations to be followed up by a
wider council/City response.
The current Green Paper ‘Independence, Wellbeing and Choice’, ‘The Future of
Adult Social Care’(2) reflects these same issues and offers guidance on a way
forward.
2.
WHY ARE WE PROVIDING THIS SERVICE
2.1 National and Local Context
The Local Authority has a legal requirement to provide for the needs of disabled
people and people with sensory needs. These powers and duties are enshrined
within a series of Acts and National Guidance. (Appendix 1.1 and Appendix 1.2).
In relation to Community Care Services provided by Community and Social
Services Directorate these include:
●
On a city wide level, to understand the level of need within the population.
To keep a record of individuals with a disability. To commission a range of
services to meet these needs, within a mixed economy of care. To stimulate
the private and voluntary sector to develop services to meet these needs. To
develop a range of preventative services.
(National Assistance Act 1948. Chronically Sick and Disabled Act 1979, NHS Community Care Act
1990. Disability Discrimination Acts 1995 and 2005.
●
On an individual level, to provide information to citizen, to offer assessments
where people may benefit from community care services, to match need
against the Councils eligibility criteria, to provide an individual care package
to meet the community care needs, to review the needs and ensure the care
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package is delivering the required outcomes. This includes the provision of
Equipment Adaptation Homes.
(NHS Community Care Act 1990, Housing Acts)
●
To ensure the Disabled Person is fully involved in the process of assessment
and care planning and can influence the type of services being provided. To
offer Direct Payments following assessment to enable the direct purchasing
of care.
(Disabled Person Acts)
●
To recognise the needs of carers of disabled people, to offer them
assessments and support.
(Carers Recognition Acts)
The SSI Report Independence Matters(1), provides a model of good practice
standards against which the service can be monitored.
2.2 Community Plan & Salford Pledges
The vision of Salford is to create a City where people choose to live and work.
The plan expands on the Salford Pledges – all of which relate to this area of work.
-
Improving Health
Through access to a range of universal and preventative services, integrated
assessments, good care provision and regular reviews peoples physical and
mental health will be improved.
-
Reducing Crime
Disability makes people feel vulnerable and value community safety
initiatives.
-
Encouraging Learning, Leisure and creativity
Disabled people want to access the same range of services as other people
– our challenge is to make those services accessible and to provide support
as needed.
-
Investing in young people
Young disabled people need assistance at the time of transition – with
information and advice about future options. The children of disabled people
need the same opportunities as other children but may need support is
accessing these.
-
Promoting Inclusion
Disabled people want to be equal citizens, to do this they need access to
services and information and be enabled to participate in community
activities.
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3.
-
Creating Prosperity
By helping people maintain employment following the onset of disability, by
supporting disabled people into work, and supporting carers through family
friendly policies, disabled people and their carers can contribute economically
to the city.
-
Enhancing Life
Disabled people can help to make the city a good place to live in.
SERVICE CONTEXT
3.1 The aims of the service provided through Community and Social Services
Directorate is:
To ensure that disabled people in Salford have access to a range of
Community Care Services to support them to live independent lives.
Services are delivered through three main locations:
●
Physical Disability & Sensory Services based at White Moss.
●
Community Equipment & Adaptations Team based at Burrows House.
●
Hospital Social Work team at Hope Hospital.
These services are supported by:
- Contacts Unit based at Burrows House
- Central Finance, Human Resources & Support Services
Services are delivered within a mixed economy, purchasing care from the
Independent Sector and linking with community groups.
(1)
The service at White Moss consists of:
(i)
Physical Disability Team (including HIV)
(ii)
Sensory Services Team
(iii)
Administrative Support
They deliver:
>
>
Information and Advice
Assessment and Care Planning and Case Management
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>
>
>
>
Rehabilitation
Service
for
Deaf
Blind/Older
People
with
Maculapathy/Blind Children
Access to Sensory Equipment (moved during review period to
Community Equipment Services)
Carer Support
Support to self-organised groups
Directly employed staff provide a customer reception service with information
and advice. Assessment and commissioning care is a service that legally
must be provided directly by the Local Authority through Social Workers and
Community Assessment Officers. These services have admin support.
In commissioning care packages, all the care is purchased from the voluntary
and independent sector through a range of service providers. The majority
are spot purchased arrangements to meet individual needs of service users.
(See Appendix 2 for examples).
Some people purchase their own care once assessed through a Direct
Payment arrangement.
A number of contracts are held with Voluntary Sector services to provide
amongst other things:
>
>
>
Talking Books
Interpreters
Equipment
Community groups and social clubs receive a small amount of funding or
support by staff.
Some services are delivered jointly with colleagues in the NHS.
Partnerships with private business providing equipment enable service
workers to use these premises to complete assessments.
(2)
The Community Equipment Service has operated as a joint service
between Community and Social Services Directorate and NHS Community
Services since 1984. In April 2004, this became a formal integrated service
with a pooled budget under the Health Act 1999 Section 31 arrangements.
In developing this integrated service, a long period of consultation took place
with users, staff, stakeholders and funders, extending from August 2002 until
the formal arrangement in April 2004.
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This constituted a fundamental review of service and how it was being
delivered.
This service therefore was not the primary focus of the best value review, but
formed part of the services we received feedback on and part of the
implementation plan.
The Housing Special Needs & Adaptation Service were co-located within
Burrows House in Summer 2005. Recommendations on this service were
made during the review.
(3)
Hope Hospital
The Principal Manager at Hope Hospital formed part of the review team.
Hope Hospital Social Work Team
The social work team at Hope Hospital provides a service to all in-patients, those
individuals who attend the accident and emergency unit and to some specialist
clinics. This incorporates all individuals over eighteen years.
Social workers work closely with the regional neurosciences unit, and the stroke
units providing a service both to newly diagnosed patients and also to those who
may have had an exacerbation of their condition to :






Provide emotional support both at time of diagnosis and on an ongoing basis
Assess needs of individual and their carers and commission care package if
appropriate and review the care
Discuss Direct payments with individuals and initiate the process
Refer for aids and adaptations as may be required
Liaise with housing/employers/voluntary agencies as appropriate
Advise on benefits
Referral to Adult Disability Team for ongoing support
For those whose condition deteriorates social workers may also commission
residential care or refer for continuing health care.
Many people with disabilities are admitted to any ward within the hospital with
medical conditions which may be unrelated to their disability. Social workers are
aware that their disability may impact upon the individuals hospital experience and
can alert the hospital to their individual needs. They then offer the services as
above.
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3.2 Our Customers
The disability services cover a very diverse group of people, each section of which
brings its own challenges.
The Community Occupational Therapy & Equipment Services, and the Sensory
Service Team provide for people of all ages, from birth to the end of life. The
Physical Disability Social Work team focus on adult service users aged from 18-65
years. They link closely with the Childhood Disability Services in identifying young
people needing to transfer between services, and with older peoples social work
teams.
The service provides for:
●
●
●
●
●
●
●
●
Physically Disabled – born or acquired degenerative conditions
Acquired brain injury
Psychologically induced disability
HIV & Aids
Deaf & Hard of Hearing
)
Blind & Partially Sighted
) Pre-lingual – from birth or acquired
Deaf Blind
Dual problems of Disability & Mental Health
The needs of people will differ if they have been born with the disability or become
disabled during childhood or adulthood.
Carers also need to be supported.
The needs to be met are for:
-
Information & Advice
Assessment, Support, Social Rehabilitation
Provision of care services – Home Support/Respite/Intermediate/Long-Term
Care
Aids & Equipment for daily living
Accommodation – adapted to meet individual needs
Psychological support
Meaningful day opportunities in recreation, education
Employment
Family involvement – including parenting
As many needs originate from a health condition, service users will have close
contact with a range of health professionals, as well as social care agencies.
The majority of service users live in their own homes within the community and will
use the range of Local Authority services and services from other agencies.
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The Social Work Team at times acts as advocate, broker or navigator in relation to
these other services.
3.3 Partnerships/Mixed Economy
The service recognises the need for delivering through a mixed economy.
Partnerships with the NHS exist in:
●
●
●
Integrated Community Occupational Therapy & Equipment Services
Neuro Rehabilitation Joint Team
Project Officer in Audiology Services
Partnership with Housing Strategy and New Prospects Housing:
●
Special Needs Housing Service
Providers within the Independent Sector:
●
●
●
●
Care Homes
Home Care
Day Services
Equipment Purchases
Working with charities, voluntary and community sector in promoting the needs of
disabled people and administering Direct Payment Scheme.
A list of these key stakeholder currently involved in this whole service area is listed
in Appendix (3).
3.4 Numbers Supported
The process of the Best Value Review has made us focus on the accuracy of the
data held for service users.
Many people had been wrongly coded in the Carefirst – client information
database – at times having more than one coding, eg: Physical Disability &
Learning Difficulties, or due to age, moving across to old age services.
The data cleansing exercise will have resulted in some changes to the
Performance Indicators for this group. However, we are now more confident in
data accuracy.
A list of the number of service users by types of service is attached in Appendix
(4).
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The Physical & Sensory Services Team support:
-
125 people through home care packages
45 people attend Day Care
41 are provided with transport to services, usually outside the area
23 people receive community support, helping them to undertake meaningful
daytime activities
48 people make their own care arrangements via a direct payment
A total of 229 people are supported with community based services.
A further 43 people are supported in residential or nursing care:
People placed in Salford
20 physically disabled
1 sensory disabled
People placed in the North West
13 physically disabled
1 sensory disabled
People placed outside the North West
2 physically disabled
1 sensory disabled
Placements at times are made outside of Salford due to the special needs that are
being met. Several people have been in residential care setting for a number of
years and have said they do not wish to return to live in Salford.
29 people used short-term residential accommodation last year.
The Community Occupational Therapy Services receives over 1,600 referrals each
month and over 2000 pieces of equipment are delivered each month.
Expenditure in 2005/6
Community & Social Services invested £1.7 million in-house in the provision of
services. A further £4.1 million was spent in the independent sector to provide:
£000
£443
£1,140
£660
£1,012
£68
£113
£251
£429
Community Equipment
Residential Care
Nursing Care
Domiciliary Care
Day Care
Respite Care
Supported Tenancies
Direct Payments
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Special Needs Housing Team
Support Services – In-House
Major Adaptations – Private
Major Adaptations – Public
£140,000
£2M
£2M
(See Appendix 5)
Partnership Board for Independent Living
As part of the Health Act 1999 Section (31) partnership arrangements for the
integrated Community Occupational Therapy & Equipment Services, there was a
need to set up a Board to monitor the service, members to include
representatives of stakeholder organisations, Users and Carers.
In Salford this has developed into a Partnership Board in September 2004 to
oversee all the strategic developments for Disability Services and to performance
monitor the whole system.
This compliments the Boards in existence for Learning Difficulties, Mental Health,
Older People and Children’s Services.
The Partnership Board will play a key role in monitoring progress against the Best
Value Implementation Plan for the Disability Services.
4.
BEST VALUE REVIEW
4.1 Timetable for Review
Review started May 2004
Visioning Challenge: July 2004
Consultations with users and carers: throughout the year
Consultation with staff: November 2005
Stakeholders meeting: April 2005
Options Challenge: 9 May 2005
Final Challenge: 29 June 2005
Directors Team: 16 June 2005
There has been slippage of one month against initial plan.
4.2 Key People in Review
Director Champion:
Anne Williams
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Nominated Director:
Lead Member:
Review Team Leader:
Bruce Jassi
Councillor Warmisham/Councillor Sheehy
Julia Clark
The full list of Review team members is in Appendix (6). Two critical friends have
assisted with this process – Hester Ormiston (Lead of the Joint Review for
Community and Social Services Directorate in 2003/4) and Jim Ledwidge
(Bradford Community and Social Services Directorate). The Lead Member
changed during the review.
4.3 Scope of Review
It was important to scope the review to a manageable size, given the breadth of
services being provided.
In order to scope the main areas for attention, the review group used the self
assessment tool contained within the SSI ‘Independence Matters’ Report.
Appendix (7.1) Improving Services Action Checklist. This was distributed to all
review group members to take back to their workplace to complete. A selection of
service user groups were consulted by the User Development Worker.
The issues identified by Inspection Reports and Joint Review were examined.
These results were brought together (Appendix 7.2).
The Visioning Challenge meeting in June 2004 adopted the following scope of the
review:
●
●
●
●
Assessment & Care Management
Support Services
Access to Mainstream Services
Active Citizenship
In consultations with service users these were reshaped into the areas of:
Access:
Person Centred
Services:
Citizenship:
To information, advice, services
Users and carers at the centre of their own care assessment
and planning, choice, quality services
Involvement, empowerment of service users. Access to
mainstream services to live normal and independent lives
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In working within this Best Value Review we needed to be clear about:
5.
●
Those issues Community and Social Services Directorate could have a direct
influence over.
●
Those issues outside Community and Social Services Directorate but within
the Local Authority to have some control over.
●
Those issues beyond the direct influence of Local Authority but effecting
people’s lives.
CHALLENGE
The reason why we provide services is to meet the statutory requirements of the
Local Authority (Appendix 1.1 and 1.2).
Part of these need to be delivered directly by the Local Authority:
-
the strategic commissioning of service to meet the populations need
the individual assessments of users and carers
The Local Authority has a duty to make available a range of information, advice
and services which it may provide directly, or through commissioning other
providers in the independent sector. Some services, eg: support to Direct
Payments’ service users are already provided through a contract in the voluntary
sector. The Best Value Review has enabled us to examine other service provision
as outlined in the option appraisal (Appendix 12).
The Local Authority has some discretion in how its services are provided, but is
encouraged to work in partnership with the NHS and other providers to deliver a
seamless service.
The level of services to be provided and spread of services will be influenced by
the budgetary allocation for these services within which Best Value must be
obtained.
The Local Authority is challenged to involve service users and wider Salford
citizens in the design, implementation, governance and performance monitoring of
all these services.
The Disability Discrimination Acts of 1995 and 2005 set a duty on public authorities
to promote equality of opportunity between disabled and non-disabled people. We
need to ensure on a corporate basis that the dedicated disability services have
robust links with other sections of the Local Authority to ensure disabled people
have a positive experience of universal services and are not discriminated against.
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There will be a specific duty to publish a disability equality scheme and to draw up
a three year action plan with the involvement of disabled people.
The best value review process “challenges” the current service and its provision by
testing these against user expressed wants and needs and by looking at how
delivery compares against best practice.
The service has also been “challenged” by users during the consultation process
and by the input of “critical friends” on the review team.
Input from Critical Friends
The review team included two critical friends who attended a number of the review
group meetings, stakeholders meetings, user and carer consultation events.
Advice was also given on the design of some of these events.
One critical friend, Jim Ledwidge, had been the Best Value Review Team Leader
for Disability Services in Bradford and was able to bring a deal of experience learnt
from that review to Salford.
The second critical friend, Hester Ormiston, has worked for the Social Services
Inspectorate, had lead several Joint Reviews, including Salford’s Joint Review in
2003 and has been involved in several Department of Health inspections or task
groups.
She was able to bring experience from a number of other Local Authorities and
provide an independent eye on the process.
6.
CONSULTATION
The Best Value Review has involved a wide ranging consultation process during
which people have commented on many aspects of their life opportunities, some of
which fall outside the scope of the Best Value Review. It is important that we build
on this process in any wider Council strategy relating to disabled people.
(Appendices 8.1 and 8.2).
People do not recognise the artificial divides of Council services but expect the
Council to work across Directorates to deliver to their needs.
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Consultation Events
●
User Development Work has lead:
→
→
→
→
4 consultation events in preparation for Best Value Review involving
73 people
17 people helped analysis in 2 workshops
5 consultation events involving 69 people
Questionnaires from 64 people
(from March 04 to March 05)
●
A Carers Forum Event in May 2004 focused on carers of disabled people
●
Stakeholder event held Feb 2005 including users/carers/voluntary and
community sector service providers and other agencies
●
Staff Consultation Event – Nov 04 – 40 people attended
●
Partnership Board for Independent Living – meeting since September
2004 has identified issues to feed into Best Value Review
Tracking Service Users Experience
Four scenarios were ‘tested’ by service users/independent consultants to identify
whether the services are good enough and can be improved.
These included:
(1)
Hospital referral systems in Hope Acute Hospital and Meadowbrook Mental
Health Services.
(2)
Access to information from website and contact centres.
(3)
Transition arrangements for young person wanting to plan for independent
living.
(4)
Return to community from residential provision.
Main Issues Raised from User & Carer Consultation:
●
The need for a Partnership Board structure similar to Learning Difficulty
Services. The need for a sensory service user to be a part of this –
recognising the wide range of Disability and differing needs.
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●
Better access to information at all stages, possibly through a resource pack.
A single point of access for information.
●
Better communication in all areas – especially at the time of hospital
discharge.
●
Planning for life – not just for an episode. This involves service users
participation in their care planning in a different way than present – identifying
what is important for them individually.
●
Better assessment systems including self-assessment.
●
Streamlining services to avoid duplication.
●
Use of a term “carer” to mean informal or family carer.
●
The provision of low level support (preventative services).
●
Independent Advocacy Services.
●
Better information on benefits.
●
Improved Housing Adaptation service – more speedy and user focused
●
Tailor Housing Adaptations & Equipment provisions to what users want and
not over provision.
●
Flexible home care packages with quality staff who are reliable, consistent
and user focused.
●
Promotion of Direct Payments.
●
Involving service users in staff training
●
Developing joint approaches to risk taking.
●
A meaningful complaints process – resulting in real changes to services.
●
Access to day opportunities with more choice.
●
Access to employment opportunities.
●
Access to mainstream/universal services
●
Transport, transport, transport. Accessible, reliable, dependable, that can be
planned, understanding, non-discriminatory.
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A wealth of information has been obtained through these processes which will be
fed back into services.
Staff Consultation highlighted the following:
Strengths
Areas for Improvement
●
Joint working is improving and
therefore better links with PCT,
Education, Children’s Services,
Voluntary Sector
●
Limited Welfare Rights service in
hospital as they have to cover the
whole hospital
●
Use of Direct Payments providing
a more flexible service
●
Difficult to set up Direct Payments
on hospital discharge
●
Early identification of children
with disabilities
●
Work placements/services
●
Committed staff
●
Better communication on services
and changes
Major items raised and progressed through to Partnership Board involved:
●
Housing Adaptations – changes to timescales and processes. A report has
been taken to Council and scrutiny.
●
Equipment provision – including use of assisted technology – development of
Telicare, SMART Housing, etc.
●
Hospital Discharge Planning – equity of experience.
Priorities
For the Stakeholders Workshop the key items raised from the previous
consultation exercises were grouped in the 3 areas of:
●
●
●
Access
Person Centred Care
Citizenship
This workshop sought to prioritise the issues to feed into the Improvement Plan,
the following lists the top priorities under each heading:
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Access
(1)
Access to Information – in appropriate format in accessible areas across the
City. Linked with health, eg: at GP’s surgery and hospitals. Single point of
access. This includes the need to promote/market services.
(2)
Environmental access to buildings – taking account of the variety of people’s
needs, eg: sensory disability – using loop systems, textured surfaces, etc, to
all mainstream services of recreation, cultural, housing. Thus, enabling the
widening of day activities.
(3)
Assistance to obtain the right service – through use of advocacy, by having
staff trained in awareness.
Person Centred/Individual Care
(1)
Work with service users to understand what is important to them and what is
their priority; include life goals in planning and assessment; do not offer
services from a ‘menu’ that people do not want, including equipment and
adaptation.
This would involve developing a shared approach to risk taking – where staff
are less risk adverse and enable true choice of service options focusing on
outcomes – and these decisions can be jointly documented.
(2)
Commission on quality and not just availability - particularly in relation to
Homecare Services, ensure agreed quality standards underpin any services
and monitor providers against standards. Users must not feel frightened to
complain if these standards have not been met. Complaints should drive
standards up. Uses can be involved in the monitoring process.
(3)
Work with NHS partners to ensure continuity of services, in particular around
assessment, hospital discharge planning, intermediate care, respite care for
neurological conditions and sensory needs.
The National Service
Framework for Long Term Conditions could provide a basis for a joint
approach.
Citizenship
(1)
Transport. The top priority in all consultation events is transport. There is no
point in having appropriate service if people cannot get to them. Transport is
vital if users enter employment. People want accessible public transport that
is dependable and reliable, and assisted transport to activities that is
available when they need it. This includes:
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Buses:
Low level buses need to be timetabled and reliable.
Bus stops must be accessible and ramps used at all times.
Taxis: Booking of adapted taxis
Plus education for bus drivers and taxi drivers on disability issues.
Extending Ring & Ride services.
(2)
Development of the Partnership Board to include people with sensory needs
- as a vehicle to ensure all users groups are involved in strategic planning,
governance and service monitoring.
(3)
Support into employment, or to retain employment for acquired disability.
This is in various forms, eg: work preparation/rehabilitation for work,
supported employment options and Local Authority providing employment
opportunities.
An overriding theme was Quality of Life. Disabled people felt in order to obtain a
quality of life they needed to have needs such as leisure, social life, holidays,
general inclusion in the life of the wider community met for their own personal wellbeing.
Focus on what people can do not what they cannot.
7.
COMPARE
In considering how Salford compares with other Local Authorities, three activities
have taken place:
(1)
Comparison of National Performance Assessment Framework (PAF)
indicators.
(2)
Benchmarking against Good Practice.
(3)
Learning from inspection.
7.1 In considering the Performance Indicators we have looked at Salford’s
performance in relation to the comparator group (Appendix 9) and its performance
over time.
The five key indicators in relation to Disability Services are:
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●
C27 – Admissions of supported residents aged 18-64 to nursing/residential
care.
-
This ideally should be low, meeting people’s needs at homes
-
Salford has a very low number admitted – giving a 5 blob rating in
2004/05– however, we would not wish to increase the numbers in
Residential and Nursing Care
-
The number has decreased over time
02/03 = 3.1 (4 blobs)
03/04 = 1.28 (3 blobs)
04/05 = 2.09 (5 blobs)
●
●
●
●
C29 – Adults with physical disabilities helped to live at home.
-
This ideally should be around 5 people per 1,000 to achieve 5 blobs
-
Salford rate has increased from 4.2 to 11.9 (5 blobs)
-
This has increased as we have counted in the people using equipment
services
C51 – Direct Payments
-
The national performance indicator includes all client group but on a
local level people with physical disabilities can be identified
-
This enables people to take direct control of their own care
-
Salford has 3 blobs, compares well with other similar local authorities
(family group) and has increased over time
D42 – Carers Assessments
-
All carers delivery significant care should be offered a carers
assessment. Many refuse, content to input into the service user
assessment
-
Whilst this will no longer be part of the Performance Assessment
Framework Indicators in 2004/05, we would continue to collect local
data.
D54 - % of Equipment delivered within 7 working days
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-
Salford has a five blob rating on this indicator. In 2004, it extended its
remit to cover all minor equipment
-
The 2003/04 performance was 87.7% and increased in 2004/05 to
91.28%
-
The Department of Health agree that 100% performance is not possible
as certain equipment needs specialised assessment and ordering
Key areas to increase performance are:
-
Help to live at home
-
Direct Payments and
-
Carers Assessments
Although Salford is performing well against its family group.
Note:Family Group Comparators reflect 2003/4 and are not yet available for
2004/5.
In 2003/4 two of the National Performance Indicators were based on a
questionnaire sent out to new service users.
Whilst this has not been repeated in subsequent years the results do help
understand how the public feel about the services.
●
D57
-
The percentage of respondents to a survey of adults aged 18-64 with
physical disabilities and sensory impairments ask ‘Do you feel that your
opinions and preferences are taken into account when decisions are
taken about what services are provided to you?’ who answered ‘Always’
30% answered Always
compared with the England average 29%
●
D58
-
The percentage of respondents to a survey of adults aged 18-64 with
physical disabilities and sensory impairments asked ‘I can always
contact Social Services easily if I need to’ who answered ‘Strongly
agree’ or ‘Agree’
85% answered Agree or Strongly agree
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compared with the England average 79%
7.2 Best Practice Examples
Examples of Best Practice were obtained from:
(1)
Publications: eg: Independence Matters from SSI.
(2)
Best Value Reports/Joint Reviews of other Local Authorities.
(3)
Disability Action Plans within Salford City Council.
(See Appendix 10).
Examples of Best Practice have not to date been followed up. It was intended to
establish what priority areas were identified through the Review & Consultation
Process. In the light of these priorities – examples of Best Practice could then be
examined with a view of drawing from these experiences to develop services.
Areas that we may learn from include:
Bromley:
Improved access to leisure services.
Bolton:
Inclusive leisure facilities for young disabled people.
Redcar & Cleveland: Provision of advocacy services.
Bolton:
Disabled People’s involvement in strategic planning.
Birmingham:
Develop corporate action plan to implement social model of
disability across all services and delivery on priority issues
identified by disabled people.
Various Authorities: Increasing employment opportunities.
Solihull:
Website development identifying services for adults with
sensory needs or physical disabilities.
Gateshead:
Working with voluntary organisation SENCE to consult with
people with dual sensory loss.
Calderdale:
Developing joint care packages with Health.
Hillingdon:
Independence Living Centre to trial equipment – provision of
intermediate care and respite care.
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Derby:
High numbers helped to live at home.
Poole:
Streamline approach to Housing Adaptations.
There are examples of good practice amongst a range of authorities but no one
stands out as an example across a number of service aspects.
Salford compares well in a number of aspects.
7.3 Learning from Inspection
At the start of the Review we considered the information from Salford inspections:
(1)
Social Services Inspectorate (SSI) Annual Review of Performance 2002/3.
(2)
Joint Review June 2003.
The progress on issues raised in inspections is listed in Appendix 11.
8.
COMPETE
Salford already delivers services within a mixed economy. In looking at where we
should strategically position our services in the future, the Best Value Review has
developed a set of preferred options.
(1)
To remain within the Local Authority but develop integrated arrangements
with NHS:
●
●
●
●
(2)
To commission from the independent sector:
●
(3)
Assessment/care planning and reviews
Commissioning arrangements – individual care
Short term care packages, focusing on enablement and rehabilitation
Administration of Housing Adaptations
Longer term support services
residential and nursing care
domiciliary and day care
To develop greater partnerships with other agencies for:
●
●
●
●
●
Day opportunities and leisure
Education
Employment
Transport
Access to Information
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(4)
To commission from the voluntary and community sector in line with the
COMPACT:
●
●
●
●
(5)
Promotion of user and carers involvement in strategy and practice through:
●
●
●
(6)
9.
Advocacy
Direct Payment Support
Specialist community services, eg: Talking News
Support to small community groups/voluntary groups
Partnership Board
Developing practice with staff:
person centred planning
risk assessment
carers assessments
Working with local groups, eg: disability forum, disabled drivers
Corporate Agenda:
●
Disabled Discrimination Act – Action Plans
●
Local Authority as employer
●
Promote positive image of disability
●
Transport
●
Build disability awareness into Think Customer approach and other
corporate initiatives
●
Disability charter
OPTION APPRAISAL
In developing the option appraisal the Best Value Team considered:
(1)
How good is the service.
(2)
Does the service have scope for improvement.
(3)
The cost effectiveness of the service.
The Disability Service, as previously identified, delivers a range of functions
through a variety of formalities – ceasing this service is not an option due to
legislative requirements but in looking at those services Community and Social
Services Directorate directly provide or commission, the options appraisal
considered each aspect of the service:
●
●
Whether it should cease / continue / needed tweaking / major re-design /
development of new service
The internal and external drivers
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●
The forms of delivery:
In-house / private sector / voluntary sector / other Local Authorities /
Partnership
These are listed in Appendix 12.
In order to prioritise issues within the implementation plan, we have considered:
(2)
What are the major areas needing attention?
(3)
What are the quick wins to be achieved?
10. RISK ASSESSMENT
Where any services/service developments are identified as being ‘outsourced’ or
provided by external providers the Community and Social Services Directorate
would follow the agreed processes of reducing any potential risk by utilising the:
●
●
Council’s Standing Orders and Contract and Financial Regulations’ and by
Agreed Directorate processes for designing service specifications and letting
contracts and inviting and approving tenders/contractors
For in-house provision risk assessment is undertaken as part of the Directorate’s
standing Risk Register and risk assessment processes which are reviewed on an
ongoing basis and submitted corporately on an annual basis.
11. CHANGE MANAGEMENT
The change management process should be overseen by the Partnership Board
for Independent Living which has responsibility for a whole systems strategic
development within health and social care.
This Board monitors the performance of all parts of the adult disability service so
will be able to identify any consequences of change on the core services.
The change will be delivered through the current management arrangements.
In order to deliver the change there will be a need:
(1)
To be focused – aware of the size of potential agenda for change.
(4)
To manage expectations and focus on deliverables.
(5)
To work with the management capacity within the team and replace the
Sensory Team leader post.
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(6)
To work in partnership with others – especially the local Primary Care Team
and NHS colleagues and other community based services.
12. IMPROVEMENT PLAN
In coming to the review it was recognised that this service area had not had the
same investments as other areas, either in strategic planning or resource
investment. This had been recognised during the Joint Value in 2002. Areas for
development within Community Therapy & Equipment Services, and the Housing
Special Needs Service had already been identified during the preparation for the
Section 31 Joint Service. It has been important through the course of the Best
Value Review to make progress during the year.
12.1 Focusing across the three priority groupings of access/person centred/citizenship,
the improvement plan therefore details achievements that have already been
made since the review commenced in April 2004.
●
●
●
●
●
●
●
●
●
●
●
●
Creation of Partnership Board to oversee strategic development and
performance management.
Development of a web-based information ‘Ask SID’ – initially for older people
can be extended to physically disabled people.
A new ‘Enablement’ service will work with service users to link into
mainstream services from June 2005.
Community Equipment Services Delivery extended to cover 6 day a week
from September 2004.
Improved waiting times for assessment through appointment of an additional
Social Worker and Community Occupational Therapist during 2004.
Increased take up of Direct Payments service through funding the voluntary
sector support service.
Review the processes in relation to Housing Adaptations.
Review Community Equipment used on an annual basis through recruitment
of additional worker.
Develop our knowledge of assistive technology in preparation of a funding
bid in 2006.
Review and re-align hospital discharge arrangements.
Appointment of Project Officer within Audiology to develop health and social
care joint systems.
Carers needs assessed through carers worker.
These developments have been assisted through additional funding from the
Access Grant and Carers Grant of £260k. A further £160k over 3 years is
available from TOPPS for the Audiology Project.
12.2 The Improvement Plan identifies a further set of actions for the next 3 years arising
from priorities identified through the consultation, stakeholders meeting and option
appraisal. These include:
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●
●
●
●
●
●
●
●
Developing an Information/Communication Strategy.
Bringing together disability services around a single access point at Burrows
House.
Developing a person centred approach to planning for life – include risk
assessment.
Greater joined up services and care planning between NHS and Community
and Social Services Directorate.
Access to independent advocacy – within community and voluntary sector.
Increased choice in day opportunities and greater access to mainstream
services through working with Leisure & Education.
Joint training with staff and service users on how to best deliver assessment
and plans.
Ensure disabled people and their carers have access to employment and are
part of the City’s employment strategy.
12.3 Several areas identified fall outside the direct remit of Community and Social
Services Directorate:
●
●
●
●
Develop a corporate approach to disabled people’s needs which will form
part of each Directorates strategy.
Ensure actions from DDA Audit are implemented.
Improve access to transport at all levels.
Ensure the Local Authority provides employment opportunities to disabled
people.
12.4 A set of performance targets have been identified – these will be measured by
performance indicators and are in line with the service plan.
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Best Value in Salford
Review of Services to Disabled Adults and
People in Need of Sensory Services
June 2005
Improvement Plan
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1.
BASELINE INFORMATION
1.1 Performance Assessment Framework Performance Indicators, which can be attributed to Physical and Sensory
Services
INDICATOR
2002/3
BASELINE
2003/4
PERFORMANCE
2004/5
PERFORMANCE
2005/6
TARGET
Not Applicable
75
87.00
90
91
4
5
88
89
2006/7 TARGET
Theme: Access
D55
Acceptable waiting times for assessment
(The percentage of assessments completed within
28 days from first contact)
D56
Performance Rating
N/A
(next to highest
banding
(estimated, highest
banding)
Acceptable waiting times for care
packages
Not Applicable
76
85.40
4
5
(next to highest
banding
(estimated, highest
banding)
(The percentage of packages of care with all
elements in place within 4 weeks of the date of the
completion of the assessment)
Performance Rating
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N/A
27
INDICATOR
Theme:
B11
2002/3 BASELINE
2003/4
PERFORMANCE
2004/5
PERFORMANCE
2005/6
TARGET
36
36
33.70
33
33
5
5
(highest banding)
(highest banding
(estimated, highest
banding)
3.13
1.3
2.09
2
2
23
24
2006/7 TARGET
Individual Care
Intensive home care as a percentage of
intensive home care and residential care
(The number of households receiving intensive
home care as a percentage of all adults and older
people in residential and nursing care and
households receiving intensive home care)
Performance Rating
C27
Admissions of Supported Residents aged
18-64 to residential/ nursing care
5
Note: a lower rate is the best performance
(per 10,000 population aged 18-64)
4
Performance Rating
C28
3
5
(next to highest
banding
(average banding)
(estimated, highest
banding)
26.1
25.21
23.80
5
5
(highest banding)
(highest banding
Intensive Home Care
(The number of households receiving intensive
home care per 1,000 population aged 65 or over)
Performance Rating
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5
(estimated, highest
banding)
C29
Adults with Physical Disability Helped to
Live at Home
3.52
4.2
11.93
11
11
3
3
(average banding)
(average banding)
(estimated, highest
banding)
27.62
38.36
68.01
95
109
(= 46 people)
(= 64 people)
(= 114 people)
(= 160 people)
(= 184 people)
14
12
94
95
(The percentage of adults with physical disabilities
helped to live at home per 1,000 population aged 1864)
Performance Rating
C51
Direct Payments
5
(Adults and older people receiving direct payments
at 31 March per 100,000 population aged 18 or over)
2
Performance Rating
The number of people with physical/sensory
impairments on direct payments was
D41
Delayed hospital discharge/transfers of
care
3
3
(next to lowest
banding)
(average banding)
(average banding)
30
43
83
34
30
15.32
4
4
5
(next to highest
banding
(next to highest
banding
(estimated, highest
banding)
97 *
87.7
91.28
5
5
(highest banding)
(highest banding)
(The number of delayed transfers of care per
1000,000 population aged 65 or over)
Performance Rating
D54
Percentage of equipment and adaptations
delivered within 7 days
(The percentage of items of equipment and
adaptations delivered within 7 days)
Performance Rating
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5
(estimated, highest
banding)
Notes:
1.
* this performance figure relates to the previous indicator definition of equipment costing less than £1,000 delivered within 3
weeks of assessment
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2.
IMPROVEMENT PLAN
2.1 Achievements since the start of the Best Value Review April 2004
THEME / Issue
ACCESS
Access to information on
local resources.
Widen access to day
opportunities
Action
Reason for Action
Develop web based information system ‘Ask SID’
Initially developed for older people’s service this will form
the basis of a user data base of services. Information officer
post funded through Performance Grant (£16k)
A new ‘Enablement’ service based In-House, to deliver
short term focused work, linking users to mainstream
services.
Due to start April 2005 – Delayed due to CRB checks.
Timely Access to
services.
Funded via the Access Grant.
(£60k)
Equipment Services extended to 6 day week same day
delivery for urgent needs.
Funded Access Grant (£ 22k)
Access to information is the number one priority for
users.
Information enables empowerment.
June 04
The underlying view from the “promoting
independence “ events was that many people did not
know what else was available other than the traditional
day opportunities. Those who were aware of some of
the possibilities felt that, different ways of providing day
opportunities should be promoted to enable choice but
also enable gradual change.
April 2005
Right Care, Right Time, Right Place.
Sept 2004
Improved waiting times for assessment:
- Community Occupational Therapy
- Social work service
Additional posts – Access Grant (£45k)
Access to meaningful
data on service use
Date
March 2005
The Physical Disability team have reviewed their duty
systems to ensure a more effective use. This will enable
people the option of self assessment or assessment at the
office plus clearer information on what the team can offer.
Data cleansing exercise for Best Value review provides a
robust baseline for data collection.
Service Planning and performance monitoring
March 2005
Promoting independence:
April 05
This has included increasing staff awareness on the
importance of gathering and inputting the correct
information.
INDIVIDUAL CARE
Individuals to have more
Increase uptake of Direct Payments – through funding
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THEME / Issue
control over their care
plan.
Action
Reason for Action
Voluntary Sector support project. (Access grant £64.5k)
Date
Government agenda.
Numbers already increased from 2002/3 baseline but this
will be a continued focus
Home Care: Commission
on quality not just who
can do the job quickly
Independent Homecare Commissioning is being
restructured to geographical basis commencing June 2005.
(Currently 30 providers across city.)
Housing Adaptations –
reduce waiting times and
bureaucratic process.
Partnership Board has directed services to review
processes and contracting arrangements: for private and
public sector.
- Recommended list of contractors
- Process for stair lifts and hoists
Equipment tailored to
individual care needs.
Special Needs Housing Team moved from NPHL to the
Joint Equipment Services at Burrows House
Integrated Community Therapy and Equipment Service
under Health Act Flexibilities formed with pooled budget.
Community Assessment Officer to Review need for
equipment.
Access Grant (£30k)
Sensory Equipment to be administered through central
equipment service.
Develop Assisted Technology options: SMART House
opens May 2005 to pilot Assistive Technology (joint with
NPHL)
Sub group formed to prepare bid for grant 06/07
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This was raised particularly in relation to home care
services; many people raised the huge variation, which
exists in localities. Service users felt the promotion of
commonly agreed standards and the training of
providers by commissioners would enable expectation
of what constitutes “Quality” to be more universal
Long waiting times leading to complaints.
June 2005
To create more seamless service / single access point
Dec 04
Promote Independent Living
April 2004
Feb05 – to
continue to Sept
05
May 2004
Dec 2004
May 2005
THEME / Issue
Robust Hospital
Discharge arrangements
Action
Reason for Action
Project Officer (4months) to work with SRHT/CSSD/PCT to
develop protocols – starts April 2005. (funded from delayed
discharge grant £7k))
Date
To ensure safe discharges and seamless transition
back to community.
April 2005
Through Partnership Board – audit of discharge
arrangements at Hope Hospital to be completed.
Develop joint Audiology
Services
Support to and
assessment of Carers.
Sept 2005
April 2005
Project Officer 3 years – funded through TOPPS (£160k) to
develop joint service approach.
Carers assessment social worker appointed.
Funded from Carers grant (£30k)
Seamless services
Carers play a key role in supporting disabled people
and need support themselves
Dec 2004
Creation of Partnership Board to take forward strategic
Director and performance monitoring of services.
Partnership working.
September
2004
CITIIZENSHIP
Physically disabled
people and those in need
of sensory services to
have the same
recognition as other
users groups.
2.2
Detailed Improvement Plan what needs to be done over the next three years
THEME
ACTION
TIMESCALE
RESPONSIBLE
OFFICER
REASON FOR
IMPROVEMENT
RESOURCES
ACCESS
Access to information
Develop Information /
Communications Strategy :
- building on SID
- Review and improve Web
based information provision
Develop links with the Call Centre
and City’s Think Customer
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By Dec 06
Deputy Director
- Via new
Communication
officer post
By Dec 06
Communication
Officer (new post)
33
Top access priority from
user perspective
identified in
consultation.
Best practice
comparison shows
scope for development.
PO4
New post needed –
communication office
PO4
See above
THEME
Increased promotion of
available services
ACTION
TIMESCALE
RESPONSIBLE
OFFICER
Promote /market service through
Salford publications
Start April 06
Communications
officer
Ensure staff in Local Authority and
NHS have access to database - SID
July 05 – LA
PM –IT services
July 06 - NHS
Communication
officer
REASON FOR
IMPROVEMENT
Best practice
comparison and
consultation results.
To ensure delivery of
this and the first priority
– access to information
RESOURCES
PO4
See above
Existing resources
PO4
See above
PO4
See above
Improve information re access to
financial advice under Community
Legal Services
By Dec 06
Communication
Officer
Best practice
comparison and
consultation results.
Develop Single Point of
Contact
Bring together disability services
around single access point at
Burrows House .
By April 2006
AD – adults
AD - resources
To deliver streamlined
services
Access to day
opportunities
Work with Leisure, Education to
improve access to mainstream
services.
Develop access to employment
services.
Start Dec 05
PM - Disability AD
–Adults
AD – Leisure
Improving service in
line with best practice
and “New Vision for
Adult Social Care”
Independent advocacy
service
Explore type of service needed, how
this can best be provided through
voluntary sector and cost of funding
service.
Start April 06
PM- disability
AD- Adults
Consultation and Best
Practice findings
Funding to be
researched.
~ £30k pa
Develop Person Centred Planning
Approach – including health needs
(with users and carers)
By Dec 06
PM - Disability
Consultation
Single Assessment
Process
Joint with Health.
Develop integrated working with
Health
By April 07
National Service
Framework
Joint with Health
Management time.
Accommodation for
non-disability staff
currently at Burrows
House
New enablement
officers.
Existing managers of
services.
Individual Care
Work with individuals to
see what they want.
Include Life Goals in
Service Planning
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34
AD- Adults
Consultancy time
(£5k)
THEME
Need to be less risk
adverse
Staff awareness and
training
Commission on quality.
Taylor equipment to meet
individual needs.
Range of rehabilitation for
long-term neurological
conditions
Carers support
ACTION
TIMESCALE
RESPONSIBLE
OFFICER
REASON FOR
IMPROVEMENT
RESOURCES
Develop a Risk Assessment
Protocol with service users and
deliver awareness training for all
staff. Taking into account issues of
‘capacity’ and recent legislation in
this area.
Develop training package with
Disability Forum / service users.
By April 2006
AD- Adults
Independence, Wellbeing and Choice
Green Paper
Consultancy time
(£2k)
By April 2006
PM – disability
AD- Adults
Consultation results
Trainer x 12 days
(£5k)
Release all staff for
training.
Use Quality Framework developed
in learning difficulties service to
develop quality services
In house Home Care moving to
short term Intermediate Care
Services
Link assessment for equipment with
the single assessment process –
enable other professionals to order
equipment
Start April 2006
PM - Contracts
New Vision for Adult
Social Care; Best
Practice comparisons
Development officers
time
By September 2005
PM – Care support
Start April 2006
PM – CES
Start December
2005
PM - CES
By 2006
AD -Adults
By 2006
AD - Adults
Increase provision of Respite Care
options
Start June 2005
Place to be offered on Board
By October 2005
Review equipment on annual basis
– possibly through Call Centre
telephone review (links to Person
Centred Planning)
With PCT develop action plan in line
with National Service Framework
Develop service with PCT – (role of
the Maples currently under review)
Existing managers
Single assessment
process;
Consultation
Training post – joint
with health
(£30k)
Call centre staff
NSF
With health – existing
managers
PM - Disability
Carers strategy
£20k carers grant
PB Chair
Users development
worker
Consultation
Interpreter for all
meetings
£12k pa
Citizenship
Sensory representation
on partnership board
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35
THEME
Development of
supported employment
/choice
Quality of life
ACTION
TIMESCALE
RESPONSIBLE
OFFICER
Extend employment services to
include those with physical / sensory
impairments
Evaluate Enablement service
Work with Local Authority
Employment Strategy
Start September
2005
DD –
commissioning
April 2006
By April 2006
PM - Disability
AD- Adults
Head of service LD
New Directorate will work to improve
access and support to use
recreation and leisure facilities
September 2005
Director / Deputy /
AD’s
Develop a corporate approach to
disabled peoples’ needs and form
part of each Directorate’s strategy
By April 2006
Director
Chief Executive
REASON FOR
IMPROVEMENT
New vision for adult
social care; Social
Inclusion
RESOURCES
Access to work RNIB
Existing managers
Existing Managers
Consultation
Existing resources
Existing Resources
CORPORATE ISSUES
ACCESS
Environmental access
Environmental access
CITIZENSHIP
Transport – strategy
Employment
Opportunities
Review DDA audit information Physical access to buildings
Corporate
responsibility
Meeting legislation
Corporate centre
Ensure planning application
presentations address accessibility
issues
Ensure dropped kerbs are
appropriately situated?
Corporate
responsibility
Meeting legislation
With Planning Section
Corporate
responsibility
Meeting legislation
With Planning Section
Offer awareness training for taxi
drivers – link to licensing
Environmental
services
Consultation
Pay Trainer
Local Authority representative to
take up the issues with GMPTE
Develop Ring and Ride service
LA rep to GMPTE
Consultation
LA to ensure positive role in
employing disabled people
HR
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Consultation
36
Disability
Discrimination Act
Research investment
opportunities
Appendix 1.1
Legislative Duties
Independence Well Being and Choice – (Green Paper March 2005)
Disability Discrimination Acts 1995 and 2005
Fair Access to Care Services – LAC (2002)
Social Care for Deaf Blind Children and Adults – LAC (2001) 8
Health and Social Care Act 2001
Care Standards Act 2000
Carers and Disabled Children Act 2000
NHS Plan 2000
Health Act 1999
Modernising Social Services White Paper 1998
Housing Grants, Construction and Regeneration Act 1996
Community Care (Direct Payment) Act 1996
Carers (Recognition and Services) Act 1995
Disability Discrimination Act 1995
NHS and Community Care Act 1990
Disabled Person (Services, Consultation and Representation) Act 1986
Chronically Sick and Disabled Person Act 1970
Section 7 Guidance Local Authority Social Services Act 1970
National Assistance Act 1948
Blind Persons Act 1920
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Appendix 1.2
National Guidance













Best Practice Standards: Social Services for Deaf and Hard of Hearing People
Progress in Sight – National Standards of Social Care for Visually Impaired Adults
2002
A Service on the Edge (August 1997). Evaluated social care services for people
aged 14 to 65 who are deaf or have significant hearing loss;
A Sharper Focus (1998). Evaluated services offered by councils to people who are
blind or have significant loss of vision;
A Jigsaw of Services (March 2000). Evaluated services offered by councils to
support disabled adults in their parenting role;
Getting the Right Break (June 2000). Evaluated the provision of short term breaks
for disabled people and older people;
New Directions for Independent Living (October 2000). Evaluated independent
living arrangements for people aged 18 to 65 with physical, sensory and learning
disabilities;
Fully Equipped (2000): The provision of equipment to older or disabled people by
the NHS and Social Services
Making it work (September 2001). Studied approaches to commissioning services
for disabled people from black and minority ethnic groups.
‘Progress in sight’ ADSS 2002: National standards of social care for visually
impaired adults.
Independence Matters (Department of Health 2003) : Social Services Inspectorate
report on the progress made by local authorities in modernising and providing
quality services for physically and sensory disabled people.
National Service Framework for Long Term Conditions (March 05)
Improving Life Changes of Disabled People (Jan 05)
Independence Wellbeing and Choice
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Appendix 2
BEST VALUE REVIEW FOR DISABLED PEOPLE AND SENSORY SERVICES
COMMUNITY SUPPORT AND DOMICILIARY CARE
Three cases were considered to show presenting needs and support provided, costs,
different providers and the use of community support and domiciliary care.
1.
Male aged 51 years
RTA aged 10 resulting in head injury and epilepsy. Recent fall left him with a
fractured skull blood clot required an urgent operation. Now has further cognitive
impairment. Lives alone, but near sister and brother-in-law; pay rent to sister, as
she owns house. Vulnerable to callers and has taken a large amount of money
from his bank account.
On discharge from hospital he received Community Support (from Rain Care) as
follows:
11.00 am – 1.00 am 7 days per week to prompt EL to get up, wash, dress and
prepare breakfast.
7.00 pm – 9.00 pm 7 days per week to encourage him to go out (needs
encouragement otherwise he wouldn’t go out).Cost: £256.76 pw (£9.17 per hour x
4 hours per day x 7 days pw).
2.
Male aged 44 years.
Has MS and uses a wheelchair; lives alone.
Vulnerable to callers; has given credit cards to others; has eggs thrown on his
windows and graffiti on the walls. On housing list to move to new bungalow but
they haven’t been built yet.
He receives Community Support from Bradmere and Merrymeet as follows:
1.00 pm – 4.00 pm Tues/Thurs taken out to access local leisure facilities and to
encourage him to clean his flat.
Cost: £65.58 per week (2 hours x 2 days pw x £10.93 per hour)
Also Domiciliary care from Hunters:
Mon-Fri 5.00 pm – 6.00 pm to prepare and cook evening meals
1.00 pm – 4.00 pm Tues only to do shopping and cleaning
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Cost: £57.12 pw (3 hours pw x £7.14 per hour)
3.
Female aged 34 years
Registered blind with moderate learning difficulties. Also epileptic with anxiety,
depression and ongoing mental health problems. Lives with Mum who works.
Receives Community support from Abbeydale Home Care as follows:
Mon/Tues 7.30 am – 1.30 pm to assist to wash, dress, help with breakfast and
participate in essential household tasks.
Wed/Thurs/Fri 7.30 am – 9.30 am to assist to wash, dress, help with breakfast.
Cost: £226.98 pw (6 hrs twice pw x 2 hrs 3 times pw x £12.61 per hr).
3 days pw (W/T/F) used to attend Craig Hall; now attends Pendleton Centre. Mum
provides care evenings and weekends. Uses Granville for short breaks as and
when required. Also used Pendleton Centre for short break when Mum was in
hospital as Granville was not available.
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Appendix 3
Key Stakeholders
Partnership Board for Independent Living
Local Authority Services/Integrated Arrangements
Physical Disability Team
●
Integrated Neuro-rehabilitation Team
Sensory Services Team
●
Audiology Project Post (joint PCT)
●
Rehabilitation Officers
Community Occupational Therapy & Equipment Services (Joint PCT)
●
Occupational Therapists
●
Equipment & Adaptations
●
Wheelchair Services
●
Special Needs Housing Service (Housing – New Prospects)
User Development Officer
Welfare Rights
Childhood Disability Family Project (joint Barnardos)
Hospital Social Work
Older Peoples Teams
Library Services
New Directions – Learning Disability Team
Housing Services
Transport Services
Access Officer
Leisure
Building Services
Publicity/Marketing
Employment Officer
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NHS Services
Audiology Services
Hospital Eye Services
Salford PCT
Hope Hospital
Neuro-sciences
Primary Care Teams
Voluntary Sector – Contracts
Henshaws Society for the Blind
RNIB Residential Services
RNID Interpreter Services
RNID Residential Services
SENSE Residential Services
Home Improvement Agency
Community Voluntary Services (CVS)
(7) Direct Payment Scheme
Voluntary Sector
Salford Talking Newspaper
RNIB Talking Book Library
North Regional Societies for Deaf and Blind
Deafness Support Network, Warrington
RNID
Deaf Blind UK
SENSE
Disability Living
Carers Centre
Other
Department of Health
Employment Services
Transport Services – GMPT
Independent Living Fund
User Involvement/Forums
Disability Forum
Disabled Drivers
Deaf Gathering
Deaf Blind Development Group (in partnership with Deaf Blind UK)
Visual Impairment groups (in partnership with HSBP)
Wheelchair User Groups
Sensory Users
SUGGEST – (Direct Payments)
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Appendix 4
Types of Services, their Usage and Costs
Number of Users
Service Type
Short Stay (During Year)
Community Based Care
Permanent Residential
Total Users (Unique)
Users
29
229
43
281
Costs of Services
Service Type
Costs
Unit
Average Per
Client
Short Stay (During Year)
Community Based Care
Permanent Residential
£115,176.00
£26,125.00
£28,369.00
Per Year
Per Week
Per Week
£3,839.20
£114.08
£506.59
Total Per Year
Type
£2,948,864.00
Total
Individuals
Comm Support
Day Care
Direct Payments
Home Care
Meals
Supported Tenancies
Transport
Totals (Unique)
23
45
48
125
10
4
41
229
Total
Weekly
Cost
1548.47
2624.6
8462.68
13001.965
0
0
487.55
26125.265
Figures at 1st June 2005
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Lowest
Cost
Package
Highest
Cost
Package
£6.00
£305.72
£1,595.00
£1,845.56
Appendix 5
Budget Paper
COMMUNITY, HEALTH AND SOCIAL CARE DIRECTORATE
PHYSICAL AND SENSORY BUDGETS 2005/2006
All budgets are shown gross and do not include any PCT-funded expenditure
Service area
Provision
by others
£
Own provision
£
PD senior management and admin
ADT
HIV
119,910
590,820
91,015
Integrated Equipment Services
733,730
PD commissioning
Community Care packages:
residential
nursing
domiciliary
day care
respite
supported tenancies
direct payments
81,470
Salford Work Development Unit
(Former PD) day centres
St Georges
Craig Hall
21,832
Community, Health and Social Care
443,000
1,140,870
660,360
1,012,813
68,210
113,620
251,170
429,970
69,917
40,642
1,749,335 4,120,013
Housing capital
Major adaptations:
private
public
2,000,000
2,000,000
admin support
140,000
Housing Total
140,000 4,000,000
OVERALL TOTAL
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1,889,335 8,120,013
Appendix 6
Review Team Members
Key Players
Director Champion
Nominated Director
Lead Member
Anne Williams
Bruce Jassi
Councillor Warmisham/Councillor Sheehy
Review Team
(Review Team Leader)
Julia Clark
Alison Norton
Kay George
Lynsey Withers
Denise Ireland
Nick Erlich
Chris Entwistle
Paulette Holness
Chris Bryson
Broderick Macivor
Carmel Reeves
Anne Robinson
Catherine Capel
Alan Bunting
Rachel Todd
Josette Phillips
Hester Ormiston
Jim Ledwidge
Keith Darragh
Chris Woods
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Assistant Director
Project Support
Principal Manager – Disability Team
Admin Support
Team Manager – Physical Disability
Sensory Team Manager
Hope Hospital – Principal Manager
User Development Worker
User
Carer
Service User
Carer
PCT
Principal Officer (Strategic Planning)
Principal Officer (Performance
Improvement)
Principal Officer (Management,
Information & Performance)
Critical Friend
Critical Friend - Bradford
Assistant Director (Resources)
UNISON Representative
Appendix 7.1
Improving Services Action Checklist
Independence at Home
Home Care Services
1.
Are home care services sufficiently reliable, flexible and
consistent?
2.
Do home care services help disabled people to maximise their
independence?
3.
Do home care staff have the skills and experience to offer enabling
support to disabled people?
Are service users notified of changes of workers?
4.
Adaptations and Equipment
5.
6.
7.
10.
No
Yes
Do disabled people experience delays in adaptations to their homes
under the Disabled Facilities Grants?
Are processes for cleaning and recycling equipment in place?
Are small items of equipment provided promptly?
Accommodation
8.
Does the Supporting People programme give sufficient attention to
the needs of people with physical and/or sensory disabilities?
9.
Yes
Yes
Is there sufficient training on disability issues for frontline staff in
health, housing and social services?
Is there a comprehensive housing database of purpose built and
adapted properties and a register of housing needs of disabled
people?
Identity and Belonging
Disabled Parents
11. Are disabled parents effectively supported in their parenting role?
12.
13.
Do black and minority ethnic disabled people have as good access
to local disability services as other disabled people?
Are culturally sensitive local services provided for minority ethnic
disabled people?
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Yes
14.
Does the council map the numbers and needs of black and minority
ethnic disabled people and address these needs in its
commissioning strategy?
People with Sensory Loss
Yes
15. Is there a co-ordinated approach between social services and
contracted provider agencies to promoting social inclusion, eg through
direct payments?
16.
Are the needs of deaf blind people being identified and met?
17.
18.
19.
People with Acquired Brain Injury and Complex Needs
Yes
Are the needs of people with acquired brain injury and/or complex
disability identified and met locally?
Carers
Yes
Does the council work with carers to plan and develop strategies
and support services for carers?
Are the family carers of disabled services users offered separate
assessments of their needs?
Active Citizenship
Day Services
20.
Is there a day services strategy to ensure a range of meaningful,
community-based daytime opportunities linked to leisure, education
and employment
21.
Do staff in day services act as facilitators and enablers to help
disabled people achieve maximum independence?
Advocacy
Yes
Yes
22. Do disabled people have access to independent advocacy services?
23.
Are staff trained to recognise the value of advocates and to work
with them?
Work Opportunities
24. Does the Welfare to Work Joint Investment Plan deliver increased
employment opportunities for disabled people?
25. Does the council encourage the recruitment of disabled people inhouse and by partner agencies and local employers?
26.
Do family carers of disabled people receive practical support to
access and sustain opportunities for disabled people?
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Yes
Systems and Process
Service User Satisfaction
28.
Is the council developing ways of finding out disabled people’s
views about the services they receive?
Yes
Information
Yes
29.
Is a good range of public information about disability services
available in appropriate locations and in appropriate formats and
languages?
Communication
Can care managers and social care staff communicate with disabled
people in their preferred language?
Assessment and Care Management
Yes
30.
31.
32.
33.
34.
Are care management processes sufficiently person-centred and
holistic in relation to the education, leisure and employment needs
and aspirations of disabled people?
Are service users and carers encouraged to undertake selfassessment as part of the council’s care management system?
Do risk assessments encompass the disabled person’s lifestyle
choices and well-being and their emotional and mental health?
Is the single assessment process being rolled out for disabled
people?
35.
Do assessments explicitly address people’s eligibility for direct
payments?
36.
Are placements of disabled people outside the council’s area
reviewed regularly?
Eligibility Criteria
37.
Yes
Yes
Are eligibility criteria for services reviewed and publicised?
Social Model of Disability
38. Do staff in social services and partner’s agencies understand and
practice the social model of disability?
39.
Is a policy commitment to the social model of disability translated
into day-to-day reality?
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Yes
40.
Are service users involved in auditing the implementation of the
social model?
Direct Payments
41.
Are service users encouraged to use direct payments and given
food information and clear criteria for access?
42.
Do care managers understand the purpose and workings of the
local direct payments scheme and do they explain the scheme
to prospective service users?
Do service users and carers participate I direct payments
planning and steering groups?
Do councillors receive regular monitoring reports on the uptake
of direct payments and progress towards targets?
43.
44.
Transitions
45.
Are procedures in place to ensure the effective transition of
disabled children into adult services?
Service User Involvement
46. Are disabled people and carers involved in the strategic planning,
scrutiny and evaluation of the council’s physical and sensory
disabilities services?
Organisation and Planning
47.
48.
49.
50.
51.
52.
Is there a jointly agreed strategy for services for disabled
people involving those commissioners providing and using
services?
Do the council’s commissioning strategies and plans give
sufficient consideration to the needs of disabled people?
Are there good partnership arrangements with health and other
agencies to provide efficient and effective services for disabled
people based on best value principles?
Do social care staff have appropriate and specialist knowledge,
skills and qualifications?
Are independent and voluntary sector providers working to
achieve local service objectives for independence and social
inclusion?
Are service developments in other service areas such as older
people and learning disabilities being applied to services for
disabled people?
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Yes
Yes
Yes
Yes
Please return by 21 May 2004 to:
Alison Norton
Crompton House
100 Chorley Road
Swinton, M27 5BP
or fax to 0161 794 0197
For an email version of this form please contact: joanne.colley@salford.gov.uk
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Appendix 7.2
Community and Social Services Directorate
Best Value Review – Physical Disability and Sensory Services
Scoping Paper 29 June 2004
Drawn from the SSI Improving Services Action Checklist
Priorities for BV Review
Assessment and care management process:
Clarity of focus and service – eligibility criteria
Case Finding – information of people
Person centred planning
Joint assessment and care plans with NHS
- clarity on Continuing Care responsibilities
Carers
Assessments recorded
Support
Transition
To services for older people
Sensory Services
Clarity on what is available
Joint working with NHS
Home Care:
£1.8m
Focus of service – enabling not doing – what can home carers do
Training of staff
Targeted service for people with Neurological problems
Monitoring of service / Success factors eg: service reduction
Working with children / families
Active Citizenship
Confidence building / opportunities for participation
Daytime opportunities
- link to leisure, education
- employment / welfare to work
Advocacy Services
Consultation with users / carers / public
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Improve choice and range of services
Influence private and voluntary sector providers, eg: providers forum
Respite care / short breaks
Intermediate Care
Support eg: relationships
Housing Adaptations
£3.58m
Time taken for assessment (Disability Facility Grant)
Staff participation
Check progress of other working groups
Direct Payments
Equipment Services – waiting times / Assisted technology / review
Crossover group (working with children’s services)
Employment Strategy / Welfare to Work
Disability Forum
Palliative Care
Significant issues for BV to influence
Joint strategy across NHS and LA for this group (NSF due)
use of Health Act Flexibilities for integrated services / pooled budgets
Social model of Disability
Range of adapted accommodation
Supporting People plan
Transport Issues:
Public transport
Access to care facilities
Assistance to school when parents have a disability
(scope of transport review)
DDA – council’s responsibility within all services to users and employees
Voluntary Sector
Areas of performance that do not require key focus of review
Equipment Services – delivery
Community Neuro Rehab team (joint)
Transition from Children’s Services
Joint Partnership Board (recently set up)
Close working with some providers
Welfare rights / financial advice
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Appendix 8.1
Consultation
Event Dates
Participation events in preparation for Best Value Review




St Georges 19th March ………….. 20 people participated
Waterside 7th April ……………….15 people participated
St Georges 27th April……………… 8 people participated
Broadwalk 28th April ……………….30 Carers approx.
Sub total = 73 people
Analysis of information from above event carried out by People supported by
services in preparation for Best Value Review:
 9th June ………………10 people participated
 14 June ……………….7 people participated
Venue waterside and St Georges.
Sub total = 17 people
Best Value Consultation Events

Little Hulton 23rd August…………… 9 people
Participated.

Carers Centre 9th September ……… 16 people
Participated

Eccles Links 14 th September …..………….6 people
Participated

Pendlebury 29th September (evening) ……. 17 people
Participated

Wardly Centre 30th March 05………… 20 people
Participated
Sub total = 69 people
participated
Questionnaires total numbers = 64 people
Total Participants = 223
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Stakeholder Day
Family Name
First Name
Organisation
Ahmed
Anderson
Azra
Melanie
Citizens Advice
Armstrong
Janet
Salford College
Beard
Joyce
Community Network
Bunting
Alan
Community & Social Services
Eric
Councillor Salford City
Council
Burgoyne
Salford Disability Forum
Burn
Mary Ann
Carson
Susan
Chinn
Carole
Clark
Julia
Disabled Drivers
Association
Community & Social Services
Contracts & Reviews.
Cosford
Tim
SPCT – Intermediate Care
Craddock
Maureen
Rain Health Care Services
Cropper
James
Community Housing
Development Team
Crookes
Victoria
CSSD
Caring Hands Group
Darragh
Keith
Davies
Peter
Community
Occupational Therapy
Lynn
Community Health Care
Services
Dixon
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Sensory Services
Dyke
Pauline
Oakwood Park Nursing Home
Erlich
Nick
Evans
Maggie
Community and Social
Services
Community & Social Services
Eve
Anne
Contracts
RNID
George
Kay
CSSD
Griffith
Mark
Harrison
Tom
Holness
Paulette
Orthoptic Dept.
Salford Deaf Gathering
Bradford Social Services
Howard
Claire
Hughes
Barbara
Ledwidge
Jim
Lord
Elaine
Salford Carers Centre
Rutland Manor
Salford Primary Care Trust
CSSD
Macbeath
Marion
Community & Social Services
Moremi
Antoinette
Wigan Social Services
Moss
Sylvia
Disabled Arts Group
Norton
Alison
Philips
Josette
Disabled Arts Group
Salford West Adult Team
Pilling
Christine
Reeve
Carmel
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New Prospect housing
Community Home Care
Robinson
Anne
Rowe
Sue
Saul
Anthony
Singleton
Elaine
Salford Disability Forum
Steers
Joan
Salford City Council Chief
Executives
Steers
Paul
PTU Turnpike
Taylor
Janet
Salford Talking News
Todd
Rachel
Waddington
Roy
Wardle
MJ
Wheelton
James
Whiteley
Williams
Withers
Deborah
Christine
Lynsey
** Two BSL Interpreters in attendance
Total Participants = 50
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Salford Disabled Motorists
Access
CSSD
CSSD
CSSD
Appendix 8.2
Index
Priority and Over view User Perspective
Access
Access to information Top Priority – the call for information, which is appropriate, in
accessible format in accessible areas all over the city, is the major request from service
users and carers. The need to target information through processes, which are already
in place, is another request for instance at the time of discharge from hospital or when
health checks or inoculations are being carried out.
More promotion of available services 2nd position – the need to promote what is
available in Salford is the 2nd priority. Many people raised the fact that when they were in
receipt of a service which was good, it appeared that there was reluctance to publish or
use this in marketing what Salford has to offer.
Environmental access is in 3rd position, the need to update older buildings was
raised but also the fact that relatively new buildings have been built without loop
systems, not taking into account tonal differences or textural variation to denote change
of area etc. Even the arrangements for stairs, lift systems etc Service users and carers
were seeking involvement of Service Users and Carers in the design, development and
refurbishment of buildings within Salford. Issues were raised around the design and
development of the new Health and Social Care Centres.
Need to be less risk averse – 4th position – many people felt that if there was less risk
aversion, more individualised planning could develop
Access to day opportunities – 5th position, the underlying view which was developed
in events which took place in the “promoting independence “ events many people did
not know what else was available other than the traditional day opportunities. Those
who were aware of some of the possibilities felt that, different ways of providing day
opportunities should be promoted to enable choice but also enable gradual change.
Independent advocacy Service 6th the need for advocacy services has reoccurred, not
only in the Best value review consultations but also in the open forums. Services such
as “Salford being heard” are at the forefront of some participative work.
Staff training 7th position particularly in the area of awareness i.e. front lines staff, and
that the training involves Services users and Carers. In fact this has led to the Salford
Disability Forum including training of “professionals” in their business plan.
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Individual Care
Work with individuals to see what they want priority 1. Service users and carers
have risen repeatedly that they are offered services, which they do not want; they would
prefer that life goals were included in assessment/planning.
Commission on Quality not just who can do the job quickly: this was raised
particularly in relation to home care services; many people raised the huge variation,
which exists in localities. Service users felt the promotion of commonly agreed
standards and the training of providers by commissioners would enable expectation of
what constitutes “Quality” to be more universal.
Unsafe hospital discharge – pressure to leave before support is in place at home or
one is actually fit enough to leave
Unused equipment, listen to the person and provide equipment if they want it, this
is a variation on working with individuals.
Lack of rehab for long-term neurological conditions – rehab services and “respite
care” are two areas where there appeared to be variation on what is required and
where. Some people felt there were the services but possibly not enough or that they
are not promoted. Others felt that as they had received specialist input via Hope the
rehab services required for their support had been commissioned albeit outside the
area.
Citizenship
Transport – if there is one area, which is top priority it is transport, every consultation
event held has raised the issue of transport, particular in relation to independence,
choice and inclusion. Many people have said what is the point of carrying out other
environmental developments to make buildings/ venues accessible if there is not
adequate transport to get an individual there.
Sensory representation on partnership board priority 2. Service users who are
participating for the first time and are now more aware of opportunities to become
involved have asked why there is no representation. Also people who are engaged are
developing the confidence to participate fully.
Lack of supported employment/ choice priority 3. This priority was also linked to the
need for information on the type of employment support available, how this support
could be harnessed and the existence of real choices as to possible types of
employment.
Quality of life priority 4, many people felt that to obtain a quality of life they needed to
have needs such as leisure, social life, holidays, general inclusion in the life of the wider
community met. This they felt was necessary for their own personal well-being. One
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person whom had been physically disabled from birth but had, undergone operations
and accidents which meant that her general physical condition deteriorated to the extent
that they could no longer take part in the amateur dramatics which had been a major
part of her life. This led her to focus on what she could not do rather than what she
could.
Areas discussed
Citizenship
Taxi Problems
Transport
No of
points
12
Openness about charges by
all sectors – public, private,
etc
3
Lack of employment support
7
Friends ignore newly disabled
people
6
Employers attitude
4
No Deaf representative on
partnership board
13
Disabled peoples attitudes
2
Funding for groups for
everyone (integration)
3
Consultation – try to create
space so that signers can
hear people on their table
Access to signing at GP could
be improved
Lack of knowledge re
advocacy.
No independent Advocacy to
advise of rights i.e. social
services not just doing us a
favour we have rights
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0
1
12
Priority
Individual
Care
Care on call not advertised
very well needs to be
developed
Lack of money to promote
integration
Change the way that social
workers and health staff
perceive Home Care Support
Workers – professionals
Lack of re-hab of long term
neurological conditions e.g.
strokes, brain injuries with
social services and health
only one centre basic for the
whole of greater Manchester
Don’t assume a service
applies to all people. In
balance between Learning
Disability, Physical and
sensory
Equipment installation can be
slow and problematic.
7
4
3
Unused equipment e.g. wheel
chairs, glasses – listen to the
person and provide equipment 8
if they want it. Don’t assume
everyone wants all available
equipment
Work with individuals to see
what they want
20
Assisted technology
4
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Change of perception of
carers/ professionals
Carers attitude wrap in cotton
wool
Minicoms only available to
deaf people and not relatives
they have to pay
Need to improve service
commissioning task not time.
7
Improve info between
commissioners & providers
2
Social Service should
commission on quality not just
who an do the job quickest
10
Appropriate care services for
younger disabled people
3
Issue of unsafe hospital
discharge following
introduction of fines, too quick
or inappropriate
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8
Access
Need to be less risk averse
9
Recording Carer assessments 1
Build on talking news. Video
news for the deaf
7
Confusion Direct payments
same name as benefit
4
Changes to care provision i.e.
shopping poor etc
2
Staff training on full
awareness
4
Information Technology
training for Disabled people
3
Deaf people need to
understand how to use
faxes/minicoms
Deaf people given second
hand equipment /faulty
Access to day opportunities –
increase
7
Access to information
14
More promotion of available
services
10
7
Physical access still needs to
improve
4
Need more specialist
accommodation
Education so that Disabled
parking spaces are not taken
by non-blue badge holders
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Solutions Stakeholder Day
Citizenship
A self-advocacy group for Deaf/Sight.
Facilitators/ interpreters
Time – 3 months July 05
Employment Support for carers
employment providers.
Time Scale – 6 months October 05
contact
existing
Better re-training for people who become disabled in later
life
Attitude and awareness raising of employers
More local links
Work closer together: job centres, Salford Work
Development, Salford College.
On supported Employment “ all doing the same job but not
working together.
Lobby Transport (GMPTE) and groups/ providers on
access to service
Disability Forum liased with some taxi Drivers and local
link on transport issues.
There is a vacancy on the partnership board and this is
being identified as a place to represent sensory disabilities.
Local Directory of accessible taxi companies
Salford Supported Employment, DEAs, Access to work,
and resistance to employers, Job Centre +, etc.
Information for Student Unions
Home Working
Use Direct Payments
Information Technology
Information for employees
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Independent advice needed
6 to 12 months
Huge benefit issues – flexible work needed
Education re: issues, approved advertising (list).
Provide information about all the types of transport
available and when it is available (can be used).
Ensuring Facilities/ support is available for the needs of all
representatives on the board.
Raise awareness – Bus company of the need for transport
for disabled people.
Need to raise awareness of what is available in terms of
supported employment – promotion.
Identify transport needs for Disabled people in the City.
Vacancy on partnership board- open to deaf person
2 months.
Transport still service led not flexible enough to meet
service user needs.
Not enough black cabs with disabled access, Solution
Council only licences taxis with access mechanisms
More lobbying of transport agencies i.e. GMPTE, train
operators etc.
Council to help/ lead or facilitate with service users.
Review types of transport (i.e. size of buses), different
options, types/sizes etc. Plus how transport is delivered
commission on agency/ taxi firm to do the work.
Consult with enforcement licensing agency - “an issue”.
 Disability awareness for taxi companies/ drivers etc.
Examine how it would be possible to extend the capacity of
the “Ring and Ride” Service
Possibility of online booking.
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Day Centres – extend or alter times/ types of activities
offered –different day opportunities- added benefit of
assisting with transportation issues.
Investigate the idea of a call centre (single telephone
contact point), which then signposts or passes work on
appropriately (multiple organisations to start).
Gaddum Centre – help and advice line (whole range of
information and advice).
Use of one stop shop for accessing information (via a
range of means) but with people available and at multiple
locations.
Information to be “user friendly” i.e. user led – simple
messages and in different formats.
Development of SID (computer based system)
 Information source
“Salford Information Database”
Council to provide flowcharts or maps for pathways (i.e.
what to do if a person wants information on an issue)
 Sharing information
Individual Care
Greater involvement of service users in commissioning to
ensure support is appropriate
Profiling population needs to match providers to local
needs
Joint training with providers to ensure objectives are
understood
Unsafe hospital discharge address with government.
Advocacy inform people of their rights
Development of services in primary care setting addressed
by SHIFT/ LIFT.
Make Care Plan a person centred plan. Listening to carers
views and take them into consideration
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Assistive Technology, need to get involved with Older
People agenda as soon as possible – need a dedicated
worker in this area
Working with the Disability Forum
Social Care Funding should be ring fenced
Care staff accessing suitable training
Community and Social Services Directorate should
commission on quality. Care Staff Services need to be
marketed in ways that make them more attractive.
Community and Social Services Directorate should
commission on quality. Introduce quality premiums for
rewarding better quality providers
Central Commissioning unit to work with training agencies
to help providers’ access good training.
Community and Social Services should commission
quality.
National pay rates for care staff need to be higher to
professionalise the service
Unsafe/ unsatisfactory discharges hospital discharges
Links with Primary Care Trust are crucial to help address
and resolve concerns
Work with individuals assisted technology can be most
useful
Work with individuals – fitting the service around the
service user, strengthens outcomes goals as well as needs
Unused equipment – need to ensure equipment that is
used is maintained
Good Communication with neighbouring PCT’s to make
discharge process the same and the staff aware.
Feedback/ Consultation about independent providers
service from service users
Consult with providers re: gaps in City of Salford
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What is a quality service?
There should be a set list and all providers should work to
these.
Continuity of Carer is important
Promote Geographical problem areas to Domiciliary
Providers.
Multi- Disciplinary Discharge Meetings - work together not
just to empty beds
Access
Access
Gaddums – provides information to the service and
promote Information in Doctor’s surgeries
Target people who are likely to use a service e.g. in
hospital letters:
 Hospital Staff / CAB
Time 3 months
Cost of support to volunteers is significant
Information Office in the High Street
E.g. Tameside model with independent provider.
Employ Information Officer (Disabled Person with flexible
working?) to develop database and run group of volunteers
Funding by CHSSD for 6 months or independent funding
for 12 months.
New information system on Salford City Council website.
Ask SID to be launched in June
Details in local paper (Access to information)
Make information available in as many different outlets as
possible:
 Supermarkets, libraries, leisure centre, G.P Surgery,
Deaf Club, Luncheon Club etc. (Use register of
luncheon clubs etc
 (Use register of voluntary clubs)
Send information out with council tax bills/ Council
newsletters or best value plan summaries.
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Provide training for GPs/Health visitors etc on where to get
access to information.
Key Worker (as covered in every child matters) for each
individual who ties together different agencies who provide
for the individual
Make use of local news channel – Channel M
Make information as attractive as possible
Better training for risk assessors on working with people
with all types of disability.
Consult service users/ carers on what information they
require and what format and where they want it distributed.
Drs Surgery, libraries, one stop shop etc.
Work Closer with Partner Agencies, such as health
Centres, Call Centres.
Do things that are possible to minimize risk
Access to information Can use existing networks to
circulate information e.g. CVS, SHIFT, Centres. Can
develop Salford Information Directory
Need to move to an enabling culture more.
Secure High Street availability of information about
services. Website sources of information e.g. Ask SID
could be very suitable
Who could take this forward – (access to info & promoting)
- Customer Care Division
- I .T Division of local Authority
One Stop shop needs to be developed as centres of
available information. Need to have decentralised
neighbourhood. One stop shop as centres of information.
Being less risk averse
Acknowledge we live in a litigation culture that can
undermine promoting independence.
Access – Who?
Service Users, Providers, Doctors
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Access – When? April 2006
One point of access - with resource to access current
information
Keep it simple – information!
Access – Dr’s Surgery, net, one stop shop
Internet – interpretation of information
Voluntary Sector role – Partnership Boards
Written agreement with S. U and staff about what risk is
acceptable.
Social Services, Legal Departments, Doctors, Disability
Team, Psychologists, Psychiatrists, Self-advocacy Group.
Timescale: April 2006
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Summary
What needs to change – Stakeholder Day
Access
Information
Requirement for better information about services and Salford in
general. Salford does not promote itself enough. Information is power
we need to share it.
Information should be available on:
- Facilities
- services
and on changes to care
- Where to find information
provision i.e. shopping etc.
- To get into services, where to go? How to get service
- Lack of money to promote information
- Need to promote services better so that people can see what is
available (Choice)
- Information at accessible points – one stop shops, G.P practices,
Supermarkets, (contact details and how to contact social workers)
- Lack of information on sensory needs and equipment
- Better access to information for people with sensory needs
- Register of people who are deaf would help to target information
- Communication and publicity not available in different formats
audio. Sign language
- Build on Talking newspapers – video news for deaf
- Talking News – Royal Mail only allows mailing free for people who
are Blind, not those who have had a stroke, therefore unable to
hold newspapers
- DWP have stopped visiting talking news to update on benefits
- Audiology at Hope Hospital has no staff on reception or in the
department who use sign language.
- Deaf People lack information on all services even the partnership
board has not yet got a representative (sensory)
- Access to signing at GP’s could be improved. Signing access at
hospital is available
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- Difficulty for people who are deaf – need to understand how to use
faxes and minicoms
- How do people find out how to get information on benefits
- What are the standards for eligibility for blue badge? Different for
each Local Authority.
- Only one port of call for information
- Care on call not advertised very well, needs to be developed
- Lack of information on new diversity access
- Contracting Services – clarity on who to contact and streamline the
address to get through to the right person quickly.
- Direct payments still get confused over what it is, same name as
benefits
- Lack of information on neuro-diversity access
Physical access
Access to buildings is still a problem. Still need to improve
Access. Door handles not appropriate, door widths or lift size
may not be sufficient for all types of wheel chairs.
- Don’t take access for granted
- Access to disabled toilets can be difficult e.g. (this is outside
Salford) where you have to pull the door to enter
- Pavement and kerbs
- Accessible pavements and car parks blocked by vehicles
- More openness about changes by all sectors (public private etc)
Processes
- System is too complex to understand, need simpler processes
- Have more unified processes for Social services, PCT, acute
trusts, including complaints as well as assessment (Health Service
Ombudsman reports)
- E- procurement needs to be processed quicker
Citizenship
Awareness
- Educate people not to park on hatched areas near disabled bays
or to park blocking dropped kerbs
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- Consultation events try to create space so deaf signers can hear
people on their table
- Lack of knowledge re: advocacy
- Deaf awareness GP receptionists still shout “next” when they know
the patient is deaf
Attitudes
-
Society
Disabled people
Employers (Insurance)
Change the way social workers and health staff perceives home
care support workers (professionalism).
- Afraid of loosing welfare benefits
- Carers attitude wrap in cotton wool
- Change perception of carers (professionalism)
Housing
- Supported housing (lack of it), need more choice in terms of
supported housing or supported living.
- Long waiting list for supported housing
- Need more specialist accommodation like Pendleway
Funding for groups for everyone (integration)
Transport
- Examine different transport options for service users getting to day
centres
- Taxi problems
- Transport
Employment
- Lack of employment support for people with dyspraxia and related
conditions (neurodiversity)
- Employment depends on transport
- Numbers of opportunities, work experience very limited. Need
more options – standard woodwork, horticulture
Advocacy
No independent advocacy to advise of rights Social Service not just doing
us a favour but we have rights
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Individual Care
Equipment/adaptation
- Unused equipment e.g. wheel chair, reading glasses Listen to the
person and provide equipment if they want it. Don’t assume
everyone will want all the equipment available.
- Equipment installation can be slow and problematic
- Minicoms only available to deaf people free and not relatives,
relatives have to pay
- Deaf people given second hand equipment sometimes faulty,
promised new but 6 years later still not received, this needs to
change
Care Services
- Care provision appropriate care services for young people
- Day care Providers caring for younger people would like more
access to day opportunities
- Foster Carers for Respite (Young People)
- Adult placement for Physical and Sensory Users
- Don’t assume a service applies the same to all people, work with
the individual to see what they want
Assessment
- Issue of unsafe hospital discharges (following introduction of fines)
No feedback on unsafe hospital discharge, forms often completed
too quickly or inappropriately.
- Carers Assessments
- Recording care assessments
Commissioning
- Pay rates (for providers) are not helping in recruiting of staff of the
right calibre
- More flexible approach between Social Services/ providers and
service users i.e. time for services or task completion
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- Need to improve Service Commissioning (i.e. task not time) how it
is achieved
- Social Services should commission on quality not just who can do
the job quickly
- Examine different operating hours/ days for day centres
- Lack of rehabilitation of long-term neurological conditions with
social services and health e.g. stroke, brain injuries. Only one
centre for the whole of Greater Manchester which receives very
little statutory funding
- Day service provision short term care
- Need to be more risk averse, risk is part of life
Training
- Staff training
- Staff training on full awareness
Consultation User and carer
Venue: Carers Centre
Are Services Good Enough
Services & Information
1. Physical Difficulties are treated different from Learning Difficulties.
2. Physical Difficulties Services has no structure; “I want the same
Services as Learning Difficulties”.
3. Physical Disability has no support on leaving hospital, no information,
and Communication - poor links between the council and hospital.
4. Departments do not work with each other
5. Professional do not speak to each other
6. Information about assessments are not known or advertised
7. No cross-referencing between service providers or teams so
sometimes gets duplication of service.
8. Appointments are sometimes duplicated and decisions are not made
to a satisfactory conclusion
9. Right information about services not widely given e.g. Direct
Payments
10.Better Care Higher Standards Document not issued to the Public
11.Information tends to be in Jargon or not in a language that is
accessible to users
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12.Need for better communication systems
Individual Care
10.
11.
Henshaws have good support from Social Services have to
Use social services transport this is not always reliable.
Have support in my home.
More support needed for help at home within physical
Disabilities.
Equipment
12.
Adaptations are not good enough. Had to involve M.P. Minor
adaptations are done items which cost more are not attended to. “
Aids/ adaptations the cheaper the faster they are provided false
sense of economy”.
Care Planning
13.
14.
15.
16.
Need for Key Workers or some facilitation between services
Lack of support for Older/ disabled i.e. cleaning up after
Workmen, moving furniture etc.
Stop passing the Buck!
Some service provision is better than others i.e. sight
impairment services
Exchange of conversation between the two groups
 Both groups agreed with no 3
 Both groups agree with no 2
 For 4 further discussion conclusions – information packs need
adapting to individual need, up to date and understandable.
 For 5 there should be departmental standards of responses to
questions
 Both groups agree with 14
 11 is same as 15
 8 is same as 11
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 A system is required to make sure information gets to people who
require it. Professionals need communication awareness training e.g.
how to talk to people.
 Services should be provided at the right time
 Lack of appropriate community workers e.g. physiotherapists
 Generalist Verses Specialist Services
 Use of service Users to promote services
 Key worker to arrange meetings between professionals – e.g. follow
up consultations etc.
 Care plans need to be more intensive to include User/Carer finance
and home environment.
What would you want to be different?
1. Replicate Learning disability structure with Partnership Board between
Physical Disability and Sensory Disability.
2. Improve communication between people leaving hospital and help
at home. e.g information pack
2. Not all help on offer is aimed at helping people to simply adjust to
their new circumstances or help them plan for a productive future.
3. Hospital Social worker OK in hospital, more contact needed on
return home. Social worker should call on a regular basis.
5. Better arrangements needed between different departments
6. Need information on who can help to fill in forms
7. Different Departments must share information, also organisations
and individual workers should talk to each other.
8. Professionals should know what is available e.g. social workers
9. Should go to one point for information
10. Support required when going through changes in life, e.g.
adaptations
11. Charging for services – when it should be free (understanding
what benefits given should be used for).
12. Better Care Higher Standards should go into a person’s home
13. All service users should have information in plain English or in
individuals 1st language
Consultation User & Carer
Venue: the Link Project
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What have I experienced
Individual Care
1.
Adaptations & Equipment
Services telling people what they are going to get rather than what a
person needs. (Don’t listen) Duplication of workers coming to survey
or carry out work. Work not done properly first time having to be done
again (use of money!).
2.
Sometimes receive wrong equipment
Care Planning
3. Recognising different needs built into plan
4.
No consistency moved from professional to professional
5.
Whilst in hospital – what about leisure – helped another patient to read,
took another patient to the café, helped another patient to open sweets
– part of hospital
experience- i.e. Care.
6.
Lose of dignity

Left on toilet for three hours

Left almost naked

Ignored by staff

Fell out of bed
Notes inaccurate or untrue
Maintaining as much dignity as possible should be part of any service
7.
Rehabilitation provision – a good model in Rochdale – family went
together into self-contained adapted flat with back up team to support
family to adapt to new circumstances.
Assessment
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8.
No Carers Assessment, huge effect on the children they needed
support from outside of family, only found out about the carers centre
recently.
9.
Once you have a Social Worker involved things moved faster
10. The effect on the family – depression, lose friends, home required
adaptation had to wait the builders from hell.
Access
Information
11. What is available in Salford, how do we let people know? Needs
communication plan?
Process
12. People are labelled and categorized this influences what a person gets
and how you are treated
13. Persons Independence – the above takes away a persons’
independence i.e. the ability to make informed decisions.
14. Information – how do I get a Social Worker?
- Occupational Therapists waiting Lists?
- Disability Forum what is it about? Should be promoted
15 . No information on leisure facilities and holiday provision.
16. Winter is the worse time as require extra heating – Is there a cold
weather payment for under 60 years old.
17. The need for good communicators – no interpreter almost had an
operation I did not need because I couldn’t speak. Follow up when
there is a problem - not consistent.
Citizenship
Awareness
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18. Treated as though not there, carer is talked to rather than the disabled
person
19. Assumption by professionals that Disabled Person would be going into
respite. Whilst the family went on holiday.
20. Police and fire service provide support not advertised e.g community
safety
User And Carer Consultation Little Hulton
Homecare and caring
Citizenship
Awareness
My mum and dad are carers but they would not accept it, they said they
would care for me any way, as I am their daughter.
Many people do not class themselves as carers. They see carers as being
people who are paid by social services.
I have children, people see my children as carers, they are not carers –
they are my children. I have gone very much the other way, as I am very
independent. I wouldn’t let my children do anything at home. I wouldn’t let
them make sandwiches or tidy up; people said I was making a rod for my
own back.
Is it Important that people who care for others recognise that they are
carers?
No, it doesn’t matter it is just a label
I have been a friend to …… for many years; I want to offer support as a
friend, relative or neighbour and not to be seen as a carer. Our relationship
as friends is important
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It is important to be recognised as a carer to be able to have services for
carers. You need to be recognised as a carer to be able to claim carers’
allowance.
Access
Information
To ensure that information and advice is available.
Commissioning
Monitoring
Years ago, I was suppose to receive 1 hour a week home help, they would
arrive turn the telly on, get the biscuit tin out. I complained to the area office
– nothing happened. My G.P said write to Val sherry. I wrote to him, then,
next thing – area manager, local Manager and another person arrives on
my door step – they said I had no right to complain – I just snapped I rang
Social Services and said can someone be at my home, but it is some years
ago.
Another time, I was receiving home care, a woman was asked to come in to
me, and she was told she had to give me a bath. We spent 5 minutes
arguing because she put a pair of marigolds on to bath me I didn’t need her
to bath me I can bath myself. She then put a pair of surgical gloves on to
wash up.
In summary
 the need for training.
 Changes in circumstances.
 Who the care staff is accountable too, if there employer is asking
them to do one thing and the service user something else. This
should be being resolved in terms of the care plans.
Are these situations because we have outcome based care plans
without designing the tasks? The aim should be to have clarity of what
is expected.
You can tell professionals what you want but they think they know better
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Is this around the way it is written down?
No, we are given a copy of the care plan
User/ Carer Consultation
Wardley Community Centre (Sensory)
Are Services Good enough approx 20 people felt they had good
communications with sensory team and felt the support arranged was
good.
7 people where not aware of sensory services and felt they could not
comment.
One participant said she had a good relationship with her Social worker
that visited her at home, arranged for equipment and some care. “she is
very good. I can ask her if I need to find out any information”.
Would like to go shopping, daughter use to take me but she has fallen
couldn’t get here without transport. Transport is main problem.
Have attended Henshaws for 13 years, social Worker put me in touch
with them and I have been coming here ever since – only time I go out.
We go out for pub lunch/ restaurant with Henshaws, and other places
not as often now – not enough money. Come for the company have
very good friends here. Should have more social /leisure activities
available
Don’t know what is available leisure/ education/ training
Need more access to work for younger people very little when I was
young. Things not changed much.
Carer comes at times when I’ve arranged to go out, so I can’t go out
have to stay in and wait.
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Would like better transport can only get out and about if transport
available.
Meeting: Pendlebury
Details of discussion
There was a good turn out, some people present were wary about the
meeting as they felt that they had experiences that had taught them to
distrust the motives behind getting people involved. Geoff made it clear
that; we are there to listen to what Deaf people have to say and to make
sure that deaf people are involved in the development of all types of
services.
Many people felt they wanted more integration, and awareness raising
many social groups that people attended was within the deaf community.
Others were weary that, hearing people would dominate and they would not
have say. Attention was drawn to the fact that use to have a Social Centre
in Salford it was taken over by hearing people and then abandoned!
People to illustrate examples of isolation and exclusion used some
examples of personal experience.
e.g. 1) Minicoms’ that are sat in cupboards and do not work
2) Immediate appointments that do not allow time to have an interpreter
present
3) Not enough social workers to make a difference – know Barrie really
well but he is very busy feel there should be more social workers.
4) Letter’s that people do not understand so have to get translation
5) Pushed out of community activities by hearing people, made to feel
unwelcome.
We like to have a community resource where people can get information,
get help to obtain services such as at the hospital, no arrangement for
interpreters and immediate appointments mean cannot get interpreter as at
least 3 week wait, booked up. Many of the people who interpret sometimes
use signs that, people supported by services can’t understand.
Not been involved before – don’t know what is expected
Its good to have Link worker in Salford, able to ask him questions and he
can give us information
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Summary of Developments since the Commencement of the Best Value
Review.
Awareness Raising
- Transport personnel/providers received disability awareness
training commissioned by the Disability Forum.
- Deaf Awareness training commissioned by Community Pride.
- (application for Funding to commission disability awareness
training in the area of sight disability).
- Life Long Learning Partnership, the colleges in Salford have
increased their provision of Disability Awareness courses and have
through promotion been able to increase take up of the courses
above their targets.
The partnership has also managed increase the numbers of
people in Salford who were taking BSL their target was 70 people
locally, they have managed to double this figure to 150 people who
aim to complete this June. The long-term aim is to increase the
numbers of people locally who are qualified interpreters
- The Salford Disability Forum is working toward being an umbrella
organisation with many Disability organisations connected to its
networks. They have focused on a Bid to develop Sensory
Participation further, in Salford.
- MCIN, presently working with Service Users/Carers in Salford to
develop an information portal geared toward sensory needs.
- Information Technology Training has been offered to Service
Users & Carers – taster courses. Further Development to take
place.
- Formation of the Partnership Board – Independent Living
- Development of enablement Service within Physical Disability
Service.
- Further Development of User/ Carer participation
Via additional developmental/link worker support.
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Appendix 9
Performance Indicators
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Appendix 10
Best Practice Examples
Introduction
This document lists examples of best practice as identified in a range of documents produced by outside organisations.
The second column outlines whether Salford already demonstrates this best practice or whether it would be appropriate
for Salford to develop a similar service or project.
Access
o Ensure that access to services will be made easy through good publicity and customer care services (Think
Customer approach)
Best practice examples:
Empowering day Services
Bromley – “no limits” joint initiative from
SS and Leisure to improve access to
leisure for disabled people. Leisure
guide has information about a wide
range of opportunities. Adult education
tries to ensure that courses are
accessible to disabled people. A
community involvement advisor assists
people to access social, educational
and work opportunities.
Bolton – Lads and Girls club is a state
of the art sports and leisure facility
funded by £4 million of lottery money
and £1 million of local support. Set up
as a voluntary agency provides
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Salford
Leisure has a Lottery bid to ensure that a recreation
centre is fully accessible to all disabled people. This is
in the early planning stages. Some leisure centres
have lifts or a ramp.
Leisure guide gives no indication of accessibility or
arrangements for subsidised leisure.
I have not seen any information on adult education
Action
Follow up issue of
accessibility with
Leisure Services.
This was initially in a poor building and some of the
Need to put an item in
services are similar to Salford Lads Club. The scheme the improvement plan
began with a particular group of young disabled people
and I am sure they would share the information on
how it was set up with you.
impressive inclusive facilities for
disabled young people.
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Advocacy Services
Redcar and Cleveland – used the
Promoting Independence Grant to
contract voluntary agencies to provide
advocacy for disabled people. These
include a specific advocacy service for
Deaf and hearing impaired people.
Service users were making good use
of this service.
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Salford
Users have not commented on any advocacy services
but have said there are some.
Action
Improvement plan item
– Independent Sector
to provide
Access to information
Newcastle City Council Ensuring
that information on services is made
available in audio, British Sign
Language Video, Braille and large
print
formats;
Establishing
a
Communications
Service
that
enables deaf and hard of hearing
people to access council services.;
Providing a corporate text ‘phone
contact number for all council
services together with individual
text ‘phone numbers for key
services.
Providing
awareness
training
to
all
staff
about
communication needs of disabled
people.
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Salford
SCC has received 3 allocations of Global Grant
funding over the last 3 years (funded via European
Social Fund). Projects that have been funded include:
Community Care Home project received funding
to have 5 employees trained by Disabled Living to
professionally assess client needs. Aims were to:
o Provide an advisory and referral service
on all disability issues using a call centre
approach.
o Provide small items of disability
equipment, available on loan or for sale,
that are not freely available from
statutory providers
A video phone was obtained but was not used and
therefore was returned.
A contract has been entered with O2 to provide a
texting service via mobile ‘phones. A loop system is
provided in the committee rooms, in each Social
Services team and at Sahal Court. There are minicoms
available in reception areas (e.g Social Services,
Environmental Services, Development Services).
Minicom installed by PCT in the Cornerstone building.
The Council owns a Braille machine. Development
Services aim to have a Braille and /or Audio
transcription service set up by April 2005.
Some Environmental Services information is on tape.
Community and Social Services information produced
in 14 point and available in larger print, on disk, audio
tape or in Braille on request. BSL signers are available
in some reception points and some have loop systems.
When I was in South Tyneside there was visible
promotion of communication in every public office with
text phones available etc. this minimises the needs of
disabled people to use SSD service. The scheme
above seems to draw people into SSD.
Brighton and Hove – Brighton and
Work being conducted by Disabled Go – research and
Hove Federation for Disabled People,
provision of information on access to variety of
an umbrella group of organisations
organisations across Salford.
providing services, seeks to promote
Sounds good and I have seen a description of it in
independence with dignity for all people Stockport as well. However the eg alongside is more
with disabilities. It manages the
than this. Is there a vol org who provides advice and
Disability Advice Centre and provides
advocacy etc.
counselling and advocacy services.
Disabled Motorists Association.
The Community Home Care project received funding to
have 5 employees trained by Disabled Living to
professionally assess client needs. The provision of
this training had two distinct aims:
o To provide an advisory and referral service on
all disability issues using a call centre approach
o Provide small items of disability equipment,
available on loan or for sale, that are not freely
available from statutory providers.
Access
Active citizenship is promoted through consultation and involvement of citizens with a disability
throughout the city
Best practice examples:
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Disabled people’s involvement in strategic
planning
Bolton – Disabled service users are members
of Bolton’s Housing, Social Services and
Health Scrutiny Committee and will be
members of the Health and Social Care
Improvement Group. Service users are
consulted on a range of disability related
issues and participated in the development of
the Welfare to Work Joint Investment Plan,
the direct payments scheme and the needs
analysis of Deaf People.
Salford
One member of Transport and Planning
Regulatory panel is disabled (non-elected,
no voting powers).
(Development Services DDA Action Plan)
Having disabled people on committees
sounds a good idea and can be extended
from this limited beginning.
The Joint Development Group involves
health and social care agencies working
with service users and carers to ensure that
their views are taken on board in all aspects
of service planning and development.
Service users have been involved in the
refurbishment / redesign of establishments
e.g. Waterside.
Disability Partnership Board has recently
been set up– strategically oversee
development of services such as Housing,
Health and Education (childrens’).
Bromley – Disabled people and people with
sensory impairments are members of the
Council’s Policy Development and Review
Committee.
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Forums set up to involve service users in
decision making and service planning – e.g.
Deaf Gathering.
Also Carers forums have been set up to
involve Carers in the development of
services for carers e.g. Carers Centre,
Carers Assessments.
Action
Review numbers of
disabled people as there
are only 3 at the
moment on the
Workstep programme.
(is this in the correct
section)
Disabled people’s involvement in strategic
planning
Dorset - A disabled person is a co-opted
member of the Social Services Overview and
Scrutiny Committee.
Salford
Disabled people are involved at various levels
in planning and decision making and in
interviews for staff.
Jim Wheelton from Salford Disabled Motorists
Association is the co-opted member on
C&SSD scrutiny committee. Service user coopted on to Social Services and Health Panel.
Partnership boards exist for older people and
learning difficulty and are in development for
the combined equipment service and physical
disability and sensory services.
Service users and carers are involved in the
recruitment and selection process including
interviews for staff posts.
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Action
Other
Birmingham – Putting in place a corporate group
chaired by the Cex to develop and implement an
action plan. Group to have senior officer
representation from each directorate with
responsibility for driving this work forward and
sharing, developing and celebrating good practice
across the Council. Developing a corporate action
plan to implement the social model and deliver on
the priority issues identified by disabled people in the
Blue Print for Birmingham (access to services –
disability equality in local government). Plus
Birmingham Coalition of Disabled People has over
600 members and over 50 of Birmingham’s disability
organisations under its umbrella. Awarded a lottery
grant in April 2003 which means it is totally
independent of the council and can campaign
effectively for what disabled people want.
Bath and NE Somerset – The Dury group chaired by
a director who is responsible to equalities corporately
and has directors as well as heads of service
attending from across the council. The overall aim of
the group is to champion and co-ordinate the
council’s corporate response and actions with regard
to disability discrimination legislation. The Dury group
set annual targets for service areas to meet. Plus
Disability Equality Forum funded by Council and PCT
operated by the West of England Coalition of
Disabled People. The Forum is run by an elected
management group made up of representatives from
local organisations of disabled people, service users
from local residential units and day centres, and
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Salford
The Joint Development Group involves
health and social care agencies working
with service users and carers to ensure
that their views are taken on board in all
aspects of service planning and
development.
The Birmingham example is corporate not
SSD and ensures disability issues are on
every agenda.
The Salford Disability Group is
represented on the Social Inclusion
Forum, one of seven Strategic Delivery
Partnerships of Partners IN Salford. The
Social Inclusion Forum is one of the seven
Strategic Delivery Partnerships of
Partners IN Salford, the Local Strategic
Partnership (LSP).
The Social Inclusion Forum strives to be
inclusive by enabling people with
disabilities and those who work with
people with disabilities to attend and
participate fully.
Action
Set up service users
advisory group on
Direct Payments. This
group will take on the
management of the
scheme.
disabled individuals. The Forum facilitates and
advises about consultation and involvement, as well
as advocating on behalf of disabled people about
local issues that effect disabled people’s lives.
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Access
o Single points of access
Best practice examples:
(none identified from the documents gathered
unless covered in other sections).
Salford
May get some ideas from the user tracking
in the scenarios.
LIFT centres should provide a single entry
point for disabled people to access Health
and Council services.
Call centres provide this for some service
areas.
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Action
Access
o Increased employment opportunities
Best practice examples:
Bolton – Multi-agency Joint Investment Plan Steering
Group has increased:
-Accessibility of benefits advice and information at all
stages of applying for and taking up employment
-Opportunities for educational and vocational training
and
-Workplace support
By developing a best practice model and a
successful European Social Fund bid.
Bromley – Access Centre for Deaf and hard of
hearing people runs a job club. Deaf Umbrella
provides communication support in education and
the workplace so facilitating access to work
opportunities for Deaf and hard of hearing people.
Liverpool - Employment support team co-ordinates
access to a range of training and employment
provision. The Acorn Centre is a new, well equipped,
accessible education and training centre offering
vocational, educational and independent living skills
courses, including computer training for disabled
people, as well as support in taking up employment
opportunities.
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Salford
Two ticks policy – disabled people
guaranteed an interview if they meet the
criteria.
SCC has received 3 allocations of Global
Grant funding over the last 3 years (funded
via European Social Fund). The grant aims
to find labour market entry for those groups
disadvantaged in the labour market.
Disabled people are a key group.
Projects that have been funded include:
Citizens as Trainers; Salford
Residents teach /consult social and
health workers about their experiences
and needs to improve service provision
for others.
Greater Manchester Coalition of
Disabled People, funding to support
expenses for delivering 2 capacity
building workshops in Salford for disabled
people.
IAS Supported Employment Service,
Action
Dorset – Staff of the community employment service
are based in area teams, hospitals and day services.
They support disabled people in accessing work
placements and employment opportunities through
the Stepping Stones and Workstep schemes, under
guidance issued by the Dept of Work and Pensions.
The service has helped a number of disabled people
to move from supported employment to jobs in open
employment
Oxfordshire’s - Employment Service, originally set up
for people with learning disabilities, now services
people with any form of disability and operates an
open referral system.
Westminster – Westminster’s Day and Employment
Service for People with Learning Disabilities
(WesDES) offers people with a variety of support
needs a range of services including innovative
pathways into education and leisure as well as
helping people into voluntary and paid work. The
employment service is being extended to include
people with physical and sensory impairments.
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received funding to assist disabled people
to develop employable skills.
The employment service is being extended
to include people with physical and sensory
impairments
Improvement plan
item – might involve
external people
Work opportunities – see page 39 of
Independence Matters, other issues:
21 councils had taken a corporate approach to
developing Welfare to Work through multiagency Joint Investment Plans that promoted
employment and social inclusion for disabled
people who found it difficult to access paid work
(2002).
Some councils reported that they were cooperating positively with Connexions in
developing work opportunities for disabled
people. In some instances Connexions had
offered funding for new initiatives.
44 councils also reported that they had engaged
positively with local potential employers to
promote the employment of disabled people as
part of their Welfare to Work initiatives. These
councils had established employers’ forums to
encourage potential employers to pursue the
Welfare to Work agenda. Croydon and Bromley
had introduced employers’ awards.
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Salford
‘World of Work’ is run by Learning Disability
Services but can be used by physically
disabled adults although there is an issue with
accessibility of the workbase for some service
users.
Action
Access
o Benefits from e-enabled services
Best practice examples:
Website development
Solihull – general info and specific web pages
identifying services for adults who are blind or
visually impaired or who have physical
disabilities. (lots of detail on this site)
Effective initiatives on communication
Redcar and Cleveland – Sensory support team
provides – minicom and type talk; mobile
phones so that staff working with deaf and
hearing impaired people can send text
messages; a BSL signed video about services;
a direct line for Asian service users to a bilingual social worker in the team; assessments
and care plans in a range of preferred formats
including Braille, audio and video.
Westminster City Council – funds a
computerised information service, WELDIS, for
disabled people. The library service maintains
the records on a database, accessible via the
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Salford
Action
Salford’s website contains information for Improvement
plan
disabled people and people with sensory issue – website to be
impairments. This includes information on how improved
to get an assessment, what an assessment
involves and information on how to contact the
relevant team including an email contact
address.
There are also links to other
organisations such as RNIB and Disability
Rights Commission. There is also a facility to
change the size of the text on the web pages.
See notes, it was not easy to find the
information on the web site.
Older Peoples’ directory being developed.
Users from one of the Henshaws groups were
pleased with the service from SI, however this
eg sounds much more extensive.
Text messaging.
Internet or via terminals in Social Services
offices, health centres and other council
buildings. Some community nurses have loaded
WELDIS on to their laptops for use during home
visits. Output can be in large print or in speech
format.
Herefordshire’s Disablement Information Advice
Line, DIAL, serves a similar function to WELDIS
but is run by a voluntary agency. Every two
years, DIAL publishes a resource directory in
addition to the service being accessible
‘phone,fax etc.
Notes:
Liverpool site easy to use and can find
information for services for disabled people very
quickly.
This area could also link into Assistive
Technology options – see Audit Commission
report, Feb 2004.
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Health and Social Care Directory on intranet
accessed by libraries and one stop shops.
Broadwalk has a database, which is being
updated.
Assessment
o That services are provided in a flexible manner that ensures alignment of expectations and promoting
choice (Person Centred Planning) –
Best practice examples:
Involving Disabled People in Planning Services
Gateshead – Sense, a national voluntary
organisation that works with people who are
deaf blind, was commissioned to undertake
a survey of all people on the dual sensory
loss register to find out what they thought of
the services provided. Health agreed that
questions about services provided by
hospitals and GPs should be included.
Tameside – A service user involvement
development worker was appointed to promote
the active participation of disabled people in
planning and shaping services.
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Salford
The BVR is a good example of involvement
and participation, but the board will develop it
further.
Partnership has undertaken a PSS survey of
disabled people and other surveys.
You have a user development worker in post
Action
Improvement Plan –
revisit previous work
and consult those with
sensory impairments
Person centred choice
o That standards of services are defined and monitored –
Best practice examples:
Carmarthenshire County Council – has drafted
codes of practice for stakeholders (social
services transport)
Salford
Transport is an area that has been criticised.
Leeds has begun developing the corporate
fleet in a much more flexible way. I am sure
they would discuss with you how they have
approached it.
Action
This is being
addressed through
the Transport Review
code of practice.
Salford
Presumably you have also? But users have
commented that there is duplication and gaps,
so may be can improve
Action
There are joint care
packages but need to
take these further –
improvement plan
item. Investigate work
of joint teams.
o Partnership working is developed
Best practice examples:
Calderdale – had arranged a number of joint
packages of care with health colleagues.
o Dedicated home support services,
Best practice examples:
Support for Family Carers
Redcar and Cleveland – Has developed a range
of carer support services including:
- A carer development worker funded through the
Promoting Independence Grant
- A quarterly newsletter sent to all identified
carers
- A carers database with details of carers.
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Salford
o Carers centre.
o Newsheet
o Carers database.
o Respite.
Action
Plans to develop a separate carers’ service in the
independent sector
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Person centred choice
o Increase in direct payments
Best practice examples:
Hillingdon – good direct payments scheme
much valued by users
Salford
Salford has a well established direct payments
scheme. The local council for voluntary service
provides an advocacy and support service,
including payroll support. There are plans to
hand over control to SUGGEST, a user run
organisation in the next 12 months.
CVS have received a DoH grant to promote
direct payments in Salford and a grant to
develop promotional material to ensure that
information is available to service users in
appropriate formats.
The system is currently under review to both
streamline the service and to harmonise adult
and children’s schemes.
Users are still commenting on lack of CRB
checks for their staff. (this is not a requirement)
Hartlepool, Middlesborough, Redcar and
Cleveland and Stockton on Tees – have a
contract with Independent Living Project, an
independent agency with links to a national
awarding body, the Institute of Leadership and
Management. Service users who complete
the direct payments training programme are
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Action
accredited with the introductory certificate in
team leading at NVQ level two.
Tameside – Recipients receive extensive
preparation and training and through and
effective ongoing support. The Direct
Payments Steering Group includes service
users, carers, staff and Direct Payments
support Agency.
Organise training.
Brighton and Hove – Brighton and Hove
Federation for Disabled People, an umbrella
group of organisations providing services,
seeks to promote independence with dignity
for all people with disabilities. The Federation
employs a full time staff member to work on
Direct Payments Scheme.
Person centred choice
o Greater range of rehabilitation and respite care
Best practice examples:
Local Services for People with complex
needs
Dorset – in partnership with Headway, NHS
agencies and Signpost Housing association,
Dorset acquired and adapted a property for 4
people with acquired brain injury. Their
individually tailored care packages include
community service volunteers, paid personal
assistants and social services staff.
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Salford
Salford has a supported tenancy scheme for 9
disabled people who need 24 hour care. This
is run in partnership with Contour housing
association and the care is provided via a
contract with Leonard Cheshire. This enabled
7 people to leave residential care and one
person to live independently for the first time.
Action
Meeting identified need for some transitional
or ‘waiting’ accommodation for people needing
complex adaptations on discharge from
hospital
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Local Services for People with complex
needs
Bolton – Working with Regional Neurorehabilitation unit to develop community-based
services for people with acquired brain injury.
This will involve social services in the local
multi-agency implementation group for neurorehabilitation.
Salford
Action
There is a multi-disciplinary community neurorehabilitation team in Salford which includes a
full time social work post with close links with
the adult physical disability team.
This should be
discussed with Health
as part of the
improvement plan.
There is an integrated equipment service
provided at Burrows House. This includes
wheelchairs. Long standing service provided
for 21 years.
Improvement plan item
– Review of housing
need and planning for
growth
Portsmouth – New integrated and multi-agency
disability support centre being developed.
Hillingdon – Develop an enhanced independent
living centre, where users can try out and
purchase equipment. Plus Barnhill
Independence Unit provides places for 15 adults
with disability (long stay or respite?)
Derby – High emphasis on rehabilitation.
Number of people assisted to live at home is
high
Hartlepool – Dedicated part-time development
worker to support people who are deaf or blind.
(check wording)
(Bradford report p20) Parenting support
provided for deaf parents with hearing
children by Bradford, Tameside and Oldham
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Improvement plan item
– review numbers living
at home and
investigate how these
are recorded (figures
are low)
Dedicated workers for users who are either:
- Deaf
- Blind or
- Deaf blind
Social worker support.
Sensory loss services –
Dorset established drop-in Sight and Sound
centres in five communities across the
county. Centres offer advice and guidance
on equipment and adaptations to people with
visual and //hearing loss. Service is well
used. New centre being developed + plans to
extend the service
Solihull – in partnership with RNIB and
Birmingham Institute for the Deaf, Solihull
supported the development of two resource
centres for people with hearing and sight loss
at two libraries. Visitors to the centres can
obtain advice and information about a range
of services and try out equipment to help
them in their daily lives. (source
Independence Matters p30).
Salford
Salford has a successful bid to develop a joint
hearing service with Audiology. A joint post is to
be established with the PCT to develop pathways
and competencies for unqualified staff with the
aim that both children and adults will have a
seamless service from the two organisations.
Integrated equipment service.
Salford has established a deaf gathering as a
social event at present but it is hoped that this will
enable the deaf community to be able to have a
greater input into the development of services.
I am going to meet some of these on 4th
November so will see how much they appreciate
being consulted.
Tameside – developed number of services to
support deaf people in active citizenship:
- A mail reading service for BSL users
who have difficulty in accessing
written English
- 3 yr community development worker
project to improve community
participation by deaf and hard of
hearing people
- A deaf club for older people who use
BSL
Is there an ‘active citizenship’ programme?
Gateshead – has sponsored DeafPLUS
north to bring its national training programme
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Action
“Titled” to the North East. This scheme offers
a range of courses in basic skills, numeracy
and IT to encourage Deaf people back to
work. Staff assist people whose first
language is BSL with reading job
advertisements and completing job
applications.
Planned: Poole – Independent Living Officer
Person centred choice
o Quicker assess to Housing Adaptations
Best practice examples:
Poole – Has introduced a streamlined
approach to housing adaptations. Service
users had to relate only to the OT involved,
who acted as the co-ordinator for the
process with the service units and external
contractors. Written information for the users
explained the procedures for adaptations
and the time-scales involved. A quality
assurance questionnaire was given to users
when the work has been completed.
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Salford
Salford has a specialist housing team based
within the integrated combined equipment service
to ensure that disabled people’s housing needs
are addressed appropriately.
Users are very critical of this service. They
consider the council is being duped by the
contractors, and that the people assessing are
not listening to their needs.
Action
Review funding and
administration of
housing adaptations –
improvement plan item.
Person centred choice
o Involvement in service monitoring
Best practice examples:
(none identified from the documents gathered
unless covered in other sections).
Salford
Action
Annual review of care plan.
Improvement plan item –
Involves monitoring of services provided would like to involve users
fed into central performance monitoring more.
programme.
Regular service reviews with contracts
department.
_______________________________________________________
Sources:
1.
Independence Matters – An overview of the performance of social care services for physically and sensory disabled
people; Dept of Health and SSI
2.
Best Value Review of Physical Disabilities, Sensory Needs and Occupational Therapy – report of Bradford City
Council.
3.
Joint review reports
4.
Access to Services – Disability Equality in Local Government: Local Government Association Disability Rights
Commission
5.
Improving Transport for Social Services users – Audit Commission
6.
New Directions for Independent Living – Inspection of independent living arrangements for younger disabled people
(Social Services Inspectorate, October 2000)
7.
Draft Disability Action Plans from Directorates at Salford City Council
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Appendix 11
1.
PROGRESS ON ISSUES RAISED IN INSPECTIONS
(Joint Review June 03)
(1)
Principal Officer was appointed in September 2003
(SSI Annual Review 02-03)
(2) Need to include users and carers in all service areas
this has been assisted through the appointment of a user development
worker
throughout 2004 a service of user consultation sessions have been in place
User reps are part of the Best Value Review
A new Disability Partnership Board has been set up with user representation.
(3)
There is a need to promote independence
we have developed 9 supported bungalows
a new service is to be developed with 2 enablement officers to work with
users to look into employment, education and community activities.
(4)
There is a need to modernise services
the Best Value review has helped focus on this.
(8)
Services for people with physical disability and sensory impairment need an
injection of energy and strategic thinking
Dedicated Principal Manager – working closely with NHS
Service User Development Worker
Best Value Review
Disability Partnership Board – Director of CSSD in attendance
Joint discussions with PCT.
(9)
Scope for Strengthening Direct Payments
bid for additional DoH money for development of scheme successful
team expanded to 3 workers – based at CVS
User lead group SUGGEST directing this work
CSSD policies on Direct Payments under review to ensure ease of access to
scheme and fair payments for services
Link to Children’s Direct Payment Scheme
Directorate Oversee Strategic Review of Developments.
(10) Equipment and Adaptations can be delayed for up to 3/6 months following referral
for equipment and minor adaptations the assessment time has been reduced
to 8 weeks maximum for OT and 2 weeks maximum for a CAO. We continue
to seek to reduce this
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-
-
other clinical staff have been trained to assess for equipment. A bid has been
put to the PCT for a member of staff to be responsible for ongoing training of
clinical staff
equipment can be ordered directly from the Users home following
assessment
deliveries are now 6 days a week
New Prospects Housing have allocated greater resources in 04/05 to reduce
the Housing Adaptations wait
Discussions are taking place with Housing Strategy to identify money to
reduce the wait for adaptation in the Private Sector.
(11) The number of people who are helped to live at home with services is low in
comparison with similar authorities
this remains an area that needs greater attention to see if we are accurately
recording everyone receiving support.
(12) Respite Care is poorly developed
discussions are taking place with PCT regarding the use of the Maples
Nursing Home for respite care
further work is needed with service users and their carers to identify the type
of respite care required.
(13) There is work needed to identify how services will look in the future
this is assisted by the Best Value review and consultation with service users
the focus in on developing services close to home.
(14) Strategic Commissioning is hampered by lack of knowledge about the needs of the
population
the user consultation exercise has assisted this
a detailed analysis has taken place regarding the use of social care services
which identified
a large use of community support without clear outcomes
a number of long stay out of area placements where work could be done to
repatriate people
the need for a service promoting independence
the need for targeted homecare provision
a review of care plans has shown some miscoding of service users and this is
now corrected
Services should respond to users needs to give a raise of choices as appropriate
this is being developed through the development of new services
discussions with Learning Difficulties Service and Mental Health are
underway to ensure the right service is assessed, where necessary involving
joint assessments
further work is needed with Substance Misuse Service to ensure access to
this service is appropriate
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Appendix 12
Options Appraisal
Tweaking
Internal / External
drivers

Legislation:
NHS Comm. Care
Act,
Best practice
‘Independence
Matters’,
NICE guidelines
Single Assessment
Process
New Vision for Adult
Social Care
Single Assessment
Process
Physical Disability Team:
Care Assessment, care planning and
review

Delivery of
Home/
Domiciliary
support
services
Intermediate
Home Care
Service
Geographical
commissionin
g of home
care
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






Legislation:
NHS Comm. Care
Act;
Best Practice –
‘Independence
Matters’
New Vision for Adult
Social Care




Partnership
Continuing
Other LA or
Health
Ceasing
Development
of service or
strategy or
New service
Private
sector
Voluntary
sector
Service
Major
Redesign
In-house
Forms of delivery
Health
With
Healt
h
Forms of delivery
Supported
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Partnership


Accessing
mainstream
services (day
activities)
[work with
Leisure,
Education and
Employment]
(Enablement
service)
Properties
Tweaking
Other LA or
Health
Day Care (non
–respite)
Respite care
for carers
Continuing
Private
sector
Voluntary
sector
Day Services
Ceasing
Development
of service or
strategy or
New service

 






Legislation:
NHS Comm. Care
Act;
Nat’l Asst Act;
Best Practice –
‘Independence
Matters’
New Vision for Adult
Social Care




Legislation:







Internal / External
drivers
Legislation:
NHS Comm. Care
Act;
Nat’l Asst Act;
Best Practice –
‘Independence
Matters’
New Vision for Adult
Social Care
Carers Act and
Carers Support
In-house
Service
Major
Redesign



tenancies
Tweaking
Internal / External
drivers

NHS Comm. Care
Act;
Nat’l Asst Act;
Best Practice –
‘Independence
Matters’
New Vision for Adult
Social Care
Linked Care
support
(Similar to
Pendleway)


Partnership
Continuing
Other LA or
Health
Ceasing
Development
of service or
strategy or
New service
Private
sector
Voluntary
sector
Service
Major
Redesign
In-house
Forms of delivery

Residential
care
Existing
Repatriation of
long-stay
residents
Community Occupational
Therapy





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Legislation:
NHS Comm. Care
Act;
Repatriation of longstay residents

Single Assessment
Process

Audit Commission
Report ‘Fully
Equipped’
Section 31
agreement
Community Equipment Service

Internal / External
drivers

Partnership
Tweaking
Other LA or
Health
Continuing
Voluntary
sector
Ceasing
Development
of service or
strategy or
New service
Private
sector
Service
Major
Redesign
In-house
Forms of delivery







With
Healt
h

With
Healt
h


Wheelchair service
Housing Adaptations – DFG
private
Housing Adaptations, public
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


Internal / External
drivers
Consultation
With
Healt
h





Partnership
Tweaking
Other LA or
Health
Continuing
Voluntary
sector
Ceasing
Development
of service or
strategy or
New service
Private
sector
Service
Major
Redesign
In-house
Forms of delivery



Internal / External
drivers

Legislation:
NHS Comm. Care
Act,
Best practice
‘Independence
Matters’,
NICE guidelines
Single Assessment
Process
New Vision for Adult
Social Car
Single Assessment
Process
Partnership
Tweaking
Other LA or
Health
Continuing
Voluntary
sector
Ceasing
Development
of service or
strategy or
New service
Private
sector
Service
Major
Redesign
In-house
Forms of delivery
Sensory Services
Care Assessment, care planning
and review

Delivery of
Home/
Domiciliary
support
services
Intermediate
Home Care
Service
Geographical
commissionin
g of home
care
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






Legislation:
NHS Comm. Care
Act;
Best Practice –
‘Independence
Matters’
New Vision for Adult
Social Care

Health



With
Healt
h
Properties
Linked Care
support to
buildings
Community
Support
Deaf blind
(Guide Help
Scheme)




Residential care

Low vision aids

Rehabilitation services for Deaf
people
Rehabilitation services for Blind
people

Befriending /Outreach service for
Blind People (Grant funded
through Henshaws society)
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






Internal / External
drivers
Legislation:
NHS Comm. Care
Act;
Nat’l Asst Act;
Best Practice –
‘Independence
Matters’
New Vision for Adult
Social Care
Section 7 of LA Act
– instruction to
provide guide help
Legislation:
LA Act 1970;
NHS Comm. Care
Act;
Repatriation of longstay residents

Consultation

Legislation:
NHS Comm. Care
Act;
Nat’l Asst Act;
Best Practice –
‘Independence
Matters’
New Vision for Adult
Social Care




  











Health

 
Partnership
Tweaking
Other LA or
Health
Continuing
Voluntary
sector
Supported
tenancies
Ceasing
Development
of service or
strategy or
New service
Private
sector
Service
Major
Redesign
In-house
Forms of delivery


Healt
h
Rehabilitation services for
Deafblind people (Guide Help
Scheme)
Rehabilitation services for Older
People with Maculopathy
(Rolling contract, 4 days per
week)
Rehabilitation services for Blind
Children
Sensory Service equipment to
the Community Equipment Store
Talking news
Talking books (RNIB)
(Rolling programme rather than
a contract)
Deafness Support Network Interpreter contract
(Cheshire Deaf Society)








Chronically Sick and
Disabled Act
Legislation:
NHS Comm. Care
Act;
Nat’l Asst Act;
Best Practice –
‘Independence
Matters’
New Vision for Adult
Social Care
Chronically Sick and
Disabled Act
(Consultation of
service users)





Educ

With
Healt
h




Partnership
Internal / External
drivers


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Tweaking
Other LA or
Health
Continuing
Voluntary
sector
Ceasing
Development
of service or
strategy or
New service
Private
sector
Service
Major
Redesign
In-house
Forms of delivery


Other
LA or
group
of LAs
or
Health
Other
LA or
group
of
LAs
or
Healt
h
Audiology Service
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
Internal / External
drivers
With
Health
Partnership
Tweaking
Other LA or
Health
Continuing
Voluntary
sector
Ceasing
Development
of service or
strategy or
New service
Private
sector
Service
Major
Redesign
In-house
Forms of delivery
With
Healt
h









Physical Disability and Sensory Services – Generic
Multi-disciplinary community
neuro-rehabilitation team

Operation of joint care packages
Direct Payments


Employment
services
Extend to
include those
with physical/
sensory
impairments
Physical access to buildings
Dropped kerbs
In-house development of
Interpreter Training
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






Internal / External
drivers

SAP – Older People’s
NSF long term
conditions
Direct Payments
legislation
User consultation –
promotion and
support


With
Health


Health


New Vision for Adult
Social Care,
Social Inclusion




Legislation:
DD Act


 
With
Healt
h


Legislation:
DD Act
Partnership

Continuing
Other LA or
Health

Ceasing
Private
sector
Tweaking
Development
of service or
strategy or
New service
In-house
Service
Major
Redesign
Voluntary
sector
Forms of delivery
Other
LA
Other
 LA or
Health

RNID
Acces
s to
Work


Advocacy

Best practice/
Consultation
User Involvement
Service monitoring
(with user involvement)
Transport
(strategy)
Internal / External
drivers
Partnership
Tweaking
Other LA or
Health
Continuing
Voluntary
sector
Advocacy
services for
disabled
people
Ceasing
Development
of service or
strategy or
New service
Private
sector
Service
Major
Redesign
In-house
Forms of delivery
LA / CHSC
Ring and Ride
Access to financial advice
(Citizens’ Advice Bureau)



Best practice/
Consultation




Best practice/
Consultation





Chronically Sick and
Disabled Persons
Act




Consultation


Best practice/
Consultation

Information on joint
commissioning
NHS and
Community Care,
Data Protection, FOI
Chronically Sick and
Disabled Act


Management information

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
 

Health
Users
and
Vol

  
 
 



GMPTE


  


Communication, including:
development of the Web, and
meeting specific needs of
people with sensory impairment
HIV
User Advisory Forums
Prevention services
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


Internal / External
drivers
Best practice/
Consultation
  
Partnership
Tweaking
Other LA or
Health
Continuing
Voluntary
sector
Ceasing
Development
of service or
strategy or
New service
Private
sector
Service
Major
Redesign
In-house
Forms of delivery

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