REPORT TITLE: “INDEPENDENCE CHOICE AND WELLBEING”
RESPONSE TO THE CONSULTATION ON THE VISION FOR
THE FUTURE OF SOCIAL CARE FOR ADULTS IN ENGLAND
BRENDA THOMPSON EXECUTIVE MEMBER FOR SOCIAL
CARE AND HEALTH
JAN DOUGLAS EXECUTIVE DIRECTOR
Date 5 JULY 2005
PURPOSE OF THE REPORT
1.
The purpose of this report is to advise the Executive of summarised
responses to the consultation on the Green Paper “Independence
Wellbeing and Choice” and to seek approval for the submission of this
response to the Department of Health.
BACKGROUND AND EXTERNAL CONSULTATION
2.
“Independence Wellbeing and Choice” was issued for consultation in
late March 2005. A copy of the Executive Summary of this Green
Paper is attached at Appendix 1 and a copy of the consultation
questions at Appendix 2. The deadline for submission of responses
is 28 July 2005.
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3.
Throughout April, May and June 2005 the Senior Management Team
within the Department of Social Care have hosted a series of
consultation events at which presentations have been made on the
key messages contained in the Green Paper. Participants at those
events have been invited to respond to the consultation questions.
4.
Thirteen separate events have been held attended by approximately
530 people representing users, carers, colleagues from the NHS, VCS
and wider community.
Summary of Consultation Responses
5.
Overall there has been widespread support for the Vision of Adults
Social Care as described in the Green Paper and agreement that the 7
outcomes for Social Care accurately reflect what people want and
expect (Question 1 and 2).
6.
The issue raised in the Green Paper of achieving a balance between
personal choice and control with managing risk (Question 3) generated
considerable debate. The conclusion was that any shift in the current
balance will be dependent upon corresponding shift in public attitudes
towards risk, protection and care. At the moment risk aversion seems
firmly embedded in the wider values of society and strong doubts were
expressed about society’s readiness to move away from this stance.
7.
A greater emphasis on provision of preventative services (Question
17) is welcomed. The point was very strongly made however that the
provision of low level services may defer but will not necessarily
prevent the need for more intensive services particularly given our
ageing population. It will also be essential to adequately resource
preventative services. Successful implementation of the aspirations
set out in the Green Paper cannot be achieved without additional
investment (Question 12).
8.
Whilst it was recognised that enhanced access to universal services is
in itself less stigmatising and more consistent with the objectives of
social inclusion, universal services will need more funding to meet the
additional demands from people using Adult Social Care Services. It
was also emphasised that an evidence base will need to be
established for low level interventions and evidence of their cost
effectiveness over time.
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9.
There was widespread support for change in the name of Direct
Payments as soon as possible, for reviewing the current exclusions
and extending Direct Payments to groups currently excluded
(Questions 8 and 9). The concept of individual budgets (Question 10)
generated a great deal of interest. Most respondents felt that an
individual budget would be a good way to ensure choice and control
and could also serve to drive up the quality of service provision. Pilot
schemes on individual budgets will be welcomed. Respondents
considered that many recipients of individual budgets would need
support in identifying and accessing services to meet their particular
needs. The care navigator or care broker role therefore would be
essential. Introducing this role would free up social worker expertise to
deal with the most vulnerable (Question 11). The development of
client self-assessment (Question 5) and sharing information across
agencies such as the Local Authority and Department of Works and
Pensions (Questions 4 and 6) was very much supported but the
resource implications of this cannot be under-estimated.
10.
There was almost total agreement that Adults Social Care cannot
deliver this new vision alone or independently with the resources that
exist in local communities. It will require skills and capacity beyond
those traditionally exercised in the Social Services Departments and
similar considerations will need to be applied to those responsibilities
relating to community capacity building. Much of this work is part of
the wider community leadership role of local government (Question
15).
11.
Partnerships with the NHS are important especially in delivering
seamless support but they form a relatively small part of the interface
between Adults Social Care and other agencies and sectors that need
to be engaged in delivering this vision for adults social care. The
proposal to develop a strategic commissioning framework was
therefore seen as essential (Questions 14, 15 and 16). The low
priority given to Supporting Social Care Agencies to develop strategic
commissioning expertised compared with that available to the NHS
was highlighted (Question 19). Several respondents felt a similar level
of investment in learning, leadership, capability and capacity given to
the NHS is also needed for Social Care.
12.
The requirement to have a statutory post of Director of Adults Social
Services and an Executive Member whose portfolio mirrors that of the
Director was considered to be the best approach to ensuring
leadership at Council Member level (Question 13).
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13.
Targets and performance indicators (Question 21) are reluctantly
accepted as a feature of public service which is unlikely to change.
However, the overwhelming view expressed by consultees was that
greater value and weight must be given to the users experience.
Development of performance measures therefore must have this at its
core.
FINANCIAL, LEGAL AND WARD IMPLICATIONS
14.
There are no specific finance, legal or Ward implications arising from
this report.
SCRUTINY CONSULTATION –
15.
A presentation on the Green Paper was given to the Social Care and
Adult Services Scrutiny Panel on 16.5.05. All Members of the Council
were invited to attend responses to the consultation questions have
been incorporated in this overall summary.
RECOMMENDATIONS
16.
The Executive is recommended to approve the submission of the
responses to the consultation on the Adults Green Paper as set out in
this report to the Department of Health.
REASONS
17.
The Department of Health has encouraged widespread consultation
and comment on the Green Paper “Independence Wellbeing and
Choice”. The closing date for responses is 28.7.05.
BACKGROUND PAPERS
The following background papers were used in the preparation of this report:
“Independence Wellbeing and Choice” Our Vision for the Future of Social Care for Adults
in England – Department of Health March 2005.
AUTHOR: Jan Douglas
TEL NO:
01642 729500
______________________________________________________
Address:
Website: http://www.middlesbrough.gov.uk
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APPENDIX 1
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APPENDIX 2
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