Agenda item

This report sets out the ASC Transformation Business Case for Cabinet’s consideration and recommendation to Council.  It includes plans to establish the Fulfilled Lives Programme comprising four priority projects, with a proposed investment of £2.9m which will lead to improved outcomes for adults who draw on support within the BCP Council area.

The Corporate Director for Wellbeing introduced the item and the Director for Adult Social Care and the Director for Commissioning presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'A' to these Minutes in the Minute Book.

Adult Social Care (ASC) services locally and nationally had faced significant challenges in recent years, with an ageing population, increased demand for support and more complex needs. As a result, the Council was holding significant risk in relation to its ability to deliver statutory responsibilities within the available budget, to adults and their families who require support.  The nature of these challenges means that long term, sustainable change was needed to ensure that BCP Council’s ASC services were modern, preventative, fit for the future and affordable.

The report set out the ASC Transformation Business Case for Cabinet’s consideration and recommendation to Council. It included plans to establish the Fulfilled Lives Programme comprising four priority projects, with a proposed investment of £2.9m which would lead to improved outcomes for adults who draw on support within the BCP Council area. It was anticipated that the one-off investment would lead to recurring savings of approximately £3.5m.

The Committee discussed the report, including:

·       In response to a concern that the objective was to reduce the amount of residential and sheltered accommodation on offer, the Committee was advised that the purpose of the transformation was to ensure the right level of care model was used to ensure the response was appropriate to the need presented.

·       In response to a request for clarity, the Committee was advised of the different elements reablement had to offer and how it could improve the lives of those in need.  It was also highlighted that a recovery model was needed and that no long-term support should be decided until they were out of a hospital environment.

·       In response to a query regarding the funding of reablement, the Committee was advised that it formed part of the Better Care Fund received from NHS England.

·       In response to a query the Committee was advised that even though the business case did include financial drivers for change, it was also about the need to modernise the service, focusing on prevention and empowerment and ensuring the fulfilled lives aspects of the transformation were met.

·       In response to a query regarding carers and whether the transformation business case was going to improve the allowance and working conditions for them, the Committee was advised of the revised Carers Strategy which was approved in 2022 and what that put in place to support carers across BCP.

·       In response to a concern regarding the reliance on third party providers, the Committee was advised that it was hoped that the council owned company, Tricuro would increase its influence on the local market, however it was acknowledged that this would require investment.  It was also highlighted that the case focused on prevention and reablement to enable transformation by building on what was already available with Tricuro.

·       In response to queries regarding the low levels of care being provided sitting at 41% with the Local Government Association (LGA) recommending this should be closer to 15%, the Committee was advised what could be done to reduce this figure, including the increased use of technology where appropriate and reaching out to the voluntary and community sectors to see what support they could offer as opposed to the regulated homecare services the Council provided.

·       The Healthwatch Manager advised that people often struggled to know what help was available and how to access it, so how would awareness be raised and in response the Committee was advised of the difficulties in this area and the work that was ongoing to improve access to services by refreshing all webpages and carers information online which was a process being undertaken with carers.

·       In response to a query regarding how transformation progress would be measured by the outcomes for users, the Committee was advised of the work regarding the three conversations and the feedback that was collected from users through that process had been positive during the pilots.  The Committee was also given information regarding the coproduction being utilised.

·       In response to a query regarding the savings and efficiencies, the Committee was advised that these would come through the changes in the fulfilled lives programme and that a combination of all the elements of the transformation programme would ensure cumulative savings were apparent.

·       In response to a query regarding the Mosaic software, the Committee was advised that whilst Tricuro did not currently feed in or have access to the system, it was planned that they and other providers would be able to in the future.

·       In response to a query about the identification and management of any risks, the Committee was advised that the possible risks would be monitored and there would be a break in the programme every six months to reflect, test and challenge.  The importance of the Committee’s scrutiny role during the programme was highlighted.

Cllr Brown joined the meeting at 18:50pm.

The Committee discussed the recommendations, and a member suggested the following additions be included in the identified programme risks:

• The current lack of feed from Tricuro and other providers into Mosaic or Dorset Intelligence and Insight Service (DiiS)
• An explicit target for the percentage of commissioning that was given to Tricuro with the idea that it increased annually.

In response to the second recommendation, the Committee was advised that this would form part of a strategic commissioning framework about how to BCP intended to work with Tricuro and other market providers and was not appropriate to be included in the programme at this time.

The Committee discussed the first addition around data feeds, and it was highlighted that the Mosaic provider portal programme was included within the transformation and that it could be recommended that Cabinet consider the risk when recommending to Council.

A Committee Member requested Officers highlighted key risks and Key Performance Indicators be included in future reports to enable the Committee to effectively monitor and scrutinise progress.  ACTION.

The Chair concluded by advising he would work on a form of words with the Director for Wellbeing to take to Cabinet around the data.

Health and Adult Social Care Overview and Scrutiny Committee RECOMMENDED that Cabinet recommends that Council:

a) Approves the business case for a new adult social care transformation delivery model to improve outcomes for residents and to achieve financial efficiencies and savings enabled by investment.

b) Agrees to the establishment of a formal transformation programme; ‘Fulfilled Lives’.

c)  Agrees to the proposed investment of £2.9M, with Corporate Management Board being provided 6-monthly stage reviews on the progress of the transformation programme.

d) Invites the Health and Adult Social Care Overview and Scrutiny Committee to provide regular scrutiny of progress towards benefits and sustainable change.

Post meeting note – in consultation with the Director of Wellbeing, the Chair on behalf of the Committee amended the recommendation d) to Cabinet as follows:

d) Invites the Health and Adult Social Care Overview and Scrutiny Committee to provide regular scrutiny of progress towards benefits and sustainable change.  In particular, the Committee be invited to review the progress against the four priority areas of the Fulfilled Lives programme and the risks and opportunities of data with ASC transformation.