Agenda item

To follow

RESOLVED:

·         that this report be noted acknowledging the positive outcomes it had showcased for the community.

Tom Brown (Executive Director for Community Services) introduced the report. The following key points were noted:

5.1. In its initial 2 years, the Empowering Lewisham programme had delivered over £4.2million in savings, surpassing the original forecast of £3.5million.

5.2. In 2023, the programme had been nominated for 2 awards- at the Local Government Chronicle and MJ awards, with judges highly commending its entry into the Workforce Optimisation category at the MJ Awards.

5.3. Due to the programme’s implementation, the workforce was now operating in a fundamentally different manner, incorporating new work methodologies and leveraging data more effectively. Notably, a significant shift had occurred in the utilisation of live data, which greatly enhanced management decision-making both at a case-by-case level and also in macro commissioning of services.

5.4. When the first diagnostic exercise was undertaken- 58% of the people being supported by the Council weren’t achieving the best outcome for them; over 1,600 people in formal care did not receive an annual review in 2020; and just 9% of practitioner time was being spent with residents, with the majority of time being spent on completing paperwork.

5.5. Based on the diagnostic exercise, this transformation programme had the following areas of focus- better decision making, examining the existing services (particularly enablement service); empowering staff by changing the culture to be much more focused on outcomes for people; multi-disciplinary working to better manage risk, and making better use of digital technology and tools such as the Power BI dashboards.

5.6. When the diagnostic exercise was re-run in September 2023, a significant shift was observed- the percentage of individuals supported by the Council who did not achieve the optimal outcome decreased from 58% to 36%.

5.7. Lewisham demonstrated exceptional performance in a key statutory metric- supporting individuals to remain at home 91-days post hospital discharge. The Council also ranked among the top performers, landing in the top decile for facilitating transitions from hospitals to the enablement service.

5.8. Despite facing challenges in recruiting skilled personnel for the adults with learning disabilities progression and next steps team, significant progress had been made. 45 adults with learning disabilities transitioned to more independent living arrangements and 68 individuals experienced reductions in their care packages.

5.9. The 2023 health check of the programme confirmed the sustainability of changes initiated in 2022.

5.10. Further enhancements were made in the hospital discharge pathway, and the programme’s impact on individuals under 65 with physical disabilities showcased its role as a catalyst for wider improvements. Around one million pounds in savings were realised during this financial year by supporting under 65s to achieve greater independence after discharge.

5.11. The programme had consistently exceeded savings targets outlined during the diagnostic stage and in the updated cash profile. Notably, substantial savings were attributed to the Enablement team’s efforts in promoting independence. Moreover, surpassing targets in the progression of individuals with learning disabilities resulted in significant financial gains, particularly due to the transitions toward independence for individuals with high-cost placements.

The Committee members were invited to ask questions. The following key points were noted:

5.12. The Committee was pleased with the sustained positive impact achieved by the programme. This programme was a strong example of a local authority undertaking transformative and creative initiatives. It served as a compelling case study for other local authorities seeking to learn innovative approaches and incorporate managed risks. It was important to acknowledge the programme’s positive impact not only on individuals who gained more independence through it but also on their friends and family.

5.13. The importance of regular quality checks was underscored to ensure data gathering and sampling yielded valid results. Data used by adult social care teams originated from Liquidlogic (case management system) and ContrOCC (a tool for managing social care finance contracts, payments, assessments, and billing). It relied on workers ensuring that records were updated, and that care package information was entered correctly. The system was set-up as such that invoices wouldn’t be paid if the care package information didn’t align with the budgetary commitment that it was being invoiced against. Various checks and case audits were in place to uphold quality standards.

5.14. A Committee member enquired about the extent to which cultural changes, such as increased proactive data usage, were embedded within the Council as an institution, recognising that officers eventually move on, necessitating institutional embedding. It was discussed that these best practices were being disseminated among colleagues across the Council including teams such as Children Social Care and Housing.

5.15. A Committee member praised the commissioning of learning disability services in Lewisham.

5.16. Long-term care for adults with disabilities was discussed with an emphasis on the importance of quality housing. It was noted that there was a lack of suitable properties in the private rented sector for individuals with disabilities. However, proactive data utilisation had led to a better understanding of housing needs, enabling services to become proactive rather than reactive. Collaborative efforts with the Council’s regeneration team were focused on acquiring suitable housing for adults with disabilities. The housing scheme in Mayow Road last year was successful and officers were hopeful about more funding from NHS England for similar projects.

5.17. It was noted that feedback from the Adult Social Care (ASC) Survey highlighted that 84% of individuals using ASC services were satisfied with the care and support they received.

RESOLVED:

·         that this report be noted acknowledging the positive outcomes it had showcased for the community.