Monday, 17 October 2011

Improving Satisfaction in Social Work Assessment and Care Management

How satisfied are the public with the social work service they are getting when they are ask for support or want to change something? In our experience, the wait for an assessment is most frustrating for families, particularly when the service users’ circumstances are changing and new care packages are required.

There are the changed appointments and rescheduling of visits, particularly if a multidisciplinary team is involved. There is IT systems used for scheduling the care package and billing against personal budgets – but what about the productivity of the assessment and care management teams? How much time is wasted through unproductive visits and rescheduling arrangements?

Probably a call centre already signposts service users but does it use a system based on volume, complexity and risk combined with dynamic scheduling and PDAs/iphones to improve customer service?

Where dynamic scheduling is being used in Councils, user satisfaction increases to over 95%. It improves productivity by speeding up scheduling, taking account of cancellations to reschedule or substitute alternative assessment arrangements and enables communication. Needless to say, it integrates into your core case management systems. In time, this will mean that there will be more effective assessments and undertaken more quickly leading to greater customer focus. It is all about getting it right first time with the most appropriate support to service users

In these straightened times, a short business case should be developed to establish the costs, savings and benefits. For a discussion, please contact janet.pearson@cpea.co.uk

Tuesday, 4 October 2011

Guest Blog from John Papworth: Adult residential homes - is a social enterprise the answer?

Guest Blog from John Papworth CPEA Senior Associate

Recently browsing the news headlines around adult social care, brought to light some depressing and yet all too familiar sound bites - “Council to shed 300 jobs in adult social care”; “Council to shut residential care homes”. All this is painted by the media as a consequence of the financial cutbacks. This ignores:

• The potentially runaway spending driven by the ageing population.
• Falling productivity of the public sector v independent sector, and accompanied by higher unit costs for services run by councils themselves.
• Increased demands for a better quality “product” from the public sector.
• Personalisation of budgets so older people determine their own care package, not the professionals or the provider organisation.
• The need for stronger preventative interventions to avoid crisis driven demand for acute services.
• Protection of vulnerable adults.
• Some independent care providers (eg Southern Cross) having unsustainable financial models that have underpinned their activities.

The fiscal crisis facing local councils and NHS community services is thus overshadowing all these other factors. So is there an alternative way of providing the service, at the same time as reducing costs, whilst increasing effectiveness and quality?

One answer may to be set up a social enterprise or mutual to take over the running of a council’s care homes. Social enterprises are businesses driven by a social purpose in which any profits are re-invested to meet that objective. The former Labour Government and the current Coalition Government was/is keen to see these develop as part of its agenda to encourage citizens take more control of their own lives, and as a way communities or neighbourhoods can help each other out.

Evidence to date in the ‘support at home’ market suggests that social enterprises or mutuals are highly effective in delivering these services (usually at a much lower cost compared with those run by councils - e.g. up to 50% per unit). They attract a committed and professional workforce with low turnover rates – something that is valued in home care. As a bonus the customers are happier too. Examples include CASA who now run adult home care services in Newcastle, North Tyneside, Calderdale, Manchester, Knowsley and more recently Leeds.

A council running its own residential care homes has to face the very same issues as home care, particularly getting its own unit costs down. This is likely to involve an element of reducing running and staff costs, and will not be popular and/or acceptable at the moment in the light of the Southern Cross affair and public sector cutbacks and redundancies. It will also have to maintain and improve the quality of its homes - which will involve refurbishment costs – and at moment the money simply is not there. So what could a council do?

A council could establish one of its care homes as a social enterprise or co-operative, support its early development, and once it is running and has been tested out as a way forward, then transfer its other homes to the new organisation. Or else it could transfer them all at once which might give the new enterprise some local market “clout” and share, and give some assets that could be deployed effectively to raise new money (e.g. a bank loan from the co-operative banks like Triodos or the Co-Op, or a joint venture with a registered social landlord that could provide sheltered residential dwellings on any surplus land). There are a number of issues that would need to be faced not the least of which is current council staff terms and conditions. And yet, as a new social enterprise, has lower overheads and is free from council staff terms and conditions, staff can be rewarded by other ways (e.g. a share of any surpluses, or else given free care when they need it when they have retired – the Joseph Rowntree Housing Trust have elements of such a financial model).

Is it worth a try? After all unless something new is done by councils, all that will happen is slow degradation of service, and ultimately many council care homes will have to be closed as the pressures they face are simply too great to ensure long term viability.

Sunday, 2 October 2011

Why not Yes, Minister?

NCERCC campaign progress report by Vic Citarella

The Institute for Social Care and Education (ICSE) was first set up about fifteen years ago, when it campaigned in Parliament for the registration of child care workers. Past government support for the successful National Centre for Excellence in Residential Child Care (NCERCC), the agreement to registration by the General Social Care Council (GSCC) and the creation of the Children’s Workforce Development Council (CWDC) – all now removed as supports to children’s homes – led to dormancy and possible complacency. After a quiescent period ICSE has now been revived to act as a professional association for people working with children and young people.

In addition to providing membership services through dual membership of the Social Care Association (SCA), ICSE is campaigning once again. Now we are seeking to position the professional residential child care worker centrally in sector-led improvement initiatives. This latter approach is the Government’s unfunded self-help approach to leadership. Our view is that NCERCC (abolished in 2009) was actually a sector-led improvement body that was well on the way towards becoming self-sustaining. We are fighting to get support for a much needed replacement body which we feel will be the most cost-effective way of drawing on the strengths of the sector for the benefit of all.

An ICSE delegation recently made the positive case for an NCERCC type body to children’s and families Minister Tim Loughton – a meeting kindly facilitated by supporter Norman Lamb MP. How was our case received?

Tim Loughton told us unequivocally that he fully supports the residential care sector. He was very clear that he does not see a hierarchy of services with residential care as the least favoured option, which is an important message. Children and young people living in homes and people working with them can be reassured that they are not locked into some sort of ‘last resort’ provision. Rather that residential care is the right positive option for some children. Every incentive there then for professional best practice and that is what ICSE promotes.

Secondly, Tim Loughton gave a (very welcome) shared commitment to the kind of representative and professional body that has been lacking, viz. one that:
• DfE’s Support & Improvement Programme can engage with in dialogue and which can be consulted on regarding issues of design, development, dissemination, implementation, and evaluation;
• forms a cost-effective option for supporting and improving residential homes using sector skills, experience and delivery mechanisms to deliver programmes;
• provides assistance in the identification of homes that require improvement;
• gives the professional residential workers input into improvements in commissioning practice;
• could be an ally of DfE in the event of scandal or crisis (abusive practice or failing business models) – identifying, anticipating and mitigating risks to the sector’s credibility and DfE’s role, for instance;
• supports Local Authorities and the Children’s Improvement Board in tackling significant under-performance of children’s homes in their areas (action to meet OFSTED requirements when owner’s efforts are not effective).

Finally, despite supporting the service and our intentions, the Minister was adamant that government had no intention of funding such a body and he went to some lengths to justify both the absolute curtailment of funds in 2010 and the deployment of his in-house team. What we did establish was that his team may consider innovative proposals that meet the work programme and/or support us in bidding to relevant sources of funding. He was open to ideas around models of social investment but was not persuaded that developing such ideas required his assistance in getting the sector organised to use its time and expertise to such ends.

If not encouraging on money, he was more forthcoming on message. The delegation saw benefit in the Minister being seen and heard to overtly support residential child care and to encourage investment from diverse sources. We intend to take up his offer of a conference address through an invitation to speak at the SCA annual seminar children’s services day on 13 March 2012. Whilst this will not re-establish NCERCC, it is step along the road for ICSE in gaining greater momentum and a vibrant membership.

It is our opinion that the establishment of a professional body for residential child care workers will do nothing but good. We can promote standards and best practice, we can provide support in times of trouble, we can avert the ‘knee-jerk’ responses to crisis but most important we can create value for children’s homes – by valuing the young people who live in them and the staff who have them as a place of work.

Therefore, through ICSE with employer body and sector support but without Government fiscal backing, but at least support as to principle, we must press ahead together as a sector to set up a replacement for NCERCC.

Our campaign looks like being a long and incremental one – we must be alert to steady improvement in residential child care over time and pick up early warning signs of any drop in standards if we are to build credibility. The Department is receptive to our ambitions, but we need to keep the pressure up and ensure that good intentions are realised.

If nothing else, what is already clear from this process and other attempts at grassroots driven reform is that organisations like ours need as much support from our peers to keep the campaign on track as we can get. To that end, we have launched an online campaign to urge the Coalition to address this issue as a priority.

So knowing how busy you all are, nonetheless, can we at the Institute of Childcare and Social Education ask that, if you haven’t done already, please sign the e-petition to re-establish the NCERCC, which can be found by searching on ‘NCERCC’ at epetitions.direct.gov.uk.

In short, as we said to the Minister, you have to have a sector to be sector-led. So if you do nothing else, join ICSE www.icse.org.uk.

Vic Citarella is Chair of the professional association the Institute of Childcare and Social Education (ICSE). (Published on Children Webmag: Saturday, October 1st, 2011.)