Caroline Norrie, Research Fellow at the Social Care Workforce Research Unit in the Policy Institute at King’s, was at the Social Services Research Group Annual Workshop this week. (801 words)
This year’s Social Services Research Group (SSRG) Annual Workshop, held at the London School of Economics (LSE) on 15 April was a particularly thought-provoking event. Entitled ‘Evidencing Service Improvement for Vulnerable Children and Adults’, the workshop featured an expertly chosen group of speakers whose presentations stimulated animated discussion from the floor. With the Care Act coming on stream and the increased drive for integration, participants, who were predominantly social care managers with responsibilities for data and organisational performance, enjoyed a great opportunity to discuss service re-figuration and its measurement.
Chairing the event, Martin Stevens, from the Social Care Workforce Research Unit, opened the workshop by introducing Karen Newbigging from the University of Birmingham who described the development of new Standards for Commissioners (#commisioning4outcomes). Karen discussed sector moves to professionalise commissioners and the possible introduction of new training opportunities or frameworks for people in this role. One conference participant raised an interesting point about poor understanding of the term ‘commissioning’ by the public and staff. This led to discussion about how ‘commissioning’ has tended to be associated with procurement and transactional work; although it also encompasses co-production and service planning and, since the Care Act, focuses on ‘market-shaping’ or ‘place-shaping’. The thorny question of how to evidence the effectiveness of the service planning element of this work within a changing policy context was raised.
Next, concurrent sessions addressed Integration in health and social care and in children’s services. I attended a presentation by Jennifer McGovern and Keith Darragh from Salford Council about the restructuring of services in Manchester in general and specifically the integration of Salford CCG, the City Council, and acute and mental health hospitals for people aged 65 years and over. Salford has initiated a three-pronged approach to dealing with rising demand: prevention through use of community assets; creation of a central health and social care hub; and, multi-disciplinary teams targeting the top 2% of those at risk in this population. The speakers outlined the planning, implementation and outcome measurement stages of this five-year integration project. During questions the presenters mentioned social care staff’s fears of being swallowed by the more short term delivery culture of health, and losing the social care approach of assessment and forward planning. However, they stressed that keeping the patient—interesting choice of terms of course—(nicknamed Mrs Hall) at the centre would ensure that staff had a shared purpose. It will be interesting to see if this transpires.
Next were presentations about Collaboration for Leadership in Applied Health Research and Care (CLAHRC) in Doncaster; and social care data collection in Derbyshire County Council. I attended the second of these entitled, ‘SALT: Warning – may cause high blood pressure!’ The intricacies of the Short and Long Term (SALT) return which is submitted by councils to the Health and Social Care Information Centre (HSCIC) was the subject of this presentation. We listened attentively to accounts illustrating the complexity of collating and meaningfully analysing the data.
This theme was continued by Department of Health Statistician, Rosemary Main, who facilitated a lively discussion about social care data collection. Points were made about new duties on local authorities imposed by the Care Act and implications for data collection, for example, gaps in knowledge about self-funders and problems of robust measurement of integration and prevention. In addition, questions were asked about including proxies in surveys (for example, family or friends of people with severe dementia) and how data on inequalities in service provision are collated.
The final presentation from Colin Slasberg and Karen Sugars from the London Borough of Tower Hamlets interestingly explored how they were taking advantage of the Care Act to create a person-centred and practice led framework in the borough. This local council remains the only one in England not to charge for non-residential social care. The speakers also stressed that the National Access to Care Eligibility Criteria will not remove the ‘post code lottery’, because of the approach taken to assessment. Their other key innovation was to change the order in which resources are allocated. Instead of using a predetermined Resource Allocation System, which generates an indicative personal budget on the basis of a broad brush assessment, in Tower Hamlets, resources are only allocated after detailed assessment and support planning. They argued that in many circumstances, it is only when the detailed needs have been identified (and accepted as ‘eligible’) that real budgets can be identified. This approach is in sharp contrast to the accepted ‘self-directed care’ route. It will be very interesting to hear results.
Overall, the event proved an excellent forum for conversations about changes currently taking place in local councils. It was disappointing that attendance was not higher, particularly by local authority staff—a reflection of the current financial situation—though, on the plus side, this allowed for more informal and highly fruitful discussions.