Adults Social Care Annual Report 2023

An account of North Lincolnshire’s adult social care services 2023

Contents

• Foreword from Councillor Hannigan
• Message from Karen Pavey (Director of Adults and Health)
• Introduction
• Who we support
• Experts Together
• Safe and well
• Independent
• Resilient and flourishing communities and workforce
• Value for money
• Help us improve

Foreword from Councillor Richard Hannigan

Welcome to the Adults Annual Report. This report is an account of what Adult Social Care has done in the last year, setting out key achievements and challenges and the focus for the year ahead.

We continued to work hard to keep people safe and well through the latter impacts of the Covid-19 pandemic, and we would like to say thank you again to the whole adult social care workforce, partners and voluntary and community organisations, across North Lincolnshire who have continued to rise to the challenge of keeping people safe and well over the last year. It is through working together and co-producing solutions to care and support that will enable people to have the best health and care outcomes and develop resilient and flourishing communities. We have continued to work with people to inform and influence the services we provide and have strengthened our commitment to co-production of services through signing the Experts Together Pledge, co-produced by citizen groups. The Pledge asks the council and our partners to Ask and Listen to the voice of people and Act to design services that improve outcomes for vulnerable people in North Lincolnshire.

We will continue to work with partners to ensure equity of access all aspects of health and wellbeing to enable people to live their best lives, in a place the call home, having choice and control over their lives.

Message from Karen Pavey, Director Adults and Health

I too would like to thank our partners and workforce for their dedication and commitment who ensure the support we provide enables vulnerable adults to have choice and control.

The Covid 19 pandemic has changed many lives and has placed increased demand on our services and with less resources we have a challenge to meet these needs in the way we would like to. The changes in hospitals means our hospital work has increased by 48 percent and we continue to see increased numbers of people asking for help from the community. To meet these challenges we are looking at how we can work differently with our communities and have developed our new strategy ‘Keeping people in their own homes, families, jobs and communities’.

Over the coming year we will continue to develop models of working and solutions that ensure people and carers are at the centre of what we do. We will work with people with lived experience to ensure that people are able to access information, advice and support early and meet need at the lowest level, enabling people to remain independent for as long as possible. This report has been coproduced with our Experts Partnership and highlights our achievements over the past year and summarises our performance, we are proud of all that we have achieved in supporting people to live independent and fulfilled lives.

Through the delivery of our strategy we will continue to strive for improvement and to do things better for our residents ensuring we ‘ask’, ‘listen’ and ‘act’.

Who do we support?

We work with partners, voluntary and community services and the wider social care workforce to support to all vulnerable adults in North Lincolnshire. We work together to prevent or reduce the need for longer term care and support, developing services that will enable people to live as independently as possible in a place they call home.

We provide information and advice as well as care and support services to people who are over 18 who have care and support needs and for those who are transitioning to adulthood. This includes:

• People who are vulnerable and at risk of harm and people experiencing domestic abuse
• Young people, who had previously been supported by Children’s Social Services, to transition to adulthood
• People with a learning disability
• People with autism or people with neurodiversities who have care and support needs
• People with physical or sensory needs
• People experiencing mental ill health
• Older adults with care and support needs
• Carers who provide unpaid care to their family and loved ones
• People who are homeless or at risk of homelessness.

People supported in 2021 – 2022

• 11,213 new people have contacted us for support, this is an increase of 38 percent on the previous year
• 3,900 people received services following an assessment of their care needs with 2,125 people receiving long-term support
• 1,428 people received rehabilitation and reablement support, of which over 93 percent of people did not require longer term services to manage their care and support needs
• 81 percent of care homes and 92 percent of home care support is rated as good or outstanding by the Care Quality Commission (CQC) as at December 2022
• 100 percent of carers who needed care and support in their own right, received a direct payment enabling them to have choice and control over how they receive and manage their support
• 417 people, who provide care for their loved ones, were supported to continue caring with a direct payment and 656  people were supported with advice and information
• 99 percent of households assessed were supported to maintain their accommodation.

Experts together

North Lincolnshire Council is committed to hearing the voice of people with lived experience. To help us understand what life is like for people there are a number of partnership groups where people are able to offer their experience and insight and have their voice heard.Working as ‘Experts Together’ we can shape services and influence strategic design.

The voice groups include:

• Experts by Experience
• Learning Disability Partnership
• Carers Advisory Partnership
• Senior’s Forum
• Autism Partnership

and we have others in development to provide voice on mental health, education and employment. The voice groups meet regularly, sharing their collective voice at the quarterly Experts Together Partnership.

Members from across the different partnership groups come together at the Experts Together Partnership. This partnership includes representatives from the citizen groups, partners from health and social care organisations, Humberside Police, Humberside Fire and Rescue, voluntary and community organisations and other public sector organisations to work together to improve outcomes for vulnerable adults and their families and carers.

Experts Together

My story

“I was part of the group who designed the Experts Together Pledge. As we developed the pledge I grew in confidence, gained different skills and experiences like having the confidence to talk at meetings, designing documents and working with others.

It was so important to us all that we told organisations what matters to vulnerable people and help organisations understand how we can work together to develop even better services.

I was so pleased to see the commitment from all of the organisations that signed up to the pledge. I am so used to facing barriers, to know people are listening to us is amazing!”

Partnership working

Through effective partnership working we can ensure that people are enabled to be safe and well.

Organisations come together at key partnership boards, enabling partners to work together to shape strategies and services to support the people of North Lincolnshire.

We work with a number of organisations including health partners, housing organisations, Humberside Police, Humberside Fire and Rescue, Job Centre Plus and other public, voluntary and community organisations.

• Humberside Police
• Citizens Advice
• Northern Lincolnshire and Goole NHS Federation Trust
• Humber nd North Yorkshire Integrated Care Board
• POhWER
• Healthwatch
• Est Midlands Ambulance Service
• Rotherham Doncaster and South Humber NHS Federation Trust
• Job Centre Plus
• Humber and Wolds Rural Action
• Humberside Fire and  Rescue
• Alzheimer’s Society
• Experts by Experience
• North Lincolnshire Disability Learning Partnership
• Lindsey Lodge Hospice
• North Lindsey College
• RDaSH
• The Forge Project
• Safecare Network
• Voluntary Action North Lincolnshire
• Carers’ Support Centre
• Mind North Lincolnshire
• Crosby One

We know we are getting things right when people say:

• “I have a place I call home”
• “I am supported to manage my health in a way that makes sense tome”
• “I know about the activities, social groups, leisure and learning opportunities in my community, as well as health and care services”
• “I have care and support that enables me to live as I want to, seeing me as a unique person with skills, strengths and personal goals”
• “I am supported to plan ahead for important changes in life that I can anticipate”
• “I have opportunities to learn, volunteer and work and can do things that match my interests, skills and abilities”.

Safe and Well

Safeguarding

Safeguarding of vulnerable people is everybody’s responsibility. The North Lincolnshire Safeguarding Adults Board (SAB) brings together partner agencies to protect adults with care and support needs from the risk of, and experience of, abuse and neglect by:

• Ensuring that local safeguarding arrangements are in place
• Partners work collaboratively to prevent abuse and neglect wherever possible
• Ensuring that safeguarding practice is person-centred, outcome focussed and proportionate to the risk presented.

The Safeguarding Adults Board sets procedures, creates a Strategic Plan 2023/2025, reports on its achieves and priorities and reviews cases if required.

• 2183 safeguarding concerns received
• 1197 concerns needed no further support after initial advice or being signpost to alternative support
• 913 concerns progressed to a Section 42 Enquiry
• 94 percent of Section 42 enquiries fully or partially achieve desired outcome of the person.

(Data from published statutory datasets and internal performance data)

Examples of Safeguarding Adults Board achievements in 2021/22

• Held events in relation to financial abuse and self-neglect
• Held online events raising awareness of Domestic Abuse
• Established a child exploitation transition to adulthood partnership group to strengthen safeguarding arrangements
• Developed a joint self assessment in partnership with the Children’s Multi-Agency Resilience & Safeguarding Board (CMARS)
• Developed 7-minute briefings in relation to advocacy which are available on the SAB website
• Lead a multi-agency pilot scheme with Humberside Police which supplied a ‘True Call’ device to adults who have been victims of nuisance telephone calls, aiming to prevent them from becoming repeat victims.

Domestic abuse

The Domestic Abuse Board ensures victims of domestic abuse have access to support to be safe and well in their homes and in their communities. The Domestic Abuse Strategy sets out three areas of focus.

• Early identification and early help offer to ensure victims, children and perpetrators have equality of access to early help and support
• Be transformational in our approach to safety and support for victims, children and perpetrators
• Create a culture and infrastructure to achieving priorities through working in partnership Domestic Abuse.

In March 2022 a Humber-wide Domestic Abuse Learning Event was held to celebrate the launch of the four local areas Domestic Abuse Strategies with over 650 people in attendance. The event also helped raise awareness of domestic abuse and coercive control. Further events are planned to continue to partnership work.

Feeling safe and being safe

The Adult Social Care Outcomes Framework (ASCOF) measures how well care and support services achieve the outcomes that matter most to people. The ASCOF is used both locally and nationally to set priorities for care and support, measure progress and strengthen transparency and accountability.

• North Lincolnshire are fourth in the country for indicators in the top quarter
• 18 out of 26 indicators are in the top quarter compared to 15 in 2020/21
• 24 out of 26 indicators were above the National Average compared to 22in 2020/21
• 23 out of 26 indicators were above the Regional Average compared to 23in 2020/21.

North Lincolnshire continues to provide high quality care services when compared nationally and regionally.81% of care homes are rated Good/Outstanding and 92% of home care (in use within North Lincolnshire boundary) are rated as good (as at December 2022).

For more information go to the GOV.UK website – Measures from the Adult Social Care Outcomes Framework, England, 2021-22 .

The All Age Carers Strategy has been refreshed and co-produced with carers and partners across North Lincolnshire. The strategy sets out the key priorities for development.

Caring for a loved one

A carer is someone who helps another person, usually a relative or friend, in their day-to-day life.

We work with partners to ensure that we reach as many carers as possible, and provide a range of services that enable carers to continue to work, have time for themselves and to enjoy time with family and friends.

We have commissioned services to ensure that carers have access to information and support. This may be through counselling, befriending, therapy sessions, group and peer support meetings, leisure activities and training.

• 70 percent of carers found it easy to find information about services, with carers telling us they have an improved quality of life as a result of support
• In North Lincolnshire it is estimated there are over 19,000 carers.

My Story

I have been supporting my mum over the last few years. Mum still lives in her own home, but recently she has preferred that I stay with her overnight. With caring for mum and staying over night more often this has meant that I have little time for myself. I have had to stop my hobbies and activities and have not been able to spend time with other members of my family.

With the information and advice I was given, and the Direct Payment, I am now able to arrange for a person to come and be with mum a few days a week, which enables me to get back to some of the hobbies and activities I had before caring and also spend time with my wider family.

Getting well again

Sometimes a little further support is needed to get back to independence following a stay in hospital or experiencing an illness or loss of mobility.

The council works together with health partners and voluntary organisations, with a ‘home first’ ambition to ensure that people are supported to be as independent as possible in their own home, reducing and delaying the need for residential care. We do this by providing rehabilitation and reablement to support people to regain and maintain their independence, building their confidence and remaining part of their community.

• 93 percent of people who received short term support to regain their independence did not require longer term services to manage their care and support needs.

My Story

I had a normal life, living in my own home, until I had a fall which dislocated my hip.

My family were able to do some things that I couldn’t do for myself, but I needed extra support to look after myself, for example washing and showering, including getting to the bathroom through the night.

With the right information and support I was able to rediscover my confidence. The therapy and adaptations to my home helped to get me to a stage where I can use the bathroom by myself without anyone else being there.

I didn’t realise how lucky I was to have my independence before this fall and I’m so happy that I’ve been able to recover as well as I have.

Independent

Early help and prevention

Early help and prevention through information, advice and short term support enables people to remain independent for longer, reducing and/or delaying the need for longer term services.

This could include information and advice on community services that may enable someone to link with others reducing isolation, get involved in activities to support mental health and physical wellbeing.

Early help may also be short term support to enable someone to maintain their tenancy, get into employment or rehabilitation and reablement to enable someone to regain or retain daily living skills and physical strength after a period of illness or loss of mobility.

People told us that services continue to support them to live in their own home safely, with 81 percent of people saying they had ‘control over their daily lives’. 91 percent of people in receipt of services told us the services they received helped them ‘feel safe and secure’.

My journey

• My health was declining after the loss of my wife
• It was getting harder for me to care for my home
• I found it difficult to get around and I was worried for the future
• Home First short stay – I was able to have some rehabilitation to help me get back on my feet
• We worked together to build my strength and confidence.
• We arranged for my home to be safe to live in again
• The stay in Home First Short Stay helped me share experiences and get connections with people again
• I now volunteer to help others
• I am proud of my achievements.
• I keep mentally and physically fit and I no longer hoard. My home is my castle.

Employment for younger adults and people with a learning disability or mental health condition

People with a learning disability or mental health condition can find getting into paid employment challenging. To support more people into employment we are working with partners to increase people’s skills to get into voluntary and paid work. We are looking at improving employment opportunities across North Lincolnshire through:

• Working with employers to promote the benefits of employing an adult with additional needs
• Exploring supported employment opportunities
• Sharing information about ‘Access to Work’ support
• Providing training and support to improve a person’s skills and confidence to access voluntary or paid employment.

We will continue to explore different ways of increasing employment opportunities for people with additional needs, and supporting people to improve their employability skills.

Housing

Our ambition for people with care and support needs is that they can live fulfilled lives in a safe place they call home, with those they care about, in their own communities. This commitment to ‘home first’ reduces the number of older people and adults living in residential care.

To support this commitment we are working to ensure there is a choice of accommodation options to enable people with care and support needs to live as independently as possible.

Supporting younger adults to live independently

Supported housing, which provides personalised support, enables people with learning disabilities and mental health needs to live independently and be active in their communities.

My Story

• I had lived at home with my parents for a long time as I did not feel confident managing my mental health needs independently.
• I was told about supported living and I felt that this was maybe a good option for me. I would have a place of my own and support every day to help me manage with life skills and medication.
• I have now moved into my own place and I’m learning to cook and look after my home and myself.I’m finding new activities to go to and I am making new friends.
• I am so pleased I was able to make the move to supported living, ‘I can’t stop smiling’.

Maximising independence for people living with dementia

Myos House is a housing scheme that has been designed to be dementia friendly. People are able to live in their own apartments, either individually or with their loved ones, enabling people to stay independent for longer.

Technology and activities support people to remain safe and reduce isolation and on-site support enables people with care needs to remain in their home for longer.

• My mum has remained independent and safe. The only other option would have been a care home which was not what my mum needed just yet
• Dad has regained general daily skills with prompts which has maintained his dignity. It has certainly helped me as his daughter
• I can see a big difference in Dad’s wellbeing, he has now settled into a routine and is a lot happier. I see him smiling a lot more. You don’t know the difference this has made to us all.

Technology can support people to be independent for longer and keep people connected to their loved ones and communities.Through exploring with people how technology can support them with their early care needs we can together reduce or delay the need for longer term services.

There are lots of different types of equipment and many situations where technology can help. For example, a smart device, such as Alexa, can remind people when to take medication, keep people in touch with family and friends or they can use it to control heating, entry systems and other things around the home with voice commands.

Other pieces of technology that help keep people safe and in control of their lives are falls alarms, epilepsy sensors and a wide range of property sensors.North Lincolnshire Council continues to explore the different technologies available to enable people to maintain their independence.

My Story

I have dementia, my partner used to support me but is no longer able to because they are unwell. I am managing to stay in my home by using technology.

I can no longer use a telephone, but I have a watch I can use to contact my family which will also tell them if I fall.

The watch will also tell my family if I am outside of the house as I sometimes leave the house and walk around the community when I’m confused. It has really given me piece of mind that help is nearby if I need it.

How do we use technology?

The Care Call Service offers many solutions including falls alarms, pendants, and mobile alarm solutions to people who do not have a telephone line. A person’s mobile phones is programmed to act as an emergency button which connects directly to the Control Centre in the same way that a pendant alarm would. Technology provides reassurance calls, alarm monitoring and out of hours support.

People at risk from domestic violence can have discreet alarm units installed in their homes.When activated, Control Centre operators will summon immediate assistance.

To prevent hospital admission and assist with getting out of hospital quickly we have worked with social care providers to help them access equipment. The equipment can help people get bank on their feet safely after a fall or enable people with poor mobility to move around.

Social care providers have found the Raizer chair very useful. The chair is assembled around a person who has fallen to the floor and, using a remote control, one person is able to operate the Raizer Chair to enable the person to be safely back into a sitting or standing position.

Resilient and flourishing communities and workforce

Live Well North Lincolnshire is a web-based, one-stop place for people to find a wide range of organisations, support groups, community groups, events and activities that can help improve their health and wellbeing.

The directory is a joint initiative between North Lincolnshire Council, the North Lincolnshire Integrated Care Board (ICB) and other partners from across the public, voluntary and community sector with an interest in improving community wellbeing in North Lincolnshire.

Anyone who provides a service or activity that supports a person’s wellbeing can create an account and enter their information so that they can promote what they do on the Live Well North Lincolnshire website.

Community activities

Exercise on Referral is a programme designed to help people with health conditions develop the knowledge, skills and confidence to improve their health and wellbeing, preventing or reducing care needs and improving quality of life. There are many different types of activities, some of which include swimming for people with musculoskeletal conditions, chair based exercises, exercise classes for people with Parkinson’s, exercises for people with long Covid etc.

People tell us the activities help them manage their conditions, improve their health and enable them to connect with people who have similar conditions, reducing feelings of isolation.

82 percent of people who joined the programmes are now meeting or exceeding the recommended levels of physical activity per week, and the majority of people that complete the programme continue to remain active through using the council leisure centres, staying active at home or joining activities in their local community, for example exercise classes or walking groups.

Adult Social Care Workforce

The workforce that supports vulnerable people to be safe and well is made up of health and social care organisations in the public and private sector, for example, care home providers and home care providers, the council social care workforce and the workforce of health partners. To support and strengthen local workforce planning and management the North Lincolnshire Care and Health Workforce Partnership was established.

North Lincolnshire Care and Health Workforce Partnership has implemented a number of initiatives to support workforce challenges within the care sector particularly with recruiting and retaining staff with the domiciliary care sector. These include:

• The development of the ‘Proud to Care’ campaign
• The Recruitment Hub and Introduction to Care training programme and
• The Wheels to Work Programme.

Development of Proud to Care

The Proud to Care brand has been developed within North Lincolnshire, including a website where people can find out more about local care jobs, careers in care, and care sector benefits. The aim of the campaign is to:

Raise the profile of the caring role, and celebrate the difference that the care sector makes to people’s daily lives

• Delivered a Proud to Care leaflet to every North Lincolnshire household
• Created a website and job board, including an employer hub with useful information for providers
• Coordinated local targeted campaigns through the utilisation of public banners, local advertisement and petrol pumps

Encourage employment into the sector and highlight the career opportunities available

• Invested in the local economy by contracting local media companies to commission specialist films and other forms of media
• The design and distribution of branded promotional material including, t shirts, pens, badges, posters, and leaflets
• Built up a bank of content to begin to localise the campaign and ensure future brand sustainability

Develop a shared brand, that is local to North Lincolnshire, that we can all be proud to promote

Provider Feedback

• We are really excited to be a part of the campaign! It’s great to see the care worker role valued and in the spotlight.
• We successfully recruited through Proud to Care! The process went smoothly and the Proud to Care team were a great support!

Recruitment Hub and Introduction to Care Programme

The recruitment hub and introduction to care programme aims to attract new employees into the care sector and reduce the burden faced by providers in the initial recruitment and induction of staff. The project is funded until March 2023 and includes:

• Outreach sessions at locations across North Lincolnshire, focussed within areas where recruitment is most needed
• Paid introduction to care programme, classroom and face to face training covering eLearning, medication training, moving with dignity and a talk from a Registered Manager about the realities of working in care
• Over 50 people have entered employment into the care sector as a result of the recruitment hub and introduction to care programme.

The scheme has been successful at supporting people back into employment, and assisted in removing the barriers of gaining employment within the sector by supported DBS checks, and promoting other proud to care initiatives such as funded childcare and Wheels2Work.

Wheels2Work

People have told us that if they do not drive they find it difficult to get a career in the home care sector, particularly those people living in more rural areas.Additionally, rising fuel costs are having an impact on recruitment and retention within the domiciliary care sector.

Wheels 2 Work North Lincolnshire is a moped, electric bicycle, and e-scooter pay as you go hire scheme, the existing scheme has been expanded to include 20 CPX electric scooters with double batteries for hire by care sector workers, with the initial £99 cost to hire funded via grant funding through Proud to Care.

Moped hire comes with the following package:

• A fully taxed and serviced electric moped
• Vehicle road tax
• Comprehensive insurance (£100 excess applies)
• Breakdown cover
• Full servicing and maintenance
• A security lock
• Safety equipment (helmet, gloves and hi-vis vest).

Developing the health and social care workforce

As the demand for health and social care support increases it is important that we develop a workforce that is equipped with the training, knowledge and technology to enable them to support the people of North Lincolnshire to be safe and well. This year we have:

• Delivered 40training events to the social care workforce attended by 1375 staff
• Supported staff through qualification to be Approved Mental Health Practitioners
• Supported staff through qualification to be Best Interest Assessor’s
• Commenced training and pilot of the Post Qualifying Standards for Social Work Practice Supervisors
• Hosted a World Social Work Day Event jointly with Children’s services
• Delivered quarterly themed social work forums that focus on areas of social work development
• Supported 10 people to develop through the new Social Work Assessed and Supported Year in Employment (ASYE) training with Humber Teaching Partnership, delivered by local universities
• Support nine placements for Student Social Workers with an additional nine new Social Work Practice Educators trained.

New initiatives – Care Friends

Research shows that 36 percent of people working in the care sector are found their job by a friend recommended the role. Care Friends is an employee referral app for social care, where care workers earn points for referring people they know into jobs within their organisation, alongside retention bonus points for good work: 1 point = £1.The Care Friends app recognises and values employees through awarding retention bonus points and enables staff to share job opportunities within their social networks.

North Lincolnshire Council have purchased the app for a period of 2 years, and currently Homecare providers are able to sign up to the scheme to promote recruitment of new employees and support retention of their current workforce.

Providers can also fund their own points, such as sharing job posts, picking up extra shifts, rewards for compliments received, mentoring new starters and work anniversaries.

We know we are getting things right when the workforce says:

• We support people to plan for important life changes, so they can have enough time to make informed decisions about their future.
• We work with people to write a plan for emergencies and make sure that everyone involved in supporting the person knows what to do and who to contact in a health or social care emergency. We make sure that any people or animals that depend on the person are looked after and supported properly.
• We don’t make assumptions about what people can or cannot do and don’t limit or restrict people’s options.
• We see people as individuals with unique strengths, abilities, aspirations and requirements and value people’s unique backgrounds and cultures.
• We keep up to date with local activities, events, groups and learning opportunities and share this knowledge so that people have the chance to be part of the local community.
• We have conversations with people to discover what they want from life and the care, support and housing that will enable this, without restricting solutions to formal services and conventional treatments.
• We have conversations with people to discover what they want from life and the care, support and housing that will enable this, without restricting solutions to formal services and conventional treatments.
• We work with people as equal partners and combine our respective knowledge and experience to support joint decision-making.
• We talk with people to find out what matters most to them, their strengths and what they want to achieve and build these into their personalised care and support plans.
• We work in partnership with others to make our local area welcoming, supportive and inclusive for everyone.
• We work in partnership with others to create opportunities for people to work, both paid and voluntary, and to learn.

Value for money

What did we spend 2021/22?

Adult Social Care have delivered improvements throughout the year and increased the number of people supported to be safe and well.

• Gross expenditure – £76.635m
• Short term reablement and recovery – £22.130m
• Longer term, personalised care – £54.358m
• Enabling the voluntary sector to support you – £146,000.

Priority Areas for further development

• Promoting independence
• Enabling the workforce
• Transforming the care sector
• Embedding integration.

Help us improve

Through Asking, Listening and Acting with people who have care and support needs and their carers we can shape our services and inform our strategic direction.

We would like to hear from you to help us do this. You may wish to be a part of projects that shape our services, join one of the partnership groups described in this document or give us your views and insight into experiences of using services in North Lincolnshire.

To provide us with your feedback or work with us on shaping our services please email us on expert.experience@northlincs.gov.uk  telephone us on 01724 297000.