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Adults Strategy 2023 – 25
Foreword
The council strives to achieve the best experiences and outcomes for our residents. Our ambition is for North Lincolnshire to be the best place for all our residents to be safe, well, prosperous and connected. We continue to drive our organisational goals of progressive and enabling in our approach, financially and environmentally sustainable.
North Lincolnshire is a diverse place with strong and vibrant communities. We want to use and build on the wealth of knowledge and expertise in our communities to help deliver our strategy. We know that people stay healthier for longer when they
are connected to and supported by communities.
By helping to strengthen our communities, we will reduce health inequalities and improve the quality of life for all our residents and keep people in their own homes, families, jobs & communities.
Through our community first approach we will:
- Improve outcomes for people and be informed by the voices of our diverse communities.
- Be person-centred, building on people’s strengths, enabling them to participate within their community and empowering them to do more for themselves.
- Ensure that people don’t pay for what they don’t need and paid for support is the last resort.
- Maximise the use of digital technologies to promote independence.
- Work together with our partners in a holistic and integrated way to achieve the best possible outcomes for people.
The strategy sets out our key areas for development and the change we want to see in making a real difference to vulnerable adults and their carers.
Our approach links to ongoing partnership working, bringing people, communities, and organisations together to share resources and expertise
The people we support
Across the services we support people with or who are at risk of, developing care or support needs, typically but these needs prevent people from managing daily living safely – albeit it temporarily – some just need support to find accommodation, others need intensive support to change their lifestyle – others need ongoing help to manage personal and intimate care. We also support carers, recognising the importance of their own wellbeing and resilience alongside those of the person they care for. Our aim at all points is to keep people in their own homes, families, jobs & communities.
In 2022 we responded to over 12,000 new requests for support from advice and guidance to urgent temporary accommodation, safeguarding and support. The primary reason for people making contact is a breakdown in current circumstance in the community, developed urgent need for personal intimate care and issues of mental capacity, and other cognitive issues.
We also support a lot of people to leave hospital in a timely manner.
We have on average about 2,500 people per year receiving longer term paid support, and a further 2,000 a year using temporary accommodation and needing tenancy related support. We also supported over 500 people to enable them to continue to care for loved ones and conducted over 900 safeguarding enquiries.
The quality-of-care provision remains high with 82 percent of care homes and 100 percent of home care support being rated as good or outstanding by the Care Quality Commission (CQC) (Sep 22).
Performance – The Headlines
- We have improved our position for indicators in the top quartile and are now in the top 5 of authorities in England.
- 24 of 26 indicators are above the England average compared to 22 in 2020/21, evidencing continuous improvement in our performance.
- 23 of 26 indicators are above the regional average, maintaining the position of 2021/22.
- 18 out of 26 indicators are in the top quartile compared to 15 in 2020/21.
- 11, 213 requests for support in 2021/22 were from adults and older people who were not already known to us, an increase in excess of 3000 from the previous year. Over 80% of these requests resulted in either signposting or the provision of low-level support supporting people to remain independent without the need for long term service.
- The council has continued to prioritise ‘home first’ and provide rehabilitation and reablement
to support people to regain and maintain their independence and keep connected to their community. 93% of people who received short term support to regain their independence did not require longer term services to manage their care and support needs. The council continued to work with health and voluntary partners to support people to be discharged from hospital as quickly and safely
as possible. - We remain above the England, regional and comparator group outcomes for availability and effectiveness of rehabilitation and reablement services on discharge from hospital.
- We are actively working with system partners to look at alternative ways to manage this increased demand and support people to return to their own homes where possible.
Over 3900 people (including carers) have received services in 2021/22 following an assessment of their care and support needs. Everyone in receipt of
services has a personal budget to help with planning their individual support and manage how their care is provided. In addition, approximately 42 percent chose
a direct payment whilst 58 percent chose local authority to manage their care. 100 percent of carers chose a direct
payment to enable them to choose how they receive and manage their support.
The council recognises the importance of keeping people in their own homes and are developing
a ‘community first approach’ to work with our communities to realise these outcomes for people. 70 percent of the prevention duties ended with securing accommodation above the 59 percent national average. 71 percent of relief duties ended with securing accommodation (40 percent national average). In year reduction of 45 percent in individuals rough sleeping (37 percent national average).
We continue to improve housing options that enable people to live independently for as long as they are able. This commitment has seen reductions in the number of new admissions to residential care for both older people and adults.
For older people we have continually improved our performance over the past 4 years and current performance is better than both the national and regional average.
Adult Social Care end of year performance – 2021/2022
| Performance measure | 21/22 outcome | National average | Regional average |
|---|---|---|---|
| Effectiveness of reablement/rehabilitation | 89.1% | 81.8% | 80.4% |
| Offer of reablement/rehabilitation | 2.9% | 2.8% | 2.2% |
| Outcomes following short term support to maximise independence | 93.7% | 77.6% | 70.5% |
| Performance measure | 21/22 outcome | National average | Regional average |
|---|---|---|---|
| Adults with a learning disability who are in employment | 3.6% | 4.8% | 4.9% |
| Adults with a mental health need who are in employment | 9% | 6% | 8% |
| Adults with a learning disability who are living independently | 79.7% | 78.8% | 79.9% |
| Adults with a mental health need who are living independently | 33% | 26% | 32% |
| Service users – Self Directed Support | 100% | 94.5% | 95.3% |
| Service users managing their support with a direct payment | 42.1% | 26.7% | 26.7% |
| Carers – Self Directed Support | 100% | 89.3% | 83.1% |
| Carers managing their support with a direct payment | 100% | 77.6% | 75.6% |
| New long term admissions to residential care (18-64) | 16 | 13.9 | 17.5 |
| New long term admissions to residential care (65+) | 501.4 | 538.5 | 611.4 |
| Performance measure | 21/22 outcome | National average | Regional average |
|---|---|---|---|
| Social care related quality of life | 19.6 | 18.9 | 18.8 |
| Control over daily life | 81.9% | 76.9% | 77.2% |
| Social contact | 42.2% | 40.6% | 40.6% |
| Quality of life – Impact of adult social services | 0.438 | 0.407 | 0.398 |
| Overall satisfaction with care and support services | 67.7% | 63.9% | 65.1% |
| Information about services is easy to find | 65.3% | 64.6% | 64.6% |
| People feeling safe | 75.8% | 69.2% | 69.3% |
| People feeling safe and secure as a result of services | 91.7% | 85.6% | 85.1% |
| Performance measure | 21/22 outcome | National average | Regional average |
|---|---|---|---|
| Quality of life | 7.5% | 7.3 | 7.4 |
| Social contact | 28.8% | 28% | 31.2% |
| Overall satisfaction with care and support services | 44.7% | 36.3% | 37.7% |
| Included/consulted in discussion about person cared for | 70.4% | 64.7% | 64.7% |
| Information about services is easy to find | 70.2% | 57.7% | 56.3% |
Areas where our performance could be better
Supporting younger adults to live independently in their communities:
We have supported a number of housing projects to explore alternative housing options which promote and support independent living for people with learning disabilities and mental health needs (see turn the curve).
There is ongoing work with partners to enable people to return from out of area placements into least restrictive housing options. We are supporting families and carers, to reduce levels of anxiety and support their loved ones to consider a move to independent living. Strengths based approaches are evident in assessments and wishes of individuals who want to move into more independent living. We have created a navigator post within the housing advice team to support people with mental health needs, whose role it is to work with people during hospital admissions,
the multi-disciplinary team and independent and social landlords to secure and maintain their own tenancies.
Overuse of short stay residential placements to support people leaving hospital:
We are actively working with system partners to look at alternative ways to manage this increased demand and support people to return to their own homes where possible. An accelerated discharge event took place in November 2022 which actively sought to discharge people ‘home first’. Evaluation and learning from this event is being collated and agreements are in place to use the discharge fund to maintain
this process.
Supporting younger adults, people with a learning disability or mental health condition into
paid employment:
Increasing the number of people with a learning disability and mental health in employment remains challenging and performance remains low, (although improved on 2020/21) when compared to national and regional peers.
We are working to increase opportunities for employment for people living with learning disabilities and mental health by:
- Exploring the viability of an employment scheme within the council.
- Reviewing and strengthening recruitment processes that would support recruitment into employment schemes for people with learning disabilities and mental health issues.
- Exploring and promoting apprenticeship programmes for people with learning disabilities & mental health within the council as a way to create employment opportunities.
- Exploring a supported employment scheme as part of community mental health transformation.
Homelessness – We have a high number of people accessing temporary accommodation in dispersed settings, the aim is to bring these into a single system to enable attention to sustained life changes
Priorities for 2023/2025
Using our performance data, practice wisdom and insight our upcoming priorities are as follows:
Developing more models for independence utilising housing and technologies and ensuring paid work is a real option for people.
What good looks like;
- People have information to enable them to plan ahead before they have an identified care need.
- Care and support assessments and plans are co-produced, person-centred and focus on strengths and
community participation. - There is a choice of accommodation and care models and people with a lived experience are involved in the design and commissioning of these.
- Working age adults with care and support needs can access work opportunities and be supported to fulfil the role.
- People at risk of homelessness are housed appropriately and safely and can play an active part in their community.
- Digital technology is maximised to support people in need and promote independence.
- People are empowered to make their own decisions to live free from harm and abuse.
- Strengthening the voice of carers, recognising the importance of their own personal wellbeing and resilience alongside those of the person they care for.
The Community First approach enables people to remain and return to their own homes, families, jobs & communities.
What good looks like;
- People at risk of losing their independence have multiagency care and support planning for daily living and
crisis management. - Population health management drives interventions to reduce or delay the need for care and support.
- People leave hospital in a timely manner exercising their right to rehabilitation in their own homes or an appropriate setting.
- Partnerships understand and respond jointly to the needs of their communities.
- Safeguarding is personal, proportionate and quality assured.
Care at home to be more modern, enabling and progressive – all care to be good or outstanding.
What good looks like;
- The care sector is good or outstanding across the place, engages in sector led improvement and is sustainable.
- There is a robust and sustainable model for supporting people at home in their communities across all adult age.
- The care sector has a vibrant, diverse and skilled workforce, with valued career progression opportunities that can meet local need.
- Care homes can meet developing complexities and are integrated with their communities.
- Technology is mainstreamed to help people feel connected and promote inclusion.
- Place partners work collaboratively with the care sector to continuously transform, improve and develop to meet
changing need.
To feel safe, supported, and enabled to be themselves, be well and healthy and are confident to Keep people in their own homes, families, jobs & communities.
What good looks like;
- The workforce can recognise and realise their potential and feel part of the wider #TeamNL family in a place where they can develop a fulfilling career.
- They embrace new ways of working in teams, across organisations and sectors and are supported by technology.
- There is a robust organisational development plan for any proposed integration / joint working.
- The workforce is equipped with the training, supervision, technology, and opportunities to do their jobs effectively.
- There is good engagement and co- production across the workforce.
- There are high levels of engagement in the safeguarding arena and the workforce is confident in their practice across the whole adult and children’s safeguarding agenda.
Together we will know we are getting things right when
People say:
- “I have a place I can call home”.
- “I am supported to manage my health in a way that makes sense to me”.
- “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”.
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 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 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 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 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.
Governance and oversight
A detailed action plan for the delivery of the strategy objectives will be developed with accountability to the Director Adults & Health, reporting quarterly to the Cabinet Member for Adults and Health.