Working for well run evidence-based public care
In the wake of the collapse of Southern Cross and following the development of the Market Oversight regime in the Care Act, CQC has published a significant report, produced by IPC in the spring of 2014, reviewing the state of the Care Market in England. IPC found that:
- The older persons' care market continues to be fragile.
- The more internationally diverse the ownership model of care providers, the more difficult it is to gain clarity about their overarching financial position.
- Debt, and the management of debt, is a critical issue for some providers.
- Recruiting a trained and well paid workforce is likely to be a major issue for the future.
- A series of factors in the next few years may persuade some smaller care home providers to cash in their assets and leave the market.
Overall, the greatest risk of failure is likely to be amongst larger care home provider who do not own the properties in which they operate, and where they have a concentration of homes in a limited number of authorities in less affluent areas.
The report contains a number of recommendations and suggestions for how CQC implements its market oversight role. A full copy of the report is available here.
IPC’s Graeme McLaren will present a workshop on market facilitation and the Care Act at the adults’ services National Commissioning and Contracting Training Conference on 11 September. At the session, Graeme will share the learning from the Developing Care Markets for Quality and Choice programme, funded by the Deprtment of Health, in which IPC worked with 152 English authorities and 9 ADASS regions to support the development of Market Position Statements.
Participants at the conference will have an opportunity to consider the market shaping implications of the Care Act and reflect on the challenges that lie ahead for local authorities. Click here for more details of the event.
IPC has supported the Welsh Government in developing new national eligibility criteria for social care. IPC helped to draft the new guidance and offered group facilitation during the development process.
The new eligibility criteria will ensure that people receive social care when they cannot meet their own well-being needs without a care and support plan. This replaces the current system which only supports those who cross a specific threshold based on definitions of need, from low to critical. The new model will base decisions on a discussion about 'what matters', what the person wants to be able to achieve in life and whether they need managed care and support to achieve this. There will be a focus on prevention, transparency, and building on people’s strengths to enable them to exercise control over their lives, while recognising that some people will need care and support managed for them.
IPC Director Keith Moultrie spoke at the National Social Services Conference in Llandudno on 26 June, hosted by ADSS Cymru, WLGA, Welsh Government, Care Council for Wales and CSSIW. In a session considering integration and service transformation for Wales, Keith explored some of the challenges facing health, education and social care agencies in delivering an integrated experience for service users. Keith described the experience of IPC over recent years in four areas of integration: services and teams, pathways, governance and commissioning.
Partners in Greenwich, supported by IPC, have won a top national award for innovation in social care by developing an approach which allows people to be cared for in the community rather than in hospital. Greenwich Coordinated Care received the top award for innovation in social care at the Municipal Journal (MJ) Achievement Awards 2014.
The integrated service has been developed by the Royal Borough of Greenwich, NHS Greenwich CCG, Oxleas NHS Foundation Trust and the local voluntary sector. It is making services more responsive to local people while reducing hospital admissions and costs. The service has seen a 7% reduction in clients needing long term care and savings of £900,000 to the local authority’s care budget, and of 5.5% to NHS community health budgets.
IPC has worked with Greenwich since 2008 in developing innovative social care services and supported the authority and its partners in the development of this innovative new integrated care model. More about our Network and Partnership working with local authorities casn be found here.
Calderdale Council has appointed Professor Andrew Kerslake as the Independent Chair of the People’s Commission on Health and Social Care. The new commission will give residents of Calderdale the chance to comment on and help shape health and social care services for the area.
The People’s Commission will have an evidence gathering panel which will include representatives from the Council’s three main political parties, as well as Calderdale Healthwatch. The Commission will hold meetings across Calderdale to listen to the views of Calderdale residents. It is expected to make recommendations about the future of health and social care services to Calderdale Council and the CCG in Autumn 2014.
Andrew Kerslake is an Associate Director of the Institute of Public Care and an Emeritus Professor at Oxford Brookes University.
New courses offering support and training in commissioning for adults' and children's services in England have been been announced. The popular courses will begin in October, November and February in Birmingham, London and Bath. The commissioning courses are run regularly around the country and offer a focused introduction to this topic. Full details of all the new courses can be found here.
A further course for commissioners in Scotland will be announced shortly.
IPC will be delivering a series of workshops for the Housing Learning and Improving Network (LIN) as it increases its presence in Wales. The Housing LIN is being supported by the Welsh government to develop its work in Wales and the website now includes a dedicated section on policy, funding and free resources exploring issues around extra care and other specialist housing in Wales. The Housing LIN network will undertake specific pieces of work in Wales to support the Welsh Government, commissioners, funders and developers as they seek to raise profile of housing for older people. The work will begin with a short series of initiatives exploring support for supply, including studies on the potential contribution of specialist housing to economic growth and the financial and wellbeing case for health and social care investment in extra care housing.
Another successful Partnership event
The latest IPC Partnership conference in Birmingham was judged a great success and was well received by attendees from eight members. Delegates considered a range of areas including commissioning for outcomes, dementia housing and a ‘prevention and investment plan’ for existing and future strategies.
The conference considered the Care Bill and the responsibilities for local authorities for prevention and early intervention and shaping the market. Attendees were also given the opportunity to consider issues of particular relevance to them in partner discussions.
Partners found the presentations useful and many noted that the event had stimulated them to a number of actions on their return to work. Attendees said they had been struck about the effectiveness of their current engagement activities and many were looking forward to talking to providers about the possible range of services and contribution to the prevention agenda that they could provide.
IPC Principal Consultant Katy Burch spoke at the Capita Early Intervention Conference in Cardiff on 30th April about 'The Interface between Early Intervention and Social Care', considering how to make these arrangements work effectively so that children don't fall through the gaps. IPC works with organisations across the United Kingdom to implement effective early intervention services and pathways for children and families.
IPC has published a new book on commissioning in health and social care, offering a clear, straightforward guide for those involved across the public sector. The new guide uses the popular IPC commissioning cycle, considering the four stages - analyse, plan, do, review - with a mix of theory and practical tools. The book, written by a number of IPC consultants, covers a range of areas and reflects the evidence-based approach to commissioning adopted by IPC in its consultancy and research work. The guide draws on legislation, research and regulation to support the analysis and will prove invaluable to commissioners working across all sectors of health and social care.
More details about the new guide can be found here.
IPC Visiting Professor John Bolton took part in a round table discussion to consider the important role housing plays in supporting communities and individuals throughout their lives. The round table was organised by the Guardian with housing provider Midland Heart.
Participants considered the key role housing plays in the health of children and adults, including those with care needs, and the important role housing providers can play in the provision of integrated care. This role has been highlighted in IPC's work to develop housing choices for older people through the Strategic Housing for Older People resource developed for the Housing LIN. The resources are available on the IPC website and details of the latest SHOP workshop on sheltered housing can be found here.
The article is available on the Guardian website.
Joint IPC partnership members Royal Borough of Greenwich, Greenwich CCG & Oxleas NHS Trust Project Greenwich Co-ordinated Care won the ‘Transformation in Health and Social Care’ category at the fifth Improvement & Efficiency Awards held in Westminster on 4 March. The awards celebrate the work of authorities which have transformed services and introduced innovative new practices.
The award for Greenwich recognised their integrated health and care teams which now offer a single point of access, with care co-ordination being developed around GP practices. Driven by staff engagement, shared resources and a strong client and prevention focus, the new approach has saved £900,000 from care budgets in recent years, reduced long term care packages and cut delayed hospital discharges by 13%.
IPC has worked with Greenwich since 2008, supporting the Council and their partners in the development and transformation of care and support services. IPC has 7 Partners and 29 Network Members. Information about our Partnerships and Network can be found here.
IPC has completed the first of a series of training and support programmes designed for staff working for Macintyre, a charity which supports people with learning disabilities. Eight participants spent 18 months working on a tailored version of IPC's popular Advanced Diploma in Leading Care Services focused on the specific needs of the organisation. The participants all considered the training to have been useful and comments noted that their confidence had increased and that they felt the course had improved their work. IPC continues to provide development training for Macintyre staff.
Details of IPC's popular one day training and development workshops, short courses and longer management development courses can be found here.
The Director of IPC, Professor Keith Moultrie, spoke to the Care Council for Wales (CCW) about the need for a strategy for developing the social care workforce over the next three years. Professor Moultrie spoke to the CCW board about this challenge, as new legislation is set to be introduced in Wales covering social care and health integration. The presentation considered the policy context and the challenges which Welsh authorities and health organisations will face. It also highlighted the value of links with other areas of the UK. More on Keith's presentation can be found on the CCW website.
The Centre for Workforce Intelligence (CfWI) has produced a paper with input from IPC which considers the implications for the respective workforces of health and social care integration. The report, 'Think integration, think workforce: three steps to workforce integration', is aimed at workforce leaders and senior workforce specialists and identifies clear steps to support integration. The report is based on a literature review and interviews with sector leaders and workforce specialists. It identifies steps for workforce leaders to promote integration from a workforce perspective.
Keith Moultrie, Director of IPC said: "Better joined up services offer the potential for better outcomes for service users. This paper explores different approaches to integration and how leaders can use better workforce management to make integration work."
IPC has been commissioned by The Guinness Partnership to carry out research to identify good practice in the housing and care and support sectors for people with dementia. The research will identify ways for The Guinness Partnership to improve its range of services, ensuring that staff properly understand dementia and have the means to respond to the needs of those people who are affected.
IPC has worked with the Guinness Partnership on a number of projects to help develop and modernise housing provision and services for older people. Professor Andrew Kerslake, Associate Director of IPC, commented: “Good quality housing can be a crucial part of enabling older people to stay within the community. That is as true for older people with dementia as it is of the wider population of older people.”
The new research project demonstrates IPC's leading role in dementia research in a week when the Prime Minister announced a doubling of annual research funding into the condition by 2025.
IPC has supported the Welsh Government in developing new guidance for professionals supporting older people. The guidance from the Minister for Health and Social Services sets out the responsibilities and duties on health and social care services to provide integrated arrangements for assessment and care management for older people, renewing earlier requirements. IPC worked with the Welsh Government to provide the underpinning analysis and to support the development of the guidance. A link to the new document can be found here
Most social care and support staff will encounter violence or be threatened in their work at some point but there is little research into this important matter. IPC has conducted a review for Skills for Care to gather evidence about violence against social care and support staff and to find out what support exists to tackle this violence.
The project involved a survey of social care staff and a review of research conducted since 2000. The project discovered that there has been limited research in this area so it offers a valuable additional resource for practitioners to support them in making the workplace safer for everyone. IPC will be gathering further evidence on local policies and practice which will help to contribute to a deeper understanding of this important issue.
The report can be found on the Skills for Care website here.
IPC conducted a review for Skills for Care's Workforce Innovation Programme which explored how care and support needs change and how the care workforce has to adapt to that change. The review sought to understand the characteristics of effective practice in integrated health and social care.
The review considered current reported practices to support workforce intelligence, planning and development, what works and what does not, key characteristics of effective practice, relevant international evidence and gaps in the evidence base. The research found that the evidence was often weak, based on the views of staff rather than relating to outcomes for service users. The range of definitions and service models means that approaches are often most effectively developed locally, although this makes comparative studies more difficult.
The report concluded that there was a need for further research to better understand what works in these areas, particularly how workforce management and development needs to be different in integrated settings. The report can be found here.
IPC prepared a report for the Welsh Local Government Association and the Welsh NHS Confederation which analyses the long-term implications of the new Social Services and Well-being (Wales) Bill. The new Bill will set out a legal framework for care services in Wales, seeking to introduce a whole system approach. It emphasises the need to develop preventative, community based care shaped by the needs of citizens.
The Bill will be enacted during a period of significant austerity and rising demand for services, putting additional pressure on care services in Wales. The report prepared by IPC highlights a range of implications for services in Wales and emphasises the role of the Welsh Government in co-ordinating developments across the country and ensuring that resources are used wisely.
Enfield Council has welcomed the work of IPC in providing a 'great' workshop on commissioning for efficiencies at the authority. The interactive one day event was delivered to eight staff in Enfield and covered a range of topics including an exploration of the concept of ‘value for money’, using commissioning to identify opportunities to improve value for money, key elements of strategic options appraisal, cost-benefit analysis, social return on investment, multi-criteria analysis and the application of tools and techniques for decision-making on resource allocation and developing strategic business cases.
The workshop gave participants an opportunity to reflect on how they could improve their approach to commissioning. Attendees commended the event and all said how useful and informative it had been.
IPC offers a range of training, from one day workshops to courses and in-depth development programmes. The support offered can be tailored to suit individual organisations or authorities. More information about how we can support you with training and development is available here.