Working for well run evidence-based public care
The Institute of Public Care is part of Oxford Brookes University. Established in 1987, our purpose is to support well run, evidence-based public care. Based in offices in Oxford and Bath, our team of 40 staff and Fellows works across England, Scotland and Wales. IPC provides an integrated combination of applied research, evaluation, consultancy, workforce development and system design. We work with national and local government, NHS organisations, schools, housing with care providers, the private and voluntary sectors.
IPC has published a new resource for both smaller care providers and local authorities to engage in market shaping and develop innovative practice to meet local needs together
The toolkit is intended to highlight good practice around the country in the way that local authorities and smaller care and support providers collaborate and provide innovative services. It offers a series of checklists and materials to encourage good quality market shaping activities.
- For local authorities, the toolkit will give some new ideas and suggestions about who to engage with, why and how, in local care markets.
- For providers, the toolkit offers a stimulus and encouragement to ask local authorities ‘Why are we not doing this?’
The toolkit was commissioned by the Department of Health, the Local Government Association (LGA) and the Association of Directors of Adult Social Services (ADASS). It can be found here.
A detailed research report developed by IPC for the Department for Education concluded that that children's residential care contains 'inherent instabilities'. The report, which involved extensive contacts with stakeholders working in and with children's residential care offered a number of observations:
- Significant numbers of the largest providers are reported as having negative tangible net worth (44%) and declining performance, including the impact of debt levels. Over half reported weaker balance sheets in the most recent reported period.
- Amongst the second tier of providers, including several charitable organisations, 75% reported weaker profit or surplus performance in the last reported period. The children’s residential care is often subsidised by other activities (e.g. fostering) or charitable income.
- Smaller providers have to work harder to generate returns, although because it proved difficult to obtain data across what is the largest part of the market, the report suggests that the picture is less clear than for the larger providers.
Overall, the children's residential care market is not stable and some of the factors present in adult care, which led to the development of market oversight, are also present in this sector, such as falling or static prices and the separation of property from care delivery.
The children's market does have some additional ways of dealing with a financial crisis, such as mothballing homes, although in such a small market these decisions are not without consequences, such as in terms of the availability of suitable placements.
The report makes ten recommendations for action, including encouraging local authorities and the provider market to work closer together in stimulating innovation and in preventing failure. The report argues that Ofsted needs to take on a wider market oversight role and responsibilities.
Among recent changes introduced in the Care Act, the right to charge carers for services was introduced. A recent enquiry to local authorities in England asked if they charged carers for services where carers meet the eligibility criteria set out within the Care Act.
Almost all of the authorities - 92% (140) - said that they do not charge carers; the other 8% (12) said they do.
74% (103) of Councils which said they do not currently charge confirmed that they had no plans to charge in future, while 19% (26) said they would be reviewing approaches to charging in the near future and that this review would encompass charging for carers.
A full consideration of the results of this enquiry can be found here.
The Institute of Public Care has been involved for several years in the development and dissemination of information and training to support Councils in implementing the Care Act in England. We have developed a new workshop for councils to help them understand the Care Act as it relates to carers and to identify key principles involved in applying the eligibility criteria for carers. It has been delivered to several partners and can be tailored to the individual needs of your authority or a group of authorities.
IPC delivered a workshop for local authorities in the South West of England in April which looked at changes introduced in the Care Act for carers. The Carers' Eligibility Workshop was held in Taunton and attracted participants from across the region.
The workshop was commissioned by ADASS to help local authorities develop their understanding of the Care Act as it relates to carers and to identify key principles involved in applying the eligibility criteria. The event attracted a good mix of participants, with 29 strategic and operational managers attending from 13 local authorities in the region.
All the attendees are involved in rolling out the Care Act and working with carers in their areas and they included people from carers centres and managers from carers' trusts. They had the opportunity at the workshop to apply their understanding to different scenarios and to identify what they might share with colleagues across the region.
The event received excellent feedback and participants called for more such events regionally and nationally to support local authorities as they implement the Care Act.
IPC offers training and management support tailored to the needs of individual authorities and regions such as the South West. If you would like to know more about this training or other support we can offer on the Care Act, please contact IPC.
IPC is working with SSIA and ADSS Cymru to deliver the second phase of the Strategic Management Development Programme – ‘Leading by Example’. The new learning opportunity, which begins in July 2015, follows the successful completion of the New Directors Leadership Programme in 2014-15.
The innovative programme is open to Directors and Heads of Service across Wales who will be invited to join two small learning teamsfocused on either adults' or children's services. The programme will enable participants to develop their strategic leadership skills in an intensive learning programme with colleagues from across Wales through visits to different local authorities in the UK which offer good practice.
Participants will have an oportunity to compare what they have learned from these authorities with each other and across the adults' and children's teams. The participants will develop workshops to be delivered across Wales for other Directors and senior managers from within Welsh Social Services, including partners where appropriate.
The development of the programme has been overseen by the National Programme Management Committee in partnership with lead Directors from ADSSCymru for Improvement and Workforce. It will be delivered by IPC.
For more information about the programme, visit SSIA.
IPC offers a range of management development opportunities and is able to develop training tailored to the individual needs of organisations or groups of organisations. Find out more about what IPC can offer here or contact IPC to discuss your needs further.
IPC delivered a two day learning event in Dundee in March for the three Tayside Health and Social Care Partnerships to build a shared understanding of joint strategic commissioning. The training helped attendees to develop the joint commissioning skills that the partnerships will need to address the new challenges in health and social care.
The training was intended to help employees of the Partnerships to respond to the Public Bodies (Joint Working) Scotland Act 2014. The Act has highlighted the importance of joint strategic commissioning to achieve the right outcomes for people and requires the NHS, local authorities and other key partners to work together to produce a strategic plan for adults by April 2016.
IPC offers management development and training to colleagues across Scotland, Wales and England across a range of social care topics. The training provided is often tailored to the needs of individual organisations, as was the case in Scotland.
“An obsession with numbers leaves us blind to what good outcomes can be achieved if we 'commission' housing effectively” contests IPC in a new blog for The Housing LIN.
Debating the benefits of taking an outcome-based commissioning approach, the blog suggests that housing should be viewed in terms of how it can contribute to an individual’s health and wellbeing outcomes rather than purely numbers of buildings developed.
Good housing can have direct benefits for both health and social care in maintaining good standards of living and enabling independence. Housing commissioners will need to develop a different relationship with the system as a whole, particularly health and social care to improve both understanding of the needs to be addressed and the delivery process.
The blog by Juliet Bligh and Nick Hooper is available here.
More information about IPC's housing offer for strategic commissioners is available here.
IPC has been commissioned to evaluate two whole-system Innovation Programmes funded by the Department for Education (DfE) straddling children's social care and early intervention services. The DfE launched the Innovation Programme in 2013 to act as a catalyst for developing more effective ways of supporting vulnerable children.
In Hampshire, IPC will evaluate the extent to which new family intervention teams, volunteers, edge of care services, social work surgeries and workforce development in support of improved direct work with families are effecting positive change including in supporting more children to remain safely at home and a reduction in the need for care.
In Windsor and Maidenhead, IPC will evaluate the extent to which locality-based teams delivering more culturally sensitive and appropriate family support services can engage effectively with communities that have been over-represented in the child in need population
It is intended that these evaluations will help to inform the development of Children's Services more broadly. The reports on both services are expected to be published in 2016.
IPC visit to China to discuss housing solutions
The Director of IPC and Head of Research have recently returned from a trip to Sichuan Province in China, where they met with representatives of the Chongqing Jinyang Real Estate Development Corporation and Chengdu University of Traditional Chinese Medicine.
Professor Keith Moultrie and Liz Cairncross visited several local housing with care schemes near Chengdu and, following discussions about potential collaboration, IPC has signed a memorandum of understanding focused on developing a shared knowledge base, knowledge and skills exchange, and research on older people.
Chengdu University of Traditional Chinese Medicine (TCM) has around 20,000 students studying health related course in both Western and traditional Chinese medicine. It is one of the top 5 'TCM' universities in China.
The Chongqing Jinyang Real Estate Development Corporation is interested in developing high quality housing with care solutions in response to the considerable growth in the number of older people in China relative to the younger population.
A People's Commission set up by Calderdale MBC and chaired by IPC Associate Director Professor Andrew Kerslake has rejected a series of proposals to reconfigure hospital services in the area.
The Commission was established in 2014 to give residents the chance to help shape social care and health services. The report, published in February 2015, questioned whether proposals from NHS providers in Calderdale and Greater Huddersfield to reconfigure hospital services would produce better health outcomes and deliver value for money for people in the area.
The Commission recommended that no costly changes to hospital services should be made unless it can be demonstrated that 'changes to community health services can provide a better approach to healthcare provision'. The report also called for the Health and Wellbeing Board to help drive improvement in the area.
The report was welcomed by Calderdale Clinical Commissioning Group which undertook to ensure that the views of residents would be taken into account as plans for local health provision are developed.
Professor Kerslake has chaired the People's Commission since it was established in 2014.
IPC has carried out a study into the likely future care needs of former UK seafarers for the Maritime Charities Group. The UK Seafarers’ Demographic Profile report has highlighted how the number of former UK seafarers continues to decline but the need for welfare services among them is expected to rise.
The oldest former seafarers are most likely to be the key drivers of demand for care and support services from the maritime charities which commissioned the report to help understand how to meet future needs. The report forecasts an increase in the number of former seafarers aged 85 and over.
There are currently 358,000 former seafarers across the Royal Navy, Merchant Navy and fishing fleets aged over 65. As well as being vulnerable to specific health problems and conditions associated with their time at sea, many will have limited or no occupational pension provision.
Changes to welfare and social care provision are also likely to create a range of needs for help and support among the adult and child dependants of serving and former seafarers. The number of dependants of ex-seafarers is estimated to be 687,000.
For more information about the report, visit the Maritime Charities Group website.
IPC supported the Social Care Institute for Excellence (SCIE) in developing new materials aimed at commissioners working to implement the Care Act 2015. The Care Act gives commissioners new duties to provide advocacy under the Care Act 2014.
The new resource will help commissioning officers in local authorities think through their new duties and understand what they are required to do to comply with the new requirements of the Act.
All the resources are available on the SCIE website.
IPC has developed the suite of learning materials published by Skills for Care today, which will help you implement the Care Act. The Act is set to transform care provision, and introduces a number of new duties for local authorities in particular, from April 2015.
The learning materials summarise and explain the statutory guidance and how it will impact on local authorities, care providers and service users. They include presentations, videos, case studies and workbooks to help facilitators design a learning programme for local audiences. The materials are free to download from the Skills for Care website.
How IPC can help you
We can help you analyse your staff’s learning needs in relation to the Care Act as well as design and/or deliver learning programmes tailored to the needs of your organisation. We can also help you to get the best out of the new materials by training your trainers.
In addition to providing learning and development support, we are currently working with a number of authorities and regions, helping them to redesign their systems and processes in preparation for April 2015.
We continue to support local authorities and providers to respond to the market shaping requirements of the Act. You can download the materials from the Department of Health funded DCMQC programme from our website.
IPC has been approved by the Department for Education as an evaluation partner for Innovation Programme Sites across England. The sites will explore new ways to deliver social work-led packages of support to children, young people and families with support from Government.
IPC's role will be to support the sites to undertake successful evaluation of the innovations they introduce, such as those looking to safely prevent young people needing to come into care or developing new ways of working with younger children and families.
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 has supported the Welsh Government in developing new national eligibility criteria for social care. IPC helped to draft the guidance and offered group facilitation during the development process.
The 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 has published a book on commissioning in health and social care, offering a clear, straightforward guide for those involved across the public sector. The 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 guide can be found here.