To receive an update from the Corporate Director of Children Families and Wellbeing.
The Director of Integrated Services for Trafford Council & Pennine Care delivered a presentation to the Committee. The presentation covered the changes which had been made to Trafford Services in response to the CQC local system review conducted in October 2017. The presentation covered the Asset based approach, Ascot House and the structure of services, the Urgent Care Control Centre, Discharge to Assess Pathway, Stabilise and Make Safe Service (SAMS), and Discharge to Assess Beds.
The Committee were informed of the services that were at the Ascot House site and how those services were coordinated to support individuals. There were four social work teams across Trafford with one based in each locality. This meant that each team was near to where the individuals they worked with lived which helped them in a number of ways including being able to link their work with GPs.
The Committee were then told about the Urgent Care Control Room (UCCR). Trafford were the first area to implement a control room of this type. The UCCR was able to track every bed and service available within the community and all related services were based in the same building. The Director of Integrated Services explained the display and daily updates that enabled the UCCR staff to track the activity and coordinate services.
The Trafford discharge to assess pathways were then explained to the Committee. There were 5 pathways available for people to ensure that each resident received the correct amount of support for them. The presentation showed the staff members who were able to put individuals onto each pathway, the conditions which defined which pathway a person should be on, the personalised services available on each pathway, funding for services on each pathway, and additional services which could be accessed on each pathway if needed.
The Director of Integrated Services then described the new discharge to assess bed service that Trafford had implemented. This service involved the Council commissioning a number of beds at Care Homes that would be used to discharge residents to for a short period of time whilst they were assessed and long term decisions around their care were decided. Trafford had around 40 beds commissioned during Christmas 2017 and had 36 as of the meeting. The reduction in the number of beds was due to residents wanting to stay in at those residences for the long term. The discharge to assess beds were spread amongst 12 providers across the area. The impact of the development of these services had been that since Christmas 2016 Trafford had reduced the average number of delayed transfers of care from over 100 to 25. Whilst this represented a large improvement in the services it was still not in line with the target of 16 set by the CQC.
The Director of Integrated Services then gave the Committee a couple of case studies of people who had been supported by the system and showed how the various elements were now working together to support them. The Director of Integrated Services read out a letter that had been sent to the service by a resident. The letter thanked staff for providing the support and detailed the improvements that she had managed to achieve through reablement, whereby she went from not being able to move unassisted to being able to return to her home.
Following the presentation the Chairman asked whether it would be possible to arrange a visit to for Members to go to Ascot House. The Director of Integrated Services welcomed the proposal and asked officers to arrange dates.
The Chairman asked about the cost to the Council of continually holding the discharge to assess beds. The Director of All Age Commissioning responded that before the Council started this service they had around 100 vacancies on average and now they had 36 discharge to assess beds instead, so the service was saving money. The Director of Integrated Services added that due to new dynamic commissioning arrangements the Council had put in place, new places at care homes could be arranged within 3 days when needed.
Councillor Bruer-Morris asked whether people have to pay to stay in the discharge to assess beds. The Director of Integrated Services informed the Committee that the individuals were given three weeks within the placement free of charge and after that point it would depend upon their circumstances.
Councillor Taylor asked whether this work linked in with the Trafford Coordination Centre (TCC). The Director of Integrated Services told the Committee that the UCCR only linked into TCC when an individual had ongoing needs.
Councillor Anstee stated that the action plan was due to finish in December 2018 and he noted that there were many items still needing to be completed. Given his knowledge of the services, Councillor Anstee was aware of a number of points that had been completed but not updated on the action plan. Councillor Anstee requested for a more complete action plan be brought to a future meeting with additional plans listed against any outstanding actions.
Councillor Duffield asked whether any people were in homes which required improvement. The Director of All Age Commissioning answered that some residents had been placed at homes that required improvement. However, when such a placement was made the Council worked with the home to improve the service.
Councillor Duffield asked what the ongoing challenges were to further reduce the number of delays. The Director of Integrated Services told the Committee that the service was revising the winter plan. Another area that was being looked into was how to support complex individuals to minimise the number of moves that they needed, as each move had a large negative impact upon their health. Trafford were also adding an extra Stabilise and Make Safe provider to the framework.
Councillor Duffield asked whether there were any issues with adaptations.
The Director of All Age Commissioning responded that the Council had identified that it was taking a long time for major adaptations to be put in place. The Council were looking to commission places with providers for individuals to stay in whilst adaptations were made.
Councillor Brophy asked about staff vacancies and whether there were delays caused by staffing issues. The Director of Integrated Services stated that there had been a large improvement in staffing numbers and that the Council had worked hard to make Trafford a place where people want to work. Due to this work there had only been a couple of instances where delays had been caused by staffing shortages within Trafford.
Councillor Haddad asked whether there were any plans to help deal with issues around flu. The Director of Integrated Services responded that Trafford already had a plan in place for staff and were in the process of developing a flu plan for the area. In order to have a full update on the flu plan it was suggested that the Interim Director in Public Health attend the next Committee meeting.
1. That a visit to Ascot House for Committee Members be arranged.
2. That an updated Action plan be brought to the Committee showing which actions had been completed and containing details of plans for any ongoing actions.
3. That the Interim Director of Public Health attend the next meeting of the Committee to present an item on the Trafford flu plan.