Commissioning social work to deliver personalisation

Community Social Work in Derbyshire

• Derbyshire’s objective is a safe, sustainable system of personalised and self-directed adult social care support -respected and valued as a part of an integrated system of care in, with and for the community

Objective

How have we achieved this?

Recognition of the vital role of social work as a profession

- Move away from process driven culture to ‘community capacity building’

- Work with individuals, families and communities

- Creating understanding and using Relationships

What do we need?

• Skilled, confident and respected Social Workers• Prevention & early intervention• Choice & control – identifying what is important

to and for people • Seeing beyond the FACS eligibility assessment

and managing risk• Person and family centred work, community

focused and fully cost conscious

Personalisation Programme in Derbyshire continues to:

•consider how best to optimise the differing styles of worker roles to be developed to support assessment, agreement of outcomes

•balance between creating new employment opportunities within local economies and communities and maintaining stability

Better Care FundThe Government’s spending review in 2013 announced a national Better Care Fund that will be available to improve integrated support for people with health and social care needs

Derbyshire Adult Care is in the process of producing a joint plan with the local NHS for delivering better integrated services

4 key priorities:-

1)protecting social care services

2)developing 7 day services to support hospital discharge

3)Improving data sharing across health and social care

4)Enabling joint assessment and identifying a lead professional for people at higher risk

Implications of the Care Bill:•Improved communication, information and advice•Same rights for carers of people with care and support needs•Holistic assessment to determine eligibility•Legal responsibility to provide each individual with a support plan•Clear approach to charging•Clear framework for safeguarding vulnerable adults at risk or abuse or neglect

Generic social work within Derbyshire

3 years on …•Generic fieldwork teams•Community Lives team•Best Interest Assessment team•Central AMHP’s team•Brokerage team

As well as Intermediate Care Teams and Reablement Teams, Social workers in Derbyshire are aligned with GP practices forming Virtual Wards responsible for coordinating care for adults identified at high risk of hospital admission or admission to a care home.

The role provides an opportunity to promote better understanding of local systems and re-enforce the added value of preventative work and risk stratification work.

Integrated care in Derbyshire represents collaborative working between key stakeholders to deliver effective planned and unplanned care –

- in essence ‘delivering the team around the person’

Integrated Care in Derbyshire

The Social Worker role

•Developing (therapeutic) relationships relies on a workforce who have the capacity, competency and commitment to intervene•Promoting choice and control – community social work that encourages, enables and advocates•Balance between care and control – active citizenship and risk

Relationships

The Business Case for Social Work with Adults (TCSW)

“..to focus on promoting active and inclusive communities, and empowering people to make their own decisions about their care”

•How do we achieve this?•What is modern social work?•What are the pressures on social work?•How do we cultivate social capital and build relationships?•How can we improve?

Work with local groups & communities to identify ‘hard to reach’ individuals, ie alcohol/drug dependentWork ongoing with local Christian Centre and church groups who have established cafés, furniture stores, drop-in centres

Engagement with local police, ie people caught stealing food and nappies. Developing a supportive rather than a punitive role

Case Studies

Quality of Commissioning•Derbyshire has aligned social workers to local residential and nursing homes, as well as GP practices•Creating a closer working relationship with residents and their families, as well as home owners and staff•When things go wrong – shared responsibility rather than blame culture•Professionals (social care, health services, CQC, police) working together•Outcome – Excellent coordination of safe & well reviews - Improved quality of care – relationship with self-funders

KatyTransition from child to adult•Abusive childhood and multiple foster placements (breaking the cycle)•Learning disability and attachment disorder•Assessment, intervention and protection•Empowerment•“A home of my own, a life and a future”

• Generic working, sharing of skills and new challenges

• Integration agenda – alignment with GP practices and care homes

• Development of the Derbyshire Trusted Befriending Network and establishment of the Derbyshire Discretionary Fund (local welfare provision)

• Thresholds for safeguarding implemented and practice guidance launched

• Brokerage knowledge of resources

• Community Lives engagement programme

• The commitment that social workers make to the team

• Equity across service user groups

• A dedicated team of Best Interest Assessors

• Specialist dementia care projects designed to promote dignity

• A Professional Development Team assessing and supporting the practice education of students, NQSW’s and PQ social work (nominated for Social Worker Team of the Year 2013) – the golden thread

What we are proud of