Part 3 - User and Carer Services

3.4 Adults with Physical and Sensory Disabilities

1.Achievements 2001- 2004 and Key Actions for 2004/05

What we have achieved through the Strategic Programme (2001-2004)

Actions to Improve Performance (2004 - 2005)

1. Transition Arrangements

A draft Devon Transition Protocol for children with special needs has been produced for consultation. Linked protocols are being produced for Care Leavers, and for transitions between child and adult mental health services.

The Adult Placements Project includes proposals for integrated transition for children leaving foster care into adult placement. This project is expected to reach completion by Spring 2004.

This early work needs to be built upon to achieve consistent transition protocols across agencies.

In the light of Best Value Review outcomes, establish 'seamless care' protocols:

Between services for younger adults and those for older people.

Between services provided by Adult Services Division, and those provided by the Mental Health/Learning Disability Partnership Trust.

Co-ordination of Services

We have yet to achieve the establishment of jointly agreed assessment, care planning and provision processes that are understood by all professionals, users and parents/carers.  

The implementation of the Best Value Action Plan from 2004 onwards will address these issues by the development and implementation of jointly agreed integrated care pathways incorporating the principles of the single assessment process.

2. Information and Communication

Disabled people and staff in relevant agencies should have clear and accessible information about services to support people who have a physical disability and/or sensory impairment.

Better Care Higher Standards Charter

A draft Charter has been produced but not yet finalised or published.

To agree a revised approach to the Charter resulting in publication of information on standards in 2004/5. Ensure that the Charter addresses Human Rights and Equalities legislation.

Care Management Forms

Large print forms now in regular use for assessment, care planning and review purposes. These forms have been reviewed and adjusted following user consultation.

Ensure that all changes to documentation take account of the need for large print versions.

Public Information

Full range of relevant literature available on request in all special needs formats. Web page developments overtaken by corporate migration to template-based content management system for entire website.

Sensory web pages with large print browsing options completed.

'Devon Link' magazine sustained as a communication medium for people with physical and sensory impairments

Direct Payments leaflets published in web page & paper formats.

Most relevant leaflets now available on request in signed video format. Signed interpretation of text on Industrial Services Group (ISG) 'PLUSS' website now completed.

Develop opportunities for joint agency publication with Health and other linked agencies.

Complete website migration to corporate template system.

Increase involvement of people with physical and sensory impairments in publication and management of Devon Link.

Explore development of online transactional capability for direct payments.

Complete production of videotape version for all standard literature.

Implement Best Value Review recommendations on specialist disability information service.

3. Choice and Control, Person Centred Planning and Independent Living

To develop a person centred approach to planning and delivery of services. To plan and organise resources and expertise in a manner which ensures that the needs of disabled adults to live independently, including those arising from their parenting role, are met effectively. To ensure that disabled adults have maximum involvement in identifying and assessing their needs, deciding what services will be provided, who arranges them and what changes can be made. Develop an inter-agency statement of principles and commitment to the promotion of service user choice and control.

Direct Payments

Information leaflet for Direct Payments for adults published and distributed.

Care management process includes specific requirement to offer Direct Payments.

Direct Payments Board for whole Directorate established.

The number of adults with physical / sensory disabilities using Direct Payments had risen from 37 to 92 by 1 Apr 03.

Identify future infrastructure requirements and funding arrangements for supporting Direct Payments, as part of the work of the Direct Payments Board.

Development of voucher schemes to be progressed as complementary to the direct payments process.

Maximise take up of Direct Payments by information and access improvements and simplified systems.

Further emphasis on Direct Payments as a ‘first option’ to be promoted in care management training.

Improve access to Direct Payments for persons from Black and Minority Ethnic backgrounds.

User Consultation & Involvement

Arrangements for user consultation are currently not equitable across the county, and do not systematically involve users in service planning and review.

Users and carers have been widely consulted and involved in the current Strategic and Best Value Review.

Continue active user / carer involvement in the Best Value action plan & implementation stages. Ensure minority groups are consulted.

Establish a joint agency strategic partnership board and locality implementation groups to maintain consistency of implementation and strategic planning arising from the Best Value Action Plan.

Support service user involvement integral to the above structure.

4. Fair Access to Care Services (FACS)

FACS process design and implementation achieved by April 2003.

Monitoring is undertaken by a countywide practice manager group which facilitates joint learning and problem solving.

Care Management Review (new objective)

Assessments of need for both service users and carers, are timely, holistic, skilled and sensitive, focusing on maintaining the service user's independence, choice and control.

  • Review and refine FACS process in the light of monitoring outcomes.
  • FACS training to be included in learning, development and induction of commissioning staff.
  • Further quantitative monitoring to be undertaken via CareFirst.

Options for the future development of assessment and care management services to people with physical and sensory impairment to be appraised within the Best Value Review process.

5. Housing

To enable people with a physical and/or sensory disability to remain living in their own home and to have greater choice over where they live.
  • Develop joint agency strategy for extra care housing
  • Increase the availability of adapted and extra care housing schemes and associated support services across the county.
  • Develop and implement countywide specification for Home Improvement Agencies.

Adaptations

Draft adaptations information packs awaiting joint agency agreement prior to publication.

Pilot of integrated adaptations service under evaluation.

  • Complete publication of adaptations pack.
  • Complete evaluation of service pilot and agree a model for consistent implementation countywide.

Community Equipment

Integrate the community equipment services of the NHS and Social Services to produce a single integrated equipment service.

  • Partial integration (2 PCT's) achieved by 1.4.03;
  • Improvements in IT support and equipment washing achieved through grant funding;
  • Equipment catalogue produced and issued;
  • Integration of Independent Living Centre into Joint Equipment Store.

  • Complete integration with all PCT's by April 2004.
  • Meet 7-day delivery timescale by December 2004.
  • Ensure equipment provision delays do not cause delayed hospital discharges

Supporting People Programme

Ensure the accommodation needs of people with a physical and/or sensory disability are addressed in the Supporting People programme.

Significant progress made with 74 people receiving grant funding to the value of over £300,000 under this programme. Services being provided by Social Services specialist provider teams, and represents 'new business'.

Respond to quality assurance framework via quality review and self-assessment tools to ensure accreditation of in-house provider and ongoing contracts.

Options appraisal as part of Best Value Review to determine strategy for future development of Supporting People programme.

6. Carers

Carer support services, including short-term breaks have been provided within generic carers' services. The Strategic and Best Value review will inform the action plan to improve support to carers of people with a physical and/or sensory impairment, including improved equity of access to respite care services.

7. Employment

Enabling more people with physical and sensory disabilities to participate in a wide range of employment opportunities

Welfare to Work

The development of the Welfare to Work Joint Investment Plan (JIP) has not yet been completed.

Through its Industrial Services Group, Devon Social Services leads in partnership with Torbay and Plymouth Social Services for the provision of pre-employment training and employment support for people with disabilities. 275 people with disabilities living in Devon are supported in employment under the Workstep scheme. 100 plus people per year with disabilities have received pre-employment training and assistance by seeking employment through a variety of schemes funded by Jobcentre Plus, ESF and the Learning and Skills Council.

We provide an Employer Helpdesk supported by a website to advise employers on disability issues.  We provide disability awareness training, carry out access audits and assist employers with the employment of people with disabilities and with their retention in employment.

Agreement has been reached for this initiative to be led corporately by the Chief Executives Directorate of Devon County Council. Social Services will retain strong involvement in the development and implementation of the programme.

The imperative to promote and complete this work is reflected in the Best Value Review report.

8. Workforce Strategy (This is a new objective)

Service development strategy arising from the Best Value Review will be underpinned by a workforce development strategy.

2. Medium Term Strategy to 2008

  • Develop and co-ordinate integrated planning and delivery of services, including jointly agreed care pathways between Health and Social Services.
  • Establish an ongoing process of consultation with service users, ensuring empowerment, choice, consent and dialogue which includes minority groups.
  • Address inadequacy and inequitable availability of specialist housing and care services through increased investment and better distribution.
  • Improve information services, ensuring service users and carers can access information, in an appropriate variety of formats, which is empowering, comprehensive and maximises independence.
  • Review how care management services are delivered, to ensure equitable availability of skilled specialist assessment, care management and commissioning of services.
  • Tackle issues of fee levels, workforce recruitment, retention and training, to ensure adequate numbers of appropriately skilled workers in both provider and care management services.

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