Last Updated 02/03/2021 11:04am
|Owner||Tim Golby, Head of Adult Commissioning and Health|
|Author(s)||Adult Commissiong and Health Policy Team|
|Contact(s)||Paul Grimesy, Policy Manager
James Martin, Senior Policy
|Date of approval and commencement||14 July 2017|
|Last review date||23 July 2020|
|Last reviewer||Paul Grimesy|
|Next review date||Quarter 2 2021/22|
Promoting independence and prevention are emphasised as duties for local authorities in legislation relating to its adult social care, children’s services and public health functions including in the Care Act 2014.
Local authorities and their partners including NHS bodies in their area are required to co-operate in fulfilling these duties.
This Promoting Independence Policy is based on the needs of our population as set out in Devon’s Joint Strategic Needs Assessment JSNA and its aims are aligned with and underpin major strategic plans including the Wider Devon Sustainability and Transformation Plan.
This policy recognises that:
- losing independence is one of people’s greatest fears
- people consistently tell us that they wish to remain as independent, or gain as much independence, as possible for as long as possible
- evidence tells us that the support we provide can often make someone more dependent on care, rather than aiding recovery and allowing them to overcome problems for themselves
- supporting people to be independent for longer enables us to better manage demand for our services, ensuring our limited resources are focused on those with greatest need
Defining promoting independence
‘Promoting independence’ means enabling as many residents as possible learn how to stay healthy and active in their communities for as long as possible with the minimal necessary reliance on publicly funded health and care services.
There are four key aspects to promoting independence:
- Personal strengths and preferences
We will focus on people’s strengths and the things that matter to them, encouraging them to draw on their own resources to build resilience and achieve their desired outcomes.
We will support people to maintain and develop rewarding social and family relationships.
- Community links
We will enable people to make connections with other people, groups and universal services in their communities.
- Supportive communities
We will work with partners to develop communities and community groups, and encourage them to make the most of their ability to support people.
The diagram below outlines the approach that Devon County Council is taking to promoting independence.
In this diagram outlining the approach to promoting independence in Devon an inverted pyramid is used to represent the population of Devon.
The widest section at the top of the triangle represents people who are well and have no support needs. The tip of the triangle (at the bottom of the chart) represents people who need long term support.
For those with no care needs the approach to help people maintain their independence is by working with communities to provide a universal offer, including:
- Development of framework approach
- Public Health programmes
- Measures and evaluation
- Community resources and connectivity
- Wellbeing assessment and early help provision
The largest section of the triangle represents people who are on the edge of care. A place-based approach will be used to support these people to maintain their independence, including:
- Self care
- Targeted prevention
- Connector role
- Voluntary sector
- Primary care and community teams
- Single disciplinary response
- Risk stratification/predictive tools
As people’s support needs increase joint ‘short-term intervention’ may be required, based on threshold and eligibility, including:
- Facilitated discharge
- Rapid response
- Intermediate care
- Social care reablement
- Multi-disciplinary teams
- Stabilisation from crisis
For people needing long term support this may include:
- Progression model
- Long term and/or complex care needs
- Multi-disciplinary teams
The new policy does not change any existing duties or policies but provides a statement of our increased emphasis on working with people, communities and partners in promoting independence in Devon.
We will continue to comply with our statutory duties under the Care Act 2014 to meet the eligible care needs of the most vulnerable adults where these cannot be met by other means.
The Care Act, along with legislation pertaining to children’s services and public health, also requires councils to aim to prevent, reduce or delay the onset of health and care needs and to promote independence.
This Policy expresses how we will comply with these requirements to promote independence by enabling people to use universal services and sources of community and social support wherever possible and by developing models of care that best enable rehabilitation, reablement and recovery.
In doing so, we will endeavor to:
- work with people to enable them to use community and social support, universal service, technology and other resources to meet their needs and promote their wellbeing
- work with communities and service providers to develop their ability to support individuals efficiently and in a way that promotes their independence.
- design services to enable better outcomes for people while ensuring their financial and clinical sustainability by managing demand
Preparing children and young people for independence in adulthood
All children should have a good start in life with skills learnt and resilience developed to prepare them for a healthy and productive adulthood and to live well as they age. We will intervene early when this is not the case.
Our role is to support children to develop and sustain their social and leisure networks, whenever possible from within their home environment.
Children will be supported to learn how to self-manage their own mental or physical health in preparation for transition into adulthood where they can be further supported to maintain their independence.
Resilient and independent people and communities
Our role is to guide people and their carers to maximise their opportunities for independence so that they feel a sense of purpose and can do the things that matter to them, whatever their circumstances.
We recognise the importance of a person’s own home, community, social relationships and networks and how these can shape a person’s identity and contribute to their independence.
These areas of strength will be how and where the majority of people’s needs are met in the first instance, without the need for formal care and support. We will focus on people’s social networks as the reason and reward for improved independence.
We will continue to aim to enable people to access their community and sources of support. This will be achieved through facilitating travel, access and communication so people can maintain social relationships and networks.
We encourage a strengths-based approach to self-care and support people to gain, or retain, their independence for as long as possible by building on their own abilities, support from family and friends, and their wider community including the voluntary sector.
Where appropriate we will work with our partners to provide support to people so they can gain and remain in employment and live in housing that enables maximum independence.
Information and communication
Quality advice and information is an empowering and important way of promoting independence. Devon County Council and other public services in Devon have a key role to play to ensuring people have access to information that will enable them to make healthy lifestyle choices.
We will provide information to help people plan for when their health and care needs may increase, and to manage new health and care needs as they arise. Information and advice may be accessed from a range of other sources, without the need to contact individual council or health services directly.
Our role is to help enable people to access advice and information without the need to contact us in the first instance.
However, when they do we will make good quality information and advice accessible that supports everyone to make healthy and positive lifestyle choices.
This will enable independence into old age; this includes access to advice on planning for later life when needs may develop or increase.
We share the responsibility to make the right choices
We will aim to support and inspire individuals, families and communities to be resilient and independent by making the healthy and positive lifestyle choices the easiest choices.
Our role is to connect people to the best solutions that can help to delay or meet their needs. We fully embrace assistive and digital technology and online solutions where appropriate and encourage their use.
We will work jointly and collaboratively across our public sector partners to promote independence.
We support people to make good decisions on key aspects of their life such as employment and housing so that the right conditions and environments are created to enable people with mental and physical health needs to learn and re-learn the skills necessary to remain in the community.
Early intervention and support when in crisis
When people are in need and in crisis, our role is to intervene early and provide support that builds on their existing strengths to maximise their independence.
Any support will focus on maximising opportunities for recovery and recuperation that supports a return to independence.
This will initially be through short term interventions, adaptations, equipment and technology that help to prevent or delay the person’s need for longer-term support.
Reducing dependency and increasing cost effectiveness
People will receive the right support at the right time and in the right place so they can make progress in managing their disability or illness and lead lives with less dependency on public funded services.
We will seek out cost-effective solutions for people that will provide support in the most appropriate and efficient way. We need to be aware that funds are limited and so we must try to gain the most from the money that is available to us and ensure that it is spent wisely.
Strategic and operational planning and guidance
Our strategies, plans and operational guidance will support the principles of promoting independence set out in this policy wherever possible.
Examples of promoting independence in practice
- Providing timely and quality information, advice enabling people to understand and make the right lifestyle choice
- Supporting prevention and wellbeing so people live longer and with more years free from disease and the need for public-funded support
- Maximising opportunities for recovery and recuperation through short term interventions
- Avoiding making life-changing decisions about long term care when people are in crisis
- Working with people’s strengths and assets and those of their community
- Collaborating in partnership to deliver better personalised outcomes
- Enabling opportunities for social relationships
- The stories people tell reveals how other people shape their identity. Positive stories are made possible by positive relationships and supportive networks to which people belong
- People may need targeted support to develop informal support
- Recognising and promoting the potential for technology to facilitate social engagement and social networks for people with disabilities as well as being a source of practical help to support risk management and enhance confidence
- Both are key in enabling social identity and independence
- Recognising and respecting the multiple identities of each person. Encourage people to see themselves, for example, as a young woman, a music lover who likes to sing, someone makes fashion choices that reflect their identity, their ideas and ideals, someone who likes the beach or countryside, not just a person who may have care and support needs
- Recognising that fundamental human needs are not just physical and include (all the following):
- positive relationships
- a sense of belonging
- individual autonomy
- active involvement in decision-making
- active engagement in community
- using one’s unique strengths in ways that provide a challenge
- making a contribution
- Encouraging people to try new things in a safe way that supports and rewards their efforts
- Recognising that too much paid support may inhibit the development of freely given relationships with ordinary people
- Providing confidence that the necessary support will be available in response to changes circumstances when needed