Prevention and Promotion John Bolton Director of Community Services Coventry City Council

Approaches to delivery of social care Social Justice Model User Led Services Navigators of system Preventative Model Universal Services Low Level Services Social Inclusion Model Enablement Challenge to keep people away from social care Stronger Communities CE NOT DASS Social Model of Disability

Council as a Commissioner Social Worker as Navigator/ Broker What might happen in 2010 Current Policy User Led Services Person Centred Planning Direct Payments Individual Budgets Council as a Commissioner Social Worker as Navigator/ Broker Same policy approach to all service users Low level preventative services Alternative Viewpoint Council as an enabler – creating the right markets Challenging service users to reach their potential Focus on enablement not dependency Different approaches for different customer groups Focus on OUTCOMES Stronger community services

Dependency Models In what way might we have developed services in a way that encourages people to be dependent on social care?

Who needs help from whom? Those people who have long-term enduring conditions which lead them to be dependent for daily living on some form of care support Those people who have conditions, which though long-term, with the right type of enablement/ rehabilitation the amount of long-term support required can change and reduce over time. Those people who have shorter-term conditions, which with the right type of enablement/rehabilitation will need little or no care support. Those people who have minimum care needs that may be helped by sign posting to community based services.

Approaches to outcome focussed work in Coventry Older People Enablement OT Services – focus on helping older people regain confidence / strength Rehabilitation Services for Visually Impaired Intermediate Care Services – Residential/Day Care/ Community Support Teams Extra Care Housing – life style promotes independence Assistive technology Community based services can contribute Engagement of Older People through Partnership Board

“Shape” High use of extra care housing (low use of residential at a higher unit cost) High level of support to people in their own homes after enablement (some higher costs) Investment in Intermediate Care Commitment to NOT keeping people in hospital (where their care needs increase)

Putting these factors in a wider context Using models of intermediate care/ enablement to reduce dependency on long term care De Montford University Finding – 62% did not need a service after enablement programme 28% needed less service Ensuring that there are wider community services that older people can access – social and fitness.

Good News for Coventry 570 Extra Care tenancies @ £85 per week 87 fewer people in residential care (from low base – total 736 and falling) @ £397 3000 people helped to live at home but reducing with enablement and with less intensive packages TOTAL SAVING in Coventry about £1 million with positive outcomes!

Low admissions to residential care 2004/05 Comparative Performance and Coventry 2005/06 projected performance

Low admissions to residential care (2) Coventry Trend Analysis

Getting intensive home care right    2004/05 Comparative Performance and Coventry 2005/06 actual performance

Role of Social Care Staff Soc Worker/Occupational Therapists To challenge the person with care needs to raise their ambitions To help carers deal with their emotions in taking risks To offer a supportive environment in which outcomes can be achieved Care Workers To do things with the person not for them To contribute to the challenge To provide the supportive environment where risks can be taken To keep focussed on the outcome

AIM OF SOCIAL CARE To make a positive contribution to people’s lives in such a way that they are transformed from someone needing care to someone who is in control of their own destiny