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Transformation

Adult social care plays a vital role improving people’s lives by helping them to remain independent at home and in their community. As we continue to support people to live well within their communities, we recognise we need to do more to ensure we can effectively meet the rising demand for adult social care support and provide sustainable, high-quality support across Torbay.

During the past year, we have undertaken a significant amount of work to improve the service to enhance the support we provide to people. We have continued to remain focused on promoting independence, managing demand effectively, and ensuring we meet our legal duties under the Care Act through preventative and person-centred approaches.

The two key areas of improvement this year have been our reablement pilot and the improvement work happening to improve how people access information and guidance before needing to approach adult social care for support; both of these initiatives have delivered positive outcomes for people and our wider health and care system.

Reablement pilot: Promoting independence

Recognising the importance of supporting people to regain and maintain their independence our delivery partners, Channel 3, helped to launch a reablement pilot in 2024. The aim was to improve people’s independence via a community pathway or on a waiting list to enable them to regain skills and confidence with everyday activities.

Key achievements of the reablement pilot include:

  • Increased independence levels for people, with 79% of people achieving full independence following their reablement intervention and not requiring a package of care.
  • A proportion of people ended up with a reduced package of care because they had developed the skills for daily activities.
  • A reduction in commissioned statutory support packages, as people are better equipped to manage their own health and wellbeing at home.
  • Positive feedback from people who use our services and families, who report improved quality of life and greater confidence in self-care.
  • Cost efficiencies within the care system, as more people successfully move to lower levels of support.

Building on this success, we will be integrating reablement principles further across our services to ensure more people benefit from strengths-based approaches that promote self-sufficiency. We will use the learning from this pilot to inform future commissioning.

Accessing adult social care services: managing demand and promoting diversion

To enhance how people access adult social care support, we have undertaken a front door service improvement activity aimed at improving demand management by promoting diversion to more appropriate services. This work aligns with our Care Act duties, focusing on early intervention, diversion, and appropriate signposting to community-based support.

Key improvements include:

  • Strengthened partnerships with community organisations and voluntary sector services, providing alternative support options that prevent escalation of need.
  • Enhanced workforce training to embed strengths-based conversations, focusing on what people can do rather than what they cannot.
  • Implementation of an enhanced telephony system.

As a result of these improvements, we have seen:

  • A reduction in formal care assessments, with more people accessing community-based solutions.
  • Greater awareness among residents of preventative support options, helping to build resilience and reduce long-term dependency on statutory services.
  • Improved oversight of call quality and demand data which has supported improved decision making, operational planning and management.

Panels

To improve decision-making, one initiative considered practice and process around panels to improve their effectiveness. Key improvements include:

  • Streamlined processes which have led to enhanced oversight and accountability.
  • More effective decision making because of changes to meeting preparation including a standardised format and chair.
  • Technology-Enabled Care (TEC) and intermediate care are now consistently represented in all meetings.
  • Commissioning representatives attending the complex care panel.
  • Arranging Support Team (AST) validates care package costs and processes care home placements.
  • All of which is contributing to improved grip on cost control.

Brokerage

Our aim was to standardise practices for sourcing care via the AST team to improve market management, process for practitioners and grip on spend. Key improvements include:

  • A refreshed process and referral form implemented across teams.
  • Fee rates negotiated consistently with agreed market rates.
  • Reduced errors with contract set up saving operational teams’ time.
  • Improved data capture.

Hospital discharge

People who no longer need acute care recover better at home, in their own bed, surrounded by their loved ones. We have been working hard to improve how we support people to return home from hospital, with a care package if needed, for lunchtime or by 5pm.

We spent time with teams to understand the reasons why some people were delayed being discharged from hospital, the impacts on outcomes, demand and costs of people discharged through pathway 2. Pathway 2 is a model designed to integrate health and social care services for people with complex needs. By offering a coordinated, person-centered approach, Pathway 2 has significantly improved health outcomes and quality of life for many residents. This has been evidenced where individuals previously at risk of hospital admission were able to receive tailored care in their homes, leading to a reduction in unplanned hospital stays and increased satisfaction people and their carers. A multi-disciplinary team (MDT) approach was used to review individuals and understand through a social work lens if people could have achieved a better outcome. Recommendations are being reviewed but immediate actions were taken to:

  • Improve Technology Enabled Care practice by organising training for the team.
  • Reinforce Home First principles.
  • Address improvements linked to mental capacity assessments
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