Some councils are “wasting” resources on undertaking social work assessments in cases where people’s problems could be resolved at the first point of contact, a report has warned.
The number of people who received a full assessment but did not receive care services afterwards could be reduced if an effective front door service were in place to signpost them to alternative help in the community, said the Institute for Public Care (IPC) report.
It pointed to evidence from the Local Government Association’s Adult Social Care Efficiency programme, which identified examples of councils’ diverting people away from social care by having front door services with a “strong focus” on resolving people’s problems.
The number of people whose issues were resolved at the front door in these councils equated to approximately 75% of those who had made contact with the council for help from adult social care, the programme found.
‘Follow up conversations’
The IPC report recommended that councils develop effective front door services as one of six steps for managing future demand for formal social care services. The focus of these services should be to “listen and talk with customers to identify solutions that are available locally”.
Councils should also have a follow up conversation with a sample of the people they have helped to ensure the solutions offered have helped people to find resolution to their problems,” the report said.
The report also set out a series of indicators for measuring performance. For managing demand through the front door, it said councils should consider the percentage of people who go on to receive a full social care assessment – which should be approximately 25% of new enquiries – and the percentage of people who receive a care package after that assessment – which should be about 90%.
Another of the six steps set out in the report was to develop a workforce that was fully trained and supported to work with people needing social care. It said one of the “biggest losses” from budget cuts was the training and development of staff, which had left workers deskilled.
It recommended that councils and providers should regularly consider whether staff have the skills and expertise needed to maximise independence, support people to regain confidence and to reduce the need for longer-term care services, where this is appropriate.
“Staff will need to learn how their care can lead people to greater dependency and how they can manage risk to assist people to move towards greater independence,” the report said.
The report was co-written by consultant John Bolton, formerly director of social care finance at the Department of Health.
His co-author, IPC assistant director Philip Provenzano, said an “asset-based” approach, where the focus is on people’s strengths, not on what they can’t do, was key.
He said: “The report emphasises the importance of person-centred, outcome focused approaches, knowing that this is about an individual’s strengths, their local community and how the most effective services and support can be designed around them.
“Practitioners come out of university full of this knowledge and good practice, but often their local systems, processes and in some instances, capacity, have distracted them from it.
“We need to continue to engage service users, social workers, service providers and commissioners to better understand what’s important to the service user and how the design of services, the assessment, support planning and reviewing processes all work together to make sure we’re all talking about delivering good outcomes.”
The other four steps to manage demand included in the report are:
- Managing demand from acute hospitals.
- Effective short-term interventions for people in the community.
- Designing the care system for people with long-term needs.
- Governance and management arrangements to sustain improvements.