Agenda item

To receive a report from the Director of Adults and Health which sets out the work undertaken to improve the take up of direct payments in the context of person-centred and strength-based care and support.

The Director of Adults and Health submitted a report setting out the work undertaken to improve the take up of direct payments in the context of person centred and strength-based care and support.

The following were in attendance:

·  Councillor Fiona Venner, Executive Member for Equality, Health and Wellbeing

·  Councillor Salma Arif, Executive Member for Adult Social Care, Active Lifestyles and Culture

·  Councillor Adrian McCluskey, Support Executive Member

·  Caroline Baria, Director of Adults and Health

·  Victoria Eaton, Director of Public Health

·  Shona McFarlane, Deputy Director Social Work and Social Care Service

·  Carmel Langstaff, Chief Officer Transformation and Innovation, Adults and Health

The Executive Member for Adult Social Care, Active Lifestyles and Culture gave a brief introduction and then handed over to the Deputy Director Social Work and Social Care Service to highlight key aspects of the report, which was presented in the form of a PowerPoint presentation.  In summary, the following points were made:

Ø  In Leeds, the proportion of people who use services who receive direct payments was 14.9% (938 people) in 22/23. This result means Leeds is ranked 12th (out of 15) in the region, 13th (out of 16) of peer LAs and 111 nationally.

Ø  Unlike some other local authorities, Leeds continues to provide people who draw on care and support with the choice for the local authority to arrange care in all circumstances, known as ‘managed budgets’. Many local authorities offer direct payments as the primary option and their social work staff are expected to prioritise the offer of direct payments over managed budgets.

Ø  The Care Act 2014 allowed local authorities to move away from a ‘care management’ approach to a strengths and asset-based approach.  There is more focus on ‘what’s strong, not what’s wrong’, so it builds on people’s own strengths and community assets.

Ø  A key area of success is with people with learning disabilities, where there are a number of people in receipt of a significant package of care which is delivered entirely through a direct payment, often managed by their families to work around the person and their family. There is also a positive level of take up of direct payments for part of a care package where the direct payment is used to meet need such as for community support – access to support in the community, short breaks for families. It is in this context that the Council is working to identify an appropriate target for take up of direct payments in Leeds. Achieving 255 new direct payments over the year (22 per month) would increase performance to 16.6%.

Ø  The Board was briefed on the wide range of improvement activity measures already undertaken over the past year.  This included the development of a Direct Payments Dashboard to monitor performance on a monthly basis.  An example of the Dashboard was shared as part of the presentation.

Ø  Current plans to improve take up of direct payments involve the development of a Direct Payments Team; improving the direct payments process; raising awareness of direct payments; undertaking targeted engagement across different groups; and developing more Personal Assistants.

During the Board’s discussions, the following issues were also raised:

Ø  Aiming to achieve a balance of choice and control – It was reported that in many local authorities, in a high number of instances, direct payments are offered to people who are then signposted to care providers such as home care agencies to arrange their care and support package themselves, directly with the providers.  The approach in Leeds is different as the direct payments offer is usually based on people who draw on services employing their own Personal Assistant/s.  This way, the Council can ensure that people have meaningful choice and maximum flexibility in the way the care and support is provided to them. Increasing take-up of direct payments in Leeds will therefore further enable choice and control for people who draw on care and support.

Ø  Improving awareness of direct payments and the benefits they offer – Targeted work will be undertaken across different groups of people who draw on care and support, as well as improved promotion, communication and guidance for professionals.  Social workers are also tasked to discuss direct payments during each new assessment, or at reviews.

Ø  Improving the direct payments process - It was acknowledged that setting up a direct payment can be a lengthy, complex process both from the perspective of the person needing the care and support and for the social work staff.  This can therefore deter people from choosing a direct payment as their preferred option. To address this, the aim of the new Direct Payments Team will be to provide dedicated support to people who want to set up a direct payment. This will support people during the set-up phase and provide a confident and positive support offer to people going through the process.

In conclusion, the Chair relayed the Board’s general support in relation to the Council’s approach and planned improvement activity surrounding direct payments and that it will also continue to monitor progress.

RESOLVED –

(a)  That the contents of the report be noted.

(b)  That the Scrutiny Board supports the Council’s approach and planned improvement activity surrounding direct payments and will continue to monitor progress.