The need for care and support is minimised and the escalation of need is prevented, whilst ensuring that the best possible outcomes for people are achieved
How we purchase and deliver services for older people
In last year’s report we informed you of the Older People’s Transformation Project, to improve the delivery of domiciliary care services in Conwy. The purpose of this is to:
- Ensure that individuals receive a modernised, flexible, person-centred service.
- Align service delivery with changes in Social Care legislation and regulation
- Adapt to the recruitment and retention challenges encountered by the domiciliary care market.
- Ensure that professional services are working together in a consistent manner and joined up approach
- To future-proof the service for predicted increased demand
Since the last update, a number of consultation activities have taken place to inform what changes need to be made. These have included the following:
- We’ve looked at lessons from the models that other authorities have put in place, and learned how important it is to ensure that a gradual approach is taken when making change.
- We‘ve undertaken a pilot of working in an outcome-focused way with 50 individuals who receive domiciliary care.
- We learned that Conwy’s business processes didn’t provide the flexibility needed for this new way of working and how important a consistent approach is.
- We’ve consulted with 450 individuals out of 700 currently receiving domiciliary care services via a survey. 95.2% of those who responded were satisfied or very satisfied with the care that they currently receive. Of those who were dissatisfied, a number of the reasons related to time and consistency, which has been incorporated in the flexibility of the new model, and in training.
- We held a ‘meet the buyer’ event for providers to explain the purpose of the changes that we’re making. We proposed three different options for feedback, and held one-to-one meetings for further consultation.
- We’ve engaged with operational staff, practitioners, Community Resource Teams and all other teams that are part of the process, such as Quality Standards and Assurance, Sundry Debtors and Financial Assessment. We’ve included their feedback in the new model, whether it’s a change to an IT system or finding a better solution to answer the types of queries that individuals phone us about most.
- We’ve also consulted with key managers at BCUHB and Members to gain their feedback on the changes we’re making.
Please see the Looking forward to 2022-23 and beyond section for more details on the project as we move into the new financial year.
Gaining feedback from people who receive our services
As part of the project to modernise how we purchase and deliver services for older people, we asked for some feedback from people who receive care and support at home, and unpaid carers who are receiving care and support. Respondents were receiving anything from 1 hour to 56 hours of direct support per week; this could be delivered by our in-house teams, or by external care agencies commissioned by us. Overall, feedback was extremely positive, with 94% of respondents stating that they were satisfied with the care and support they had been receiving. People appreciate consistency in care delivery, with the same team or individuals visiting at set times, and the impact is felt when carers change or call timings and duration are not as expected.
In terms of helping people to attain personal outcomes, 95% of respondents stated that the care and support they receive does help them to achieve what matters to them.
Without carers I would be bed bound.
Respondents appreciate that the care support they receive helps them to remain in their own homes and enjoy a degree of independence which otherwise wouldn’t be possible. Informal carers are able to take time out of their caring duties with the knowledge that their loved one is in good hands.
Having the care and support allows me the freedom to unwind and relax knowing my husband is being cared for.Informal carer
We asked what people would change about the service if they could, and several themes emerged around:
- Support workers being able to spend more time on the call and not having to rush to the next client.
- More flexibility around the times and duration of calls.
- Seeing the same support workers on a consistent basis.
- The age, skills and experience of support workers in their role.
- Respite arrangements, as many informal carers would appreciate more time to themselves.
This engagement exercise has been extremely valuable and will help us to make decisions on how we deliver services in the future, as part of the wider project.
Older People Services – Staffing Challenges
Our Older People Service coordinates care and support from five Community Resource Teams located in Llanfairfechan, Llandudno, Llanrwst, Colwyn Bay and Abergele. Our assessment and domiciliary services continued to operate as normal throughout the Covid-19 pandemic, with assessments carried out virtually to ensure staff and public safety. However, the demand now placed on the service is unprecedented, and we are struggling to handle the number of cases open to us, especially where they are complex and require the intervention and oversight of a Qualified Social Worker. At the time of writing we have 320 unallocated cases, and this can partly be put down to individuals not wanting to approach us for help during the pandemic and instead attempting to manage their own needs. Many individuals have now reached crisis point and require urgent support; had the pandemic not prevented them from accessing informal support networks and family, many cases would not have escalated to such high levels of need. Our teams are therefore dealing with increasing numbers of crisis cases and navigating the obstacles of commissioning care packages.
The staffing crisis within Social Care has been well documented in the media, and Conwy is no exception. Within our Social Work teams we have been making use of locum and agency staff to absorb some of the workload demand, but due to the expense involved, this isn’t our favoured option. Our external partners are struggling to recruit and retain staff, and as a result have had to hand back care packages which they cannot deliver. These have been absorbed by our in-house teams, who are experiencing their own difficulties in recruiting staff.
We hope to be able to recruit to some targeted roles within the Social Work and Reablement teams to help combat waiting lists and support the increased demand in the community. The national We Care recruitment campaign aims to raise the profile of Social Care as a rewarding career choice, whether that be with the Local Authority or with a private provider. As well as hoping to capitalise on the national campaign, we are being proactive in our approach to recruitment and retention within Social Care, focusing on three key areas:
Conwy Social Work Traineeships
- A programme was introduced in 2009 to address social work recruitment challenges through a ‘grow your own’ approach.
- Trainees remain in their substantive post and gain their qualification via the Open University.
- For the first two years of the programme we supported two employees per year. In the third year we increased financial support for the programme to raise the number of trainees to three per year.
- In recognition of the increased recruitment difficulties, resulting in intensified pressure on existing staffing resources, we’ll be offering five social work traineeship places in 2022.
Social Work students and newly-qualified social workers
- Conwy is a tri-partner of the Bangor University MA in Social Work course, therefore twice a year we host students. Recognising the pressures on our existing pool of Practice Educators we have invested heavily in supporting experienced social workers to undertake the Practice Educators accredited award.
- Within the tri-partnership we have hosted workshops with our social workers and Bangor University to make amendments to the teaching content on the MA course. This is to ensure that social work students’ theoretical models of social work and their practice is aligned to current best practice in social work.
- Social Care Wales data evidences that a third of appointed social workers are newly qualified. As such, staff are required to complete the First Three Years in Practice Framework (Social Care Wales). Our Practice Coordinator takes a lead role in supporting both the new employee and their manager through the framework, including completion of ‘Consolidation Continued Professional Education and Learning’.
Supporting recruitment to the Social Care sector in Conwy
- We have resourced a new service, WeCareWales.Conwy to support people into employment across the care sector, with a new Community Employment Mentor post to support it.
- The service works closely with the Conwy Employment Hub to ensure that the Social Care sector benefits from Welsh Government employment programmes.
- We are collaborating with Coleg Llandrillo and Social Care employers to coordinate Health and Social Care student work placements.
We talk in detail about our workforce plans later in the report, however in short we’ll be looking to:
- Focus on staff health and wellbeing as we recover from the pandemic, including retention and sharing best practice.
- Deliver a refreshed workforce strategy that incorporates learning from the pandemic.
- Embrace new, more productive ways of working that create opportunities for staff to work flexibly.
- Explore the pressures created by workload volume across the department.
- Promote social care as a career field of choice.