Funding is limited, so we have to be confident that we run our services wisely to make sure the people of Conwy are getting value for money from Social Services. We need financial plans that are fit for purpose now, and looking ahead to the future, to meet the needs of our service users within the budget we are given. The development of various panels in Conwy has proved very useful in making sure that services are cost effective.
Vulnerable Adults panel
The Vulnerable adults panel was set up as part of a discreet, non-conventional service as a response to support vulnerable people who had previously ‘fallen through the net’ as not meeting statutory criteria. The panel meets on a monthly basis and receives referrals for those people age 16+ who may not have a definitive diagnosis and do not readily meet the criteria for traditional services. The panel is attended by the VA Social worker and representatives from Mental Health, Substance misuse, LD, HOST, etc and also links closely with MAPPA. Cases are discussed and allocated on the basis on need. Those people allocated to the VA Social worker receive 6 week intervention to enable them to cope with immediate presenting issue and develop strategies and access networks to assist them to deal with issues that may arise in the future.
The panel has grown in popularity and attendance continues to increase. A Terms of Reference has been agreed for the Panel and it has been seen as an area of good practice, with various agencies requesting that they send their students along to observe. As part of the transformation programme, this area of need has been fully recognised and will become a fully established, mainstream service, with a full staff compliment. The service area will work closely with the Community Wellbeing service and supports the preventative agenda.
What difference has it made?
Vulnerable people have been assisted at an earlier stage, preventing them reaching crisis and becoming dependant on statutory services. Intervention is short and focuses on assisting people to build resilience and to better manage their daily lives and circumstances. The panel often brings to the fore the fact that individuals are known to other services e.g. Substance Misuse, Mental Health etc. and can be referred back to these services with some joint working. This prevents duplication and assists more seamless transitions. The panel also ensures that work is completed by all agencies as cases are reviewed monthly and do not get taken off the agenda until they are closed.
Learning Disabilities Panel for funding applications
Historically, Learning Disabilities funding applications were considered by an Operational Manager or Principal Practitioner, in isolation from other members of the team. An opportunity was identified to improve the way we consider applications, by including a panel of key people. This would provide a more robust, transparent and consistent approach to the consideration of funding applications, and help to ensure that our resources are used flexibly to meet identified needs.
The panel has been established and is regularly attended by the in-house community support manager, the health manager, team manager, practitioners and the senior finance officer.
Practitioners ensure there is a clear rationale in terms of an individual’s ‘progression’ in their application. A record of the panel deliberations is kept, including the risks associated with not approving the funding applications. Decisions regarding funding are communicated from the panel not the practitioner.
Where funding is not approved the panel makes recommendations as to ‘what next’.
What difference has it made?
- We are better able to predict spending at the end of each quarter, which clearly affects the stability of financial planning.
- The panel provide quality reports on things like whether assessments were recorded on the client system (PARIS), and whether reviews were carried out in timescales. This has led to a more robust management of these kinds of performance issues.
- Team managers have a greater sense of the range of requests, and are now in a better position to shape services for the future.
- Practitioners report that although initially challenging, the panel is now seen as supportive and professionally challenging in a positive way.
- Service users are aware that there is a robust process in place for considering their funding applications
The panel has provided opportunities to do things differently. For example an application was made for additional support to assist a service user to find voluntary work. The service user had previously accessed the New Work Connections project and had completed all levels of the John Muir conservation award. He was described by those supporting him at the time as somebody who was actually assisting other service users to achieve their goals, towards the end of the project. As the service was continuing with the John Muir award, the Team Manager offered a volunteer placement to mentor other service users.
Substance Misuse Action Team (SMAT) Panel
The Substance Misuse Rehab Placements Panel was set up several years ago to consider and approve funding applications from SMAT Grants for adult service users. The Panel meets monthly and receives referrals for adults who are ready to make the commitment to enter into a recommended Treatment Programme or Residential Placement. The panel seeks to fund placements within the region, where appropriate. If an individual has complex issues, the Social Worker, Key Worker and BCUHB colleagues seek to commission appropriate placements from a range of experienced service provision out of county or outside Wales.
The Panel is made up of SSD Service Manager, BCUHB Team Manager, Social Workers, Key Workers, Conwy SMAT Lead Officer, SSD administration support and there are formal records kept of decisions made, cases discussed, and progress reports made about individuals already in treatment.
Conwy has in place an agreed Terms of Reference for the SMAT panel.
New Terms of Reference will be required to reflect how the new Regional Substance Misuse Team Structure, the host authority (Wrexham) governance arrangements for future funding, and existing local good practice arrangements are supported in the future. Unless directed otherwise, Conwy (local panel) arrangements will continue during the next phase of regional working, and will be reviewed with key stakeholders, once the staffing matters for existing officers and new appointments are finalised.
What difference has it made?
People who have serious health and wellbeing issues and chaotic lives have been supported through the panel funding applications to engage with services that can provide a comprehensive range of detox / abstinence programmes and daily living skills and mentoring.
Some individuals manage to complete several weeks / months in residential placements and go on to other supportive programmes on their journey to recover from Substance Misuse problems. Other individuals discharge themselves early from a placement at various stages of the plan. When this happens, commissioners of these services negotiate where possible with the service provider to re provide the service for another appropriately assessed individual.
The Tier 4 services in Wales are of an exceptionally high quality and create an environment in which to give individuals every chance of a successful and sustainable recovery from substance misuse. Area Planning Boards are encouraged to support and sustain the availability of high quality service provision in Wales which are compliant with the National Core Standards for Substance Misuse Services in Wales.
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