How we run our services

We are committed to having a structured and fair system of social care, which makes the best use of limited resources to offer residents access to high quality services to meet their care or support needs in a personalised way.

Some of the key principles in achieving this are:

• Encouraging people to be as independent as possible, drawing on their personal, family and community resources

• Ensure value for money for all services, while maintaining service quality and a focus on achieving defined outcomes for the service user;

• Ensuring fairness and equity across the range of needs or conditions;

• Work in partnership with the NHS to ensure co-ordinated health and social care services which are person centred;

• Develop a range of services aimed at reducing or preventing the need for longer-term care and support.

Our priorities are:

• Ensure everyone with ongoing use of social care services has a personal budgets and promote the use of direct payments to maximise the choice and control people have over managing their own care and support;

• Consider the wider networks of support or universal services which people access and optimise the use of these within the more formal support packages of care, e.g. the use of community groups, library services, adult education.

• Continue to develop a range of housing options together with partners which offer care and support in the community and reduce the need for long-term residential care;

• Make effective use of technological solutions, including Telecare, to maintain safe independent living, and assist with the care-giving process

• Support younger adults into work or employment;

• Develop commissioning plans based on robust analysis of local need and understanding of our provider markets

• Apply a means tested approach, implementing eligibility and charging policies which reflect Central Government guidance.

Services in the community

We know that people want to remain in their own homes and neighbourhoods if they develop health or social care needs. We will endeavour to support people in these settings and, wherever safe or feasible, will seek to avoid admissions to hospital or residential care settings.

We will ensure that assessments consider a range of things which impact on health and wellbeing including health, housing and other support, alongside social care.

Resources spent wisely

We are acutely aware of the need to balance meeting the growing need for services, with reduced resources available to the Council and its partners. We need to ensure resources are spent in a fair way, which gives value for money to the public, who fund these essential services.

This means that we normally will

• not pay more for a community package of care than we would pay for a residential or nursing package of care
• undertake a continuing healthcare check if we think someone might be eligible for free NHS care
• include all ongoing care services in someone’s financial assessment
• not admit someone to residential care from a hospital bed
• not allow a care service put in place to resolve a crisis to continue as a normal service without careful review
• consider a range of housing options in seeking the most appropriate and affordable for each individual

Wherever possible, we will put short-term services in place that will aid recovery or recuperation and a return to independence, before considering long-term care or support.

We will encourage creativity and innovation to meet identified outcomes, and encourage everyone involved to look for solutions that offer the best quality and value for money.

Assessments will ensure that the right level of support is identified according to a person’s needs and choices. We recognise the value of wider support networks that many people have within their own families and communities and will look at all available resources when considering how to meet needs.

Where family or other support networks do not exist, we will help people to build them through appropriate community networks.

Supporting and valuing carers

We recognise that most care and support is provided by family or friends.

Carers will be supported to recognise their own needs and access appropriate support to help ensure a longer and more manageable caring role for their family or support network. Carers will have the right to an assessment of their needs, separate to those of the cared for person, and regardless of eligibility for formal social care input.

Managing risks

Our aim is to balance risk management alongside delivery of services that promote independence and empower people to take control of their health and social care needs.

We will ensure that we talk openly about possible risks in relation to decisions that service users may make, and that there is an understanding of these risks.

Ultimately, decisions will be made by the service user and this may mean that some people make decisions we would not have made.

We will never take responsibility away from someone unless we have a court order which determines that the person does not have capacity to manage their own affairs.

Focusing on prevention

People are living longer with more complex health conditions, so there will be increasing need to spend the resources available to social care services, in a fair and equitable way.

We will focus resources across the system to reduce the overall need for services later in life. This preventative activity be undertaken jointly with partners in health services and through early intervention, helping people to live their lives in a healthier way, reducing the need for intensive social care services later in life.

Inevitably though, there will always be those who suffer illness or accidents which cannot be avoided. However, we will always look for ways to support people to delay further onset of needs and make the most of the assets they have.

Integration of social care and health

Looking ahead to 2018, the NHS and Lewisham Council will continue to work together to transform health and social care in the borough for all adults.

Our ambition is to make joined up and co-ordinated health and social care the norm by 2018 achieving our vision of: ‘Better health, better care and stronger communities’.

This means where possible, and with increasing regularity, we will have shared health and social care assessments and a single plan that will help people retain independence in the community.

In Lewisham, we aim to ensure that there is an early or targeted intervention to reduce the necessity for more invasive long-term care. This will be particularly relevant to people at risk of hospital admission.

Social care providers

We will work with social care and support providers, including in-house services, to ensure service focus on outcomes and meeting needs in a way which maximises independence.

We will develop and commission community-based services which meet needs flexibly and address issues relating to social isolation. We will always ensure that services deliver value for money and will develop appropriate performance measures, focussed on outcomes.

With personal budgets for all in place from April 2015 onwards, and direct payments used where possible, we will shape the provider market to ensure that providers offer their service users choice and flexibility.

We will encourage providers to offer creative, innovative services, focussed on meeting needs with the least amount of formal care and support, while delivering identified outcomes, whether this is a user-led organisation, social enterprise or private business.

A valued workforce

All staff working directly for the London Borough of Lewisham and those within provider agencies will understand our vision and commitment to maximise independence and quality of life.

We will work with staff and partners to develop methods of sharing good practice, ensuring seamless, joined up services which empower service users and challenge staff and providers to meet needs in increasingly person-centred and creative ways.

Measuring success

We will know we are successful in delivering the commitments we have detailed in this statement, through the following measures:

• A reduction in the number of people we are directly supporting through formal social care services and an increase in the numbers of people being helped in their communities;

• An increase in the number of people living in their own homes for longer,

• An increased number of people recovering from an episode of poor health or illness through the use of intensive ‘enablement’ or recovery programmes;

• An increase in independence, with people taking increasing control of managing their own health and care needs, through the use of direct payments​

Local Account

In 2011, the Department of Health recommended that all local authorities publish an annual Local Account to tell people what their adult social care department is doing.

The Local Account explains how much we spend, what we spend money on, what we are doing and how we plan to improve services in the future.

The Local Account gives people an opportunity to read about the our achievements through the year and priorities going forward. It supports a regular cycle of self-assessment, consultation and review to enable us to deliver high quality services to residents who have care or support needs.

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