Lancashire’s Directorate of Adult and Community Services (DACS) has co-ordinated a cross-directorate, multi-agency project to develop a strategic approach to preventative services for adults and older people with lower level needs.
Initially the project involved undertaking an analysis of the lower level needs of the population of Lancashire and mapping relevant local services to identify gaps and duplication in services for people with lower level needs. This work was taken forward through 12 Local Strategic Partnerships (LSPs) across the county – to establish local multi-agency dialogues, based on the analysis, and to set local priorities for the development and funding of services for people with lower level needs.
The Directorate is also working towards making the database of low level services more widely available - through the council’s website, Customer Service Centre, libraries and information centres - so that citizens not eligible for a package of care can be signposted to local services better suited to meeting low level needs.
What prompted the organisation to develop this approach?
- Recent white papers including Our Health, Our Care, Our Say and Strong and Prosperous Communities encourage agencies to put greater effort into prevention and wellbeing services.
- The Directorate was encouraged to develop a prevention strategy for adult social care by the social care inspectors (then SSI) approximately two years ago. At the same time, it was becoming increasingly clear that a more strategic approach to preventative services was needed on a multi-agency basis. More details on the rationale for developing a strategic approach to prevention can be found in the Interim Report.
- Work was undertaken in order to map lower level needs and those community services available to meet these needs. Rather than provide a 'snapshot' of services, it was decided to develop a comprehensive database which could be published on the Lancashire website and which would signpost those citizens not eligible for a package of care to local services better suited to meeting low level needs.
What has the work involved?
- Work was led by the Strategic Development Manager from the Adult & Community Services Directorate. Considered by the authority as a multi-agency activity, the first stage was to seek approval of the Chief Executives of the 12 district councils and 8 PCTs as well as Lancashire’s County Management Board.
- A county-wide stakeholder event was held in October 2005 to launch the project and get people on board. Attendees included representatives from Directorates of the County Council, PCTs, district councils and the voluntary and community sector.
- Three working groups were established to carry out the work of identifying and analysing information in three areas - lower level needs of the population in Lancashire, services for people with lower level needs, views and experiences of people with lower level needs and other stakeholders. An example of the analysis for one locality is Burnley Lower Level Needs and Services.
- Information about each locality was then pulled together and published on the council’s web site to provide a picture of low level needs and services in each of Lancashire's 12 districts. This can be accessed at www.lancashire.gov.uk/social-services/lowerlevelneeds.
- Stakeholder workshops about the project were held with the 12 LSPs to secure ownership of the project at a local level and to identify the element of each LSP structure that is to be tasked with leading the local dialogue and setting local priorities.
- All 12 LSPs have agreed to take on the work to overcome gaps in services to meet low level needs. They have been encouraged to take a year on year approach to developing services. Action plans for developing lower level needs in each locality have now been approved.
- The authority is now working towards making the lower level needs database - currently called 'That little bit of extra help directory' - available through the new Customer Service Centre which has been set up between Lancashire and some of the district councils. The centre acts as a front desk for all nature of queries.
- Customer Service Officers are tasked with distinguishing between low level needs and those more complex needs requiring a package of social care. The database is used to signpost lower level referrals which are better dealt with by an alternative information and advice service.
- Due to problems with data the council is currently undertaking a data “revalidation” exercise – see below for detail of challenges faced.
- The first phase is to successfully and fully implement the database through the Customer Service Centre. The next phase will be for people to be able to access the database more widely e.g. in libraries, information centres and online, as part of the authority’s wider wellbeing programme aimed at ensuring appropriate universal services are developed in each locality to meet low level needs and promote wellbeing. The authority hopes to be able to officially launch the database during summer 2007.
How have things changed for the better?
- More accessible and comprehensive information provided to citizens, which promotes greater independence.
- The work involved in developing the database has helped identify current gaps in services to meet low level needs and contributes to a greater understanding of the wider ‘wellbeing’ agenda and involvement of more people in meeting this agenda.
- Greater understanding of the connections between the work of adult social care and district councils.
- Development of a more community-focused approach to the wellbeing agenda rather than purely health prevention and promotion.
What have been the major challenges/drawbacks?
- The challenge of identifying/pre-empting what the end user/citizen wants. People don’t express their needs in a way in which the information is currently collected and presented on the database i.e. social exclusion, social interaction or practical assistance needed. Instead, people express their needs in terms of statements such as “I’m really lonely” or “I’ve got no money”. The authority therefore needs to rethink how the information is presented on the database.
- Too much information is often provided. For example, if someone living in Chorley expresses concerns about being “lonely” the database will throw up 50 or so local and national agencies which used the term “social inclusion” to describe their work during the initial information gathering stage.
- The authority needs to find a way of filtering and reducing the information so that it is a manageable product which goes from the Customer Care Officer to the person expressing the need or concern.
- Quality assurance of all services featured on the database isn’t guaranteed. This is an issue for smaller, voluntary groups rather than larger organisations, such as Age Concern, already known by the authority.
What lessons have been learnt?
- The challenge of working across agencies – LSPs, district councils, county council.
- Data collection would have been much easier if it had been a requirement of the authority’s SLAs with some voluntary, community and faith sector organisations to collect data on the authority’s behalf.
How might this work affect commissioning in the longer-term?
- It will strengthen Lancashire’s commissioning effort for community-based, universal services and move the current focus from individual assessments and packages of care.
- By improving commissioning at the lower end and focussing on prevention and wellbeing, the customer base of people with complex needs and long term conditions may decrease and people be prevented from reaching crisis point. Local services for local people will be improved and will thus contribute to more sustainable communities.
- Information from this exercise will be able to feed directly into the development of a commissioning strategy.
Contact
For more information about this case study please contact Don Rowbottom, Strategy Development Manager, Adult & Community Services, Lancashire County Council This e-mail address is being protected from spambots. You need JavaScript enabled to view it . The low level needs analysis and the report of the consultation group can be accessed at www.lancashire.gov.uk/social-services/lowerlevelneeds.
May 2007
