Adult Care and Community Wellbeing Executive Update

Substance misuse recommissioning

Executive DLT supported a proposal for the recommissioning of the Substance Misuse Treatment, Recovery and Family Support Services. All current contracts for the Public Health Substance Misuse Services expire on 31 March 2024. A recommissioning exercise is underway and the proposed new model is due to be considered by the Executive on 4 July 2023.

Lincolnshire County Council currently commissions treatment and recovery services through contractual arrangements with We Are With You (With You). The contract delivers drug and alcohol services (including evidence based clinical and psychosocial therapies) to adults and young people, reaching 3,244 service users in 2021/22.

The new proposal will be an integrated treatment and recovery model that includes all age drug and alcohol treatment (psychosocial/clinical services and needle syringe programme), Stay Safe prevention (awareness raising/targeted work including children and young people) and a recovery service. There will be a separate specialist all-age family support service with links to treatment and recovery.

The Integrated Treatment and Recovery Service will provide a stronger focus on recovery throughout the pathway. No transitional arrangements will be required for service users moving from treatment to recovery, creating a simple pathway for services that should make it easier for people to know how to access support and increase the numbers benefitting from services. It should also provide economies of scale through governance and organisational infrastructure such as IT and premises. The provider will be able to flex funding across the model to meet local needs and strategic priorities.

There will be a clear identity for the Family Support Service which will improve awareness of the support available and how to access it. Families are more likely to access a service that is not attached to treatment and recovery. This option will procure a specialist family support service that will provide quality interventions and achieve the outcomes required for this service.

Funding will be protected at the 2021/22 level of nearly £5.5m but the new contract will allow for the budget and scope of the service to be scaled up and down in response to variable grant funding. National supplementary funding opportunities will be key to continuous improvement of the service.

Good Home Alliance

Executive DLT have been updated on the findings of research and co-production regarding a Good Home Alliance in Lincolnshire as the service design phase of the project is ending. Proposals regarding next steps are now being outlined to ensure that the momentum and enthusiasm for this project is maintained.

The aim is for Lincolnshire residents to live as independently as possible in a safe, warm, and suitable home, for as long as possible. Alongside this, Lincolnshire County Council (LCC) has a corporate priority objective to create a One Stop Shop for aids, equipment, and adaptations.

Through our 5-year strategic partnership, Lincolnshire and the Centre for Ageing Better (AB) agreed to explore what a Good Home Agency might look like. In Lincolnshire, this is referred to as the Lincolnshire Good Home Alliance, reflecting the need for existing services to work differently rather than creating an entirely new entity. The design stage is now complete and agencies like the district councils, need to decide which elements can now be implemented. The learning from Lincolnshire will be used as a model which could be rolled out nationally.

Eight themes have been identified which could lead a Good Home Alliance, including:

• Good quality information – available to everyone. Connect to Support could provide good quality, trusted information as the online hub for information and guidance on housing issues.

• Trusted tradespeople – available to everyone. This will link with the development of the Buy with Confidence scheme being launched by Trading Standards.
• Healthy home assessment – available to everyone. Short and long assessment to allow residents, their families or staff working with them to identify any potential hazards and risks in the home and to access help and support in resolving these.
• Support for funding sources – available to everyone. Cost could be a barrier to home repair and maintenance. Details on local and national loans, grants and other financial resources are being collated, and ways of linking residents with funding sources.
• Advice and casework – this will help residents to assess work that needs doing within their home, provide support from start to finish and act as a contact point.

Some themes will develop quickly (e.g., good quality information; healthy home assessment; trusted tradespeople); others are likely to take longer.

Discussions will continue with partners around funds for developments and how a casework pilot can be achieved. Pilots to test some aspects require further work, including scoping financial commitments required to achieve these. The Centre for Ageing Better has retained funds to provide an evaluation.

Day Services update

Executive DLT were given an update on activities and successes from John Waters, who manages Day Services. Key highlights include:

• New base for Market Rasen. Fully refurbished new site, a community project benefitting from lottery funding and an asset for the town.
• Volunteering opportunities – over 70 individual examples including Boston servicereaping regards from volunteering at local stables.
• The Quad Café, County Offices – work experience, skills independence for existing day service users, school and college leavers.
• Blackbird Flies mixed ability theatre – theatre company practice and perform at the Riverhead Theatre.
• Supported volunteering – supporting work in the community: Keith’s Animal Rescue, Salvation Army charity shop, senior citizens club, church and sheltered housing garden, maintaining nature trails.
• Enhanced opportunities – service users from Horncastle and Boston enjoyed weekend of outdoor pursuits in Lake District.
• ICE Conference – organised week-long conference at Butlins, Skegness, supporting service users, families and staff as a fun, learning event.
• Community archaeology – with The University of Evansville, supported people to take active part in an archaeological dig at Harlaxton Manor.

The number of people accessing the service are slowly increasing up to around 300. In addition to supporting its traditional user group, the service has started to offer a range of drop in opportunities and provide a venue for various community groups. Uptake of this offer has been steadily growing across the year. Drop-in figures for March include support to carers, older people with dementia, and veterans. This has been achieved by working in partnership with a range of local organisations including Age UK, Carers First, Deaf Society, Young Carers.

CQC Assurance Programme

The Care Quality Commission (CQC) have new powers to assess how local authority adult social care performs (think OFSTED for Adults!). These new powers come into force from April 2023.

Under the new regime, the CQC will be reviewing data and published evidence across all 152 local authorities with responsibility for adult social care, focusing on care provision, integration and continuity as well as assessing needs. Data and evidence won’t be published at individual local authority level but published at an overall national level as a collection of evidence, similar to their annual statutory State of Care report to Parliament. Initial formal assessments of local authorities are expected to start later in the year from September. In the intervening period CQC intend to visit up to 5 local authorities to test their Assurance methodology.

We have decided to apply for Adult Social Care in Lincolnshire to become one of the 5 pilot sites – we’ve been notified we are in the running so fingers crossed. Justin Hackney, Assistant Director, has been asked to lead the programme on behalf of DLT as we begin to prepare for a possible ‘inspection’.

If we are successful in becoming a pilot, it will involve the CQC being provided with evidence both on-site and off-site – face-to-face with leaders, colleagues and partners as well as processes and outcomes for our customers, plus financial information. The CQC will then provide a report and indicative score for all the quality statements and an overall rating (though not a formal rating for the pilot).

Upcoming comms promotion

Forthcoming comms activities:

• Supporting promotion of Lincolnshire Community Equipment Service as the new contract starts.
• Vapes – continue to promote the work of Trading Standards/Public Health as the profile on this topic is so high.
• Supporting social media promotion for World Immunisation Week (24-30 April).
• Supporting promotion of the new Joint Strategic Needs Assessment (JSNA) website with stakeholders.
• Comms promotion of engagement surveys (Let’s Talk Lincolnshire) for Integrated Lifestyle services and NHS Health Checks – posters, news releases and social media to drive response to the surveys.