Reflections on ADASS Summer seminar and the session I co-presented: ‘How to deliver good adult social care - despite Covid’
To date, many councils have focused attention on the Older People cohort to help address their financial challenges. The rationale for this makes sense. In comparison with Younger Adults, the Older People cohort has greater volume, greater flow in and out of the system, greater political and public pressure for change, and lower levels of service user resistance.
Those councils who have focused on Older People have seen a positive impact, and have often been able to achieve improved outcomes for less money. Successful demand management programmes are resulting in fewer older people being placed into residential and nursing homes – and more old people remaining independent at home. This should be celebrated.
Nonetheless, financial challenges remain, and they are forcing a shift in focus. Councils are realising that they cannot continue to sidestep the financial pressure coming from the Younger Adults cohort.
Over recent years, typical spend on Younger Adults has made up approximately 40% of the adult social care budget. But that is changing. A Director of Adults told me the other day that a tipping point had been reached for their service, and that spend on Younger Adults now accounts for more than half of their budget.
As lives get longer, the Older People cohort bring increasing demand and increasing complexity – yet the situation for Younger Adults is even more challenging. There is a lack of national and local political appetite for change, often driven by adversarial relationships with the families of Younger Adults. This toxic mix presents a different challenge altogether.
If we look at the outcomes the sector achieves for working age adults with learning disabilities, they are simply not good enough:
- Only 52% of clients with learning disabilities live alone or with family and friends, whilst 25% are in a mix of residential, nursing or temporary/unsettled accommodation
- Just 6% of clients with learning disabilities in receipt of long-term support are in employment – with only 2% securing over 16 hours per week
- Only 8.92% of total planned reviews for 18-64 year olds lead to a positive outcome (ie increased levels of independence)
At IMPOWER we believe that public services must and can do better; they can achieve better outcomes for people, and at less cost.
We recently helped one of our clients to change the way they conducted review conversations with a group of Younger Adults. IMPOWER supported council staff with behavioural science (MINDSPACE) workshops, safe space role plays, behavioural tools and daily huddles to help them conduct imaginative strengths-based review conversations.
Although the sample was small, the results were significant:
- 34% of case reviews resulted in a proposed or likely decrease in support within six months (projected to save approximately £29,000)
- 40% of case reviews resulted in agreed steps or goals towards greater independence
- 13% of case reviews resulted in no change
- 13% of case reviews resulted in a proposed increase in support
These results represent a dramatic improvement for the council. In total, 74% of reviews led to greater independence, whereas previously, reviews had resulted in greater independence in just 6% of cases.
This is just one example of how IMPOWER are helping forward-thinking clients to embrace new ideas and improve outcomes as a result. If you would like to discuss this with us, please get in touch.