1. What is the name of the policy or service that is being assessed?
Care Management Process
2. What are the aims of the policy or service? Whose needs is it designed to meet? What are the current priorities?
The Care Management Process is a framework for good practice in social care assessment, care planning and provision of services, advice and guidance as well as signposting to other services.
It ensures that current care management practice, procedures and systems are in line with national government initiatives and the council's corporate objectives.
It links with the corporate aim to ‘remodel adult social care to align policies within available resources, giving priority to those at greatest risk and promoting independence and well being’.
It is designed to meet the social care needs of and ’enable older people and people with disabilities to live independently and lead full lives in their communities.
Current priorities include ensuring that assessment is person-centred and appropriate, that ‘those at greatest risk’ are able to access assessment whilst those not eligible for services are signposted to other sources of help. Also, that social care practitioners are informed of current best practice in assessment via information contained within policy, procedures and protocol.
3. In what ways might this policy or service affect some groups of people differently? Might some groups find it harder to access the service? Do some groups have particular needs that are not well met by the current policy or service?
Access to assessment should be available to all adults with disabilities as everyone has a right to an assessment of their social care needs. Our assessment processes do not discriminate in terms of a person’s age, disability, gender, sexual orientation, race, culture or religion and ethnic monitoring is performed as standard practice on assessment documentation.
Some hard to reach groups may find it more difficult to access information, advice and guidance which can lead to the assessment process:
- Older and disabled people from black or ethnic minority groups whose first language may not be English,
- Carers from black and other minority ethnic groups
In accordance with our eligibility criteria and desire to promote independence with an ethos of "lives not services", some people may find that their needs are best met through sourcing their own service via a personal budget or with activities or support available universally within local communities. Our responsibility is to ensure that everyone can access the appropriate advice at first point of contact and this has improved following our focus review.
4. What evidence do you have for your judgement? Is there evidence of public concern (e.g. complaints)? Have staff raised concerns? Is there local or national research to suggest that there could be a problem?
The FOCUS Review implemented between July and December 2009, has ensured that bureaucratic processes were removed enabling all our services to be more customer-centric. Whilst we acknowledge that a change in the way we have provided our service (or advice and guidance) appeared initially, to some, to be disruptive. As improved systems were settling down; our overall evidence is that customers’ perception and satisfaction with our service and or our contact with them has greatly improved. We have succeeded in transforming social care in accordance with Government policy at a time when the recession has impacted on increased demand for our services.
We actively encourage feedback at all stages of our involvement with customers. We recorded 237 compliments about our service during the last financial year and recorded 95 complaints. This was an increase from the previous year. We take all feedback very seriously and have strengthened our internal processes so that we can learn from the feedback we receive.
We offer support to those who wish to give feedback and Complaints Advocacy is offered where required. Complaints recorded by category are as follows:
| Category | No. |
|---|---|
| Older People | 40 |
| People with a learning Disability | 23 |
| People with a physical or sensory disability | 18 |
| Peple with mental ill health | 6 |
| People with HIV/AIDS | 0 |
| People who misuse drugs, substances ands alcohol | 0 |
| Carers | 8 |
Positive action to ensure that all groups including carers from black and other minority ethnic communities are aware of how to access our services has been taken throughout 2009 and 2010.
We use two kinds of statistical evidence to monitor the equitability of the adult social care management teams
1) We compare data about the proportion of people from black and minority ethnic groups whom we assess for service and whom we provide services with data about the proportions of those groups in Wiltshire’s general population. These data are defined and collected by the NHS Information Centre in a statutory statistical return. They are used as part of the Care Quality Commission’s performance measurement system and form part of their annual performance assessment of adult social care. We monitor these equitability measures quarterly. We also monitor subsets of them for specific service inspections. For example, in our Self-assessment for the Care Quality Commission’s 2009 service inspection, we analysed a subset of data relating to the equitability of our services to older people with mental health problems. A copy of our analysis is available on request.
2) Our local performance management arrangements include a routine customer experience survey, sometimes called the “FOCUS” survey because it was defined from objectives that were defined by our customers in “Voice of the Customer” consultation groups during the recent FOCUS transformation project. A survey questionnaire is sent to everyone who has had a social care assessment or review in our Locality Teams. (These are the same assessments that are counted in the equitability measures referred to in (1) above.) The survey contains 18 questions, 9 relating to people’s satisfaction with our service, for example, whether they believed that we treated them with respect; and 9 to the quality of aspects of their life that are likely to be affected by them having a social care need, for example, having control over the routine activities of daily life. The survey is confidential – individual responses are never reported to the team that worked with the respondent; but they are not anonymous. This allows us to relate responses to data about the respondents that are stored in our case recording systems and hence to analyse the survey using standard diversity monitoring terms: ethnic origin; age; disability-type; gender; and sexuality. Our data on the first four types are complete and accurate to a high degree; our data about sexuality are limited.
5. Who have you consulted with as part of your assessment? What were the results? Have you published the results of that consultation? If so, where?
A review of our current work processes was undertaken in 2008 and 2009 to analyse how we could deliver our service with improved focus on our customers and to make our services more accessible. Consultation was undertaken with a group of customers and carers as well as with staff and the proposed system was tested first with a “proof of concept” team which proved successful and was welcomed by our customers.
Many groups including The Wiltshire & Swindon Users’ Network were involved in the consultation.
The processes were also subject to scrutiny by the Health & Adult Care Select Committee who have received reports at 3 meetings over 2009/10
6. If you have found that the policy or service might have an adverse impact on a particular group of people, can you justify this?
Care Management Procedures and Training aim to inform practitioners of good practice in assessment, i.e., values, procedures and skills for assessing service users’ and carers’ needs toward ensuring people are not discriminated against. In relation to the need to address the issue of access to assessment and information about services for black and other minority ethnic groups - we have visited many groups e.g. West Wiltshire Community Club to talk about our new way of working and our staff have continued to meet with the organisers and with the group to ensure access to our services are widely understood.
7. If the impact cannot be justified, what do you intend to do about this? Are there changes that you could introduce which would make the policy or service work better for this group of people? Is further research or consultation required?
Further investigate how people from traditionally excluded groups and communities can be better served through improved advice and information about Wiltshire Council services, advice and guidance and assessment.
By analysing complaints and concerns as well as general feedback about our services and to consider whether there needs to be policy review recommended
8. How will you monitor the take-up or impact of the policy or service in future?
Our Performance Management Processes enable us to monitor and assess numbers of enquiries resulting in advice, information & signposting as well as access to assessment and provision of services to all groups.
9. What actions do you plan to take as a result of this equality impact assessment? Please state any resource implications
Work with the commissioners, providers and all operational staff to ensure that those from traditionally excluded group have improved access to information about Wiltshire Council adult services, advice information and guidance as well as assessment.
Improve the quality, range and accessibility of information on Care Management Procedures, assessment and community services
Monitor and review practitioners’ access to and take up of training on Equality & Diversity.
Continue to promote the work of the department through regular liaison with appropriate customer representative groups.
10. There is a legal requirement to publish the outcomes of Equality Impact Assessments. Please outline how / where this will happen
To be published on the Wiltshire Council website.
11. Senior manager approval
Assistant Director Operations
Date
1 September 2010
Contact Details (LiveLink)
Multiple Contacts:
eMail: equalities@wiltshire.gov.uk
Telephone:
Out of hours:
Fax:
Postal Address: Equality & Diversity Team
Wiltshire Council
County Hall
Trowbridge
Wiltshire
BA14
8JN
In Person:
DX:
Last updated: 13 May 2009
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