Our social care achievements can't be pinned to one single component

By Adrian Loades | 16 March 2020

Our focus in Redbridge is around changing our relationship with residents and working with them to help them thrive.

Through a range of measures, we’ve been able to achieve the highest adult social care satisfaction scores in the country according to the Department of Health and Social Care survey results - with 76.9% of people using services very or extremely satisfied with their care and support. That’s miles ahead of the London (58.6%) and national (64.3%) average scores.

In addition, Redbridge was also named one of the top 15 strongest performing local authorities in adult social care, in the productivity INDEX from IMPOWER.

Our achievements can’t be pinned to just one single defining component, because performance in adult social care is a complex interaction of a multitude of factors. For us, we believe the following have been key.

Passionate and committed staff

Our staff display passion, commitment and endeavour for supporting the most vulnerable members of society daily. Redbridge is the 9th lowest funded local authority per head in the country, with funding in no way reflecting the need in our communities. It’s the effort and abilities of our staff that enable us to at least partly reconcile the issue of low funding and high demand for services, however, we know this may not be sustainable.

Strong foundations

We have strong systems and processes in place, which, together with the focus of our staff has meant that performance in areas such as minimising delayed transfers of care has been historically good. Redbridge has also had an ethos for many years of putting individuals in control of their care, with very high rates of Direct Payments.

Successful integration

In 2105, we entered into a formal partnership with North East London NHS Foundation Trust (NELFT) to deliver integrated health and social care in the borough. Four integrated locality teams made up from multidisciplinary health and social care staff are managed under a single management structure.

We’re able to meet both health and social care needs from within the same service. This means fewer handoffs, which is typically what people experience when trying to access health or social care and is a cause of great frustration for many. Our social care staff work with their health colleagues in the same team to assess, plan and deliver care together. The benefits of integration are illustrated well within our First Contact Service, which provides an immediate response to requests for help and support from the public. First Contact seeks to resolve issues for people quickly without detailed assessment processes, and the integration allows for a responsive, multi-disciplinary service to be offered to residents.

While the direction of travel nationally is towards collaboration between health and social care, few areas have genuinely integrated their services in the way that has happened between Redbridge Adult Social Care and NELFT. We have all the necessary structures of integrated services, but integration in Redbridge is built on day-to-day working relationships, we know that we’ve failed if we have to reach for the s75 to resolve an issue.

People-focussed culture

The social care element of the service has been enhanced by the ‘People Matter’ programme, a strength-based approach to delivering social care based on the Three Conversations model. We’ve been delighted with the impact this has had on professional practice. It enables staff to truly listen to people and support them to maximise their own abilities while remaining as independent as possible.

There’s been a positive impact on managing demand, while maintaining the high levels of service user satisfaction, with powerful testimonies from people that we’ve worked with. People Matter aligns strongly with the Council’s ‘One Brilliant Team’ culture programme, aimed at devolving decision-making to as close to the front line as possible. We are on a journey, but people are increasingly empowered to make decisions.

What’s next

We know ourselves well, and this drives ambitious plans for improvement. We want to develop a more strategic relationship with our homecare providers, with an emphasis on them having a greater focus on specific geographic areas, and to start to deliver health and social care tasks. This has driven our recent procurement of all homecare services in the borough.

We know that our transition arrangements need to be stronger and work is being done with children’s services to adopt a more flexible and responsive approach to transition.

And we’ve reconfigured our day services, we’re strengthening our approaches to progression models within Learning Disabilities and are part of multi-agency efforts to improve support for the street homeless.

We’ve had some great achievements, but we know there’s always more to do. Ultimately, we don’t tend to stand still in Redbridge!

Adrian Loades is corporate director of people at Redbridge LBC

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Health and Care Integration Adult social care productivity