Coventry Adult Social Care Annual Report 2021/22 (Local Account) - Print version

What is the Local Account?

Every year Coventry City Council produces a report which describes what Adult Social Care service is doing to help improve the lives of vulnerable people and how well as a service it is performing along with areas where we seeking to improve further. This report is usually referred to as the ‘Local Account’ but is also referred to as the ‘Annual Report’ for Adult Social Care.

We hope you find this account interesting and that it provides you with an insight into Adult Social Care in Coventry and the work that is being done to support improvements.

Download a printable copy of the report. [https://www.coventry.gov.uk/downloads/file/39285/coventry-local-account-for-adult-social-care-2021-22]
 

Adult Social Care 2021/22 key changes

We could not write a Local Account reflecting back on 2021/22 without mentioning the continued
impact Coronavirus (COVID-19) has had on the work of Adult Social Care and how we needed to
respond to national restrictions, vaccination requirements and continue to refine a blend of the use
of technology with face-to-face work.

2021/22 also saw the publication of Government proposals for Adult Social Care reform.

These included;

• 'Build Back Better’ plan for health and social care
• People at the Heart of Care: Adult Social Care reform White Paper
• Health and Care Act 2022 (which received Royal Assent in April 2022)
• White Paper on the integration of health and social care
• Consultation on Liberty Protection Safeguards (due to replace Deprivation of Liberty Safeguards DoLS)

Together, these introduce major reforms to Adult Social Care, with measures including further integration with health care, a cap on social care costs, changing charging thresholds, an intervention in the social care market intended to ensure local authorities pay a ‘fair price’ for care and the Care Quality Commission (CQC) being responsible for assessing Local Authorities’ delivery of their adult social care functions. These reforms will impact on the work of Adult Social Care over the years to come.

A year in the life of Adult Social Care - 2021/22

We start the year still in lockdown measures. On March 2021, care home residents can have one nominated visitor.

Month/time	Event
1 April	National Shielding programme comes to an end
12 April	Care home guidance changes to allow 2 visitors to care home residents.
17 May	Lockdown restriction ease, with indoor mixing allowed, pubs and restaurants re-opening.
15 June	The Government announce that COVID vaccinations are to become mandatory for care home staff.
18 June	All adults are eligible for the COVID vaccination
21 July	All legal restrictions are lifted, including the re-opening of nightclubs, and the ending of wearing face masks.
7 September	Build Back Better: Our plan for Health and Social Care is published.
7 September	The Government produce plans to introduce a new health and social care levy which will be introduced in April 2023.
16 September	The cut-off date for all care home staff to have had their first vaccination.
11 November	All care home staff must have received 2 jabs unless exempt. In Coventry, 96% of care home staff have had their vaccination.
1 December	Government publish People at the Heart of Care - White Paper which outlines a number of plans for social care reform.
31 January	The Health Secretary announces the decision to abolish mandatory vaccinations.
9 February	Government publish Joining Up Care for People and Populations - a White Paper outlining proposals around integration.
1 March	Mandatory jabs for all healthcare workers are scrapped.
17 March	Government launch consultation on the newly proposed Liberty Protection Safeguards.

 

Foreword

Pete Fahy, Director of Adult Services and Housing

The production of this Annual Report remains an important part of the annual cycle of Adult Social
Care. It provides an opportunity for reflection on the progress we have made and challenges we
face in delivering Adult Social Care within the city.

The year this report covers, 2021/2022, a year that remained overshadowed by the continuing
COVID-19 pandemic, but also one where we were able to undertake much more in person
work than the previous year. Speaking to people, understanding their circumstances and finding
ways to support them is at the core of what we do and simply cannot be done as effectively
through windows and on screens. 

In our performance data we see the impact of the pandemic, there are less people satisfied with social care. This is most likely as a result of the restricted manner in which we have had to operate during periods of the pandemic. Understanding more about customer experience and how this can improve is increasingly important to us.

Each year this Annual Report includes a number of examples of the experiences of real people
who we have supported – these examples are both powerful testimony to the impact that social
care has on people's lives and the positive work we do. They add a richness and honesty to
what could otherwise become a raft of data and performance information.

As we now look ahead to 2023 and the challenges of future years it is right to remind ourselves of the huge reform agenda facing social care.

In October 2022 we are required to produce our Fair Cost of Care calculations and by February
2023 we are required to finalise a Market Sustainability Plan as part of the introduction
of a Fair Cost of Care. Then in April 2023 there is the introduction of oversight and assurance
for social care by the Care Quality Commission (CQC) to be followed by a series of financial
reforms taking effect in October 2023 including the introduction of the care cap and changing
financial thresholds. Alongside these reforms will be the introduction of Liberty Protection
Safeguards and the Mental Health Act changes. All of these are a ‘must do’ and will form a large
part of our programme of work for the next couple of years.

Regardless of what lies ahead, due to the people I work with and the commitment they show I
remain certain that we will rise to the challenges and remain immensely proud and privileged to
be the Director of Adult Social Care for Coventry City Council.

I hope you find this Annual Report informative and as always myself and my team are happy for
any feedback.

Mal Mutton, Cabinet Member for Adult Services

This is the third year I have had the pleasure of contributing to the Adult Social Care Annual
Report and it is amazing to see the consistently highest standards of services being delivered
with such a huge commitment and dedication from the workforce and partner organisations
across the city. 

Whilst many of us may be starting to feel that life is returning to some form of normality the
challenges faced by some of the most vulnerable adults living in the city continue. We have seen
increased demand upon Adult Social Care and the need for services to adapt and develop in
order to meet demand has never been greater. 

The report highlights some of the ways in which services are making real impact upon lives and
the feedback and reflections of those people receiving services included within the report
say it all!

I know there are far too many examples of individuals, teams and services to include all
of the good work being undertaken every day across Adult Social Care but I do hope you
find the report highlights well the wide range of support and services provided.

I want to give my own personal thanks for the hard work, resilience, compassion and dedication
demonstrated consistently by our wonderful social care workforce. I am confident that they will continue to rise to the challenges ahead and support the delivery of the forthcoming Adult Social Care reforms with their usual professionalism and commitment.

Please do get in touch if you would like to offer any feedback on the Annual Report by emailing
getinvolvedasc@coventry.gov.uk [mailto:getinvolvedasc@coventry.gov.uk].

Introduction to Adult Social Care

The delivery of Adult Social Care is the responsibility of the Local Authority which interacts with a range of other local authority functions to support people in our communities, including Housing, Public Health, Children’s Services or Culture and Leisure to name but a view. Our work is also closely connected to health organisations and the voluntary and third sector who work with many of the same people who come into contact with Adult Social Care.

Although Adult Social Care has a distinct identity, much of what we do is achieved through working with others. Our success is increasingly intertwined with our health partners. New partnerships ‘Integrated Care Systems’ (ICS) are bringing together; Acute Trusts, Community Health Trusts, GPs, Primary Care services with Local Authorities and other care providers. These aim to bring
organisations together to redesign, improve support and outcomes for residents.

Adult Social Care in Coventry is one of several health and care organisations across Coventry
and Warwickshire, making up the Coventry and Warwickshire Health and Care Partnership. This
Partnership is working to improve the health and wellbeing of our residents. In all our efforts
to achieve this we share a common vision: 

‘We will do everything in our power to enable people across Coventry and Warwickshire to pursue happy, healthy lives and put people at the heart of everything we do.’

In working to this vision, we believe that all our residents deserve to:

1. lead a healthy, independent and fulfilled life
2. Be part of a strong community
3. Experience effective and sustainable health and care services.

As part of this Partnership, NHS Coventry and Warwickshire Integrated Care Board is now
responsible for commissioning health and care services on behalf of people in Coventry
and Warwickshire (this replaces Clinical Commissioning Groups).

From an Adult Social Care perspective, we do not have a complex strategy but at every level,
we intend to provide support to the residents of Coventry, in the least intrusive manner possible,
based on the assets, resources and abilities available to them. Our focus is on the promotion
of independence, and this continues to be the at the heart of the way we work and provide
support. Progressing this overarching objective is delivered day in, day out through the many
interactions between our staff and people with care and support needs and through a series
of developments and future planning overseen by the Director of Adult Services aimed at
constantly improving what we do.

During the last year we have made significant progress in our plans for the future, including:

• Improving access to support - Expectations are changing and for many, the provision of day centre-based support should be complemented with the opportunity to undertake activities, with support, outside of a centre environment. An informal engagement exercise with stakeholders and a focus group from Alzheimer’s Society co-designed the vision for the Coventry Dementia Hub and subsequently, permission was granted to commence a formal public consultation on the proposal to redevelop Maymorn Day Centre into a single Dementia Hub for Coventry. The proposals for the creation of a Coventry Dementia Hub, resulted in strong support for the new model, plans are progressing and formal Cabinet approval for the Hub is expected to be received in September 2022 with the opening of the hub predicted for April 2023.
• Use of technology - Our use of technology to support our assessment activity has grown significantly. We have introduced a new animated self-assessment process so people can identify what they understand to be their own needs prior to an assessment. Furthermore, through the use of a digital dictation tool staff can now create documents of any length and share them directly from a mobile device (usually a mobile phone). Both these innovations are saving people time and reducing
  unnecessary delays.

Our Coventry Adult Social Offer

Adult Social Care supports people aged 18 and over who have care and support needs as a result of a disability or an illness. Support is also provided to carers who spend time providing necessary care to someone else. We continue to work in accordance with our primary legislation, the Care Act (2014)
and the required changes to practice and policy set out by the Act.

In 2021/22 we produced a ‘Coventry Adult Social Care Offer [http://www.coventry.gov.uk/ascoffer]’ which is a clear statement explaining our vision and objectives, aligned to the Council’s One Coventry Plan ambitions. It has been developed as a way of setting out how we do things in Coventry including a description of what people can expect when they contact us, how they can participate in our work and useful links to information and advice.

The delivery of Adult Social Care in Coventry focuses on approaches that promote well-being and independence to prevent, reduce or delay the need for long-term support and to enable people to achieve their outcomes. In performance terms, this means that we would expect to see a relatively smaller number of people in receipt of ongoing social care, and where ongoing social care is required that this is mainly provided in people’s own homes. We would also expect that the short-term services we have in place to enable people to be independent are successful in reducing demand for ongoing Adult Social Care.

Our Health and Care Partnership Vision

We will do all we can to enable people across Coventry and Warwickshire to pursue happy, healthy lives and put people at the heart of everything we do. 

How will we do this?

Our work in Adult Social Care, at every level, intends to provide support to the residents of Coventry, in the least intrusive manner possible, based on the assets, resources and abilities that are available to them.

Our commitment to people who need to access our services

• Taking a strength-based approach - We are committed to enabling people to live as independently as possible, drawing on people’s own strengths and doing the things that are important to them, making use of what’s available in local communities.

• Helping people to stay at home - We will look at how we can adapt people’s homes and provide equipment or if unable to do so explore alternative accommodations to enable people to live an independent life more easily.

• Living and ageing well - We will help people think about the support they need and plan for how they can live the best life possible both now and into older age. We will enable people to find solutions that work best for them.

• Making the best use of resources - We will aim to provide the right amount of support to meet people's needs and outcomes. In providing appropriate support, we consider costs and will look at innovative ways to deliver care and support. 

• Joined up care and support - We will work closely within the Council and with different organisations, including the NHS, to support people to achieve what is important to them. We will work with organisations providing support to ensure safe and quality services. 

• Keeping people safe - We will help people stay well and safe from harm and abuse, working alongside other organisations when we need to, and supporting people to make their own choices.

• Carers are at the heart of all we do - We recognise, value and support the vital role of unpaid carers and will support them in their caring role, as well as supporting them if their caring responsibilities change or end.

• Committed workforce - We have a valued and respected Adult Social Care workforce and will support and develop our own and those of our partners, equipping them with the skills, knowledge and values to provide effective care and support. 

How does Adult Social Care work in Coventry?

• By phone - 024 7683 3003
• By professional/carer referral - online referral
• By online self-assessment

This is the process for referrals received by City Council Customer Services, not Mental Health and Hospital referral routes.

Adult Social Care Direct

Customer Services will take any initial information regarding a referral, such as contact details, key information, and the reason for the referral. They may be able to provide signposting advice and information advice at this stage.

Initial Contact Team

The initial contact team complete a follow-up call for any new referrals. They will gather more detailed information about the referral and will advise the next steps.

Duty Team

Support any incoming queries through Adult Social Care, for people that are in receipt of support.

Opal Equipment Services

Provides information and advice about equipment to enable people to manage everyday takes and live at home safely.

Occupational Therapy 

Provides advice and support about a range of possible solutions that may make everyday tasks easier for you. This could range from daily living equipment such as bathing aids to stair lifts and monitoring systems.

Telecare Services

The Telecare Team will look at whether telecare equipment, such as a personal trigger alarm, movement detector or medication dispenser are required.

Short-term support

• Promoting independence - The Promoting Independence (PI) Service works with older people and people with physical disabilities to develop their independence and daily living skills and develops a greater understanding of long-term/ongoing care and support needs.
• Promoting independence - learning disabilities - A multi-disciplinary team that works with adults with learning disabilities and autism to promote independence. The team provide support such as travel training, occupational therapy and support to use assistive technology.

Long-term support

• Older People's Assessment and Case Management Team - Works with adults over 65, they will explore the provision of support such as home support, day
  opportunities, supported housing, respite, and residential care.
• All Age Disabilities Team (Transitions 18-25) - Support adults turning 18 (or about to turn 18) until age 26, they will explore the provision of support such as home support, day opportunities, supported housing, respite, and residential care.
• All Age Disabilities Team 25+ - Support adults aged 26 and above. They will explore the provision of support such as home support, day opportunities, supported housing, respite, and residential care.

Setting the scene - Adult Social Care in a changing landscape

The demand for Adult Social Care rises every year as people live longer and there are more people living longer with more complex needs. 

The illustrations on the next few pages give you an indication of the position for Adult Social Care during 2021/22 in respect of;

• Budget - money matters
• Activity - facts and figures
• Demographic - The people who come to us for support
• Our Workforce - The people that provide support where required

The Council is a large organisation spending a net £252.8m on revenue activity during 2021/22. The gross Adult Social Care Spend in 2021/22 minus citizens and other contributions was £110.4m
as shown below. This includes £8.2m of additional resources provided to support the care market during the pandemic.

Adult Social Care spend (£110.4m)

This compares to a spend of £103.2m in 2021. The largest element of the increase relates to Spend on People (provision of services.)

• £85.m spent on people
• £17.m spent on community, assessment and overheads
• £6m spent on central recharges
• £0.3m spent on transport
• £0.7m spent on other

2021/22 spend on people (£85.8m)

The 'Spend on People' referred to in the chart has increased from £79.5m in 2020/21. 'Spend on People' is money spent directly on the following services:

• £25.9m spent on homecare
• £22.1m spent on residential
• £9.3m spent on direct payments
• £8.2m spent on COVID
• £7.8m spent on nursing
• £6.3m spent on housing with care
• £2.3m spent on supported living
• £2.4m spent on day opportunities
• £1.1m spent on equipment and adaptations
• £0.4m spent on individual service funds

How do we compare?

In recent years we know that Coventry demonstrates comparatively low spending as a  local authority per 100,000 population. The Local Government Association publish information about spend later on in the year but you can view information for 2021/22.

Facts and figures

COVID-19 and the country’s response to the pandemic continued to impact on work of Adult Social Care during 2021/22, with national lockdowns and limited family contact impacted on the activity of Adult Social Care, those accessing our support and how we needed to work. We are now starting to understand the long-term impact of the pandemic and are seeing more needs associated with mental health and well-being.

People receiving support

Adult Social Care receives a large volume of requests for support on a day-to-day basis. Our aim is to maximise people's independence and support people in the least intrusive way. 

• 11,316 new requests for support (an increase of 14% on last year's figure of 9,902)
• 6.5% of requests resulted in a long-term service (an increase on last year's 5%
• 18% received low-level support (a reduction on last year's 34%)
• 28% received a short-term service to promote independence (a decrease on last year's 30%)
• 2,539 people had been in long-term support for over 12 months as of 31 March 2022
• 1,364 people received a planned or unplanned review throughout the year (compared to 1284 last year) 
• 31 people transitioned from Children's Services to Adult Social Care compared to 23 last year.

Carers receiving an assessment

Adult Social Care has an equal responsibility for anyone providing unpaid care within the city. Anyone providing necessary care to another adult is entitled to a carer's assessment. 

• 1,211 carers had their needs assessed, of which 335 received a separate assessment
• 1,364 carers received support

How do we compare?

CQC Local Area Analysis data suggests in Coventry, compared to other local authorities that have similar populations, that we think of other solutions first, signposting to universal services and other community support rather than looking at traditional models of support. To explore the Local Area Analysis in more detail you can view the most recent reports from CQC. [https://www.cqc.org.uk/publications/themes-care/area-data-profiles#profiles-c.]

In comparison to other local authorities, Coventry continues to have:

• low rates of new requests for Adult Social Care, with an average of 31 a day compared to the national average of 35 in 20/21.
• continued lower rate of people receiving long-term support per 100,000 population compared with our comparators
• a lower rate of new requests for Adult Social Care support going straight into an ongoing long-term service than comparators
• a higher proportion of new requests for people aged 65+ going on to receive short-term support to maximise independence than comparators

Safeguarding

Protecting adults to live in safety, free from abuse and neglect is a core duty of Adult Social Care. The rising rate of safeguarding concerns reported suggests people know how to report abuse and we are addressing concerns without the need for an enquiry or investigation.

2021/22 safeguarding information

• 5,858 safeguarding concerns received, a 36% increase from the previous year (4,321)
• 899 safeguarding enquiries, an 82% increase from the previous year (493)
• 15% - the rate of concerns that led to an enquiry was up from 11% last year
• 869 completed safeguarding enquiries were undertaken in the year compared to 508 in the previous year
• 768 people (88%) were asked about their outcomes, an increase from 83% of people asked last year (423)
• 97% of people reported fully achieved/partially achieved outcomes compared to 94% last year

We continue to closely monitor our all activity and use ‘sampling’ audits and develop improvement plans when we need to look into our approaches in more depth.

How do we compared?

Coventry has a higher rate of concerns per 100,000 population in 2021/22 (1962) compared to 2020/21 for England (1121) and West Midlands (1038). Coventry has a comparable number of enquiries started in 2021/22 (301) with England (343) and West Midlands (217) rates per population. The high number of concerns started compared to England and West Midlands has meant that Coventry’s conversion rate (15%) is lower than England (34%) but comparable to the median West Midlands conversion rate (15%). 

2021/22 comparator data is due to be published in November 2022 on the NHS Digital Adult Social Care Analytical Hub. [https://app.powerbi.com/view?r=eyJrIjoiMGM5OGRlOTAtY2QxYy00YzAxLWEyZWEtNjI3ZWRmOTE2OWI4IiwidCI6IjUwZjYwNzFmLWJiZmUtNDAxYS04ODAzLTY3Mzc0OGU2MjllMiIsImMiOjh9]

Deprivation of Liberty Safeguards (DoLS)

The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act 2005. The safeguards aim to make sure that people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom.

• There has been a 14% (307) increase in the number of applications, from 2,237 in 2020/21 to 2,544 in 2021/22
• 469 (18%) are in due process compared to 349 (16%) in 2020/21
• In 2021/22 there were 2,075 applications completed, which is a 10% increase from 1,889 in 2021/22
• There was an increase of applications granted after 6 months of being received from 27 (4%) in 2020/21 to 127 (14%) in 2020/21.

Our work during year continued to be impacted as a result of the pandemic due to reduced staffing capacity and assessments taking longer to complete. Liberty Protection Safeguards are due to replace DOLs for which the service is actively preparing for.

Demographic

Coventry's population is growing, changing and increasingly diverse.

• Coventry is home to 345,300 residents (census 2021)
• 14.6% of the population is 65+
• 2% of the population are aged 85 and over
• Recent census information suggests that population growth has been lower than projected
• but Coventry has a slightly faster rate of population growth than the West
  Midlands average of 6.2% and the England average of 6.6%
• Life expectancy in Coventry remains consistently below England, but healthy life expectancy is similar to England.
• Health outcomes are worse in the most deprived areas where people not only live shorter lives, but spend a bigger portion of their years in poor health, and are more likely to die of preventable causes.

National data suggests that between 2015-2017 and 2017-2019, life expectancy between the richer and poorer increased further. In particular, there was a decrease in life expectancy for females in poorer areas - resulting in a widening of inequality in the life expectancy gap among females (7.4 years). Although, the gap for  males (9.4 years) remains larger.

Our workforce

• 920 internal staff
• 81% female staff 
• 19% male staff
• Average age of workforce is 48.2 years
• 48.4 of the workforce is aged over 50
• 73.1% of the workforce is white
• Vacancy rate is 11.5% compared to 6% nationally
• 20.6% of the workforce is Black, Asian, Minority Ethnic
• Leaver rate is 15.3% (141) people
• New starter rate is 14.7% (135) people
• The wider Adult Social Care workforce in Coventry amounts to 9,500 jobs which includes staff working in 181 CQC-registered establishments.

Key achievements - based on our Adult Social Care Offer

The previous section contained a volume of data and comparisons across a number of areas of performance. To summarise this as succinctly as possible would be to say that Coventry continues to support a relatively low number of people with ongoing care and support needs and as a result is a comparatively low spender on Adult Social Care.

This position has largely been arrived at by our approach to Adult Social Care and Support which is based on supporting people to be as independent as possible. Where independence Key achievements - based on our Adult Social Care Offer has been lost or reduced, we work with people to regain skills and where levels of independence have been limited, we work with people to improve this. Our goal is for people to be living independently within their own homes. This is not always achievable and in many cases living independently is only possible with support. The examples below give a flavour of how we have delivered this approach. We have used real examples given with the consent of those involved.

• Saba's story
• Ahmed's story
• David's story
• Making the best use of resources
• Joined up care and support
• Ian's story
• Carers at the heart of everything we do
• Committed workforce

Making a strength-based approach - promoting strength, independence, diversity and inclusion in our Shared Lives Scheme - Saba's story

Shared Lives is the essence of family living; sharing a home, life and community with like-minded people. We pride ourselves on our rigorous matching and introduction process, ensuring the adults we support have the greatest opportunity of finding the right family, right home and support to lead a happy and fulfilling life whilst having their individual needs met. This process cannot be successful without placing the adults we support at the heart of everything we do. Individuals living in Shared Lives are supported to express their wishes, explore their dreams, and share the highs and lows of living as part of a family. Here Saba shares her story in her own words about what it's like to be supported by the Scheme.

Hi I'm Saba. I moved to England in 2008 from Pakistan where I lived with my Grandparents and Uncle. When I moved to England, I was diagnosed with a Brain Tumour, I spent a lot of time in hospital meeting Nurses and Doctors and other children. I was taken into Foster Care in 2010, I was very unhappy during this time and struggled to settle in, I had different foster carers. In 2011 I met the perfect foster family; I now live with the family as part of Shared Lives and my younger sister lives with us too.

Shared Lives has made a massive difference to my life, now I am an adult I’m treated like an adult, Mandy and Mem are my shared Lives Carers, they support me with my independence and encourage me to do as much as I can. Mandy manages all my medical appointments and supports me with my health needs, but she has taught me about my medication and injections, I can now manage my own medication and do my own injections, I’m proud of this.

My biological family are so important to me, I love going to see my Mum and Dad, Mandy has always supported me with this, I can now do this on my own on the bus. My relationship with my Mum is so much better now, and we meet for drinks and go shopping together. I also like to go shopping on my own as I have the confidence to do this because Mandy has supported and encouraged me. As a Muslim I can celebrate my culture and all the festivals and events that are important to me, I share these with my Shared Lives family. Mandy always ensures I have Halal meat and we often cook traditional meals together.

What I like about living in Shared Lives is I can make some great memories, I have some lovely holidays with Mandy and Mem, we have been to Spain and Turkey, as well as short breaks to Butlins, I love going to amusements parks, although I don’t like the fast rides. 

I love living in Shared Lives, I have a great future to look forward to, I feel I am free to live my life and do what I want to do, I am looking forward to starting an apprenticeship in September, my aim is to find a job. Since coming into Shared Lives aged 18 years of age, I have had a financial appointee to manage my money, my aim is to manage my own finances which Mandy is supporting me to work towards, I feel confident I will be able to do this.

Another wish of mine is to return to Pakistan for a visit, I have been unable to do this because of the COVID-19 pandemic and my health needs, but this is something I plan to do in the future.

I love my life and wouldn’t have it any other way. 

• www.coventry.gov.uk/sharedlives [http://www.coventry.gov.uk/sharedlives]
• Follow us on Twitter: @SharedLives18
• Facebook: Shared Lives Coventry

Helping people stay at home - Ahmed - a home adapted to meet my needs

Ahmed is a 29-year-old young man with physical disabilities who lives with his parents. He and his family wanted safe and independent access to a sleeping area, toilet and showering facilities on the ground floor. His health conditions included respiratory failure, chronic back pain, weight problems and poor mobility. He was sleeping on a mattress in the lounge and was not able to get to the bathroom to use the toilet or shower; his mum was washing him on the mattress in the lounge. Although there were two reception rooms, Ahmed could not get into the second room due to the width of the doorways.

A request was sent in July 2021 by the Occupational Therapist (OT) for a joint visit to
establish the best way of meeting his needs. Between the OT and the Housing Officer they identified that a Disabled Facilities Grant (DFG) could be provided to:

• Widen doorways to enable Ahmed to access the whole of the ground floor
• Alter the layout of the kitchen to enable him to pass through to the bathroom
• Bathroom alterations to remove the existing cubicle and provide a level-access shower
• Alterations to the back door so that Ahmed could go outside

The OT also arranged for a hospital bed to be provided so that Ahmed could sleep in a bed, not just a mattress. This also meant that he was able to get in and out of bed without his mum pulling him up from the floor. 

Whilst carrying out her assessment, the OT noticed that Ahmed’s mother was also struggling with her mobility, so she was able to arrange for a stairlift to be fitted for her.

Nigel Goode, Home Improvements Officer, commented;

"In my role I am fortunate to be able to support people in ensuring their homes are adapted to meet their needs, it’s a great pleasure and a true sense that we are helping people in our city. Ahmed’s life changed when the work was completed, he was able to mix with his family rather than being confined to
his room, have improved facilities to look after his personal care and access the wider community and meet up with his friends".

Permission for the DFG scheme to go ahead was given by the private landlord in November 2021 and three contractors were allocated to provide quotes for the job. The most cost-effective quote was accepted and the grant was approved in January 2022.

The work was completed in March 2022 and Ahmed’s mother wrote in to thank the Housing Officer and the OT for all their support and understanding in dealing with the
adaptations at their property. She stated;

"You have made a young man very happy".

She also thanked the contractor for going beyond their expectations in keeping them updated and addressing any concerns without hesitation.

The purpose of a Disabled Facilities Grant is to enable disabled people to have access in and around their home. 

A Disabled Facilities Grant can help, for example, to pay for a ramp, to widen doorways or replace a bath with a shower and is a process made up of a number of stages from an initial assessment, applying for a grant, getting estimates for the work and completion of any work. 

To find out more about DFGs please see our webpages [https://www.coventry.gov.uk/money-legal-matters/disabled-facilities-grant]

Aideen Staunton, (pictured) Head of Service, Partnerships and Social Care Operations said;

"It’s great to see the difference this has made to Ahmed’s life. An accessible home is so important and has a direct impact on our
health and wellbeing."

Currently, awards through the grant scheme are mandatory but a new updated Housing Assistance Policy agreed in 2021/22 enables the Council to use a more discretionary approach to the awarding of grants. This more flexible approach will help more people who apply to us for funds. This will mean grants awards that do not exceed £6,000 would no longer need a financial assessment while there will be a new option to top-up grants that exceed £30,000.

Living and ageing well - David's journey towards more independence

David is 84-year-old man who has been profoundly deaf for most of his life following a fall from a great height as
a small child. David uses British Sign Language (BSL) to communicate. To add to his challenges David cannot read or write and has started to lose his sight due to Glaucoma and cataracts.

David has always been independent but due to his failing sight he tripped whilst out due to an uneven pavement and since such time he has lost his confidence and stopped going out altogether. It was at this time that his daughter made the referral to Adult Social Care for an assessment.

David said:

"I hardly leave the house anymore as I'm embarrassed when I keep bumping into people".

David has no contact with the outside world and over the years his friends have passed away, so he has become more isolated, he also stopped attending the Deaf club and other social venues due to his failing sight.

"My only lifelines are Facetiming my daughter on the iPad and watching western films, without those I'd have
nothing else to enjoy".

David’s main aim was to be part of the community and to have a social life without having to rely upon his daughter. 

To enable David to fulfil his outcomes he received an assessment visit from the Visual and Hearing Impairment Team who provided him with a white cane to use when he is out, he also needed to learn a new form of communication before he lost all of his sight. The social worker and deafblind assessor identified a specialist service to teach David ‘hands on signing’ where David would gently place his hands on top of his communicator
guides hands to feel the movements of the signs.

Learning ‘hands on signing’ will take a lot of practice, however, David is embracing and enjoying learning a new skill, he has gained in confidence.

He has started to go out with the guide to the shops and is looking forward to joining the Coventry Resource Centre. David is also teaching his daughter some of the signs so that when the time comes they will be able to communicate. David still worries about his future and doesn’t want to become completely isolated.

“I wonder what I will do, if it does become dark for me. Will I go into a home, just sit there in my chair and sleep  more, just to be able to see in my dreams?”.

Short Term Services to Maximise Independence (STSMI) are provided to promote people’s independence with the purpose of enabling people to regain skills, confidence and to hopefully achieve what’s important to people and promote their strengths. This service has not only improved David’s quality of life now but will also help to prepare him and his family for the future when his needs change.

Janet, the social worker involved said;

"Working with David has given me the opportunity to use services creatively, seeing the transformation through his continued journey and how much he has gained in confidence with a positive outlook is very satisfying. On reflection, I think “I’m just doing my job” but “just doing my job” has made such a difference to David’s life and future".

In law, people are regarded as deafblind if their combined hearing and sight loss causes problems with communication, access to information, and mobility. People regarded as deafblind all have difficulties in these three areas caused by the interaction of the two impairments. 

It is estimated that there are nearly 400,000 deafblind people in the UK. This is expected to increase to over 600,000 by 2023 due to our ageing population.

Deafblindness affects people of all ages, including children and young people, but it is more common in older people as our sight and hearing naturally worsen as we get older.

The Care Act 2014 says that a suitably qualified person who can understand the impact of both sensory losses must assess a person who is regarded as deafblind. We are pleased to say that following a successful training course we now have 2 more social workers trained as deafblind assessors in Adult Social Care. 

Making the best use of resources - supporting Adult Social Care staff through digital innovation

Adult Social Care continuously looks for ways to support the workforce, through the use of digital and innovative tools and developments. One of the ways we are currently doing this is through the use of a digital dictation tool. ‘Dragon Anywhere’ is an application that supports staff to create documents of any length and edit, format and share them directly from a mobile device (usually a mobile phone), offering the following benefits; 

• Saves time typing and eases pressure on administrative tasks
• Removes the need for social workers to travel to the office to make case notes saving time and reducing delay 
• The software is intuitive and easy to navigate
• Dictation can be used as a memory aid 

Stephanie Lamb, Community Case Worker and one of the members of staff taking part in the trial gives the following feedback on the tool;

"You can use it within 30 seconds. Just press the record button and, after you've finished,  you can email it to yourself - it’s that simple. It really is quick. I can now spend 10 mins dictating all the points I want to write, it saves time and is easy to use and it can help with long assessments and phone calls".

Adrian Flynn, Mental Health Social Worker also commented; 

 "I love the app and use it after all of my assessments. I find it very helpful, and it makes my work life a lot easier".

Hear more from Adrian directly about what this means in practice. [https://www.youtube.com/ watch?v=pINkPlEFIuo]

Louise Ferro (pictured), Head of Business Systems and Continuous Improvement said; 

"We are really keen to support our workforce in ways which can reduce time spent on recording and  administrative tasks to enable more time to be spent having valuable conversations with people. Following evaluation later this year, if deemed a success the tool may become part of a suite of digital options available to staff to support them in their everyday tasks".

Online animated self-assessment tool

Coventry City Council Adult Social Care has been part of a small group of Local Authorities who have worked together with an organisation called ‘Looking Local’ to develop an innovative online self-assessment form using short animations to support accessibility with what can seem a very complex process. Social workers, occupational therapists and technical experts were fundamental in ensuring the self-assessment tool included all the right questions in an easily accessible format covering all of the Care Act 2014 domains of care eligibility. The tool has been embedded into our initial contact process, and people making first contact with Adult Social Care are asked to complete the self-assessment process prior to being contacted by our Social Work Initial Contact Team. The tool also offers to signpost information and guidance to enable those people who are not eligible for or do
not require social care interventions to find local support through other organisations. 

This process will also support people and our social work teams by saving time during later assessment processes and help people navigate the Adult Social Care system when we are expecting an increase in requests for support. 

Joined up care and support - Community Discharge Team rises to the challenge

Based at the University Hospital Coventry and Warwickshire NHS Trust (UHCW) our Community Discharge Team are hard at work supporting people to be discharged safely home, 7 days a week. The team has had to respond to significant change over the last 2 years.

In March 2020, revised measures were put in place nationally to manage the COVID-19 pandemic. This fundamentally changed the offer to people across health and social care nationally and impacted on the way patients were discharged from hospital. 

Some of the requirements included:

• It was required that the discharge of patients would be extended to have discharge support available seven days a week
• Services needed to be available to support patients from 8am to 8pm daily 
• Services to support effective discharge needed to be in place and this included brokerage, administration, equipment and therapy services in addition to social work

During this time the world's attention was brought to UHCW as it became the first hospital to issue the Covid vaccination with Margaret Keenan (pictured opposite) being the first person in the world to be vaccinated with the Pfzer Biotech jab!

Margaret returned to the hospital in 2022 to receive her spring booster.

Working at the hospital over the last 2 years brought about some key challenges, but at the heart of the team was ensuring that people who were in hospital were well supported on discharge. 

Staff working during this time said; 

"Not being able to see loved ones whilst they were in hospital, I think was incredibly difficult for any family and not having a regular point of contact. I hope I helped alleviate some of that anxiety by passing on any messages, even if it was just a quick hello or to say that their pet was being looked after".

"Ever-changing requirements for COVID-19 swabbing of residents in hospital for discharge back to care providers. This was challenging and very complex with high risk. The team had to be dynamic and adaptable."

"The pandemic also in some instances helped build resilience of staff working under stressful and dangerous circumstances".

"Throughout the pandemic the team was able to take on two social work students. Which was a fantastic way of
gaining valuable work experience as front-line workers during a crisis".

The team continued to work at the hospital during the pandemic and held daily huddles to ensure that staff felt supported and were up to date with the Government changes.

They established the affectionately known ‘FAB’ team who worked with people who were isolating or had been exposed to the virus in commissioned services outside of the hospital setting. 

In response to the requirements from the Government the Hospital Social Care Team and the Short-Term Therapy Team based at the Opal, came together as the ‘New’ Community Discharge Team, delivering services over seven days 8am to 8pm.

The 7-day offer has seen several improvements with people who are medically fit to leave the hospital being able to be discharged faster and supported to leave the hospital at the weekends. 

In addition to the discharge capacity for patients, the central safeguarding function for West Midlands Ambulance Service (WMAS) referrals has been extended to cover seven days 8am to 8pm via the hospital-based Community Discharge Team. This has proved particularly successful in both responses to safeguarding and admission prevention.

The Community Discharge Team works to positively promote the ‘home first approach’ by using the established discharge pathways together with the Community Discharge Therapy team implementing a service that helps people regain and develop their skills.

Integrated Care Record goes live

In a further example of how we are joining up care and support, during the year Coventry City Council took its first step in going live on the Integrated Care Record (ICR). This is an important development that will allow other health and care organisations to view our records and ultimately help us deliver better, safer care for people. It is widely recognised that the sharing of relevant data in a timely and secure manner supports the delivery of effective care.

As well as our own data, Coventry City Council professionals providing care for people will soon be able to see corresponding health care records. In the meantime, if you’d like to know more, please visit the ICR web pages. [https://www.happyhealthylives.uk/]

 

Keeping people safe - Ian's story - a comfortable new home

Ian is a 65-year-old man with mental health problems who was admitted to hospital with an infection and  confusion having collapsed at home. After 4 weeks in hospital, he was discharged to accommodation within a Housing with Care complex. 

What was the situation?

Ian was on a very low income as he was under pension age and on Universal Credit. His income was £74 per week only. He had no family or friends who he was in contact with. He had a flat which was not in a habitable state to return to as it was in a state of disrepair and needed extensive cleaning. Ian also had rent and council tax arrears. Ian did not want to go back there as he associated it with becoming ill and being on his own.

Before going into hospital, a safeguarding concern had been raised due to concerns about his living conditions and that Ian was self-neglecting. It is likely that his poor health was a result of his environment, living conditions and not eating a balanced diet and Ian needed multivitamins and other minerals to be prescribed for him whilst
in hospital. 

Whilst staying at the Housing with Care complex, staff reported that Ian needed prompting with personal care, with preparing healthier food choices and with keeping his accommodation tidy. Ian did not want to go back to his previous home. He was keen to live in a Housing with Care environment. He enjoyed talking to people and likes the company of others. 

However, there were a number of barriers to moving;

• Low income, debts and not being on the right benefits 
• No help from friends or family 
• No furniture or belongings to take with him other than clothes
• No money in the bank to buy new furniture and carpets
• Difficulties managing money and budgeting

What did we do?

With the help of staff at the complex Ian was assisted to apply for the right benefits and applications were made for a Community Support grant to be able to access a new bed, kitchen items and bedroom furniture. The staff also gathered donations of furniture and white goods. Ian was referred to a money advisor for help with his debts
and was eventually helped to move into a new flat in another Housing with Care scheme. 

Stephanie Lamb Community Case Worker in the Older People’s team said; 

‘When someone has a low income and no family support there can be a lot of obstacles to moving house. A joint approach from teams in the Council and Adult Social Care meant that Ian was able to move and not return to an environment which might have made him ill again."

How are things now?

Ian is now settled in his new flat and really happy with it. He has made friends and enjoys going to the restaurant for meals. Within days he had a TV donated to him from another resident. Ian was awarded backdated benefits which allowed him to clear his debts. 

"Life is precious to me; I feel so lucky that people helped me to move here. I have made friends and have a garden to look out on, I feel I have my life back now. I reach my retirement age in September and can spend my retirement here as I have a lot of my life  left to live."

Since moving into the Housing with Care environment Ian’s physical and mental health has improved. Ian was getting depressed at the thought of going back to his old tenancy as he did not want to live alone, had memories of the conditions he was living in and associated it with the trauma of being found on the floor collapsed. He is reassured by having staff on site who he can go to if he needs help. Having the right living environment can help
people be as independent as possible and have a positive impact on their health and well-being.

Housing with Care, sometimes known as Extra Care, is housing designed for older people, with various levels of care and support available on-site. People who live in Housing with Care have their own self-contained flats, their own front doors and a legal right to live in the property. In Coventry, there is a range of Housing with Care schemes [http://www.coventry.gov.uk/housingwithcare] run by both the Council and private companies. 

If you are experiencing difficulties due to the rising cost of living the City Council has a web page dedicated to information and advice concerning how to reduce outgoings and get help and support. [http://www.coventry.gov.uk/costofliving]

Carers at the heart of everything we do - Carers Trust Heart of England get creative

Within Coventry we work in close partnership with the Carers Trust Heart of England to ensure that we can support as many people across the city who have caring responsibilities. Supporting carers is such an integral part of the way we work in Adult Social Care. Here the Carers Trust Heart of England tell us a bit about their work throughout 2021/22 with a focus on coming out of pandemic restrictions and what carers told them was important. 

The impact of the pandemic lasted longer than any of us imagined with the ever-changing social restrictions. This led to all of us constantly changing the way we work and socialize and undertake our daily routines. The impact on those with additional caring roles was immense. Here at Carers Trust, we continued to adjust what we did to ensure we continued to support Carers on their caring journey in a way that responded to those changing needs.

Like many organisations, the hybrid way of working was born. Delivering services both digitally and face-to-face, will be a lasting legacy from the pandemic which has changed service delivery for everyone. The service continued to utilise the enhanced funding from Adult Social Care:

• To support carers who were isolated and lonely
• Supporting carers experiencing grief and loss
• Ensuring hard-to-reach communities were involved
• Supporting carers who don’t have access to technologies
• Supporting carers experiencing financial hardship
• Worked with employers to support carers who are juggling work and caring
• Providing direct payments for carers to help achieve outcomes

Supporting Carers to take a break

This year we developed our offer on respite opportunities for carers. The last year had an 
unprecedented impact on carers connecting socially and interacting with other carers and accessing vital respite and peer-to-peer support. We secured additional funding to complement and enhance our contract within Coventry. This funding gave us the additional resources to offer a variety of respite opportunities to carers both face-to-face and digitally.

Connecting carers – The Carers Creative

We ran a programme of activities and events, the most popular were creative activities, such as flower arranging, gardening, pinch pottery, also relaxation sessions such as Yoga, Zumba, Mindfulness and Aromatherapy and events around festivals such as Diwali and St Patricks Day. For many carers it was a tentative step back into the community and doing something for themselves after many months of staying at home worrying about the impact of the pandemic keeping themselves safe and those they care for. Doing something fun and engaging also
helps us connect with carers in a way that helps explore other support such as offering a carers assessment or identifying the need for a direct payment. 

"Coming to the flower arranging session enables me to do something I enjoy and take something home to show my loved one what I have done. Learn a new skill and make new friends". 

"When I am being creative I am putting myself first not last, I know now this is ok to do. Thank you, carers Trust,  for giving me the space for an hour". 

"The last two years I have been so lonely, coming to the flower arranging I am doing  omething wonderful and now have some good friends who understand me".

Reaching out in new ways

In the last year, we started to make use of podcasts. We released a number of podcasts 
during Carers Week and are continuing to produce content for them, this includes an episode on Lasting Power of Attorney with Emma Austin from the Central England law centre. You can listen to all episodes online. [https://anchor.fm/carerstrusthoef]

We are so excited to start recording these podcasts. It’s so accessible to everyone and we can really focus on information and services that we know really impact the Carers we support as well as highlighting real Carer stories.

Committed workforce - working in Adult Social Care, making a difference

Recruitment and retention within the Adult Social Care sector has been an ongoing issue for a number of years and has been further exacerbated by the COVID-19 pandemic. To support our providers in
drawing in new recruits and retaining their existing staff through these challenging times, the Adults Commissioning Team worked to produce a 2-minute animated video [https://www.coventry.gov.uk/asccarejobs] for use free of charge by providers, aiming to highlight the benefits of a career in care and the wide variety of jobs available.

The video directs potential applicants to job roles advertised through the Find A Job website [http://www.findajob.dwp.gov.uk] and acts as a valuable resource to support recruitment. 

Promotional work was undertaken with a wide variety of partners in the city including The Job Shop, Coventry University, voluntary sector organisations and Health, to drive recruitment and increase retention within the city’s social care workforce. 

The video has so far been viewed over 600 times on YouTube, displayed in the window of The Job Shop and has been used by a number of providers in their own recruitment and advertising campaigns. The video remains available for any provider needing to supplement their own recruitment practices. 

 Neil Byrne, Service Manager Adult Commissioning said;

"The pandemic, although a particularly challenging time for recruitment and retention in the adult social care workforce, brought attention and recognition to the sector on an unprecedented scale; more people than ever before became aware of the value and importance of those working in the care sector. 

"To build on the increased public appreciation, a more innovative method of recruitment was needed. The video offered a more personable and relatable means of advertising which could be used to target a wider audience than traditional recruitment campaigns. The video worked to show our commitment in supporting the provider market and we encourage feedback from all Coventry providers on how we can best support with recruitment on an ongoing basis. Most recently, we have worked with the Council’s Migration Team and The Job Shop on a recruitment event where 10 people were recruited to roles in care."

Working with providers

During last 12 months, Coventry’s (Care Homes and Community based Adult Social Care services) Care Quality Commission (CQC) ratings have not changed significantly. There has been an increase in “Inadequate” rated provision but a larger reduction in ‘Requires Improvement’ rated services since last year, similar numbers remain the same for ‘Good’ rated providers. The Joint Health and Social Care Quality Assurance Team worked with operational colleagues to ensure the safety of service users including where provision was rated as  Inadequate’ or ‘Requires Improvement’ (Please note since March 2022 a number of the inadequate providers no longer operate in Coventry). 

In comparison to national figures, Coventry Adult Social Care CQC ratings fair well, Coventry has higher rated good providers compared to the national average (6% more) however the requires improvement providers are slightly above the national average (by 2%) with the same number for inadequate rated provides nationally. Work is ongoing with providers in 2022/23 to improve this position. 

March 2022 - CQC Rating for the Coventry Care Market

• 5% (6) - inadequate 
• 4% (4) - outstanding
• 16% (18) requires improvement
• 75% (85) good

Care home improvement

The COVID-19 pandemic impacted on our ability to conduct visits to care providers and although visits continued to take place where essential, In the last 12 months the Joint Quality Assurance Team started work with all care homes to ensure a full quality assurance visit and a continued focus of assurance activity on commissioned community providers with poor ratings.

In addition to the above programme in the last 12 months we developed a refreshed quality assurance approach and reviewed the effectiveness of our Provider Escalation Panel (PEP). PEP is a multi-agency panel led by the City Council, made up of agencies across health and social care working together to address any provider quality or market concerns. 

During 2021/22 the quality improvement campaigns restarted with a focus on Infection Prevention and Control, reinstatement of the care home provider forums and the creation of improved service engagement and involvement activities within care provision.

Care providers providing the love

Care providers across the city needed to respond to the COVID-19 pandemic and as the pandemic subsided kept a focus on keeping their clients and staff safe whilst continuing to provide support for people and help them maintain contact with friends and family. This included paying attention to special occasions. 

Tenants at Copthorne Lodge Housing with Care scheme enjoyed a special Valentine’s lunch. Staff worked hard to ensure that those who are widowed or single were not left out or feeling lonely. Whilst Valentine’s Day can be a great day for some, it can be a difficult day for those whose loved ones have passed or those who are living on their own.

Although there were no wedding proposals! Everyone felt loved and had an opportunity to remember their loved ones. 

Tenants commented on the day; 

"Very, very nice and thank all the staff it was lovely and very beautiful. The card, arrows and how the tables were set were so beautiful". 

"I enjoyed it very much and to thank all the staff, I felt was in love, and it was very beautiful and brilliant". 

Jon Reading, Head of Commissioning and Quality said; 

"The Valentine's celebration beautifully illustrates how it is possible to deliver care and support in a way that is person-centred and treats people in a way that we would all like to be treated. It is just one example of where providers go above and beyond each and every day to support people to live a full life. In our quality assurance work, we strive to build on good practice like this as well as tackling issues where standards fall below what we would all expect". 

Innovation and change

The Social Interventions Collective (SICol) – one year on 

A new and transformative service has been operating in Coventry for the past 12 months, led by the City Council’s Approved Mental Health Practitioner (AMHP)/Social Work Service and two of the Council’s internal provider services; The POD, which specialises in social advocacy and brokerage and Axholme Services
providing intensive personalised one to one support. It has proven its worth, in its first year, by identifying and supporting at least 75 people at risk of psychiatric admission or serious mental health deterioration.

SICol is a way of working that recognises the importance of weighting social and medical factors in crisis case formulation’ (understanding key factors of a problem situation), rather than relying on the traditional dominance of the medical model. It was created and piloted in response to the tragic and untimely deaths of 2 males by suicide where social factors were identified as contributors. Those stressors included eviction, debt, loss of independence, loss of vital personal relationships and loss of access to key health and social care services caused by declining physical health. 

The service was awarded funds from NHS England after a successful pilot and operates within the revised crisis support offer within the City. SICol provides intensive and timely support on complex social issues. This means it covers a wide spectrum of social needs such as housing, debt and employment, bereavement, access to children
subject to statutory procedures. SICol mobilises advocacy, provides specialised support and links to key statutory services, local community groups, faith and user-led organisations. 

Peb Johal, Senior Social Care Practitioner said;

"Although delivering and designing a service from grassroots has been challenging and has some way to go, it has been an extremely rewarding experience working with our NHS colleagues". It was a common statement, heard almost daily, from our NHS colleagues 'it's not a mental health problem it’s a social one' without realising just how interrelated  someone’s mental health and social needs are".

SICol has helped people in different ways, from providing intensive and one off support, with the crucial aim of resolving fundamental social issues. 

Andy Seys, AMHP Lead and Team Manager SICol, said; 

"SiCol has been deliberately developed organically, via a bottom-up process with messages from individuals using services. The evaluation shows clearly the complexity  of the work and also the commitment, hard work, skill and tenacity of those working within SiCol".

Sally Caren,  Head of Adult Social Care and Support at Coventry City Council, said; "In a short space of time, this work is already leading the way and informing social work across Coventry and Warwickshire. The commitment of colleagues to make this project a reality has been inspiring. The social model applied doesn’t use a one fits all approach, but it does recognise peoples’ own expertise and lived experiences. It puts the person first and helps people in handing back power so they can shape the solutions. It aligns itself well with the principles of the Care Act 2014 in terms of wellbeing and strength-based approaches". 

Over the past 12 months 95% of psychiatric admissions were prevented, and at least 125 social
issues were addressed with the support of a large network of around 50 partners playing their part. The approach now forms a recognised element of the NHS Mental Health Transformation programme locally.

Co-production and engagement

In Adult Social Care, we place adults and their carers at the heart of everything we do. We are committed to ensuring that people with care and support needs and their carers can be equal partners in planning and shaping future developments in Adult Social Care. But we know we’ve got some way to go with this. 

Behind the scenes, we’ve been working hard to try and develop our own approach to co-production and ensuring that we are involving people with care and support needs and carers in the development of services, something as simple as ensuring we get feedback along people’s journeys, to being part of recruitment decisions to helping shape and create new services. That is why we’ve developed the ‘Engagement, Involvement and Co-Production Our Approach – 2022’ a  document which outlines our key commitments to making this happen. We want to ensure that the involvement of people with care and support needs and carers becomes standard practice.

Peter recruits his own support staff

What did we do?

For the last 4 years, we have tried to improve the involvement of Promoting Independent Living Service (PILS) tenants in the recruitment of their own staff. 

The Promoting Independent Service offers support to people in their own tenancies around the clock to live as independently as possible, to be active in their local community and to live the lifestyle that they choose to live. 

Some people live in their own house, others live in shared accommodations with friends. Peter lives in his own flat, within a small number of flats, with staff on hand 24/7.

What could be more powerful than people choosing those that are going to be supporting them in the future?

We provide training with tenants to ensure they understand the recruitment process and how to identify the right attributes in their future staff. We use a card system made up of staff pictures with a description of them on the back. This is designed to ensure people are not choosing a friendly-looking face or rejecting people on grounds of gender, race, or age.

During COVID-19 we have had to suspend tenant involvement due to recruitment happening on-line, but now we are back in the room, so to speak, we are really looking at innovative ways of getting the most involvement we can in partnership with our tenants.

Peter's role on the interview panel

Peter is a 43-year-old man, with mild learning disabilities, who receives support involving everyday tasks, shopping, cooking cleaning etc. Peter has its own tenancy and works very hard on keeping his flat clean and tidy. Peter is not the most confident of people as he has a slight speech impediment which can make it difficult
to understand him when talking so being part of the interview panel and asking his own questions was a big challenge for him.

Peter chose his own questions with help from the staff who support him at home, independent of the recruiting panel.

Peter was able to ask his own questions to each candidate and other panel members were able to clarify any parts of the question candidates did not understand as Peter is not always easy to understand if you don’t know him well.

Peter contacted the successful candidate to offer them the job! Peter reflected on the process;

"Scary!". "Really enjoyed it". "Will I be able to do it again?".

Malc Shiner, Support Coordinator said;

"We started doing this to continue the empowerment of our tenants in the process of employing staff. Who better to have input into this than the very people being supported? We have done this a few times now and it has always been a positive experience for all tenants. It has built their confidence, increased their self-esteem and a chance to do something that they would find difficult to experience in any other service. Interviewees also get the opportunity to meet and interact with those that they will work with right at the start of their career, giving them a small taster of what the future could be like as part of the PILS family". 

What next and looking forward

PILS are hoping to use photos and video footage in our adverts in order to show candidates our commitment to
involving tenants in the recruitment process and showing what they can expect if they come to interview. 

In the future PILS want to look at how we involve our tenants who don’t use speech as their way of communication in the interview process. Potentially as part of the interview, all candidates will be asked to do a project or test with the tenants designed to see how they interact with people.

Tracey Denny, Head of Service Localities and Social Care Operations said;

"It’s great to see what the service is doing to involve people in recruitment and something we want to ensure we build on and see happening across the rest of our teams".

Adult social care stakeholder group

The work of Adult Social Care continues to be supported by our Stakeholder Group, who meet regularly to discuss any updates and influence the improvements of the service. The group is made up of Coventry residents who are experienced in how services work.

June, one of the new members, said;

"One of my personal reasons for joining the Adult Social Care Stakeholder Group was to be involved in the development and improvement of services. I have a combination of experience in both my previous working life and in my personal life and now that I am retired I am keen to share and use this experience to help improve outcomes for people living in Coventry. I am passionate about good Mental Health Services and  supporting people, their family, friends and carers who support them with the right information and advice at 
the right time. The Adult Social Care Offer is an example of how the group has been involved in the production of information and our views and suggestions have been incorporated to ensure the statement is clear and accessible for all".

Find out more about getting involved. [https://www.coventry.gov.uk/getinvolvedasc]

Performance matters

On a yearly basis, Adult Social Care undertake a survey of the experience of adults in receipt of support and every other year we undertake a survey of the experience of carers. These infographics shows our performance. This information helps us set our future priorities and identify any areas for improvement.

Understanding the views and experiences of Adult Social Care carers 2021/22

About the survey

A random selection of people with caring responsibilities who received an assessment or review within the 12 months prior to 31 August 2021.

• 314 people gave feedback during October to November 2021
• Survey respondents age between 20 and 100. The average was 72.
• 34% were male, 66% were female
• Of the people who were being cared for, 27% had physical support, 15% had memory and cognition, 42% unknown and the rest included learning difficulties, mental health and other needs

Enhancing the quality of life for people with caring responsibilities

• Carers reported quality of life (7 out of 24)
• 25% said they had as much social contact as they would like

Ensuring that people with caring responsibilities have a positive experience of care services and support

• 3 out of 10 carers said they were satisfied with the social care support they received
• 60% said it was fairly easy to find information about services

Ensuring people with caring responsibilities are included and consulted in the discussions about the person they care for

• 67% of people with caring responsibilities felt included or consulted in discussions about the person they care for.

Understanding the views and experiences of Adult Social Care people with care and support needs 2021/22

About the survey

A random selection of service users were contacted who received long-term support as at 1 December 2021

• 385 service users gave us their feedback
• Ages of respondents varied between 18 and 102. The average age was 60
• 43% of respondents were male. 57% were female
• Of the people who were being cared for, 58% had physical support, 20% had learning difficulties, the rest had other needs.

Enhancing the quality of life for people with caring responsibilities 

• People scored their quality of life 19 out of 24
• 42% said they had as much social contact as they would like
• 7 in 10 people said they have enough control over their daily life

Ensuring that people have a positive experience of care services and support

• 6 in 10 people said they were satisfied with the social care and support they received
• 66% said it was fairly easy to find information and advice about support, services or benefits

Ensuring that people who are vulnerable feel safe and protected from harm

• 72% said they feel safe (this includes feeling safe from abuse, falling or other physical harm both inside and outside the home)
• 85% said services received helped them feel safe

S75 Partnership Agreement

We have a Section 75 Partnership Agreement with Coventry and Warwickshire Partnership Trust (CWPT) for the delivery of integrated mental health services. This agreement dating back to 2014 has now been extended for a further three years from April 2022. Each year the Partnership Trust produces its own Annual Report of the performance of the partnership arrangements to provide integrated mental health services in Coventry and Warwickshire. This report when published will be available via the Trust's website. [http://www.covwarkpt.nhs.uk/]

Complaints and compliments

Everyone has the right to receive a good level of service and we want people to get the best possible support from us. Listening to your views helps us to put things right and improve our services for the future, so comments, compliments, complaints and suggestions are important and always welcome. [https://www.coventry.gov.uk/asccommentscomplimentscomplaints]

In 2021/22, we received

• 72 complaints
• 279 compliments (nearly 4 times more compliments than complaints)

Celebrating our own strength, awards and good news

Adult Social Care celebrates our City of Culture

In 2021-2022 all eyes were on Coventry as we became the second City of Culture in the UK. The start of festivities were slightly delayed until June 2021 to take into account the national lockdown and to ensure that people would get the most out of the programme of activities and that Coventry still got its chance to shine. It was important that all residents in Coventry felt part of the year. The company Creative Mojo with funding from the Coventry City of Culture Trust were able to work with Care Home residents to create some wonderful artwork across the city as part of the Winter Wanderland display. The displays played on the strengths and interests of residents from Care Homes,  including celebrating the automobile industry within Coventry. The materials used meant that it was easy to get residents included in the design and creation of a number of different art installations. The end results are incredible.
 

Bringing it all together event

In March 2022 representatives from across Adult Social Care came together to discuss and celebrate the strengths of the service, with workshops focusing on the future developments taking place in Adult Social Care and to introduce the development of Team Planning approaches. These Annual Team Plans are key documents which show how individual teams contribute to the Council’s overall priorities and how by working together we can deliver our Adult  Social Care service effectively whilst continuing to improve.

Foodie Awards 2022 - Finalist announcement - Community and Food Hero Award - The Pod Café

This award recognises those who have gone the extra mile for the food scene in Coventry and Warwickshire. Whether that’s helping the local community, providing opportunities, creating a brand-new business that benefits the area, or anything else that supports the food and drink world in the region. The Pod Café is a finalist this year, with a public vote to take place. 

Adults Services Wellbeing

A staff wellbeing week was held in March 2022 this being a daily mixture of online and in-person activities and events focusing on health and wellbeing for our Adult Services. The week was organised as an opportunity to reflect on our own wellbeing and perhaps learn some new ways of looking after ourselves and our health. There were a variety of sessions on offer which included virtual sessions focusing on learning new skills, boosting well-being and virtual yoga sessions and appointment-based sessions for nutrition, musculoskeletal issues and blood pressure/cholesterol levels. The week was well received by our staff with over 200 people attending various sessions over the week.

Improving our internal provision

Eric Williams House are moving forward and working towards the Butterfly Model of Care. This looks at creating a home from home and means that they personalise all residents’ care and address holistic needs of the individual.

Part of this was looking at the bedroom doors, they were all drab and a battleship grey in colour, this meant that the residents could not identify their own bedrooms as they all looked the same. Eric Williams staff embarked
on a project which meant that all the bedroom doors would be replaced to look like front doors.

They were to have to room numbers on with door knockers or letterboxes to resemble a front door, this is to make them easier to be identified as bedroom doors as the lounges also compromise of bathrooms, toilets, and linen cupboards. The bulk of the work took a little over 4 weeks, the old doors and frames were removed and swiftly replaced with the new frames and doors. Although they are not fully finished and there are still some things left to do it has already had a positive impact on residents.   

One of the residents, Celia, has fallen in love with her front door and is absolutely over the moon with it. She said; 

"I absolutely love it! It makes such a difference".

We are continuing to improve the physical environment for people supported in our internal services but also for the staff who work there. The last years have been a challenge for staff, with ever-changing guidelines to work to, increased infection control and cleaning protocols, managing outbreaks and maintaining a safe service. A lot of the time staff did not get a chance to take a break and took on different roles and extra duties so there was not a lot of time spent reflecting on what was happening to enable staff to deal with the effects this may have been having on their health and wellbeing. So, at Eric Williams House a project was led by Christine Calcott Assistant
Manager to update the staff room which had not been changed for many years. Staff were engaged as to what they wanted, and workforce grants were accessed to make the improvements. The staff are really pleased with the end results.

They commented;

"It's nice and more relaxing."
"It creates a relaxing atmosphere."

Terri Hallinan, Unit Manager, said;

"Eric Williams House is a family, the journey that we have taken together through the last few years due to the pandemic has strengthened our foundation. All staffing roles are physically and mentally demanding, and being kind to yourself is not always easy when looking after others. If there is one thing we have learnt, it is we need to also think about our own mental well-being. This was the seed that was planted for this project, as you can see it grew into an area that now has a positive impact daily on team members working life at Eric Williams House". 

Achieves in the Community Award

Sarah Laughton, Development Worker at the POD and Christine Eade, Manager of The POD, won the Ladies First Professional Development Awards 2022 in the category Achieves in the Community. The event was celebrated at Coombe Abbey. A person who accessed their support through The POD, nominated them for their outstanding work.

Principal Social Worker Annual Report

Most areas now have a Principal Social Worker for Adults and Children’s, supported by national and regional networks. The Care Act 2014 says local authorities should make arrangements to have a ‘qualified and registered social work professional practice lead’ in place. 

In support of ensuring visibility for the role and celebrating achievements, our Adults Principal Social Worker, Andrew Errington, has produced a fourth annual report. [http://www.coventry.gov.uk/pswannualreport]

What's next? Key areas of development for Adult Social Care 2022/23

In previous years our improvement priorities have been shaped around four key areas:

• Our Promoting Independence model
• Accommodation offering care and support
• Locally based support
• Digital Technology and innovation

However, the environment in which Social Care operates is changing. As we reflected on earlier in the Report this includes Government proposals for Adult Social Care reforms, the introduction of Integrated Care Systems and the One Coventry Plan currently being consulted on. Whilst the changes will impact on Adult Social Care as we move forward, what has not changed is the people who come to us for support and the core purpose of Adult Social Care in supporting people to achieve their outcomes and to live as independently as possible. Therefore, when considering our future priorities, we must be conscious of the impact of the changing environment while remaining committed to our core purpose. Recognising the changing environment, we are focussing our improvement work on three areas: reforms, partnerships and internal improvement. The key elements of each of these areas are summarised above.

Adult Social Care reform

This will include;

• Act in accordance with Government requirements to move towards a Fair Cost of Care and to develop and utilise a Market Sustainability Plan by February 2023 
• The implementation of a cap on social care costs, the Care Cap requirements to be in place by October 2023.
• The implementation of new Charging thresholds and a revised Charging Policy by October 2023.
• Continuing to prepare for the implementation of Liberty Protection Safeguards (replacing the Deprivation of Liberty Safeguards) at a date to be confirmed by the Government

Adult Social Care improvement

This will include

• Workforce - We will look to develop and support our internal and external workforce with a focus on recruitment, retention, culture and learning and development. 
  Supporting our residents - We will review our service levels and customer
• standards in order to provide clarity on what people can expect from Adult Social
  Care when contacting us and receiving support.
• Diversity and inclusion - We will undertake community engagement events to
  raise awareness of Adult Social Care, including specifically within hard-to-reach
  communities. We will listen and respond to feedback regarding our service and how
  we can improve.
• Information and engagement - We will ensure the Adult Social Care Offer is
  accessible to all, redesigning the way we share information on our webpages and
  expanding the ways we engage on and co-produce our services.

Adult Social Care partnerships

This will include;

• Change and transformation – We will continue to build relationships with partner agencies. Working jointly with Coventry and Warwickshire Partnership NHS Trust (CWPT) within the Section  75 Agreement we will find new solutions and ways of working to support people experiencing mental health problems
• Improving lives for older people – We will work in partnership with health and voluntary sector organisations to implement the improvements identified by this programme to ensure older people can live independent lives in good health in Coventry.
• Integrated Care Record – We will use new joined-up records to deliver, better, safer and more timely care and support to people.
• Voluntary Sector and Communities – We will work in partnership with the voluntary sector and community groups to improve the support available locally to adults.

Glossary

This section provides an explanation of some definitions and terms that appear throughout these pages.

• One Coventry - One Coventry is how we describe the Council’s objectives, key strategies and approaches. It includes the Council’s vision and priorities; new ways of working; and core areas of activity.
• Integrated Care Systems (ICSs) - Integrated care systems (ICSs) are partnerships of organisations that come together to plan and deliver joined up health and care services, and to improve the lives of people who live and work in their area. 42 ICSs were established across England on a statutory basis on 1 July 2022.
• Home First - Providing short-term care and reablement in people’s homes or using ‘step-down’ beds to bridge the gap between hospital and home meaning people no longer need to wait unnecessarily for assessments in the hospital. 
• Brokerage - A brokerage service finds information about service providers and other resources.  For example, agencies that provide help with personal care and activities of daily living. 
• Power of Attorney - A power of attorney is a legal document that lets you give one or more persons the power to make decisions and manage, your money and property, and/or your health and welfare. 
• Housing with Care - sometimes known as Extra Care, is housing designed for older people, with various levels of care and support available on site.
• Promoting Independence - Short-term services which aim to maximise the independence of the individual. At the end of the support, ongoing care and support services will be arranged as required.
• Short-term Support - Short-term support is intended to be time-limited, with the aim of maximising the independence of the individual and reducing the need for ongoing support by the Council.
• Safeguarding - Safeguarding is how we work with people to prevent them from experiencing harm from others or sometimes themselves. It includes helping people recover when they have been abused.
• Carer Assessment - If you care for someone, you can have an assessment to see what might help make your life easier. This is called a carer's assessment. 
• Disabled Facilities Grant (DFG) - A Disabled Facilities Grant or DFG is available from Local  Authorities to pay for essential housing adaptations to help disabled people stay in their own homes.
• Infection Prevention and Control (IPC) - Infection prevention and control is a practical, evidence-based approach which prevents people and care workers from being harmed by avoidable infection as a result of bacteria and viruses not responding to medicines.
• Section 75 Partnership Agreement - These partnership agreements, legally provided by the NHS Act 2006, allow budgets to be pooled between local health and social care organisations and authorities. Resources and management structures can be integrated, and functions can be reallocated between partners.
• Co-production - When an individual influences the support and services received, or when groups of people get together to influence the way that services are designed, commissioned and delivered.

Useful contacts

The Adult Social Care and Communities directory [https://cid.coventry.gov.uk/] has all the information and advice you need in one central place, so you can find all the information you need easily.

Council contacts and mental health services:

Name	Explanation	Contact
Adult Social Care Direct	The first point of contact for any referrals into Adult Social Care.	024 7683 3003
Emergency Out of Hours (After 5pm Monday to Thursday, 4.30pm on Friday and throughout the weekend)	For urgent enquiries/emergencies only outside of normal office hours	024 7683 2222
Main Council Customer Services	The main switchboard for Coventry City Council	080 8583 4333
Mental Health Access Hub	Run by Coventry and Warwickshire Partnership NHS Trust (CWPT), this is the first point of contact for people accessing CWPT mental health services.	080 8196 6798

Other organisations

Name	Explanation	Contact
Age UK Coventry	Supporting adults 18+ providing information and advice, support and groups	024 7623 1999
Alzheimer’s Society Coventry	Supporting adults with a diagnosis of dementia and their families with the provision of information and advice and group-based support	024 7665 2602
Carers Trust Heart of England	One-stop shop for unpaid carers of all ages	024 7663 2972
Coventry & Warwickshire MIND	Support for people living with a mental health condition	024 7655 2847
Macmillan Cancer Support	Cancer Support Service	024 7696 6052
Healthwatch	Independent organisation supporting people to have their say in health and social care services	024 7625 2011
SEND Information, Advice and Support Service	Providing information and advice to young people with disabilities and special educational needs	024 7669 4307

Special Thanks to….

• Saba, Ahmed, David, Ian and Peter
• Carers Trust Heart of England
• All care providers across the city
• The staff at Adult Social Care
• All our partners and stakeholders

Contact Us

You can contact us about this report at: getinvolved@coventry.gov.uk [mailto:getinvolved@coventry.gov.uk]
For Adult Social Care Direct email: ascdirect@coventry.gov.uk [mailto:ascdirect@coventry.gov.uk]
Next Generation Text (also known as Text Relay and TypeTalk) Call 18001 024 7683 3003
Telephone: 024 7683 3003
More information about Adult Social Care [http://www.coventry.gov.uk/adultsocialcare].
 

Previous reports

Previous reports are available to download and print [https://www.coventry.gov.uk/downloads/download/1882/adult_social_care_local_account].