Local Account 2015/16

File pathway: H: Adult Projects/Needs & Intelligence/Local Account//2015-16/Local Account 2015-16 V1

Local Account

2015/16

Derbyshire County Council

Adult Care

This is the Local Account 2015/16 for Adult Care in

Derbyshire. It explains how we are doing, outlines our

current priorities and future plans.

File pathway: H: Adult Projects/Needs & Intelligence/Local Account//2015-16/Local Account 2015-16 V1

Contents

Executive Summary Page 2

Foreword Page 3

Derbyshire’s Social Care Profile Page 4

Acting on what you tell us Page 5

Our Performance – The Local Account for 2015/16 Page 7

The Cost of Care Page 10

Complaints, Comments & Compliments Page 13

Adult Care priorities 2016/17 Page 20

Public Health priorities 2016/17 Page 24

Appendix Page 28

Feedback Page 46

Version History

Version Date Detail Author

1.0 20.10.2016 First draft Becky East

2.0 28.10.2016 Second draft incorporating amends from LMF Becky East

3.0 11.11.2016 Third draft including amends from SDs & GMs Becky East

4.0 17.11.2016 Fourth draft incorporating amends from LMF Becky East

5.0 28.11.2016 Fifth draft incorporating amends from SMT Becky East

6.0 30.11.2016 Sixth draft incorporating amends from Cllr Smith Becky East

7.0 2.12.2016 Final Approved Version Becky East

This document has been prepared using the following ISO27001 standard controls as reference:

ISO Control Description

4.3.2 Control of Documents

4.3.3 Control of Records

PUBLIC

2 | P a g e

Executive Summary

Welcome to the 2015/16 Derbyshire County Council (DCC) Local Account.

We’ve achieved a great deal over the past year but still have to work hard to ensure

that the people of Derbyshire get the care and support they need. Adult Care

continues to operate under huge financial pressures which makes the task of

providing quality care even harder.

That’s why it is extremely encouraging to see that we performed really well when

compared with other similar local authorities; we’ve received some excellent

feedback from clients and their families, and there have also been fewer complaints

this year.

This tells us that, despite the challenges, we’ve still managed to keep standards

high, which is testament both to the hard work of the Adult Care teams delivering

support in our county and the careful use of our funding.

What next for Adult Care? We can certainly expect budgets to get tighter in the

coming year. We are going to carry on focusing our attention on meeting the needs

of the most vulnerable, with the aim of keeping people independent for as long as

possible and helping to maintain individual wellbeing.

This is not going to be an easy task, but we are committed wholeheartedly to doing

the best we can for those who come into contact with Adult Care, using our

resources wisely and fairly, and maintaining high quality care and support for those

that need it most.

Joy Hollister, Strategic Director, Adult Social Care


PUBLIC

3 | P a g e

Foreword

This Local Account covers the period from 1 April 2015 to 31 March 2016. Like all

local authorities, Derbyshire is operating in an increasingly difficult environment, and

the past 12 months have been no different.

There are currently immense pressures on Adult Care as local authorities around the

country are having to manage their responsibiliites with significantly less funding.

The Chancellor’s Autumn Statement made no reference to social care despite

numerous independent bodies stating that the sector is at a tipping point. To

compound this, the NHS is clearly relying on social care to help manage rising

demand and has called on the Government to increase funding to local

authorities. It is therefore clear that we have to operate under severe financial

constraint for the foreseeable future.

Meeting the new obligations placed on councils under the Care Act, along with the

continued development of personalisation1, means we have to look at new ways of

managing services that keep costs down, while continuing to support the most

vulnerable. Therefore our work in the coming year will focus on key areas of both

preventing need from arising, and managing demand for services.

This Local Account looks at how the budget for Adult Care was spent during

2015/16, plus how our services have performed when compared with other local

authorities. It also shows how we are working with our local communities, and

building on feedback, in order to improve the experience of those who come into

contact with Adult Care. We’re always looking at ways of doing things better. If you

have any comments about this Local Account, or ideas on how we can improve

Adult Care services for the people of Derbyshire, please fill out the feedback form at

the end of this document. We’d like to hear from you.

Cllr Paul Smith, Deputy Council Leader and Cabinet Member, Adult Social Care


1Personalisation - also known as ‘self-directed support’ - gives people more choice and control over the way their

social care needs are met.

PUBLIC

4 | P a g e

Derbyshire’s Social Care Profile

Nationally, the pressures on care and support are being compounded by the

increasing demand for those services arising from the fact that people are living for

longer whilst also managing increasingly complex health conditions.

Derbyshire has a higher proportion of older people compared with the national

average. Currently around a fifth (21.3%) of the people of Derbyshire are aged over

65 (compared with 17.8% nationally); 2.7% of these individuals are aged over 852

(2.4% nationally). The overall population of older people is projected to increase by

10% nationally by 2021.

Around 70% of Adult Care clients are older people; younger adults make up the

remainder; these are people aged 18-64 with either a physical impairment, a learning

disability or a diagnosed mental health issue.

We also have over 90,000 carers in Derbyshire, individuals that provide informal,

unpaid care to those with a disability or illness; more than 20% provide 50 or more

hours of support per week. Carers perform an invaluable role in helping to support

people’s independence and ability to remain in their own homes for longer.

Although life expectancy in Derbyshire is generally similar to the national average,

residents in the least deprived areas of our county are likely to live around a decade

longer than those in the most deprived areas (many of which are in the north east of

the county). Some Derbyshire residents are also coping with health conditions that

reflect the former industries in our county. Geographically, large areas are also rural,

which makes delivering care in these areas more difficult.

Along with our colleagues in Public Health, we are helping to reduce avoidable

health inequalities by improving health, wellbeing, diet and lifestyle, and reducing

illness arising from excessive alcohol consumption, smoking, obesity and lack of

exercise. Even though our resources are stretched, we are working hard to help the

people of Derbyshire enjoy lives that are healthy and inclusive for as long as

possible.

2 Office for National Statistics (ONS) population projections.

PUBLIC

5 | P a g e

Acting on what you tell us

By consulting with local people, and regularly meeting with different community

groups, stakeholders and voluntary organisations, we can be sure that we take into

account the views of Derbyshire’s communities when planning, shaping and

restructuring our services.

This is particularly important when difficult decisions have to be made around the

future of some of our services. One of the most significant consultations in 2015/16

focused on the future of Derbyshire’s homes for older people.

Taking place over a 12 week period, the consultation encouraged residents at the

homes, their families, staff, local people, various groups and organisations, to give

their views. These comments and concerns helped inform part of the report to the

Council that considered the potential effects of the home closures on residents and

the local community.

In order to address some of the concerns raised in the consultation, DCC signed up

to a series of pledges aimed at the 78 residents whose homes were due to close.

These included treating residents with dignity and respect, consulting closely with

them at every stage, discussing their preferences plus their care and support needs,

and addressing their concerns about moving.

Over the past year we have met with a number of groups which has led to some

positive outcomes for local people.

The Derbyshire Older People’s Advisory Group which meets four times a year set up

a series of initiatives during 2015/16 as part of the ongoing Community Ventures

Project. These include establishing programmes designed to encourage older people

to use technology more, developing an interactive workshop aimed at reducing road

accidents amongst the 70 plus age group, and ensuring older adults were aware of

their rights to social security benefits in order to maximise their income.

Some of these groups are aimed at supporting certain sectors of the community or

specific client groups, and others are more generic in their remit.

PUBLIC

6 | P a g e

For example, the work of the Local Learning Disability Partnership Boards has led to

the co-production of certain services aimed at supporting adults with learning

disabilities. Over the past year this work has helped to raise awareness of paid

employment skills for people with learning disabilities in Derbyshire; it has also led to

the development of a pilot scheme aimed at improving engagement with the learning

disabled community.

The work of the Derbyshire Stakeholder Engagement Board has led to the co-

production of policy, information resources and services across all Adult Care client

groups. Over the past year this work has brought about the development of a web

page for the Discretionary Fund (which aims to address urgent need in times of

crisis). It has also helped to develop a ‘Need a bit of help at home?’ leaflet which

details a range of free and paid-for support available to adults in Derbyshire. This

not only provides useful information in its own right, it helps DCC to fulfil its

obligations under the Care Act by ensuring that the local communities are informed

of the Adult Care services available to them.

PUBLIC

7 | P a g e

Our Performance – The Local Account

for 2015/16

The performance of local authorities that provide for people with social care needs is

measured by what’s known as the Adult Social Care Outcomes Framework

(ASCOF).

This is a nationally recognised tool, devised by the government, that allows different

authorities to be compared in a standardised way. The ASCOF is therefore

considered a good measure of how well care and support services achieve the

outcomes that matter most to service users.

Various data returns3 are used as the basis for the ASCOF measures. The Adult

Social Care Survey (ASCS) also feeds into seven of the ASCOF measures, and

uses survey information completed by the users of Adult Care services themselves

about their experience of social care.

Specifically, this includes indicators relating to quality of life, levels of control and

social contact, ease of finding information, satisfaction levels and how safe the

individual feels4.

Derbyshire’s 2015/16 ASCOF performance has been compared with the national

average, the average for those local authorities in the East Midlands region, the

average of similar ‘matched5’ local authorities, and also our performance last year.

Figure 1 on page 8 highlights how we have performed in relation to those local

authorities we are matched with. We also list the performance indicators we are

doing well in, as well as those we need to improve. Figure 2 on page 9 shows how

our 2015/16 performance compares with the previous year.

3 Short and Long Term Support (SALT) collection, Delayed Transfers of Care (DToC), Hospital Episode Statistics

(HES), Mental Health & Learning Disabilities Dataset (MHLDS), mid-year population estimates, ONS (Office for National Statistics). 4 Local authorities also run a Survey of Adult Carers (SACE) every two years which forms the basis of some

ASCOF measures. However, the most up to date data will not be available until mid-2017, therefore this Local Account does not report on ASCOF data derived from this source. 5 Known as the ‘CIPFA family’, these include 15 other nearest neighbour local authorities that share similar

characteristics to Derbyshire including population size and spread, levels of social deprivation, how rural it is, and so on.

PUBLIC

8 | P a g e

Figure 1 – How Derbyshire’s performance compares 2015/16

In summary, these are the areas we are generally doing well in:

Social care related quality of life

People receiving self-directed support

Adults in contact with mental health services in paid employment

Adults with learning disablities in stable accommodation

Adults in contact with mental health services in stable accommodation

Service users with as much social contact as they would like

Delayed transfers of care attributable to social services

Service users who find it easy to get information

Delayed transfers of care

Client satisfaction with care and support

People who use services and feel safe.

Above average 56%

Below average 39%

On a par 5%

Our Performance 2015/16

PUBLIC

9 | P a g e

These are the areas we need to improve:

Service users with control over their daily life

People receiving Direct Payments

Adults with learning disabilities in employment

Permanent admissions to care homes: people aged 18-64

Permanent admissions to care homes, people aged 65 and over

Older people at home 91 days after leaving hospital into reablement

People who say the services they use make them feel safe and secure.

Although we are aware that there are areas we will need to work on in the coming

year, these performance measures are generally very positive. They indicate that,

despite the challenging financial context in which we must operate, and the difficult

decisions we have had to make as a result, the standard of service to current clients

has not been adversely affected.

Further, levels of satisfaction with care and support services have remained high,

and the hard work of the Adult Care teams continues to be valued by those that

receive support. For more detail on each performance indicator, please turn to the

Appendix at the end of this document.

Figure 2 – Our performance – comparing 2014/15 with 2015/16

50%

44%

6%

56%

39%

5%

0%

10%

20%

30%

40%

50%

60%

Above average Below average On a par

Pe

rce

nta

ge

DCC's ASCOF performance compared with similar 'matched' authorities

Our Performance comparing 2014/15 and 2015/16

2014/15

2015/16

PUBLIC

10 | P a g e

The Cost of Care

Figure 3 – What we spent on Adult Care 2015/16

The chart above shows how the outturn budget was divided amongst the various

areas of Adult Care work during 2015/16. Tables 1 and 2 overleaf show the

breakdown of expenditure in 2015/16 compared with the previous year.

Together, these help to illustrate the fact that our expenditure has been split slightly

differently across the various Adult Care functions in order to accommodate the

constricted funding context and at the same time manage increased demand for

services.

Care Packages, 81.6%

Fieldwork, 6.0%

Prevention, 3.4%

Housing Related Support,

2.8%

Senior Management, 0.3%

Strategy & Commissioning,

1.7%

Business Services, 3.9%

Other, 0.3%

Adult Outturn Budget 2015/16

CONTROLLED

11 | P a g e

Table 1 - 2014/15 Adult Care Net

Expenditure

Service £m %

Care Packages 181.6 77.8

Fieldwork 17.7 7.6

Prevention 11.4 4.9

Housing Related

Support

11 4.7

Senior Management 0.7 0.3

Strategy &

Commissioning

2.0 0.9

Business Services 8.2 3.5

Other 0.8 0.3

Sub-total 233.4

Health Contribution (16.5)

2014/15 Spend 216.9 100%

Table 2 – 2015/16 Adult Care Net

Expenditure

Service £m %

Care Packages 162.2 81.6

Fieldwork 11.9 6

Prevention 6.8 3.4

Housing Related

Support

5.5 2.8

Senior Management 0.6 0.3

Strategy &

Commissioning

3.4 1.7

Business Services 7.8 3.9

Other 0.6 0.3

Sub-total 198.8

Health Contribution 0.0

2015/16 Spend 198.8 100%

The total Adult Care expenditure for 2015/16 was £198.8m, a reduction of £18.1m on

the previous year (£216.9m6). This is £4.5m under the budget allocated for this

period and was achieved by:

Meeting the majority of the additional responsibilities outlined in the Care Act

using existing resources. This means that the £4.567m Care Act Grant has not

yet been utilised.

Achieving budget cuts of £1.107m ahead of schedule.

Using some of the Better Care Fund allocation to fund the additional resources

that were put in place over a number of previous years to reduce the level of

delayed hospital discharges.

Note that the ‘Health Contribution’ referred to in 2014/15 was “Section 256” funding

that has now been rolled into the Better Care Fund (BCF). The BCF allocation for

2015/16 is explained in more detail on page 21.

6 Note, there was a financial contribution from health in 2014/15 which helped to reduce the total spend by

£16.5m in that period.

PUBLIC

12 | P a g e

As expected, in 2015/16 the largest amount was spent on care packages (the

combination of services put together to meet a person’s assessed needs). Even

though the overall spending reduced, the proportion of the budget itself was around

4% higher, making up 81.6% of the total 2015/16 Adult Care expenditure compared

with 77.8% in 2014/15. Overall expenditure has reduced in all areas, but the

Department has protected statutory services as far as possible. As the spend on

care packages is all statutory, this has led to relatively fewer cuts and therefore an

increase in the overall percentage of spend.

This leaves 18.4% of expenditure; Fieldwork makes up the largest proportion of this

remaining area of cost, amounting to 6% of the overall expenditure compared with

7.6% the previous year. By far the biggest year-on-year reduction in expenditure can

be seen in the areas of Prevention (3.4%) and Housing Related Support (2.8%)

which made up 4.9% and 4.7% respectively of the expenditure for the previous year.

Strategy and Commissioning made up 1.7% of the overall expenditure in 2015/16

compared with 0.9% in 2014/15, with an increase in actual expenditure of £1.4m.

This additional expenditure is the contribution from Adult Care into the Better Care

Fund Pooled Budget (a budget created to assist in joint working between Adult Care

and Health), and represents a direct transfer of spend from the Prevention element

of the budget.

Whilst the amount spent on support services to Adult Care (including business

administration, IT, finance and management information) actually reduced, this made

up an increased proportion of the overall expenditure, from 3.5% to 3.9%.

Derbyshire’s spend on support services is relatively low and this has reduced the

opportunity for making further substantial cuts.

Costs relating to Senior Management and ‘Other’ have remained the same at 3%.

In the coming year we will need to make a number of savings; these will be achieved

through a range of actions including demand management, reduction in Housing

Related Support services and savings on the introduction of the Care Act.

PUBLIC

13 | P a g e

Complaints, Comments & Compliments

This section of the Local Account examines the feedback from clients and their

representatives received by Adult Care throughout 2015/16.

Where concerns are raised, staff at a local level will actively seek to resolve a

problem as soon as possible without the need for the more formal complaints

process to be entered into. However, where a formal complaint is requested, or local

resolution has been unsuccessful, the concerns will be logged and escalated to an

operational manager for action and follow up.7

The complaints process is governed by key areas of legislation and DCC’s own Adult

Care complaints process; in general, this involves working out a plan with the

aggrieved party on how the issue will be managed, agreeing a timescale, and

outlining what potential outcomes are reasonable to expect.

Whatever the issue, all feedback is dealt with in confidence, and, where appropriate,

there is an emphasis within the Department on taking responsibility and learning

from mistakes; similarly, we understand the importance of passing on positive

feedback.

Before considering the amount and type of feedback received, it is worth examining

the ‘bigger picture’ in terms of the volume of work handled within Adult Care. This

helps to place the numbers of complaints in context.

Between 1 April 2015 and 31 March 2016, 35,625 referrals were received from new

clients which resulted in a service (including signposting to other services).

Performance and Personalisation services (what used to be known as Fieldwork)

undertook 6,538 client assessments and 4,283 carers’ assessments. A total of

16,388 reviews were completed; this includes reviews of support plans and personal

service plans for clients receiving home care and day care.

7 Adult Care complaints include those which, according to the NHS and Social Care regulations, relate to social

care within the meaning of Part 1 of the Health and Social Care Act 2008

PUBLIC

14 | P a g e

Within Direct Care 1,746 clients received a home care service, 1,295 received day

care and 1,284 received care in a council run establishment.

WHAT DOES THE FEEDBACK RELATE TO?

Complaints, comments and compliments regarding Direct Care relate to those

services Derbyshire County Council delivers itself; for example, home care using our

own carers, plus council-run residential homes and day centres.

Those in respect of Prevention and Personalisation include those related to

assessment and services provided by third party organisations but contracted

through DCC. Feedback relating to home care fees, billing processes and brokerage

services are dealt with by the Commissioning and Performance division (formerly

Strategy and Commissioning).

Complaints arising from work undertaken by third party providers commissioned

through Adult Care are initially managed by individual providers’ complaints

procedures. Only if the issue remains unresolved are they passed to Adult Care.

Those services involving the most frequent and prolonged client contact inevitably

attract the largest proportion of feedback, namely Prevention and Personalisation,

and Direct Care.

Overall, 15% less feedback was received during 2015/16 compared with the

previous year; there were 391 compliments (467 in 2014/15) and 228 complaints

(260 in 2014/15).

COMPLIMENTS

It is always encouraging to receive positive feedback from clients about the work we

do in Adult Care as it represents formal acknowledgement of the degree to which

the work of our staff is valued.

Table 3 overleaf shows the distribution of compliments received, and split by

division, over the last three years.

PUBLIC

15 | P a g e

Table 3 - Breakdown of compliments received

COMPLIMENTS RECEIVED - BY DIVISION AND YEAR

Division 2013/14 2014/15 2015/16

Direct Care 292 (59%) 289 (62%) 240 (61%)

Prevention and Personalisation 192 (39%) 171 (37%) 143 (37%)

Commissioning and Performance 7 (2%) 7 (1%) 8 (2%)

Total 491 (100%) 467 (100%) 391 (100%)

This shows that, of the 391 compliments received, the majority, 240, were received

by Direct Care, 143 related to Prevention and Personalisation services, and the

remaining eight were received by Commissioning and Performance.

Whilst the overall number of compliments has dropped over the past two years, the

proportions across each division remain very similar, with the largest percentage

relating to Direct Care (59% to 62%), around one third (37% to 39%) directed at

Prevention and Personalisation services, and the remainder (1% to 2%) relating to

Commissioning and Performance.

COMPLAINTS

In terms of complaints, the past year has seen a decrease by about 9% in the

number received, from 260 in 2014/15 to 228 in 2015/16.

Table 4 shows how the complaints received over the past three years have split

according to Adult Care division. Although there was a small increase last year, the

overall number has now dropped to below the level recorded three years ago.

PUBLIC

16 | P a g e

Table 4 – Breakdown of complaints received

COMPLAINTS RECEIVED – BY DIVISION AND YEAR

Division

2013/14

2014/15

2015/16

Direct Care 56 (24%) 39 (15%) 64 (28%)

Prevention and Personalisation 169 (71%) 189 (73%) 143 (63%)

Commissioning and Performance 13 (5%) 32 (12%) 21 (9%)

Total

238 (100%)

260 (100%)

228 (100%)

Looking at the distribution of complaints across the divisions, this appears to have

shifted over this time. Whilst the number of complaints received overall has reduced,

there were more in relation to Direct Care than in the previous two years, and fewer

in respect of Prevention and Personalisation work. Those in relation to the

Commissioning and Performance division have reduced compared to last year,

making up around 9% of the total, but are still higher than the number recorded in

2013/14.

Around a quarter, 26% (60), of these complaints relate to the quality of our work

(issues such as a perceived lack of care provided, a care worker not attending or

arriving late for a meeting); a similar proportion (56) relate to poor communication.

Some of the other issues raised relate to disagreement over decisions made by

Adult Care, problems relating to charges or billing, and eligibility disputes8.

Figure 4 overleaf shows the outcomes of the complaints themselves. Nearly half

(47%) were not upheld; one in five (19%) were partially upheld, and around a quarter

(26%) were upheld. The remaining 8% were either dealt with under other

procedures, withdrawn, unsubstantiated, or had not been concluded by the end of

the relevant financial year.

8 For more detailed information please refer to the Annual Compliments and Complaints Report 2015-16

available on the DCC website.

https://www.derbyshire.gov.uk/images/Annual%20Compliments%20and%20Complaints%20Report%202015%20-%2016%20_tcm44-282632.pdf

PUBLIC

17 | P a g e

Figure 4 – Outcomes of the complaints received

HOW THE COMPLAINTS PROCESS WORKS

Over the past three years the Department has become better at acknowledging

complaints within the regulatory three-day timeframe. During 2015/16 this was

achieved in 93% of cases, (compared with 91% in 2014/15 and 87% in 2013/14).

We aim to respond to 80% of complaints within the timescale indicated at the time of

acknowledgement; this should be within ten working days (or 20 for more complex

cases). This is an area that shows marked improvement, in part because more

realistic timescales are now being given to complainants. Overall, 169 complaints

(74%) were responded to within the timescale given at the time of the

acknowledgement; by comparison, the timescale was met in just 53% of cases in

2014/15.

SERVICE ENQUIRIES

This refers to requests for a change or adjustment to a service or for information on

how a decision has been reached. Correspondence from MPs and Elected Members

will usually be categorised under this heading where they are representing a

constituent with a concern.

Upheld 59, 26%

Partially upheld 43, 19%

Not upheld 108, 47%

Other 18, 8%

Complaints outcomes

PUBLIC

18 | P a g e

The number of Service Enquiries dealt with by Adult Care this year was 108. Of

these 72 were from MPs and 22 from County Councillors on behalf of their

constituents, the remaining 14 were from clients or their representatives. The

number of enquiries from MPs shows a decrease from 83 in 2014/15 and 85

enquiries in 2013/14.

CORPORATE COMPLAINTS

A further nine complaints were handled under the DCC corporate complaints

process which deals those that fall outside the legal parameters for Adult Care

complaints. This number is considerably lower than the previous two years (35 in

2014/15 and 27 in 2013/14). Two of the nine complaints were upheld.

LOCAL GOVERNMENT OMBUDSMAN COMPLAINTS AND ENQUIRIES

If a client is not satisfied with the response to a complaint they have raised with Adult

Care, they may ask the Local Government Ombudsman (LGO) to investigate it

further; the LGO will then look into how DCC has handled the complaint and

comment on its findings. 21 complaints were received by the LGO in 2015/16, up

from 11 in the previous year and seven in 2013/14.

Of the 21 received, Adult Care was found not to be at fault in three cases, fault was

found in five cases, and the LGO decided not to investigate a further four. Seven

cases were passed to Adult Care as they had not yet been through our own process;

the outcomes are awaited in the two remaining cases.

IMPROVEMENTS RESULTING FROM COMPLAINTS RECEIVED

Dealing with a complaint successfully is not the end of the process for Adult Care;

we want to learn from feedback which can translate to making changes to working

practices and processes. Here are some examples:

There were comments about difficulties in knowing which staff were

responsible for which role within DCC’s residential care homes. As a result,

different coloured polo shirts were introduced to help differentiate carers, staff

PUBLIC

19 | P a g e

responsible for residents’ activities and those involved in domestic duties.

More prominent name badges were also brought in.

Feedback was received that the standard 10-day period for collecting

equipment following bereavement (such as commodes, ‘grabbers’ and kitchen

aids) was too long. As a result, a new three-day collection was introduced in

December 2015.

Concerns over lack of information have led to the introduction of factsheets for

the general public and updates to staff on specific issues to help build

knowledge.

PUBLIC

20 | P a g e

Adult Care priorities 2016/17

As a result of tremendous financial pressures, Derbyshire, like all local authorities, is

having to come up with new ways of delivering Adult Care services to meet the

needs of the most vulnerable members of our society.

Adult Care has had to make very considerable savings in the last three years and

the need to find further savings will continue for the forseeable future9. At the same

time, eligible need will continue to rise; it will be around 18% higher in 2019/20

(39,000 people) than it was in 2010/11 (33,000), and the projected budget will be

28% less than it was in 2010/11.

This means that we have to manage our finances very carefully when deciding what

our priorities will be for the coming year. First, however, it is first important to

consider the changes to the law, amendments to policy and guidance, which will

impact on what we do and how we do it.

The Care Act 2014 - We have already made great strides in changing our working

practices to ensure that we meet our obligations under the Care Act. However,

bearing in mind the extensive reach of this piece of legislation, and the severe

constraints on funding, we will have to work harder to meet our legal obligations in

the coming year. Here are some of the areas we will be focusing on:

Continuing our programme to strengthen the provision of information, advice

and advocacy.

Improving moves from Children’s Services, to ensure young people are better

supported in their transition to Adult Care.

Shaping and managing local social care provision, by communicating the

nature of need, maintaining positive relationships with stakeholders and

providers, and improving the way we identify and mitigate risk of provider

failure.

Safeguarding the most vulnerable people in our county, by continuing to work

with partners to managing the safety and wellbeing of those most at risk.

9 Adult Care & Public Health Service Plan 2016-17, The Impact of Austerity, pages 15 -16.

PUBLIC

21 | P a g e

Introducing new arrangements to support Derbyshire’s informal carers,

including the development of a revised carers’ strategy.

The Better Care Fund – This is a single pooled budget of existing expenditure

designed to support local joint-working practices between health and social care

services. The total fund for 2016/17 is just under £65m, with £33.9m of this allocated

to Adult Care. However, we have to work hard to fulfil the conditions attached to the

fund which include, for example, taking a joint approach to assessments and care

planning, and working to reduce hospital discharge delays into social care support.

We are also continuing to measure the rate of dementia diagnosis in Derbyshire as

part of our Better Care Fund work.

Integration with health – DCC is strengthening the collaboration between health and

social care in a number of ways. For example, we have already placed registered

social workers with Derbyshire community health colleagues in the same locations to

help manage discharge from hospital better. Other changes may be required to

support the local NHS in the delivery of its Sustainability and Transformation Plan

(STP) which is likely to see further closer working over the next 12 to 24 months.

Supporting people with learning disabilities – both the NHS and local authorities are

required to deliver a new model of care in support of people with learning disabilities

by 2019. A Transforming Care Partnership has therefore been set up to build on

existing work in this area and help make this happen.

How does all this translate to plans for 2016/17? Here are some of the priorities for

the coming year:

Prepare the Adult Care workforce with the skills to manage the complex social

care needs of an ageing population.

Support more people with disabilities and long term health conditions into

work.

Help build resilient communities by implementing Local Area Co-ordination

plans in more areas of Derbyshire.

Help people to get their voices heard by providing sustainable advocacy

services for those that need them.

PUBLIC

22 | P a g e

Develop integrated models of working in partnership with NHS and other

stakeholders that focus on ‘whole person care’.

Work together with health partners to help provide the right care, at the right

time and in the right place, for those with mental health problems.

Increase the number of Safe Places for people with learning disabilities to go

to if they feel scared, threatened or are in trouble (see page 44).

Work with children and adult safeguarding partners to help protect vulnerable

people and reduce inappropriate police detentions.

Provide better access to employment and volunteering opportunities for

people with mental health needs and learning disabilities.

Help people struggling with poverty by providing emergency funding though

the Derbyshire Discretionary Fund.

Increase pensioners’ income through a targeted welfare rights campaign that

ensures they receive all the benefits they are entitled to.

Promote social inclusion and stimulate opportunity for young people moving

into adulthood through joint working initiatives.

Continue to reduce avoidable admissions to hospital and long term residential

and nursing care placements.

Improve outcomes for people with dementia and their families by developing

the Dementia Support Service in partnership with Derby City Council.

Improve quality, accessibility and performance of service providers to help

improve standards and reduce provider failures.

Progress a range of development projects that will provide quality care and

support facilities such as the new Community Care Centre in Darley Dale.

Redesign our day opportunities for older people and those with learning

disabilities in order to provide improved person-centred care and support, and

integrate these with Health where possible.

Establish new information, advice and rehabilitation services for people with

sight impairments.

Introduce carers’ personal budgets linked to identified needs, and ensure that

providers are proactive in their work with carers.

Place dignity and respect at the heart of provider services by encouraging

take up of the Derbyshire Dignity Award.

PUBLIC

23 | P a g e

Continue to promote high standards of social work practice led by the

Principal Social Worker.

Develop appropriate housing options that enable more people with learning

disabilities and/or autism to live in the community.

Expand the Community Connector service so that it helps more people with

learning disabilities increase independence through the development of better

community links.

PUBLIC

24 | P a g e

Public Health priorities 2016/17

In 2016/17 a new organisational arrangement was put in place when Public Health

and Adult Care became one department. This will allow us to work more closely in

managing social care need in Derbyshire, particularly in terms of preventing (and

delaying) that need, and also helping to manage demand for services.

Our aim for 2016/17 is to reduce health inequalities, and support and promote

healthy lifestyles for the people of Derbyshire. Specifically, we are planning to:

Deliver Public Health leadership through the following:

Review all Public Health commissioned physical activity programmes to

ensure value for money and improve access for key groups such as those at

risk of falling.

Support the training and development of public health specialists and

practitioners, including supporting local implementation of the regional Public

Health Practitioner Registration Scheme.

Enhance the skills of the wider public health workforce through delivery of

programmes such as Making Every Contact Count.

Produce a Director of Public Health Annual Report focusing on Healthy

Places.

Continue to play a lead role in developing and advising the Health and

Wellbeing Board to support effective delivery of improved health outcomes

through the Health and Wellbeing Strategy implementation.

Deliver a programme of Public Health Network training events to share good

practice and enhance public health awareness.

Deliver an updated State of Derbyshire report as part of the Joint Strategic

Needs Assessment (JSNA) in order to inform the Health and Wellbeing Board

of the key public health, healthcare and social care priorities in Derbyshire.

Facilitate the assessment of health impacts of major policy and programme

changes as part of the council’s procedures for carrying out Equality Impact

Assessments (EIAs).

PUBLIC

25 | P a g e

Support local planning authorities to achieve a healthy built and natural

environment by promoting health and wellbeing through ‘place-shaping’, for

example better housing and urban design and access to well-designed public

spaces and facilities.

Further develop the locality programme linked to delivery of the prevention

agenda and development of STP ‘places’.

Implement the Derbyshire substance misuse strategic plan.

Improve health and wellbeing through the following:

Engage with more organisations in the Workplace Health programme.

Deliver the Healthy Child Programme to all families in Derbyshire and develop

a Healthy School Community model to build health into all aspects of life at

school and in the community.

Support people at risk of food poverty through initiatives such as Super

Kitchens and the Fareshare hub.

Increase the number of adults aged 40-74 taking up the offer of a NHS Health

Check, targeting specific geographical areas and younger men in the age

criteria.

Support pregnant smokers to quit by providing Babyclear training for

midwives, providing CO monitoring equipment and ensuring that effective

electronic referral systems are in place.

Develop an all-age mental ill-health prevention framework.

Raise awareness of the Live Life Better Derbyshire service and increase the

number of people accessing stop smoking services and successfully quitting

smoking.

Enhance children’s health and emotional wellbeing by ensuring all families

receive support and guidance through the Healthy Child Programme.

PUBLIC

26 | P a g e

Protect health and improve health outcomes of vulnerable population groups through

the following:

Support and increase the visibility of substance misuse recovery opportunities

across the county. This will be achieved by working with primary care, social

care and other key stakeholders to promote the Derbyshire service offer and

commissioning work on social marketing to look at how we support and

reduce harm in “at-risk” groups.

Extend the Healthy Home project to more people in fuel poverty to help

reduce associated health problems.

Work with strategic partners to review arrangements for the timely response

to public health incidents.

Continue to support the Local Resilience Forum and jointly co-ordinate the

Local Health Resilience Partnership with NHS England, PHE and local NHS

organisations.

Work collaboratively with Adult and Children Services to reduce the risk and

burden of flu amongst frontline staff. This will be done by making vaccines

available from multiple settings for staff e.g. local pharmacies using a voucher

scheme and monitoring vaccination uptake rates, targeting messages to staff,

as appropriate.

Work collaboratively across the County Council, Districts and Boroughs and

other key stakeholders on programmes to minimise health protection risks

(e.g. from air pollution) for Derbyshire residents.

Reduce the risk of harm to individuals and communities from substance

misuse through initiatives such as the procurement of a county-wide needle

and syringe programme, roll out the Naloxone programme, targeted work with

injecting steroid users, and improved access to Hepatitis C support.

PUBLIC

27 | P a g e

Provide Public Health support to the NHS (Healthcare Public Health) by delivering on

the following:

Provide support for reducing clinical variation with a key focus on primary care

quality.

Support a programme of work on the role of Clinical Commissioning Groups

(CCGs) in prevention, based on the NHS Five Year Forward View.

Produce a State Of Cancer report for a range of major groups of cancers

covering prevention, early identification, treatment and recovery services.

Support CCGs to develop improved End of Life Care in Derbyshire.

PUBLIC

28 | P a g e

Appendix

Figure 6 – Social care related quality of life

This indicator gives an idea of the quality of life for users of social care

support. It is a composite measure based on eight questions in the Adult

Social Care Survey.

Derbyshire’s measure (19.3) shows a slight improvement on 2014/15 (19.1).

Like last year, Derbyshire’s service users rate their social care related quality

of life at a similar level as those in other authorities, those matched with us,

the England and East Midlands averages.

19.3 19.1 19 19.1

0

5

10

15

20

25

Derbyshire England Average East Midlands Average Similar Local AuthoritiesAverage

Po

ints

ou

t o

f 2

4

Social care related quality of life

NHS Digital I 2016

PUBLIC

29 | P a g e

Figure 7 – Proportion of people who use services who have control over their daily

life

‘Personalisation’ is about matching services with what that individual both

needs and wants, thereby putting them in control of their care and support.

Asking users of Adult Care services the extent to which they feel in control of

their daily lives is one way of measuring whether or not this outcome is being

achieved.

Like last year, the amount of control that service users in Derbyshire have in

their daily lives is lower than the recorded level in our matched local

authorities.

However, the gap appears to be closing. Derbyshire’s indicator has increased

slightly (from 75%), and the percentage recorded by the local authorities we

are compared with has dropped (from 79% last year).

75.3 76.6 76.4 77.6

0

20

40

60

80

100


Pe

rce

nta

ge (

%)

Service users with control over their daily life

NHS Digital I 2016

PUBLIC

30 | P a g e

Figure 8 – Proportion of adults receiving self-directed support

When an individual is allocated a budget, and the freedom to decide how this

is spent in achieving their social care outcomes, this is known as ‘self-directed

support’.

This ASCOF measure is designed to reflect the progress made by local

authorities in delivering personalised services in this way and is based on

their own data.

All the categories above show increases compared with the previous year, but

the increase for Derbyshire is quite marked, rising to 92.1% from 85.7% in

2014/15.

This is likely to be the result of efforts to meet the responsibilities of the Care

Act which came into force in April 2015. This places responsiblities on local

authorities to work with people to enhance their wellbeing, and to do so in a

way that places the individual at the heart of the process – the essence of

self-directed support.

92.1 86.9

96

85

0

20

40

60

80

100


Pe

rce

nta

ge (

%)

People receiving self-directed support

NHS Digital I 2016

PUBLIC

31 | P a g e

Figure 9 – Proportion of adults receiving Direct Payments

This indicator measures the progress made in terms of delivering

personalised support through Direct Payments. These are payments made to

someone with assessed need so that they may purchase their own social care

and support themselves.

Fewer of Derbyshire’s service users received Direct Payments compared with

our matched local authorities, the average for England and the East Midlands.

We are unable to compare this data with the figures reported last year due to

changes in the collection and measurement process.

Derbyshire is working on plans to introduce pre-paid Direct Payment accounts

that can simplify their management and administration, and broaden their

appeal.

We are reviewing the Direct Payment strategy to improve information and

support to potential and current Direct Payment users. Alongside this we are

building specialist knowledge about Direct Payments within area social work

teams while also improving understanding centrally.

Social work conversations and supporting information in Derbyshire continue

to include Direct Payments as an option for securing provision through use of

a personal budget that supports individual choice and control.

23.3

28.1

37.9

31

0

5

10

15

20

25

30

35

40


Pe

rce

nta

ge (

%)

People receiving Direct Payments

NHS Digital I 2016

PUBLIC

32 | P a g e

Figure 10 – Proportion of adults with learning disabilities in paid employment

There is an established link between employment and enhanced quality of

life; at the same time we know that it is often more difficult for people with

disabilities to get work.

This measure is therefore designed to help improve the prospects of work

amongst this section of the population.

Although Derbyshire’s performance has improved slightly when compared

with last year’s figures (1.6%), it is still lower than the average percentages

reported by our matched authorities, the East Midlands and England as a

whole.

Clearly, more needs to be done across the board to improve employment

prospects for those with learning disabilities, and we have identfied this as a

priority in Derbyshire.

One option being considered is the creation of social enterprises, small

businesses that will provide employment opportunities for people with learning

disabilities.

1.7

5.8

3.3

5.9

0

2

4

6

8


Pe

rce

nta

ge (

%)

Adults with learning disabilities in employment

NHS Digital I 2016

PUBLIC

33 | P a g e

Figure 11 – Proportion of adults in contact with secondary mental health services in

paid employment

If an individual’s mental health needs cannot be supported by primary care

services, they may be referred for more specialist support known as

secondary care, (provided by community mental health teams, and other

mental health service providers). This indicator measures the employment of

those adults that are in contact with these services.

Derbyshire’s performance is better than that of similar authorities, the national

and East Midlands average. Having said that, Derbyshire has dropped from

11.7% in 2014/15 while the percentage for simlar authorities has increased

slightly from 8.7% in 2014/15.

D2N210 funding for the Inspire Programme will help Derbyshire residents with

serious mental illness to get back to work or support them towards

employment.

In addition, the Recovery and Peer Support service will be in place from April

2017, one of the aims of which is to improve employment outcomes for people

with mental ill health.

10

D2N2 is the Local Enterprise Partnership for Derby, Derbyshire, Nottingham and Nottinghamshire

9.4

6.7

4.7

9

0

3

5

8

10

13

15


Pe

rce

nta

ge (

%)

Adults in contact with mental health services in paid employment

NHS Digital I 2016

PUBLIC

34 | P a g e

Figure 12 – Proportion of adults with learning disabilities who live in their own home

or with their family

This indicator examines the percentage of adults with a learning disability

living in a stable and appropriate home environment, a factor known to affect

overall quality of life.

Although the percentage for Derbyshire is significantly higher than that of the

similar local authorities, the East Midlands and the England average, it has

dropped over the last 12 months, as has the performance across all these

comparator groups.

It is important to consider this in the context of Derbyshire’s historical

performance with this indicator, as percentages increased year on year prior

to this point (from 59.5% in 2010/11 to 88.8% in 2014/15).

The reason for this reduction is not clear. However, one possible factor may

be the proposed changes in housing benefit resulting in the removal of

enhanced rates to accommodation providers of people with learning

disabilities. This may in turn have led to a reduction in the amount of available

accommodation being put forward in this sector of the market due to lack of

confidence in future funding.

84.3

75.4 76.3 75.9

0

20

40

60

80

100


Pe

rce

nta

ge (

%)

Adults with learning disabilities in stable accommodation

NHS Digital I 2016

PUBLIC

35 | P a g e

Figure 13 – Proportion of adults in contact with secondary mental health services

who live independently, with or without support

This measure is intended to improve outcomes for adults with mental health

problems by demonstrating the proportion in stable and appropriate

accommodation. This is closely linked to improving individual safety and

reducing risk of social exclusion.

Although Derbyshire shows a large increase over the last 12 months (from

57.1% in 2014/15), and current figures are significantly higher than our

matched local authorities, the national and East Midlands averages, this

significant upward trajectory must be considered with caution.

Due to changes in the collection methods in January 2016, the 2015/16

outcomes are based on eight months of data rather than the usual 12. As a

result, the ASCOF measures have been calculated using an average over

part of the year.

The outcomes for 2016/17 will therefore provide a more realistic indication of

performance in this measure, but, again, it will not be possible to make robust

year-on-year comparisons until the subsequent ASCOF has been published.

82.1

58.6

48.1 53.9

0

25

50

75

100


Pe

rce

nta

ge (

%)

Adults in contact with mental health services in stable accommodation

NHS Digital I 2016

PUBLIC

36 | P a g e

Figure 14 - Proportion of people who use services who reported that they had as

much social contact as they would like

Loneliness is known to impact on an individual’s mental and physical health.

This indicator is therefore based on responses to the ASCS in which social

care users were asked to indicate the level of social contact they experienced.

The percentage of service users in Derbyshire that consider that they have as

much social contact as they would like is higher than those in our comparator

group of local authorities and the East Midlands, plus the national average.

This measure is also higher than last year’s reported figure for Derbyshire of

42.4%.

47.2 45.4

43.4 44.8

0

10

20

30

40

50


Pe

rce

nta

ge (

%)

Service users with as much social contact as they would like

NHS Digital I 2016

PUBLIC

37 | P a g e

Figure 15 – Long term support needs of adults aged 18-64 met by admission to

residential and nursing care homes, per 100,000 population

As a general rule, people prefer to stay in their own homes rather than move

into residential care. Avoiding long term placements of this kind is therefore

considered a good measure of individual independence.

Unfortunately, because of changes in the collection and measurement

process, we are unable to compare this data with the figures for 2014/15.

Although the level of Derbyshire’s admissions to long-term care for those

aged 18-64 is higher than our matched local authorities and above that for the

East Midlands authorities, it is slightly lower than the average for England.

In an effort to reduce long term care admissions for this age group,

Derbyshire has improved co-ordination of access to Supported Living

options11 for those with a learning disability. We have also continued to

develop other living options for vulnerable adults in this age group through

programmes such as Shared Lives12.

11

Supported living provides support and accommodation to help clients live as independently as possible. 12

Shared Lives provides accommodation based in approved family homes for those who rely on the help and support of others help maintain independence.

12.9 13.3

11.3 12.6

0

5

10

15

20

25


Pe

r 1

00

,00

0 p

eo

ple

Permanent admissions to care homes: people aged 18-64

NHS Digital I 2016

PUBLIC

38 | P a g e

Figure 16 – Long term support needs of adults aged 65 and over met by admission

to residential and nursing care homes, per 100,000 population

As mentioned under Figure 15, avoiding permanent placements in residential

and nursing care homes is a good measure of delaying dependency.

Again, we are unable to compare this data with the figures reported last year

due to changes in the collection and measurement process.

However, it is possible to see that Derbyshire admitted a higher rate of people

aged 65 and over to long term care placements than our matched authorities,

the East Midlands and England average.

It is a strategic aim within Derbyshire to help reduce this high long term

admissions rate, and we hope to see improvements on this figure in next

year’s performance data.

730.7

628.2 612.7 589.6

0

200

400

600

800


Pe

r 1

00

,00

0 p

eo

ple

Permanent admissions to care homes: people aged 65 and over

NHS Digital I 2016

PUBLIC

39 | P a g e

Figure 17 – Proportion of older people (65 and over) who were still at home 91 days

after discharge from hospital into reablement/rehabilitation services (effectiveness of

the service)

Reablement services support people in their own homes after leaving hospital

as a result of illness or injury. They also form part of the Better Care Fund

national measures which require that this indicator is at least 82.5%.

Unfortunately, this has dropped in Derbyshire compared with last year

(87.1%) when we had the highest proportion of older people still living at

home three months after reablement (compared with our matched authorities

plus the East Midlands and England average). We also now compare

unfavourably with these comparators in this year’s figures13.

However, the indicator is reported using data collected during the final quarter

when performance dipped significantly in Derbyshire and also when there was

a 27% increase in referrals compared with the previous quarter. The service

also coped with a higher number of clients overall in 2015-16 than in 2014-15.

We are currently undertaking a comprehensive review of the reablement

service; part of this work is looking into ways of targeting the service more

effectively.

13

Taking this into account, actual performance for 2015-16 was 82.0%.

77 82.7 80.5

84.1

0

20

40

60

80

100


Pe

rce

nta

ge (

%)

Older people at home 91 days after leaving hospital into reablement

NHS Digital I 2016

PUBLIC

40 | P a g e

Figure 18 – Delayed transfers of care from hospital which are attributable to adult

social care per 100,000 population

This examines the prevalence of delayed transfers (when someone is ready

to leave hospital but is still occupying a bed) which are ascribed to social care;

the lower the figure the better the performance level.

Not only is Derbyshire’s 2015/16 figure better than the England, regional and

similar authorities’ average, our performance has improved compared with

last year; in 2015/16 Derbyshire recorded 2.7 delayed transfers per 100,000

people compared with 3.3 in 2014/15.

Another notable shift in the last 12 months is that, while the 2014/15 figures

show Derbyshire with a similar performance across the national (3.7), East

Midlands (3) and matched local authorities average (3.8), in 2015/16 the

figures have become more disparate.

The reduction in delays attributable to Adult Care can be linked to the

investment in, and commitment to, increasing social work capacity within the

acute hospital sector. During 2015-16 staffing teams were co-located in both

Chesterfield and Derby hospitals to facilitate the timely discharge of people

back home.

2.7

4.7

3.7

5.6

0

1

2

3

4

5

6


Pe

r 1

00

,00

0 p

eo

ple

Delayed transfers of care attributable to social services

NHS Digital I 2016

PUBLIC

41 | P a g e

Figure 19 – Proportion of people who use services who find it easy to source

information about services

This measure reflects the experiences of service users in accessing

information and advice about social care. Underpinning this is the notion that

such information helps give service users greater choice and control over their

lives.

There is a marked improvement in Derbyshire’s performance. Last year

72.8% of people said that they found it easy to get information; this year this

figure was 78% - nearly eight in every ten service users.

We have recently put a great deal of effort into helping people find the right

information about care, support and welfare benefits, which appears to be

reflected in this measure.

This work includes the development of 150 Adult Care information points,

expansion of the First Contact signposting service, production of a ‘Your Care

Journey’ animation on the web explaining the social care offer in Derbyshire,

increasing the range of Adult Care literature in Easy Read format,

dissemination of a quarterly newsletter to district, boroughs, GP practices, and

some other venues detailing universal services and support, plus production

of a targeted information pack sent to all Home Library Service clients.

78 73.5 71 72.6

0

20

40

60

80

100


Pe

rce

nta

ge (

%)

Service users who find it easy to get information

NHS Digital I 2016

PUBLIC

42 | P a g e

Figure 20 - Delayed transfers of care from hospital per 100,000 population

This measure illustrates the prevalence of delays in people transferring

from hospital into Adult Care support. This looks at these delays in general

terms, rather than Figure 18 which examines delays specifically

attributable to social services. Similarly, the lower the figure, the better the

performance (the fewer the delays).

The figures show an improvement for Derbyshire compared with last year.

In 2014/15 there were 9.7 delays per 100,000 people; in 2015/16 this had

reduced to 8.5 delays. Again, as with last year, our performance is better

than the average figures for England, the East Midlands and our matched

local authority group.

Figure 18 explains the action Adult Care is taking in order to help manage

more timely discharge of people back home. It is worth noting that, whilst the

2015-16 performance represents a big improvement, across the country as a

whole delayed transfers of care rates started to increase towards the end of

the financial year. This upward trend is expected to continue during 2016-17.

8.5

12.1 12.7

14

0

3

5

8

10

13

15


Pe

r 1

00

,00

0 p

eo

ple

Delayed transfers of care

NHS Digital I 2016

PUBLIC

43 | P a g e

Figure 21 – Overall satisfaction of people who use services with their with care

and support

Like last year, Derbyshire’s rate of client satisfaction in terms of the quality

of care and support received is better than our matched authorities,

England and the East Midlands.

This indicator also shows a slight increase on last year’s figure (69% in

2014/15).

This is extremely encouraging bearing in mind the very difficult financial

pressures placed on social care currently.

70.1

64.4 64.1 64.6

0

20

40

60

80


Pe

rce

nta

ge (

%)

Client satisfaction with care and support

NHS Digital I 2016

PUBLIC

44 | P a g e

Figure 22 – Proportion of people who use services who feel safe

More of Derbyshire’s service users feel safe compared with the average

for England, the East Midlands and similar local authorities.

This percentage has increased from last year (65.2% in 2014/15) when

Derbyshire’s performance was also lower than the comparator groups.

A significant amount of work has been done over the year to expand the

Safe Place scheme and Keeping Safe Cards to support people with

learning disabilities. The number of safe places across the county has

increased from 51 to 114. The number of Keep Safe Cards has increased

from 145 to 413.

There are now Safe Places in all Derbyshire borough and district areas. 19

GP practices have signed up to the scheme and there is at least one of

these Safe Place practices in each Derbyshire borough or district. The

growth of the Safe Place scheme and Keeping Safe Cards is likely to have

made a contribution to improving our performance for this indicator.

70.6 69.2 68.2 69.4

0

20

40

60

80


Pe

rce

nta

ge (

%)

People who use services and feel safe

NHS Digital I 2016

PUBLIC

45 | P a g e

Figure 23 – Proportion of people who use services who say that those services

have made them feel safe and secure

Nearly 87% of service users in Derbyshire say that the Adult Care services

help them to feel safe.

Although Figure 22 indicates that more service users in Derbyshire feel

safe, the percentage those that say services play a part in this is slightly

lower than last year’s figure (90.3%), but still very positive.

This year’s indicator is higher than the national average but lower than the

regional figure, and that of our matched authorities.

86.9 85.4 88.5 87.6

0

25

50

75

100


Pe

rce

nta

ge (

%)

People who say the services they use make them feel safe and secure

Health & Social Care Information Centre I 2016

PUBLIC

46 | P a g e

Feedback

We’d like to know what you think about this Local Account. Please share with us

your thoughts by completing and returning this form.

1) How do you rate the content of the Local Account? [please tick one option]

Poor Fair Good Very Good Excellent

2) How do you rate the charts and tables? [please tick one option]

Poor Fair Good Very Good Excellent

3) Which of the following words would you use to describe the Local

Account? [please tick all those that apply]

Boring Confusing Helpful Interesting Informative

4) Please use the space below to tell us any other feedback you might have

about the Local Account, and ideas on how we can improve it.

Thank you. Please return this form to: Service Need & Evaluation Section,

Derbyshire County Council, County Hall, Matlock, DE4 3AG or email it to:

[email protected]

mailto:[email protected]