Agenda item

Managing Demand in Adult Social Care.


The Committee considered a report of the Director of Adults and Communities, the purpose of which was to advise the Committee of the current demand pressures being faced by the County Council’s Adults and Communities Department, including people waiting for care and support, an overview of waiting lists and the current allocations across the County Council’s Adults and Communities Department Care Pathway Teams. A copy of the report marked ‘Agenda Item 10’ is filed with these minutes.


In introducing the report, the Director informed the meeting that the report had been brought to enable the Committee to be sighted on challenges in meeting demand in Leicestershire and nationally, and the growing awareness of some of the issues in social care, particularly in terms of unmet need. The report provided context and information on the current position of people waiting for assessment and analysis of how performance in Leicestershire compared to that of other local authorities.


Members were further asked to note that there was no set timeframe within the Care Act for an assessment to be carried out: the requirement was a ‘reasonable’ or ‘appropriate’ timeframe. The County Council’s position had identified 28 days as a reasonable timeframe, although it was noted that some more complex cases could take longer.


Arising from the discussion the following points were made:


(i)             It was questioned, with the rising numbers of referrals, how many cases were allocated to each worker at any one time. It was reported that through the target operating model that the allocation of cases had been looked at closely and was carefully managed. Waits were triaged and reviewed frequently, to enable workers to manage the cases they had. The benchmark for usual cases for a full-time equivalent worker was no more than 25 cases, with throughput of one to two cases per week for social workers, three cases per week community support workers and three to four cases a week for review officers. The duty team would be used to allocate short term intervention for urgent cases.


(ii)            Members noted that most assessment activity was undertaken by the Home First Team. The client group for this team was predominantly elderly people using the service for the first time; more detail would be provided for members of the types of service user and relevant statistics. Home First also undertook assessments of people being discharged from hospital. These usually took place within one to two days, and very often people would be discharged with support services prior to an assessment taking place.  Members requested more detailed performance information relating to hospital discharge.


(iii)          Members referred to the low, medium and high priority weighting for cases for mental health awaiting allocation, noticing in particular the ‘high’ prioritisation figure which was a large percentage. In response it was noted that the level of risk did not relate to the level of support that was needed: someone of high risk to the Authority might not be at risk of admission to hospital.



(iv)          People who had return visits to hospital would not be identified separately but would be characterised as either being new to the Authority, existing service users, or existing users with increased level of need.


(v)           Members noted the number of people waiting for assessment had risen by 90,000 (44%) in five months. In response it was noted that the highest demand was in hospital discharge which was driving demand in social care at a rate the Authority had not seen before. It was further noted that organisations such as Age UK and Mencap amongst other national voluntary sector organisations had been saying for some years that there were hundreds of thousands of people whose social needs were not being met. The data that was now being presented was corroborating the statements of voluntary organisations.  However, not all people awaiting an assessment would be eligible for state funded care.


(vi)          It was noted that, despite a 34.7% increase in demand, Leicestershire only had a 4.6% increase in people waiting for an assessment.  It was explained that the Authority had moved from 50 vacancies to 19, which had increased the ability to undertake assessments, and would have had a significant impact on people awaiting assessment. In addition, the work on the Target Operating Model, which had been undertaken pre-pandemic, had enabled officers to have throughput and increased efficiency compared to other authorities in the ADASS survey. A lot of information from the work undertaken with Newton Europe on the Target Operating Model was being rolled out to other interested authorities.  Officers were also scoping a piece of work across 10 authorities in the East Midlands looking at people waiting for assessment and care, with a focus on how to engage with people waiting for services and frontline staff, to understand the key issues and how to address them. Work was planned for the New Year, and it was hoped that a bid for funding to the University of Birmingham would be successful.


The Chair noted the report and asked suggested the issue of rising numbers remain as an item to be watched. He further asked the reports contain figures when presenting detail alongside percentages.




That the report on managing demand in adult social care be noted.

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