Rising to the Challenge: Good planning and co-production has helped us respond to the demands of the Care Act

By Cathy Kerr, Director of Adult and Community Services at the London Borough of Richmond-upon-Thames.

Featured article – 11 August 2015

Photo of Cathy Kerr, Director of Adult and Community Services at the London Borough of Richmond-upon-Thames

The significant size and scope of the Care Act makes it transformative for the way we support and care for people.  Looking back from the reign of Elizabeth II to the Poor Laws under Elizabeth I, perhaps only the 1948 National Assistance Act stands comparison with the Care Act’s ambition to radically reshape the way social care is delivered to people in our society.

Here in the London Borough of Richmond, we recognised that to take advantage of the Care Act’s potential to improve the lives of people with care and support needs and their carers in the borough, we would have to embrace the changes - and do so far enough in advance to be able to train and support our staff to be ready for what this meant in practice.

We recognised too that you can’t change outcomes – to some extent these are pre-determined by the way that people lead their lives - without changing the processes and thinking around how we can best support them to do so.  We have had really strong preventative, community-based support and person-centred social services in Richmond for some time, but we saw the Care Act as the legislative clout we needed to promote and drive forward that work even further.

For example, with the mandate to integrate and cooperate, we realised this could help strengthen our multi-disciplinary reablement service; and the focus on individual outcomes and wellbeing gave us the impetus to reshape some of our key assessment processes to make them as person-centred as possible.  

In Richmond, we are fortunate enough to have significant in-house knowledge and expertise to take on this work, which had served us so well in developing our personal care arrangements over the last seven years. But we face the same significant pressures on workload as every other local authority, meaning capacity was an issue.  It was clear that, to really engage with and fully leverage the Act’s possibilities, it would be useful to bolster our Care Act implementation project with additional capacity and expertise, both with known external support and that beyond our own resources.  We engaged the consultants, PPL and also SCIE, two organisations who between them understand how public sector organisations work, to come with their expertise to shape what the Care Act might achieve in Richmond.  

Embracing this additional capacity, Richmond embarked on a short, focused piece of work, to make sure that we had the right people in the right places along the care pathway to ensure local people with care and support needs remain as independent as they can for as long as possible, and get the right help when they do need statutory support.  And, in order to make sure that we understand exactly what needs they have, but more importantly what lives they want to live, we redesigned all of our assessment and planning tools, to reflect the Care Act’s focus on personal outcomes and wellbeing, because promoting people’s wellbeing is now our core legal duty.  It’s what we’re here for.

We also established a co-production group made up of people who use services and carers to help us think through the redesign of services. Linked to a wider engagement strategy, this group, along with the many who took part in events, helped us keep our implementation plans aligned to outcomes and the needs of local communities. 

The result was that we felt equipped and prepared when the Care Act came in.  But of course the planning doesn’t stop.  We know, as many other local authorities recognise, that to achieve the goals of the Act, that the Care Act goals can only be achieved through changes to culture, behaviours and through a focus on prevention and co-production. We will need to continue to work with people who use services and carers to re-design systems and processes, to transform the way we commission services, and to work more and more closely with our partners. Care Act is legislation on a potentially historic scale; local authorities need to focus on the long-term benefits and challenges of it now, and into the future.