An interesting week

Over my time in local Government, I have attended lots of training course from various organisations and if I look back through my training log and yes I do love a good list; there is a theme, and it has predominantly been about Leadership, Leadership of place, Leadership of organisation etc., etc.  Of course, some people think that is far beyond the role of a councillor, but then again I do ponder what those people think local government is there to do, presumably keep its head down and empty the bins.  When in fact, local government is at its very best when Councillors and officers lead and shape the places we all live in as we are all residents.  To me, if I were to define Leadership it would be to quote a saying on another of my lists, my Top 10 quote list:

“Managing is helping to make happen, what is supposed to happen anyway.  Leadership is making happen what isn’t going to happen anyway” – Richard Pascal

Last Tuesday at Suffolk County Council the cabinet agenda made for interesting reading not so much the predictable increased costs of the Upper Orwell Crossing but the cabinet paper on Domiciliary Care Commissioning.  At its simplistic it was the abandonment of an innovative approach, dividing the county up into geographical lots so that providers had to provide care in areas where they could do so quickly and areas where they would find it more challenging to deliver, this is true of all rural counties as like Suffolk.

In reality, last Tuesday’s cabinet decision is not a new initiative, approach or attempt to redefine the market but a return to a more traditional form of commissioning of care in the home, albeit hopefully with some learning along the way.  However, given Suffolk and other counties ageing population, without true innovation, any council will unacceptably end up managing a service well for an ever-decreasing percentage of residents as the demand outstrips the money.  Addressing that challenge is where leadership, not management is needed.  But Leadership is not a comfortable space, for comfort aim to manage, for maximum comfort strive to manage well.

A sense check of where we are at

On Friday last week, I spent the morning at a conference jointly hosted by the East of England Local Government Association and ADASS.  For the person who read this blog and FOI questions why I have the right to attend anything nowadays, firstly thanks for reading and secondly to save the cost of responding to an FOI – for they do cost actual money – you could always ask me.  So here goes, I attend as I am a member of its Improvement and Efficiency Panel of the EELGA and as a member of the Community Wellbeing Board of the LGA – but I digress.

The conference was chaired by James Buillion who never fails to remind me I once had the chance to employ in Suffolk but chose internally!  James has become an excellent Director of Adult Social Services (DASS)and now works in Norfolk following in the footsteps of Harold Bodmer whom I and many others remember with great affection.  So big boots to fill but I hear good things from Councillors in Norfolk.

One of the key speakers for the morning session was Richard Carr the CE of Central Bedfordshire, and in many ways, he typifies the commitment that Local Government officers and councillors now committed to the integration agenda across Health and Social Care.  From Richard, we heard about the focused work he is engaged in with the NHS CE group across the Bedfordshire system and of the complexity that entails.

To give a sense of the range of attendees from James and Richard, I also met up with Dr Peter Topping the former Leader of South Cambridgeshire District Council, who as a County Councillor chairs the Cambridgeshire Health and Wellbeing Board, alongside Councillors and officers from across the region including Suffolk. It was also a chance to briefly catch up with Jacquie Lansley who works with the CCG in Southend on Sea and with whom I recently spent a few days in Stafford as part of the LGA Peer team. Where we undertook Staffordshire CC’s Corporate Peer Challenge, and on the day we have both received the first draft of the final Staffs CPC report for our review and comments.

The conference was called ‘A system Approach to Integration: A Local Government Perspective on the Journey so far’.  And during the morning various speakers gave their reflections both on the system as a whole and his successes difficulties and work still to come.

It struck me that on the subject of Health and Social Care we were further down the line now that at any point in the past.  I can say we have come a long way these past eight years and I have seen first-hand the realisation from both Local Government and essentially from Health and Social Care that the issuers we collectively dace of an ageing population and an increasing cohort of work-age adults needing complex care.  The solution does not lie in any one area be it a super drug, procedure or social workers.  It’s in how the whole system comes together to support older people as they live their lives, not as a system construct.

 

The conference venue, Grant Park is not far from the Cherry Hinton Community Centre, albeit two venues worlds apart but as I sat taking notes on Friday, I recalled something I heard said ten years ago in that other hall.  It was there that I first met one of today’s NHS Board members Lord Victor Adebowale CBE, then and now also CE of a charity called Turning Point whom I first met at the Cherry Hinton Community Hall some ten years ago.  He talked about organisations, and how they expect people to conform to their way of doing things and how that has to change, our organisations and structures should be around the people we service and who use the services our residents, our families and well, us.  Of course, it’s as true today as it was then.

 

Fast forward ten years and are we getting there? Yes, albeit slowly.  So, call them what you will: STPs (Sustainable Transformation Plans) to ICS (Integrated Care Systems) any plan or system must focus on residents, not the other way around!

 

 

Speech about DFG – Disability Facilities Grant

On Monday I was asked to give the Keynote speech to the Centre for Ageing Better Conference to launch their new report ‘Adapting for Ageing: Good Practice and innovation in homes adaptation.

The paper can be downloaded from http://www.ageing-better.org.uk

Its a challenging report into a quiet backwater of services often routed in the aftermath of emergency falls of older people rather than front and centre in the prevention agenda as it should be, the conference and report is about trying to remedy this failing.

As I thought about my speech, I recalled my own experiences as a Councillor with Adult social care responsibilities at an Upper Tier Authority and dealing with my District Council housing department who hold the budget for grants and works to install home adaptation for older people.  A budget so small it’s usually spent part way through the year and frankly so slow in programming improvements that I have on two occasions cancelled the works as the residents have died in one case and moved in a residential care setting in another.  When done promptly they can help the frail elderly and those with disabilities continue to live in their own home at a significantly lower cost to the state than in residential care.  Such small improvements can have a big impact on attendance at A&E and Hospital Admissions.

The Disability Facilities Grant is probably not known to you unless you are from a Local Authority background but essentially it’s a pot of money to provide for home adaptations form such simple things like a rail out of the bath to new ramps at the front door to make it easier in a wheelchair.

At the event was Jeremy Porteus of the Housing LIN a brilliant think tank for housing for an ageing population and those with disabilities, well worth a look at their website. http://www.housinglin.co.uk

Their website front page sums it up:

‘We are the ‘go to’ sharing network for anyone working in housing, health and social care promoting solutions that enable everyone to live well in good quality housing’.

I am personally a member and attend their regional events for some of the most insightful discussion on housing issues today.

I focused my speech around the most pressing call to action today namely not so much social care pressures but the pressures on our NHS.  A better system of home adaptions will result in a decrease in attendance at A&E and support an improvement in the DETOC figures as more people can safely be returned home quicker.  If adaptations are integral to a prevention agenda, this would have a significant effect on the number of older people attending A&E through falls and if their homes were adapted discharge could be quicker and less likely be to a residential setting.

Many years ago, in Suffolk as the Cabinet Member for Adult Social Care, I insisted, in response to the Roundtree Foundation report of the fears of older people.  The worry for many older people is that once admitted to hospital they might never return home.  So in Suffolk at least, in most case, the policy is to facilitate a return to home, and any decision to then transfer to a residential home setting occurs in a person’s own home with a social worker and family support around them, not from a hospital bed.

In my speech, the other thing I focused on was the balance between future housing such as extra care and bungalows V adaptation to existing homes.  In 20 years time, about 80% of the households we will be living in will have already been built; this is particularly significant for an ageing population.  So how we adapt our existing stock will have more impact thatn just focusing the debate on future homes.  In my Q&A session at the end of the speech there was a discussion on equity release, and afterwards, I had a very interest conversation with someone from the London Rebuilding Society

http://www.londonrebuilding.com/society/

And its certainly something I shall be suggesting to those I meet in local government to consider how to expand such schemes in the future.

And finally, while my slot was listed on the agenda as the Keynote Speech, it felt more like a warm-up session for Nick Knowles of DIY SOS fame who spoke and chaired the closing panel.   He talked about the need for design to play its part in better homes in the future homes which are lifetime homes built in ready to cope.  I could not agree more.

October Newsletter

Here’s my latest Newsletter that goes to my growing list of those who have asked to receive it direct via email and distributed to Parish Councils across Row Heath for their members.

It’s also important to keep people informed as to what is happening with the councils, the thinking behind decisions, however bizarre they at first look, maybe details about services available in a community and frankly the occasional myth busting!

So here is the link to October’s:

http://mailchi.mp/7c1acc74fb81/colin-nobles-row-heath-newsletter-oct-2018

If you would like to receive it please just email me colin@askcolinnoble.com and I’ll add you to the circulation list.

A new LGA year and a new role

Last Thursday was the first meeting of the Local Government Association Community Wellbeing Board’s new year and so a chance to catch up with old conservative friends and start to forge the sort of cross-party cooperation that is the hallmark fo the LGA Boards. Where local government comes together to look at the issues our residents and we face and to be a collective voice to Government of the concerns we have and the solutions we can deliver.

The community WelBeign Board is essentially about well…communities, Public Health and the issue of an ageing population not only of all of us as we get old face but also about an increasing cohort of working age people who for reasons of disabilities need social care support.

Of course, it’s not new territory for me as I previously did two years as a deputy member and then two years as a full member of the Board a few years ago during which time I was one of those who represented the LGA on the NHS task groups forming the Health and Wellbeing Boards.

These boards, six years on, vary in success across the country but they are all a potentially powerful forum for the NHS, in its many forms, and Local Government to design new ways of working together. Of course, since their formation – we have had the Better Care Fund, the NHS 5 year plan, more of that later, and the STP plans not to mention integrated Care organisations. But for all the changing agenda HWBs when they work well do great stuff of driving forward the integration agenda we all want to see.

At the first board, meeting with we joined by the Government Minister of State for Care, Caroline Dinenage MP. After her opening remarks, I was able to ask her about her views on Health and Wellbeing Boards, now and going forward. She was positive, but clearly, we need to provide far better informed as to their purpose, progress and outcomes they have delivered in our communities because, well… they have.

In the afternoon we heard from the NHS on the new 10-Year Forward plan, and I recall the 5-year plan so at least they are starting to think longer terms however they were as always very silent on the role of communities and voluntary organisations. So in the discussion afterwards I made the points about our LGA response, and it should emphasise the voluntary sector and community resilience as its a bit in short supply in the NHS lexicon.

So good to be back and I hope my experience over the coming year can contribute to this critical area of discussion. The first of which is the forthcoming Social Care Green Paper. The board meeting was timely as it came a day after the close of consultation on the LGA’s version of the green paper, a document intended to help inform the Government of Local Government views. No doubt over the coming weeks the comments in the consultation will be an integral part of the lobby position to come once Government publishes the Green Paper, it certainly will be interesting!

Windows and deadlines!

Every year without fail the window opens up for parents and carers to apply for primary and secondary school places for September 2019 across the country.

It relatively short but well-advertised and I urge anyone kind enough to read this blog to check with their family and friends with little ones they know and get their applications away as early as possible because frankly it helps council officers plan and shape the system to try to best accommodate parental choice.

The deadline for applications to secure a place at a Suffolk secondary school is Wednesday 31 October 2018 and for a primary school it is Wednesday 15 January 2019.  Secondary schools include all the high and upper schools and primary schools includes infant, junior and middle schools.

Last year, Suffolk County Council received over 15,000 applications from parents and carers indicating which school they would prefer their child to be educated at from September 2018.  With 93% of applicants received offers for their first preference school and more than 98% of applicants received an offer for one of their top three preferred schools.

This year, parents and carers will also need to consider the changes to Suffolk’s School Travel Policy, which were agreed by Suffolk County Council’s Cabinet on 19 June 2018.  The new policy will assess eligibility for funded school travel to the nearest suitable school with a place available.  You find more information about the changes is available at www.sufffolk.gov.uk/admissionsand remember parents and carers can list up to three schools on their application form and we recommend applying for more than one school.  If parents or carers are planning to move house or perhaps circumstances may change before September, it is still important to make an application on time. Advice and guidance about this process is available at www.suffolk.gov.uk/admissionsand they’ll receive confirmation that we have received their application.

If for any reason parents and carers are unable to apply online they should apply on a paper CAF1 application form. Suffolk County Council is unable to acknowledge receipt of paper applications and therefore suggest that proof of posting is obtained.

Then over the coming months every effort is made to accommodate parental or carers choice and then families who apply online will be able to log on to the Online Service on the National Offer Day, Friday 1 March 2019 for secondary school places and Tuesday 16 April for primary school places to see their offer of a school place, and they will receive an email to confirm this offer on the same day.  Offer letters will be sent by second class post to applicants, who made a paper application.

So now is the time to get your choices registered.

A different role

Last Wednesday we held the first informal meeting of the Conservative Executive of the LGA ahead of our first formal meeting the following morning and both were a chance to catch up with those of us who have been on the Executive before and new members under the Leadership of Cllr. James Jameson whom we elected Group Leader in July.  At these meeting, we discussed what we think should be the key focus of the work of the LGA over the coming year namely the financial challenges faced by all councils and in particular those who have to run Children services and Adults services.

For a number of years now, the issues of an ageing population and growing cohort of those with Disabilities who need our support has been discussed and been our main focus.  But increasingly Children Services and the cost overspends in making sure our young people have the protection and support we must rightly offer them is a worry. Both regarding the sheer number of younger people seeking or identified as needing help and the associated costs of social workers number increases and the sheer cost of the protection we put in place.

After the Executive came, the LGA councillor’s induction day for those of us from across the county asked to sit on the LGA’s various board, panels and roles. For the past two years I have enjoyed helping Councils across the Eastern region as the regional Conservative Peer but have now switched across to the Community Wellbeing Board where I hope my experience as an Adult Social Care and later Finance Cabinet Member and more recently as Leader of an upper tier authority will allow me to usefully contribute to this vital debate on Adult Social Care.

If you are one of those kinds enough to read my blog, you will have often heard me speak about our ageing population and its impact on services and costs over the coming years.  Last year I commissioned a Public Health report in Suffolk as a part of the Suffolk in 20 years report, and the starkest fact was that at the current rate of hospital admissions we would need an additional 492 Acute beds in Suffolk in 20 years.  That is just not going to happen, and so in Suffolk and across the country, we have to find ways for our communities, our councils and the NHS to integrate better and support older people away from the acute hospitals or a bleak old age awaits us all. Okay if we are well but as any of us will live with more and more-morbidity’s as we age it will not be much fun unless we redefine the services we provide.  So, an exciting challenge for the government, local government the NHS and all of us going forward.  It starts with the next Social Care Green paper, and there is still a chance to feed into the excellent work of the LGA both in term so its practical approach to the problems now and in the future.

And from the LGA comes a dedicated web site:

http://www.futureofadultsocialcare.co.uk

And the hashtag #FutureofASC

For me, the building block has to be the Health and Wellbeing boards across the county.  Whatever your view of the Lansley reforms of the early coalition government in 2010. I was with him and other in 2009 when we spoke of the need for a new space for local government and the NHS to come tighter to solve the problems.  Nine years on, the best of them such as Suffolk’s HWB with the great work of the West Suffolk Health Alliances shows what’s possible and we have to make sure this sort of best practice becomes standard practice across the county.

Can’t wait to get stuck into the work agenda of the LGA’s Community Wellbeing Board.

%d bloggers like this: