In September last year, Westminster City Council took a brave decision to let seven social care experts loose to investigate the way that the council ran and funded its social care services. Through the establishment of a Commission, the brief was to identify the ways that the council could improve services, use fewer resources more wisely and improve outcomes for its service users. The Commission heard evidence from officers in the council, local voluntary organisations and representatives from the Primary Care Trust and local GP consortia, as well as making visits to social care sites. I represented Age UK on the group of Commissioners.
The report makes 40 recommendations, one of which concerns the professional contact time with service users. In fact, it was found that typically a professional will spend only one-third of their time with service users, and the rest of their day on administration. Whilst the Commission acknowledges that there has to be reasonable time spent setting up care packages, travelling and on general administration, these proportions are all wrong. Time with service users has to be the priority for professionals. It is also suggested that Westminster take a more proportionate approach to assessment.
Other councils have broken ground on this. One, in the north of England, has reduced its huge waiting list for aids and adaptations by allowing people to access small pieces of equipment (like a grab rail) without an assessment. Occupational Therapist time is now spent with those people who have more complex difficulties, ensuring that their time-consuming packages are set up well. The waiting list for all service users wanting adaptations has reduced. Other more detailed recommendations on financial planning, service delivery and joint working are outlined in the report. If accepted, some will take up to four years to implement, but others can be organised very quickly.
The Commission’s findings are important to Westminster, because they are specific, relevant and tailored to the particular factors which affect this area of the capital city. However, whilst there are specifics, there are many similar factors affecting local authorities across the country. Pressures on budgets, demographic trends, health reform and changing models of service delivery are all challenges that will change the way that services are provided. It’s easy to cut budgets rather than reform services when times are tight, but this report shows that councils cannot afford not to reform services.