Meeting documents

            Meeting: Communities Scrutiny Sub-Committee (County Hall, Durham - Committee Room 1a - 05/09/2005 10:00:00 AM)

                  Item: A4 Performance Management (a) Report of Director of Social Care and Health (b) Presentation by Corporate Policy Unit

1. Purpose of the Report

To provide Scrutiny Sub-Committee with an update on performance information for year end 2004/05 and also for the first quarter of 2005/06.

2. Background

Performance is measured using a variety of methods and tools such as the Department of Health Spring and Autumn Delivery and Improvement Statements for Adult Services as well as the Department for Education and Skills Annual Performance Assessments for Children’s Services. External inspections reports are also used in gauging the level of performance. Of universal relevance to this process are the Performance Assessment Framework (PAF) indicators some of which are also Best Value indicators.

Adult Services: -

Adult Services PAF indicators for which there is available data for 2004/05 are grouped by Department of Health bandings as follows:

10 very good (dark green)
7 good (light green)
6 acceptable (yellow)
2 ask questions (orange)
2 not banded

One indicator in the light green and two indicators in the yellow are in the highest banding that can be achieved. In total thirteen out of twenty five indicators are in the top banding that can be achieved.

Where PAF indicators have not been amended or newly introduced they can be compared against the previous year. In 2004/05 of the twenty five indicators that the Department of Health have banded, six indicators improved, three went down and fifteen have remained in the same banding. This represents a substantial achievement especially when it is remembered that seven of these indicators were, and have remained in the top banding that can be achieved. Overall, the direction of travel for Adult Services PAF indicators remained very positive.

The indicators that have reduced banding are PAF C26 (admission of supported residents aged 65 or over to permanent residential / nursing care per 10,000 population aged 65 or over), PAF B13 (Unit cost of residential and nursing care for older people) and PAF B17 (Unit cost of home care for adults and older people).

Of the indicators that have reduced a banding, PAF C26 (admission of supported residents aged 65 or over to residential / nursing care) has moved from the dark green banding to the light green banding due to an increase in admissions from 85 to 102.5 per 10,000 over 65 population. It is a priority for Adult Services managers who are working to understand the reasons for this increase as this is a key threshold indicator that could potentially limit the Social Care and Health star rating. PAF B13 has moved from the light green to the yellow banding largely because fees increased significantly in 2004/5 following legal action by the Independent Sector Residential Care Home providers. Low occupancy rates in many County Durham Care residential homes have also affected this indicator and increased the unit cost from £310 to £366.

PAF B17 (Unit cost of home care for adults and older people) has also dropped a performance level moving from the light green to the yellow banding as a result of changes made by the Department of Health. Durham’s unit cost of £12.75 for home care for adults and older people is a single penny above the threshold that would leave the indicator in the light green banding which is the highest banding that can be achieved for this indicator. Furthermore, Durham has achieved value for money in providing home care as is shown by our unit costs which are lower than for our comparator group as defined by the Institute of Public Finance.

Performance for adults and older clients receiving a review as a percentage of those receiving a service (PAF D40) remained in the orange banding with 50.5%. Performance against this indicator is also below Durham’s IPF comparator group average of 64.9% and work is therefore underway to develop action plans which will increase the number of reviews carried out.

The ratio of the percentage of older service users receiving an assessment or review that are from minority ethnic groups (PAF E47) remains within the orange banding with a ratio of 0.6:1. This is below the IPF comparator group average of 0.9:1. Work is to take place with the Race Equalities Council to explore ways of better engaging service users from minority ethnic groups.

For the established user feedback surveys carried out within Adult Services satisfaction remains mostly high. Action plans arising from the results are developed and agreed by the Adult Services Management Team and are used to address areas of low performance and drive improvement. The table below contains overall average satisfaction for the main user feedback surveys within Adult Services. Bandings have been developed locally.

User Assessment 84.9% 87.3% 89.0% 89.7% 89.8% Carer Assessment 91.3% 90.2% 90.8% Services for Carers 66.5% 68.3% Community Mental Health Assessment 85.9% 86.3% 83.5% Home Care users 9Hospital Discharge patients / carers 80.1% User Reviews 88.8%

Children’s Services :

Children’s Services PAF indicators for 2004/5 are grouped by Department for Education and Skills bandings as follows:

7 very good (dark green)
5 good (light green)
5 acceptable (yellow)
2 ask questions (orange)
2 not banded

One indicator in the yellow banding is in the highest banding that can be achieved. In total eight out of nineteen indicators, almost half, are in the top banding that can be achieved.

Of the Children’s Services PAF indicators that can be compared against the previous year, three have improved, one has reduced and twelve have remained in the same banding. This represents a substantial achievement especially when it is remembered that five of the total of nineteen PAF Children’s services indicators were already in the top banding that can be achieved. The direction of travel for Children’s Services PAF indicators has also been very positive for 2004/05.

PAF B8 (average gross weekly expenditure per looked after child in foster care or in a children’s home) has moved from the yellow to the orange banding as a result of the indicator being calculated differently. The unit cost is similar to the Institute of Public Finance comparator group average and demonstrates that Durham is providing services to a cost effective level. PAF E45 (percentage of children in need from minority ethnic groups as a ratio of the percentage of minority ethnic groups in the child population) has remained in the orange banding despite an improved ratio of 0.8:1. Performance is moving in the right direction and a ratio of 1:1 would see this indicator move into the yellow banding, the highest banding that can be achieved for this indicator.

A new survey was introduced in Children’s Services in September 2004 which is distributed to the parents/guardians of children who have received an Initial or Core Assessment. Initial findings are encouraging. Results are reported to managers at Children’s Services Performance Days on a quarterly basis, where improvement actions can be developed.

4. Current Position

Performance against PAF indicators for the 1 ^st Quarter 2005 is shown in Appendix A. Once again results are traffic lit and can range from dark green (‘very good’ performance) to red (‘investigate urgently’).

Adult Services: -

Adult Services performance indicators for which there is available data in the first quarter 2005/6 are grouped by Department of Health bandings as follows:

7 very good (dark green)
3 good (light green)
2 acceptable (yellow)
3 ask questions (orange)
1 not banded

One of the indicators in the yellow banding is in the highest banding that can be achieved. In total eight out of fifteen indicators that can be banded at this point in the year are in the top banding that can be achieved.

Where PAF indicators have not been amended or newly introduced they can be compared against the previous year. In the first quarter 2005/06, and of the fifteen indicators that the Department of Health have banded, two indicators went down and thirteen remained in the same banding. This represents a substantial achievement especially when it is remembered that eight of these indicators were, and have remained in the top banding that can be achieved.

The three indicators in the orange banding are PAF D40 (adults and older clients receiving a review as a percentage of those receiving a service), PAF E47 (ratio of the percentage of older service users receiving an assessment or review that are from minority ethnic groups) and PAF D55 (acceptable waiting times for assessments).
An explanation of performance levels for PAF D40 and PAF E47 are given in section 3 of this report. Work to improve performance in these areas was also noted. PAF D55 (acceptable waiting times for assessments) has dropped from the light green to the orange banding partly due to a change in banding but also due to a change in how the indicator is calculated. Workers are now required to make contact with the client within 48 hours of Social Care and Health having received a referral. Action plans are being put into place to speed up waiting times for the start of assessments, which will improve performance against this indicator.

The other indicator that has reduced in banding is PAF D56 (acceptable waiting times for care packages) which has moved from the dark green to the light green banding. This is due to the Department of Health changing the banding for 2005/6. Performance levels remain good and higher than the Institute of Public Finance comparator group average.

Children’s Services:

Children’s Services performance indicators for which there is available data in the first quarter 2005/6 are grouped by Department for Education and Skills bandings as follows:

6 very good (dark green)
1 good (light green)
1 acceptable (yellow)
1 ask questions (orange)

In total six out of nine indicators are in the top banding that can be achieved.

Where PAF indicators have not been amended or newly introduced they can be compared against the previous year. In the first quarter 2005/06, of the nine indicators that the Department for Education and Skills have banded, two indicators have improved, one went down and six have remained in the same banding. This represents a substantial achievement especially when it is remembered that four of these indicators were, and have remained in the top banding that can be achieved.

PAF C18 (final warnings and convictions of children looked after as a ratio of all children given a final warning or convicted) has moved from the yellow to the orange banding. The figure reported as at the end of September 2004, which was used for the PAF entry in 2004/5, was uncharacteristically low. A backlog of cases awaiting court dates and issues with computer data entry caused this. A Restorative Justice Approach has been implemented which will lead to different ways of working with young people and hopefully reduce the number of incidents within Children’s homes.

5. Improvement Plans

Responsible managers are already aware of those indicators against which improvements are most urgently needed and action plans are being developed. The success or otherwise of agreed actions will be closely monitored.

6. Recommendations and reasons

Members are recommended to:

For copy of appendix for Item 4 (a) please refer to hard copy records

Scrutiny Sub-Committee 5th September 2005 Strong Healthy Safe Communities ~ Performance Update 1st Quarter 2005/06

Purpose of the Report

1 The purpose of this report is to provide a first quarter performance update (2005/06) for Best Value Performance Indicators relevant to our Corporate Aim, Promoting Strong, Healthy, Safe Communities.

Comments

That Community Scrutiny Sub-Committee Members:

Key to Symbols & Colours

	Better than target performance	Colour	Quartile Position
	On target performance - within ±10% tolerance		Top
	Worse than target performance		Second
	Missing Actual Data		Third
	Missing Target Data		Bottom