Meeting documents

            Meeting: Communities Scrutiny Sub-Committee (County Hall, Durham - Committee Room 1a - 04/09/2006 10:00:00 AM)

                  Item: A6 Performance - a) Promoting Strong Healthy and Safe Communities Quarter Performance 2006/07 b) Report of Head of Services (Quality & Performance) and Performance Monitoring Manager

         

---

Communities Scrutiny Sub-Committee 4th September 2006 Promoting Strong, Healthy & Safe Communities Quarter 1 Performance 2006/07

Report of the Head of Corporate Policy

Purpose of the Report

Priorities for Improvement

There are 3 priority areas for improvement aligned to our Corporate Aim, Promoting Strong, Healthy and Safe Communities.

Protecting and Supporting Vulnerable Children

Within this theme there are 3 outcomes that have been identified as areas we want to improve.

Fewer children at risk - to know if we are succeeding at this we are measuring:
Performance of this indicator is exceeding target despite a deterioration during quarter one. During the 12 months ending 30 June, 31 children were re-registered on the Child Protection Register. However, it should be noted that performance of this indicator is prone to fluctuation. The reason is that re-registrations often include large sibling groups. As the indicator is calculated on a 12 month rolling total, these large sibling groups can ‘fall-out’ as well as become included in the cohort. On 30th June 2006, there were 191 children on the Child Protection Register.

Better access for young people to mental health services - to know if we are succeeding at this we are measuring:
This indicator follows on from the development of an emotional and well-being strategy that will be produced during 2006/07. This strategy would allow a baseline and targets to be established before March 2007. County Durham Youth Engagement Service (CDYES) is unable to provide any data for quarter 1 due to the implementation of a new management information system (web-based careworks). CDYES is only one of 4 YOS/YES nationally to have gone live and there are delays rolling out the reporting tools to enable CDYES to extract the data.
Although, the latest available data (year-end 2005/06) implies that performance has deteriorated, it does not reflect the actual ‘activity’. During 2004/05, there was one recorded case and this was assessed within 5 days (100%). During 2005/06, 9 cases were referred and 8 were assessed within 5 working days (88.9%). CDYES is unable to provide any data for quarter 1 due to the implementation of a new management information system. The latest available data (year-end 2005/06) shows that performance has improved. During 2004/05, 9 of the 17 recorded cases were assessed within 15 working days (52.9%). During 2005/06, 20 of the 24 recorded cases were assessed within 15 working days (83.3%).

Fewer young people offending - to know if we are succeeding at this we are measuring:

Information relating to this indicator is provided annually each April. The latest information from detailed tracking of the 2004 cohort (October-December) over 12 months to 2005 (as per YJB counting rule) shows a 14.8% reduction in re-offending compared to 2003 cohort tracked over 12 months to 2004. This is against a national target of 5% reduction. CDYES is unable to provide any data for quarter 1 due to the implementation of a new management information system. A 6.7% reduction was achieved in 2005/06. This exceeded the local target of 2%.

Protecting and Supporting Vulnerable Adults

Within this theme there are 2 outcomes that have been identified as areas we want to improve.

Improved opportunities, choice and independence for vulnerable adults and older people - to know if we are succeeding at this we are measuring: 6,173 items (91.7%) of equipment were delivered / adaptations made within 7 working days during the 12 months ending 30 June 2006. This compares to 6,097 (90.9%) items during 2005/06, an increase of 1.2% (76 items) Performance has increased from “good” to the “very good” dark green PAF banding despite an increase in the banding thresholds. 90% of new older clients received services within 4 weeks of the completion of assessment. This is higher than Durham’s comparator group average. (LAA stretch target)
331 adults and older people received direct payments at 30 June 2006. This compares to 321 at the 31 March 2006, an increase of 3.1%. An additional 300 people received council tax benefit during quarter 1, 2006/07, equating to a 1% increase. The authority’s commissioning strategy is to support people to live at home, helping them to retain their own independence. This indicator measures the number of households receiving intensive home care (more than 10 hours and 6 or more visits per week) as a proportion of households receiving intensive home and residential care. The indicator is calculated using a sample week. During quarter 1, 1,981 households received intensive home care, compared to 1,802 during 2005/06, an increase of 9.9%. The creation of Extra Care Housing where all tenants receive 13 hours home care per week has contributed to this improved performance.

Improved employment opportunities for people with learning difficulties - to know if we are succeeding at this we are measuring:

64 of 2,248 people with learning disabilities are in work. Performance has improved since the year-end 2005/06 but remains below target. The next integrated Learning Disabilities Services Performance Day to be held on 4 ^th September will include this key measure.

Improving Health

Within this theme there are 4 outcomes that have been identified as areas we want to improve:

Reduction in County Council sickness absence - to know if we are succeeding at this we are measuring:
For the year to 30^th June 2006 whole council sickness has declined to an average of 9.55 days. The dotted line on the graph below indicates the likely projection for performance since 2001/02. Durham’s actual annual reported performance is represented by the solid line. The current trend is one of improvement.

TO VIEW TABLE PLEASE CLICK ON PDF ATTACHEMENT OR REFER TO HARD COPIES LOCATED IN CORPORATE SERVICES AND THE COUNTY RECORD OFFICE The table below shows the first quarter data by service. (Please note it was not possible to produce a year’s figures by service due to the recent restructure). During this quarter Service Direct and Adult and Community Services averaged more than 3 days, whilst Environment and Children and Young People’s Services averaged less than 2 days of sickness.

TO VIEW TABLE PLEASE CLICK ON PDF ATTACHEMENT OR REFER TO HARD COPIES LOCATED IN CORPORATE SERVICES AND THE COUNTY RECORD OFFICE

More children eating and drinking healthily, and regularly and involved in physical activity inside and outside of school - to know if we are succeeding at this we are measuring:

(LAA stretch target)
77% of primary schools achieved the previous healthy schools standard Level 3. No primary schools had achieved the new NHSS during 2005/06. Since 1 April 2006, 12 of the authority’s 241 primary schools (5%) have achieved the new standard.

(LAA stretch target)
This indicator will be calculated from a national survey that is to be carried out during September 2006. The results of the survey will be available November 2006 and will inform how many children and young people (aged 7 to 14 years) spend a minimum of 2 hours per week on high quality PE and sport, both within and beyond the school curriculum.

Reduction in the number of people smoking - to know if we are succeeding at this we are measuring:

This data is available annually. The latest information (year-end 2005/06) taken from the GP register states that 29.4% of people aged 15-75 years smoke. (LAA stretch target)
Quarter one data is not available until 31 August 2006. The latest data (year-end 2005/06) states 4,891 people quit smoking for at least 4 weeks after attending NHS cessation services.

Reduction in teenage pregnancies - to know if we are succeeding at this we are measuring:

Data relating to teenage pregnancy is published, in arrears, each year by the Department for Education and Skills (DfES) and the Office of National Statistics (ONS). 2005 data should have been available by March 2006 but there has been a significant delay. The latest data was published in February 2006 and relates to the 2004 calendar year. 1998 data is used as the baseline to calculate the change in the <18 conception rate. During 1998, there were 499 teenage pregnancies in Durham County ( a rate of 54.5 per 1,000 girls aged 15-17). During 2004, this had dropped to 444 teenage pregnancies (48.1 per 1,000 girls aged 15-17).

Other Best Value Performance Indicators (BVPIs)

There are 24 BVPIs relevant to our Corporate Aim, Promoting Strong, Healthy and Safe Communities that are not aligned to our corporate priorities for improvement. Of these indicators 5 improved performance, 4 deteriorated, 11 remained static and 4 had no comparative data.

It should be noted that 7 BVPIs have achieved the 2006/07 year-end target during quarter one.

Performance	BVPI
Improved	49 - children in care 3+ placement 53 - intensive home care per 1,000 65+ population (T) 54 - older people helped live at home (T) 127b - robberies per 1,000 population 128a - vehicle crimes per 1,000 population (T)
Static	162 -reviews of child protection cases (T) 100% 166b - checklist - trading standards (T) 100% 99ai - road accident casualties: KSI all 99aii - % change - KSI all 99aiii - % change - 1994-98 KSI all 99bi - road accident casualties: KSI child 99bii - % change - KSI child 99biii - % change - 1994-98 KSI child 99ci - road accident casualties - slight injuries 99cii - % change - slight injuries 99ciii - % change - 1994-98 slight injuries
Deteriorated	126 - domestic burglaries per 1,000 households (T) 127a - violent crimes per 1,000 population 163 - adoptions of children looked after (T) 195 - acceptable waiting times for assessment
Q1 data unavailable	197 - teenage pregnancies 226a - advice and guidance services: total expenditure 226b - advice and guidance services: CLS quality mark 226c - advice and guidance services: direct provision

(T) denotes that the target for that indicator was met

.

Areas of Improved Performance

During the 12 months ending 30 June 2006, 47 looked after children had 3 or more placements (336 had less than 3). Although this indicator has continued to improve, it is worse than target. Children entering the looked after system often encounter more than 3 placement moves during their early stages in the system.

1,904 households were receiving intensive home care on the 30 June 2006. This is 103 more than at the year-end 2005/06 and equates to a 5.7% increase. Current performance exceeds the target set for 2006/07.

8,401 older people are being helped to live at home, 293 more than in 2005/06, which equates to a 3.6% increase. This indicator has exceeded the 2006/07 target.

There were 15 fewer robberies (9.3% reduction) during quarter one.

140 fewer vehicle crimes occurred during quarter one, reducing the 12 month total to 3,984, equating to a 3.4% decrease. The 2006/07 target was exceeded.

Areas of deteriorated performance

Although the number of domestic burglaries has increased by 13 offences, performance is exceeding target.
During quarter one there was an increase of 132 violent crimes. This increase can be attributed to Durham Constabulary continuing to rigorously comply with National Crime Recording Standards (NCRS) and tackle quality of life issues across the communities of County Durham. This positive policing is resulting in an increase in the amount of low level violent crime recorded.
Although, performance at 30 June 2006 was slightly lower than that of the 31 March 2006, it is exceeding the target set for 2006/07. During the 12 months ending 30 June, 40 adoption and 4 guardianship orders were granted.
Performance has moved into the orange “ask questions” PAF banding after a change in banding thresholds for 2006/7. 71.9% of assessments of new older clients are started within 48 hours which is consistent with performance from the previous year but an increase of the banding threshold of 10% has resulted in a drop in banding. Analysis of this indicator has identified that the majority of delays occur within Occupational Therapy assessments. Work is ongoing to make the process more responsive, including the appointment of an Occupational Therapist within Social Care Direct, the creation of a new Occupational Therapist post in Easington and the further development of Equipment Shops.

Recommendations

That Corporate Scrutiny Sub-Committee Members:

Contact: Debra Kitching Tel: 0191 383 4186

TO VIEW APPENDICIES 1 & 2 PLEASE CLICK ON PDF ATTACHEMENTS ABOVE OR REFER TO HARD COPIES LOCATED IN CORPORATE SERVICES AND THE COUNTY RECORD OFFICE

Communities Scrutiny Sub-Committee 4th September 2006 Performance Update and Review of Medium Term Improvement Priorities
Report of Ann Campbell, Head of Corporate Policy

Purpose of the Report

1. The purpose of this report is to
· provide an update on performance for Quarter 1 2006/07; and
· seek the views of the sub-committee to inform the review of the Council’s medium term improvement priorities.

Quarter 1 Performance 2006/07

2. Attached as Appendix 1 is a performance update for quarter 1 of 2006/07. This performance information focuses on our current priorities for improvement and other key performance indicators. As well as providing information on current performance this provides useful context for our annual review of improvement priorities.

Review of Medium Term Improvement Priorities

3. On an annual basis the Council reviews its medium term priorities for improvement. Following our review of priorities in 2005 we revised the Council’s Statement of Medium Term Improvement Priorities. The revised statement includes more specific outcomes that we want to achieve over the next three years for each of the six key priority areas.

· Protecting and supporting vulnerable children
· Improving educational attainment/achievement
· Protecting/supporting vulnerable adults
· Improving health
· Promoting economic well-being
· Quality of the Environment

A copy of the Statement Of Medium Term Improvement Priorities is attached as Appendix 2.

4. The current improvement priorities were agreed following an evidence-based approach, taking account of feedback from consultation and external assessment and also baseline information on the relative position in County Durham in respect of national floor targets in key areas such as health, worklessness, educational attainment and crime. They also reflect discussions with partners to agree priorities and outcomes for inclusion in the Local Area Agreement for County Durham.

5. As part of our consultation arrangements in 2006 we are seeking views on our current priorities. In particular we are seeking views as to whether they are still relevant and whether there are any other factors that we should be taking into consideration. The views of Overview and Scrutiny members will be taken into consideration as part of the annual review.

Recommendations

6. It is recommended that members:

· note the performance information provided in Appendix 1; and
· give their views on the Council’s medium term improvement priorities to be taken into consideration in the overall annual review.

Contact: Ann Campbell Tel: 0191 383 3929

TO VIEW STATEMENT OF PRIORITIES PLEASE CLICK ON PDF ATTACHEMENT ABOVE OR REFER TO HARD COPIES LOCATED IN CORPORATE SERVICES AND THE COUNTY RECORD OFFICE

Scrutiny Sub-Committee Promoting Strong, Healthy & Safe Communities 4 September 2006 Performance Management

Report of Performance Monitoring Manager

1. Purpose of the Report

To provide Scrutiny Sub-Committee with an update on performance information for Adult and Children’s Social Care for 1 ^st Quarter 2006/7.

2. Background

Since 2000/1 Durham’s performance against the Commission for Social Care Inspection Performance Assessment Framework indicators as a whole has steadily improved. In an analysis carried out by Cordis Bright Consultants, Durham was ranked as the top authority in England in terms of average PAF bandings for 2004/5. This is an improvement of one place from 2003/4 and is an indication of consistently high performance of which the council can be rightly proud.

This has also helped improve the Social Care Star Rating awarded to Durham. The authority has moved from 1 star in 2002/3 to 2 stars in both 2003/4 and 2004/5. Separate judgements on performance for 2005/6 will be available for Adult and Children and Young People’s Social Care Services later in the year.

3. Current Position

Performance against PAF indicators for 1^st Quarter 2006/7 is shown in Appendix A. Results are traffic lit and most range from dark green (‘very good’ performance) to red (‘investigate urgently’).

3.1 Adult Services: -

Overview

Adult Services performance indicators for which there is available data (sixteen out of twenty seven) are grouped by Commission for Social Care Inspection bandings as follows:

8 very good (dark green)
3 good (light green)
1 acceptable (yellow)
4 ask questions (orange)
0 investigate urgently (red)

In total eight out of sixteen indicators that can be banded at this point in the year are in the top banding that can be achieved.

Achievements

Very good performance is reported in relation to households receiving intensive home care, helping adults with physical disabilities, learning disabilities and mental health problems to live at home. Delivering items of equipment within seven days and the number of delayed discharges from hospital are also in the top (very good) banding. The acceptable waiting times for care packages also moved into the top banding despite an increase in the banding threshold.

Areas for Improvement

PAF C72 (Adults aged 65+ admitted on a permanent basis in the year to residential or nursing care per 10,000 65+ population) is in the orange banding with 108.7 admissions per 10,000 65+ population. Although this figure is in the orange banding, it demonstrates a significant improvement in performance from the figure reported at the year end with the indicator moving out of the red banding. The high rate of admissions continues to be addressed by Adult Services with an action plan developed and local targets set to reduce the number of admissions across the County. It is hoped to bring the rate of admissions down to 100 per 10,000 65+ population by the end of the year. This would move the indicator into the yellow banding.

PAF D55 (Acceptable waiting times for assessments) is also a Best Value Indicator (BVPI 195). Commentary on the indicator is included in the Corporate Performance Report.

An Equality and Diversity Action Plan to address issues in relation to PAF E47 (ratio of the percentage of older service users receiving an assessment or review that are from minority ethnic groups compared to the percentage of older people in the population that are from minority ethnic groups) has been developed and implemented. A meeting has also taken place with the Race Equalities Council to explore ways of better engaging service users from minority ethnic groups. Due to such a small minority ethnic population in County Durham, small numbers can affect this indicator dramatically. Indeed, the ideal ratio of 1:1 would have been achieved if another five users from a minority ethnic group were assessed.

PAF E48 (ratio of the percentage of older service users receiving services following assessment or review that are from minority ethnic groups compared to the percentage of older users assessed or reviewed that are from a minority ethnic group). The indicator moved from the yellow to the orange banding. This is because the percentage of users from minority ethnic groups who received a service following assessment is higher than for the rest of the population. This is a volatile indicator that is liable to fluctuate year on year owing to the small numbers of people, only two in the rolling year, being assessed that are from minority ethnic groups.

Changing Performance

PAF D56 (acceptable waiting times for care packages) has increased from the light green to dark green banding. This indicator is also a Best Value Indicator (BVPI 196). Further commentary on the indicator is included in the Corporate Performance Report.

Developments

On the 2 August 2006 a consultation document was published by the Department of Health entitled ‘A new outcomes framework for Adult Assessment of Social Care 2006/07’. The intention of the CSCI proposals is to allow judgements of Adult Services performance to be based on how they improve people’s lives, which should be more meaningful for both staff and people in communities served. It is also the intention to reduce the demand for data from councils.

The proposed framework is structured around the seven outcomes that were introduced in the White Paper ‘Our health, our care, our say’ plus the last two in the list below which are included because effective outcomes can only be delivered through excellent leadership and effective commissioning. The full list is:

A copy of the consultation document will be placed in the Members Library for comments.

3.2 Children and Young People’s Services :

Overview

Children and Young People’s Services performance indicators for which there is available data (fourteen out of twenty two) are grouped by Commission for Social Care Inspection bandings as follows:

6 very good (dark green)
3 good (light green)
1 acceptable (yellow)
0 ask questions (orange)
0 investigate urgently
4 not banded

One of the indicators in the light green banding is in the highest banding that can be achieved. In total seven out of ten indicators that can be banded are in the top banding that can be achieved.

Achievements

Very good performance is reported in relation to the number of looked after children who are adopted. There is also very good performance in relation to the low number of re-registrations on the child protection register and the number of children looked after who have had 3 or more placements in a year. Very good performance is also reported in relation to the completion of core assessments to timescale, timeliness of reviews of children looked after and the percentage of child protection cases reviewed.

Areas for Improvement

All of the indicators that are banded for the 1 ^ST Quarter 2006/7 are performing in at least the yellow (acceptable) banding. While this performance is commendable, Children and Young People’s Services managers are aware that this is not the full set of PAF indicators and a better indication of performance will be available for the 2 ^nd Quarter.

Changing Performance

PAF C63 (children and young people communicating their views specifically for each of their statutory reviews) reduced from the light green to yellow banding. Senior Managers are aware of the dip in performance and will continue to monitor this indicator closely. An improvement in performance is expected in the next quarter.

4. Recommendations and reasons

Members are recommended to:

Contact: Keith Newby Tel: 0191 383 4959

TO VIEW APPENDIX A PLEASE CLICK ON ATTACHEMENT ABOVE OR REFER TO HARD COPIES LOCATED IN CORPORATE SERVICES AND THE COUNTY RECORD OFFICE

Attachments

 Appendix A.xls;
 Sep 06 Scrutiny sub-committee.pdf;
 Statement of Priorities March 06.pdf;
 Appendix B - SHC - Q1 2006-07.pdf;
 Appendix A - SHC - Q1 2006-07.pdf;
 SHS Communities Scrutiny Report - 4 Sept 06 v2.pdf;
 O&S performance & priorities 06.pdf