Coventry Adult Social Care Annual Report and Key Areas of Improvement 2020/21 (Local Account) - Print version

What is the Local Account?

Every year Coventry City Council produces a report which describes what Adult Social Care is doing to help improve the lives of vulnerable people and how well as a service it is performing along with areas where we are seeking to improve further. This report is usually referred to as the ‘Local Account’ but is also referred to as the ‘Annual Report’ for Adult Social Care. We hope you find this account interesting and that it provides you with an insight into Adult Social Care in Coventry and the work that is being done to support improvements.

Download a printable copy of the report [https://www.coventry.gov.uk/downloads/file/37256/adult_social_care_annual_report_202021]

COVID-19 and Adult Social Care

We could not write a Local Account reflecting back on 2020/21 without mentioning the impact Coronavirus (COVID-19) has had on the work of Adult Social Care and how it has dominated our work during this year. It has been a year unlike any previously experienced and as such this Local Account needs to be viewed through the lens of a year unlike any other.

When the pandemic commenced, Adult Social Care needed to adapt quickly to continue to deliver most of our responsibilities for assessment and safeguarding through digital means while ensuring we continued to undertake face to face work where this was required. As we progress through continuing to live with COVID-19, we will increasingly blend the use of technology with face-to-face work. This blended approach has proved successful in a number of cases and is an approach we will continue to refine. We did, however, have significant challenges in respect of care capacity during the first wave of the pandemic and were one of only six local authorities nationally to activate the Care Act Easements due to a shortage of care and support staff early in the pandemic and the resulting need to prioritise our work. This required us to temporarily reduce our approach to Promoting Independence and simply ‘get care to people’, reassigning staff from day centre activity to other services.

Although the pandemic has impacted significantly on Adult Social Care it has not changed the essence of what we do, which continues to be supporting people to live as independently as possible within their communities. During 2020/21 demand for social care has not been like a usual year, as a result of; furlough, stay at home guidance, the requirement to limit face to face contact with people outside of your household or bubble, there was an increased tendency to not seek care and support services. In addition, the group most impacted by the pandemic were those with vulnerabilities. These factors combined meant that demand for Adult Social Care and the number of people supported reduced. However, as we moved into 2021/22 we started to see demand for Adult Social Care increase and the indication of a return to pre-pandemic levels. Indications are however that alongside the support with activities of daily living that make up most of our referrals, more people are presenting with a  combination of issues associated with the detrimental impact of social isolation on mental health, wellbeing and social skills. People are also now approaching social care at a later stage in their care journey than would normally have been the case, with higher levels of need. Unpaid carers have also seen their caring roles intensify and have been placed under increased pressures during 2020/21. This will have had an impact on the emotional and physical health of carers across the city which again is placing demand on Adult Social Care.
 

Foreword

Pete Fahy, Director of Adult Services

The production of this Annual Report remains an important part of the annual cycle of Adult Social Care. It provides an opportunity for reflection on the progress we have made and challenges we face in delivering Adult Social Care within the city. The year this report covers, 2020/2021, was a year unlike any other as the unique challenges of COVID-19 dominated much of our work, and the demands placed on people who work in social care, along with people that access our services and their families and carers were like nothing previously experienced. Due to the uniqueness of the year much of the comparative information in this report is of limited use – it was an exceptional year and as a result the performance data is also exceptional. What is however becoming clear is that as we move forward we need to continue to adapt to new challenges, whether resulting from the ongoing impacts of the pandemic or other factors including the changing health and social care landscape due to the introduction of Integrated Care Systems from April 2022. A key aspect of this Annual Report is the opportunity to highlight improvements and progress made and those who know me will know that the concept of continual improvement and finding ways to do things better are core character traits of mine. For this reason, I am pleased to write this forward to a report that, despite the many challenges of the year, still evidences improvements made in Adult Social Care and the impact on people as a result. Indeed, we must never forget that we are a people business. There will continue to be significant amounts of effort and energy taken by the big issues of social care reform, health and care integration, growing demand and a limited resource environment but all of this is for nothing if it does not result in improving outcomes for the people that rely on us for support. This is the reason why this report contains real life examples and stories describing what we have done to improve outcomes for people and producing the report in this way helps ground us back to why we are here. Due to the people I work with and the commitment they show I remain immensely proud and privileged to be the Director of Adult Social Care for Coventry City Council. I hope you find this Annual Report informative and as always myself and my team are happy for any feedback.

Councillor Mal Mutton, Cabinet Member for Adult Services

This year’s Annual Report was produced during continuing challenging times for both the nation and Adult Social Care here in Coventry. I hope you find the report effectively reflects both the ongoing day to day activity of the service as well as the truly inspirational impact the team working in Adult Social Care have continued to make during the last year. Throughout the COVID-19 pandemic, the most significant and tragic health crisis in living memory, I have felt immensely proud that Council colleagues, care providers and their care staff have not only risen to the challenge but have truly gone above and beyond in the interests of the people they work to support. It is not unusual for people who work in Social Care to see their roles as more of a vocation than a job and often when asked why they go to work, the resounding answer is ‘to make a difference'. I continue to be astounded by the difference people are making in all areas of Adult Social Care through the ways in which they support and care for the most vulnerable adults in the city. This report contains stories demonstrating this, along with key information on our performance and resources. Whilst there are in fact far too many examples of incredible work happening across Social Care for me to list here, I want to take the opportunity to record my heartfelt thanks for the hard work, perseverance, compassion, humanity and dedication that mean so much to so many residents of Coventry, I along with many am truly grateful. Please do get in touch if you would like to offer any feedback on the Annual Report by emailing getinvolvedasc@coventry.gov.uk [mailto:getinvolvedasc@coventry.gov.uk].

Karen McKay, Adult Social Care Stakeholder Group

During the last twelve months the Adult Social Care Stakeholder Group has continued to meet virtually bi-monthly using Microsoft Teams. This has been a learning curve for many of us but has worked really well and has led to some really engaging conversations and contributions from group members. It was lovely to be able to check-in even if only virtually. We continue as a group to try to be the voice of service users and carers, to contribute to ongoing developments in Adult Social Care, be part of conversations about new developments, improvements and the way that services have adapted during the pandemic. Some of the key agenda items have focussed on digital developments and care technology and we have been able to use a demo of a new animated tool for online self-assessment which again is helping the group to continue on their own digital skills journey! Thinking about how we can include more voices and improve on real collaborative working is another regular theme, rather than being asked after plans have been made. There is always more work to do on this! I personally look forward to the long-awaited national review of Social Care, which cannot come soon enough. Previous national crises have led to significant social improvements, and if ever it was a time to tackle the long-standing problems in Social Care it is now. The Association of Directors of Adult Social Services (ADASS) has spoken of significant numbers of people waiting for support, calls for urgent social care reform, investment and a proper workforce strategy. We need to add our voices locally in any way we can to insist this happens. For me, rather than applause, doing this for our Social Care staff and service users is the best way to show how much we value them. The work of Adult Social Care continues to be supported by our Stakeholder Group, who meet regularly to discuss any updates and influence the improvements of the service. The group is made up of Coventry residents who are experienced in how services work.

Introduction to Adult Social Care

The delivery of Adult Social Care is the responsibility of the Local Authority which interacts with a range of other local authority functions to support people in our communities, including Housing, Public Health, Children’s Services or Culture and Leisure to name but a view. Our work is also closely connected to health organisations and the voluntary and third sector who work with many of the same people who come into contact with Adult Social Care. Therefore, although Adult Social Care has a distinct identity so much of what we do is achieved through working with others. We do not have a complex strategy for Adult Social Care – all our work is tested against our objective of: ‘Providing support, in the least intrusive manner possible, based on the assets, resources and abilities that are available to people’. Progressing this overarching objective is delivered day in, day out through the many interactions between our staff and people with care and support needs and through a series of improvement projects overseen by the Director of Adult Services aimed at constantly improving what we do. During the last year we have made significant progress in delivering these improvements including;

Use of Technology:

Our use of technology to support our assessment activity has grown significantly. Whereas previously the majority of our work was completed face to face, doing things remotely has become the norm wherever possible. As we progress achieving the right blend of technology and face to face contact we will be required to ensure we continue to engage with people in a way that is both safe and effective.

Accommodation Offering Care and Support:

We are finalising a market development plan in respect of accommodation-based support for people with severe mental health problems. This will help care providers plan and develop high-quality provision over the coming years, in line with our Adult Social Care vision and values. We have started work on this by developing new reablement accommodation to support women with mental health problems who have experienced crisis events in their lives such as abuse or exploitation and need support with their recovery and return to independent living.

Adult Social Care Vision

Adult Social Care supports people aged 18 and over who have care and support needs as a result of a disability or an illness. Support is also provided to carers who spend time providing necessary care to someone else. We continue to work in accordance with our primary legislation, the Care Act (2014) and the required changes to practice and policy set out by the Act. The delivery of Adult Social Care in Coventry, as embodied in our vision is that we focus on approaches that promote well-being and independence to prevent, reduce or delay the need for long term support and to enable people to achieve their outcomes. In performance terms this means that we would expect to see a relatively smaller number of people in receipt of ongoing social care, and where ongoing social care is required that this is mainly provided in people’s own homes. We would also expect that the short-term services we have in place to enable people to be independent are successful in reducing demand for ongoing Adult Social Care.

Adult Social Care vision

To enable people in most need to live independent and fulfilled lives with stronger networks and personalised support.

Strategy

Provide support, in the least intrusive manner possible, based on the assets, resources and abilities that are available to people.

• Adults and carers at the heart of everything we do: People we work with are involved as equal partners in planning and decision-making.
• High quality, person centred and effective support: We deliver high quality, person centred effective care and support to service users, their carers and families. Empowering people with the right support, at the right time in the right way using the resources that are available to them.
• Reflective and responsive to change: The support we provide reflects and responds to the changing needs of Coventry's diverse population of adults and older people.
• Outcome driven and meaningful: Support is outcome driven and we are clear about the impact we are having on the people we support.
• Support around people and their families: People are supported to live at home wherever possible. When people cannot live at home they will be supported to live in the most appropriate and least intrusive alternate setting.
• Effective enablement and prevention and wellbeing: We provide support to people in cost-effective ways to enable them to reach or regain their maximum potential so that they can do as much as possible for themselves.
• Mature partnerships: Our partnerships are mature, trusting and effective at both a strategic and operational level. In all our work with partners, the focus remains on the people that need our support.
• Committed workforce: Our workforce is stable, skilled motivated and committed to delivering excellent services. They feel supported to make decisions, assess and manage risk and work with people to achieve their outcomes.
• Innovative: We will develop ways of supporting people and use innovation as a key way to deliver good outcomes for people and manage our resources.
• High performing: The outcomes we achieve for adults and older people compare favourably with similar local authorities. We make an active contribution to the delivery of the Council Plan.

24 Hours in the life of Adult Social Care

Adult Social Care works 24/7

With spending of over £103million, Adult Social Care works with many organisations, providing advice and support to our residents.

Night

• Emergency Duty Team – From 5pm onwards our emergency duty team help people who might require urgent support during the evening and night.
• Mobile Night Carers – From 10pm onwards the Mobile Night Carers service supports people who need help and assistance during the night.

Morning

• Adult Social Care Direct – Our Adult Social Care contact team opens at 9am, they provide information and advice and are the first point of contact.
• Home Visit – Our home support providers help people to maintain their independence in their own homes.

Afternoon

• Jenner8 – Our Jenner8 project supports adults with learning disabilities to access the community.
• Shared Lives – Our Shared Lives Service supports people 24/7 by providing support in a family setting.

Evening

• Assistive Technology – We provide a wide range of assistive technology to help people be as independent as possible both day and night.
• Self-Online Assessment – Our online assessment can be completed at any time of the day and suits people that might have busy lives.

Setting the scene - Adult Social Care in a changing landscape

The demand for Adult Social Care rises every year as people live longer and there are more people living longer with more complex needs.
The illustrations on the next few pages give you an indication of the position for Adult Social Care during 2020/21 in respect of:

• Budget – Money Matters
• Activity – Facts and Figures
• Demographic – The people who come to use for support
• Our Workforce - The people that provide support where required

The Council is a large organisation spending a net £238.4m on revenue activity during 2020/21. The gross Adult Social Care spend in 2019/20 minus citizen’s and other contributions was £103.2m as shown below. This includes £7.8m of additional resources provided to support the care market during the pandemic.

Budget - Money Matters

2020/21 Adult Social Care spend £103.2m.

This compares to a spend of £95m in 2019/20. The largest element of the increase relates to spend on people (provision of services).

• £79.5m spent on people
• £17.1m spent on community assessment and overheads
• £6.1m spent on central recharges
• £0.3m spent on transport
• £0.2m sent on other

2020/21 spend on people (£79.5m)

The ‘Spend on People’ referred to in the above chart has increased from £70.4m in 2019/20. £7.8m of that increase relates to the additional support to providers referenced above. ‘Spend on People’ is money spent directly on the following services.

• £21.9m spent on homecare
• £21.8m spent on residential
• £9m spent on Direct Payments
• £7.8m spent on COVID
• £6.6m spent on housing with care
• £6.1m spent on nursing
• £2.4m spent on day opportunities
• £2.4m spent on supported living
• £1.1m spent on equipment and adaptions
• £0.4m spent on individual services funds

How do we compare?

Coventry still continues to be a comparatively low spending local authority per 100,000 population. In recent years we know that Coventry demonstrates comparatively low spending as a local authority per 100,000 population. The Local Government Association publish information about spend later on in the year.

Activity - Facts and figures

COVID-19 and the country’s response to the pandemic, with national lockdowns and limited family contact impacted on the activity of Adult Social Care, those accessing our support and how we needed to work. We don’t know what the future holds but as a consequence of the pandemic we are starting to see more demand associated with mental health and wellbeing.

People receiving support

Adult Social Care receives a large volume of requests for support on a day-to-day basis. Our aim is to maximise people’s independence and support people in the least intrusive way.

• 9,902 new requests for support (a small decrease on last year’s figures of 10,534).
• 5% of requests resulted in a long-term service decrease from last year’s 7%) received low level support (increase from last year’s 25%).
• 34% received low-level support (increases from last years 25%).
• 30% received a short-term service to promote independence (increase from last year’s 21%) Adult Social Care receive a large volume of requests for support on a day-to-day basis.
• 4,529 people received long term support during the year (an increase of 1.7% from last year’s 4453).
• 1,430 received a planned or unplanned review throughout the year.
• 23 people transitioned from Children’s Services to Adult Social Care compared to 44 last year.

Carers receiving an assessment

Adult Social Care has equal responsibility for anyone providing unpaid care within the city. Anyone providing necessary care to another adult is entitled to a carer’s assessment:

• 588 carers had their needs assessed of which 286 received a separate assessment
• 802 carers received formal support

How do we compare?

CQC Local Area Analysis data suggests in Coventry, compared to other local authorities that have similar populations, that we think of other solutions first, signposting to universal services and other community support rather than looking at traditional models of support.

In comparison to other local authorities Coventry continues to have;

• Low rates of new requests for Adult Social Care, with an average of 27 a day compared to the national average of 35 in 19/20
• A lower rate of new requests for Adult Social Care support going straight into an ongoing long-term service than comparators
• A higher proportion of new requests for people aged 65+ going on to receive short term support to maximise independence than comparators
• Continued lower rate of people receiving long term support per 100,000 population compared with our comparators

Safeguarding

Protecting adults to live in safety, free from abuse and neglect is a core duty of Adult Social Care. The rising rate of safeguarding concerns reported suggests people know how to report abuse and we are addressing concerns without the need for an enquiry or investigation.

2020/21 Safeguarding Information:

• 4,321 safeguarding concerns received, a 2% decrease from the previous year
• 508 completed safeguarding enquiries were undertaken in the year compared to 563 in the previous year
• 11% the rate of concerns that led to an enquiry was down from 12% last year
• 423 people (83%) were asked about their outcomes, an increase from 80% of people asked last year
• 493 safeguarding enquiries, a 7% decrease from the previous year
• 93% of people reported fully achieved/partially achieved outcomes compared to 95% last year

We continue to closely monitor all our activity and use ‘sampling’ audits and develop improvement plans when we need to look into our approaches in more depth.

How do we compare?

Coventry has a higher rate of concerns per100,000 population than comparators. In 2020/21 1481 compared to the average rate in England (2019/20) of 938 - but thorough initial enquiries address these sooner without the need for a full enquiry. 2020/21 comparator data is due to be published in November 2021 on the NHS Digital Adult Social Care Analytical Hub.

Deprivation of Liberty Safeguards (DoLS)

The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act 2005. The safeguards aim to make sure that people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom.

• There has been a 1% (13) reduction in the number of applications from 2250 in 2019/20 to 2237 in 2020/21
• 349 (16%) are in due process compared with 254 (11%) in 2019/20
• In 2020/21 there were 1889 applications completed which is a 5% decrease from 1,996 in 2020/21
• There was an increase of applications granted after six months of being received from 22 (3%) in 2019/20 to 37 (4%) in 2020/21

How do we compare?

Comparator information will be published at the end of 2021 however we know from last year that Coventry continues to have a higher proportion of applications and completes a higher proportion of assessments per 100,000 than our comparators. As a
result of this Coventry has a lower rate of applications not completed than our comparators.

Our work during the year was impacted as a result of the pandemic due to reduced staffing capacity and assessments taking longer to complete. Liberty Protection Safeguards are due to replace DoLS in April 2022 for which the service is actively preparing.

Demographic

Coventry’s population is growing, changing and increasingly diverse. 

• Coventry is home to 379,387 residents (mid 2020 est). 
• Population growth is still amongst the top 10% of local authority areas but has stabilised (growing by 2.1%).
• Highest growth in the population is amongst the young working aged adult population. 
• 13.31% of the population is 65+ but this is expected to grow and accelerate in the next 10-15 years
• Life expectancy in Coventry remains consistently below England, but healthy life expectancy is similar to England.
• Health outcomes are worse in the most deprived areas, where people not only live shorter lives, but spend a bigger portion of their years in poor health, and are more likely to die of preventable causes

National data suggests that between 2015-2017 and 2017-2019, life expectancy between the richer and poorer increased further. In particular, there was a decrease in life expectancy for females in poorer areas - resulting in a widening of inequality in the life expectancy gap among females (7.4 years). Although, the gap for males (9.4 years) remains larger.

Early mortality ( less than 75 years) is worse than average for males and females for cardiovascular, cancer, respiratory diseases and communicable diseases. For liver disease in men, it is also worse that the national figure.
 

Our workforce

• 928 internal
• 83% female staff
• 17% female staff
• Average age of workforce 47.5 years
• 50% workforce aged over 50
• 69% workforce is white
• Vacancy rate is 9% compared to 6% nationally
• 19% of workforce is BAME up 2% from last year
• Leaver rate is 9% (83 people)
• New starter rate is 15% (141 people)
• The wider Adult Social Care workforce in Coventry amounts to 9,600 jobs which includes staff working in 177 CQC registered establishments

Key achievements – based on the Adult Social Care Vision and our priorities for 2020/21

The previous section contained a volume of data and comparisons across a number of areas of performance. To summarise this as succinctly as possible would be to say that Coventry continues to support a relatively low number of people with ongoing care and support needs and as a result is a comparatively low spender on Adult Social Care.

This position has largely been arrived at by our approach to Adult Social Care which is based on supporting people to be as independent as possible. Where independence has been lost or reduced, we work with people to regain skills and where levels of independence have been limited, we work with people to improve this. Our goal is for people to be living independently within their own homes. This is not always achievable and in many cases living independently is only possible with support. The examples below give a flavour of how we have delivered this approach alongside how we have responded during the COVID-19 pandemic. We have used real examples given with the consent of those involved.

Adults and carers at the heart of everything we do

What is SICol?

The Social Interventions Collective (SICol) – Working together to empower.

The SICol brings together some of the key services involved in mental health support; Home Treatment, The Pod, Axholme Services and is a unique approach aimed at promoting independence and avoiding hospital and residential care admissions during a mental health crisis which is proving to be hugely successful.

This strengths-based approach relies on a mix of human connection, relationships and support to enable people to take back control of their lives. Intensive support is provided through daily contacts, active listening and working together to find solutions, leading to better outcomes and increased long term mental health stability. What started as a project bringing a group of passionate professionals together to make a difference has now been recognised for its innovation and impact. The project has now attracted a 3-year funding grant to enable the team to continue and expand their work, in order to reach more people in a mental health crisis.

Crisis Plus Initiative

Alternatives to admission:

• Holding you in mind
• Collaborative intensive outreach
• Social intervention collective
• Crisis houses

What difference is this approach making to people’s lives?

Peter's story

Peter is a 32-year-old man with a long history of mental health problems leading to hospital admissions and a prison sentence. He had moved to Coventry from London to escape gang culture and had become disconnected from all family and friends, leaving him with no social connection and support. Peter had been placed in inadequate accommodation which was making his situation worse and he had lost all trust and confidence in mental health services due to a lack of consistency in support provided. All of this led to Peter feeling unloved and abandoned with risk of further hospital treatment or involvement with the police.

What did we do?

The team worked closely and intensely with Peter, showing kindness and compassion to regain trust and to really listen to his needs. ‘Co-production’ is at the heart of the work of the team and enabling Peter to make decisions and plan his own future was key to this. Twice weekly visits and daily phone calls to listen, offer hope and address practical issues and discuss options all contributed towards enabling Peter to have choice and control over his life. Practical support helped Peter to find solutions to some of the difficulties he had been experiencing, for example; liaising with family to gain support, viewing properties with Peter, help in making an application for benefits, GP registration, provision of funding towards essential goods such as microwave, pots and pans and advocacy and advice. There is a long list of improved outcomes for Peter as a result of the work of the team and Peter’s commitment to co-production and consistent contact, including the following:

• Peter is better able to trust professionals
• Peter has avoided the need for acute medical services, admission to hospital and police involvement
• Peter has improved family and professional relationships
• Peter is using his medication appropriately and taking a lead in liaising with pharmacy and GP
• Peter is accessing psychological and employment support

Peter said;

“I trust you guys, just want to say thank you so much for all your help, I’m sorry I come across as blunt sometimes and direct but it’s not you guys, I just feel let down all the time. I really appreciated the microwave and everyone seeing me, I still get stressed where I am but just want to say thank you I appreciate it even if I can come across as I don’t.”

Peter’s journey continues and he is hopeful in finding employment

“I have a trial shift at a restaurant as a kitchen hand tomorrow afternoon, I think this may benefit me as it is giving me purpose to better myself in my life for my future and I believe being positive can help me deal with feeling stressed and very low at points.”

Peter’s social worker Mariam said;

“Peter’s journey showed us that using an empowering approach with co-production at the heart, helped Peter achieve what he wanted to. Not only this, but by Peter working with the different services involved in SICoL, he was able to become better connected with housing, employment as well as creating his own support networks.”

High quality, person-centred and effective support

Transforming Care - Martin’s Story

Martin is a young man who has Autism. He lives in a shared house just outside of the City. In December 2020 Martin became unwell, there were incidents within the home where he assaulted another person and took an overdose of his medication. His
relationships with friends and family were breaking down and Martin felt out of control.

“I felt angry, depressed, shouting at people and being abusive. I didn’t take care of myself, hitting people and screaming. I was upset inside, anxiety, shaking and worrying about everything.”

To avoid a hospital admission Martin was supported under Transforming Care where he worked with his Social Worker, Learning Disabilities Nurse and Personal Assistant (PA) accessing a direct payment. An urgent increase in Martin’s support was agreed and this enabled Martin to have access to additional hours to support him at home. Gradually these hours were reduced to a level that Martin is now able to manage in order to keep himself safe and well. Martin now has strategies in place supported by Julie his PA to minimise any future incidents within his house and the community.

“Julie listens to what the problem is and gives me advice, with a direct payment I can change the hours around with Julie, she is kind and helpful and makes me feel better.”

The increase in support has enabled Martin to stabilise his mood and thought processes which in turn has had a positive impact in every aspect of his life and his ability to cope with anxieties and stress levels.

“I don’t feel frightened in my own home anymore.”

Those that know Martin well cannot believe the changes in him and have voiced that;

“It is like having the old Martin back, the Martin I have not seen for many years. He is calmer, kinder and more engaging and is a pleasure to spend time with.”

Everyone is proud of Martin’s achievements including his family and friends. Martin has also recognised that he is feeling much better and able to cope with stress in a different way and is very positive about this change.

“I can get back to being creative and doing amazing pictures, I feel in my own head things are working out.”

Martin was offered support from an agency but this model did not suit him as it was too fixed and they had set times. A direct payment gives flexibility to meet changing needs and has been the best solution for Martin.

“The networks in Transforming Care continue to grow stronger with our health colleagues supporting people to improve their situations and preventing hospital admissions for people with autism and learning disabilities to remain in their own homes with the right support to live their best lives.” Michelle Perry Social Worker, All Age Disability Team

Direct Payments enable people to have control over spending their personal budgets and many people choose to have a payment to employ their own personal assistant because they wish to have support from someone they know well and who has the right skills or experiences. Coventry City Council are working closely with a local direct payment support service, Penderels Trust to attract more people to apply to become personal assistants making this a more viable option for people eligible for social care. Interested in becoming a PA? [http://www.penderelstrust.org.uk/coventry.php]

Reflective and responsive to change

Enhancing Support to Carers

The pandemic changed all our lives when it hit in 2020 but for carers the impact was huge with many having to cope with additional caring responsibilities. Carers Trust adjusted what they did, like many organisations to ensure that there was continued support for carers. Carers Trust was granted additional funding in September 2020 by Coventry City Council to give extra support to carers.

What the Carers Trust did

The additional funding was used to support carers by addressing several key themes:

Loneliness and isolation
We supported over 400 carers with over 1000 contacts and have provided a buddying service and a listening ear.

Loss and grief
We held three, six-week courses and additional oneoff sessions on change. This has supported over 350 carers who are dealing with grief in their lives, whether it is the loss of a loved one, change in a relationship or coping with the diagnosis of a loved one.

Impact on BAME (Black, Asian and Minority Ethnic) carers
We appointed a BAME development worker to link and engage with various groups and networks representing the diverse population of the city.

Digital inclusion and engagement
We supported carers to access platforms such as Zoom and access equipment (laptops and tablets) through a one-off payment to enable them to digitally engage in their communities and access peer support virtually.

Hardship and poverty
We helped to address hardship through providing one-off payments to over 40 carers, to pay for equipment and appliances and to engage in activities to support their health and wellbeing.

Working and caring
We recruited a Working Carers Development Officer and supported over 400 working carers and encouraged employers to support those who are carers in their workplaces.

One carer tells us his story. Stephen, a carer (who now is a volunteer providing awareness workshops on scamming) talks about how the support has helped him.

“I am so grateful that, when the COVID-19 pandemic hit, and I found myself caring for two people, my older mother, and my wife. My ability to cope with the burden of care, a burden that turned out to be larger and longer than expected, got a huge boost when I engaged with the Carers Trust. My stress levels dropped enormously just knowing that there was an understanding and well-organized service out there, one that had diligently assessed my needs and was ready to help me meet them. The people I support benefited, and not just because their carer was less stressed thanks to Carers Trust; they too were better able to get through the lockdowns, the isolation, and the long road to vaccination, knowing that Carers Trust knew what care they would need if something happened to me. Now, as we work our way towards whatever the new normal may be, I am benefitting from the excellent ‘HOPE Programme’ and looking forward to the growing number of opportunities to engage with other carers that the Carers Trust is enabling."

Anna Luczyna Working Carers Development Officer, reflected on the support provided by the Carers Trust

“The pandemic has had a huge impact on everyone, but it has been particularly hard on people who juggle work and caring responsibilities. It has been so rewarding being able to support carers facing those challenges and working alongside such a dedicated team.”

Outcome driven and meaningful

Helping people take back control of their lives

Sarah's story

Sarah is a 43-year-old woman who has a diagnosis of attention deficit hyperactivity disorder (ADHD) and has a Personality disorder which has led to several admissions into hospital since 1989 under the Mental Health Act (MHA) 1983 (amended in 2007). Sarah also experienced a year-long compulsory stay in a mental health hospital (under a section of the MHA 1983) and had appealed her stay under a section of the Act several times. Being discharged into the community under Community Treatment Orders had not helped Sarah to improve her mental health, particularly as she was often recalled into hospital due to not feeling safe in the community. Sarah was struggling to live independently.

Sarah lived with several risks including self-harm and self-neglect and consuming alcohol would often make things worse. Her longest period outside of hospital since 1989 had been six weeks and therefore Sarah had regarded the local mental health hospital as her ‘home’ and the outside community felt unsafe and unknown to Sarah. Although Sarah felt the hospital was her home, she was desperate to leave, to be closer to her family and to build a life outside of formal services. She was worried about managing her distress in the community but said

“I hate being in hospital, but I’m scared of being in the community I don’t feel safe without a section on me.”

What did we do?

Adult Social Care suggested to Sarah that a Guardianship Order could enable her to become more independent and less reliant on services and Sarah agreed to try this approach. Guardianship is a different approach to managing mental ill-health with a focus on enabling individuals to live as independently in the community as possible, with a focus on welfare rather than treatment. The use of a Mental Health Act advocate is key in ensuring an individuals’ voice is heard and at the centre of the discussion. The role of an advocate depends on the person’s situation and the support people want, they are there to support a person’s choices. An advocate can listen to someone’s views and concerns, explore their options and rights, help them to contact relevant people and accompany and support them in meetings or appointments. It can often be overwhelming when the room is full of professionals, without the help of an advocate. With an advocate, Sarah was able to identify that Guardianship would help her feel safer in the community. She was also included in all discussions regarding options for support in the community, this was with the social workers, doctors, nurses and psychologists involved. This meant that Sarah was at the centre of every conversation about her wellbeing and her wishes and feelings were listened to. Sarah’s family, nearest relative and other important people were also included, and this meant all of the important parts of Sarah’s life were being considered when care and support planning was undertaken. Sarah’s care and support plan was co-produced with her heavily involved. This included finding a suitable placement to meet her needs and enable her to continue seeing her sister. Sarah moved into a specialist supported accommodation setting and has now had the longest period out of hospital since she first came into contact with mental health services – approximately nine months! Sarah takes an active part in the community she lives in and has stated that she feels safe under the Guardianship Order. Sarah stated;

“The Guardianship makes me feel safe, it feels like it’s a section for me and for the people looking after me. Even when I have low points, the most important thing is the staff bring me back home.”

Not only this, Sarah told us she is now an activity champion in the community and said;

“I’ve organised a trip to Weston-super-Mare for the residents in a few weeks. We are looking forward to it! I’m part of the coffee mornings and planning of activities in the community. I also now go see my sister on my own."

Support around people and their families

Janet’s Story

Janet is a 71-year-old woman who was referred to Adult Social Care by the Police who were concerned about her vulnerability and welfare. Janet was the victim of financial abuse by a doorstep scammer and was visited by Maxine the Social Worker as part of a safeguarding investigation. Maxine became aware that Janet had problems with hoarding and her property was almost uninhabitable due to the scale of the problem. Janet also had seventeen cats living in the home and although they were like family to her, she was struggling to care for them. Janet told Maxine that she felt very isolated and it soon became apparent that Janet had social care needs. She was not looking after herself, eating regular meals or taking her medication as prescribed. Formal carers were unable to provide care within her home environment as it was cluttered and unkempt. Janet’s strengths were recognised and she was willing to accept support to help her maintain her home and with personal care, medication and meal preparation. Janet had a love of cats but was overwhelmed by the responsibility of caring for 17. Janet stated that she wished to stay in her family home and that she was keen to meet new people and contribute to the local community in which she had lived all her life. Maxine worked with Janet to access support from voluntary, private and statutory agencies to help her situation:

• Enabling Spaces [https://enablingspacescic.co.uk], an agency that helps people to learn/gain skills in maintaining a healthy home environment, supported her to clear and clean her home over seven months. They now visit weekly to support Janet to make sure everything is still ok.
• A care agency to support Janet with her personal hygiene, meal preparation and medication management
• The RSPCA attended to 15 of Janet’s cats and rehomed them. Janet wished to keep two female cats and agreed for them to be spayed for their welfare
• An appointee was set up to support Janet with her finances, help her pay her bills and agreed plan for how she wants to spend her remaining money
• Support with shopping on a weekly basis to ensure she has regular nutritious food in for the care staff to prepare
• A fortnightly companionship visit from AGE UK to reduce her social isolation Maxine also supported Janet to find a job as a volunteer in a local charity shop. She now goes every Tuesday. Janet has met new friends and her confidence has improved dramatically

Janet’s wellbeing has been enhanced. Janet is happy living in a clean environment with her beloved cats. She is receiving the support she requires to remain living in her home. Janet states that she loves her volunteer job and the charity shop staff love Janet.

“I am really happy working in the charity shop. I enjoy meeting new people and working with the other members of staff. The staff like me and I feel valued.”

What have we learnt?

• The importance of working with people at their own pace, listening to people, identifying what’s important to them, their resilience and resourcefulness
• When identifying older adults’ strengths and needs during assessments, we need to think creatively to empower people by looking beyond traditional services to meet social isolation needs such as day centres and support people with their desired outcomes such as working and volunteering
• Multidisciplinary working with private and voluntary partners is crucial in meeting people’s identified strengths and needs

Want to know more about how to support people who may be hoarding, see the Coventry Safeguarding Adults Best Practice Framework and Guidance [http://www.coventry.gov.uk/hoarding].

Effective enablement, prevention and wellbeing

Mohammed’s story

Mohammed is a 20-year-old man who now lives with his mum and two younger brothers in a rented three-bedroom house. Mohammed came to the UK in 2018 from Syria. Mohammed has physically disabilities which includes scoliosis, a spine condition and has no movement or function in his lower limbs. Mohammed has good upper body strength which enables him to move from one place to another and will use a selfpropelling wheelchair to mobilise. Mohammed was originally referred into ‘Promoting Independence’ services when he was 18 in 2019, he could speak very little English and required an interpreter. He was at the time living in a first floor two bedroom flat with his family which was unsuitable. Mohammed’s mum was having to carry him up a flight of external stairs to the property. Mohammed’s mum was providing all care at this time and wished to continue with no formal support. The Occupational Therapist (OT) assessed Mohammed and due to the size of the property and space within it there was little that could be done to make the property more suitable to support the situation

What did we do?

The family needed to have more accessible accommodation so the OT got in touch with a Housing Association and discussed Mohammed’s needs for a priority move to another property, which would allow Mohammed safe access to the community and education facilities. Mohammed was also very keen to access education and wanted to study ESOL (English to speakers of other languages) and he said he hoped to become a lawyer. The OT contacted the Special Educational Needs (SEN) team regarding Mohammed’s wish to access education and an EHCP (Education, Health and Care Plan) was started.

Once a new property was identified the OT visited and requested provision of a stair lift so that he can move between the upstairs and downstairs of the property. A ramp at the front for access and converting the bathroom to level access showering facilities means that Mohammed can maintain his independence. More recently Mohammed’s mum was needing some support in her caring role and a care package of two calls a week to assist with personal care was arranged. This is the only support that Mohammed and his mum felt that they needed at this time to ease some of the pressure off his mum.

How did it go?

Mohammed’s mum said they feel comfortable and very happy in their new property and Mohammed is freer to do what he wants to do. His mum said;

“The only word I can say to you is thankyou you have the magic touch and thanked all those involved.”

Mohammed has been attending college studying ESOL, English, Maths GCSE and ICT and he no longer requires an interpreter as his English has improved greatly. Mohammed stated that;

“I am much happier in my new home and the care support is working well. I can be independent and can get myself around. I am very happy with college, the teachers are very good, I go there on the bus like everyone else and have made friends. I struggle on the telephone with English, but this is getting better. I am unsure what I will do after this course but there are lots of good courses at the college and I hope to have a job working in an area where I can help people.”

Rachel the OT involved said;

“It has been satisfying seeing all the different services joining up to support Mohammed, they are such a great family that have been through such a lot.”

Mature Partnerships Coventry Dementia Hub

During the past six months informal engagement with partner organisations, people living with dementia, their carers and networks has led to resounding support for the proposals for a ‘Coventry Dementia Hub’ to open. If plans go ahead this will be one of the very first within the country and the only one of its kind in the West Midlands region.

The proposed Dementia Hub offers an innovative approach providing a One Coventry service. Using an existing Council building (Maymorn day centre), Coventry City Council are in the process of developing a proposal for dementia hub that will bring together a range of health, social care and voluntary sector services in one place.

The hub will potentially include both a physical location and a single telephone number, simplifying access to support for people with dementia, their families and professionals including GPs. The physical base will be designed, furnished and managed in a dementia-friendly way to ensure those attending feel safe, comfortable and relaxed, reducing stress and anxiety often felt by those accessing support for dementia. The hub will include a social space café to enable people to build relationships with others living the same experiences and to facilitate peer support, helping people to help themselves. There will be a wide range of activities and information provided through the hub to enable people to extend their living well years through information. This will include; healthy lifestyles advice and support, physical and social activities leading to improved quality of life for those with dementia and their carers and families. Some traditional day service activity will continue from the hub, but this will be combined with outreach approaches to ensure options available are inclusive and personalised. It is proposed that the hub offers a source of information and support based on good practice elsewhere as well as specific community outreach events, public information via the café and information on accessing dementia assessments. It is hoped that the hub will be open in summer 2022. April Ross, Service Manager said;

“At the very heart of this model is the person living with dementia. Their personal experiences pre and post-diagnosis were integral to the design of the model and will hopefully improve the experiences for those with dementia and their  loved ones, now and in the future.”

 

Committed workforce

Our Internally Provided Services – adapting and innovating during COVID-19

During the past year staff within our internally provided services have been working differently to ensure continuity of care and support for the most vulnerable adults in the city.

Movement of staff

During the first national lockdown, some of the non-critical services were closed such as day services. During this time over 70 staff were moved to support critical 24/7 services at very short notice. These staff ended up being crucial members of the teams often in services they were not familiar with, working with a different group of people. At the same time many staff needed to self-isolate and it cannot be underestimated how these staff played an integral part in keeping services operational, most of whom had their own fears and anxieties around the unknowns of COVID-19.

Changes to the way we supported people

In responding to the pandemic, staff at Maurice Edelman House installed a COVID-19 safe ‘Visiting Pod’ during the lockdowns to enable families to visit their loved ones. This allowed families to meet in a safe, private space and ensured those vital relationships were maintained when visits into care homes were not possible. Across our day opportunities services for people with Learning Disabilities, we implemented a creative timetable of ‘virtual activities’. The staff teams worked very hard to develop these sessions and hosted them live on Microsoft Teams so that service users who could not return (due to social distancing restrictions at the time of the Annual Report) were able to be involved, see and interact with their friends and people they know. Sessions ranged from quizzes and music from around the world to relaxation and sensory activities. The staff team attracted funds to purchase laptops for service users and families who previously didn’t have access.

It was lovely to see how we supported people to stay connected and develop relationships with people they know whilst keeping safe. At any time, not just during the pandemic loneliness can be a big problem for people, with a lot of older people being affected and this can trigger depression and anxiety. Research has linked animal-assisted therapy to improvements in mood and the quality of life for older people, including those with dementia. A recent review of studies on robotic pets for people with dementia linked time spent with the robots to lower levels of depression and anxiety.

These pets respond to the person’s voice and touch and have a ‘lifelike’ coat. They also make sounds, cats can purr, dogs can bark and are able to move their heads, lift their front paws and open and close their eyes.

Eric Williams House purchased these robotic cats and dogs and the residents took great pleasure in unwrapping the boxes to see what was inside, their faces lit up and big smiles spread across their faces.

The pets have had a positive impact within the home and have provided the residents with hours of joy and comfort. Some of the residents will sit for hours nurturing the pets and talking to them, the pets bark/purr and move in response to touch so they are also providing sensory benefits as well as a sense of self-worth.

The pets have also given people a sense of purpose which is very important as it makes people feel like they have something to look after having a positive impact on mood and self-esteem.

Innovative

From Tablets to Tables – Using Digital Solutions

During the last year Adult Social Care has continued to develop and increase our use of digital solutions to help residents living in care settings to remain connected to family members and loved ones during the pandemic.

What’s been happening?

The Council provided a significant number of tablets and laptops to independent care homes in the city in November 2020 and some to our own internal provider services. The Council have also facilitated a number of workshops to review the use of the tablets and to understand the challenges providers may have experienced in using technology. This equipment is being used by staff to keep in touch with professionals for example in holding virtual reviews, virtual consultations with GPs and enable residents to see and speak to relatives. This includes using them for special occasions, for example to enjoy virtual birthday celebrations with family members as seen in the photograph below from Brandon House Care Home.

Another example of the service utilising new digital tools has been the purchase of two interactive projector activity tables. Staff at Eric Williams House Care Home strive to deliver the best care possible for the residents who have dementia. This has included looking at new ways to keep residents active and using the key skills in life for as long as possible. The OMi Activity Table is a portable projector system that enables this to happen in the most amazing way.

Firstly, it provides sensory stimulus, whilst being bright it also plays music and sounds in the background. One of the residents was able to recognise the call of a thrush in the background. This then led to him reminiscing about the times he had spent out in his garden. The table also allows residents to keep active and mobile as some of the games involve movement, so they can have a game for example of air hockey or beachball.

Angela Wilson, Activities & Lifestyles CoOrdinator at Eric Williams House said;

“For me the best games are those that encourage coordination, these games require the residents to think about what they have to do, where they need to place their hands or feet in order to continue with the game. The table is mobile and on wheels, it can be taken anywhere within the home. I can honestly say it is the best piece of equipment that we have purchased, and residents are really benefiting from it.”

The residents have taken to it like ducks to water, one resident said;

“It’s brilliant, I love it"

another

"Well, I’ve never seen anything like that before!”

Jon Reading Head of Commissioning and Provision said;

“Staff at Eric Williams House do a wonderful job in not just looking after people with dementia but also helping them to live well and enjoy new experiences as well as old favourite pastimes. This state of the art equipment helps residents (and staff!) to participate in an enjoyable activity whilst benefitting from stimulation and interaction.”

The team at Eric Williams House update Facebook on a regular basis so that the families can keep in regular contact and see how their loved ones are. Below are some quotes from resident family members in reaction to sharing pictures of the table in use on Facebook;

“I need an OMI table; they all look so well.”

“That looks amazing.”

“Fantastic fun.”

Another table is also available for use across other establishments and is currently being utilised by residents living in Housing with Care settings

What Next?

We are continuing to adopt new digital approaches and tools to support staff and people accessing our services. Some initiatives we will be focussing on during the next year are;

• the development of an Integrated Care Record enabling health and social care staff to view shared information
• the implementation of an animated online self-assessment tool, offering people who contact Adult Social Care an accessible guided process to learn more about their own needs and the help that is available
• a project focussing on increasing and improving our use of care technology such as sensors and reminders within the home
• adoption of a digital dictation tool to reduce administrative time for our practitioners, enabling them to spend more time working directly with people

High Performing

Care Provider Support, Improvement and Response to COVID-19

The Care Quality Commission (CQC) is the independent regulator of health and social care in England. The joint Health and Social Care Quality Team continue to work closely alongside CQC to ensure that we work collaboratively to make sure that health and social care services provide people with safe, effective and high-quality care.

March 2021 - CQC rating for the Coventry Care Market

• 3% (5) outstanding
• 76% (111) good
• 20% (29) requires improvement
• 1% (1) inadequate

During the last 12 months Coventry’s (Care Homes and Community based adult social care services) Care Quality Commission (CQC) ratings have not changed significantly as CQC paused visits during the pandemic and reconvened visits based on a risk-based approach from March 2021. Therefore, the ratings are very similar to 2020.

Care Home Improvement Programmes

We currently use a range of quality improvement campaigns, which are central to contract and quality assurance activities for the people of Coventry. The quality improvement campaigns look to ensure good care outcomes for commissioned services. Unfortunately, due to the COVID-19 pandemic all campaigns were put on hold and these will be recommenced as soon as possible.

Supporting Care Providers across the City

COVID-19 brought challenges to all, not least of all the health and social care providers across the country. All care providers had to manage challenges most had never experienced before. Care providers across the city demonstrated amazing resilience and commitment to the people they support during the pandemic. Staff had to make significant changes within their day-to-day practices at work as well as in their personal life. The Joint Coventry City Council and Coventry and Warwickshire Clinical Commissioning Group (CRCCG) Quality Assurance Team, adapted their working practices in line with government guidance and provided an extensive range of support to providers across the city in response to changing government guidance on how to manage COVID-19, from Personal Protective Equipment (PPE), selfisolation and care home admissions

What did we do?

• Kept in regular contact with all providers to offer support and ensure they were aware of changes to national and local guidance and how to apply this to their practice. This contact was as frequent as required and included visits to providers as appropriate. The City Council Public Health team supported all providers and chaired an Incident Management Review meeting for each outbreak
• Held information events for providers during the pandemic for example on Infection prevention control and outbreak management
• Produced a weekly bulletin with information as a reference point for all providers and this continues a monthly basis
• Implemented a PPE request service for free PPE due to the difficulties some providers were having purchasing stock as there was an unprecedented demand before the national portal commenced in September 2020
• The CRCCG medicines team for care homes implemented a medicines support telephone line, staffed by experienced pharmacy technicians who could access records and support with queries
• Supported providers to respond to and to record capacity information on a new single national system, the National Capacity Tracker. This provides real time data on bed capacity, staffing, PPE supplies and COVID status of homes
• Myton Hospice introduced a 24-hour helpline for all care providers with access to a medical support Finally, in December 2020 the rollout of the COVID-19 vaccination amongst frontline workers in Coventry commenced, the team supported our NHS colleagues ensuring maximum uptake of vaccination and access across staff groups. This was a fast-paced program and we were and continue to be in constant contact with providers ensuring they are aware of availability and access to vaccines.

Care Providers and their responses to COVID-19

Care providers across the city needed to respond to the COVID-19 pandemic with a focus on keeping their clients and staff safe whilst continuing to provide support for people and help them maintain contact with friends and family. Weavers Care Home in Coventry upgraded their network supply to help the home deal with increased IT usage needed to keep residents connected and confirmed equipment was in place to ensure a COVID safe environment for visitors and staff.

The home also worked hard to keep up the spirits of residents with events including a live stream from the Belgrade Theatre for the Christmas panto on a big screen, cinema afternoons, quizzes and celebrations.

All of this was very well received by those living in the home; Jean said;

“staff have kept us busy we have had Skype calls on iPads and they have been a lifeline as my family live out of area and it means I can still see their faces.”

Dora said;

“now we have pod in the garden I can see some family members, not touching is hard but having contact is important to me and the home have made this possible and safe."

Brandon House Care Home also went to great lengths to keep in touch with staff with more frequent staff meetings via Zoom to keep all the staff updated. They encouraged staff to bring their furry friends into work which benefited both residents and staff alike and established a staff Whatsapp group to be able to send messages of support to everyone to keep them going or to ask for support and help when they needed it. Staff were encouraged to learn the facts about COVID-19 via a COVID notice board.

The home also set up a POD for visiting, which was funded by the Adult Social Care Infection Control Fund. They also made all the residents a framed picture of what they have been doing during lockdown

Performance Matters

On a yearly basis Adult Social Care undertake a survey of the experience of adults in receipt of support and every other year we undertake a survey of the experience of carers. This infographic shows our performance. This information helps us set our future priorities and identify any areas for improvement.

Understanding the views and experiences of adult social care.

Carers 2020/21

The National Survey of Adults Carers in England did not take place in 2020 due to the pressures of COVID-19 however the survey will take in place in November 2021.

People with care and support needs 2020/21

NHS Digital due to COVID-19 did not require Local Authorities to undertake a survey in 2020. However, a decision was made by the Director of Adult Services to carry out a local survey to provide an opportunity for people in receipt of long-term support to
share their views with us. We asked a smaller number of questions and used telephone calls as well as encouraging staff to help people complete the questionnaires. This survey was different to the usual annual survey and respondents were in a smaller
number of settings which may not be representative of the population. The findings were positive though, with very few negative responses to any of the questions asked.

About the survey

• Total number of responses 166. Compared with 345 in 2019/20
• 75% aged 65+
• 20% aged 18-64
• 5% age unknown

When analysing the results, although not comparable we tried to link these to the usual survey questions and as a result, we found;

• 93% of people who are vulnerable felt safe and protected from harm
• 93% of people had a positive experience of care services and support
• 92% of people with care and support needs had enhanced quality of life

We also asked people some specific questions about their experience during the pandemic, responses included;

“Staff helped me stay in contact with friends and family. I would like more social contact."

“Staff did well at keeping people safe.”

“Would like more consistency with carers.”

“More chocolate.”

“Staff have done everything they can to support me.”

Celebrating our own strengths - awards and good news

Great British Care Awards shortlisting

The Great British Care Awards are a series of regional events throughout the UK and are a celebration of excellence across the care sector. We have seven staff/services shortlisted for the regional awards and if successful they will go on to the national finals.

Coventry’s nominations are:

• Dolly Kirby: Housing with Care Award
• Dawn Faulkner: Home Care Registered Managers Award
• Terri Hallinan: Care Home Registered Managers Award
• Telecare Responder Service includes mobile night team: Home Care award
• Elizabeth O’Grady: The Ancillary worker Award
• Copthorne Lodge: Housing with Care Award
• Eric Williams House: Care Home Team Award

Councillor Mal Mutton, Cabinet Member for Adult Services, said;

“This is a fantastic achievement and I send my congratulations to everyone who has been shortlisted. The amazing and selfless work carried out by Adult Social Care staff often goes unnoticed so I’m delighted Coventry’s staff and teams are getting the spotlight. I wish them all well."

April Ross, Service Manager, added;

“Just to be shortlisted is an achievement so well done to all. Good luck!”

Shared Lives Scheme

Do you have a room to spare and a life to share?

Relationships and human contact are so important to all of us, so how did Shared Lives ensure the people we supported made and maintained these relationships through such difficult times? COVID-19 has proven to be a challenge to all of us, having to
change habits of a lifetime and losing those all-important contacts that are so important to us.

Shared Lives with the help of Shared Lives carers, have helped to break the isolation felt by people with learning disabilities and helped them to keep in touch with family and friends. Kerry and Damien both live in Shared Lives placements with different carers. They have a very close relationship and although they don’t live together it’s extremely important to both of them that they continue to enjoy each other’s company and spend time together. Lockdown and the restrictions in place threw a challenge to both carers to support them in maintaining that relationship. Through the use of Facetime and Zoom they were able to catch up with each other, enjoy meals together over Zoom and their carers organised virtual Bingo nights and fancy-dress discos, so both could enjoy some fun together and as shared lives families. Kerry and Damien also decided to make cards and write letters to each other and on their walks posted them, both thoroughly enjoying receiving their post. A lessening of restrictions allowed Kerry and Damien to meet once again and are being supported to organise lots of days together. Shared Lives really is about supporting each other, giving individuals the opportunity to live with families who will support and nurture the opportunities to make and maintain real relationships. Kerry and Damien love sharing their life together on the Shared Lives Facebook and Twitter pages. If you would like to know more about our Scheme and see more stories and photos please take a look at our new website [http://www.coventry.gov.uk/sharedlives] which explains the Scheme’s values and commitments to supporting people to live their lives the way they want to.

Clinical Extremely Vulnerable and ‘Shielding’

The government produced guidance for people, including children, who were at very high risk of severe illness from COVID-19 because of an underlying health condition. This included the use of ‘Shielding’ as a measure to protect people during national lockdowns. People identified were strongly advised to stay at home at all times and avoid any face-to-face contact for a defined period after receiving a letter from the NHS.

• 15,743 people were identified as needing to shield in Coventry
• 29,000 calls were made to check if people had access to food and check if they needed additional support
• 1,300 food parcels were delivered
• 3,000 social contact calls were made
• The library, customer services, CV life, adult social care and third sector organisations all worked together during the three periods of shielding to support Coventry residents

Shielding timeline

• 23 March 2020 – 1 August 2020 clinically extremely vulnerable people were asked to shield
• 5 November 2020 – 2 December 2020 clinically extremely vulnerable people were asked to follow additional precautions during the second national lockdown
• 5 January 2021 – 1 April 2021 clinically extremely vulnerable people were asked to shield again

Improving our internal provision

We are continuing to improve the physical environment for people supported in our internal services.
Maurice Edelman House is a care home for people with learning disabilities. Residents used to have small bedrooms with a sink, with all other facilities being shared with other residents. New extensions meant we were able to create en-suite facilities offering a much-improved personal living space for residents.

Quinton Lodge is a Housing with Care scheme for older adults, we have improved the shared communal space and there is now more space for people with mobility issues, more natural lighting for visual impaired and dementia friendly furnishings.

Principal Social Worker Annual Report

Most areas now have a Principal Social Worker for Adults and Children’s, supported by national and regional networks. The Care Act 2014 says local authorities should make arrangements to have a ‘qualified and registered social work professional practice
lead’ in place. In support of ensuring visibility for the role and celebrating achievements, our Adults Principal Social Worker, Andrew Errington, has produced a third annual report. Read the report [http://www.coventry.gov.uk/apswannualreport].

What’s next? Key improvement themes for Adult Social Care 2021/22

Reflecting on the last year, our own service model and our work with partner organisations we are continuing to frame our improvement work under the four key areas identified below. We are keen to continue to engage stakeholders in this work as we develop it to help ensure we are focussing on areas of greatest impact. However, we recognise we will need to monitor the post pandemic impact of changing demands on Adult Social Care as we move through 2021/22 and will adjust our improvement areas to reflect this as required. We will also adjust what we do as we move into a new landscape with Health of Integrated Care Systems.

Our Promoting Independence model

We have over several years been clear about our service focus on promoting independence. We now want to take this model further and combine our resources with partners in the city to support people to prevent deterioration and to actively support themselves as much as possible. This means looking first at what people can do with their skills, resources, relationships and their communities.

This approach will help us to support people be as independent as possible and reduce and delay the need for people to move into residential care settings.

Accommodation offering care and support

Our continued commitment to support people at home remains a priority. However, when an alternative is required, we seek to ensure this offers the best opportunity for reablement and promoting independence. We will do this by encouraging and supporting the development of facilities within the city offering provision for people to live as independently as possible, even when they require care and support to do so.

Providing the right accommodation within the city is a key part of enabling people to live as independently as possible and to be close to family and friends. This also reduces the need for more intrusive care and support.

Locally based support

We will continue to work with the local care providers and to enable future stability and resilience by setting standards and managing costs robustly. We will also utilise opportunities to work with local communities and organisations to improve access to support.

This will strengthen our model of supporting people at home whilst including a focus on accessing the resources available in the local area, thus delaying and reducing the need for more formal packages of care.

Digital technology and innovation

In order to maintain and develop modern, person-centred services, we will use technology enabled care opportunities and ensure our workforce are equipped with technology to work agilely and support people effectively. We will focus on self-service wherever possible, giving people the opportunity to access adult social care on their terms, at a time and place of their choosing.

The use of technology helps us support people to live as independently as possible and enables people to access services remotely and in a more flexible way.

"Our success in achieving the vision for Coventry depends on placing adults and carers at the heart of everything we do. We will ensure people we work with are involved as equal partners in planning and decision making.”

Glossary

This section provides an explanation of some definitions and terms that appear throughout this document.

Integrated Care Systems (ICS)

These are new partnerships between the organisations that meet health and care needs across an area, to coordinate services and to plan in a way that improves population health and reduces inequalities between different groups.

The Association of Directors of Adult Social Services (ADASS)

This is a charity representing Directors of Adult Social Services in England and a leading body on Social Care issues.

Care Act Easements

As part of the government’s response to the coronavirus pandemic, some temporary changes were made to the Care Act 2014. These changes, called ‘easements’ made it possible for local authorities to reduce their usual duties.

Promoting Independence

Short-term services which aim to maximise the independence of the individual. At the end of the support, ongoing care and support services will be arranged as required.

Short-term Support

Short term support that is intended to be time-limited, with the aim of maximising the independence of the individual and reducing or eliminating their need for ongoing support by the Council.

Safeguarding

Safeguarding is how we work with people to prevent them from experiencing harm from others or sometimes themselves. It includes helping people recover when they have been abused.

Carer Assessment

If you care for someone, you can have an assessment to see what might help make your life easier. This is called a carer’s assessment.

Co-production

When an individual influences the support and services received, or when groups of people get together to influence the way that services are designed, commissioned and delivered.

Transforming Care

Transforming Care is about improving health and care services so that more people with a learning disability and/or people with autism can live in the community, with the right support and close to home.

Personal Budgets

An amount of money the Council will pay towards any social care and support a person may need.

HOPE Programme

HOPE (Helping to Overcome Problems Effectively) courses are self-management support courses. They are designed to help people become more knowledgeable, skilled and confident in managing the consequences of living with a long-term condition.

Community Treatment Order (CTO)

A community treatment order (CTO) is part of the Mental Health Act. A CTO allows you to leave the hospital and be treated safely in the community rather than in the hospital.

Education, Health and Care Plan (EHCP)

A written plan for children and young people (up to 25) who have special educational needs or a disability that cannot be met by the support that is available at their school or college.

‘One Coventry’

One Coventry is how we describe the Council’s objectives, key strategies and approaches. It includes the Council’s vision and priorities; new ways of working; and core areas of activity.

Housing with Care

Housing with Care, sometimes known as Extra Care, is housing designed for older people, with various levels of care and support available on site.

Adult Social Care Infection Control Fund

Government grants to improve Infection Prevention Control measures in care homes, provided to Adults Social Care to facilitate access.

Useful contacts

Adult Social Care and Communities Directory [https://cid.coventry.gov.uk/]

This online directory has all the information and advice you need in one central place, so you can find the information you need easily.

Council Contacts and Mental Health Services

Service	Description	Telephone number
Adult Social Care Direct	The first point of contact for any referrals into Adult Social Care	024 7683 3003
Emergency Out of Hours (After 5pm Monday to Thursday, 4.30pm on Friday and throughout the weekend)	For urgent enquiries/emergencies only outside of normal office hours	024 7683 2222
Main Council Customer Services	The main switchboard for Coventry City Council	080 8583 4333
Central Booking Services (Mental Health Services)	Run by Coventry and Warwickshire Partnership NHS Trust (CWPT), this is the first point of contact for people accessing mental health services and CWPT services	0300 200 0011

Other organisations

Organisation	Description	Telephone
Age UK Coventry	Supporting adults 18+ providing information and advice, support and groups	024 7623 1999
Alzheimer’s Society Coventry	Supporting adults with a diagnosis of dementia and their families with the provision of information and advice and group-based support	0333 150 3456
Carers Trust Heart of England	One-stop-shop for unpaid carers of  all ages	024 7663 2972
Coventry & Warwickshire MIND	Support for people living with a mental health condition	024 7655 2847
Macmillan Cancer Support	Cancer Support Service	024 7696 6052
Healthwatch	Independent organisation supporting people to have their say in health and social care services	024 7625 2011
SEND Information, Advice and Support Service	Providing information and advice to young people with disabilities and special educational needs	024 7669 4307

Special thanks to:

• Peter, Martin and Stephen
• Carers Trust Heart of England
• Sarah, Janet and Mohammed
• Residents and staff at Eric Williams House
• Residents and staff at Weavers and
• Brandon House Care Homes
• All care providers across the city
• Kerry and Damien
• The staff at Adult Social Care
• All our partners

Contact us

You can contact us about this report at: getinvolved@coventry.gov.uk [mailto:getinvolved@coventry.gov.uk]
For Adult Social Care Direct email: ascdirect@coventry.gov.uk [mailto:ascdirect@coventry.gov.uk]
Telephone: 024 7683 3003
More information about Adult Social Care [http://www.coventry.gov.uk/adultsocialcare].