Modernising Community Care - The Housing Contribution: Page 3

Modernising Community Care - The Housing Contribution

3.0 LOCALITY PLANNING AND WORKING

Need for Bottom up Approach

3.1 "Modernising Community Care" stresses the need to develop joint planning and joint working at the local level. Local authorities are already required to prepare community care plans and housing plans that explain their policies, priorities and activities together with the associated investment plans. But if it is to be effective strategic planning cannot just be a top down process with decisions taken at the Council wide level and imposed on local areas, whether rural or urban (or a combination of both). Council wide plans must be informed by analysis of needs at the local level and involve the development of solutions which reflect particular local circumstances. Localities should influence council wide plans and develop their own plans within the scope of the Council wide plans.

Definition of Locality

3.2 The definition of "locality" will vary between areas, for example between urban and rural areas. However, the boundaries should take account of community care services as a whole, and should cover a natural catchment area for community care. While a locality need not be self-sufficient in terms of services, it should be large enough to be supported in community care terms (i.e. a natural catchment area for community care such as a town or part of one, a group of villages, a district or a social work management, health or housing district, or a group of them). In addition, where services are delivered and jointly managed at a local level, roles and responsibilities should be clearly defined and formalised through interagency agreements and protocols.

Locality Planning

3.3 Locality planning in community care is relatively recent but is now developing rapidly. Early pilots focused on rural areas where there are distinctive local characteristics and a clear need to develop services that reflect these local needs. But employment, education opportunities and recreation facilities all have to be included to develop a holistic approach.

3.4 Proper and suitable administrative arrangements have to be put in place to ensure that locality planning is correctly established within a particular area. Specifically, partners must agree on the boundaries, practical communication networks and arrangements for the exchange and sharing of information. In addition, there must be links and consistency with other delivery systems and planning processes that impact on community care.

Locality Planning

The locality planning exercise in Skye and Lochalsh was one of the first comprehensive examples of locality planning. Initial discussions led to the establishment of the Skye and Lochalsh Locality Planning Partnership - a pilot multi-agency project that was aimed at developing joint planning for integrated health and social care within the district of Skye and Lochalsh (now known as Skye and Lochalsh Area). The partnership now comprises Highland Health Board, The Highland Council, Highland Communities NHS Trust, private sector providers and representatives of users and carers. Funding has been provided from the NHS Management Development Group and a project assistant employed temporarily to support this work.

Initial Partnership targets were: -

1. To establish a working structure for the Partnership

2. To establish an inter-agency database

3. To draw up a local plan initially focused on: -

(a) services for frail elderly persons

(b) mental health services

The outcomes of efforts to date are threefold: -

the benefits accruing from the joint planning process itself with heightened awareness of agencies and staff towards the needs of users and carers and the better mutual understanding of agencies' roles and resources;
the efforts of locality groups has given a focus for the central planning of the community care plan in terms of its relevance in particular, to a local area;
the processes/techniques used have wide application to other Highland Council areas. To date, three other areas have held initial meetings to identify local issues and how to further these.

Contact: Kenny Oliver, Locality Liason Officer, Highland Health Board, 01463 717123

3.5 The focus on localities brings particular advantages in identifying users and carer needs. At the Council wide level it can be difficult to identify needs for community care since the populations involved are relatively small and needs can vary very significantly from community to community. Local needs assessments allows these variations to be identified. In addition, users and carers often find it easier to give an input to local rather than council wide planning.

Community Care-Needs Assessment At The Local Level

Highland Community Care Forum, in partnership with Age Concern Scotland and Rural Forum carried out a wide ranging needs assessment on behalf of the Local forum in North and West Sutherland. The assessment sought to fully involve people living and working in the area and to develop a method of needs appraisal suitable for such a remote and fragile community. Local workshops, in-depth interviews with 60 users and carers and 45 key members of the community were drawn together in a publication which provides a baseline of information from which planners and providers of services can work in making decisions about future developments. Already a number of needs identified in the report have been acted upon with significant capital and service developments taking place.

Contact: Ms Ann Clark, Highland Community Care Forum, 01463 718817

3.6 The output of locality based planning should be a joint commitment to the locality comprising a clear perspective of its needs, the period over which change will take place, the joint and individual agency investments and services required and the responsibilities falling on partners. Integrated local care partnerships are the way ahead. This may mean that, occasionally, individual agencies will give priority to matters of greater benefit to the common good of the locality rather than to the individual agency. The joint vision and investment and the sharing of responsibility are all vital if a locality is to be well served.

Balance Between Council Wide and Locality Planning

3.7 There is clearly a balance to be achieved between council wide planning and locality planning. The council, health board and Scottish Homes all remain accountable at corporate level for decisions taken locally. Locality planning must therefore be clearly set within a planning framework agreed at the council wide level.

3.8 Whatever the preferred approach: -

the wider strategic direction must be decided at council wide level but should be informed by local inputs. The "strategic direction" will include values, standards and strategic objectives and resourcing;
joint planning structures should reflect the community wide geographical focus of the planning. For example a series of local housing fora, including all sectors, may be appropriate where there is a system of locality planning;
locality planning within a particular authority area must be consistent with the community care plan;
it will be essential to develop performance management systems to ensure accountability for decisions taken locally.

(See also discussion in Section 4-Implementation)

Working Together Locally

General

3.9 Collaborative working between agencies is a well-developed feature of local project development. Purchasers and providers across the housing, health and social care sectors have long been involved in negotiating co-ordinated packages of housing and care for individuals, and in many cases on projects for the provision of new housing and associated support services.

Joint Locality Working

The Moray Council Community Services Department, Grampian Health Board and Scottish Homes have been collaborating to develop community care services locally.

The objective is to achieve flexible services and management allied to the allocation of resources to local managers enabling them to respond flexibly to the needs of individuals and their carers.

Background information relating to the local population and current provision of care services provides the context within which the type and level of new service is determined. Discussions also take place between the local authority and their preferred provider. This dialogue is designed to ensure the build up of trust and working relationships over a prolonged period at elected member/committee member level and between senior staff. From this has emerged Plasman Mill, Forres, a development of very sheltered housing, respite care and day centre facilities for older people and those with dementia.

Contact: Mike Martin, Moray Council, 01343 557001

3.10 Co-operation between agencies at the locality level can be improved by a number of measures such as: -

locating staff from different agencies in the one building or site. This has consistently proved beneficial to both professionals and people who receive services;
a single manager directing and developing all or some of the community care resources in a locality;
secondment between agencies to strengthen the relationships between the agencies;
individual staff responsibilities arranged in a way which is conducive to joint working arrangements;
joint working on the development of systems underpinned by joint training;
clearly defined roles, responsibilities and sharing of information backed up by interagency agreements and protocols (which are discussed elsewhere in this guidance) to improve joint working at the locality level;
the involvement of users and carers since their experience of how local services are delivered, and whether they are integrated or not, can provide a valuable perspective on whether interagency co-operation is effective at grass roots level;
grouped budgets covering capital and revenue funding (see Section 4 for a more detailed discussion).