Equality Impact Assessments (EIAs) are public documents. EIAs accompanying reports going to County Councillors for decisions are published with the committee papers on our website and are available in hard copy at the relevant meeting. To help people to find completed EIAs we also publish them in the Equality and Diversity section of our website. This will help people to see for themselves how we have paid due regard in order to meet statutory requirements.
| Name of Directorate and Service Area | HAS |
|---|---|
| Lead Officer and contact details |
Tina Simpson, Head of Locality, Care and Support Rachel Bowes, Assistant Director, Care and Support, Health and Adult Services. |
| Names and roles of other people involved in carrying out the EIA |
Claire Sherwood, Project Manager, Business Development Officer, HAS Emma Dixon, Senior Adult Services Lawyer Rachel Bowes Assistant Director HAS |
| How will you pay due regard? for example, working group, individual officer | The project will be reviewed at Locality Monitoring meetings, Project Team and Project Board meetings. Progress will be reviewed at HAS leadership team meetings. |
| When did the due regard process start? |
1 st June 2016 Phase 1 1 October 2018 Phase 2 |
Section 1. Please describe briefly what this EIA is about. (for example, are you starting a new service, changing how you do something, stopping doing something?)
Phase 2 of the Strength Based Reassessments is a continuation of the project which commenced in July 2016.
The original scope (as lifted from full business case) states “The scope includes all community based care packages including those provided in supported living.”
Most clients have now received an initial strength-based re-assessment (completion rate 102% of target as at month 24, of phase 1) however some remain outstanding, particularly in the Supported Living cohort.
A change request outlining the phasing of the original scope was approved on 01/08/18 by HASLT. Phase 1 has reported (24 month report) savings on target at circa £4m, this is in line with the original target set. However, the original financial modelling included significant savings from Supported Living (SL) and this has yet to be achieved in order to focus efforts on the SL customers, Phase 1 has concluded as of the end of May 2018.
As the Supported Living (SL) cohort has still to be assessed using the SBA approach and, as this cohort was included in the original scope, Phase 2 has been introduced thus enabling the project to complete all outstanding SBA’s for the SL cohort.
Section 2. Why is this being proposed? What are the aims? What does the authority hope to achieve by it? (for example, to save money, meet increased demand, do things in a better way.)
The implementation of the Care Act in 2014 has fundamentally changed the approach that local authorities are required to take in the assessment of adults. This project ensures that North Yorkshire Health and Adult Services (HAS) are able to meet its statutory duties and that the service works with customers to improve outcomes through applying a more strength-based approach to meeting care needs; rather than a deficit-based more service-orientated approach. Having commenced delivery in June 2016, Phase 1 of this project has now at the end of a 24 month delivery phase, during which time it has facilitated the change to enable HAS operational teams in adopting a strength-based approach therefore allowing every opportunity for people to become more independent and achieve their outcomes through creative care and support planning. This has taken many forms ranging from the provision of information, advice or guidance, drawing on the skills and resources of the adult and carers, the use of equipment or telecare or a period of reablement that has helped the person regain some skills or confidence in aspects of their lives.
Phase 1 of the project has focussed on the re-assessment of existing (legacy) cases; assessment and support planning for new cases will be based on new ways of working including strength-based approaches. Evidence from other authorities and from strength-based approaches used in HAS to date is that these approaches can improve outcomes for people whilst also achieving cashable savings. It is assumed therefore that a strength-based approach will lead to a reduction in cost of community based care packages whilst still achieving positive outcomes for people and meeting their identified needs. Phase 2 of the project will focus on the cohort of people living in Supported Living. The needs of the individuals will be considered along with the support required within the whole household. Background support will be considered in order to achieve the most efficient way to meet individual’s needs.
The project also seeks to deliver a non-cashable, transformational change in culture in order that independence and strength based approaches to assessment, re-assessment and support planning are embedded. These approaches have been shown to give better outcomes for people.
Section 3. What will change? What will be different for customers and/or staff?
Customers will see a change to the types of conversations that they have with practitioners which will include, where appropriate, more emphasis on them taking ownership of their support needs and more emphasis on universal and community services.
Over the next 18 months we will ensure that future assessments, reassessments and reviews will adopt a strength based approach and will maximise every opportunity for people to become more independent or achieve their outcomes through creative care and support planning. This may be through the provision of information, advice or guidance, drawing on the skills and resources of the adult and carers, the use of equipment or telecare or a period of reablement that will help the person regain some skills or confidence in aspects of their lives. Consideration will also be given to ensure the individual is living in the correct type of accommodation.
Strengths-based practice is a collaborative process between the person supported by services and those supporting them, allowing them to work together to determine an outcome that draws on the person’s strengths and assets. As such, it concerns itself principally with the quality of the relationship that develops between those providing and those being supported, as well as the elements that the person seeking support brings to the process. Working in a collaborative way promotes the opportunity for individuals to be co-producers of services and support rather than solely consumers of those services.
The phrases ‘strength based approaches’ and ‘asset based approaches’ are often used interchangeable. The term ‘strengths’ refers to different elements that help or enable the person to deal with challenges in life in general and in meeting their needs and achieving their desired outcomes.
These elements include:
- Personal resources, abilities, skills knowledge, potential etc.
- Social network and its resources abilities, skills etc.
- Community resources also known as ‘social capital’ or ‘universal resources’
For example: exploring with the person what things they can do for themselves with the resources they have, such as using technology for online shopping, or for finding services required by the person such as cleaning or handy person services. Or having undertaken an assessment the person has a good social network and has friends visiting frequently during the week who are also happy to provide support on these occasions and the person would prefer this. Using some of these solutions may mean that formal social care services are not required for some parts of the overall care and support package, the person maintains their independence and social contact and formal social care services deliver against outstanding needs and support the person to achieve their desired outcomes.
We continue to have a duty to provide preventative services and contribute towards preventing, reducing or delaying the care and support needs of those people, adults or carers to whom we provide care and support and the wider community.
Section 4. Involvement and consultation (What involvement and consultation has been done regarding the proposal and what are the results? What consultation will be needed and how will it be done?)
Formal consultation is not required for this project as the proposed ways of working represents accepted best practice across the adult social care sector and is fully in line with the approaches set out in the Care Act 2014. To ensure consistency of approach from staff who undertake assessments a guidance document has been written and will be cascaded to staff through team meetings. A programme of assessments will be agreed, people and providers will be contacted to advice a reassessment will be undertaken. Once all the individuals in one household have been assessed and their case files audited they will be looked at by members of the Quality Assurance Group. The purpose of the group is to ensure consistent practice is applied across the county.
Quarterly data collection for the project will include changes to personal budgets and the hours of care provided. This will be reported to HASLT.
Section 5. What impact will this proposal have on council budgets? Will it be cost neutral, have increased cost or reduce costs?
It is expected that the cost of the care provided in Supported Living will decrease across the County as clients are re-assessed using a strength based approach.
Adopting a strength based approach is an approach that will be applied to everyone that we work with. It is predicated on the assumptions that people will have individual personal strengths and resources as well as resources within their family and communities. We recognise that some individuals, families and communities will have different resources, and where needs remain outstanding, the local authority will continue to meet them. This means that in some circumstances personal budgets will remain the same or increase. Alternatively, as part of the reassessment, additional needs or solutions outside of formal social care services may be identified, for example, the requirement of nursing care and referrals will be made to relevant agencies or requests for funding for CHC will be made. The need for background support and night support will also be reviewed and support and cost will be attributed to the individual.
Evidence shows that a strength based approach does result in an overall reduction in the cost of packages a County wide savings target of £600,000 worth of savings for ourselves over an eighteen month period has been attached to the project. This figure takes into account the fact that the results of a strength based approach will be different for every customer with packages increasing, decreasing and staying the same. Evidence from Phase1 of the project suggests that these savings will be achieved.
It is also important to note that a strength based approach is applied regardless of who funds the package and savings are often identified to the benefit of other organisations or the customer themselves if they self-fund their packages.
There are 870 people who will be assessed as part of Phase 2. 470 of these people live in a supported living environment.
Section 6. How will this proposal affect people with protected characteristics?
| Section 6. How will this proposal affect people with protected characteristics? | No impact | Make things better | Make things worse | Why will it have this effect? Provide evidence from engagement, consultation and/or service user data or demographic information etc. |
|---|---|---|---|---|
| Age | X |
The people who will be assessed are aged over eighteen. Ages range for those people in supported living is 18-89, in the existing legacy cases the age range is 18-105 |
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| Disability | X |
440 people living in Supported Living environments have LD recorded as their primary need. The assessment process will be person centred and individual needs will be taken into consideration. |
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| Sex | X |
Of the 870 people there are 476 male and 384 female. In the supported living cohort 276 are male and 194 are female. Research is available that suggests that older men are less likely to have a social network and this will be taken into consideration during their assessment and they may end up with a more traditional care package which relies less on support from community and social networks |
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| Race | X |
A small proportion of the cohort are classed as BME. This is to be expected as the BME population as a whole across North Yorkshire is only 4.6%. As with older men research suggests that BME communities living in majority white communities may have less access to a social network and this will be taken into consideration during their assessment. |
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| Gender reassignment | X |
No available data but as the assessment process is individual and takes into account the particular needs of the client gender reassignment should not present any form of disadvantage. |
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| Sexual orientation | X | Very little data available as clients are given a choice to self-declare. As the assessment process is individual and takes into account the particular needs of the client sexual orientation should not present any form of disadvantage. | ||
| Religion or belief | X | As the assessment process is individual and takes into account the particular needs of the client religion or belief should not present any form of disadvantage. | ||
| Pregnancy or maternity | X |
No data available but as the assessment process is individual and takes into account the particular needs of the client pregnancy or maternity should not present any form of disadvantage |
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| Marriage or civil partnership | X | The most prevalent status of the 47.3% who provided information were single with 40% or 346 people. It is difficult to say whether marital status will have any impact on the assessment process and this will have to be monitored through the audit process which checks the quality and outcome of the assessment process. |
Section 7. How will this proposal affect people
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Section 7. How will this proposal affect people who… |
No impact |
Make things better |
Make things worse |
Why will it have this effect? Provide evidence from engagement, consultation and/or service user data or demographic information etc. |
|---|---|---|---|---|
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Live in a rural areas |
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X |
|
Due to the rural nature of North Yorkshire 16.9% of the population are classed as living in a ‘super sparse’ area (fewer than 50 persons per/km). Whilst this will not have any impact on the assessment process. The impact of this will have to be monitored through the audit process which checks the quality and outcome of the assessment process. |
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Have a low income |
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X |
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No data available but as the assessment process is individual and takes into account the particular needs of the person having a low income should not present any form of disadvantage. Financial assessments are undertake for everyone to ensure they are only contributing financially if they are over the appropriate savings thresholds. |
Section 8. Will the proposal affect anyone more because of a combination of protected characteristics? (for example, older women or young gay men) State what you think the effect may be and why, providing evidence from engagement, consultation and/or service user data or demographic information etc.
The information provided in Section 6 suggests that people who may be affected by a combination of protected characteristics are older females, older people with a disability and people living in ‘super sparse’ areas. As the assessment process and resulting care package is based on individual needs all of these will be taken into account and should not put them at a disadvantage.
The majority of people assessed will be living in shared occupancy dwelling. The assessment will need to consider the relationship between people sharing the supported living environment and any impact proposed changes to support may have.
Section 9. Next steps to address the anticipated impact. Select one of the following options and explain why this has been chosen. (Remember: we have an anticipatory duty to make reasonable adjustments so that disabled people can access services and work for us)
| Section 9. Next steps to address the anticipated impact. Select one of the following options and explain why this has been chosen. (Remember: we have an anticipatory duty to make reasonable adjustments so that disabled people can access services and work for us) | Tick option chosen |
|---|---|
| 1. No adverse impact - no major change needed to the proposal. There is no potential for discrimination or adverse impact identified | ✓ |
| 2. Adverse impact - adjust the proposal - The EIA identifies potential problems or missed opportunities. We will change our proposal to reduce or remove these adverse impacts, or we will achieve our aim in another way which will not make things worse for people. | |
| 3. Adverse impact - continue the proposal - The EIA identifies potential problems or missed opportunities. We cannot change our proposal to reduce or remove these adverse impacts, nor can we achieve our aim in another way which will not make things worse for people. (There must be compelling reasons for continuing with proposals which will have the most adverse impacts. Get advice from Legal Services) | |
| 4. Actual or potential unlawful discrimination - stop and remove the proposal – The EIA identifies actual or potential unlawful discrimination. It must be stopped. | |
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Explanation of why option has been chosen. (Include any advice given by Legal Services.) Option 1 has been chosen due to the individual nature of the assessment process which allows a flexible approach to be taken. People will find that they are part of a more positive and collaborative process that is designed to meet their needs in the most appropriate way possible. |
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Section 10. If the proposal is to be implemented how will you find out how it is really affecting people? (How will you monitor and review the changes?)
Individuals who have not yet had a strength based assessment have been identified on Liquid Logic and those people living in a supported living environment. The cohort of people being assessed will be flagged on liquid logic and data will be collected on a monthly basis by the Performance Team. Information detailing changes to personal budgets will be provided for each locality.
Assessments for those people living in a supported living environment will be reviewed at a weekly Quality Assurance Group meeting.
An outcomes spreadsheet will be completed which will capture a combination of quantitative and qualitative information. Information will be shared with HASLT on a quarterly basis and there will be formal reviews throughout the lifetime of the project.
Case file audits will be completed on each case being discussed at the Quality and Assurance Group.
Section 11. Action plan. List any actions you need to take which have been identified in this EIA, including post implementation review to find out how the outcomes have been achieved in practice and what impacts there have actually been on people with protected characteristics.
| Action | Lead | By when | Progress | Monitoring Arrangements |
|---|---|---|---|---|
| Ensure Case File Audits reflect equality considerations | Claire Sherwood | Case file audit tool being updated, audits to be completed for a cases being reviewed a QAG | Head of Practice and Project Board | |
| First formal review | Claire Sherwood | Feb 2019 | Review carried out by the Project Team | |
| Second formal review | Claire Sherwood | Aug 2019 | Review carried out by the Project Team | |
| End of Project Review | Claire Sherwood | Feb 2020 | Review carried out by the Project Team |
Section 12. Summary Summarise the findings of your EIA, including impacts, recommendation in relation to addressing impacts, including any legal advice, and next steps. This summary should be used as part of the report to the decision maker.
The findings from this EIA screening shows that whilst evidence is available to suggest that some protected characteristics are more prevalent than others the individual nature of the assessment process means that there is unlikely to be any adverse impacts upon any customer with protected characteristics as defined under the Equalities Act 2010. While assessments will be completed for individuals living in a supported living environment consideration will be given to impact any change may have on the whole household. Once the new approach is embedded in supported living environments it will be monitored to ensure that people are part of a more positive and collaborative process with good quality assessments and outcomes.
Section 13. Sign off section
This full EIA was completed by:
Name: Tina Simpson
Job title: Head of Care and Support SWR
Directorate: HAS
Signature: Tina Simpson
Completion date: 10 Dec 2018
Authorised by relevant Assistant Director (signature): Chris Jones-King
Date: 07/08/2019