Keep up-to-date with the latest developments in adult social care.
Welcome to the October 2016 Developments in Adult Social Care Bulletin. The bulletin contains brief details of news, research reports, journal articles and government policy relating to adult social care.




Older people



Physical disabilities and sensory impairment

Learning disabilities

Mental health



Statement highlights social care funding crisis

The Local Government Association has published its submission to the Treasury ahead of the Autumn Statement. The statement claims that the current crisis in our social care system is hampering councils’ ability to support our nation’s most vulnerable adults, and states that it is essential that the government prioritises tackling the funding crisis facing adult social care whilst also ensuring that prevention and early intervention are priorities across government. This means addressing the funding gap of £1.259 billion facing adult care services by the end of the decade, as well as taking action to alleviate the immediate pressures facing the sector, particularly the fragility of the provider market. It is also crucial to speed up the progress with integrating health, social care and public health services to secure the best outcomes for improving people’s health and wellbeing, and closing health inequalities.
Statement: Growth and opportunity for all: Local solutions to
national challenges: The LGA’s submission to the Autumn Statement 2016 (PDF, 358Kb)

Care Act statutory guidance updates

The Department of Health has published further updates to the Care Act statutory guidance, which supports the implementation of part 1 of the Care Act 2014 by local authorities. Paragraph 9.67 in Chapter 9 on Deferred payment agreements has been updated to include more detail about the national maximum interest rate. Paragraph 18.5 has also been updated, to make clearer how section 75 of the 2006 NHS Act and the Care Act work together in terms of prescribed partnership arrangements.
Guidance: Care Act statutory guidance

Cold weather plan

Public Health England has updated its cold weather plan for England for the 2016 winter season. The plan gives advice to help prevent the major avoidable effects on health during periods of cold weather in England.
Plan: Cold weather plan (CWP) for England

Embedding social values in health and care commissioning

Social Enterprise UK (SEUK), the national body for social enterprise, has published a short report detailing the difference social value can make in health and care commissioning, and sharing learning for commissioning authorities to make the most of social value. The report presents the initial findings from SEUK's Health and Social Value Programme, a three-year programme bringing together local Clinical Commissioning Groups (CCGs), local authorities, Health and Wellbeing Boards and Voluntary, Community and Social Enterprise (VCSE) organisations in 12 areas across England. SEUK has also put together a 12 step approach for commissioners looking to make the most of social value.
Report: The social value difference in health and care commissioning

Healthwatch annual report

Healthwatch has published 'Every Voice Matters', its Annual Report to Parliament for 2015/2016, which outlines the ways in which the Healthwatch network has worked with people up and down the country to inform how services are being improved.
Report: Every Voice Matters

Emergency measures for DoLS applications

The Association of Directors of Adult Social Services (ADASS) has issued an advice note for managing and processing cases generated by the Supreme Court decision in 2014 in relation to Deprivation of Liberty Safeguards (DoLS). The note, which advocates the use of desk-top assessments in certain cases, has been developed in response to unprecedented levels of requests for DoLS authorisations beginning in April 2014 at the point of the Supreme Court judgement and continuing since then. ADASS stress that the note has been issued as an emergency interim measure and only relates to renewal and low priority applications.
Note: Advice note for managing and processing cases generated by the supreme court decision in 2014 in relation to deprivation of liberty safeguards (PDF, 441Kb)

Adult Social Care Outcomes Framework (ASCOF) findings

NHS Digital has published the findings from the Adult Social Care Outcomes Framework (ASCOF) in England for the period 1 April 2015 to 31 March 2016. The ASCOF measures how well care and support services achieve the outcomes that matter most to people. Among the findings, 85.4% of service users in England reported that the services they received helped make them feel safe and secure, while 76.6% of service users in England reported they have control over their daily lives.
Statistics: Measures from the Adult Social Care Outcomes Framework, England - 2015-16

Short and Long Term Services (SALT) findings

NHS Digital has published the findings of the SALT (Short and Long Term Services) data collection for 2015-16. The SALT data collection tracks the client journey through the adult social care system in England. Among the findings, there were 1,811,000 requests for support from new clients during the reporting period - 28% from clients aged 18-64, with the remaining 72% from clients aged 65 and over. 57% of requests for support resulted in no direct support from the council. Just 55% of clients who had been accessing long term support for more than 12 months at the year end were reviewed (planned or unplanned) during the year, and a third of carers in contact with the council did not receive a review or assessment during the year.
Statistics: Community Care Statistics, Social Services Activity, England - 2015-16

Questions on direct payments answered

Community Care has published an article summarising legal trainer Belinda Schwehr's responses to questions about direct payments under the Care Act 2014 posed by practitioners at legal training sessions and webinars.
Article: Your questions answered on direct payments under the Care Act

Adult social care 'approaching tipping point'

The Care Quality Commission has published 'State of Care 2015/16' - the annual overview of the state of health and social care in England. This year's report reveals that, despite challenging circumstances, most health and adult social care services in England are providing people with safe, high quality and compassionate care. However, the Commission warns that, with pressures rising on demand, access and cost, the adult social care market is fragile, and evidence suggests it might be approaching a ‘tipping point'.
Press release: Adult social care 'approaching tipping point' warns quality regulator
Report: State of Care

Increasing integration and improving lives

NHS England has published details of two more common frameworks for local health and care systems, organisations, communities and patients, wishing to develop and implement new ways of working. The documents are based on the learning so far from the primary and acute care system (PACS) and enhanced health in care homes vanguards – describing the key ingredients that make up both models. They demonstrate how the new models can strengthen primary care, improve access, focus on the prevention of ill-health and control costs. They follow on from the multispecialty community provider (MCP) care model framework, which was launched in July.
News story: NHS England launches frameworks to increase integration of health and care services and improve the lives of care home residents

Plans to cut red tape

Department of Health has announced it will challenge bureaucratic red tape on the health and social care front line to increase the focus on patient contact and care. Minister for Health Lord Prior is setting up a 'Burden Reduction Challenge Panel' in partnership with NHS Providers, NHS Confederation and Care England. The panel will look at evidence of both the burdens and benefits of current NHS and social care regulatory activity and will then challenge their use and necessity. Regulatory activity judged to be unnecessary by the panel and relevant officials will be amended or removed.
News story: Plans to reduce health and care red tape burden

Unsafe discharge from hospital

The House of Commons Public Administration and Constitutional Affairs Committee (PACAC) has published a follow-up to the Parliamentary and Health Service Ombudsman (PHSO) report on unsafe discharge from hospital. The PACAC inquiry found that the discharge failures identified by the PHSO report are not isolated incidents but rather examples of problems that patients, relatives and carers are experiencing more widely. It claims that while excellent guidance on best discharge practice is available, the extent to which good practice is implemented varies across the country. Barriers to the implementation of best practice are prevalent both within hospitals and at the interface between health and social care. Pressures on resources and capacity within hospitals are leading to worrying and unsafe discharge practices. The Committee calls upon health and social care leaders to ensure that staff are operating in a culture where person-centred care is the undisputed priority.
Article: Political maladministration to blame for unsafe hospital discharges, says Committee 
Report: Follow-up to PHSO report on unsafe discharge from hospital

Older people

Older private tenants living in appalling conditions

Age UK has published a report about older people who privately rent their homes. The report, based on calls to the charity's advice line, suggests that many older private tenants are living in appalling conditions with disinterested landlords and negligent letting agents. The report makes a number of recommendations for change to improve housing in the sector and the support offered to older people in terms of housing options.
Press release: Squalor and distress - older people in private rentals
Report: Behind the headlines: Older people who privately rent their homes (PDF, 666Kb)

Mental health services failing older people

Age UK has published a report on older people's mental health, highlighting that the current availability of mental health services does not meet the increasingly high demand from our ageing population. The report reveals that currently 3 million people in the UK over the age of 60 are living with depression, with this figure set to rise to 4.3 million in the next 15 years due to the growing number of older people in our society, and that the NHS is not providing those in later life with mental health problems with sufficient treatment options, such as talking therapies and integrated care plans. Age UK is calling on the NHS to make sure that plans are in place across the country to improve access to talking therapies for older people, and strategies are developed to help the many older people suffering with both physical and mental health problems. 
Press release: Mental health services are failing older people
Report: Hidden in plain sight - older people's mental health (PDF 891 Kb)

Exposing the homecare deficit

The United Kingdom Home Care Association (UKHCA) has published a report which highlights the ‘widespread and systematic underfunding’ of homecare services for older people. The findings provide further evidence of genuine risks to the viability of state-funded homecare services, and the possible consequences for over half-a million people supported at home. This is despite the increasing recognition that home-based care should be the solution to meeting people's care needs at home, rather than being treated in hospital. UKHCA's analysis also highlights serious implications for recruiting and retaining homecare workers, who are essential for effective home-based care, and exposes the postcode lottery of the prices that individual councils are willing to pay for essential care services, even within the same region.
Press release: Older people's homecare at risk from £513 million UK deficit
Report: The Homecare Deficit Report, October 2016

Self-funders' challenge to get a fair deal

Age UK has published a report highlighting the challenge of getting a ‘fair deal’ faced by older people who pay their own way in care homes. Two in five (41 per cent) of all residents in UK independent care homes are now paying for their own care, an increase of almost a third in the last ten years. The report is based on actual calls to Age UK’s information and advice line and highlights the real challenges many self-funders face.
Press release: New report from AGE UK highlights the challenge of getting a ‘fair deal’ faced by older people who pay their own way in care homes

Harnessing social action to support older people

The Nuffield Trust has published an evaluation of the government's 'Reducing Winter Pressures Fund', which aimed to scale up and test projects that used volunteers to support older people to stay well, manage health conditions or recover after illness, and thereby reduce pressure on hospitals. The research report presents the findings of the Trust's evaluation of seven social action projects funded by the Cabinet Office, NHS England, Monitor, NHS Trust Development Authority and the Association of Directors of Adult Social Services. The evaluation resulted in a mixed set of findings. Evidence from interviews suggested that services that had made an impact by providing practical help, reassurance and connection with other services that could reduce isolation and enable independence. However, the analysis of hospital activity data in the months that followed people's referral into the projects did not suggest that these schemes impacted on the use of NHS services in the way that was assumed, with no evidence of a reduction in emergency hospital admissions, or in costs of hospital care following referral to the social action projects.
Report: Harnessing social action to support older people

Physical disabilities and sensory impairment

Inadequate support compromising future of young disabled adults

Scope has published a new report into care and support for 17 to 30 year old disabled adults. The findings of the report suggest that a lack of adequate social care support is letting young disabled people down and holding them back.
Press release: Young disabled adults’ futures compromised by inadequate care support
Report: Leading my life my way

Learning disabilities

Campaign to move people out of inpatient units

Charities Mencap, the Challenging Behaviour Foundation and the National Autistic Society have produced new campaign guidance for groups and individuals wanting to apply pressure on NHS England and local areas to deliver change for thousands of people with a learning disability, autism and/or challenging behaviour currently stuck in inpatient units. The ‘Making it Happen’ guide highlights NHS England’s promise to make sure 35-50% of inpatient beds close, and the right support is built in the community by 2019. It outlines how campaigners can help ensure these promises are met through the new Transforming Care Partnerships, which have been set up to implement NHS England’s plan, ‘Building the Right Support’.
Press release: ​​​​​​​Charities renew pressure to move people with a learning disability out of inpatient units, five years on from Winterbourne View scandal
Guide: Making it Happen (PDF, 276Kb)

Mental health

The Mental Health Five Year Forward View Dashboard

NHS England has published 'The Mental Health Five Year Forward View Dashboard', as a response to the recommendation in the Five Year Forward View for Mental Health that NHS England create a tool to be able to monitor progress on its commitments to transform mental health services. By making the data publically available, NHS England aims to ensure that that commissioners can use it as a tool to inform their work and that services users and their families and carers can see how local services are performing and understand where to look to make informed choices about their care.
Resource: The Mental Health Five Year Forward Dashboard

Recovering quality of life

The University of Sheffield has launched a new self-assessment measure which aims to help mental health service users in their recovery. Recovering Quality of Life (ReQoL) is a Patient Reported Outcome Measure, developed by a team at the University’s School of Health and Related Research (ScHARR), to assess the quality of life for those experiencing mental health difficulties. The questionnaire will be used in helping to decide what support or services people receive and also to measure and improve the quality of care that service users receive. Researchers from ScHARR worked together with service users and clinicians to generate the themes, items and scoring of the measure. ReQoL has been commissioned and funded by the Department of Health Policy Research Programme in England for use in the NHS.
Press release: University of Sheffield research improves the life of mental health service users
Resource: ReQoL: Recovering Quality of Life

Is mental health crisis care in crisis?

The NHS Confederation has published a briefing which explores the gap between the policy rhetoric around mental health crisis care and reporting on the ground. The Confederation claims that despite the clear policy direction and pledged government investment, funding has not reached the front line of care and significant challenges remain for providers to meet demand and for individuals to get the help they need.
Briefing: Is mental health crisis care in crisis?

Mental health and housing

Housing and Health has published a working paper which focuses specifically on an analysis of the potential economic benefits of including housing services on the acute care recovery pathway. With analysis and expertise from the London School of Economics' Personal and Social Services Research Unit, the paper identifies the possible opportunities for releasing resources from inpatient care and re-investing them in alternative support services, either provided or supported by housing associations. In order for this to take place and the savings to be realised, NHS commissioners would need to develop alternative forms of community-based services while maintaining existing infrastructure. The paper aims to provide a practical roadmap towards more flexible service provision.
Paper: Working paper: Mental health and housing: Potential economic benefits of improved transitions along the acute care pathway to support recovery for people with mental health needs

Suicide and homicide by people with mental illness

The University of Manchester has published an annual report and 20-year review of the national confidential inquiry into suicide and homicide by people with mental illness. The report presents findings from 2004 to 2014, and reviews 20 years of data collection. It provides the latest figures on suicide, homicide and sudden unexplained deaths and highlights the priorities for safer services
Report: The national confidential inquiry into suicide and homicide by people with mental illness

Reducing out of area placements in mental health

The Department of Health has published a guide for care providers and commissioners in monitoring and reducing their use of out of area placements (OAPs) in mental health services for adults in acute inpatient care. It is intended to support providers and commissioners in accurately monitoring and reducing their use of OAPs and to help providers submit accurate information on OAPs to national data collections. It will also be of interest to individuals using mental health services and who may be placed out of area for their care. The government has set a national ambition to eliminate inappropriate out of area placements (OAPs) in mental health services for adults in acute inpatient care by 2020 to 2021.
Guidance: OAPs in mental health services for adults in acute inpatient care


Carers and the NHS

Carers UK has published a report which examines the role of carers in reducing emergency admissions and delayed transfers of care from hospital. The report suggests that, due to a lack of appropriate support in the community, unpaid carers are reluctantly taking the person they care for to A&E. The charity highlights that 4 in 10 carers who have taken their loved one to A&E in the past 12 months believe their admission could have been prevented with more or higher quality support for the person they care for, more local support for them as a carer, or access to a district nurse. Carers UK is calling for a carer friendly NHS programme, increased funding for social care, and greater access to social care and health care in the community,
Press release: Lack of community services to support to carers is piling pressure on NHS emergency care
Report: Pressure points: carers and the NHS

If you have any comments or questions about the bulletin, please contact Bryony Shannon on 0114 2057155 or email
This bulletin is produced monthly by Bryony Shannon, Development Officer in the Quality Team in Sheffield City Council Communities portfolio. It is distributed to all staff in the Communities portfolio as well as to individuals and local and national organisations who ask to receive it. The information in the bulletin is drawn from a wide range of sources, including: national and local government; research bodies; newspapers, journals and magazines; think tanks and charities. External links included in the bulletin are checked on the day it is distributed. Sheffield City Council is not responsible for the content of external websites and resources linked to from the bulletin. Any references to guidance, toolkits or other resources should not be understood to be an endorsement of the resource by Sheffield City Council, and while we encourage you to inform your practice with evidence from external resources, you should not change your practice based on the information in the bulletin without prior discussion with your line manager. You can subscribe to receive the bulletin each month. If you no longer wish to receive the bulletin, please unsubscribe.

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