How Herefordshire Council designed a strengths-based approach for its social care pathway

Herefordshire Council has been making significant strides towards improving outcomes for its population, by completely redesigning local social care pathways using a strengths-based approach.

Overview of the redesign

Herefordshire’s Advice and Referral Team (ART) has been instrumental to the redesign. The Council selected Imosphere’s latest version of the FACE Personalisation Toolset and Formulate to support the delivery.

Some factors for the redesign included:

• The need to promote well-being in line with Care Act guidance.
• The drive to reduce waiting times between initial contact and care packages.
• To maximise the potential of untapped community resources.

Initial contact

At initial contact, a customer services officer has a holistic conversation with the person, looking at their strengths, support network and history.

Community brokers sit within this team to help identify any community resources that can support the person. The ART also uses the senior practitioner in the team to oversee the new process and help identify any safeguarding issues.

A letter is automatically generated from the contact assessment, which is sent to the person with details of community resources, information and advice.

If a person has unresolved needs following ART’s involvement, the new Home First service (multi-disciplinary reablement) becomes involved to support them.

Short-term assessment

During this assessment, the strengths-based conversation continues and a fuller picture of the person’s needs, outcomes, strengths and family support is built up. Using Formulate, an estimated personal budget is produced to help provide a framework for the care and support plan, if needed at this point.

Long-term assessment

Within six weeks, the person’s support is reviewed and, if required, an assessment for long-term care and support is carried out. If the review indicates a change in care and support needs, the estimated personal budget is reviewed alongside the support and care offer. The community brokers are again involved in the care and support planning process to help identify if any community resources can be utilised.

FACE Personalisation Toolset

Herefordshire chose Imosphere’s FACE Personalisation Toolset (V8) to help support their strengths-based conversations. The core principles of the toolset are proportionality, focusing on strengths and enabling conversations. Imosphere worked with Herefordshire to ensure that the toolset was the best fit for their pathway, helping them shape the tools to suit their needs.

The core principles were applied to the Council’s locally developed forms and processes. Keeping these core principles allows Herefordshire to benchmark against other local authorities in the future.

Feedback from the community brokers has been that having a good, holistic and well-evidenced assessment is key to identifying appropriate community support.

Estimating a personal budget

The community brokers’ view is that Formulate is essential for providing a strong framework, allowing them to build community structure around formal care.

The team at Imosphere supported Herefordshire to calibrate it with local costs and helped align to local budgets and commissioning arrangements.

Formulate has ensured personal budgets are estimated fairly and consistently, while providing a high level of accuracy which reflects the local landscape.

The newly designed process also means that estimated personal budgets are only produced when required, saving valuable staff time.

The results

• By improving their community offer, Herefordshire has seen an average reduction of £3k pa for new care packages.

• Herefordshire expect to see 75% of referred people being supported wholly by free or very low-cost community services.

• Formulate data is being used to measure the impact of the community brokers. This is helping to create an evidence base to see how Herefordshire’s approach is working and identify where unmet needs in the population remain.

• Once Home First is fully up and running, it is expected that of the remaining 25% of people, 70% will have their support needs met here, with only 30% going on to receive short-term care.

• There have been improvements to citizens’ experience of adult social care: waiting times for assessments have dropped dramatically, with all of the community teams now having a waiting list of zero.

• The Council and their citizens now have a process which flows better, uses the right skills at the right times and ensures that resource allocation happens only when other avenues have been fully explored. The ART said this is a positive change and they have received overwhelmingly positive customer feedback.