Managing waiting lists and waiting times for Care Act assessments and reviews
Supporting councils to minimise and monitor waiting lists and waiting times through the use of prompts for strength-based approaches and a consistent set of indicators.
West Midlands Association of Directors of Adult Social Services has reviewed how waiting lists, and the associated waiting times, for adult social care assessments reviews are monitored and managed.
This is addressing a key risk faced by councils and those who draw on social care and is also reflecting some national interest in this issue.
As well as developing a consistent set of indicators to minimise and monitor waiting lists and waiting times, we have also tested out some prompts to assist councils in monitoring how they are managing their lists and mitigating any risks to ensure the individuals receive the support they require, whilst focusing on strength-based approaches.
Why are timely responses important?
Although there are not specific national performance measures relating to waiting lists and waiting times, providing a timely response is essential to using strengths-based approaches and supporting individuals to live as independently as possible. The form is directed at those people responsible in council for overseeing waiting lists. This is meant to be a series of prompts to assist councils in assessing if they are doing everything possible within available resources to reduce waiting lists and to mitigate the risks associated with them. The prompts are designed to complement local processes and not provided as a solution to all circumstances. Combined with these prompts, it is also important that councils have a sound methodology for monitoring and keeping track of their waiting lists and waiting times and applying robust monitoring to ensure those in most need are protected.
Four key areas
Do you have up to data, including trends on:
waiting times for assessment and review – including consideration of risk and carers assessments
number of people requested assessment (broken down by cohort and benchmarked to enable any variation to be understood)
assessments and eviews completed?
caseloads of staff (and complexity)
proportionality of assessment and review activity (gold standard for some while others wait)?
how is this data reported and who is seeing it?
is there a documented and understood process to dynamically review risk within waiting lists and reprioritise accordingly?
are waiting lists and waiting times for social care assessment on a directorate or corporate risk register; what’s the risk escalation points, who to and what for?
How do you know if colleagues feel confident in their ability to escalate/seek advice from a manager or peer to resolve an issue that then enables completion of an assessment or review? What feedback are you getting?
How do DASSs know if practitioners are using asset-based approach to social work practice that aims to put individuals, families, and communities at the heart of care and wellbeing? What case audits/reviews are being completed and what is the learning?
How do you know if all staff at all levels commit to the same goal of improving outcomes and maximising independence as part of the assessment and review process? Are you collecting evidence of any diversion, signposting, and stories of difference?
How do you gain assurance that practitioners are effectively exploring digital care solutions in their determination of service requirements for users and carers?
How are you managing your “front door” to help ensure people are signposted effectively? Please note Top tips for hospital discharge.
Does it include triage with dedicated support from an experienced practitioner? What data do you see that gives you assurance?
Have you established an effective prevention offer, what are your community assets, and have you any evidence how the usage can be increased for demand management and early intervention?
How do you get assurance that there are arrangements in place to respond to citizens who present to us in crisis?
How are managers monitoring the outcomes of your assessments, that is whether it ended up with no services, short term services or long term services?
Do you have a clear framework that identifies different models and approaches for assessment? For example:
Do you have any interagency working agreements or trusted assessment relationships in place to complete non statutory assessments and support for local citizens, for example, social prescribing?
Do you commission or delegate responsibility to another organisation to support statutory assessments and reviews, and how are you gaining assurance?
Do you regularly:
re-visit waiting lists to re-prioritise a way of risk assessing
set targets based on waiting times
review monitoring and maintain a focus on planned reviews
model demand and mix skills of staff, for example, social workers and social care assessors, to ensure that resources are maximised
use inclusive language for all professions?
How do you get assurance that people waiting for assessment or review know how to get back to the council if their needs change?
How do you make sure residents know who to contact if their needs have changed significantly?
Are you promoting and encouraging the use of phone or video access, uptake of Direct Payments and digital solutions?
Are practitioners effectively exploring digital care solutions in their determination of service requirements for users and carers?
The ideas presented here are intended to support those trying to create more capacity and better flow and to specifically unblock delays in hospital discharges.
This project has been a collaboration between West Midlands ADASS and the LGA's Care and Health Improvement Programme. Any feedback, comments or examples of good practice will be appreciated. Please email [email protected].
