Adult Social Care Plan 2024 to 2027

Foreword

Leeds Adult Social Care is committed to supporting adults who have care and support needs to be as independent as possible throughout their lives. We know that getting the right help and support at the right time can help people to manage their daily lives as independently as possible, can support people through a crisis and can really help people to flourish. 

This plan sits alongside the Better Lives Strategy, which has been shaped by listening to what people have told us is important to them and what matters the most. It supports the implementation of the Health and Wellbeing Strategy, the strategy for the health and care system within Leeds. It also supports the delivery of the Care Act 2014 duties within Leeds.

Our Adult Social Care Plan 2024 - 27 sets out how we will continue to work together to build on the good progress we have made to implement a strengths and asset based approach, focusing on prevention and reablement, supporting family and friend carers, and working towards the integration of services. To do this we will use our resources effectively to deliver better outcomes for people who have care and support needs. We want Leeds to continue to be a great place to grow older in, where all adults with care and support needs, as well as their families and carers feel included.

As the Adult Social Care Plan 2024 – 27 sets out, Covid has had a significant impact on our communities in Leeds and in many cases has drawn attention to inequalities – in health, in access to services, and in access to a range of opportunities. The health and care system worked tirelessly throughout the pandemic to keep people safe as far as possible, it is time now to focus on supporting people to thrive in their communities.

Access to services in a timely way is critical to ensuring that people can stay at home for as long as possible. As the Executive Member, I am committed to ensuring that Adult Social Care reaches out to every community, that it provides services which are empowering, equitable and culturally competent, so that every adult with care and support needs receives a good service that has their interests at its heart – a truly person centred and strengths-based service that delivers our vision for people with care and support needs:

Councillor Salma Arif
Executive Member for Adult Social Care, Public Health and Active Lifestyles

Caroline Baria
Director Adults and Health

What is Adult Social Care?

The Care Act (2014) places a duty on local authorities to carry out a needs assessment in order to determine whether someone has needs for care and support. This duty applies to all adults over 18yrs as well as a responsibility to assess a carer’s needs for support, where the carer appears to have such needs. In addition, the local authority must consider providing information and advice or preventative services. The local authority is not required to meet any eligible needs, as defined by the Care Act 2014, which are already being met, for example by a carer who is willing and able to continue to do so, but it should record that this is the case.

Adult Social Care aims to help adults with care and support needs to stay independent, safe and well so they can live the lives they want based on what’s important to them.

People who draw on care and support include:

• Are older
• Have learning disabilities
• Have physical disabilities
• Have conditions like dementia, Parkinson’s and Alzheimer’s
• Have autism
• Have mental health conditions
• Are Deaf, blind or visually impaired
• Have drug and alcohol issues
• Are recovering from severe illness or injury
• Look after a friend or relative (carers)
  

They might need support with: 

• Preparing or eating food and drinks without help
• Keeping themselves and their clothes clean
• Managing toilet needs
• Getting dressed
• Moving around safely
• Keeping their home clean and safe
• Having enough contact with other people
• Taking part in activities like volunteering or learning
• Using transport and local services
• Caring for the people they are responsible for
  

What happens if I or someone I look after needs care and support?

You can find information on all our services on our website: www.leeds.gov.uk/adultsocialcare. 

You can also access the Leeds Directory online to find out about services to help people to remain independent at home. Our Contact Centre (0113 222 4401) is a telephone-based service that provides information and advice on care and support.

When you contact us we may arrange for you to have a discussion with a member of our team. They'll work with you to understand your needs and make a plan to help you live well. We call this an assessment. Your plan could include ways to help you stay independent and do the things you enjoy. This could be adapted equipment to make daily tasks easier, help getting out and about, daytime groups and finding ways to reconnect you with friends and family. You may need a care worker to help with dressing, washing and personal care. If you need it, we can help you find the accommodation that works best for you. We will be able to help you to consider alternative places to live which may better suit your health and care needs.

If you require a care service, you may be required to pay for it or make a contribution towards the cost. We will support you to complete a financial assessment and explain how much you would be required to pay and how to make payments. If you are eligible for support, you can arrange and manage your own care with the help of direct payments from the Council. Direct payments can give you much more flexibility and greater control of your support package.

Support if you look after someone

If you care for someone and feel like you need support or a rest, you can ask the adult social care team for a carer's assessment.

This is a chance for you to have a conversation about how your caring responsibilities affect your wellbeing and quality of life. It is not to judge the care that you provide, but to see how we can help make your life easier.

If you look after a friend or relative, you might benefit from help around the home so that you can focus on caring for them. When you need a break, the person you care for might need respite care (a short break). We can also give advice on benefits you could get or help you find support groups.

The plans that shape our work

The Adult Social Care Plan is rooted in the ambition and principles of the city’s core strategies. Leeds has a strong focus on tackling health and economic inequality and working with people to influence the development of services that they need – where people who are the poorest will improve their health the fastest. We have established a clear framework for strengths and asset based working, with a focus on community led support, that shapes how we work with our partners and communities.

How we work

Our vision for people with care and support needs is set out in the Social Care Futures vision for Adult Social Care. This vision has been embedded in the Better Lives Strategy:

In Leeds, we work in a strengths and asset based way which means we recognise that the communities we live in and the relationships we have are what matter most to people. Our approach to social care starts by looking at ‘what’s strong, not what’s wrong’. We work in a person-centred way, to understand how we can support everyone with care and support needs to live the life they want to.

We work with our partners across health and care to provide the right care, at the right time, in the right place.

We aim to:

• Provide access to support at an early stage, meeting with people in community locations closer to where they live.
• Enable all adults with care and support needs to become more independent.
• Work with people to make sure they have as much choice and control as possible over how their support needs are met.
• Help people to easily access information and support when they need it.
• Keep people safe from abuse and neglect and ensure this is viewed as ‘everyone’s business’.
• Recognise and value the contribution made by unpaid carers.
• Maximise our partnership work with the Third Sector, the independent sector, families and carers.
• Develop our workforce and support staff to understand their role in delivering the vision and plan.

We help people to live in dignity and enjoy healthy, active lives.

Supporting people to be an independent as possible is key to the way we work. through the use of telecare and equipment and by connecting them to local organisations and community groups.

We set up Talking Points enabling people to meet with a member of social care staff in a local community hub, talk through their concerns and work together to find solutions.

We see thriving communities as key to delivering that ambition and have continued to invest in community building and social infrastructure in partnership with the Third Sector. Working with the Third Sector, we have established community-based Neighbourhood Networks across the city that support older people to live independently and participate within their own communities. We have pioneered ABCD (Asset Based Community Development) that has supported people to make the changes they want to see in their communities. We are transforming the way care is provided in people’s own homes to strengthen connections to communities by rooting care and support in neighbourhoods through the Community Wellbeing Teams work.

We are committed to improvement and have developed a new Quality Assurance Framework which underpins all we do to ensure we are providing a high-quality service for people with care and support needs, ensuring their welfare is safeguarded and promoted.

Understanding our City

Leeds is a dynamic, vibrant city with a robust economy and strong, diverse communities. Since 2011, Leeds has grown by over 8% and with an estimated population of 812,000 people, is the second largest local authority in England. From the 2021 census we know that:

More people are living longer in Leeds. A third of people in Leeds are over 50 and over 15% are over 65. By 2043, we expect to see a 51% increase in people over 80.

Leeds is becoming more ethnically diverse in terms of its people and communities. In 2021, 6% of the 65+ population, 20% of those aged 25 - 64 and 30% of the 0 - 24 population are from ethnically diverse communities. 10% of people living in Leeds identified as ‘Asian’ and 5.6% identified as ‘Black’.

1 in 4 people in Leeds live in the most deprived 10% of areas in England. Around 186,000 people in the city live in areas that are ranked in the most deprived 10% nationally, an increase of more than 20,000 people since 2015.

Health inequalities have become worse in Leeds. Life expectancy varies across the city from 72 for men and 74.3 for women in Burmantofts and Richmond Hill, to 83 for men and 88 for women in Adel and Wharfedale.

1 in 6 people in Leeds are disabled. This means that they have a physical or mental impairment that has a 'substantial' and 'long-term' negative effect on their ability to do normal daily activities. An estimated 2000 people in Leeds have a mild to severe learning disability and approximately 5500 people have learning difficulties. There are an estimated 8,700 people living with dementia.

1 in 10 people in Leeds provide unpaid care. We estimate that:

• 3% of the population (33,000) provide up to 19 hours of unpaid care per week.
• 7% (13,000) provide 20 to 49 hours of unpaid care per week.
• 6% (20,000 people) provide 50 hours of unpaid care per week.

We have a duty under the Care Act to shape the care market to ensure quality and equality of access to all. Our focus will be to develop a range of services and interventions that will enable the adult social care service to shape the market to meet needs, whilst recognising different ways of doing things and ensure that services meet the widest range of people’s needs.

The council is responsible for ensuring that these services meet the needs of local residents and that they maintain and improve their quality standards.

Leeds City Council commissions the majority of its care provision from the independent sector. This currently includes working with:

• In excess of 90 Residential & Nursing homes for older people.
• Over 140 Homecare Providers.
• 53 care homes for working age people with disabilities.
• Over 500 extra care apartments
• A range of day services
• Information, advice and support for people with caring responsibilities.

Further information can be found in our Market Position Statement.

Understanding what is important to the people who use Adult Social Care services

The financial position within which Local Authorities find themselves cannot be ignored. We have a duty to achieve value for money in terms of the Adult Social Care budget for the citizens of Leeds. A key priority is to develop a highly skilled workforce who are confident and able to find the best ways to meet needs and aspirations and also provide value for money. This means that we will have to work with people and communities to develop the most cost-effective approach that we can in order to meet our statutory duties, which means that some of our existing services may need to change or be transformed.

The pandemic in 2020 had a significant impact on the way we worked. It saw us working increasingly in collaboration with our partners including NHS services. However, it also meant that we did not have access to the local community resources in the same way. We have taken time to reflect on the impact that covid has had and are looking to find new and different ways to link with and speak to people to find out what they need and want from the service. We also know that people are waiting too long for services as a result of some of the changes that took place during and after the pandemic. We know that people want us to listen to their experiences and to make processes simpler and more joined up – they want it to be simpler and quicker to access our services.

We have been working to embed a strength-based approach to adult social care in Leeds since 2015. We have changed how we work, our systems and processes, to ensure that we work in person centred way. This approach has enabled people to be independent for longer, to live an ordinary life and remain at home with fewer people admitted to residential care. It enabled us to respond to people sooner and reduce the time that social workers spent on ‘paperwork’, enabling them to spend more time with people in their local communities. Since 2017 we have implemented a new model of delivering community based care and support called ‘community led support’ (CLS)

What is Community Led Support?

Community Led Support involves local authorities working collaboratively with their communities and partners and with staff, ideally across the whole authority (not just within social care) to design a health and social care service that works for everyone. Changes made to local services and systems include a combination of interconnecting elements, all of which are essential, but which are shaped and refined to reflect local circumstances. These elements are summarised in the graphic below.

At the heart of the approach is a set of underpinning principles about how local support should be delivered.

Community Led Support (CLS) Principles:

• Co-production or engagement brings people and organisations together around a shared vision
• There is a focus on communities, recognising that each community may be different
• People can get support and advice when they need it so crises are prevented
• The culture is based on trust and empowerment
• People are treated as equals and their strengths are promoted and built on
• Bureaucracy is kept to the absolute minimum
• The system is responsive, proportionate and delivers good outcomes

We have agreed with our partners that we won’t put labels on people and will move away from language that people have told us is stigmatising. When we need to record information about you it will be written in your own words as far as possible, our conversation records will be just that – what we spoke about, what matters to you and most importantly what action we will be taking. We will share with you what has been written about you – you will receive a copy of your conversation record and any support plan that we develop, so that you can check it and make sure that it reflects your views and priorities.

Working in partnership

Working in partnership – with people

The adult social care plan focuses on working ‘with’ people, this means that we don’t ‘do for’ people, or ‘do to’ people, we are committed to working with people and their families as equal partners. We work with them to find the best solution they can, on their own, or with a little help, or with full support, to live the best life they can. We recognise the importance of speaking to people about their experiences of Adult Social Care and the impact of our involvement in their lives; we are committed to working in equal partnership with people who use our services, carers, family and friends, colleagues across the council, and our partners to find shared solutions.

This approach is called ‘co-production’. 'Co-production' describes working in partnership by sharing power between people who draw on care and support, carers, families and citizens and is at the heart of good, personalised community-based care and support. As reflected in this plan, Leeds has signed up to the ‘Making it Real’ principles to develop our co-production framework, it will be used by us to address what matters to people and to improve services. 

We want to continue to support people to be independent, live in dignity and enjoy healthy, active lives. We see thriving communities as key to delivering that ambition and will continue to invest in community building and social infrastructure in partnership with the Third Sector. The diversity of the sector is what makes it so unique and we aim to provide the best advice and guidance for groups and organisations – enabling them to promote access to a range of adult social care services within these communities.

Working in Partnership – with Health and Care Partners

We want to support people to avoid hospital and care home admissions as much as possible. Building on our strong partnerships, we are working collaboratively to deliver an integrated, person-centred, home-first model of intermediate care across Leeds. By 2025 the Home First programme aims to achieve 1,700 more avoided admissions to hospital each year with 400 more people going home from hospital rather than to a bed each year. The Home First Programme involves everyone who works in the health and care system in Leeds.

A key aspect of the Home First Programme is the way in which Adult Social Care works in partnership with Leeds Community Healthcare to deliver a range of community-based services. This includes helping to reduce delays between health and care settings and improve people’s experiences and outcomes. We call this partnership “The Alliance”.

Services within our Alliance include Active Recovery and Recovery Hubs which support people to become more independent at home, using recovery focused outcome based approaches. The Recovery Hubs and Active Recovery also help prevent people from needing to go into hospital.

Homefirst Programme Vision

A sustainable, person-centred, home-first model of intermediate care across Leeds that is joined up and promotes independence.

What would the impact across the system be?

Based on the evidence gathered in the diagnostic, each year we could see:

• 100 more people able to go home after their time in intermediate care
  
• 400 people able to go home sooner from a short-term bed
  
• 1,200 people benefitting from a more rehabilitative offer in their own home
  
• 1,700 fewer adults admitted to hospital
  
• 400 more people going directly home after their stay in hospital
  
• 800 people spending fewer days in hospital
  

Working in Partnership - with Social Care providers

We have a Market Position Statement which sets out the types and range of services we need in Leeds. This Statement is aimed at our independent, voluntary and third sector care and support providers to enable them to plan and develop the right types and volumes of services to meet the needs of our local residents now and in the future.

Our Priorities, ambitions and actions

We have taken the priorities from the Better Lives Strategy and Health and Wellbeing Strategies for Leeds, which work to enable people with care and support needs to live good and fulfilling lives. We have used the ‘Making it Real’ framework to identify our priorities and ways of working. The framework has been designed to help providers and commissioners deliver good, personalised care and support. It was developed by Think Local Act Personal, a national partnership of organisations committed to transforming health and care, with people who access services. The ‘Making it Real’ framework has six themes that collectively set out what is important to people and will support them to live a good life.

Priority Area 1 - Wellbeing and independence

Living the life I want, keeping safe and well

We will support people to live a fulfilling life, connected to family, friends and community, through support that promotes wellbeing and independence. We will enable people to use digital tools, technology, and services in the right way for them to live as independently as possible. We will continue to trial new and emerging technologies so new technology becomes a core part of what we do, enhancing how we work.

Priority Area 2 - Information and advice

Having the information I need when I need it

We will make it easier for people to access and get the information and advice they need when they need it, in the accessible formats that they need. This will include working with our health partners and third sector colleagues to promote health and wellbeing for all ages and access to services that promote health and wellbeing and help them manage their self-care and support needs appropriately

Priority Area 3 – Active and Supportive Communities

Keeping family, friends and connections

We will support people to access the broad range of support that is available to them in their communities including third sector support, neighbourhood networks and friendship networks. We will work closely with our partners so our systems and processes are better integrated, so we save time and make better decisions for people as they move between our services.

Priority Area 4 – Flexible and Integrated Care and Support

My support, my own way

We will develop innovative ways to provide care and support to people at home and supporting people and their carers to stay healthy. We promote choice and control; we trust people to make the right decisions and direct their own support. We focus on the resources and support to make this work.

Priority Area 5 - When Things Need to Change

Staying in control

We listen to people and the key people in their lives, helping people to plan ahead and to respond to changes in their lives and in their care and support needs.

Priority Area 6 - An inclusive, valued and well trained workforce

The people who support me

People are listened to and respected by a workforce with a can-do attitude, that responds to their needs as unique individuals. Our social care teams work to deliver anti-racist, anti-discriminatory and anti-oppressive practice standards. We welcome and celebrate diversity and the strengths this brings to our communities and our workforce. We seek to create an inclusive culture with a sense of belonging for everyone.

Our key actions over the life of this plan

Over the next three years Adult Social Care will continue to work towards some of our current developments which include:

• Continue to develop the skills, knowledge and experience of our workforce, including further embedding our Workforce Race Equality Standards.
• Continue to work with partners through the Leeds Safeguarding Adults Board to help people to be and feel safer and tackle abuse when it occurs
• Continue to work on our Digital strategy, helping people to access services through use of website and apps, supporting people through use of care technology and working more efficiently
• Further develop our services through our existing Adult Social Care plan and our HomeFirst transformation programme, supporting people to remain independent at home for longer.

In addition to the above we will prioritise the following:

2024-2025

1. Reduce waiting times and timeliness of assessments by offering more Talking Point appointments and delivering more proactive, preventative approaches such as further developing our Enhanced Care at Home Programme with Leeds Community Healthcare Trust.
2. Increase the flexibility and control people have over how their care and support needs are met through increasing the up take up of Direct Payments, Personal Health Budgets and Section 117 Personal Health Budgets. We will pilot Individual Service Funds.
3. Increase the number of people who receive an annual review of their care through using new technology and increase access to technology that can support independence.
4. Enhance our offer of information, advice and access to adult social care services, making it easier to find the information people need.
5. Implement the first phase of our Community Health and Wellbeing service – a new way to provide community led home care.
6. Work with Housing partners on our Accommodation Strategy to improve access to housing especially when people leave hospital to support faster discharge.
7. Implement the Community Mental Health Team Hub pilots in line with the Community Mental Health Transformation Programme as part of the Mental Health Strategy.
   
8. Implement our strategic plan for ABCD (Asset Based Community Development), including expanding the programme with 3 new ‘pathfinder’ sites, developing an enhanced training offer and new grant schemes to support communities to makes the changes they want to see.

2025-2026

1. Build on our Digital Plans and Front Door redesign by offering on-line early help assessments and undertaking more yearly reviews.
2. Increase access to reablement support – help for people after a fall or a stay in hospital.
3. Continue our work to develop a diverse workforce and increase skill mix across teams.
4. Evaluate the Community Mental Health Transformation Hub pilot sites; to make sure that access to mental health service has improved for everyone.
5. Continue our improvement and HomeFirst design principles to increase the amount of reablement and rehabilitation available in the city.
6. Support creativity and use our budgets to support innovative services that work and are underpinned by our ‘diverse by design’ principles.
7. Continue our work to support people to live independently at home and access advice, information and guidance about care and support available, including development of a new ASC website.
8. Continue to Listen Act and Learn from the feedback we receive from people who use services.

2026–2027

1. Continue our community led support focus and create co production opportunities between people who use services, carers, and professionals to deliver better outcomes.
2. Further develop our information advice and guidance offer including Leeds Directory and website in co production with our partners and people who use services.
3. Continue building on our workforce strategy that includes the whole system, focussing on equality, diversity, and inclusion.
4. Further develop our commissioning approach to ensure we have a choice of affordable, accessible care and support available with a focus on people’s experiences and improving quality

How will we know if we are making a difference?

The Adult Social Care plan is a three-year plan which takes us from 2024 to 2027. We are committed to continual improvement – we have developed a new Quality Assurance Framework which underpins all we do to ensure we are providing a high-quality service for people with care and support needs, to co-design real, tangible and meaningful measures to reflect progress on each of the priorities below. We will use these to supplement our existing data collection and analysis through our Adult Social Care Outcomes Frameworks.

Our priorities build upon the 6 themes of Making it Real, that reflect the most important elements of personalised care and support and our actions in the section above largely reflect the measures set out below. We will use this approach to measure the improvements we make over the next three years.

Each theme has a number of 'I' statements that describe what good looks like from an individual perspective. These are followed by 'We' statements that express what we should be doing to make sure people’s actual experience of care and support lives up to the 'I' statements.

Priority - I statements and key measures - we statements:

We will monitor how our Adult Social Care Plan is delivered using our performance management processes and evaluation frameworks. We will report each year in our Local Account how we are progressing against the commitments that we are making and will summarise feedback from the people we serve.

The Better Lives Board has been set up to monitor the Better Lives Strategy and this board oversees the Local Account and our work to improve Adult Social Care. This will help us measure the effect and impact of our work at a local level.

How to get help from Adult Social Care

The following information explains how to get help for yourself or another adult, including how to get support or have a conversation with the Council.

Online

Information on our services is available through the Adult Social Care pages of Leeds City Council website: www.leeds.gov.uk/adult-social-care.

Leeds Directory can support you to live well by connecting you to checked and vetted local services and tradespeople as well as local activities and events. 

Home | Leeds Directory https://www.leedsdirectory.org/

Phone

0113 222 4401 

(Weekdays, 9am to 5pm, except Wednesdays when we are open from 10am) 

Our contact centre where you can ask for information about our services or arrange an assessment. 

Email

leedsadults@leeds.gov.uk

Urgent out of hours

If it cannot wait until the next working day try our emergency social care contacts 

0113 378 0644 

edt.ss@leeds.gov.uk

British Sign Language

Call with Sign Video live BSL interpretation