Optalis Performance Review 2020/21
- Meeting of Adults, Children and Health Overview and Scrutiny Panel, Wednesday, 9th June, 2021 6.15 pm (Item 75.)
To receive a presentation and note its contents.
Hilary Hall, Executive Director of Adults, Health and Housing, introduced the item and explained it was about the performance of Optalis over what had been a very challenging year. She introduced the Panel to David Birch, Chief Executive of Optalis, who would do the presentation.
David Birch began by stating Optalis and the Royal Borough had a shared vision for adult social care to allow people to lead independent and fulfilling lives, and explained the shared principles of prevention, community, choice and values. He explained the quote at the top of the presentation slide – “Thank you for keeping us safe” – came from an autistic user of one of the Optalis services, and it encapsulated the summary of the presentation and what Optalis hoped to achieve. The Panel was informed that Optalis operated more than 20 different care services in the Royal Borough.
In the presentation David Birch highlighted that over the last 15 months no customers or members of staff had been lost to a Covid infection picked up within Optalis’ services, which was a significant achievement. He said this was thanks to management’s expertise at interpreting the guidance from Public Health England regarding infection prevention control and ensuring there was adequate PPE resources. When the NHS was under the greatest amount of pressure in the New Year, staff in the social work, reablement and occupational therapy teams were able to help create much-needed capacity at Wexham and Frimley Park hospitals. A number of vulnerable groups of people had been identified and additional risk assessments and vaccine education sessions took place to help support them. The Panel was told that mandatory restrictions had prevented a number of day services from operating, and as many alternative methods of support as possible were brought in so as not to disadvantage people who used these services. David Birch said staff had shown a great willingness to try new things to assist service users.
Michael Murphy, Director of Statutory Services and Deputy DASS, said the ability to provide the required support was testament to the strong foundations that were already in place pre-Covid, highlighting that the most recent CQC inspection recorded all areas as good or outstanding. He stated his belief that the services would retain this rating. Michael Murphy also highlighted to the Panel that the percentage of users who received rehabilitation support on leaving hospital who subsequently were at home 91 days later stayed consistent, with more than 80 per cent of people not returning to hospital within three months of discharge. This had assisted with creating adequate hospital capacity during the second wave of Covid. There had been a 50 per cent increase in hospital discharges during the first three months of 2021 compared to the same period the year before. The Panel was told that although there were significant challenges services were delivered £500,000 under budget, thanks to efficiencies and grant funding. Daily and weekly meetings had taken place with various provider groups regarding outbreak control.
The Panel was told that during the pandemic Optalis took control of the Extra Care service at Lady Elizabeth House in Maidenhead and the Supported Employment service, which was previously delivered by Ways into Work. More investment was taking place into the specialist reablement service, so that more people would be able to live safely and independently for longer.
The presentation then went on to consider ways of transforming Optalis. David Birch explained that it had been hoped planned changes could have been brought in a year ago, but they had been delayed due to the pandemic. However during Covid there had been a growth in the number of community groups willing to engage with, and provide support for, people and Optalis had been looking at these offers of help and considering how they could be incorporated into their services. It was hoped that this would enable people to get the help they needed at an earlier stage; often it was the case a resident would only seek services when they were at crisis point. David Birch said providing preventative support for people would provide the biggest transformation for residents, but it would be the hardest aspect of the transformed care provision to get right. The Panel was told that a revision of day service provision was taking place, which included an ‘out and about’ service. This would take services to where they were required rather than being building based, although it was accepted some users may still prefer to use a building-based service. David Birch said the long-term hope was for Optalis and the Royal Borough to become a beacon of national excellence in terms of adult social care.
Cllr Hunt noted that traditional ways of providing services had been reviewed and amended, and asked how many of the changes had been brought in out of necessity due to the pandemic. David Birch said some of them had initially been discovered by accident and staff had thought creatively on how to make best use of alternative provision of services. He said Covid had allowed staff the opportunity to run a number of things differently, and looking at alternative strategies was being prioritised over introducing new ones. Responding to a question from Cllr Hunt, David Birch said the budget savings meant it had not been necessary to bring in agency staff to cover.
Regarding the ‘out and about’ service, the Panel was told that this had been trialled by Optalis in Wokingham and had been so successful it had been necessary to introduce a subscription service to prioritise users. David Birch said out and about allowed for greater provision of services in evenings and at weekends and was a self-funding service. Responding to a question from Cllr da Costa about how someone who did not have the finances to pay in to the service Lynne Lidster, Head of Commissioning – People, said a consultation on future provision of day services had begun following approval of the budget by Full Council. Creating a more diverse day opportunities offer was dependent on the closure of the Windsor and Oakbridge Day Centres, which would generate sufficient funds and savings for everyone to use the new out and about service whilst retaining some building-based services for those who wanted them.
Responding to a question from Cllr Tisi regarding discharges of patients from hospital during the period January-March, David Birch and Michael Murphy explained additional risk assessments and due diligence had taken place to ensure the patients were safe to be discharged. Additional protective measures were put in place in care homes where patients were to be discharged to. Cllr da Costa said she had had a family member discharged during this time period and this had been done very successfully. David Birch said Optalis provided support for 5,000 people across the Royal Borough and also in Wokingham, of whom around 2,500-3,000 lived in the Royal Borough. Responding to a question from Cllr Sharpe, he said the biggest challenge they faced was recruiting enough staff to be able to expand services as they wished to. Responding to a question from Cllr Tisi, David Birch said Brexit was unlikely to have an impact on recruitment as relatively few members of staff came from EU countries. It may be the case that applicants would be inexperienced but seeking to retrain or learn new skills.
Cllr Bateson noted that it was often difficult to get an appointment or speak to a doctor as many had been redeployed elsewhere due to Covid, and this was particularly an issue for people who lived alone. Hilary Hall said some GP surgeries were working closely with community groups to provide alternative support, although this was not possible to do on a consistent basis across the whole Borough. Michael Murphy said this tied in the priority of trying to identify needs at the earliest possible opportunity to avoid later crises. Referrals could be made using social prescribers, who worked closely with GP surgeries and adult social care.