IT project's key part in making joint working work

Bristol City Council’s Social Services Department, like other such departments across the county, has been undergoing reorganisation and the last twelve months have been a particularly testing time. Apart from organisational changes, for example separating out of children’s services, the main focus has centred on the sensitive issue of budgets and unit costs.

This means reducing the emphasis on more expensive in-house services and to move more towards a strong assessment and commissioning role.

Whilst continuing to meet its duty of care, Bristol’s new adult community care department - newly created by re-organisation - is moving away from established methods of providing services by increasing things like direct payments, which is very much in line with the national agenda, and re-assessing how it uses more institutional models of care.

The intention is get people away from institutional care and out of hospital quicker and the difficulty according to Bill Venables, project manager for the adult community care, is that with this approach what happens after discharge is critical. His concern is that the new department must be able to provide the full range of follow-up services in order to keep people moving back home and living independently. Without that the system could get blocked up.

Adult community care’s strategy is to free up some of its current investment in services based on more dated care models. Much in-house home care is focused on people with relatively low needs, with staff geared up to going into peoples homes for comparatively short periods of time during the day.

The move now is to provide more intensive care packages. This requires extending staff’s skills and introducing more flexible working.

Bill comments: “Changes are happening and one of adult community care’s projects, the intermediate care service (ICS) is providing intensive short-term help for people to return home from hospital or prevent admission in the first place. ICS is an intregrated Health and social care service. Initially there was a partial implementation of the Paris system, this made it much easier to talk about the functionality that health and social care staff were looking for in joint working teams. This was helpful in overcoming some of the difficulties thrown up in the early stages of implementing an integrated service.”

An example of this was the request for forty-five separate health forms to be included and built into the system from scratch. Analysis and review managed to dramatically reduce this number, while still using the core documentation, to nearer the document levels used by social care staff with some special assessment forms added in.

According to Sarah Boyd, adult community care’s ICS project manager, the project started as a limited specialist programme to bring all of the specialist assessments into Paris and to upgrade their processes to be more Single Assessment Process (SAP) compliant, it has in fact helped create a joint service with 200 plus staff using the Paris system.

She said, "Although we have still some ground to make up with SAP in Bristol, we are probably among the first services to begin ticking all the boxes. We have been going live gradually with PARIS in ICS and expect that everybody should be full trained in the use of Paris by the end of July.

“In addition we’ve been running a mobile working pilot with a learning difficulties team and, as a result of this successful trial of Mobile Paris using Citrix, we will be looking at rolling out wireless enabled laptops.”

Alongside adult community care the council has also set up a children and young people’s service (CYPS) which, combines children’s social services and education. Such developments are happening across the country and while building on a shared focus on children the new arrangements have to reconcile different professional imperatives.

“Keeping social care issues on the agenda is key and we’re working with CYPS colleagues to make sure that happens,” Bill Venables says. “Because of Bristol’s particular circumstances, we in adult community care continue to run a number of services on behalf of the CYPS supporting staff previously employed in the children’s part of social services. This includes IT and management information services.”

Bill said that he and his colleagues will continue to work on and develop the Paris application for children’s services: “Paris is a system that is up and running. We have looked at alternatives, but haven’t found one with the same multi-agency focus. In4tek’s decision to involve customers in product development has been an important factor in this.”

(The views expressed in this article are those of the individuals concerned, rather than those of Bristol City Council.)