6. Developing the care and support workforce

The local workforce is a key enabler to the delivery of the local vision of support to adults with LD&A.


6.1 Introduction

The local workforce is a key enabler to the delivery of the local vision of support to adults with LD&A. It is important that councils work closely with their partners to ensure the local workforce has the capacity and capability needed to meet the full range of care and support needs (which includes being able to meet multiple/complex needs, including behaviour that services may find challenging, in the community) of the adults with LD&A who live in the area to enable them to: Lead the lives they want to lead, make progress toward their personal aspirations and maximise their independence safely. The workforce in scope, includes the assessment and care managers, care and support providers and staff in universal services used by adults with LD&A.

6.2 What good looks like

The best councils ensure their own staff use strengths-based approaches consistently when working with adults with LD&A including at first point of contact, throughout the assessment, care management and review processes. This must be checked and re-enforced through supervision and appraisal.

They monitor and analyse Social Care Workforce Data published by Skills for Care Adult about the LD&A workforce in their area and benchmark themselves against others. This gives indications about workforce satisfaction, motivation, capabilities, and the attractiveness of a career in care and support. They use the data to forecast future workforce challenges and underpin council and joint workforce plans with these forecasts.

They work hard to develop and maintain a cultural and organisational commitment to strengths-based working beyond frontline practice. For example, leadership and administrative and management systems are aligned with a rights and strengths-based practice model which ensures that how health and social care workforce (including allied professionals) work is in line with their values, skill set and vocational calling.

They work in partnership with local care and support providers and other stakeholders to develop a shared value set, understand the local labour market and monitor its capacity and capabilities. They work jointly to:

  • ensure the workforce has the skills needed to work with people with LD&A
  • ensure there is a career pathway for people working in the care and support sector
  • promote the attractiveness of a career in the care and support sector
  • collaborate on recruitment and retention initiatives
  • understand the value of the care and support sector to the local economy so the local narrative is about the positive value the sector adds; rather seeing it as a cost/burden.

They use commissioning arrangements to require LD&A care and support providers (internal and external) to use human resources processes that help to: recruit, retain and motivate staff with the values and skills needed to use a flexible, personalised and strengths based approach to support people with LD&A. For example, they use value-based recruitment, and manage, reward, train, develop and supervise staff to re-enforce the local LD&A vision and strategy. They also ensure each worker has the skills and knowledge they need to deliver support flexibly and effectively. Key competencies include specialist communication and positive behaviour management skills.

They use procurement and contract management processes to ensure sustainable fees are paid so LD&A providers can pay a living wage, limit the use of agency staff except to cover temporary peaks in demand and to encourage investment in skills development in key areas such as how to manage risk positively, enable the development of the skills of daily living, work in an outcomes focused way.

They give jobs to adults with LD&A as experts by experience, or in roles that provide assistance to other people with LD&A.

6.3 Expected outcomes

In terms of outcomes councils that are implementing good practice should find that the:

  • Satisfaction of Adults with LD&A and carers with the staff who support them increases over time.
  • Continuity of support workers improves over time.
  • Workforce job satisfaction improves over time while proxy measures of this such as staff vacancies/ shortages/ sickness rates should reduce over time if all other things are equal.
  • Quality of the support (as rated by CQC and by the people who with support) will improve over time.
  • Number of adults with LD&A employed as experts by experience, or to support other people with LD&A by the council, by care/support providers and by local businesses increases over time.
  • Proportion of adults with LD&A supported locally and in the community rather than out of area and in bed-based support models increases over time.
  • Quality of life reported by adults with LD&A increases over time.

6.4 Developing the local care and support workforce Performance Indicators

Outcome indicators

Outcome Indicators

To improve aim for

National/Local

Analyse CQC ratings of local services in more detail and monitor the percentage of providers rated “Outstanding” or “Good” for the key lines of Inquiry on are they (1) Caring? and (2) Responsive to people’s needs?

Increasing percentage

National data

ASCOF (1E) Population of adults with LD support in paid employment

Increasing percentage

National data

Number and proportion of key stakeholder organisations that are signed up to a shared statement of or a memorandum of understanding about LD&A care and support workforce values that they will promote.

Increasing percentage

Local data

 

Individual experience indicators

Individual Experience Indicators

To improve aim for

National/Local

Ask people who use services and carers to assess their experience compared to the Making it Real “I” statements domain “The people who support me – Workforce.

Increasing % answer “positively”

Local data

Changes in care and support packages following reviews. Consider the percentage of individual:

  • Outcomes achieved in each reporting period, and
  • Care and support arrangements where support activities or costs change after a review in line with changing needs and/or preferences.

Increasing percentage

Local data

 

Financial value for money indicators

Financial/Value for Money Indicators

To improve aim for

National/Local

The Skills for Care Adult Social Care Workforce Data on the social care workforce in each council area gives data on the costs, capacity, and capability of the local workforce. Therefore, monitor and analyse data on:

Increasingly permanent, less vacancies, good mix of ages/ gender and race, paid fairly with improving skills/ qualifications

National data

  • Recruitment/Retention of LD&A workforce e.g. Turnover, Sickness, Experience etc.

National data

  • Qualifications/training/skills of LD&A workforce e.g. Qualifications by service type/sector

National data

  • LD&A workforce size/structure e.g. Full/part time, Perm/temp/agency etc.

National data

  • Demographics of LD&A workforce e.g. age, gender, ethnicity, nationality etc.

National data

  • Pay rates for LD&A workforce e.g. hourly rate by job type, Council v Independent sector etc.

National data

 

6.5 Self-evaluation questions

How to rate yourselves against the self-evaluation questions

For each chosen section the DASS should consider each statement about good practice that follows and work with their senior management team, representatives of key partner organisations and local experts by experience to rate how close the councils approach to supporting adults with LD&A is to the best practice described using the following five-point scale, where one means it is far away from best practice and five means it is already using best practice.

The scale to be used is as follows:

1. Commitment

The importance of this best practice has been recognised. Conversations are taking place internally or with partners including experts by experience, but work has yet to begin.

2. Developing

Work on this best practice has commenced internally or with partners including experts by experience, but it has yet to be signed off, is only in the planning stages and with resource identification is still in progress.

3. Implementation

An agreed fully resourced and commissioned (where relevant) plan is in place. Implementation has started, but best practice is not yet fully operational.

4. Operational

Best practice is in place and is being used, albeit implementation is at an early stage, and further refinements in line with the learning from implementation may be needed before expected benefits are fully realised.

5. Sustainable Delivery

Best practice is in place and is working well. Long-term funding, resources and structures are in place i.e. best practice now represents “business as usual” and continuous improvement processes are in place.

Developing the local care and support workforce

Score 1 - 5

Basis of score

1. The council ensures their own staff use strengths-based approaches consistently when working with adults with LD&A for example: at first point of contact, throughout the assessment, care management and review processes, and they check/re-enforce the use of strengths-based approaches and use of direct payments through the supervision and appraisal processes. Where possible staff will encourage and facilitate use of a person’s personal and community assets as the first choice, rather specialist care

 

 

2. The council monitor/analyse Skills for Care ASC Workforce Data on the LD&A social care workforce in their area and benchmark themselves against others to get indications about staff satisfaction, motivation, capabilities and the attractiveness of a career in care and support.

 

 

3. The council works in partnership with local care and support providers and other stakeholders to: develop a shared value set, understand the local LD&A workforce market, monitor the local workforce capacity/ capability and work jointly to:

  • Address current or potential future capacity/capability gaps in the LD&A workforce through recruitment, retention and training and development initiatives, and
  • Promote the attractiveness of a career in the care and support sector working with adults with LD&A and to actively develop care and support career pathways.

 

 

4. Council commissioning arrangements require care and support providers (internal and external) to use human resources processes that help to recruit, retain and motivate staff with the values and skills needed to use a flexible, personalised and strengths based approach to support people with learning disability and autism. For example:

  • Use value-based recruitment that involve experts by experience.
  • Involve experts by experience in training courses.
  • Manage, reward, train, develop, supervise, appraise, and mentor staff to re-enforce the local LD&A vision and strategy.
  • Training and development processes ensure each worker has the skills/knowledge they need to flexibly support the people they support incl. specialist communication skills and positive behaviour management skills when these are needed.

 

 

5 The council regularly undertakes research to understand how satisfied council and provider staff are with their work and their working environment AND to understand the satisfaction of the people who are supported (and their carers) with the council and provider staff. These findings are used to inform improvement actions plans.

 

 

6 Council procurement/contract management processes ensure provider fees are sustainable so they can afford to pay staff a living wage and invest in skills development so they can meet requirements to:

  • Manage risks positively use the least restrictive options.
  • Enable the development of the skills of daily living in line with the outcomes in each person’s individual care support (and if appropriate treatment) plan.
  • Work to achieve outcomes rather than deliver inputs.
  • Limit the use of agency staff to covering temporary peaks in demand (where possible).

 

 

7 The council supports adults with LD&A and their carers to find, recruit, manage and retain personal assistants (PAs) so support can be personalised

 

 

8 The council supports adults with LD&A and their carers to apply for and manage direct payments so they can manage and personalise care and support.

 

 

9 The council supports adults with LD&A to find and keep employment. It:

  • Actively (along with its partners) seeks to employ adults with LD&A in their own workforce(s), including as experts by experience and advisers to others with LD&A
  • Ensures access to good quality employment is a matter considered in needs assessments and reviews of ongoing care and support.
  • Provides, or commissions, support services giving tailored support to adults with LD&A to find/keep work and is flexible about the length of time people may need support.

 

 

10 The council works in partnership with local care and support providers and other stakeholders to understand the value of the care and support sector to the local economy so the local narrative is about the positive value the sector adds; rather seeing it as a cost/burden.

 

 

 

Guidance

To understand the what adults with LD&A and carers want from the support workforce see: Making it Real: TLAP (2018)

To learn about best recruitment/retention practice see: Recruitment and retention in ASC see: Secrets of success: Skills for Care (2017)

To develop the capability to support more complex needs in the community see: Specialist Staff: Understanding the challenges in supporting people in their communities: NDTi (2016)

To understand what capabilities the social work workforce needs to have/develop see: Two capability statements for social workers by DHSC/BASW on working with:

  1. Adults with Learning Disability (2019)
  2. Autistic Adults (2019)

To understand the capabilities the social care workforce needs in relation to transitions see: Learning Disability Transition Pathway Competency Framework: Health Education England (2016)

To access specialist autism training resources see DHSC Autism Training resources or those provided by Skills for Care

To access guide to training the workforce to support people with profound and multiple learning disabilities see: Raising our Sights how-to guide 8 - Training the workforce: Mencap (2010)

When asked what a good support worker does, an expert by experience told us:

They put themselves in our shoes and have had learning disabilities awareness training"
 

Who is good at this?

In Darlington a 15 week training programme developed by the Life Stage Service, the PICKS (Process, Information, Competency, Knowledge and Skills) aims to develop the skills of the workforce to enable them to implement the “Progression” model across the service. The model supports the team to embed a positive enablement approach, supports capacity building for individuals and in turn leads to cost efficiency and future planned efficiencies for the organisation.