Health and Wellbeing Proposals

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Health and Wellbeing Services

This area of the Council includes services such as:

  • Adult Social Care
  • Children’s Social Care
  • Support for vulnerable families
  • Education
  • Public Health


Health and Wellbeing Priorities

Key priorities in this area are as follows:

Enable more adults to live longer, healthier, and happier lives

  • Continued support to deliver vaccinations to tackle COVID-19
  • Continuing a robust testing and tracing approach to manage infections and outbreaks
  • Improving services that support good mental health
  • Improving public health, particularly in relation to obesity
  • Transforming Adult Social Care to provide care, which is more joined-up with the NHS, closely connected with communities and embraces technology
  • Continuing to ensure that affordable, accessible and sustainable leisure services are available

Support children and young people to have the best start in life

  • Supporting the emotional health and wellbeing of young people
  • Finding new ways to support families at an earlier stage and reduce the need for more costly crisis services
  • Finding more cost-effective ways of supporting children with complex needs
  • Supporting the education needs of all children and young people
  • Supporting inclusion of children with special educational needs and disabilities
  • Supporting young people into education, training or employment


Health and Wellbeing Proposals

Overall, the budget for this area is £199.7 million a year. Government has made announcements about funding for Adult Social Care, but at the time of writing it is uncertain how much of this funding will be needed to pay for new costs to support people to pay for their care as a result of the reforms. It is unclear whether this money will therefore be sufficient to meet current pressures. To balance the budget and ensure there is enough money to tackle the priorities set out above, the following proposals are under consideration:


Support to Adults Proposals

(1.1) Additional investment to support the rising number of adults with learning disabilities: £1.5 million over three years to support the rising number of adults with learning disabilities. This is on top of £3.8 million of additional funding that the Council had already planned for as more young people with learning disabilities move into adulthood.

(1.2) Additional investment to ensure there is sufficient funding in place to meet the care needs of older people: An additional £600,000 from next year to meet the care needs of older people. This is needed as more people live longer and may require care.

(1.3) Additional investment in the Reablement Service to help people regain their independence: A further £700,000 on a permanent basis from next year to invest in the Reablement Service which helps residents recover their independence after a crisis such as a fall or a hospital admission. This additional support is needed as more adults require this service, particularly older people. £509,000 of this will be funded by using the Better Care Fund grant.

(1.4) Additional investment in technology to support people to be more independent in their own homes for longer: A further £119,000 from next year to invest in switching our technology-enabled care offer from analogue to digital equipment, ensuring residents are fully supported to be more independent in their own homes for longer. This is on top of the £331,000 already in place for this.

(1.5) Improving services and saving money by supporting more residents with learning disabilities to receive care within the borough: Where possible, we try to support residents to receive their care in the borough, close to friends and family. Sometimes this is not possible due to the nature of the help they need, and specialist support is sought in other locations across the country. We are proposing to work with care providers to develop this support in Cheshire West and Chester and reduce the need to find support elsewhere. Overall, this could deliver a better service and reduce costs by £230,000 from 2023-24.

(1.6) Improving services and saving money by designing a joined-up service with the NHS to support people with dementia in care homes: Residents in our care homes who have dementia may, at times, require 1:1 support. This is often due to a delay in specialist support being available. Sometimes this is provided by the Council, and in some cases also by the NHS. Joining our resources up could help us establish an integrated, specialist team that would provide fast-paced, professional support to delay, prevent or de-escalate the need for such a level of 1:1 support for dementia. If this was taken forward it could improve service delivery and reduce costs by £250,000 from 2023-24.

Support to Adults - further ideas for the future

To meet future challenges the following is being considered, but work is at an early stage:

(1.7) Consider changing social care practice by providing support focused on individuals’ personal strengths and social and community networks at an earlier stage, to encourage greater independence: Work is underway to change the way that social care operates. More emphasis is being placed on focussing on the strengths of an individual rather than what they can’t do. This includes looking at personal strengths and social and community networks. This encourages a focus on independence and thinking creatively about what matters to each person and the wide sources of support they can draw on. It also involves working with people in a more timely way and not only at a point of crisis. Over time this could deliver more responsive support for the individual and reduce reliance on traditional packages of care.


Public Health Proposals

(1.8) Additional investment to improve stop-smoking services, so that they are available to all residents trying to quit smoking: A further investment of £182,000 from next year is proposed for stop-smoking services. Currently services are largely targeted to certain groups, but this investment would make the services available to all residents trying to quit smoking. This will significantly improve their health and wellbeing whilst helping reduce the future demand for more expensive health and care services. This will be funded by the Public Health Grant.

Public Health - further ideas for the future

To meet future challenges the following is being considered, but work is at an early stage:

(1.9) Consider developing a long term response to managing COVID-19 and other outbreaks: Given the Council’s statutory public health duties, we have been at the very heart of leading the local response to the pandemic since March 2020. We have been managing outbreaks, providing essential advice and support to our residents, supporting our care homes, education, and business settings. This has seen us develop successful local contact tracing services, personal protective equipment supplies, self-isolation support packages, testing and vaccination programmes with the NHS, and helping our high streets return safely. The Council has put its own resources, alongside funding provided by government, into this local pandemic response since March 2020. Consideration is now being given to the longer term funding the Council may need to manage COVID-19 as we learn to live with the virus, as well as ensuring we have the right support in place to manage other outbreaks.

(1.10) Continuing to review Leisure Services to ensure they remain affordable, accessible and sustainable to meet the needs of residents: As part of the Council’s significant investment and ongoing transformation of the leisure, health and wellbeing services provided by Brio, we need to ensure these services remain affordable, accessible and sustainable to meet the needs of our residents. This includes significant investment in Northgate Arena and the development of a new Hub and Spoke Delivery Model. We will continue to review and develop these services by working closely with our communities and wider partners to maximise the potential health and wellbeing developments that are available.


Support to Children and Young People Proposals

(1.11) Additional funding to support the rising number of children at risk, who require care and support to ensure they are safe: As COVID-19 restrictions eased it was clear that there were more children requiring care and support. This has been experienced nationally. One impact of this is that more children have come into the care of the local authority to ensure they are safe. This has increased both the demand and cost, for things like foster care placements. Specialist support is also required to tackle issues such as child sexual exploitation and county lines. To meet this challenge, it is proposed that an additional £1.8 million is invested into Children's Social Care over the next three years. We will continue to find ways to intervene early and reduce the demand for crisis support in order to fund this budget pressure.

(1.12) Additional funding to support the rising number of children with special educational needs and disabilities who require specialist support: An increasing number of children and young people require specialist support from the Council as they have special educational needs and disabilities. This includes the need for specialist educational support and transport. Further funding of £2.8 million over the next three years is proposed to meet this challenge.

(1.13) Increasing income by marketing our residential services that support short breaks for disabled children, young people, and families to other local authorities: The Council has a residential provision that children and young people use for short breaks to support them and their families. We have worked with a neighbouring council who will buy this service from us without compromising the offer to local children and young people, this will secure income of £106,000 next year, although it is not certain that this will be a permanent arrangement.

Support to Children and Young People - further ideas for the future

(1.14) Consider reviewing the accommodation needs of children in care and care leavers, to provide more local accommodation within the borough: Some children in care who need residential support may need to be placed outside of the borough due to a lack of local available services. As well as meaning they are moved away from local networks of support such as friends and family, it is also a significant cost to the Council. Young people leaving home for the first time often receive support from their families to do so, young people leaving the care system often need that same support with accommodation. A full plan will therefore be developed looking at the accommodation needs for these groups with a view to investing in more local and cost-effective options.

(1.15) Consider introducing salaried carers who would be specially trained to strengthen support for children in care who have complex needs: For children and young people in care who have needed intensive residential support, foster support is not always the right option to meet their needs and it may not be possible to step them down to a less intensive form of support in a family setting. We are proposing to tackle this by developing salaried carers who have special training and support to support children in care with more complex needs. Subject to further work this may better meet the needs of some children in care and be more cost-effective.


Health and Wellbeing Services

This area of the Council includes services such as:

  • Adult Social Care
  • Children’s Social Care
  • Support for vulnerable families
  • Education
  • Public Health


Health and Wellbeing Priorities

Key priorities in this area are as follows:

Enable more adults to live longer, healthier, and happier lives

  • Continued support to deliver vaccinations to tackle COVID-19
  • Continuing a robust testing and tracing approach to manage infections and outbreaks
  • Improving services that support good mental health
  • Improving public health, particularly in relation to obesity
  • Transforming Adult Social Care to provide care, which is more joined-up with the NHS, closely connected with communities and embraces technology
  • Continuing to ensure that affordable, accessible and sustainable leisure services are available

Support children and young people to have the best start in life

  • Supporting the emotional health and wellbeing of young people
  • Finding new ways to support families at an earlier stage and reduce the need for more costly crisis services
  • Finding more cost-effective ways of supporting children with complex needs
  • Supporting the education needs of all children and young people
  • Supporting inclusion of children with special educational needs and disabilities
  • Supporting young people into education, training or employment


Health and Wellbeing Proposals

Overall, the budget for this area is £199.7 million a year. Government has made announcements about funding for Adult Social Care, but at the time of writing it is uncertain how much of this funding will be needed to pay for new costs to support people to pay for their care as a result of the reforms. It is unclear whether this money will therefore be sufficient to meet current pressures. To balance the budget and ensure there is enough money to tackle the priorities set out above, the following proposals are under consideration:


Support to Adults Proposals

(1.1) Additional investment to support the rising number of adults with learning disabilities: £1.5 million over three years to support the rising number of adults with learning disabilities. This is on top of £3.8 million of additional funding that the Council had already planned for as more young people with learning disabilities move into adulthood.

(1.2) Additional investment to ensure there is sufficient funding in place to meet the care needs of older people: An additional £600,000 from next year to meet the care needs of older people. This is needed as more people live longer and may require care.

(1.3) Additional investment in the Reablement Service to help people regain their independence: A further £700,000 on a permanent basis from next year to invest in the Reablement Service which helps residents recover their independence after a crisis such as a fall or a hospital admission. This additional support is needed as more adults require this service, particularly older people. £509,000 of this will be funded by using the Better Care Fund grant.

(1.4) Additional investment in technology to support people to be more independent in their own homes for longer: A further £119,000 from next year to invest in switching our technology-enabled care offer from analogue to digital equipment, ensuring residents are fully supported to be more independent in their own homes for longer. This is on top of the £331,000 already in place for this.

(1.5) Improving services and saving money by supporting more residents with learning disabilities to receive care within the borough: Where possible, we try to support residents to receive their care in the borough, close to friends and family. Sometimes this is not possible due to the nature of the help they need, and specialist support is sought in other locations across the country. We are proposing to work with care providers to develop this support in Cheshire West and Chester and reduce the need to find support elsewhere. Overall, this could deliver a better service and reduce costs by £230,000 from 2023-24.

(1.6) Improving services and saving money by designing a joined-up service with the NHS to support people with dementia in care homes: Residents in our care homes who have dementia may, at times, require 1:1 support. This is often due to a delay in specialist support being available. Sometimes this is provided by the Council, and in some cases also by the NHS. Joining our resources up could help us establish an integrated, specialist team that would provide fast-paced, professional support to delay, prevent or de-escalate the need for such a level of 1:1 support for dementia. If this was taken forward it could improve service delivery and reduce costs by £250,000 from 2023-24.

Support to Adults - further ideas for the future

To meet future challenges the following is being considered, but work is at an early stage:

(1.7) Consider changing social care practice by providing support focused on individuals’ personal strengths and social and community networks at an earlier stage, to encourage greater independence: Work is underway to change the way that social care operates. More emphasis is being placed on focussing on the strengths of an individual rather than what they can’t do. This includes looking at personal strengths and social and community networks. This encourages a focus on independence and thinking creatively about what matters to each person and the wide sources of support they can draw on. It also involves working with people in a more timely way and not only at a point of crisis. Over time this could deliver more responsive support for the individual and reduce reliance on traditional packages of care.


Public Health Proposals

(1.8) Additional investment to improve stop-smoking services, so that they are available to all residents trying to quit smoking: A further investment of £182,000 from next year is proposed for stop-smoking services. Currently services are largely targeted to certain groups, but this investment would make the services available to all residents trying to quit smoking. This will significantly improve their health and wellbeing whilst helping reduce the future demand for more expensive health and care services. This will be funded by the Public Health Grant.

Public Health - further ideas for the future

To meet future challenges the following is being considered, but work is at an early stage:

(1.9) Consider developing a long term response to managing COVID-19 and other outbreaks: Given the Council’s statutory public health duties, we have been at the very heart of leading the local response to the pandemic since March 2020. We have been managing outbreaks, providing essential advice and support to our residents, supporting our care homes, education, and business settings. This has seen us develop successful local contact tracing services, personal protective equipment supplies, self-isolation support packages, testing and vaccination programmes with the NHS, and helping our high streets return safely. The Council has put its own resources, alongside funding provided by government, into this local pandemic response since March 2020. Consideration is now being given to the longer term funding the Council may need to manage COVID-19 as we learn to live with the virus, as well as ensuring we have the right support in place to manage other outbreaks.

(1.10) Continuing to review Leisure Services to ensure they remain affordable, accessible and sustainable to meet the needs of residents: As part of the Council’s significant investment and ongoing transformation of the leisure, health and wellbeing services provided by Brio, we need to ensure these services remain affordable, accessible and sustainable to meet the needs of our residents. This includes significant investment in Northgate Arena and the development of a new Hub and Spoke Delivery Model. We will continue to review and develop these services by working closely with our communities and wider partners to maximise the potential health and wellbeing developments that are available.


Support to Children and Young People Proposals

(1.11) Additional funding to support the rising number of children at risk, who require care and support to ensure they are safe: As COVID-19 restrictions eased it was clear that there were more children requiring care and support. This has been experienced nationally. One impact of this is that more children have come into the care of the local authority to ensure they are safe. This has increased both the demand and cost, for things like foster care placements. Specialist support is also required to tackle issues such as child sexual exploitation and county lines. To meet this challenge, it is proposed that an additional £1.8 million is invested into Children's Social Care over the next three years. We will continue to find ways to intervene early and reduce the demand for crisis support in order to fund this budget pressure.

(1.12) Additional funding to support the rising number of children with special educational needs and disabilities who require specialist support: An increasing number of children and young people require specialist support from the Council as they have special educational needs and disabilities. This includes the need for specialist educational support and transport. Further funding of £2.8 million over the next three years is proposed to meet this challenge.

(1.13) Increasing income by marketing our residential services that support short breaks for disabled children, young people, and families to other local authorities: The Council has a residential provision that children and young people use for short breaks to support them and their families. We have worked with a neighbouring council who will buy this service from us without compromising the offer to local children and young people, this will secure income of £106,000 next year, although it is not certain that this will be a permanent arrangement.

Support to Children and Young People - further ideas for the future

(1.14) Consider reviewing the accommodation needs of children in care and care leavers, to provide more local accommodation within the borough: Some children in care who need residential support may need to be placed outside of the borough due to a lack of local available services. As well as meaning they are moved away from local networks of support such as friends and family, it is also a significant cost to the Council. Young people leaving home for the first time often receive support from their families to do so, young people leaving the care system often need that same support with accommodation. A full plan will therefore be developed looking at the accommodation needs for these groups with a view to investing in more local and cost-effective options.

(1.15) Consider introducing salaried carers who would be specially trained to strengthen support for children in care who have complex needs: For children and young people in care who have needed intensive residential support, foster support is not always the right option to meet their needs and it may not be possible to step them down to a less intensive form of support in a family setting. We are proposing to tackle this by developing salaried carers who have special training and support to support children in care with more complex needs. Subject to further work this may better meet the needs of some children in care and be more cost-effective.