Current Market Position

Statement 2017 Position Market www.bolton.gov.uk

Bolton Council Services (CVS) Bolton Community and Voluntary Bolton Healthwatch Bolton NHS Foundation Trust Bolton Together Mental Health NHS Foundation Manchester Greater (GMMH) Trust (CCG) NHS Bolton Clinical Commissioning Group The Council’s / CCG’s vision for how services might vision for how services / CCG’s The Council’s and support to the changing needs for care respond in the future The Council’s / CCG’s commissioning intentions / CCG’s The Council’s What Bolton looks like in terms of current and future and future like in terms of current What Bolton looks provision demography and service Our vision and delivery plan for this new model of care Our vision and delivery plan for this new model of care Locality Plan, which has is set out in the Bolton 5 Year been developed and supported by key stakeholders in the borough. • • • • • • • Key partners: Over the next five years health and care partners in care Over the next five years health and a model working together to shift away from Bolton are and on illness to one of prevention predicated of care early intervention that supports everyone in Bolton to stay healthier and independent for longer. 2. is need and fiscal challenge, a radical change and care health At a time of growing to to ensure planned and delivered services are care needed in the way health and who to those safe, accessible and cost efficient care of high quality, the provision need it. • • • It contains information about: It contains information

A market position statement (MPS) sets out to identify what the care and support and support the care identify what sets out to (MPS) position statement A market their to inform for providers information strategic provides looks like. It market within the working social provider health and we expect any plans and business the local their organisation fits in this and understand how to have read Borough the for discussions between MPS is a good starting point the market. Therefore other commissioning organisations. and CCG, local providers Council, Bolton 1.

Market diversity for people funding their own care or Market diversity for people funding their own care payments those taking direct Residential and nursing care services for older people Residential and nursing care particularly for people with dementia Community based services such as Home Care and Community based services such as Home Care new models of home based care Services which enable someone to remain Services which enable someone to remain independent for longer such as reablement, Enabled Care equipment, adaptations and Technology Services need to be provided in conjunction with Services need to be provided community assets such as using volunteers, and local facilities community groups Community based early intervention and prevention Community based early intervention and prevention and which supports individuals to self help, self care, enable them to support themselves People who receive direct payments in order to payments in order direct People who receive arrange their own care People who are funding their own care People who are Young people and adults with caring responsibilities Young Vulnerable people living alone Vulnerable People with learning disabilities and autism with complex needs increasingly Young people and adults with mental health problems problems people and adults with mental health Young People living with one or more long term health long or more People living with one conditions Older people with multiple care and support needs, and support multiple care Older people with with dementia in those increase including a sustained • • • • • • With the demand for social care an ageing population In particular we year. services is continuing to rise year on demand for traditional be an increased to expect there including: and new models of care The Council currently commissions or provides care for care commissions or provides The Council currently A further 4,000 6,000 people each year. approximately equipment a one-off intervention such as people receive as Home Support or a period of short term support such Reablement each year. • • • • • • • • It is expected that there will be an increase in the be an increase will that there It is expected of: number 3. Key Messages in the statement the in Messages 3. Key

Helping people to recover from episodes of ill-health from Helping people to recover or following injury Enhancing quality of life for people with long-term conditions Preventing people from dying prematurely people from Preventing We want to encourage providers who can providers want to encourage We can focus and centred demonstrate a person on outcomes, evidence their achievements independence and enhancing reablement Our aim is to stimulate and assist providers in providers and assist is to stimulate Our aim which and support new models of care developing for quality and value outcomes, deliver sustainable money 3. 2. 1. Indicators in the NHS Outcomes Framework are Indicators in the NHS Outcomes Framework are five domains: around grouped Measuring and publishing information on health and Measuring and publishing information outcomes is important for encouraging social care The NHS Outcomes in quality in care. improvements Framework 2015/16 and the Adult Social Care Outcomes Framework 2015/16 contain a number of a balanced coverage of indicators selected to provide activity and set out the high-level NHS and social care Our commissioning national outcomes to be improved. nationally on this and performance is measured we will be seeking to incorporate these into therefore service specifications. In addition we expect providers to meet our own In addition we expect providers high quality care. for delivering standards rigorous as part of our Quality monitored are These standards services. Assurance Framework for commissioned OFSTED and CQC’s fundamental standards and standards fundamental OFSTED and CQC’s the quality of ratings system set the benchmark for young people and adults should expect children, care Our expectation is that providers their provider. from judged to be ‘Good’ or ‘Outstanding’. are 4. safe to commissioning high quality services which are The Council is committed who can will work with providers for services users. We and deliver good outcomes high quality. safe and of that their services are consistently demonstrate • •

About the Strategic Key Quality and Growing Demand Current Workforce Commissioning Providers who Fit for the Healthwatch Co-design How we use Appendices statement direction messages in performance needs market intentions we want to future our resources the statement work with 7 Prevent abuse and neglect happening within the neglect happening abuse and Prevent and in service settings community of vulnerable interests the safeguarding Promote wellbeing and to enable their adults and children safety and consistently to instances of Respond effectively abuse and neglect Care Home Excellence Home Programme Care and health and As part of our plans for improving have in Bolton, the Council and its partners social care for Care of improvement embarked on a programme Home is known as Care Homes. The programme Excellence and is collaboration between Bolton Council, NHS Bolton CCG, care Bolton NHS Foundation Trust, we aim Together, and the community. homes, residents the quality of life for people living in care to improve access to primary improving safety, homes by improving and and supporting the workforce developing care, joined up commissioning between Bolton more providing homes play a vital Council and NHS Bolton CCG. Care important system and are health and care in our role to have some of the proud are community assets. We Manchester and we homes in Greater best quality care to continually improve. homes who aspire will reward Homes Excellence who sign up to our Care Homes Care an additional and work with us will receive Programme payment, be able to display our continual improvement Home Excellence quality mark and access our Care Network. Improvement Rewarding qualityRewarding demonstrate who can providers believe in rewarding We attract quality high quality services and some services payments. Care Home on the who are of Home Care, providers reward We with an enhanced framework agreement, Council’s on time and by a consistent is delivered payment if care know these things are We set of well-trained carers. we believe important to our customers’ and therefore able to meet our are who providers we should reward customers’ expectations. The main aims of the Safeguarding Board are to: are Board Safeguarding of the main aims The • • • and to protect support the aims of the Board To we have established the Safeguarding vulnerable adults, to assess information about provider Intelligence Forum harm or interventions to prevent risk and put in place this is necessary. quality where abuse and improve Develop a culture of continuous quality improvement of continuous quality improvement Develop a culture good celebrate and share – seeking to recognise, practice Work collaboratively with local care partners and have collaboratively with local care Work links with the wider community strong Promote an open culture, where any issues can be where an open culture, Promote people who use services or staff and by raised freely quickly addressed are Harm free care e.g. prevention of pressure ulcers, falls of pressure e.g. prevention care Harm free and infections Lack of standardised systems and processes systems and Lack of standardised Administration of medication Poor quality leadership Unsuitable environments and poor or infrequent and poor or infrequent environments Unsuitable a and to social care equipment (in adult checks on GP practices) lesser extent Issues with staffing levels, training and support (in support (in and training levels, with staffing Issues and adult social care) hospitals A new multi-agency screening and safeguarding service and safeguarding A new multi-agency screening (MASSS) with a single point of access was launched work closely with providers in September 2016. We with a multi-agency focus, with input on safeguarding GMMH, police, housing and and Bolton FT, CCG from probation. The Bolton Safeguarding Adults Board (BSAB) and the Adults Board The Bolton Safeguarding (BSCB) Board Children Bolton Safeguarding Children’s for ensuring the children, responsible the bodies are safe. young people and adults in Bolton are Safeguarding For non-social care / voluntary sector providers the / voluntary sector providers For non-social care important to the Council quality of the service still remains we will look at the opportunities and CCG and therefore to develop quality marks. • • • Providers should aspire to be ‘Outstanding’. In should aspire Providers should: particular providers We expect providers to be able to demonstrate that expect providers We made, they to be improvements they do require where the situation for service make positive steps to improve as will support providers users as quickly as possible. We improvements. to make the required appropriate • • • • • •

Pre-school, older teenager (16-19 years), and older teenager Pre-school, years) populations to reduce, younger adult (20-24 age secondary school ages, and older whilst primary, increase groups By 2025 we expect: we By 2025 •

Like many areas in England, Bolton’s demographic change in the coming years coming years change in the demographic Bolton’s in England, areas Like many will We economy. and care our existing health to significant challenges represents including an population, growing of our a result people as support more need to needs. health and care complex more people who will have number of older increased 5.

18 16 14 12 10 Children in agency placement 31/3/16 Children Number of children of Number placements 31/3/16 of children’s Type Children in agency placement 31/3/16 in agency placement Children 800 600 400 200 People in treatment 2015/16 People in treatment 1400 1200 1000 Over the next 10 years, pre-school and younger and younger next 10 years, pre-school Over the primary, whilst will reduce, adults (20-24) populations ages and older teenagers (16-19) will secondary school increase. Bolton have been from children show more Figures to the majority compared for by a local authority cared Young People Young age of 20 years people under the and young Children of of Bolton. 34.9% 26.0% of the population make up group. a minority ethnic from are school children

About the Strategic Key Quality and Growing Demand Current Workforce Commissioning Providers who Fit for the Healthwatch Co-design How we use Appendices statement direction messages in performance needs market intentions we want to future our resources the statement work with 11 Mental Health Mental Health Needs Assessment indicates The 2014/15 Mental of common mental health that the adult prevalence and obsessive depression including anxiety, problems, constant over the is likely to remain compulsive disorder, suggest 27,352 coming 5-10 years. Estimates for 2015 mental disorder, people in Bolton will have a common 593 an antisocial personality disorder, 765 a borderline with and 680 a psychotic disorder personality disorder psychiatric disorders. over 12,200 having 2 or more in of all mental health disorders Estimated prevalence aged 5-16 is 4,400. For those aged Bolton children just 5.3% have poor wellbeing in the 65 and over, to 18.6% in the most compared least deprived group deprived. start by age Half of all cases of psychiatric disorders quarters by age 24, with some estimates 14 and three age 18. Estimates suggesting the majority start before and children suggest that each year 1,270 Bolton health problems young people will experience mental Child and adolescent from to a response appropriate mental health services (CAHMS) at Tier 3 and 55 at Tier 4. The latest 3-year pooled suicide and injury undetermined rate for England is 8.9 (per 100,000). The Bolton rate consecutive period (now 9.5 per has fallen for the third from the 100,000) and is no longer significantly different national rate following a decade of very high rates. Most emergency admissions for self-harm in Bolton are younger people. Self-harm (usually deliberate cutting/ scratching) mainly occurs between ages 11 and 25 admission. The rate of young people requires and rarely of aged under 18 being admitted to hospital as a result at a higher rate than the England self-harm is increasing higher among young average. Levels of self-harm are women rather than young men. needs making the transition into adult services. This will This adult services. into the transition making needs 2016 it is estimated of services. In a range impact across ASD, 16 with a young people with 14 are that there learning learning a profound disability and 2 with severe SEND services. From continuing who will require disability young will be 35 that there we can estimate information 2020 and 27 in 2025. people with ASD in with people with learning will also be an issue There become older. home as their carers disabilities living at additional support being required This may lead to either or alternativeto manage at home accommodation may for their dependants. need to be resourced Changing needs for learning disabilities mostly relates to Changing needs for learning disabilities mostly relates ASD and complex young people with learning disability, The expected increase of people with learning disabilities The expected increase is 5% in the next 10 years with people with Autistic by 2%. (ASD) increasing Spectrum Disorder As at 31st March 2016 there were 626 adults with a were 2016 there As at 31st March learning disability accessing a long term service. Of these with 8% an ethnic minority background from 17% are Indian and 4% Pakistani. People with learning disabilities are one of the most People with learning disabilities are in our society and this is socially excluded groups of services of an historical segregation primarily a result that unintentionally deny people their own home, and a decent income; factors which choice and control ultimately deny citizenship and social inclusion. Half of the population of adults with learning disabilities of the remainder in England live with their families; most Only 15% of adults with care. (33%) live in residential or long-term tenancy learning disabilities have a secure with 70% of the their own home. This is in comparison own home and general adult population who own their nearly 30% who rent. In 2014, approximately 4,100 adults (3% of the adult In 2014, approximately that limits their population) have a sensory impairment hearing and visual day to day activities. The incidence of with age rising sharply after 75. impairments increases visual impairment, For those people age over 75 with a as blind serious enough to be registered half of them are or partially sighted. There is considerable variation across the borough in the in the the borough across is considerable variation There under 65 years with a long of people aged proportion or disability that limits their day to term health problem 3% in Heaton and Lostock day activities; ranging from in Farnworth to 10% and Halliwell. Cross and Bromley Disability free life expectancy (DFLE) is the average life expectancy (DFLE) Disability free a from person can expect to be free number of years a DFLE The most recent or disability. long-standing illness (2012-14) is 9.8 years for men and at age 65 for Bolton 11 years for women. Disability population 29% of Bolton’s Census shows that The 2011 long term people) has a and over (13,642 aged 65 years day to day that limits their or disability health problem with a of the population a lot. The proportion activities of those aged age, rising to 56% with increases disability 85 and over.

The national programme Transforming Care for Care Transforming The national programme Adults with Learning Disabilities sets out an ambitious care of system wide change to improve programme for people with learning disabilities and/or autism, and complex needs (learning disabilities). Locally we with practitioners, to work in partnership required are and people with learning disabilities and providers they can live within their local their families to ensure communities, with the right level of support, and close to small cohort of people home. Although this is a relatively careful the complexity of these service users requires planning and in some cases will health and social care they can move detailed transition planning before require and other specialist provision. hospital from Transforming Care Transforming Young People in Transition People Young with learning disabilities Our information on children services to transition indicates that will need to provide and multiple young people with profound 85 around in the learning disabilities and autistic spectrum disorder next four years. The latest Carers Survey 2014/15, shows that over half The latest Carers caring for (54%) indicated they were of the respondents term illness with someone who had a disability or long 65% of carers 38% caring for someone with dementia. of for someone over 75 years of age and 33% care for over 10 years. have been undertaking this role carers able that they are in 2014/15 reported 22.5% of carers like and enjoy to spend time doing the things that they in 2012/13. which is lower than 28.1% reported The Council funds a number of voluntary sector The Council funds a number of voluntary approximately organisations who deliver services to carers in Bolton. Less than 10% of these 4,000 carers assessments. carer have requested Carers identified just over 30,000 people in The 2011 census 2,000 of an increase responsibilities, Bolton with caring are of these carers 6,000 since 2001. Approximately informal many more are know there aged over 65. We as ‘carers’ who do not see themselves out there carers etc. friends wives, husbands, daughters, sons, simply but

The expected changes in our local population places increased demand on health and on health demand places increased population in our local changes The expected this demand will manage We challenge. financial a time of significant services at care a particular Plan with Locality in the 5 Year set out models of care the new through and reducing services and primary care capacity in preventative focus on increasing acuity care. demand for high 6. Demand

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IMHA (Independent Mental Health Advocacy service) ICAS (Independent Complaints Advocacy service) Advocacy for Looked After Children

2012/13 2013/14 2014/15 2015/15 2013/14 2012/13 1,008 1,008 981 893 15 Apr

• • • Numbers of Advocacy Services Recipients: in Bolton were In 2015/16 the main IMCA referrals people 80 (51%) and those who are Dementia sufferers years of age or older (46%). Over 49% of IMHA referrals over 50 with 38% between 26 and 50. ICAS aged were people with a physical lower 70% from are referrals from disability or long term disability with 69% of referrals under 55s. Number of service users and carers using direct direct using carers and users of service Number payments:

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May 14 May Apr 14 Apr disability/frailty Physical and sensory Learning disability Mental health Substance misuse Other vulnerable people Adults aged 18 - 64 Adults aged 65+ 0 80 60 40 20 950 900 850 800 160 140 120 100 IMCA (Independent Mental Capacity Advocacy service) Out of all learning disabled direct payment recipients recipients payment all learningOut of direct disabled of direct the largest proportion living in Bolton services, with care spend is on home payment activities all receiving support, and social community spend. payment of local direct proportions significant New Direct Payment agreements 2015/16 agreements Payment New Direct Trend in clients in receipt of a direct payment (at the end of each month) payment a direct of in receipt in clients Trend 1,000 1,050 • The Council commissions an Advocacy Hub to cover the following requirements: Advocacy Advocacy can be defined as taking action to help people their their rights, represent say what they want, secure and obtain the services they need. Advocates interests and advocacy services work in partnership with the people they support. Advocacy is seen as promoting social inclusion, equality and social justice. The Council of the in respect has a range of legal responsibilities of access to independent advocacy. provision •

About the Strategic Key Quality and Growing Demand Current Workforce Commissioning Providers who Fit for the Healthwatch Co-design How we use Appendices statement direction messages in performance needs market intentions we want to future our resources the statement work with 16 In 2015/16 the Council funded 591,024 hours of In 2015/16 the Council week, for an average of 1,352 people per home care 4,187 people over the year in 15/16 hours delivered The number of home care of increasingly surpassed that of 14/15 and, because of 10% in the complex needs, we expect an increase 10 years next five years and 25% in the next funded As at 31st December 2015 the CCG for 385 service users, 201 Continuing Health Care and Funded Nursing Care service users received levels are 11 had Personal Health Budgets. Similar in 2016/17 predicted older people into In 2015/16 The Council placed 295 demand for day local day services and we expect the years support/activities will rise in future tenancies 320 Extra Care were In 2015/16, there and the care with an average of 202 clients receiving people over coming from demand for care greatest has increased the age of 75 (63%). Demand for care 2013/14 with 113,726 hours delivered by 22% from has care in 2015/16 although the numbers receiving 212 clients in 2013/14 by 5% from decreased Adult Social Care User Experience Survey 2013 Adult Social Care Communitybased services for people independent strategy is to keep Bolton’s 6,000 we support over possible. Each year as long as home care services such as community based people in and day services. recent years significantly in has increased Home care of need. However this mainly due to the complexity decline in the by a small scale has been countered types of community other receiving number of people and organised by the council. based services funded and the impact of payments direct Our analysis is that services to universal and prevention signposting people to demand. has not made a difference • • • • • that those customers revealed Our survey of social care most valued continuity of staff, good home care receiving Our survey found timekeeping and consistency of care. a likely to report more service users are that home care poor quality of life. Clients who approach their local authority and are their local authority and are Clients who approach above the eligible but income and / or assets are threshold Clients who approach their local authority but do not their local Clients who approach meet eligibility criteria Clients who do not approach public authorities and public approach Clients who do not make their own arrangements The number of self-funders is predicted to rise due to a The number of self-funders is predicted range of factors, including population ageing and rising Act despite this the fourth Care Yet eligibility thresholds. implementation stocktake (published in August 2015) indicated that ‘uncertainty about additional demand was the number one risk identified self-funders’ from Act reforms. by local authorities in delivering the Care essential that local authorities develop It is therefore to understanding and supporting their local approaches self-funding population. The parliamentary act on the future of sustainable The parliamentary act on the future was care funding system for long term adult social This will place new postponed and is now due in 2020. on the council to support and assess self- responsibilities homes. or be placed into care care funders to receive opportunities for the council to This will also provide intelligence on the needs of self-funders. obtain more We can estimate that 360 people in residential or nursing can estimate that 360 people in residential We of self-funders. Based on the numbers in receipt are care up to 1,900 self-funders are attendance allowance there conservative although a more paying for home care is 900. estimate based on the ELSA survey The Institute of Public Care (IPC) estimates that 44.9% The Institute of Public Care self–funded. The home places in England are of care 5) (ELSA) (Wave English Longitudinal Survey of Ageing the age of 65 pay estimates that 1.83% of people over for their own home care. • • • There are three principal categories of self-funder who principal categories of self-funder who three are There (with or without full costs of their care generally fund the are: benefits). These any disability-related People who fund their own care own fund who their People is fund their own care of those who Our knowledge of Directors studies by the Association limited but the Local Government Services and of Adult Social total social care of the indicate the proportion Association growing. is self-funded is market that

These services should meet individual’s needs in a These services should meet individual’s accommodation, personalised manner and could address social inclusion, information advice and advocacy, counselling, community equipment, activities, support for support. Befriending people following illness and carers isolation and and social Inclusion activities that reduce a vital part of the early network of support are a provide outcomes and this is an area intervention and prevention market to of work we aim to work with the provider upscale. Another key prevention workstream is voluntary sector workstream Another key prevention baseline capacity capacity building. This will look at the to services, waiting times for new referrals of prevention provided. these services are and where support receive had a high demand for a service that If a certain area this will be developed. does not exist in their local area topics will be Falls, Other population health prevention and Healthy Weight Dementia, Suicide, Self-Care, Physical activity. Alongside this local approach Bolton Council and partners Alongside this local approach planning planning interventions as part of the locality are element of the for GM devolution. The population health and will address Locality Plan focuses on prevention to develop a a range of subjects including intentions complimentary or model to provide Social Prescribing alternative interventions. This interventions to health assets such as will involve connecting citizens to local or befriending services to for exercise walking groups is another isolation. Developing community assets reduce and this will involve identifying community workstream sustainability. assets, maximising their use and supporting Early Intervention and Prevention and Prevention Early Intervention citizens’ to maintain its The Council in order wellbeing, individual’s to help improve independence and and funds a range of prevention commission and grant in the Private, Community, early intervention services This approach and Social Enterprise sectors. Voluntary reduce to prevent, Act requirements supports the Care health citizens’ need for statutory and/or delay Bolton’s support people services. These services and social care health conditions, disabilities, with low to moderate needs. These individuals may mental health or age related to need support in be coping fine but have the potential their do not engage with them to prevent if we the future worse. getting needs from

7. Current Market Market 7. Current

About the Strategic Key Quality and Growing Demand Current Workforce Commissioning Providers who Fit for the Healthwatch Co-design How we use Appendices statement direction messages in performance needs market intentions we want to future our resources the statement work with 21 Stair and Grab Rails Stair and Shower Seats Rails and Drop-down Poles Floor to Ceiling Mounted Bath Boards Wall Half Steps Technology Enabled Care Care Enabled Technology equipment a range of Telecare The Council provides 1,500 people at any one time. The service is for around by many different Council run and equipment is provided was an average of 40 new telecare suppliers. There allocations/assessments per month in 2014, increasing to 67 per month in 2015 and again to 95 in 2016. The main equipment utilised being falls detectors, bed as per the Chronically Sick and Disabled Persons Act. Persons Disabled Sick and the Chronically as per may include: These modifications • • • • • a needs assessment to The Service undertakes eligibility and requirements. user’s determine a service individual minor 4,109 from 3,282 people benefitted with the average time from adaptations in 2015/16 being 7.76 days. This has assessment to installation minor 2,128 people and 2,600 individual from increased with an average time of 10.5 adaptations in 2012/13 days. increasing The Housing Market Assessment identified independence needs for support services that promote cleaning at home such as help with gardening, our Home and Repair, and transport. Bolton Care who support for people provides Agency, Improvement improve, disabled or on a low income to repair, older, are a range of maintain or adapt their home. It provides information and a Handyperson to advice, services from the home, to large scale assist with small jobs around and Care for those who need it most. home renovations find solutions to any Repair work with their customers to them issues they have, supporting home improvement to other services that with works and making referrals and Repair completed could assist. In 2015/16 Care customers 1,810 jobs, supporting 1,321 individual in to 1,795 jobs and 1,271 individuals (compared Demand for 2014/15) to maintain their independence. year on year. this service continues to increase Repair also delivers our Disabled Facilities and Care major adaptations to those Grant service, providing assessed as in need by an Occupational Therapist. This home adaptations to a maximum of £30,000 provides stairlifts to extensions, assisting people to ranging from across 7.4% of all properties Currently, live independently. Bolton have been adapted or purpose built for a person In or disability. with a long-term illness, health problem 2015/16 226 (2014/15 - 228) major adaptations were completed at an average cost of £8,000 each. The most common types of adaptation continue to be stairlifts and adaptations. bathroom The Independent Living Service within the Council has modifications (Minor Adaptations) the duty to provide costing less than £1,000 that facilitate people with be eligible their homes. To disabilities to manage around a person must have a substantial or significant disability Living independently at home Living at independently wide variety of disability equipment retailers is a There the following providing the borough and suppliers across equipment: mobility; toileting; bathing; kitchen; and the home. These are equipment for general use around is a council run mainly used by self-funders but there equipment service that can also help with advice and information on equipment and modifications in the home. Bolton NHS Foundation Trust are the CCG’s main the CCG’s are Bolton NHS Foundation Trust of acute services with 734 beds. provider The CCG has delegated responsibility for NHS England The CCG has delegated responsibility 50 member for commissioning GP services from of the Bolton practices in Bolton. The introduction in 60,000 additional GP Quality Contract has resulted appointments in 2015/16 and extended opening hours to for people in Bolton. access to primary care improve Bolton CCG’s main NHS providers are Bolton NHS are main NHS providers Bolton CCG’s community services) and (acute and Foundation Trust Trust Manchester Mental Health Foundation Greater commissions (mental health services). The CCG also other NHS trusts in the North some health services from social enterprises, the voluntary and community West, sector and the private sector. Health Using an asset based approach to maximise outcomes Using an asset based approach their gifts and using them means individuals recognising accessing local to help themselves and their community, working with places to meet and deliver support and needed to deliver local organisations to get support when dependencies on reduces their outcomes. This approach which is necessary council funding and council officers assets. of the council’s due to the reduction Mapping assets, listening to stories and connecting Mapping assets, listening and supporting together interests people with similar model is not reliant their assets. This them to improve as it works with people in the on long term funding to change their outcomes and community who want a dependency so without creating supports them to do to funding. Connecting assets together is key to Asset Based Based to Asset is key together assets Connecting An Asset Based Development (ABCD). Community in was established Development Partnership Community cross for Bolton. This direction strategic 2016 to provide “the Bolton a Social Enterprise developed sector group operational as the Development Partnership” Community for change within the catalyst organisation who provide the community.

About the Strategic Key Quality and Growing Demand Current Workforce Commissioning Providers who Fit for the Healthwatch Co-design How we use Appendices statement direction messages in performance needs market intentions we want to future our resources the statement work with 22 Public Health has a key role to play in terms of Public Health has a key role need. At demand on health and social care reducing health inequalities the heart of this is the aim to reduce the gap in life expectancy within Bolton by narrowing healthy life expectancy and increasing which is the average number Healthy Life Expectancy, of years that a person would expect to live in ‘good 61.3 years for males and 62.2 health’, is currently wide gaps, years for females. Within are there Bolton could for example males in the most deprived areas expect to live 52.2 years in ‘good’ health, compared who could with males in the least deprived areas expect to live 70.5 years in ‘good’ health. The picture is similar for females available As described earlier much of the resource small is spent on a relatively for health and healthcare of the population with high levels of need proportion Public Health Services Health Public • • • Carers’ services Carers’ Strategy 2017-2020 the In line with the Bolton Carers in with all carers Council seeks to identify and engage living in Bolton all carers Bolton. The Council provides assessment to with the opportunity to access a Carers for council support. This could eligible see if they are needed a and where lead to a support plan being agreed personal budget provided. Grant the Carers Alongside this the Council provides voluntary and community groups local where Programme which can apply for grants to deliver services/activities A range of services help achieve outcomes for carers. under the grant including provided and activities are advice and information, health and breaks, carers’ services, self-help wellbeing services, dementia specific forums and 24 hour helpline, carers’ carers’ a groups, culturally sensitive activities. Commissioned Services include young people’s young people’s include Services Commissioned domestic violence accommodation, supported service, outreach hostel and teenage parents’ refuge, for offenders, supported hostels, services homeless and with mental health for people accommodation for, support services needs, and floating complex offenders, people with drug and homeless families, needs. They help prevent and complex alcohol problems thus avoiding crisis services and post escalation of crisis recovery. to sustain and aid crisis offer options services have assisted the These Social Inclusion Act of the Care the requirements Council in meeting early intervention and a range of 2014 in providing service users needing high services to avoid prevention possible. These services for as long as levels of care the through also meet a range of outcomes as agreed JSNA and the Strategy, Health and Wellbeing Council’s commissioning strategy local priorities. Those who have not fallen but are at risk Those who have not fallen but are Those who have fallen with no injury or a minor injury Those who have fallen with a major injury Services to prevent or reduce homelessness or reduce Services prevent to support services work with socially Housing related support excluded vulnerable people in Bolton providing which help vulnerable people to develop the life skills non- to live independently of public services. They are to help vulnerable people maintain provided are statutory, or achieve independent living and aimed at promoting independence and social inclusion, delaying the need for interventions such as intensive supported acute more care. or residential housing, home care The Falls Prevention Delivery Model embeds falls The Falls Prevention into existing service delivery. prevention • • • Falls Prevention Delivery Model Prevention Falls spans multiple tiers of to falls prevention Our approach the older population: The Wellbeing in Later Life initiative offers befriending in Later Life initiative offers befriending The Wellbeing and social activities for older people visits and leisure Keeping activity. with a focus on physical and creative physically and socially active supports good mentally, dependence on higher health and wellbeing and prevents services. acuity health and care Wellbeing in later life in later Wellbeing 2017/18 will see further expansion of this service which is 2017/18 will see further expansion of to meet demand. the borough out across being rolled Staying Well Well Staying the service for the over 65s uses The Staying Well of tool to assess the assets and needs Staying Well GPs to profile an individual. The service works with condition and those over 65 with a long term health Staying Well arrange assessment and support from Co-ordinators. We are currently undertaking a project to gain a better undertaking a project currently are We market Enabled Care Technology understanding of the looking at how are available. We and the products cohorts can benefit different the use of technology learning visual impairments, dementia, including mobility, and the and supporting end of life care disabilities, carer’s available to the Council and the CCG range of solutions a Toolkit developing are We in commissioning services. to assessment of staff linked care for health and social Bolton market in care solutions for the needs to provide in and undertaking a pilot project including self-funders outcomes and build evidence. Bolton to measure sensors, property exit sensors and medication prompts. prompts. and medication sensors exit property sensors, for independent remain people to enabled has Telecare for formal delaying the need or preventing whilst longer, care.

About the Strategic Key Quality and Growing Demand Current Workforce Commissioning Providers who Fit for the Healthwatch Co-design How we use Appendices statement direction messages in performance needs market intentions we want to future our resources the statement work with 23 Protecting the most vulnerable Protecting those most in need Target in deprived areas Targeted safe Keeping citizens and the organisation Acting as a ‘critical friend’ in helping the council quality of services the improve Children’s Services Children’s gaps and to address identify priorities is ongoing to Work and education care of joined-up health, in the provision and families. young people services for children, related in partnership to working are The Council and CCG strategy which joint commissioning develop a children quality local and national data. will be based on high should avoid duplication, save on Joint commissioning funding goes further and ensure cost of procurement quality. whilst maintaining strategies that all to ensure All organisations want and outcomes for children the and improve protect this is the effective young people in practice. Central to commissioning of local services based on this The commissioning of services will be that it should fit needs assessment and it is important strategic plans, within the context of, and inform, all delivery plans. commissioning strategy plans and service focus on funding The joint commissioning intentions will linked to key themes of: priorities that are • • • • a whole system Commissioning should be based on and which takes a holistic view of children approach, and which pools young people, and families’ wellbeing, to commission and provide appropriate budgets where services. all needs to ensure The commissioning process elements of any child, young person and family pathway in place and working well to are services through along the outcomes. Key measures achieve the desired of continuous pathway should be used to drive a culture and learning. improvement it is important not to become scarce, As resources weaken universal services in favour of a solely targeted to service commissioning for vulnerable approach a evidence-based universal services are Strong groups. targeted services. necessary foundation for more Many voluntary organisations have detailed understanding of specific local needs, high levels of trust and engagement with local communities and the ability “holistic” multiple services to provide to work across services for individuals as well as: • The Children and Young People’s drug and alcohol and alcohol drug People’s and Young The Children Wellbeing Health and is part of the Holistic service (360) by Bridgewater. delivered service (5-19) Addressing the needs of the complex and vulnerable Addressing Ensuring good quality care for those with existing Ensuring good quality care needs Identifying and dealing with problems early with problems Identifying and dealing Helping people stay well Helping people stay and this need is increasing. There is a clear economic economic is a clear There is increasing. need and this This focus on prevention. for a greater case therefore industrially scaled to be systematic, needs prevention in of disease the overall burden to reduce prevention and sustainable health and enable a the population system social care BiDAS provides a seamless, integrated drug and BiDAS provides Bolton enabling and empowering alcohol service across individuals and their families to achieve their full potential, health and wellbeing. positive outcomes and improved The service for adults, young people and families early intervention and recovery includes prevention, support including support to help people sustain their with their lives. and make progress recovery Drug and alcohol servicesDrug alcohol and (BiDAS) Bolton Integrated Drug and Alcohol Services help support includes a number of services which of their as a result individuals experiencing problems and friends drug and/or alcohol use. Family members (sometimes of people who use drugs and/or alcohol to as ‘concerned others’) can also receive referred the support support, either in their own right or alongside to their loved one. offered More comprehensive demographic data can be found on demographic data can be found comprehensive More Matters website the JSNA which is on the Bolton Health www.boltonshealthmatters.org • • • • The Public health commissioned services contribute to services contribute to The Public health commissioned priorities set out in the aligned to the this vision and are focusing on the following Strategy, Health and Wellbeing areas:

About the Strategic Key Quality and Growing Demand Current Workforce Commissioning Providers who Fit for the Healthwatch Co-design How we use Appendices statement direction messages in performance needs market intentions we want to future our resources the statement work with 24 50 48 Apr’16 43 52 Apr’15 Total places per week Total 215 534 Attending community based activities within the centres activities Group Centre Community Care 215 Thicketford Winifred Kettle Brazley 104 no. of places Total Temporary Permanent Number of Placements Day care range of services and Services covers a Day Care Service Users to continue to live in activities which help The service is their own home or with families or carers. which at day centres homes outside of people’s delivered a welcoming, comfortable and safe environment. provide services care day people Older for older people The Council has 534 places per week places are of which 116 Centres Day Care three across diagnosis of allocated for Service Users with a formal dementia. weekly places The following table lists the number of within each centre: LD day care services operates Disability day services Bolton currently primarily for people with learning disabilities who live to enable individuals to maximise their with family/carers independence, develop skills and social networks as well and support. with valuable respite carers as providing Services, 136 Service Users receiving currently are There 1,268 sessions per week with a total of approximately support offering a range of individual and group of direct activities and an average attendance of 21 Service Users per session. Each service user has a personalised support plan which outcomes sets out how their eligible needs and desired attending the day service. Typical will be met through staff care activities for service users with support from include: • • Shared Lives Shared scheme adult placement) lives (formerly The shared short long term, by the Council provides operated is The long term service sessional care. term, and with a learning to adults disability provided predominantly with 82% of placements homes in Bolton (88%) in family for under 65s. Missing from home service Missing from Domestic abuse support for looked after children Disagreement resolution service (DRS) for special resolution Disagreement educational needs and disability Information advice and support service (IASS) for special educational needs and disability Family mediation for homeless young people Mediation for special educational needs and disability Advocacy for looked after children and child Advocacy for looked after children protection Independent visitors for looked after children Young carers Young Vulnerable Children and young people services young and Children Vulnerable Early Years (0-5) Early Years Positive Activities 5-19 Needs and Positive Activities Special Educational Disability Providing a local ‘community voice’ a local ‘community Providing Provide evening, weekend and holiday services evening, weekend Provide Harnessinglocal the time, talents and ambitions of who wish to volunteer residents Being able to reach excluded communities statutory communities excluded to reach Being able cannot services sometimes Attracting additional external resources and funding to funding to and external additional Attracting resources Bolton • • • • • • • • • • Service will be commissioned through a competitive Service will be commissioned through for services for: tendering process Together we are committed to achieving the best we are Together and young people possible outcomes for all children disabilities (SEND) with special educational needs and/or on providing focusing predominantly by and/or in care and stability of high quality education, health provision placement. • As part of the review of the new Starting Well of the new Starting Well As part of the review to Service services have been commissioned support: • • The intention is therefore to offer through a Grants to offer through The intention is therefore to £50k over two years to grants of up Programme provide: • • • • •

About the Strategic Key Quality and Growing Demand Current Workforce Commissioning Providers who Fit for the Healthwatch Co-design How we use Appendices statement direction messages in performance needs market intentions we want to future our resources the statement work with 25 Proposed daily capacity Proposed 2017 65 35 14 25 0 139 Variance -8.2 4.8 1.6 -1.2 2.6 -0.4 Brazley Centre, Horwich Brazley Centre, Halliwell Jubilee Centre, Moor Tonge Centre, Thicketford Moor Tonge Centre, Autism Thicketford Home care Issues care Home commissioned by Bolton The volume of home care 1,000 hours per by approximately Council has increased appears to be week in the past 12 months. This trend for linked to both demographic changes, and the desire people using services to be supported within their own complex packages Consequently more home for longer. in the The growth two carers. often requiring are of care hours has impacted the need to increase volume of care of staff. However, retention and improve the work force months outstripped the demand has over recent in periods when demand has been available resources high. Home care Home 15 providers from The Council commissions home care A framework agreement on a framework agreement. three across delivered to be home care allows ordered on the providers geographical ‘zones’ between those zones is designed The allocation through agreement. and to minimise travelling time between customers is also a There resources. to maximise efficient use of specific service for people with a learning disability or mental health issues. with CQC registered a total of 53 providers are There in Bolton. This number and mix to deliver home care sector organisations private and third of statutory, means that the local market is highly competitive. typically small although some larger are Local providers in Bolton. organisations also have a presence Disability day services are currently provided from the from provided currently services are day Disability bases: following • • • • of the usage and capacity The table below demonstrates 2017: 2013 – from the disability day services 2017 48.6 34 14.8 21.4 17.6 136.4 Average users per day Average 2013 56.8 29.2 13.2 22.6 15 136.8 These services also provide valuable respite for respite valuable provide These services also during the daytime families/carers Supporting the specialist community health therapist health therapist the specialist community Supporting centres. whilst at the services for individuals to deliver community therapy, occupational (Physiotherapy, therapy) Speech and Language nursing and Developing independent living skills living skills independent Developing Service Jubilee Centre Centre Thicketford Autism Centre Thicketford Brazley Centre Harrowbys Overall total There is a current in-house sensory impairment service current is a There (part of the independent living service) which works to help and support people with a sensory impairment people both vision or hearing loss. The aim is to ensure lead a full and active life within their community and maintain independence at home. The service provides assessment, advice, training and equipment. The service and a separate one to one a drop-in through is delivered appointment system. Sensory Support Impairment Services There is a community meals service, including delivery is a community meals service, including There Luncheon of hot meals to individual service users, meals, and delivery of frozen Clubs and Day Care finding it difficult which is available for people who are to cook for themselves. This service helps maintain a in it is provided independence and also, where person’s social luncheon clubs, gives the opportunity to reduce to pay for delivered required isolation. Service users are in 2015/16, delivered meals. Over 96,000 meals were in 2016/17 up to end of Feb, over 86,000 have been In 2015/16 over 22,000 lunch club meals delivered. and YTD 2016/17 (up to end of Feb) over delivered were delivered. 23,000 lunch club meals were Community meals As identified in the table above the overall usage of As identified in the table above the stable over a three disability day services has remained have been some There year period with a 0.4 reduction. in a larger reduction services resulting movements across as individuals have either ceased at Jubilee centre bases closer to attending or moved to one of the newer their home. • • •

Housing Services and private Providers In partnership with Registered a range of developers, the Council co-ordinates supported and specialist housing, with specific focus on and support for older people and the provision improving people with disabilities. Supported Living The Council commissions services within 73 shared houses for 277 people with Learning Disabilities or mostly autism and Mental Health conditions. These are facilities with other service users share houses where people with similar needs. This accommodation has a good base for delivering good quality support provided to service users for the last 25 years. However and care has considered supported housing review the recent to meet that most of the accommodation has not altered expectations and changing service user and relatives’ to diversify the types/ fairly urgent requirement is a there needs. and accommodation to meet future standards Respite Care Respite to an provided Respite is planned or emergency care to provide and support needs in order adult with care caring for to family members who are temporary relief for care short stay/respite them. The Council provides Hall View and New Lane. at Mere adults and their carers support for seven people who Hall View provides Mere secondary physical disability, have a learning disability, and other complex needs. mental health problems support for six for people with severe New Lane provides hospital where and enduring mental illness in crisis, or necessary. admission is not appropriate at Wilfrid is provision Geere For Older People there different in three purchased spaces are bed and three homes. care residential The Council’s residential intermediate care service care intermediate residential The Council’s 30 beds at Darley Court, is provided for older people and Laburnum provides beds. The service Lodge, 32 occupational health with on-site rehabilitation residential within a multi-disciplinary working and physiotherapists step a step up or providing team social care health and hospital. down from 2015/16, made to the service 1,115 referrals were There month. 78% step down from an average of 93 per step up with 810 accepted. Of the 676 hospital and 22% home. 66% returned discharged in 2015/16 (65 and over) who were of older people The proportion hospital into after discharge from still at home 91 days was 70.1%. services in 2015/16 reablement/rehabilitation Intermediate Care Bed Based Services which are at Bed Based Services which are Intermediate Care Darley Court and Laburnum Lodge Home Pathway. A joint service provision between between A joint service provision Home Pathway. at Royal Bolton NHS Foundation Intermediate Care Reablement Team. and the Council’s Home Team 2015 this includes a speech and language mid From therapy service The Admission Avoidance Team which now includes Team The Admission Avoidance the IV Therapy Team reablement services which are typically provided in typically provided services which are reablement an active period of own home, providing a person’s designed to short-term intense activity and support enabling thereby independence, people’s promote a and requiring them to live at home for longer, care amount of long term health and social reduced services supported discharge in a patient’s own home, with supported discharge in a patient’s and home care nursing and/or therapeutic support, necessary, support and community equipment where at home and recovery to allow rehabilitation residential rehabilitation in a setting such as a in a setting such as rehabilitation residential for home or community hospital, care residential people who do not need 24-hour consultant-led and but need a short period of therapy medical care, one to six weeks normally ranging from rehabilitation, acute care at home from specialist teams, including specialist teams, at home from acute care of intravenous such as administration some treatment antibiotics rapid response teams to prevent avoidable admission avoidable to prevent teams rapid response General from for patients referred to hospital Accident & Emergency (A&E) or Practitioners (GPs), in and support with short-term care other sources, their own home Bolton Council’s Reablement Service operates a 24 Bolton Council’s Bolton. Bolton’s hour service, 365 days a year across Reablement Service takes on an average of 105 new per month, or 26 per week, and packages of care in 2015/16. Over 1,262 new packages of care provided no the service required 40% of clients discharged from ongoing support. • • • Bolton’s Intermediate Tier services are comprised Intermediate Tier services are Bolton’s of: • • • • • Intermediate care Intermediate as be considered of services that would The types include: Care Intermediate

About the Strategic Key Quality and Growing Demand Current Workforce Commissioning Providers who Fit for the Healthwatch Co-design How we use Appendices statement direction messages in performance needs market intentions we want to future our resources the statement work with 27 Extra care housing schemes offering 320 Bolton has ten Extra Care provided are All of the properties individual properties. currently Bolton Cares housing providers. by registered at four of the schemes with the the care provides by independent providers. 6 provided remaining 298 available with on-site care, Of the 320 properties equity properties. shared and 22 are rent for social are Our local service offer is quite dated with four schemes built in the built in the early 1970s and the remainder late 1980s and early 1990s with the exception of one purpose built scheme completed in 2009. Within sheltered and extra care housing a housing related related housing housing a Within care and extra sheltered tenancy as part of a tenant’s is included support service related Housing social landlord. with the agreement people to help vulnerable a service provided support is aimed living and is or achieve independent maintain inclusion. This and social independence at promoting housing officer / scheme manager is achieved by the accessing the older people are help to ensure providing daily to live independently, right services to continue managing their home and arranging well-being checks, social isolation. activities to reduce to a specialist contact services provide Community Alarm 24/7 via a small unit that connects operator available home. The customer customer’s to the phone in the in the unit and a microphone normally wears a pendant if they can’t means that operators can hear customers get to the phone. The operator can facilitate help or emergency assistance that mainly includes contacting access to a family or for some customers services, GP, service. In addition Community Alarm mobile response services Telecare services form the basis for additional such as fall detectors. type village also two private retirement are There located in Harwood and schemes in the borough, housing is not as high Horwich. Demand for sheltered demand varies as for most general needs homes and and property considerably depending on the scheme type available. that Housing Needs Assessment found The recent living remain the majority of older people want to 2,500 around independently in their own home. However, considering a move in the older person households are and in some appropriate, require next five years and will cases specialist, accommodation to enable them to do properties, so. This should be one and two bedroom options across primarily flats and bungalows and provide to meet the aspirations outlined in the a range of tenures, research. Extra care = 320 units Extra care (Cat 2 type) support with alarm = 3,448 Sheltered (Cat 1 type) alarm only = 402 Sheltered = 6,379 Careline = 974 response Telecare Leaseholders = 314 • • • • • • Housing for OlderHousing for People living accommodation range of sheltered is a There schemes, including under one roof Bolton across of the services bungalows and apartments. A breakdown is set out below: Transforming Care is still a cross cutting priority for both is still a cross Care Transforming work is ongoing to the council and the CCG. Transition placements out of borough service users from relocate is planning to such as specialist hospitals. The council Framework to use the opportunities of the GM LD Ethical responses services and develop bespoke recommission (if required). There were 33 voids in supported living properties as 33 voids in supported living properties were There in finding vacant at December 2016 due to difficulties to the needs of service compatible that were properties economies of users on the waiting list. The reducing also houses are to five bed shared scale for the three costs such with increasing apparent becoming more being These issues are as the National Living Wage. modelling of services. part of the future as considered There are five properties for 20 adults in supported for 20 adults in supported five properties are There via direct is commissioned the care housing where in response payments. This has developed incrementally individuals however it is anticipated that to demand from in the future. this will have modest growth The Council also commissions support for 131 adults support for 131 also commissions The Council 12 people with learning living in 33 properties, disabilities in one and five people properties, with ASC in three is care condition, where with a mental health property people Two sector provider. by an independent provided also are There borough. outside the live in properties Care Transforming commissioned under properties three people. supporting up to nine Bolton Cares currently provides support to 83 people to 83 support provides currently Cares Bolton also It 25 properties. with learning disabilities across across health condition 23 people with a mental supports four properties.

2011/12 2012/13 2013/14 2011/12 2012/13 2013/14 85+ 75 - 84 65-74 85+ 75 - 84 65-74 0 0 50 800 600 400 200 400 350 300 250 200 150 100 Age profile of adults living in residential or nursing care funded by Bolton Council with a type of dementia or nursing care of adults living in residential Age profile Age profile of adults living in residential or nursing care funded by Bolton Council or nursing care of adults living in residential Age profile 1400 1200 1000 Number of people living in older people people living in older Number of funded by Bolton Council care residential 65-74 75-84 85+ Total Number of people in residential care funded care Number of people in residential by Bolton Council with a client type of Dementia by age group 65-74 75-84 85+ Total Residential andResidential Nursing Care currently number of people below detail the The tables by funded are who care people residential living in older the Council.

Fragility of independent sector workforce including Fragility of independent sector workforce staff home and home care care Safer staffing requirements as a result of the Francis as a requirements Safer staffing Inquiry Reliance on agency and temporary staff to fill gaps left and temporary staff to fill gaps left Reliance on agency professionals health and care by lack of permanent Reduced training opportunities resulting in fewer resulting Reduced training opportunities staff nationally health and care professional As part of the development of the Workforce Strategy, Strategy, As part of the development of the Workforce has mapping of the existing workforce comprehensive been undertaken. Workforce Models and New Role Development • Workforce • Education, Leadership and Development • Recruiting and Retaining Talent • Engagement and Communication The delivery of this vision will be structured around around The delivery of this vision will be structured four key themes: We intend to create a “ladder of opportunity” which will a “ladder intend to create We professions care enable local people to enter health and development and access training, support and skills These opportunities will improve their careers. throughout and in turn boost employment, local job prospects health and and physical and mental economic prosperity wellbeing. Our vision is for the development of a single care a single care Our vision is for the development of which bridges traditional organisational workforce barriers. Health and care partners in Bolton have developed a Health and care which sets out our Strategy Workforce Health and Care develop a highly plans to tackle these challenges and to support workforce skilled, flexible and fit for the future the Bolton Locality Plan. • • • • There are significant workforce challenges across the health and care economy which which economy and care the health across challenges workforce significant are There locally and nationally: being faced are 8. Workforce

Public Health have undertaken an exercise to prioritise undertaken an exercise Public Health have spending based on a set of rational criteria future commissioning intentions. which will also inform future as follows: impact on health The six criteria are to reduction inequalities, closing the gap, contribution morbidity in in mortality rates, contribution to reduction on investment / value for (i.e. disease) rates, return evidence base, and mandatory services money, commissioning Public Health have undertaken a joint a Council and through City with Salford exercise won the Trust competitive tender Bolton Foundation Health Service contract to deliver an Integrated Sexual This new service started Bolton and Salford. across on 1st July 2016 Greater Contributed to the establishment of a for Sexual Charging Agreement Manchester Cross to deliver a simpler and more Health Services in order charging for Genito-Urinary equitable system of cross Medicine (GUM services) the Single Emergency Accommodation Retendered Homelessness Services. New and Preventing contracts started on 1st April 2017 and these services focusing long will be based on asset-based approach, and the rates of re-referrals term outcomes, reducing demand on crisis services reducing The Complex Lifestyles Service was retendered and started in January 2016. The Service improves outcomes for adults in Bolton with a sub-set of proactive, coordinated, complex needs, is responsive, focused, and specific to each individual Client The Supported Housing Review has been set up to look at the supported housing model of provision to be made by the Council within the time period a five year 2015-2025 with the aim of producing of the development plan. It will include a review within the physical condition of existing properties context of the barriers that may exist for the client access supported living. It will include a to groups • • • • • •

People Children and Child Protection Children (IASS) Information, Advice and Support Service (IASS) For Special Educational Needs and Disability (SEND) Domestic Abuse Support for Children and Young and Young Domestic Abuse Support for Children Independent Advocacy Service For Looked After SEND Information Advice and Support Service

A Review of the Children’s Services Voluntary, Services Voluntary, A Review of the Children’s Community and Faith Sector Grant Funding 2016–17 and Children of the following Vulnerable and re-tender was completed: People services Young A Review of Children’s Centres was completed in Centres A Review of Children’s December 2016 with changes to be implemented by 2017 31st March Shared Lives Plus - Successful NHS England funding Lives Plus - Successful NHS England Shared GMMH and bid in partnership with Bolton CCG, Lives Service to expand the Shared Bolton Cares clients Lives Service to include more existing Shared with mental health issues and learning disabilities A Technology Enabled Care (TEC) Strategy has been (TEC) Enabled Care A Technology Council, Bolton developed in partnership with Bolton Housing and voluntary CCG, Bolton Foundation Trust, and community sector Set up of Bolton Cares, our Local Authority Trading our Local Authority Trading Set up of Bolton Cares, and the transfer of in-house Extra Care, Company, Learning Care, Supported Living, Older People Day and Respite Services Outreach Disability Day Care, July 2016 from Development of a Grants Process for Preventative for Preventative Grants Process Development of a services for older Grants. Have funded and Carers health, sensory mental sufferers, people, dementia Services and carers. sufferers impairment, stroke support carers include befriending, luncheon clubs, ins, one to one support, networks, home visiting, drop programme information and advice. A second round was grants focusing on specific groups of carers’ undertaken in 2016

• • • • • • What has changed since our last Market since our last Market What has changed Position Statement?

A “commissioning intention” is a brief statement that sets out the priorities of the the priorities that sets out brief statement is a intention” A “commissioning to it wishes market changes of services and in respect authority commissioning CCG’s and of the Council’s an outline are below intentions The commissioning deliver. 2017-2020 priorities during 9. Commissioning Intentions 9. Commissioning

The development of a GM framework for Rehab and 1st April 2017 Detox Placements will go live from A review of care fee structure was undertaken, for the fee structure of care A review system was first time in over 15 years. The payment homes. simplified, working in consultation with care the Dementia High was renamed The EMI premium Needs Payment A tender for a Home Support Framework was A tender for a Home Support Framework on 5th undertaken in 2016. New contracts started for September 2016 incorporating the requirement continuity around to meet quality standards providers The timeliness of visits and training for staff. of care, commissioning framework will pilot the monitoring of and carers. outcomes developed with service users review of quality and quantity of existing properties properties existing of and quantity of quality review including the accommodation requirements and future of distribution and the geographical models needed boundaries of Bolton within the properties the following undertaken using has been The review methodology: Maternity and WiganBolton is working with Salford as one of and choice for improved pioneer areas NHS England’s personalisation in maternity services. As a pioneer we that is will champion personalised and high quality care We the woman, her baby and her family. around centred Budgets which will will also offer Personal Maternity Care a wider range of providers enable women to choose from for their maternity care. which meet NHS standards Starting Well Commissioning Intentions 2017 to 2020 • • •

About the Strategic Key Quality and Growing Demand Current Workforce Commissioning Providers who Fit for the Healthwatch Co-design How we use Appendices statement direction messages in performance needs market intentions we want to future our resources the statement work with 33 To work with Bolton Cares to develop more to develop more work with Bolton Cares To community based and volunteer run models of service including exploring the possibility of piloting innovative people can be day support and activities where We are seeking to combine and align two integral are We payments delivery: direct elements of the Council’s and payroll payments support and brokerage Direct services these services we found that of retendering In a recent the market was ‘immature’ The Council wishes (with partners) to perform and development a market stimulation exercise ability to provide the market’s sessions to strengthen Payments Support, combined Direct the required service prior to undertaking any and Payroll Brokerage exercise procurement future payments support of direct a review will undertake We within the next 12 months aimed at and brokerage in demand and incorporating meeting the likely growth including Personal the joint commissioning approach Health Budgets and SEN. This will include a market tendering assessment and development of future Manchester wide solutions options including Greater The redesign of the Bolton health and social care health and social care of the Bolton The redesign and community based care system will mean primary contact for non-life threatening is the first point of when urgent care with responsive illness and injury, required and efficient discharge will prioritise the effective We hospital into a safe and clinically of patients from supported community environment, appropriate and enhanced by an Integrated Discharge Team for be cared intermediate tier services to help people close to home for longer have been (INTs) Integrated Neighbourhood Teams needs developed to support patients with complex a range of specialisms, including medicine, across nursing, social work and therapies This approach will enable patients to see the most the most to see patients will enable approach This and wellbeing their health for professional appropriate more will be available for to home. GPs needs closer to and will be able support to these teams intensive being admitted to patients prevent to act proactively hospital unnecessarily Day supportDay and activities • Direct payments support and brokerage support and brokerage payments Direct • • • • Urgent and Community Care Urgent • • • • GPs will work as part of integrated teams which such as Health include allied health professionals Practitioners, Advanced Nurse Improvement Practitioners, district nurses, pharmacists, MSK and mental health practitioners and therapists Health Improvement Practitioners will provide health Practitioners will provide Health Improvement and wellbeing support to those identified as needing additional help with their wellbeing needs Our vision for transforming primary care in Bolton will Our vision for transforming primary care see GP practices working in neighbourhoods with an enhanced, fit for purpose workforce A strategic partnership between Bolton Council, Bolton A strategic partnership between Bolton Housing and voluntary CCG, Bolton Foundation Trust, and community sector has been set up to oversee and TEC in Bolton with tangible outcomes. drive forward of It will enable service users/patients to take control working in partnership with their own health and care, and the families, carers professionals, health and care voluntary sector TEC has the potential to unlock new models of care models of care TEC has the potential to unlock new to show and a number of pilots have been initiated these pilots are how TEC can be embedded in Bolton; pathways, using taking into account adjusted referral packages and to offer additional care TEC to review support for early intervention and prevention Our ambition is to deliver high quality care for all ages care Our ambition is to deliver high quality continues to rise as demand for health and social care and develop and to achieve this we need to evolve better coordinated that provide new models of care hospital and social community, and integrated primary, services care We have developed with partner organisations a have developed with partner organisations We Strategy for Bolton (TEC) Enabled Care Technology To help deliver this we will run a programme of help deliver this we will run a programme To Autumn 2017 Grants from Prevention We will work with community and voluntary service will work with community We and prevention to develop early intervention providers based models services using asset Develop a quality mark in partnership with CCG and with CCG quality mark in partnership Develop a sector providers and voluntary care CVS for non-social Broaden the scope of support services delivered delivered support services of the scope Broaden Agency and also Improvement our Home through organisations, and voluntary sector community through needs to meet increasing • • • Primary Care • • • Technology Enabled Care Enabled Technology • • • • •

About the Strategic Key Quality and Growing Demand Current Workforce Commissioning Providers who Fit for the Healthwatch Co-design How we use Appendices statement direction messages in performance needs market intentions we want to future our resources the statement work with 34 The current frameworks for both Learning Disabilities The current 2018 in March and People with Autism expire and when we have completed the Supported strategic Accommodation Review and have an agreed GM then we will begin implementing from direction intentions commissioning future We will be working with the CCG to review our working with the CCG to review will be We and develop local commissioned requirements services in transition to adult’s services for children stage bringing them back to Bolton from an early from out of borough procedures policy and our Transition will review We and Disability) to ensure (Mental Health, Leaving Care in Bolton provided services are that appropriate Tender for Low Level Mental Health Accommodation Health Accommodation Low Level Mental for Tender asset based lead provider Moving to a Based Service. to maintain independence Aims are delivery model. and learn to live independently; the skills needed physical wellbeing; mental and Maintain and improve Community; Achieve Participate in the Bolton getting into work, education and aspirations, including training The Misuse Tender. Manchester Substance Greater (BST) cluster commission and Trafford Bolton, Salford Manchester of Greater is an important component GM substance misuse (GM) system change activity. with the GM commissioning leads have been working and New Economy Public Service Reform (PSR) Team As a to develop a series of common standards. will be of this commission common standards result for local authority areas the three implemented across be the blueprint drug and alcohol services and this will of GM for the rest services of 0-19 redesign Future be re-tendered Services. To and Care HIV Prevention New as part of the GM collaborative commissioning. contracts in place by 1st July 2017 a fully integrated sexual health service Tender GM Local collaboratively commissioned with other Authorities Supported housing • Disabilities Services transition in those for • • • Health Public • • • • Social Inclusion — The MCISS is commissioned by Macmillan Cancer Information and Support Service (MCISS) In 2017/18 we will continue to support and make to the MCISS with a view to further improvements expanding the range of activities and support offered and families to cancer patients and their carers Bolton CCG to offer high quality information, support The and practical advice to people affected by cancer. at Bolton centres drop-in three service operates from One, Royal Bolton Hospital and Bolton Hospice and and awareness offers emotional support, prevention advice, financial advice and signposting to local support groups Offer grants to the voluntary sector to develop services We will continue to explore opportunities to work with to explore will continue We assessments to undertake carer providers We will continue to work with monitor providers of will continue to work with monitor providers We level of grant funded support and expect a good Strategy outcomes delivery against the Carers Develop Carers’ Partnership board to implement Partnership board Develop Carers’ Action Plan in line with Strategy and Carers Carers voices Continue to review the Carers’ Strategy for Bolton with the Carers’ Continue to review it meets needs and demand partners to ensure We will work with community and voluntary service will work with community and voluntary service We to develop services to support informal providers using including models of volunteer run groups carers asset based models We will review existing provision and look at options to existing provision will review We develop an all-age service in the future The existing provision is adequate to meet existing is adequate The existing provision or no plans to further develop are need and there expand the provision We will review requirements and look at all-age requirements will review We Advocacy model We will continue to monitor the Advocacy Hub to monitor the Advocacy will continue to We it meets requirements ensure enabled to get employment, access to education and to education access employment, to get enabled Guidance NICE activities reflecting leisure • Cancer • • • • • • Carers supportCarers • • Sensory Support Impairment Services • Advocacy •

Work with Bolton Cares on an asset based approach approach on an asset based with Bolton Cares Work and volunteer run community based to stimulate more including exploring the possibility models of service day support and activities where of piloting innovative access to people can be enabled to get employment, activities education and leisure significantly upscale alternative forms of provision To that avoid us having to commission accommodation based services for all client groups Manchester) is seeking to expand Bolton (with Greater The Council wish the use and uptake of this provision. the before can be offered lives if shared to explore lives if shared use of supported living and to explore complex needs (due to can support people with more health) behaviour support needs and/or mental use of shared examine the opportunity to increase To of older people lives for short term care of in the process The following developments are being commissioned to be available in 2017/early 2018:

Day supportDay and activities • Lives Shared • • • •

housing offer in future development to expand flat housing offer in future supported by the service users) to type and (where design models to continue to share use the current will provide high quality, vibrant, safe, attractive, high quality, will provide sustainable and well-designed supported an enabling accommodation which creates expect good design We for residents. environment economic, social and to add to environmental, cultural value which will help local communities to flourish project to deliver a diverse range of quality to project supported accommodation to meet the needs and communities and future aspirations of our current Bolton council seeks to improve the quality of the Bolton council seeks to improve We aspire to work in successful partnerships which aspire We Bolton Council is committed to an ambitious

In developing new models of supported housing and In developing new models of supported across the quality of providers seeking to improve Bolton market then the following principles are proposed: Develop a small, six bedded, LD residential service. Develop a small, six bedded, LD residential (small) number This is to augment the councils current placements of residential has review The supported housing accommodation of the state of the current given an initial picture fit are stock, but also highlighted which properties for re for purpose and which could be earmarked (if not up to modelling or even decommissioning standard) The Greater Manchester (GM) Learning Manchester (GM) Disability The Greater and is being developed is currently Ethical Framework expected to be in place by August 2017 Framework Following the launch of the GM LD Ethical new mini competitions will be held to award Learningsupported housing frameworks for both Disabilities and People with Autism In responding to the Transforming Care Programme Programme Care to the Transforming In responding to framework providers to work with we will continue can that based properties community identify suitable ensure service users and complex needs of meet the delivery of positively with the assists the environment care for specialist 24 hour support and In light of demand exploring we are Care to Transforming in response community based services options of commissioning the CCG. One of the potential in partnership with options for a crisis developments is exploring accommodation service

• • • • • • •

Development of a single falls risk check embedded into existing services private from of falls hazards removal Proactive sector housing Home safety checks and balance Community based strength Pharmacy-led medication reviews 2017/18 will see further expansion of the Staying 2017/18 will see further expansion of out service for the over 65s which is being rolled Well demand to meet the borough across A key priority for the CCG is to expand the Bolton A key priority for the Service which is nationally Memory Assessment early access to assessment and provides accredited for older people and post-diagnostic support services Further investment in experiencing memory problems. will keep waiting 2017/18 onwards this service from development times to a minimum and support further of evidence based post-diagnostic support a number of older people with dementia are There behaviour that challenges, requiring who present placed outside of the intensive supervision, who are The Council will work with NHS colleagues borough. such specialist to identify the need and demand for This provision. services with the aim of delivering local “step down” may include the ability to “step up” and to the needs of the individual according care, Staying Well Well Staying • Delivery Model Prevention Falls As part of the Bolton Locality Plan, we will fully establish Delivery model including: the Falls Prevention • • • • programmes • Well Ageing Dementia • •

to prevent the avoidable deterioration of mental to prevent health needs are assessed swiftly and effectively and are assessed swiftly and effectively and are needs are and support they able to access the treatment need, when they need it the decisions about me capital needs and recovery those things that matter to end users, carers and those things that matter to end users, carers people stakeholders within Bolton and will ensure commissioned and provided (Stakeholder / Public commissioned and provided engagement) develop services in line with best practice and develop services in line with best practice need (evidence based) and support (co-production) receive (quality) receive Social Care) services to be integrated (Health and quickly as it is required (speed) quickly as it is required (choice) support and where Receive help and interventions sufficiently early Have an improved quality of life as mental health Have an improved and support Have a positive experience of care Have personal choice and control or influence over Have personal choice and control both their designed around Know that services are Outcomes Commissioning will be outcome focused on Have the opportunity to influence how services are services are Have the opportunity to influence how Demand that commissioners seek to improve and improve Demand that commissioners seek to treatment Be involved in planning and delivering Have control over the services and support they over the services and support they Have control of those Expect the commissioning and delivery Access the services and support they need as Access the services services and how they receive Have a choice over

The joint commissioning strategy focuses on how we focuses on commissioning strategy The joint prevent and seek to good mental health can support the need to promote health. It emphasises mental ill the people to overcome and support recovery illness so that they can lead consequences of mental lives. and productive satisfying, independent the people of committed to ensuring that are We Bolton can:

Mental health Mental •

About the Strategic Key Quality and Growing Demand Current Workforce Commissioning Providers who Fit for the Healthwatch Co-design How we use Appendices statement direction messages in performance needs market intentions we want to future our resources the statement work with 37 Review the Workforce Development Plan Review the Workforce Develop a Revised Multi Agency Workforce Development Plan for Safeguarding The development of the Integrated Health and Social action plan Development Workforce Care Partnership continue to the Workforce Through support talent management and essential training into Health and Social Develop options for recruitment on Employer Led Academy with Bolton focusing Care College Extra Care housing can delay or prevent the need for delay or prevent housing can Extra Care support of health and care intensive forms more is needed of Extra Care provision New additional that will increase over the long term in the borough opportunities to take this explore will We the supply. providers with housing and care forward of Extra Care providers will work with current We it meets the to ensure the service model to review needs and of tenants with varying requirements sustainability long term ensure homes is a shortage of nursing beds within care There of nurses within the sector has in Bolton, recruitment a problem been highlighted by some homes as placements in Demand for older people residential particularly with growth Bolton is likely to increase, is a continuing need for self-funders; there from the supply of good quality residential increasing Residential homes are accommodation and care. is Bolton. There generally operating at full capacity in the supply of beds specifically for a need to increase residential those with dementia, demand for dementia and nursing dementia bed spaces is anticipated care to steadily increase is a need to encourage investment in care There is updated with local provision homes, to ensure a high standard modern facilities and provides an of accessibility for disabled people; providing of high quality that supports provision environment care Workforce Development intentions Development Workforce • • • • • • • • care care/nursing Residential • • • Extra Care Review of current Frameworks and procedures to Frameworks and procedures Review of current better meet market need Consider new models of care at home through GM at home through Consider new models of care Commissioning arrangements and examine piloting reduce hospital that will forms of home care different care the need for residential admissions and reduce To consider remodelling some existing sheltered and existing sheltered some consider remodelling To schemes in partnership with our Registered extra care fit for the future they are to ensure Providers To focus new supply of such schemes, and To in the north of the borough, specifically extra care, and Horwich south of the borough To facilitate the development of specialist housing To and tenure cross scheme for older people that are the spectrum of income and capital across affordable, for owner is a need to focus on provision levels. There older is a lack of this in the current occupiers as there housing market people’s Ensure patients receive long-term management/ receive patients Ensure (within 4 months of fracture) monitoring and treatment Provide interventions to improve bone health including bone health including interventions to improve Provide clinic to the specialist falls referral Provide information and support to patients to reduce to patients to reduce information and support Provide fracture the risk of a future Assess bone health and falls risk Assess bone health Identify patients over 50 years who have suffered a 50 years who have suffered Identify patients over Care) A&E and via Primary (through fragility fracture • Home care Home • • • • Housing Services This will build upon the existing well-established This will build upon the existing well-established appointments for rheumatology service which provides linking to and IV therapy service, whilst also osteoporosis our plans for falls prevention. • • • • • Fracture Liaison Liaison Fracture to further Liaison Service a Fracture will introduce We healthier and vision to keep people support our hospital admissions reduce for longer and independent will: The service care. on social and reliance

Create new employment, apprenticeships and training employment, apprenticeships new Create unemployment and develop opportunities to address skills in the local community Effective engagement between the public sector, Effective engagement between the public sector, voluntary sector and the population Sign up to the Bolton Locality Plan and Bolton Visions 2030: Active, Connected & Prosperous Sign up to outcome-based models which require require Sign up to outcome-based models which agencies and new collaboration between different solutions provider Those who work with us to ensure financial Those who work with us to ensure sector in our sustainability for the health and care locality Those embed a culture of dignity and respect into of dignity and respect Those embed a culture services Those that promote independence choice and control independence choice and control Those that promote of service users Those that work to develop and train their workforce their workforce Those that work to develop and train to deliver the above Those that proactively listen to service users views Those that proactively service delivery when improving Those that are delivering improved value for money value for money delivering improved Those that are avoiding sacrificing quality and added value whilst standards Those that want to work in partnership with all Those that want to improve to continuously the borough agencies across service provision Those that work proactively to quality assure their to quality assure work proactively Those that the positive able to evidence services and are users outcomes for service 1. We are signed up to the objectives of the GMCA are We to: Policy which ask providers Social Value We want providers who will commit to delivering Social providers want We is not what is bought by Social Value in Bolton. Value the contracts put in place, but what the suppliers can add, in addition to these services, for the benefit of the community. • • • • • • • • • • and work with in Bolton with work and • 0. Providers we want to engage to want we 10. Providers

Increased use of community and voluntary sector use of community Increased care services to complement existing statutory Further develop prevention such as early intervention such Further develop prevention demand future services to help reduce A model of quality assurance for care services which services assurance for care A model of quality and other citizens of the quality informs service users level of service The commissioners and providers need to consider the The commissioners and providers choice, accessibility and availability of services provision including young carers. When considering the current market and the direction market and the direction When considering the current the feedback received of travel we have considered to service users including an integrated approach from with conjunction in care of continuity and choice services, budget. a reducing

Healthwatch Bolton is charged with engaging with the public to capture their with engaging with the public to capture Healthwatch Bolton is charged and services. They work with service providers care experiences of health and and experiences to service user’s strategies for responding commissioners to develop concerns. 12. Healthwatch • • • To ensure that Bolton services are fit for the future, based on what we know about on what we based fit for the future, are services that Bolton ensure To the following working on we will be of resources, and the level and demand supply next few years. over the 11. Fit for the future Fit for 11.

Presenting evidence collected in co-production in co-production evidence collected Presenting to decision makers and and engagement activity and weighted is reviewed ensuring that this evidence appropriately available in the and data reports Making evidence, and analysis review public domain for engagement and Communicating co-production the back to service users and recommendations the Engagement Alliance public, with support through • • • and It is our intention to support better engagement and co-design as standard to establish co-production personalised practice and as a key means of delivering improved aims to provide services. This approach use services and partnership working with people who their carers. to develop As part of the commissioning process users and services we have consulted with service An for Change”. Together “Working with their carers user with learningengagement event was held for service the future disabilities and their families to help inform and the borough development of supported housing in using these the needs and aspirations of the people in our hostels services. Consultation with service users and social inclusion mental health accommodation of these services prior to services has led to the redesign their re-tender. partner organisations will be asked to build In future, into their business models. co-production

ensure additional activity is commissioned ensure evident and opportunities are are gaps where identified maximise all current engagement opportunities maximise all current

Gathering existing co-production and engagement Gathering existing co-production new activity so as to: evidence and co-ordinate Actively identifying opportunities for co-production Actively identifying opportunities for co-production and engagement Understanding the risks, considerations, benefits Understanding the risks, considerations, and to co-production and possibilities with regards engagement with the public Ensuring meaningful public engagement on all Ensuring meaningful public engagement of implementation changes that will emerge as a result of the Locality Plan

• • • • All health and care partners in Bolton are developing developing are partners in Bolton All health and care the through their knowledge and experience in co-design committed to: are We Co-design Enabling Group. Co-design is about listening to and acting on staff, Co-design is about to lived experiences the public’s service users’ and purpose, accessible fit for are develop services which Embedding the a positive experience. and provide planning and delivery of of co-design in the process care in person-centred services will result health and care with better outcomes. We need to ensure that our approach to change is open and values experiences, experiences, and values change is open to approach that our need to ensure We services. accessing local of those and the needs opinions expectations, 13. Co-design 13.

Bolton Inter Agency Forum Workforce Development Partnership Workforce Bolton Community Homes Partnership Bolton Together Bolton Together Information and Advice Forum Health and Care Together Forum Together Health and Care Forum Providers Prevention and Community Sector Forum Bolton Voluntary Carers Forum Carers Market Shaping Group Market Shaping Group Forum Provider Home Care Forum Learning Provider Disability Forum Provider Home Residential and Care Forum Public Health Provider Contact: Bolton Community Homes - [email protected] Contact: Bolton Community Homes • Contact: [email protected] • Contact: [email protected] • Contact: [email protected] • Contact: [email protected] • • • Contact: [email protected] • Contact: [email protected] • • • • • • for further details Contact: [email protected] Provider forums/groups Provider Appendix 1 Appendix

Intelligence based commissioning — based of the target demands needs and future on current using evidence based population and delivered interventions to meet service user needs. Healthwatch — is the independent consumer working to gather and champion in health and care, the views of people who use health and represent Healthwatch voices people’s Locally, services. care and providers feedback to service concerns and provides commissioners. — is about taking action to tackle a Early Intervention — is about taking action to tackle a started to develop though may that has already problem vulnerable adults at be in its early stages. Engaging with or delay their needs reduce an earlier stage to prevent, escalating. from Direct Payment — people assessed by the Council Direct a can decide to receive as being eligible for Social Care own care. Payment to allow them to organise their Direct Continuous improvement – is an ongoing effort to Continuous improvement to service or processes improvements make incremental constantly audited and modified are over time. Processes based on their effectiveness and sustainability. — adult social care includes — adult social care Adult Social Care of services or needs, provision assessment of people’s their to enable a person to purchase allocation of funds home care, residential and support. It includes own care of services, the provision personal assistants, day care, aids and adaptations. to assess the needs Commissioning — cyclical activity that will be and support for care of the local population to be designed, arranged by the Council/CCG. Services appropriate evaluated to ensure and monitored delivered, outcomes. Glossary Appendix 2 Appendix

want information to plan for their future carry out formal or informal caring duties and may carry out formal or informal caring duties support others to live independently have had a change in circumstances and are unsure unsure and are in circumstances have had a change they can access about what they need to do or where support are currently accessing some support services but accessing some support currently are change whose needs may ‘My Life in Bolton’ is an online resource that helps give ‘My Life in Bolton’ is an online resource over and control people in Bolton independence, choice of local services their own lives. It brings together details • • • • Whilst we know that people often look for information at people often look for information at Whilst we know that is no life, when an elderly relative ‘crisis’ points in their at home on their own for example, longer able to cope and and advice is much broader the need for information who: may include those The Local Directory The Local Appendix 3 Appendix

Alzheimer’s Society (2007) Dementia UK report Alzheimer’s www.alzheimers.org.uk/downloads/file/2/full_dementia_uk_report UK (2007) report Society Update to the Dementia Alzheimer’s www.alzheimers.org.uk/site/scripts/download_info.php?fileID=2323 Fund Better Care www.england.nhs.uk/ourwork/part-rel/transformation-fund/bcf-plan/ Strategy Bolton Carers www.bolton.gov.uk/website/pages/Carersinformationandservices.aspx Strategic Plan 2014-19 5 Year Bolton Clinical Commissioning Group www.boltonccg.nhs.uk/media/1105/5yearstrategicplan14-19.pdf Bolton CVS Funding portal www.boltoncvs.org.uk/funding Strategy Health and Wellbeing Bolton’s www.boltonshealthmatters.org/knowledgehub/bolton%E2%80%99s-health-wellbeing-strategy-2013-2016 development under – currently Bolton Housing Market Position Statement under development Bolton Housing Strategy – currently (JSNA) Bolton Joint Strategic Needs Assessment www.boltonshealthmatters.org/ Locality Plan Bolton 5 Year www.boltonccg.nhs.uk/media/3027/bolton-locality-plan.pdf Adults Board Bolton Safeguarding www.boltonsafeguardingadultsboard.org.uk/ Board Children’s Bolton Safeguarding www.boltonsafeguardingchildren.org.uk/ Commissioning Strategy Bolton Specialist Care www.bolton.gov.uk/sites/DocumentCentre/Documents/Specialist%20Care%20Commissioning%20Strategy%20 FINAL.pdf Development Partnership Bolton Workforce www.bolton.gov.uk/website/pages/Socialcarepartnerships.aspx 2014 Act Care www.legislation.gov.uk/ukpga/2014/23/contents/enacted/data.htm 2014: Fact Sheets Act Care www.gov.uk/government/publications/the-care-bill-factsheets • • • • • • • • • • • • • • • • • Useful links Useful Appendix 4 Appendix