KIRKLEES COUNCIL – WRITTEN EVIDENCE (PSR0010)
Introduction
Kirklees Council is a unitary metropolitan borough in West Yorkshire. Our vision for Kirklees is to be a district which combines a strong, sustainable economy with a great quality of life - leading to thriving communities, growing businesses, high prosperity and low inequality where people enjoy better health throughout their lives.
We know that the impact of the pandemic will affect different residents more profoundly. We are committed to tackling inequalities head on through our Covid 19 recovery planning, with a focus on empathising with people who have been affected by both the pandemic and longer term factors.
And we are committed to working collaboratively with people and partners – building relationships and communicating effectively. Individuals and communities in every part of Kirklees have stepped up to support each other in the initial response to the crisis. It has highlighted the wealth of community spirit and social capital in Kirklees and shows we must continue to strengthen our place-based approach, to work with people and communities and understand how services can be shaped by the people who use them. Members’ community leadership role has never been more important in delivering this strengthened relationship between the council and the people it serves. Equally, we must learn from the cooperation that has taken place across sectors over recent months to share practices, ideas and resources and build new relationships within Kirklees, regionally and nationally.
It is that focus on tackling inequalities and developing ways of working across systems and with partners in a place based way that has encouraged us to respond to this inquiry.
Summary
8. Have inequalities worsened during lockdown? Were groups with protected characteristics (for example, people living in areas of deprivation or BME groups) less able to access the services that they need during lockdown?
9. Are there lessons to be learnt for reducing inequalities from the new approaches adopted by services during the Covid-19 outbreak?
15. Are you able to provide examples of public services collaborating in new ways with the voluntary sector as a result of the Covid-19 outbreak?
16. How might charities and community groups be better integrated into local systems in the future?
18. Can you provide any examples of how effectively a ‘place-based approach’ to delivering services has performed during the Covid-19 outbreak?
Detailed response
7. Have public services been effective in identifying and meeting the needs of vulnerable groups during the Covid-19 outbreak? For example, were services able to identify vulnerable children during lockdown to ensure that they were attending school or receiving support from statutory services? How have adults with complex needs been supported?
Our Community Response approach to Covid-19 has been focused on vulnerable groups, targeting those already known to us as well as reaching out to citizens who may not have previously been engaged with our services.
Our partnership approach with schools, communities, health and other statutory partners has meant vulnerable children were easily identified. All cases were risk assessed, ensuring those at most risk or vulnerability are given priority. Links to schools have ensured that those who were attending during lockdown from disadvantaged backgrounds have been connected to appropriate statutory services.
Individual Risk Assessments for all vulnerable children, including those with EHCP in relation to them being in education, have been undertaken, attendance at school has improved and we continue to encourage parents and carers to support children and young people to attend school.
The Risk Assessments are being supported through a Community Hub model, with additional teams supporting children and young people outside the model ensuring we are sighted on all vulnerable children. While Covid-19 has meant we have had to deliver some services differently e.g. Initial Child Protection Conferences, robust business continuity plans have meant we have been able to maintain business as usual across all aspects of Children’s safeguarding.
Our adult services have maintained levels of support for adults with complex needs, as have the services which we commission from independent sector providers. We have not used the Care Act easements.
Some adults with complex needs will be those on the shielded patient list (SPL). We are monitoring how many people on the SPL have been contacted by national and local support teams and received help with food or medical supplies and we know how many people on the SPL have also been supported via the community response. We have built a prioritisation process into our response to people on the SPL based on issues known or likely to increase vulnerability (such as living alone, having mental health or substance misuse issues).
Wide ranging communications have been sent out internally and externally to encourage anyone experiencing domestic abuse to seek help (including men). Close liaison with commissioned provider services has also enabled continuous support for victims of domestic abuse. Operation Encompass (DA notifications into schools) have continued and all processes to protect vulnerable, high risk individuals and families have operated remotely (ie. MARAC).
Our Rough Sleeping workers also continued to provide outreach. As a result of this approach, all but one verified rough sleeper have been accommodated and provided with intensive support by the council to enable them to sustain this accommodation. The one individual who has refused accommodation (due to lifestyle choice) has continued to be supported through outreach engagement.
Asylum Seekers are a vulnerable group in Kirklees. Information sharing between the Home Office and Council has been problematic during COVID19. As a result, there are a number of families that the Council’s Education Safeguarding Team have not been aware of. This has meant the council has not been able to provide welfare check phone calls, enable support to ensure free school meals are in place and the family can understand how to use them (digital inclusion and language barriers are issues), or provide support for families around digital inclusion to ensure children could be involved in home learning.
With regards to adult asylum seekers we have only been able to make welfare check calls to those known to us via a Welcome Mentor programme and English language support. To try and mitigate this issue we have posted translated information to every household on the support available in Kirklees at this time.
Our adult services have maintained levels of support for adults with complex needs, as have the services which we commission from independent sector providers. We have not used the Care Act easements.
We monitor the profile of those we contact by certain equality categories and analyse it weekly to see if any specific trends or issues need to be addressed. We have commissioned our local university (The University of Huddersfield) to undertake a qualitative study on the health impact on BAME communities and men, and why they are more at risk, incorporating behavioural factors into the approach.
We are developing a suite of indicators that will provide us with a clearer overview of how demands on services (e.g. CSC, ASC, Mental Health) have changed during the pandemic and how many people may be at increased risk directly and indirectly from C19 and its wider impacts.
8. Have inequalities worsened during lockdown? Were groups with protected characteristics (for example, people living in areas of deprivation or BME groups) less able to access the services that they need during lockdown?
It is too early to say in totality at a local level in terms of hard data and intelligence. However, it can be strongly argued that it is exacerbating pre-existing structural inequalities in our society. For example, there has been greater demand for support to access food in areas of greater deprivation.
At the beginning of our response to Covid-19 the council carried out a brief tabletop health needs assessment which was used in inform high level planning. While we are yet to have any collated data to quantify the impact of Covid-19 across the social gradient it is clear the outbreak will serve to widen inequalities in terms of access to food and services more generally – both because of families’ financial positions and ability to access less traditional service provision channels (e.g. online and pop up).
For asylum seeking families and individuals, it is clear things have been worse during the Covid-19 outbreak. This has been particularly true for individuals who have No Recourse to Public Funds (NRPF)[1], who for a range of reasons, have been more vulnerable during this time. This community’s reliance on attending voluntary groups and organisations for support – for help understanding what is happening with their asylum claim, or a place to go to have company and a meal during the week – has meant the impact of lockdown has been very negative. Kirklees Council’s community response has responded to those who we have been aware of that needed help, providing support via our partnership with the Mutual Aid Groups, such as food and other essential items as needed.
Being able to communicate key messages to those whose first language is not English is always important but at a time of crisis is even more so. Work has taken place to translate key information that staff can share with those they are supporting. Examples of support materials which have been translated include: Covid-19 specific social distancing guidance, to support work in communities and town centres; information on free school meals and the process; support available for migrants in Kirklees; and information on domestic abuse and where to access support at this time. In Kirklees we translate information in to the top 11 community languages.
There have also been concerns about the outbreak resulting in a reduction in involvement of individuals and their families in managing their care. For example, there have been concerns locally about ‘do not resuscitate’ notices being put on the records of vulnerable adults (including people with a learning disability and older people) living in care homes without the active involvement and therefore consent of the individual or their family if they lack capacity. Similarly, concerns have been raised about negative impacts on people’s ability to access health services, where they have been moved to ‘Covid free’ sites without due regard to their ability, or willingness, to access these new locations.
We have some (limited) data on the protected characteristics of people requesting help via the community response offer. Using the ONS recommended definition of disabled we can identify the proportion of requests for help coming for disabled people and it is large (62% of those who responded) compared with a national estimate of 1 in 5 people who are disabled. It will be important to explore this data in the context of national evidence on the impact of C19 on disabled people from the ONS.
In addition to the immediate health impact of the covid-19 breakout, we are also expecting to see ‘health debt’ caused by the closure of ordinary care pathways, which then cause access to care to be delayed and therefore chance of early diagnosis and treatment to be reduced. This has the potential to aggravate the existing situation for those communities already less likely to engage early with standard care pathways for behavioural, cultural, or other socio-economic reasons.
Particular attention will need to be paid to reducing inequalities as services start back up (for example, screening and immunisation) to make sure that catch up sessions are targeted at the right communities. Those in more manual occupations are less likely to be able to work from home, observe social distancing and therefore be at greater risk as lockdown reduces.
The geography of service provision will need careful consideration as services reopen and/or are relocated as part of a covid-19 response. As any relocation of services as part of a redesign process could have unintended consequences in relation to access inequalities, especially for those disadvantaged groups who rely on public transport or support from others to travel.
Like ‘health debt’, the economic gap is expected to widen as individuals in disadvantaged situations are likely to be ‘at the back of the queue’ when the job market starts to pick up post-covid. During the covid-19 outbreak we have already seen disparities in financial support provided to vulnerable groups. For example, Universal Credit has been increased by £20 since the lockdown to pay for the extra costs of the pandemic, but millions of disabled people on older out-of-work benefits such as the employment and support allowance (ESA) will not receive the extra financial support. A survey by the Disability Consortium found nine out of 10 disabled people are struggling with additional food costs, with others unable to pay for medicine collections or their rising utility bills as they shield at home.
Access to accommodation has also been affected by lockdown, with house moves postponed and lettings suspended. As a result, disadvantaged groups have been in housed in temporary accommodation, which is unlikely to be wholly appropriate to their needs, for longer than normal. We also have concerns locally about the potential impact on disadvantaged groups when the rules are lifted which current prevent landlords from evicting tenants, as this is expected to create an increase in homelessness.
A key issue (which pre-dates Covid-19) is gaps in data and intelligence to understand inequalities e.g. ethnic group data not included in SPL data from CCGs. Longer term we will be able to monitor and assess impacts and outcomes across protected characteristics via our programme of local population surveys (adults and CYP) which provide us with valuable population indicators on a regular basis to monitor and understand local inequalities, as well as educational attainment data, etc. There needs to be a system-wide commitment to understanding inequalities across the whole population and much of this is dependent on efficient and effective data sharing.
9. Are there lessons to be learnt for reducing inequalities from the new approaches adopted by services during the Covid-19 outbreak?
A fundamental issue which the covid-19 pandemic has brought into a new light is the intersectionality of inequality - the complex overlaps between different communities and the inequalities faced by people living with a range of socio-economic, health, gender, sexuality, race and disability issues – and therefore the need for a holistic and collaborative approach to tackling them. We are applying this lesson by refocusing on the equalities gap and embedding tackling inequalities at the centre of our Kirklees Recovery Plan.
The Covid-19 crisis has also raised the profile of health inequality beyond the health and social care system, creating further drivers for integration across the wider public sector and coordinated responses from organisations, in both their capacity as a local leaders and employers.
The outbreak has magnified the wide ranging poverty and digital inequalities that exist in our communities and how these are real barriers for some households during this period when connectivity has been essential for communication, education, public safety news and the ability to access basic essentials such as food. There are lessons to be learnt from the joined-up system approach taken to mobilise a response to address inequalities, that could have a significant impact on outcomes if sustained.
In Kirklees, we have been at the hearts of our communities and have learnt about them, with them and improved our channels of communication – both directly and through our third sector partners. For example, the development of better web-based and digital platforms has played a key part of our approach to encouraging victims of domestic abuse to seek help.
We have also worked to improve our translation capabilities in order to support people for whom English is not their first language. This has been important for our work supporting asylum seekers and migrants, as well as our resident communities. It can still be problematic translating into some community languages and providing a speedy, efficient translation service, so this will need to be an area of focus going forward.
The scale of the pandemic has required us to take a much more devolved / delegated approach to tackling inequalities. For example, empowering local mutual aid groups, and staff-led task and finish groups to develop and implement solutions on behalf of wider groups of people.
We need to engage with communities more proactively and moving forward reducing inequalities will be even more explicitly incorporated into our engagement and recovery planning for the economy and public health.
Our approach to utilising community assets will need further review and revisiting based on the lessons we have learnt so far and in recognition of the ongoing impact of the pandemic. For example, how we look to tackle digital inequalities through provision of access to technology infrastructure, equipment and support.
The need to consider the impact of inequalities on our staff, as well as our communities, has also been brought to the fore by the Covid-19 outbreak. As a result, Kirklees Council has been working across the council to align community and employee facing support, and coordinating with partners to support staff in vulnerable groups.
The importance of data, and data sharing, has also been highlighted during the crisis. For example, we have recognised the need to establish an internal system for how we record information on all asylum seeking families and individuals in Kirklees which can build on our newly agreed data sharing arrangement with the Home Office, and how current ‘teething problems’ can be addressed (e.g. missing data on children and family members households where information was only made available on the main applicant).
Data sharing from organisations such as PHE and DHSC has been wholly inadequate. Local areas have been left with significant gaps in the local intelligence required to proactively respond to the outbreak. The lack of data on testing, particularly Pillar 2, has left local areas with no mechanism for monitoring the number of confirmed cases of Covid-19. This area continues to be problematic with very little data flowing from PHE and DHSC that would enable the local authority to monitor and identify local outbreaks.
Data required for understanding deaths has been problematic. Local arrangements that have been put in place to try and address the gaps in national data sharing have required lengthy manual data cleansing processes.
A revised approach to Data Protection Impact Assessment (DPIA) was implemented locally to enable new data flows to be established quickly while still being compliant with GDPR. There are some examples of quick and effective data sharing between the council and CCGs to respond to the urgent needs of shielded patients. However this has gaps and much of the data needed to understand inequalities was not provided by primary care.
Data sharing between individual NHS Trusts and the council has been difficult historically. However, this has improved during the pandemic with data flows between local NHS Trusts and the Council established.
15. Are you able to provide examples of public services collaborating in new ways with the voluntary sector as a result of the Covid-19 outbreak?
The Council set up its community response based on the four Early Intervention and Prevention hub footprints (Dewsbury and Mirfield, Batley and Spen, Huddersfield, Kirklees Rural) with a multi-disciplinary team in each hub. The hubs worked with VCS Anchors – nine local community organisations leading the response in their areas, covering the whole district. The local Anchor groups worked with the more local neighbourhood mutual aid groups. Councillors worked within their individual wards and across ward boundaries to ensure local support was relevant to how people live and not just administrative boundaries.
We are working in partnership with the VCS, locally organised groups and individual volunteers to provide relevant and proportionate support for people. Where the Council receives requests for support directly, we assess what is needed and hold onto those things that only the Council can do, wherever possible passing support requests to VCS anchors and mutual aid groups. This enables us to provide a response that balances a centralised offer with local neighbourhood support from trusted networks and individuals. Support, coordination and information sharing at a community level helps ensure supplies, support and information are where they need to be.
A semi-independent organisation has helped to hold the middle space by hosting a learning and sharing space for local community and mutual aid groups providing links and direct communication routes with the Council and VCS. This has helped the Council to listen to what communities need from us and how we can provide participatory leadership rather than controlling the response.
A community response website has been created and used as a basis for ensuring all relevant information and support in in one pace and is shareable across digital and social media platforms. This is hosted away from the Council’s main web-space and is owned jointly with the VCS.
We have provided online dynamic mapping of local support and resources which the VCS and community groups can access to understand what is available and how best the local system can respond to need.
We have developed food pathways in partnership with the VCS that bring our resources to support them in a co-ordinated and responsive way. We have used our market supply chain to provide food to food banks and individuals using local capacity to deliver. We are now working with the three large local foodbanks to set up a network where they can help and support smaller local foodbanks and food provision to develop in a coordinated and safe way.
Early signs of growing financial pressure are flagged through regular meetings with the Local Job Centre Plus and Department for Work and Pensions Link worker, allowing us to prepare local welfare services for increased demand.
Our existing grant/funding approaches have been amended to support the response to Covid-19 and to support essential activity needed to enable VCS organisations to continue to function, this includes more rapid responses to applications. Councillors have been provided with specific Covid Ward budgets in order to allow them to proactively and visibly provide community leadership to the citizens they represent.
Additional support for foster carers and children with complex needs has included collaborating with voluntary sector organisations to provide 1:1 support to children who can’t access their usual activities or take exercise etc because of shielding (for themselves or the wider household). This can be online, over the phone, or a socially distanced 1:1 session outdoors. It provides a contact, some informal learning and fun for the child, and a short break for carers. This has been led by the Kirklees Youth Alliance network. The KYA is an umbrella organisation for community groups providing positive activities for young people across Kirklees which was created by a partnership of third sector organisations to develop a new model of youth provision that could plug the gaps left by a reduction in the council’s youth services.
Kirklees Active Leisure staff – who would otherwise be furloughed - are providing additional capacity for residential settings to provide children looked after with enrichment sessions.
For the Children and Young People’s Partnership - we quickly developed an online staff awareness and training offer to support any partners’ staff / volunteers to become more aware and confident in tackling homophobia / transphobia and improving LGBT+ young people’s inclusion and outcomes. Run in partnership with Brunswick Centre and supported by the BASE, Northorpe Hall and KYA – it delivered four online workshops.
A Kirklees COVID Home Visiting (CoHoRT) service was established offering a same-day service for housebound patients of all ages that are symptomatic, have Covid-19 or live within someone who does and need face-to-face support. CoHoRT services are managed by the Kirklees GP Federations and work alongside our COVID Clinical Assessment Centre operations. Running these services together meant we could ensure appropriate workloads, equipment and clinical oversight/support. MyHealthHuddersfield (Greater Huddersfield) and CURO (North Kirklees) have coordinated both staffing and activity on the CoHoRT service. This has been supported by the mutual aid offer of 100 hours per week of our Community Services provider, Locala, staff across both services. Our local COVID Clinical Assessment Centres offer Kirklees residents face to face consultations for COVID symptomatic patients in designated facilities – one in Huddersfield and one in Dewsbury.
We have been working with the mental health ‘Working Together Better Partnership’ on a weekly basis since the lockdown period. There have been some good collaborative initiatives and sharing of information, one being the ‘Wellness Packs’ developed by Support 2 Recovery (S2R) and including items from all services in the partnership. We have agreed to fund continuation and translation of these.
Supporting people with autism, we ran a completely on-line annual autism show. This was something never done before, with or without Covid-19!
We are working with VCS providers on alternatives to care including Community Catalysts micro-enterprise and local cooperatives, and this has been accelerated because of interest and awareness raised through Covid-19. The direct relationships and trust have enabled people to engage and think differently about this provision and accelerate new ways of working.
16. How might charities and community groups be better integrated into local systems in the future?
There is a lot we can learn from the response to Covid-19 and we need to start that learning now to inform future models.
We will think about how we design community-based services to be led by those who have a relationship with the individual. Services need to be enabling and wrapped around people in the right way to support where they are in their lives, and this is often best led by those with whom they have a trusted relationship. As an example, mutual aid volunteers have developed relationships with people when delivering food or medication and we need to help them to draw in support from the VCS and statutory sector rather than referring people on to multiple independently administered services. Community coordination needs to be exactly that - a system that recognises what support people need and how and where they get it locally, not a top-down, centrally administered system.
We will use the data and intelligence that has been gathered through the community response to C19 to help address structural inequalities and shift to effective targeting. This needs to be a system wide effort as the full extent of need, capacity and support is not visible to the Council and the VCS and community groups hold a large part of the picture. We need to develop an approach to shared data, metrics and accountability that helps everyone to understand their contribution to achieving outcomes to help us to design appropriate local solutions.
We need to understand how local and national funding system can be redesigned to support the VCS and communities. At a Council level that might include building on our focus on outcomes rather than service delivery. We also need to look at how funding to the VCS might be provided in an unrestricted way to support core costs rather than just being based on the services delivered or the results seemingly achieved. Third sector organisations that have become financially sustainable through income-generation are at risk of collapsing if their income falls through the crisis and changes to how we fund in future could help to reduce this risk.
Local authority commissioning rules should be flexible enough to support local community organisations. We will re-evaluate our approach to procurement and commissioning to facilitate commissions that have the greatest local impact and to understand the social value of our investment decisions.
18. Can you provide any examples of how effectively a ‘place-based approach’ to delivering services has performed during the Covid-19 outbreak?
Providing services that are focused on individual needs and delivered locally has been effective.
Delivery through local trusted networks and individuals has helped to personalise the services and support people receive.
Service delivery being provided by the whole system has helped to ensure that everyone who needs it receives support. There are individuals who would not have accessed support/services if it had only been provided by the Council as they can be fearful of the results of being visible to the Council or the stigma of needing help. Community groups can offer help in a way that the Council cannot and use local knowledge to identify those in need.
Service delivery spread across different groups, working to different geographical footprints has helped us all to work in a more systemic way and to assume appropriate roles. The Council, working to a four hub footprint, was able to focus on strategic coordination, the VCS were able to build on this coordination and mobilise more local support and that fed into more hyper-local on the ground delivery through mutual aid and local community and neighbourhood groups.
The capacity gained from individual volunteers (over 1000) who have stepped forward and offered their time and skills to help, and taken on a raft of roles, has contributed to making the wider system work in a speedy way, while keeping a local focus.
Neighbourhoods have very quickly identified their local assets, mobilised them, and in doing so created the capacity and capability to deliver.
The value of the voluntary sector and their ability to quickly change to adapt to arising situations cannot be underestimated and better links could improve this. We are looking at this along with CCG colleagues through the development of a ‘Mental Health Alliance’.
[1] No recourse to public funds (NRPF) is a standard condition applied to those staying here with a temporary immigration status to protect public funds. Indefinite Leave to Remain (ILR) is set as the general threshold for permitting migrants to access public funds. Migrants who are here without leave are also subject to no recourse to public funds. Therefore, most migrants do not have access to public funds as a matter of course.