Equity in experiences and outcomes

Understanding and reducing barriers to care and support and reducing inequalities

As highlighted in our Adult Social Care Strategy, diversity and inclusion are priority areas for us, but we recognise that we are on a journey to be able to fully realise our ambition in this area and move from an Equality Act compliance focus, to one which embodies inclusion and truly person-centred services and support. It is a key focus in our improvement programme and one of the key principles we consider when looking at service design.

We have developed a strong approach to co-production which acts as a building block for work in this area. This aspect of our approach is described in more detail in the summary section. To tackle inequalities, through the JSNA we are able to understand groups at a higher risk of poorer health outcomes including those with high vulnerability such as people with severe mental illness, children in care and care leavers and homeless/people with multiple complex needs. Through public health data profiles we are able to understand the demography of those in West Sussex with protected characteristics, other groups and the wider determinants including education, employment, environment and housing which have an impact on health. In terms of inequalities, there is a six year gap between the life expectancy between the most deprived and least deprived areas of the County. Cardiovascular disease remains the biggest cause of the gap.

Inclusion and accessibility arrangements

We have been working with partners to create a more complete data set, cut by both population group and place-based Integrated Care Board (ICB) data.

We have set up a dedicated service wide equality, diversity and inclusion advisory group which is chaired by the Director of Adults and Health. This group engages with several different customer engagement groups for example our Partnership Boards.

There are regular EDI (equality, diversity, and inclusion) thematic practice focus sessions for frontline staff and managers, focused on improving practice. In 2023 we rolled out reflective EDI sessions across adult social care. These are held monthly by all Service Managers and Team Managers and are cascaded across teams. Feedback from staff about these sessions has been extremely positive. Identified actions are fed back to the leadership team to be included in future planning cycles. We are starting to explore EDI within the workforce through the Local Government Association (LGA) Diverse by Design toolkit and will use some of the Skills for Care Workforce Race Equality Standard metrics to benchmark where we are now and to measure the impact of our initiatives and changes.  Our current focus is to enhance our understanding and develop actions to support us as a diverse and inclusive employer. 

Staff survey feedback identified feelings that the service should focus more on celebrating diversity, understanding and acknowledging the experiences and inequalities of diverse customer groups and staff, and explaining how the service is working to address those inequalities. Staff also fed back that there were some positive accounts of individual practice and team approaches, but a lack of resources, community services, and culturally competent services impacted the provision of person-centred support for people from diverse communities.

We are working to use Equality Impact Assessments as part of our broader learning or service design. Broadening their use, scope and associated learning is a focus within our improvement programme. Inclusion is a design principle for all elements of the improvement programme and ensures that we regularly review the impact of service developments as they progress throughout a customer’s journey, not just as they begin it.

We want to build on examples of effective and/or innovative practice, both locally and nationally. Notable successes for us have been the development of our Changing Futures programme, which is led and hosted by West Sussex, a pan Sussex Ministry of Housing, Communities and Local Government (MHCLG) funded project aiming to support people with the most complex needs. We want to take the learning from the Changing Futures into our own wider improvement programme.

Aligning to the corporate and directorate action plans, both our Executive Leadership Team (ELT) and our Directorate Leadership Team (DLT) regularly receive data about our performance in this area. An important element of this will be customer experience to improve our person-centred approach.

We are compliant with the Accessible Information Standard  (AIS) which sets out the actions we must take to enable people to fully participate in decisions about their care and support, for example, providing communication professionals such as BSL translators, and making information available in easy read, large print and audio as necessary. We also ensure people can access our services via different channels such as email, phone, postal address and these options are promoted on all our information literature and online. We will also translate key forms and information into other languages as necessary, although this is not covered by the AIS. We have a translation and interpretation service  (managed by East Sussex County Council) which staff can access to book interpreters, translators and written word translations. 

All our consultation activity on service change and development is subject to a rigorous research governance/quality assurance process which includes ensuring that we remove any barriers to participation by those impacted by proposals. This is underpinned by a comprehensive Equality Impact Assessment (EIA) leading to research methodologies tailored to target groups.

Our websites comply with online accessibility regulations and our West Sussex Connect to Support website, which supports people to live healthy and independent lives, enables people to translate content into other languages, increase font size, and adjust contrast.  The Shaw Trust, which works with central and local government bodies to support them to create an accessible environment for their staff and customers, sets a very high bar for online accessibility. The county council’s main website is accredited by the Trust and we are currently working through some minor adjustments to the Connect to Support website following their feedback.  

We provide an extensive range of accessible information and advice in a variety of formats. This comprises a range of leaflets and booklets, health and wellbeing information (see channels below), and information about how to get adult social care support. Our key information publications have the Plain English Campaign's Crystal Mark for clarity and are available in easy read as a matter of course and in audio and large print on request. We will translate into other languages if necessary.

Our internal staff communication channels are fully accessible for colleagues using screen readers and any videos are created with subtitles. Staff events, such as the recent service-wide conference in April 2024, are planned with accessibility and inclusion in mind. For example, venue selection, the provision of BSL translators and a dedicated prayer room.