Agenda item

At the last meeting the committee asked to see the proposals that were being put forward to the Executive prior to the Executive meeting.

The Committee had before them the report from the Director of Housing and Community Care which set out the results of the consultation on the draft Day Opportunities Strategy which was a precursor to the transformation of buildings-based, directly provided adult social care with options and a recommended course of action. Alison Elliott (Assistant Director, Community Care) introduced the report and outlined the consultation process that had commenced following the decision of the Executive in July 2010. The aim was to provide services appropriate to the personalisation and choice agenda. Buildings could be closed in some areas with services re-provided in others.

Alison Elliott summarised views expressed by service users and carers who, while in favour of a more personalised service had concerns about the possibility of closure of any existing premises. They wanted to stay with their friends and there were feelings of vulnerability. The Assistant Director advised that option 4 was being recommended to the Executive, which involved and the increase of levels of independence by 30% and the sale of the day centres at Stonebridge and Strathcona with the new John Billam Resource centre providing for users from Albert Road Day Centre and ASPPECT, a provider of day services for adults with autistic spectrum disabilities, currently located on the Strathcona site. The new John Billam would be the buildings base for those assessed as in need. There would be significant savings given the need for less building space, staff and care staff.

The Assistant Director outlined the terms and implications of the other options that would be put to the Executive. Option one, involving no change from the present, requiring £150,000 investment to carry out repair works to the Stonebridge Day Centre which was currently underutilised. While this option was preferred by users and carers, it did not meet the personalisation agenda nor the draft day care strategy. Option two, to invest a further £850,000 approximately in Stonebridge to ensure it was fit for purpose, with the current service model in the same buildings. Current Stonebridge users would have to be relocated but there would be no increase in capacity. This option was supported by service users and carers. Option three was to retain the Strathcona Centre and to close Stonebridge. The Assistant Director advised that options one, two and three were supported by users and carers. Options one and two were not considered by officers to be aligned to the draft Day Opportunities Strategy and would have little or no impact on the levels of independence. A further option had been put forward by users and carers namely to use Millennium Day Centre for people with learning disabilities.

The Assistant Director emphasised that option four was dependent on thorough, independent and transparent assessments during which users could have present supporters of their choice. She acknowledged the lack of trust felt by carers and service users. In any event, there would be a regular review of service to give people the best level of care. Alison Elliott acknowledged that service users and carers wanted the service to improve however there was a difference of opinion as to how this could be achieved. She then referred members to the equality impact assessment that was appended to the report from the Director of Housing and Community Care and assured the meeting that people’s independent needs could be met, respecting individual choice and control. Staff would need to be consulted separately should the Executive agree option 4.

Members sought clarification of the number of places that would be available under each option and were advised that both Strathcona and Stonebridge Day centres have capacity for 130 each and currently have 69 and 39 users attending daily respectively. There was presently no additional demand and staffing levels had not been adjusted to the minimum required.

Ms Manek and Ms Rina Hirani addressed the meeting to set out how carers and service users perceived the consultation process. Ms Hirani stated that they had spoken to many carers and the widely held view was that the concerns they had expressed had only been noted and not taken into account. They sought information on the closure timetable and a full picture of what would replace it and how it would be delivered and they felt that the case studies presented as part of the consultation were irrelevant. At the first consultation meeting, the closure options had been greeted with shock, anger and suspicion. Service users and carers were concerned about the future of Strathcona Day Centre. They questioned the statistics presented and felt they should be taken in the context of the total number of potential users.

Ms Manek, also speaking on behalf of service users and carers put that the council was making an artificial link between the building base and the service. It should not be necessary to move carers to another building in order to achieve the service delivery objectives and value for money. It should be possible to make the Stonebridge Day Centre fit for purpose for less than the anticipated sum, or to only use part of the site and to do likewise at Strathcona. In this way users could have a base in both the north and south of the borough. Ms Manek stated that the financial business case made assumptions about the potential number of service users but it was the same people under consideration in all the options. Another factor raised by Ms Manek was the impact of the proposals on the health of carers who were becoming stressed at the thought of not being able to cope with the revised arrangements and some were considering putting their family members into care homes. This would result in additional costs to the tax payer. Finally Ms Manek expressed concern at the possibility of fair access criteria being revised and of current service users being significantly downgraded as a result of their reassessment.

In discussion, members asked questions concerning what would happen if following re-assessment it was not possible to increase the level of independence to 30%, the transparency of the assessment process and to comment on the perception that view service users and carers’ views had not been taken into account. The Director of Housing and Community Care, Martin Cheeseman, confirmed that should the level of independence not be achieved, he would be reporting back to members. The council had up until then to transform the service to be provided. Alison Elliott added that the council intended to involve carers in what would be transparent assessments and to support them. There was no wish to act quickly. Regarding views expressed the Assistant Director referred to the three waves of consultation and felt that the shock and emotions expressed during wave one had been reflected honestly in the report. The report had also made clear carers preferred options. The department had tried to present pen pictures of direct service provision and to have available people who received service in this way. She also confirmed that there was no intention to revise the eligibility criteria; those eligible would continue to have a service. Once complete, the indicative budget would be calculated and a support plan developed. At this stage, voluntary sector agencies could be involved. Service users would be given opportunities to try different types of service provision and respite care would continue to be available.

Members also questioned how long it would take to carry out all the assessments and the number of current users compared to the provision that would be available at the new John Billam site. The Assistant Director confirmed that one case manager was expected to carry out assessments for two persons in a day, on average, and that the process was expected to be completed by May 2011. Taking into account current users at the Albert Road Day Centre and ASPPECTS there were potentially 160 service users involved and places for only 60 at John Billam. The Assistant Director accepted that judgements of independence and support required would be crucial. Martin Cheeseman confirmed that once the new premises at John Billam were available, should it be found that more people required building based support, the Strathcona Centre could still be available and he would report back to the Executive. The committee noted that the buildings to be closed, Stonebridge and Albert Road day centres, were both in the south of the borough and the question was raised regarding the environmental impact of services users being transported to the north of borough. The Director pointed out that the introduction of themed day centres some years ago had increased transportation time but he agreed that the environmental impact could also considered.

Consideration was then given to alternative options of using parts the existing sites at Stonebridge and Strathcona, the Bridge Park centre or libraries. The Director advised that any premises used would need to be adapted and it would be difficult to sell part of a site.

From the feedback received the importance of being able to maintain friendship groups was accepted and the Director added that consideration could be given to developing support to allow them to meet in different ways and to also using the Millennium Centre as a base. He acknowledged that new users were likely to be able to be better placed to accept the use of new facilities and it was noted that the report to the Executive did indicate that option four was dependent on the outcome of assessments and having time for people to adjust.

Ms Manek then summarised the carers and service users’ comments on the consultation. She felt that while their concerns were captured in the report, they were not reflected in the recommendations. Ms Manek felt that places should be kept in case of emergency and reminded the meeting that the different needs of young and older people should be taken into account. She urged members to visit the families so they could more fully appreciate how they felt about the proposals.

RECOMMENDED:

(i)         that officers report back in the event of any problems in implementing the recommended option 4;

(ii)        that the Strathcona Centre be kept open as a safety net in the event of the projected number of service users being higher than anticipated as a result of the 30% projected percentage level of independence not being achieved following individual assessment.