Agenda item

For the Community and Wellbeing Scrutiny Committee to receive an update on Adult Day Care Services.

Lynette Gbedze (Market Oversight Manager, Brent Council) explained that there were 13 day opportunity providers in Brent, 2 of which were in-house. The Council were working closely with providers and had done since the start of the pandemic, staying very engaged with them. During the pandemic, day services had paused, but engagement with providers continued through meetings and forums, and the public health team had provided support and local guidance on how to manage infection in local services. Operations had to change as building based services were no longer possible, and day services adopted a creative approach to deliver services with a hybrid offer. This included virtual activities as well as activity packs sent to people in their homes, and providers had assisted service users with practical issues such as shopping and essential needs. Tiffany Adonis-French (Head of Services Access information and Long Term Support, Brent Council) highlighted that the face of day opportunities had changed nationally as a result of the pandemic. The model of delivery was changing everywhere and there were signs of that in Brent too.

The Chair thanked officers for the introduction and invited comments and questions from those present, with the following issues raised:

The Committee asked how easy it would be for a Brent resident, who may not know such services existed, to reach out and get onto the system for day opportunities. They highlighted that the figures in the report detailing total number of service users was quite low in light of the population of Brent. Tiffany Adonis-French advised that the Council were always taking steps to encourage accessibility and visibility of Adult Social Care services in Brent, working closely with community stakeholders and colleagues across the Integrated Care Board (ICB). Most referrals were received through the Brent Customer Service Centre, which was the main point of access for residents in the community. The Adult Social Care team also worked closely with GPs across the borough to encourage them to include information on access to Adult Social Care services in their practices.

Committee members highlighted table 3.3 of the report, which detailed support need figures for learning disabilities / mental health and asked why the 2 were combined. They felt the presentation of data could be interpreted as saying that Brent only provided services for those with learning disabilities if they also had a mental health need. Tiffany Adonis-French confirmed that they were separate, and there was a cohort of residents with a learning disability and a cohort of residents with mental health needs that were supported separately. She also recognised there were a number of residents who had a dual diagnosis of a learning disability and mental health need. It was agreed that the Committee would be provided with the figures for each cohort separately for a truer reflection.

In relation to performance, the Committee queried how that was measured at a personal level. Lynette Gbedze advised the Committee that the Community and Prevention Team within Commissioning did quality assurance work, where Placement Relationship Officers did reviews, quality checks, reviewed documentation and worked with providers for that level of assurance. There were monthly provider forums looking at a range of issues and social work teams who reviewed day centres. In relation to whether that quality assurance could be tangibly shown through performance data, Tiffany Adonis-French advised that the team wanted to look frequently at the number of people using services, the demographic characteristics of those users, where those users were accessing services and what type of service they were accessing, and the mode of service. The team were looking at a range of different data to tell the story about the level of uptake and quality to feed back into its commissioning intentions. Service user feedback had been gathered by the team which could be provided to the Committee.

Those present highlighted that there were a larger number of people accessing day opportunities pre-pandemic, acknowledging that day opportunity services may not necessarily be needed for life and those people may now be using other services and appearing in other data. However, they queried what plan had been put in place for those residents wanting a phased return following the pandemic. Phil Porter (Strategic Director Community Wellbeing, Brent Council) advised that there were a small group of people for whom Covid-19 was not over who had profound illness and would not be able to access building based services. The services were using technology to ensure those residents engaged. Lynette Gbedze explained that the phased reopening of services was initially done as a trial pilot where a very small number of people attended day services. The pilot focused on infection control and guidance which fed into how providers could open day centres fully and manage Covid-19. Day centres reopened officially in September 2021 with a business as usual approach. The number of service users had dropped but the model of delivery had changed to hybrid, with users attending virtual activities and activities in the community.

The Committee queried whether there was a care pathway for day opportunities that could be shared with the Committee. Tiffany Adonis-French advised that they were able to provide information about what the general customer journey might look like in Brent from the point of contact through to the process of assessment, support planning, service delivery and review. Brent used national guidelines for care pathways and residents did not access services based on their illness but based on the impact an illness had on their ability to carry out the activities of their daily life. In relation to the routes of raising awareness of services available, officers agreed to provide information on the effectiveness of different avenues of awareness.

The Committee queried whether the figures in table 3.3 in relation to support for people with learning disability included people with dyslexia or dyspraxia. They were advised that the numbers related only to those diagnosed with a learning disability from the mild to severe spectrum and would not include those with dyslexia as there were other services they would access.

The Chair thanked those present for their contributions and brought the discussion to an end. The Committee RESOLVED:

i)              To conduct a visit to day opportunity services.

Several information request had also been made during the course of the discussion, recorded as follows:

i)              For the Community and Wellbeing Scrutiny Committee to receive information on the care pathway to day opportunities.

ii)             For the Community and Wellbeing Scrutiny Committee to receive information on the effectiveness of different modes of raising awareness of services.

iii)           For the Community and Wellbeing Scrutiny Committee to receive the full figures of those service users with a learning disability and those with a mental health need who required support in section 3.3.