Decision details

The scope of the Adult Social Care Change Programme includes delivery of approved budget savings, designing the new model for Social Care and implementing the changes associated with the Care Act. This report will update Cabinet on the outcome of the Remodelling of Day Opportunities consultation and seek approval for associated planned activity. In addition to this the report will ask Cabinet to consider required changes associated with the Care Act 2014 such as the Deferred Payment Scheme.

The Cabinet heard representations from Lindsay Scottwho had submitted a petition containing 2,028 signatures on behalf of the Friends of Brookdale which stated:

 

“Our campaign is to challenge the proposed closure of the Brookdale Resource Centre in Ainsdale. We need the Council and MP’s to listen and work out a way to keep this centre open.”

 

The Cabinet also heard representations from Mrs Margaret Mathieson who had submitted a petition containing 27 signatures on behalf of a deputation which states:

 

“We ask that the Elected Members investigate the administrative process in order to ensure that both the monitoring and scrutinisation of the outcomes of the questionnaire relating to the remodelling of the day services provision is truly representative of the recipients.”

 

 The Cabinet then considered the report of the Director of Older People which provided details of the outcome of the Remodelling of Day Opportunities consultation and sought approval for associated planned activity. The report also detailed the required changes associated with the Care Act 2014.

 

The Director of Older People referred to the following key issues, with regard to the proposals set out in the report:

 

1.         The Health and Wellbeing Strategy for 2013 - 2018 sought the provision of care facilities and services closer to the home of the service user, through the use of direct payments, which allowed great choice and control on the use of facilities and services.

 

2.         The Sefton Strategic Needs Assessment (SSNA) indicated a decline in the number of people using day centres. More people were using personal budgets and the direct payments system to improve their choice and control. The latest data in the SSNA indicated that the average unit cost in 2012/13 was £193, which was 45% higher than the average Metropolitan Authority and represented a 14% increase on 2010/11. 

 

3.         The day care provision provided by the Council had steadily declined over the last three years. He stated that this trend was a national one with average attendance numbers falling by 28% between 2011/12 and 2013/14.

 

4.         The majority of day care facilities in the Borough were in need of significant repair and maintenance. The facilities needed to be modernised and re-modelled to accommodate people with highly complexed needs in order to provide a more efficient and effective service.

 

5.         The consultation process had been agreed by the Public Consultation and Engagement Panel and the Cabinet Member – Older People and Health. Since July 2014, he had met monthly with a wide range of voluntary organisations, User Groups and Advocacy Organisations to discuss a wide range of issues as set out in the report.

 

6.         The first stage of the consultation had been held in October 2014 to discuss the vision, the provision of activities and transport provision. The second stage had commenced at the end of November 2014 on the various options for the two year programme of modernisation after taking into account the responses to the first stage consultation.

 

7.         404 responses to the second stage consultation were received, of which 302 were from service users or carers and a dip analysis was undertaken to ensure probity. As a result of the consultation responses, a number of changes were proposed which included Brookdale Resource Centre remaining open; Chase Heys day centre closing, but the other provision for intermediate care and respite care at Chase Heys would remain unaffected and Mornington Road would become a centre of excellence for people with complex needs with physical and learning disabilities, as set out in paragraph 2.19 of the report;

 

Members of the Cabinet raised questions on the following issues referred to during the representations made by the Lead Petitioners and in the report and the Director responded to the issues as indicated below:

 

An increased number of people appear to be using personal budgets – what are the alternative service options available to service users?   Response: In addition to the use of day centres, service users can use personal budgets to provide assistance with their day to day living and access to leisure activities and training opportunities and the direct payments system allows greater choice on service provision.

How will the assisted transport policy be refreshed to meet the needs of service users?   Response: The transport needs of service users would be reviewed and reassessed based on their personal needs and circumstances to ensure that they have access to day centres.

How will we move forward on the consultation on the programme of modernisation?   Response: A commitment has been given that all service users, stakeholders and staff would be consulted and engaged on the design and modernisation of the day centres.

How will we communicate the decision taken by the Cabinet to all of the service users to remove any uncertainty?   Response: All service users would be advised of the Cabinet decision, given an assurance that their individual needs and circumstances would be reviewed and reassessed by a new team of Social Workers to be established and be offered the use of Advocacy services, where appropriate. They will also be informed of the proposals for the modernisation of day centres and their views will be sought in the coming months. Information would be provided on the Council’s website; and Sefton New Directions, other private service providers and all of the organisations involved in the consultation process would be informed of the Cabinet decision.

 

The Cabinet Member - Older People and Health indicated that the provision of day care facilities had to be re-modelled in view of the poor state of repair of some centres, the need for modernised facilities, the falling attendances at day centres and service users using alternative services. He reiterated that the Council had been fully committed to engaging with all service users and other stakeholder groups on the consultation process and refuted the view made by some people that “the decision was already made” and indicated that the changes to the proposals consulted upon for the Brookdale Resource Centre and Chase Heys day centre demonstrated that was not the case.

 

The Cabinet Member also referred to the organisations involved in the consultation process listed on page 28 of the report and the positive comments he had received from them on the process undertaken. He indicated that the Council was fully committed to the “Challenge on Dementia” and a Dementia Strategy would be submitted for approval in the near future.

 

The Chair commented that the consultation exercise had reflected that there was a wide range of needs by service users and a different provision of services was required by people who do not want to use day centres. The report set out proposals for a programme of modernisation to a reduced day centre estate based on the models of support described in the report. He gave an assurance that the Council would continue to listen to the views of service users during the forthcoming consultation on the re-modelling of the service provision at day centres.

 

Decision Made:

 

That:

 

(1)       the petitions be noted and the petitioners be thanked for their contributions;

 

(2)       it be noted that the current understanding of assessed needs; the forecasted demographic changes, the current and forecast usage rates and the usability and sustainability of the New Direction Day Centres had been considered and taken into account;

 

(3)       it be noted that the detail within the consultation feedback set out in  Annex A in respect of day care and transport together with the Public Sector Equality Duty analysis report set out in Annex B of the report had been considered and taken into account;

 

(4)       the risks and the mitigating actions identified be

           noted;

 

(5)       approval be given to the progression to a modernised but reduced day centre estate based on the models of support described in the report;

 

(6)       approval be given to the closures and modernisation as described in paragraphs 2.8 to 2.10 of the report and Officers be authorised to implement the plan immediately;

 

(7)       the intention to engage further with the users and all interested parties of the Chase Heys Day Centre be noted;

 

(8)       the refreshed Assisted Transport policy set out in Annex C of the report be approved for implementation with effect from 1April 2015;

 

(9)       the potential impact of the programme of modernisation on the Specialist Transport Unit be noted and Officers be authorised to implement the programme in line with the plan including the issue of relevant statutory and contractual notifications, if appropriate to achieve change; and

 

(10)     it be noted that the financial and other risks to the Council had been considered and taken into account.

 

Reasons for Decision:

 

The Council had significant existing responsibilities for Adult Social Care (ASC) and invested considerable resources (£92 million per annum) into this service. The Adult Social Care Change Programme’s overall aim was to develop a model for Sefton Council’s Adult Social Care that was sustainable, modern and flexible, delivering the four strategic priorities as set out in the ASC Strategic Plan 2013-20 as approved in November 2013, and the delivery of the changes associated with the Care Act 2014.

 

In developing future plans against a background of reducing resources the core purpose of the Council was assumed to be

 

•      Protect the most vulnerablei.e. those people who have complex care needs with no capacity to care for themselves and no other networks to support them.

•      Commission and provide core serviceswhich meet the defined needs of communities and which are not and cannot be duplicated elsewhere.

•      Enable/facilitate economic prosperity i.e. maximise the potential for people within Sefton to be financially sustainable through employment/benefit entitlement.

•      Facilitate confident and resilient communities which are less reliant on public sector support and which have well developed and effective social support networks.

 

In February 2013, the Council approved a proposal to remodel day opportunities so that in the future opportunities would be shaped by how best to meet assessed eligible needs and made more appropriate to people who use them. The proposed programme of modernisation had been developed by taking account of the current understanding of assessed needs, the forecasted demographic changes, current and forecast usage rates and the usability and sustainability of the New Direction day centres.  In addition to this the feedback from both phases of the consultation and impact assessment had informed the decision.

 

The Cabinet took in to account the following principles

 

•      Efficiency before cuts – Protect the impact on communities

•      Focus on our core purpose.

•      Keep the needs of our citizens at the heartof what we do rather than think and act organisationally.

•      Proactively manage demand not just supply.

•      Ensure we provide services strictly in line with eligibility criteria.

•      Pursue growth/investment as well as savings.

•      Communicate and engage with people to expect and need less

 

New requirements, duties and responsibilities associated with the Care Act 2014 would be designed, developed and implemented from April 2015 with full implementation planned for April 2016. In the light of the timescale, breadth of changes and associated risks, it was important that the Council prepared for implementation despite of the lack of clarity about some of the key features.

 

Alternative Options Considered and Rejected:

 

The proposed programme to deliver the modernisation of day opportunities was based on the current understanding of assessed eligible needs, forecasted demographic changes, the impact assessment, feedback from both phases of the consultation, the current and forecast usage rates and the usability and sustainability of the New Directions (ND) day centres. The ND day centre buildings require in the region of £2.7m capital expenditure to maintain them and incur significant general operating costs.

 

Maintaining the status quo is not an option due to demographic and budgetary pressures and new legislation.