Agenda and minutes

The Chairman welcomed everyone to the Meeting and reported that there had been a change in Membership since the last Meeting.  Mr R Udall had replaced Ms P Hill.

None.

Members of the public wishing to take part should notify the Head of Legal and Democratic Services, in writing or by email indicating the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 21 January 2018). Enquiries can be made through the telephone number/email address below.

None.

Previously circulated

This Item was deferred until the next Meeting.

Attending for this Item from the Adult Services Directorate were:

Elaine Carolan, Strategic Commissioner for Adult Services

Steve Medley, Senior Project Manager

Adrian Hardman, Cabinet Member with Responsibility for Adult Social Care

By way of presentation, Outcome Based Commissioning in Domiciliary Care was explored and the following main points were highlighted:

·         Since its introduction in April 2017, a dynamic purchasing system had enabled a thriving domiciliary care market to be built up in Worcestershire

·         This had resulted in the opportunity for the Council to build up a stronger and more responsive relationship with Providers

·         Providers work in a locality and are then responsible for covering the social care needs of that population

·         Challenges around the rurality of Worcestershire remain and cross border working was accepted.  Examples were given whereby Providers based in Birmingham may work in north Worcestershire

·         The financial risk and reward is managed with the Provider to deliver an agreed set of outcomes that promote and maintain independence

·         There was a lot of contract monitoring and assurance was given that no resident in Worcestershire had a 15 minute call (for care) with 30 minutes being the minimum.  However, other visits, for example checking if medicine had been taken could involve a 15 minute visit

·         Of the 3 Pilot Projects in Worcestershire (Pershore and Upton, Central Bromsgrove, Malvern), initiated in October 2017 and being run until September 2018, savings had already been made and national examples cited, suggesting Council savings could achieve 20% savings over 2 or 3 years

·         Providers would be much more involved in delivering the care on outcomes, therefore if a provider felt that there was an alternative delivery model, discussions would be had with the client and Council.  There would no longer be any Social Worker prescribed 'task and time'

·         This new of working aligned well with the Three Conversation Model of Social Care

·         The Pilot Projects would only be working with Older People who were new to social care, with Officers reporting that routines for existing clients would not be disrupted

·         In return for securing a block contract, Providers had agreed to reduce from a Tier 4 to a Tier 3 banding rate, enabling a saving of around £300 per week reduction per person

·         Other savings had already been achieved by Providers proactively getting in touch to suggest alternative care packages

·         Challenges included the capacity of Providers, especially given the perception of the care profession and the reliance on Eastern European workforce

·         There was a need to manage expectations going forward and investigate whether housing is able to meet future caring needs

·         Additional Pilot Project Areas were being developed in Wyre Forest, Redditch and Worcester City with a view that a Tender process would be enable projects to start in April 2018 and run for 12 months

·         It was hoped that evidence would continue to be collected to prove the effectiveness of the Outcome Based Commissioning approach and develop further to ensure the approach was sustainable

·         A risk/reward payment model with existing Providers  ...  view the full minutes text for item 268.

Attending for this Item were:

Elaine Carolan, Strategic Commissioner for Adult Services

Emma Allen, Commissioning Manager

Adrian Hardman, Cabinet Member with Responsibility for Adult Social Care

A presentation was given outlining the background, purpose and next steps in the engagement process on options for future delivery of Learning Disability (LD) Day Services.

Members were reminded that Cabinet received a report on 2 November 2017 and agreed that Officers could start engagement with people using services, carers, staff and other stakeholders to shape future services.  It was clarified that this was pre-consultation, that no firm proposals had been developed and a report on the engagement phase would be taken back to Cabinet in due course.

Worcestershire County Council provide Learning Disability Day Services in a number of ways, mainly:

-       Resource Centres (for those with profound learning disabilities)

-       Connects Service (Day Centres, Staff Ratio is around 1:7)

-       Leisure Link (small service in Wyre Forest)

This model was adopted following detailed consultation from December 2012, through to completion in 2016, although at the July 2014 Cabinet it was agreed to look at tendering out in-house Learning Disability Day Services.  Market engagement had shown there was limited appetite to take on services in their current form and the Council need to get best value for money from the Council's budget.  It was noted that what people want and expect from their services has changed over time and there is variety in the marketplace, although in-house provision tends to be building based.

Engagement was already taking place and would continue until early March, with meetings taking place at each centre/service.  Speakeasy Now was supporting the engagement with service users and wider engagement was being undertaken at forums and consultative groups around the County.

It was reported that Resource Centres cost £2.1m and estimated to be £280,000 more than it would cost to purchase similar services from external providers.

The Connects Service costs a total of £1.8m (£1.2m for the LD Day Service) and estimated to be £480,000 more than it would cost to purchase similar day services from external providers.

Examples of the types of questions asked as part of the engagement process were given to the Panel, enabling Officers to determine what works well, what doesn't, how things could be done differently and where the gaps are.  It was noted that it was also important to factor in any local need.

After analysis of the engagement phase, a detailed report would be taken back to Cabinet, with any proposals for future service delivery and proposals for any required formal consultation.

In the ensuing discussion, the following main points were made:

·         The Panel felt that residents were generally confused due to the volume of engagement or consultation programmes that the County Council had undertaken over recent years, however, hoped that this programme would build on previous positive engagement in LD Day Services in 2014

·         The Cabinet Member reported that the number of individuals involved in the engagement was around 200, compared to  ...  view the full minutes text for item 269.