Agenda item

In attendance for this item were:

Paula Furnival, Strategic Director for People

Hannah Perrott, Assistant Director: Communities

Korrina Campbell, Interim Day Opportunities Review Manager

Adrian Hardman, Cabinet Member with Responsibility for Adult Social Care

Hannah Perrott, Assistant Director for Communities referred to the presentation slides included in the Agenda which summarised the report going to Cabinet on 4 February on the review of Council provided Day Services for adults with learning disabilities. The context for the review was around the Council’s duties under the Care Act 2014, to meet the care and support needs of adults and support needs of carers who are assessed as eligible under the Act’s eligibility criteria.

Korrina Campbell, Interim Day Opportunities Review Manager explained that there was a mixed market of day opportunities (40% internal and 60% external), with the Council providing two different types (Resource Centres for those with more complex needs which were more buildings based and Connect Services which mainly supported those with less complex needs).

Covid had impacted on day opportunities which had had to close or be delivered differently, and this had triggered a review of provision in order to continue to meet assessed need in the most efficient, cost-effective way that promoted independence, social inclusion and importantly, positive outcomes. The preferred approach was to move to a position where internal day opportunities would only be provided where there was not capacity within the external market.

The report to Cabinet provided an update on the first phase of the review which focused on provision for individuals with more complex needs. Officers were very conscious that those involved may be anxious, therefore a Communications and Engagement sub-group had been set up to ensure engagement with stakeholders and carers across all key areas of the review. Desktop exercises had been very important in establishing the picture pre and during Covid and the level of assessed need within the service and proportion of those with health needs. Staff had been included as well as a review of the market and transport.

Profiling of existing service users at the four Resource Centres was concerning for the future in terms of the older age of service users and duration of service, since 74% had used services for over 15 years.

Regarding the location and level of support provided by external providers in Worcestershire, only two services specialised in working with people with profound and multiple disabilities (PMLD) in the Worcester/Droitwich areas. The Resource Centres had been reviewed to assess whether they were fit for purpose. Interestingly, only 14% of individuals were identified by centre staff as being suitable for just a Resource Centre service and 45% as being better supported through attending a combination of both Resource and Connect Services.

Engagement feedback and options for future consideration were set out in a slide which would be used for further engagement with staff and carers, which generated questions about the service user journey and whether doors were being opened to all potential service users, including elements such as shared lives, supported accommodation, education/employment and replacement.

Key findings included:

·         service user journey was limited

·         for some the Resource Centre became a ‘service for life’

·         the Council may be ‘over providing’ for some and was the Council providing a truly strengths-based approach? 

·         significant variance in numbers attending the four Resource Centres, with only a small proportion of younger adults and a large number identified as having health needs yet only 5% were receiving Continued Health Care funding

·         127 individuals who were 17 years old identified as potentially needing some sort of day care opportunity

·         similar unit costs across both types of centre when you would expect specialist services to be higher

·         Covid meant that new ways of working had already started to be explored

·         lack of provision for PMLD needs in the external market

·         heavy reliance on transport to attend Resource Centres

·         overwhelming feedback that some of specialist day opportunities buildings could become ‘hubs’ for an extended service, offering support for people in their homes as well as during the day and overnight.

In terms of next steps, the key areas needing further exploration during the next phase of the review were consideration of the long-term and future offer of the Resource Centres to ensure an equitable approach, how to ensure a clear difference between the Resource and Connect Centres, understanding the make-up of Connect Service users, considering the GOLD element of service users in both Resource and Connect Services, understanding the variance across the four Resource Centres and exploring alternative/complementary options for specialist and complex services.

The Chairman invited discussion and the following main points were made:

·         Overall, Panel members supported the aim to have a service which was relevant, future-fit and facilitated independence.

·         The Strategic Director for People highlighted that while current services were highly valued, it was important to have good services for those with complex needs and the Council had a statutory responsibility to ensure that individuals had choice and control and that services were fit for purpose for the future.

·         A Panel member sought reassurance around the reference to some individuals expecting a ‘service for life’, since he envisaged that this would in fact be the reality for many individuals because of their needs - the Officers acknowledged this point although it was important that service users had the opportunity to consider other options along the way. Officers felt passionately about having good quality services for those who needed them.

·         Gail Greer, the representative from Speakeasy N.O.W was invited to comment, who said that she was very reassured by the discussion and fully understood the fact that people often remained in the same services for years and it was important to encourage them to embrace change and younger people coming through also had very different aspirations. Covid had prompted change and it was important to grasp that.

The Chairman asked about timings for the second phase of the review, and Officers advised they were planning for the Summer.

The Cabinet Member with Responsibility for Adult Social Care observed that at this interim stage, the review findings were different to those expected, and he believed the work would be more around service delivery than policy.