Agenda item

In attendance for this item were:

Avril Wilson, Interim Director of Adult Services

Fran Kelsey, Lead Commissioning Manager for Learning Disabilities

Amanda Blackton and Emma Allen, Commissioning Managers

The Lead Commissioning Manager for Learning Disabilities highlighted the key points from the presentation which had been circulated earlier (available on the Council's website).

Supported Living was housing and support for people with learning disabilities (LD) which gave them their own tenancy, choice of support provider and offered a range of options such as self-contained flats or shared houses. The Supported Living Strategy had been refreshed in 2017 and of 1457 people in receipt of an LD package of care (June 2018), 367 lived in supported living, a figure which had been growing over recent years. Since 2014, the Council had helped around 180 people to become tenants in their own homes.

Supported living developments were planned or in progress in Bromgrove (Bromford Housing) Upper Lodge (near Droitwich) and Kingfields (Droitwich), with business cases for sites in Kidderminster and Worcester. It was a misconception that people with complex needs required residential care, although there was particular need of more supported living options for complex needs, and also for people with profound and multiple disabilities.

Supported living was generally lower cost to the Council than residential care and there was a savings target of £2.619m.

Supported living was very much a win-win option, as well as being lower cost than residential care, however it needed to be planned.

Main discussion points

·         Panel members asked about timescales for the financial savings and were advised that the timescale had just been revised from 2019/20 to 2021/22 because experience to date indicated that those entering supported living were moving across from residential care settings, rather than through Children's Services, and that this would take more time.

·         When asked whether the revised timescale caused budget problems elsewhere, the Director explained that the LD population coming through to Adult Services remained relatively static in number but more complex in people's needs. There were an additional 66 people with enhanced care packages or who were being supported for the first time because of parental frailty, which did increase cost pressures. At the moment the Director believed the Directorate was on track to deliver the £6.1m savings target, although there may be some changes to timescales. At this early point she was not able to confirm a balanced budget would be delivered however a lot of work was being done to take measures to mitigate the impact on the budget.

·         Members acknowledged the need to revise the savings timescale, and asked about projected figures. It was confirmed that around 300 people were being worked with, who may potentially move to supported living over the next 5 years, although not all would make the move. Further details of projected figures would be provided.

·         When asked about work with providers and district councils, the officers explained that this took place in a variety of ways. If using one of its own sites, the Council asked for expressions of interest and it was a competitive process. The Council took a strategic, long-term view about what provision was needed and it was exciting work.

·         The Panel was reassured that work with families who had adults with learning disabilities living at home, was a very gentle process around planning for the future.

·         A member commented that the move to independence was good.

·         When asked about receptiveness of partners, the Director was conscious that working as a local family was the only way forward. One of the district councils' Chief Executives (Kevin Dicks) had helped deal with planners and housing providers. It was important to understand plans for growth and the Joint Strategic Needs Assessment for Worcestershire – for example if 40,000 additional houses were planned, some of those needed to be other types of provision, and not all general housing. This work was just starting and support from members who were also district councillors would be very much welcomed.

·         The Director also highlighted the need for a more joined up view on other types of housing, for example care homes. It was important for Worcestershire to have a good range of provision and to consider the long-term health and social care needs for the population moving in. For example, the construction of large numbers of care homes risked the County becoming a net importer of care.  Panel members asked why this work had not been started beforehand and the Director, whilst new to the Council, acknowledged that whilst housing could offer real opportunity and choice, the social care sector had been slower to catch up.

·         Members welcomed the increased and improved LD living options which were being made possible through work with providers. Was enough being made of the Council's capital budget? The Director advised that its use through supported living projects would take pressure off revenue budgets and that some sites would generate considerable interest.

·         Comment was invited from the Healthwatch Worcestershire Chair, who would support a message to Worcestershire's Health and Wellbeing Board (HWBB) and district council colleagues – that the strategy of using housing needed to be part of the solution.

·         A member was aware of many older parents who looked after their child (with LD) at home, and asked what would happen when the parents were no longer able to continue to do so? The Director advised that the needs of the individual and carers would be assessed, which needed to be a gentle process and could be difficult with some conditions in particular.

·         In relation to encouraging supported living, the Vice-Chairman asked what changes were taking place around work with Children's Services? The Director highlighted the need to plan early for a smooth transition and referred in particular to those in less straight forward situations, for example in residential schools outside Worcestershire; such cases needed earlier planning with Children's Services, although she believed the Council worked well on transition of more straight forward cases. 

·         The Director confirmed she was confident of getting the required input from Children's Services and gave reassurance that the directorates were actively engaged. This joint work was being developed in the medium term.  The Lead Commissioner pointed out that the SEND (Special Educational Needs and Disabilities) Strategy, recently presented to the HWBB, included preparation for adulthood as one of its priorities, which she was leading on. There was also a jointly prepared action plan from the recent Ofsted visit.  West Sussex and Essex Councils were examples of where an 'all age' approach to services was being explored.

·         When asked why the Council was not also building supported living provision itself to maximise income, the Director pointed out that housing associations had a great deal of expertise from a project and service perspective.

Comment was sought from the Cabinet Member for Adult Social Care, who was now in attendance, having come from the Acute Hospital Trust AGM. Why had the Council been slow to invest capital in supported living, and to seek input with planners regarding the health and social care implications for Worcestershire, from developments such as a growth in care homes? The CMR acknowledged that the Council had started this work later than other local authorities.

The officers agreed to provide the Panel with the leaflet on planning for the future, and figures of projected demand.

The Panel agreed to highlight the need for close partnership working on housing to the Health and Wellbeing Board.

The Chairman and Vice-Chairman asked about further information on the work referred to with the Children and Families Directorate on earlier planning for the transition of children to adults. The Director explained that this work was in the very early stages and the Panel therefore agreed to keep it in mind for the future work programme.