Care Consultation Paper

8/4/2019 Care Consultation Paper

1/6

PAPER D

Purpose: For Approval

Committee CABINET

Date TUESDAY, 11 OCTOBER 2011

Title FEEDBACK FROM THE INITIAL CONSULTATION AROUNDCARE FOR OLDER PEOPLE ON THE ISLE OF WIGHT,INCLUDING THE ROLE OF THE ADELAIDE AND THEGOULDINGS

Report of CABINET MEMBER FOR ADULT SOCIAL CARE,COMMUNITY SERVICES AND HOUSING

EXECUTIVE SUMMARY

1. This paper updates cabinet members on the outcome of community engagementwork undertaken in July and August this year, as previously discussed andapproved by Cabinet on 10 May 2011.

2. It contains a summary of the feedback from the engagement work including viewsabout future commissioning of support for older people and more specifically aboutthe future for services delivered at The Adelaide and The Gouldings.

3. In the plan set out before cabinet on 10 May 2011 the intention was to presentoptions relating to the future of The Adelaide and The Gouldings alongside thereport from the initial consultation phase. It was proposed that there would be afurther 90 day consultation following cabinets decision.

4. Feedback from the initial consultation has highlighted a range of possibilities whichwould have an impact on other council services not previously included.

5. This paper seeks the approval of cabinet to allow further time for officers to developa clearer picture of the potential business models and delivery options which wouldtake into account the feedback received thus far, whilst also delivering efficiencysavings and realising the council intention to move away from direct serviceprovision in a managed way.

BACKGROUND AND STRATEGIC CONTEXT

6. At its meeting on 10 May 2011, Cabinet considered and approved proposals for aconsultation exercise which would include a period of engagement prior to makingmore detailed proposals which would then be subject to a further 90 dayconsultation period.

7. The paper reflected on the need to consider the future of The Adelaide and TheGouldings Resource Centres in the broader context of care for older people on theIsland.

D - 1


2/6

8. This was also set within the context of firstly the council moving to being acommissioning body (as outlined in the Chief executives paper The CouncilOrganisation: future shape and direction, 7 December 2010); and secondly theimmediate requirement to reduce our financial commitments whilst making sure thatthe most vulnerable people on the Island continue to have access to the supportthey need.

9. The review of care for older people on the Island is directly relevant to the EcoIsland vision to develop a healthy and supportive Island as well as impacting onthe corporate priority to support older and vulnerable residents and deliverbudget savings through changed service provision.

CONSULTATION FEEDBACK

10. A full report on the community engagement is attached at Appendix I, whichincludes information about who was consulted and how, together with an analysis ofthe comments received.

11. The work undertaken in July and August was shaped and supported by a range of

organisations with an interest in the needs of older people including Age Concern,Older Voices, Quay Carers, Isle of Wight Advocacy Trust, Carers UK, AlzheimersSociety, Isle of Wight LINk and NHS Isle of Wight. We are grateful to theseorganisations for their advice and support in undertaking this work.

12. The community engagement involved the production of what was termed a marketreport describing the population of the Island and its likely changes over thecoming years. The range of services that are currently available on the Island,services that are available elsewhere but not well developed here and the currentinvestment and services delivered by the Adelaide and the Gouldings.

13. A survey form was developed and made available both online and through a range

of outlets and was heavily advertised. In addition the Advocacy Trust wascommissioned to facilitate people who currently use the services of the Adelaideand the Gouldings expressing their views through individual interviews and sixpublic sessions were held in Newport, Freshwater and Ryde. Senior managers alsoheld separate briefing sessions for both staff groups at the Adelaide and theGouldings.

14. This process resulted in 237 individual survey responses with a further 15 peoplewriting separately and the views of an additional 35 people being summarisedthrough 4 responses representing discussion groups led by either the LINk or OlderVoices. There was also a written response representing the views of 60 staff and

the League of Friends of the Gouldings and 21 people attended the public events.15. The following paragraphs summarise the key messages from this community

engagement. They are considered in terms of:

(a) The range of services that the Council should look to develop

(b) The particular contribution of the Adelaide and the Gouldings

(c) The future organisational arrangements for the Adelaide and the Gouldings

16. In terms of the range of services that the Council should look to develop the keymessages were as follows:

(i) Separate and specialist support for people with dementia

(ii) Separate and specialist support for people at the end of life, available quicklyand with minimum bureaucracy

D - 2


3/6

(iii) Homecare provision with increased capacity delivering a more promptresponse when required and with a greater consistency of individual carers

(iv) Preventive work addressing growing problems such as diabetes, dementia,obesity, smoking, hypertension/stress and depression

(v) More positive involvement of older people in shaping services

(vi) An updated Carers Strategy and delivery plan

(vii) Effective self assessment and direct access to services

(viii) One Stop Shop/information feedback highlighted the need for improvedaccess to information, including developing a directory of services availableboth in print and online (either through joint funding or advertising).

17. In considering the future contributions of the Adelaide and the Gouldings there wasvery strong support for the residential respite and day care services being provided.Both people who use these services and their carers expressed great appreciationof them and the difference that they make to their lives. In addition there was strong

support for developing the range of services provided from these centres including:(i) Broadening the resource centre concept so that they become more of a focus

for the community

(ii) Reaching out into the community to identify and support more vulnerablepeople

(iii) Widening the range of activities available at the centres so that they are not just focussed on care but on a range of wellbeing activities that promotesocial interaction, intellectual stimulation and healthy living

(iv) Streamlining approaches with NHS services particularly in relation to crisis

response and reablement services(v) Streamlining approaches with the councils homecare and Wightcare services

(vi) Being accessible for people wishing to purchase directly from their ownresources without the need for assessment by adult social care. This viewwas particularly expressed in relation to residential respite care and day careservices.

18. Finally, there was considerable concern in terms of the future organisationalarrangements for direct services. This focussed on the concern about externalisingthe services to a private provider. It was felt that such providers would be driven byprofit rather than quality motives.

19. The strength of this view might be considered surprising given that the vast majorityof the Islands nursing and residential care home services and homecare servicesare delivered by private sector providers and are, generally, well regarded.However, this engagement exercise took place against the horrific disclosures ofabuse of learning disabled people at the Castlebeck facility near Bristol and thefinancial crisis of Southern Cross that potentially placed thousands of vulnerableolder people at risk of losing their care home placement.

20. The overriding view was that the future of these services should rest in some formof not for profit arrangement where the focus was on quality services meeting thecommunitys needs albeit delivered at competitive prices.

21. To support this approach, there was also considerable feedback from members ofstaff themselves who identified the opportunity to manage these services at arms

D - 3


4/6

length of the council, and ultimately completely independently. However, the staffrecognised that they would want to prepare thoroughly to be able to ensure that thebusiness would be successful in the longer term. Therefore they would value aperiod of time where they could develop the necessary skills and insight. Duringthat time they would be in a position to shape the business in terms of the range ofservices provided and ensure that they delivered high quality at a price that would

enable them to compete in the open marketplace.HUMAN RESOURCES

22. There are no Human Resources issues at this stage other than recognising theimportance of continuing to fully involve members of staff in the process. We willfully assess the impact of any future proposals on members of staff as part of theEqualities Impact Assessment.

FINANCIAL / BUDGET IMPLICATIONS

23. There are no costs at this stage, but a detailed financial assessment will beincluded in future proposals.

CARBON EMISSIONS

24. There are some implications associated with developing local resource centreswhich may minimise the need for people to travel distances for support and therebyreduce carbon emissions. Consideration of this will be included alongside moredetailed proposals in future.

LEGAL IMPLICATIONS

25. The legal duties relating to social care for older people placed on local authoritiesinclude:

(a) carrying out assessments of peoples needs (NHS & Community Care Act 1990,

Disabled Persons Act 1986, Chronically Sick & Disabled Persons [CSDP] Act1970)

(b) access to social work advice (National Assistance Act 1948)

(c) access to support service and facilities for rehabilitation, adjustment to disability,occupational, social, cultural and recreational activities (National Assistance Act1948)

(d) ensuring access to information about relevant services (CSDP Act 1970)

(e) a joint duty with Health to provide after care services for people with mentalhealth needs (Mental Health Act 1983)

(f) safeguarding vulnerable adults (Mental Capacity Act 2005)

26. The Equalities Act 2010 created a unified and extended public sector duty. In theexercise of its public functions and provisions of services to the public, a publicauthority, including a local authority, must have due regard to the need to eliminatediscrimination, harassment, victimisation and to advance equality of opportunitybetween persons who share arelevant protected characteristic and persons that donot. The local authority will consider the impact that any future proposals may haveon individuals who may be affected and, in particular, those with a protectedcharacteristic under the Equalities Act 2010.

27. The duty covers all the following protected characteristics: age, disability, gender,gender reassignment, pregnancy and maternity, race, religion or belief and sexual

D - 4


5/6

orientation. It also covers marriage or civil partnerships, but not for all aims of theduty.

EQUALITY AND DIVERSITY

28. The initial Equality Impact Assessment has been revised to include specificinformation resulting from the first consultation phase.

PROPERTY IMPLICATIONS

29. There are no property implications at this stage.

OPTIONS AND EVALUATION

30. Option One: doing nothing would present a high risk to the council both in termsof being unable to make the necessary savings as well as failing to respond topublic feedback once requested, which would have a detrimental impact on thecouncils reputation

31. Option Two: Do some limited work to enhance services at The Adelaide and TheGouldings in isolation. This approach may deliver a level of savings but this is likely

to be limited given the high costs of corporate overheads and running costs. Suchan approach would also not deliver the customer benefits envisaged by thosefeeding back in terms of streamlining community-based services.

32. Option Three: Undertake a wider piece of work covering all directly providedservices within the Community Wellbeing and Social Care Directorate includingWestminster House, The Adelaide, The Gouldings and Wightcare (communityalarm) as identified in the Budget Paper presented to Full Council on 21 September2011. This would allow officers a further period of time to prepare a more detailedreport, considering all directly provided services within the Community WellbeingDirectorate, including No Barriers, Beaulieu, Homecare/Reablement and Mental

Health Day Services. This work would result in specific proposals being brought toCabinet describing how services could be enhanced while delivering financialsavings and for the programme of work to be undertaken to test and deliver theprovision of these services outside the councils direct control and management.

33. Option Four: That officers take into account the broader feedback in terms ofpriorities for service development in considering the future commissioning of careand support services for older people and that these are brought together into astrategy that integrates both council and NHS provision.

RISK MANAGEMENT

34. Those risks identified by respondents to the initial consultation phase will beincorporated as part of the risk assessment of proposals which emerge.

35. There are significant risks associated with not taking additional time at this stage totake full account of feedback and develop a sufficiently detailed proposal, namelythe potential:

(a) Failure to realise the optimum proposal capable of delivering increasedcapacity to support older people in future

(b) Failure to realise optimum efficiency in the longer term and council savings inthe immediate future

(c) For the value and quality of consultation to be minimised should insufficient

information be available to fully inform the process

D - 5


6/6

RECOMMENDATION

36. That Cabinet receives the attached report and approves Option Three, to allow afurther period of time for officers to prepare a more detailed report which will then comebefore Cabinet in December.

37. That Cabinet also approves Option Four, that officers take account of the feedbackreceived in developing an integrated strategy for future commissioning of care andsupport services for older people across the council and the NHS.

APPENDICES ATTACHED

38. APPENDIX - Care for Older People on the isle of Wight including the role of TheAdelaide and The Gouldings Engagement Report (including the updatedEqualities Impact Assessment)

Contact Point - Kim Ball, Operations Manager,

01983 814675e-mail [email protected]

IAN ANDERSON

Strategic DirectorCommunity Wellbeing and Social Care

COUNCILLOR ROGER MAZILLIUS

Cabinet MemberAdult Social Care, Housing

and Community Safety

D - 6
http://www.iwight.com/council/committees/cabinet/11-10-11/PAPER%20D%20-%20APPENDIX.pdfmailto:[email protected]:[email protected]:[email protected]://www.iwight.com/council/committees/cabinet/11-10-11/PAPER%20D%20-%20APPENDIX.pdf

Care Consultation Paper

Documents

Transcript of Care Consultation Paper