Agenda item

To consider the outcomes of the consultation on the future of Bulmer House Day Services in Petersfield, and Masters House Day Service in Romsey, prior to the decision of the Executive Member for Adult Social Care and Health on 13 March.

The Director of Adults’ Health and Care spoke to the report and presentation, which set out the outcomes of the consultation on the future of Bulmer House Day Services in Petersfield and Masters House Day Services in Romsey (see Item 6 in the Minute Book).

The Director provided an overview of the two separate day services, noting their utilisation both prior to, and following the conclusion of, the consultation.  The two services under consideration were traditional in their nature, and overall interest in this type of service had declined across the County, with service users choosing more personalised options that meet their needs at the times that suited them and their carers.  Day opportunities should also enable independence and choice, and there were a range of alternatives in the vicinity of the two locations which would better meet the needs of service users, and meet these aims.

Currently 19 service users attend the locations in Petersfield and Romsey.  A total of 12 staff would be affected by any decision the Executive Member may take.  The cost of providing services, especially those that are underutilised, was significant, owing to the fixed cost of the building, staff and resources.  The Department had a role to play in ensuring that day services are sustainable in future, and to ensure this felt that blending different forms of support from a range of public sector, voluntary and community providers was most appropriate.  It was expected that after re-provision approximately £177k would be saved annually.   This had been calculated on the basis of service users’ needs being supported at an equivalent or higher level than they were currently.

The consultation had been robust, taking place over a period of eight weeks and closing in early January 2018.  Both online and paper-based physical surveys were made available to service users, their families and carers, as well as to the general public.  The Department had supported consultation events in Romsey and Petersfield, where officers were available to talk through the proposals and alternative options, and listen to feedback.  The Department had ensured that there was designated 1-2-1 social work resource available to help identify alternatives for service users and their carers, and this would be available throughout the implementation period if the recommendations were agreed.  In tandem, the Department had held a staff consultation for the 12 individuals affected.

The outcome of the consultation showed clear opposition to the proposed closures, with 53 out of the 65 responses answering in this way.  A number of issues had been raised through the consultation which the Director had taken close account of, and his primary concern remained assuring service users and their carers that their ongoing needs would be met, but in an alternative way.  The equalities impact of the proposed closures had also been measured, and this was detailed in the main report.

All staff employed within the two day services had been offered redeployment.  Some had expressed a wish to take the opportunity to retire or leave Hampshire County Council’s employment, and therefore an enhanced voluntary redundancy window had been opened in early February for those who wished to state an interest in taking up this option.  Of the twelve staff members, four had opted for enhanced voluntary redundancy (should the service close), and one had found alternative employment and resigned.  The seven who remained would become redeployees, and found appropriate alternative positions within the Department, making the best use of their skillset in day activities for service users where possible.

The recommendations after this HASC meeting would go forward to the Executive Member for Adult Social Care and Health Decision Day on 13 March, and service users would continue to receive support leading up to and following this meeting.  If the decision was taken to close both day services, the Director was committed to maintaining services until all service users have identified and decided which alternatives would best meet their needs.

In responding to questions, Members heard:

·         That there had been a decrease in attendance by services users to all day opportunities County-wide; this wasn’t an issue solely seen in Petersfield and Romsey.  This decrease was believed to be due to a lessening in demand for traditional types of day services, with more individuals electing to attend alternative types of provision.

·         Referrals were open to the Petersfield and Romsey day services up to the start of the consultation.  Three referrals had been received in the week immediately prior to the consultation’s commencement.

·         Service user choice was also important to consider in terms of day opportunities, as the Department wasn’t able to decide on their behalf which service was most appropriate for them to attend, as this would depend on level of need, service user and carer requirements, time and day preferences, location, etc.

·         Service users were also able to use personal budgets (should they use this service) to purchase their own support and care which may include a range of day opportunities.

·         Although the number of individuals taking part in the consultation seemed small, this was a high consultation response rate given the small number of service users affected.

·         Some service users have been reluctant to look at alternative provision until a decision had been made, and therefore not everyone had considered what services would be appropriate as alternatives in their area.  Although service users currently attending services in Petersfield and Romsey, not all lived in these locations, and therefore it may be that alternative suitable options were in place closer to home.

·         Service users and their carers were being supported to attend new day opportunities for taster sessions, so that they could decide if a service met their needs before moving to it.

·         A detailed list of alternative options in the Petersfield and Romsey geographies had been shared as part of the consultation.

·         Hampshire County Council was leading on market-shaping work to ensure the sustainability and resilience of day services in the community.  The Department would be content to share a wider map of services with the HASC once this work had been completed.  In the interim, the ‘Connect to Support Hampshire’ pages were live and provided a directory of activities that take place within local communities.

·         It was important to ensure quality of service in those day opportunities provided by private residential and extra care homes, and both the Care Quality Commission as the social care regulator, and Hampshire County Council have a role to play in ensuring the quality and regulation of activities, with this being a major consideration of how services are assessed.  Hampshire County Council has a highly regarded workforce development team which aims to help develop external care staff and their offering to service users.  This approach did require balance, as although the Council has a right of access in terms of quality of care, it is not able to intervene if the provider declines assistance, and not all providers were open to such approaches.  The Council also works closely with the Hampshire Care Association in this area to ensure consistency and sharing of best practice across the County.

·         The Director believed that without the cost pressures being faced by the County Council, the Department would still have made the recommendation to close these day services, as the service needed to adapt to the preferences of service users, and the services were not well utilised.

·         There was not a specific end date by which all services users should have found alternative provision, and the day services would therefore close, as the Department did not want to hasten individuals to make decisions at a pace that was not suitable for them.  However, the Director was mindful of the need for certainty, and felt that there would be a ‘critical mass’ point at which service users would make a decision to move to new provision.  Some individuals were waiting until a final decision had been made before looking at alternatives.

·         Service users would be supported with travel arrangements where this was required; some travelled to services through their own transport, and others may be able to attend services close to home.

·         Day services for those with dementia were provided through a mixed economy, with support from both dementia and old-age related charities, private and public sector care provision.  Expanding dementia support services was a key part of the Department’s business strategy, as demographic trend data showed an increase in the number of those likely to have dementia in future.  Dementia Hubs are currently being developed across the County, and this support would need to adapt in future to meet the needs of service users with dementia throughout their lives, from diagnosis and early support, to end of life care and assistance. 

The Chairman moved to debate, where the following discussion was heard:

·         That there were some concerns that by dismantling the more traditional types of day service, there may be an increase in pressure on community and voluntary groups to pick up support.  It was important for Adult Services to play a part in helping to ensure the resilience and sustainability of the groups service users attend.

·         Further work needed to take place to complete the map all of the day opportunities available across the County, and this should be made available to Members to assist them with tackling social isolation in their localities.

·         The savings that might be realised were significant, but the costs elsewhere were not always visible and this should be monitored following any changes to day opportunities.

·         That the designated 1-2-1 social worker support to service users and their families was imperative to ensuring that alternative provision was tailored to needs, and that all service users received support that prevented social isolation and loneliness.

·         That it would be important for the Committee to monitor the decision to close, if agreed, to ensure that all service users are able to access alternative services.

The Chairman moved to recommendations.

RESOLVED

That the Committee:

1. Support the recommendations being proposed to the Executive Member for Adult Social Care and Health in Section 1 of the report.

2. Request that anonymised data be provided to Members, which shows the progress made to 13 March 2018 in identifying alternative options for the remaining service users attending the day services in Romsey and Petersfield, in time for the Executive Member’s Decision Day.

3. Request that, should the decision be taken to close the two day services, an item is received to a future meeting of HASC monitoring the progress and success of the alternative options identified for service users and their carers, and outcomes for staff members choosing redeployment or voluntary redundancy.