Report of the Deputy Leader and Cabinet Member for Health Care and Wellbeing
Councillor Alan White, Cabinet Member for Health Care and Wellbeing, Richard Harling, Director of Health and Care, and Amy Evans, Commissioning Manager, Learning Disability Commissioning Team attended the Committee to present the report and gave a short presentation.
The Committee was asked to consider the future of Day Opportunities for Adults with a Learning Disability (ALD) and/or Autism in advance of recommendations to Cabinet. The report and presentation specifically focused on the provision of Day Opportunities including Complex Needs Services provided by the Council; Day Opportunities provided by the independent sector; and, services provided by Personal Assistants.
The purpose of the ALD Community Offer was described as “To establish the assessed eligible needs and desired outcomes of the Adult and Learning Disability cohort and ensure that there are appropriate and sustainable services across the county to meet the identified needs: supporting citizens to maximise their independence, in accordance with Staffordshire County Councils (SCC) new Whole Life Disability Strategy (WLDS)”. It was reported that the WLDS tries to address the financial challenge of the ageing population, rising costs and a budget that is falling in real terms.
There were currently 1,800 service users; six complex needs centres; and 55 independent providers. It was hoped that the outcomes of the programme would empower citizens and their carers; move from a community presence to genuine community inclusion; maintain or increase quality of support provided; establish clear contracting arrangements; address the differentials in prices paid; ensure the offer is equitable transparent and proportionate to need; and contribute to budget savings.
A Member asked if services would be changing or relocating as in some areas service users travelled considerable distances to access services for short periods of time. The Member also questioned the quality of some of the services which were commissioned through direct payments and were not monitored for quality or value for money. In response, the Director said there were no plans at the moment, but he was not sure that all services were sustainable in the long term. A payment formula would need to be developed to provide fair funding to people based on their needs and taking into account their geographical location and the need for to travel. The Member also questioned how information on providers was exchanged as it seemed to depend on the local area and if you know the right people.
A Member questioned how different disabilities could be categorised in an assessment. In response, the Committee was informed that the person centred approach attempted to address these issues with services for those with complex needs being very different to those with moderate needs. This raised the question of whether this should be reflected in the funding allocated to people.
A Member asked if it was worth looking at the 55 Social Service providers who cared for 400 individuals and if we would reduce this number by using an in-house trading company such as Nexxus. In response the Cabinet Member agreed to look at this suggestion.
A Member felt that the systems need to be right from childhood through into adulthood and into employment. Another Member asked if we were trying to meet a persons needs or their aspirations. In response, the Director confirmed that the Council’s duty was to meet assessed eligible needs and that we would try to do this in a way that met their aspirations, within the resources we have available.
It was suggested by a Member that the Council could reduce the number of providers. It was acknowledged that this did bring into question the potential of having to change provider and some service users will have established relationships with their service provider/carer.
Members suggested that there was a need for a whole life plan that considered transport needs, carers, aspirations, language need etc, but was also flexible. The number of individuals working who were also in receipt of care was requested.
RESOLVED: The Committee made the following main points which should feed into the consultation prior to Cabinet in January 2019:
· Direct Payments encouraged people to access their own provision from the private sector and should be supported.
· It was felt that the need to consult and deal with issues in public, to ensure transparent decision making was important.
· The number of individuals who are working and also in receipt of care was requested.