Report of the Director for Health and Care.
Councillor Alan White, Deputy Leader and Cabinet Member for Health, Care and Wellbeing; Richard Harling, Director of Health and Care; Amy Evans, Commissioning Manager, Learning Disabilities Commissioning Team; and, Cathy Prendergast, Head of Nursing for Learning Disabilities were present at the meeting to present the report and answer questions.
The Committee considered a report of the Cabinet Member for Health, Care and Wellbeing on the day opportunities for people with learning disabilities and/or autism. The report was due to go to Cabinet on 19 June for consideration and the Select Committee was being asked for comments prior to decision. The Cabinet report was attached to the agenda for members to consider.
The purpose of Staffordshire’s Adult Learning Disability Community Offer 2022 Programme was to establish the eligible care and support needs of adults with a learning disability and/or autism and ensure that there are appropriate and sustainable services across the county to meet them.
The programme included considering the future of day opportunities. Engagement had taken place with key stakeholders the outcome of which had now been completed and used to analysis the options. In addition, the paper provided an overview of the remaining Learning Disability Services that are currently provided by the County Council and the externally commissioned respite service, whose contract was due to expire on 31st March 2020.
Reassurance was requested over the quality of services and how this was monitored, particularly since the national light touch regime introduced in 2015. In response, the Committee was informed that whichever method of procurement the local authority chose to use, be it; a single provider; a framework which was a range of providers appointed for a set contract period; or a dynamic purchasing system, where providers are appointed at the outset, and new providers could be appointed during the life of the contract. Whichever method is chosen, the local authority would want a clear set of standard specifications and range of standards to measure performance against.
A Member expressed concern that some of the more rural areas of the County, e.g. Staffordshire Moorlands had a limited number of providers and little transport links between communities. It was acknowledged that it is always likely to be more difficult to find providers to serve a rural areas, however a procurement offered an opportunity for the Council to clearly specify the services required and attract new providers or existing providers into new areas
A question was asked on whether the tightening up of standards and increased monitoring could lead to a reduction in the number of providers prepared to work in rural areas. Again, the challenges of providers operating in rural areas was acknowledege, but it was stressed that it was essential to hold providers to account against an objective set of standards. Transport availability and its costs would be looked at
The funding rate for certain tasks such as personal assistants hadn’t increased for a number of years and it was felt that this was putting families under financial pressure. The Committee asked what consultation was taking place with carers. It was explained that they were a vital part of the engagement and redesign of the service. Their needs would also be taken into account.
The report implied that respite would be more difficult to arrange and it was felt by Members that if anything this should improved. It was explained the it was important to balance the needs of individual carers against the need to rebalance the ‘weekend heavy’ demand for services which made staffing difficult and services potentially unsustainable.
It was felt that staffing in residential care services was also a concern particularly as decisions made by Cabinet in 2017 were still live but not implemented. This created uncertainty over the long term future of certain facilities. It was explained that Cabinet in September would be considering an options appraisal and recommendations which should give some clarity to staff and service users.
A question was asked on future demand predictions and the types of service currently being accessed. It was explained that this information was available and would be include in the September Cabinet report.
A question was asked on the way that funding for carers’ short breaks was calculated and offered. It was explained that this was calculated based on need and a reference price. Members felt that carers were critical, and as such the process should not be made more difficult. In response it was explained that there needed to be a clear policy that would be applied so that funding was allocated consistently and fairly, based on assessed eligible needs.
RESOLVED: That the Cabinet Report be noted and the following points be considered for inclusion in the development of the ALD 2022 Community Offer Programme:
a) In respect of day opportunities purchased from the independent marketplace:
i. The Authority needed to develop a clear service specification, inclusive of quality standards, ensuring the delivery of safe, quality services;
ii. Further consideration should be given to the availability and provision of services in Staffordshire Moorlands and other rural communities (and supporting transport arrangements);
b) Clarify needs to be established over what direct payments can purchase in respect of meeting eligible needs (including activities within day opportunities and respite / short breaks)
c) In respect of all services in the scope of the Programme, consideration of the needs of carers should be of the utmost importance and regard;
d) In respect of services directly provided by the Local Authority:
i. The Local Authority needs to understand both the current and future needs;
ii. There needs to be clarity about ambition and outcomes;
iii. The Local Authority needs to be clear about its position in the marketplace.