Agenda item

Report of the Deputy Leader and Cabinet Member, Health Care and Wellbeing.

Alan White, Deputy Leader and Cabinet Member for Health Care and Wellbeing, Amy Evans, Commissioning Manager, and Taryn Poole, Commissioning Officer presented the report on the Adult Learning Disability 2022 Community Offer.  The report covered the Adult Learning Disability Services provided directly by Staffordshire County Council and the Carers Strategy ‘All Together for Carers’.

Part A of the report covered Staffordshire County Councils directly provided Learning Disability Services.  The report included the draft Cabinet report which was to be considered at its meeting on 18 September 2019.  Members were informed that the purpose of the Adult Learning Disability Community Offer 2022 programme was to establish the assessed eligible care and support needs of adults with a learning disability and or autism and ensure that there would be appropriate and sustainable services across the county to meet them.

The report outlined the services directly provided by the local authority and those externally commissioned respite services.  Options for each service had been evaluated following engagement with users, carers and staff.  Current and future demand had been considered along with the present market and the quality and availability of current services.

It was reported that over 80% of providers in the independent sector were rated outstanding or good by the Care Quality Commission (CQC) and there had been no provider failures in the last 24 months.

The Committee was informed that Greenfields was a residential care home with 8 residents located in Staffordshire Moorlands.  In 2007 Cabinet decided to reprovide the service however, this decision had not been implemented.  Care Act Assessments have indicated that the needs of the current residents could best be met in Supported Living.

Horninglow Bungalows were supported living, accommodating 15 tenants located in East Staffordshire and was rated Good by the CQC.  Again, the Care Act Assessments had indicated that the needs of the current residents could best be met in Supported Living.  Residents and carers had expressed strong support for the service to continue.  It was proposed that the commissioning of the care part of the supported living should be provided by the independent sector, to replace the care currently directly provided by the Council.

The Select Committee considered and commentated on the 18^th September Cabinet recommendations which were listed in the report as:

a)    Approves commissioning of a Supported Living service (care and accommodation), from the independent market, to replace the residential service currently provided by the Council at Greenfields House in Staffordshire Moorlands.

b)    Approves the commissioning of a Supported Living service (care only), from the independent market, to replace the care currently directly provided by the Council at Horninglow Bungalows in East Staffordshire.

c)    Approves consultation with staff (and recognised Trade Unions) on the proposed changes for Greenfields House and Horninglow Bungalow.

d)    Approves the revised Service Charter for the Complex Needs Day Services, including rebranding to “Staffordshire County Council Specialist Day Opportunities.

e)    Delegates the authority to implement any future changes to staffing and accommodation for the Staffordshire County Council Specialist Day Opportunities to the Cabinet Member for Health, Care and Wellbeing, in consultation with the Director for Health and Care.

f)     Approves an extension to the contracts for two block-booked residential replacement care services at Woodland View and Silverbirch with the current provider until July 2020.

g)    Requests that proposals for the remaining directly provided learning disability services and the long-term future of block-booked residential replacement care services be presented to Cabinet in October 2019.

A Member asked how services would be commissioned and how providers would be monitored.  In response, it was informed that services would remain CQC regulated and contracts would be monitored via; visits by regulators at regular intervals, relatives and carers remained a strong part of the contract monitoring process and Healthwatch was contracted to monitor and inspect.

The risks associated with the Horninglow approach was discussed.  The risks and their mitigations were set out in the Community Impact Assessment which was attached to the report.  The Committee were also given assurance that there was a process for dealing with the potential for private companies failing or going into administration at very short notice.

The Committee questioned the request for delegated authority as in recommendation e) and wanted reassurance that any strategic or substantial decisions made would be consulted on before decisions made.  This rewording was agreed to.

It was confirmed that the current contract for block-booked residential replacement care services at Woodland View and Silverbirch would expire on 31 March 2020.

The Committee wanted reassurances that during the development of the Strategy, all options were looked at and innovative solutions researched.  It was confirmed that this had been the case and that the Whole Life Disability Strategy had been the unifying document with the Adult Learning Disability Community Offer 2022 Programme adding the detail to the previous proposals.

Part B of the report outlined the Carers Strategy which included the engagement feedback and included a copy of the draft carers strategy which would be considered by Cabinet on 16 October 2019.   The Strategy set out seven priorities which had been based on national research, the NHS 10 year plan and learning from earlier consultations with carers:

·         Improving information, advice and guidance

·         Identifying carers

·         Staying healthy

·         A life outside of caring

·         Assessment and support

·         Crisis Management

·         Recognition and value.

Consultation with key stakeholders, including carers had taken place, the result of which had led to the Strategy being redrafted, noting that the core information and priorities had remained the same. It was estimated that there were approximately 98,000 carers in Staffordshire, including young carers, equivalent to 10% of the population.  The Strategy was therefore an important document both to the quality of peoples lives and to the finances of the local authority.

A Member reported that carers had found the process of assessment and funding for Respite Services long, difficult and inflexible.  It was reported that the home based respite service were due to be retendered to provide a more flexible and responsive service.  A triage service assessed urgency on point of contact.

Following a question on how carers were identified, it was reported that information came from GP’s, Schools, Universities, Family members and Assessment teams.  It was acknowledged that young carers who were caring for people with emotional or psychological difficulties were harder to identify and yet may struggle more.

A Member felt that the policy was very detailed, and the principles were correct but asked how it was to be monitored and was the Carers Partnership Board part of the monitoring process.  In response, as part of monitoring of the contract, feedback was and would continue to be used to inform service development and Officers were planning to revitalise the existing Carers Partnership Board, in addition to developing a citizen’s board which would also feed into the monitoring process.

It was felt that this was an opportunity to use the hubs to share information on the importance of Power of Attorney etc. particularly via sources other than the internet.

RESOLVED:  That subject to the rewording or recommendation (e) to reflect the need for substantive changes to come back to Members for consideration, the draft Cabinet recommendations as outlined in the report and listed above be endorsed and the engagement process noted.