Issue - items at meetings - Day Activities Commissioning plan

Report of Director of Adult Social Services (copy attached).

(1)       That it is noted that the Adult Care and Health Committee on 19 November 2012 approved the proposed Vision for day activities set out in Section 7 of the report.

(2)               That it is noted that the Adult Care & Health Committee on 19 November 2012 agreed the next steps set out in Section 8 of the report, that is to work with service users, advocates, carers and providers in the co-design and modelling of services to realise the Vision for day activities.

28.1    The Board considered a report of the Director of Adult Social Services which summarised the feedback on the current provision of day services in Brighton & Hove, made recommendations about a future vision for day services and outlined the next steps.

28.2    Janice Robinson asked why this report was being presented now when successive meetings of the JCB had been reviewing and changing day services. 

28.3    The Head of Commissioning & Partnerships confirmed that extensive work had been carried out on day services.  However, there had not been so much work carried out for people learning disabilities.  The Commissioner, Learning Disabilities & Older People explained that it was predicted that there would be more people with learning disabilities who would need the service.

28.4    RESOLVED - (1)      That it is noted that the Adult Care and Health Committee on 19 November 2012 approved the proposed Vision for day activities set out in Section 7 of the report.

(2)               That it is noted that the Adult Care & Health Committee agreed the next steps set out in Section 8 of the report, that is to work with service users, advocates, carers and providers in the co-design and modelling of services to realise the Vision for day activities.

Report of Director of Adult Social Services (copy attached).

(1)       That the proposed Vision for day activities set out in Section 7 in the report be approved.

(2)               That the next steps set out in Section 8, as amended, be agreed, that is to work with service users, advocates, carers and providers in the co-design and modelling of services to realise the Vision for day activities.  (Note: The amendments to Section 8 are as follows:  Paragraph 8.4 to be moved to become paragraph 3.11, Relevant Background Information.  Paragraph 8.5 to be moved to become paragraph 5.4.15, Feedback and Developments)  

30.1    The Committee considered a report of the Director of Adult Social Services which reminded members that a report was submitted to the meeting on 25 June 2012 that set out proposals for a consultation on a Day Services Commissioning Plan.  The current report summarised the feedback on the current provision of day services in Brighton & Hove, made recommendations about a future vision for day services and outlined the next steps.

30.2    The Commissioner, Learning Disabilities & Older People presented the report and summarised feedback to the consultation. She informed members that the Day Services Needs Assessment had been placed in the Members Rooms.  

30.3    The Commissioner stated that the feedback had shown that Day Services were highly valued but that there was a gap in knowledge regarding personal budgets.  There was a lack of awareness regarding alternative services and some buildings were underused.  The Craven Vale service was being reviewed and officers were identifying alternative day services for all service users. Section 7 detailed the Vision for Day Activities in the Future.  The next step was to engage with service users and carers.  If the recommendations were agreed officers would bring back a progress report with a plan.  

30.4         The Director of Adult Social Services informed the Committee that the commissioning plan related to a broad range of individuals with different skills and needs.  The plan considered how people could use individual budgets and direct payments.  The Director stressed that direct payments could not be used to access in house services. 

30.5         Councillor Norman stated that the report referred to what had already taken place at Tower House and Montague House when he was Committee Chair and later Cabinet Member.  A few years ago there had been anxiety regarding the changes to those services, however the proposals had come to fruition and were working well.  Councillor Norman saw the current report as part of the process of providing a better service.  He agreed with the recommendations.  There was now a need to move on to look at the detail.  At this stage he supported the proposals but stressed that more detail was needed in the next report. 

30.6    Councillor Meadows stated that people had expressed anxiety about personal budgets.  One of the concerns was that people with learning disabilities would become employers.  Councillor Meadows agreed with the proposed vision for day services but disagreed with recommendation 2.2, “That the Committee agree the next steps set out in Section 8, that is to work with service users, advocates, carers and providers in the co-design and modelling of services to realise the Vision for day activities.”  Councillor Meadows felt that Section 8.5 was asking the Committee to agree to the closure of Buckingham Road and the transfer of the Connaught Day Options Base. 

30.7    Councillor Meadows expressed concern about paragraph 5.1.5 relating to Craven Vale.  She asked if a decision had already been taken to close the Craven Vale Day Centre.  Councillor Meadows stated that she needed more information before she could agree recommendation 2.2.

30.8    The Director of Adult Social Services explained the situation in relation to Buckingham Road and Connaught Road.  Both these buildings had been mentioned in reports to other committees.  Buckingham Road had been mentioned in a report to Policy and Resources about work styles.  The Director was now having conversations about these buildings.  If a decision was required about the future use of the buildings, it would be necessary for a report to be submitted to the Adult Care & Health Committee for decision.   

30.9    The Director explained that the report before Members was trying to explain that day services needed to be shaped by the people who used them.  Building based services were needed for more vulnerable people.  There were other service users who liked to use personal budgets.  The Embrace initiative would be launched at the end of the month and this would provide useful information about activities across the city. 

30.10  The Head of Commissioning Partnerships reported that there had been extensive consultation on the re-provision of day services for older people at Craven Vale.  The service was currently operating for three days a week and occupancy was continuing to reduce.  A number of service users had said they would like to go to Tower House.  Service users had been fully consulted and were already going to Tower House one day a week.

30.11  Councillor Meadows mentioned that there was a café at Buckingham Road which helped service users with life skills.   Art services were also provided.  These services were not mentioned in the report.  She asked where these services would be moved to in the future. 

30.12  The Head of Commissioning & Partnerships assured Councillor Meadows that there were no proposals to close Buckingham Road at present.  She agreed that tremendous work was being carried on at this service.  If any proposals concerning Buckingham Road went ahead, the service would continue elsewhere. 

30.13  The Chair stated that there was no suggestion that the service would not continue. 

30.14  Councillor Meadow made the point that the report was asking members to agree an option on Buckingham Road.  The Committee needed to know if there was a possibility that there would be a move from Buckingham Road.  She could not agree the report without this information.

30.15  Councillor Marsh concurred with Councillor Meadows.  She had great concerns about Buckingham Road.  She asked if recommendation 2.2 could be re-worded more carefully.  Councillor Marsh also asked for details on other activities that took place at Craven Vale.

30.16  The Director of Adult Social Care explained that the Buckingham Road service was based in two buildings.  One building was used by mental health.  The Sussex Partnership Foundation Trust had given notice on that building.  The other building housed a range of activities.  Two committee reports (Children and Young People’s Committee and Policy and Resources Committee) had sited the names of Adult Care & Health buildings.  There were currently conversations about where the services would be relocated if it was agreed they should move. 

30.17  The Head of Commissioning & Partnerships explained that Craven Vale was used for short term intermediate care.

30.18  At this point the Senior Lawyer stated that not all the paragraphs in Section 8 of the report were proposals.  Paragraph 8.1 was a proposal.  Paragraph 8.2 was a proposed service mapping exercise.  Paragraph 8.3 looked at further detailed work and contained three proposals. Paragraph 8.4 and 8.5 were information paragraphs.  It was clear that if a decision was required about Connaught Road and Buckingham Road, a recommendation must be submitted to the Adult Care & Health Committee.  Recommendation 8.6 proposed that work begin on the vision and a progress report be brought back to the Committee.  If any decision was required about the Connaught Road and Buckingham Road buildings between programmed meetings, a special meeting would need to be arranged.

30.19  Councillor Wilson referred to tables in the report that related to the number of people supported and asked for details of what period this covered.   She also asked for data on percentages of people consulted so far.  The Commissioner, Learning Disabilities & Older People explained that the data represented people supported on a weekly basis and was based on current data and taken from the CareFirst database. There was no information on percentages of people consulted and this would be added.

30.20    Councillor Norman referred to paragraph 8.5 and made the point that the report did not say that Buckingham Road or Connaught Road buildings would close.  He still supported the recommendations. 

30.21Councillor Mears stressed that the Buckingham Road and Connaught Road services were the responsibility of the Adult Care & Heath Committee and discussions should have started at this committee.

30.22  The Director replied that it was her understanding that although the buildings were used by Adult Care & Health, all properties were managed corporately.  There had been no discussion with Adult Care & Health until the Director had seen the Policy and Resources report. 

30.23  Councillor Mears made the point that if there was a move from the buildings the money would go to the general fund.  She stated that the committee needed to be clear on where the money would be found for the services.   Councillor Mears referred to paragraph 5.4.9 and stated that there was no education for younger people coming through the system.  She asked what was being done about this situation.  There needed to be different ideas on how these young people could be assisted.  Councillor Mears referred to the financial implications in paragraph 10.1 and stated that there needed to be more detail.  She felt that there were massive opportunities with other providers in the city.  Young People wanted to expand their learning.    

30.24  The Head of Commissioning & Partnerships replied that opportunities needed to be balanced with sensitivity.  People felt strongly about day services and did not want them to change.  There was a waiting list for council provided services.  Some services were blocked with people who may require another type of service to suit their needs. The aim was to have more rigorously assessed services to ensure people in need could receive them.

30.25  Councillor Mears responded by stating that buildings should not be disposed until all the opportunities had been looked at.

30.26  The Director stressed that she had made it clear that if there had to be a move from Buckingham Road and Connaught Road, Adult Care & Health would need help in finding alternative space and capacity. 

30.27  Councillor Jones stated that he was worried to read in paragraph 4.5 that the vast majority of people did not know about direct payments or personal budgets.  He accepted that services had to evolve and broadly welcomed the report, however there needed to be clarity on how many people were consulted in percentages and more financial information.    

30.28  The Director replied that the government had now announced that they recognised that personal budgets were not suitable for everyone and had reduced targets to move service users in the community on to self directed support to 70%. 

30.29  Councillor Meadows stated that she was concerned that there would be financial implications for Buckingham Road should they move and she was not prepared to agree the report without full detailed information.  She did not agree to paragraph 8.5.

30.30  Councillor Powell stated that she was shocked to hear that most people did not know about direct payments or personal budgets.  She referred to the problem of the lack of post-19 education options mentioned in paragraph 5.4.9.  She thought that the problem lay with the education providers who were reluctant to take on disabled students.  She asked what conversations were going on to resolve this situation.  Councillor Powell mentioned that one problem encountered by disabled students was that bus passes issued by the council could not be used before 9.00am.

30.31  The Head of Commissioning & Partnerships referred to Councillor Powell’s first point and stressed that there was a need to highlight the benefits of direct payments.  With regard to the second point she agreed that there needed to be conversations with education providers

30.32  Councillor Norman was pleased that the target for direct payments had been reduced to 70%.  He stressed that people moving to direct payments did not have to manage the budget themselves.  The council would manage the budget for them.

30.33  The Chair stated that there were mixed attitudes regarding direct payments and it was necessary for the council to expand the options and ensure people received the service they wanted.

30.34  It was agreed that in order to make the report acceptable to members, the Senior Lawyer’s advice should be accepted.  Section 8 of the report could be amended as follows.  Paragraph 8.4 should be moved to become paragraph 3.11. Section 8.5 should be moved to become to paragraph 5.4.15. 

30.35  RESOLVED - (1)      That the proposed Vision for day activities set out in Section 7 in the report be approved.

(2)               That the next steps set out in Section 8, as amended, be agreed, that is to work with service users, advocates, carers and providers in the co-design and modelling of services to realise the Vision for day activities.  (Note: The amendments to Section 8 are as follows:  Paragraph 8.4 to be moved to become paragraph 3.11, Relevant Background Information.  Paragraph 8.5 to be moved to become paragraph 5.4.15, Feedback and Developments)