Bournemouth LINk 'makes a change'!
The Bournemouth LINk and Bournemouth People First have consulted with local people about their views about the future of local day services for people with Learning Disabilities.
Bournemouth Borough Council's response in full:
Bournemouth Borough Council Response to Bournemouth LINk:
Learning
Disability Day Service Review Report 2010/2011
Bournemouth Borough Council would like to thank Bournemouth LINk, working in partnership with Bournemouth People First for their report of March 2011. The report is both informative and constructive, an approach appreciated by the Council.
Given the attendance by both Council officers and LINks at many of the same meetings with service users, families and carers, it is unsurprising that our conclusions from the consultation process and ideas on how to take day services forward are very similar. This is reflected in our response below and will be developed further in the forthcoming June Health Overview & Scrutiny and the July Cabinet papers. There are, however, some differences which are detailed below.
The Council is responding to each recommendation in the LINk’s report which for clarification are repeated in full below.
1. A consultation pathway is put in place to ensure that all service users and carers are fully engaged before any proposed change in the provision of a service is decided upon in the future. This is extremely important when change affects the most vulnerable in our society, who may find change very disturbing and upsetting. It was felt that no consultation with any service user or carer was undertaken prior to this major change in service provision.
Consultation with service users and carers was undertaken, however, the feedback received from some service users and carers was that the SIMALTO process was complicated. The Council has reviewed its consultation process in light of the comments, and this year had a broader more general consultation with the public and had more targeted consultations over specific changes.
Consultation meetings with service users, families and carers are on going, with further meetings being held at each day centre and the collective “Day Services meeting” being held monthly. Further, your LINks report will also be considered in developing the Council’s proposals.
2. Safeguards (for example advocates in place, accessible information about choices for each review) are put into place to ensure that people who are in residential care are able to choose their day activities. This includes accessing the various Council-run day activities (Day Centres; Community based team activities etc.) They should be offered the same day opportunities as people who do not live in Residential Care.
We will ensure that details are made available to residential care homes about day opportunity services, to include Council-run day activities. Homes will be able to purchase these services to meet their residents needs. Providers of residential care will be required to provide a copy of their Support Plan so that we can see how they will meet the day opportunity needs of service users. In addition, our contract monitoring regime will include a Citizen Checker review by Bournemouth People First whereby service users will receive peer support to express their level of satisfaction with services. Our contract with providers already requires them to access advocacy services when necessary.
3. The Council publish the detail of the new Community Based Team prior to any changes coming into force.
The Council is happy to agree to this proposal. Work is currently underway to clarify further the purpose of this service and its staffing structure building on the service based at Horizons. We will ensure these details are made widely available.
4. The Council not close Malvern Day Centre until people have been given the opportunity to choose where they wish to go for their Day Care provision (all 280 eligible people have a personal budget or direct payment) and it is proven that Malvern is no longer economically viable to be run as a Day Centre.
The Council is willing to agree to this proposal. Work is underway to meet with service users to transfer their current “direct provision” into a Personal Budget and / or a Direct Payment. Alongside this work we are developing methods to offer people a wider choice of service opportunity, work that will utilise the new “on-line” information system “Source” www.sourcedirectory.org.uk , support from our partner agency Enham and support from Day Services themselves.
The Council will expect officers to submit a further Cabinet report making the case for the closure of Malvern Day Centre. Details explaining why this is financially necessary would be expected as part of this Cabinet report.
5. It would be good practice to develop an Adult Services Learning Disability Commissioning Strategy for the next 15 years.
Work is underway to develop a Joint Health and Social Care Learning Disability Commissioning Strategy across Bournemouth and Poole. Jonathan O’Connell, Principal Officer Joint Commissioning is leading on this piece of work and has made contact with Bournemouth People First and the Bournemouth Learning Disability Partnership Board in respect of engaging with people with a learning disability and their carers. Given the current uncertainty surrounding the country’s economic climate, it would be ill advised to develop a strategy for a long period as long as
15 years. The commissioning strategy will be for the next 3 – 4 years instead.
6. In order to improve the offer to adults with learning disabilities, we propose that the council further develops work-based activity projects and publishes these on “Source” (www.sourcedirectory.org.uk), the web-based directory of advice, information and support for adults living in Bournemouth, Poole and Dorset.
As you are aware from the recent presentation at the day services meeting on 14 March we already have a good employment support service providing a range of work based support for both voluntary work and paid employment. Information about this service will be on the Source website at the end of March 2011.
Bournemouth has achieved the highest percentage of people with a learning disability in paid employment over 16 hours in the UK for the past 2 years.
The Community Employment Support Team (CES) can work with up to 150 service users with any disability known to the Borough who can attain work readiness within 30 hours one-to-one support from the team. CES provide work preparation, job searching, matching, job coaching, and develop ‘natural supports’ in the workplace. They provide reasonable adjustment and employment law advice and guidance for employers as well as disability awareness coaching/training. Once an appropriate work placement is sourced and set up, they monitor progress, with the aim of trouble-shooting any potential issues, and ensuring the sustainability of the work.
CES are currently developing a transitions service in conjunction with Linwood School, run a 2-year work training programme at Kings Park Allotment, where we also provide horticulture and life skills qualifications, have a move-on service from both the Allotment and Wallisdown Heights Kitchen Project, weekly drop-in information services and a Job Club. They also have a Staff Support Service for all Bournemouth Borough Council staff, can provide retention support and are a specialist referral organisation for Work Choice.
CES medium term vision also includes development of a carers employment service and social enterprise opportunities, which will create paid employment for local disabled people.
7. If a Day Centre is closed, the council consider offering it to a Community Interest company or charity that could offer a day care service.
The Council is already involved in discussions with various voluntary agencies about this possibility. We are interested in exploring both the possibility of an alternative day care service, but also a wider community centre. We are aiming to have firmed up recommendations where it has been possible to agree this type of development in time for the Cabinet paper in July.
8. A review is undertaken of the self-assessment tool that assesses an individual’s needs. Clear and concise criteria need to be published to ensure that a person’s needs are transparently assessed and that day care provision is provided to all who need it. The self-assessment tool should be available in accessible formats to meet the individual’s needs.
The Council will be conducting a review of its self directed support policy and procedures including the supported self assessment tool, as part of the routine process of introducing new practices. We will seek to involve some service users, families and carers in this review and the revision of supporting information for people completing it. We agree that the self assessment tool should be available in an accessible format and will be developing this following the current review.
The Council agrees that clear and concise criteria should be published regarding the way that it determines eligibility and how eligible needs will be addressed. The council has a published eligibility criteria which applies to the full range of social care needs of adults and older people, in line with central government guidance. A copy of the eligibility criteria checklist is available.
9. The 2.5 max day limit should not to be included if the criteria are based on a holistically assessed need (including health & safety and the home environment).
The use of the 2.5 days guidance was used to help people understand the need to make reductions in services resulting from the financial climate in which we are currently working. It is made clear in Cabinet papers and in consultation meetings that if service users’ assessed needs and / or carers’ assessed needs were greater than 2.5 days that this would be provided. It is recognised, however, that in the past we had offered more than the service user’s assessed need in an effort to provide a better quality of life for people and it is this “extra” that unfortunately now has to be limited due to financial restraints.
10. Reassurance is sought that no carer will have to give up work or be stopped from seeking work, for fear of their cared-for person not being eligible for Day Care.
The Council does not expect carers to give up work or not to consider work due to the person they care for not being eligible for day care.
11. It was acknowledged at a public meeting by a senior council officer that people’s quality of life will decrease as a result of this review. Measures need to be put in place to ensure that this does not happen. The Council needs to be mindful that one of their priorities is “protecting the vulnerable”.
In these financially difficult times the Council is unable to afford to provide the additional service above 2.5 days unless this is to meet a service user’s or carer’s assessed needs. Where people have above this allocation and this is not an assessed need we are unfortunately having to reduce the financial allocation. I would emphasise however that this is only about responding to additional requests from service users. Reductions in service will not be putting anybody at risk. We absolutely recognise our responsibility in protecting vulnerable people.
However, the Council is seeking to develop alternative cost effective options for service users which it is anticipated will allow service users greater choice in what they do, with the potential of spreading their allocated funding more widely than currently. In this way it is hoped to offset some reductions for some people in their quality of life through reducing their frequency of attendance at a day centre with other interesting more personalised opportunities.
12. There needs to be a transparent and consistent time-table of the changes provided to all individuals, parents/carers, residential homes and day centres. This should include dates for the closure of Horizons Day Centre and the development of the new community based team at Wallisdown Heights Day Centre. This should be available in accessible formats to meet the individual’s needs.
The Council is committed to giving greater clarity over the timetable of changes. This was difficult to do at the outset of the consultation as there were a number of “unknowns” (e.g the time it takes to undertake a proper review with people ensuring people have time to consider the outcome of their review before the new allocation was agreed). However, we now have a better idea of the time this will take and a timetable was distributed at the last day services meeting.
13. There needs to be clear answers in relation to the breakdown of what cashable saving there will be if the changes happen. This should be given in a £ amount.
Financial figures were made available in the December Cabinet report. These are being reviewed and will be presented in the June Health Overview & Scrutiny and the July Cabinet papers.
14. The Equality Impact Needs Assessment needs to be reviewed to cover all the impacts of the changes to all individuals, parents/carers, residential homes and day centres including concise numbers.
Alongside reviewing the financial savings the Council is also undertaking a review of the Equality Impact Need Assessment (EINA). This will also be published as part of the June Health Overview & Scrutiny and the July Cabinet papers.
The Council again thanks LINks in partnership with Bournemouth People First for their helpful report, and offers assurance that the details in this report will be considered alongside other feedback given to the Council during and arising from the on going consultation meetings.
Neil Smurthwaite
Service Director, Community Care Services
30 March 2011
For more information about this project
For more information about this project, please contact Chris Wakefield, Development Officer for the Bournemouth LINk, on chris.wakefield@helpandcare.org.uk.
Read the Easy Read version of this report here
