Agenda item

To receive and consider a report from the Head of Scrutiny and Member Development which provides information presented to Executive Board about the future plans for Day services across the city.

Further to Minute No. 24, 29^th July 2009, the Chair welcomed Members and officers to this special meeting of the Board, which had been arranged to look at the issue of day services for older people and people with learning disabilities and, in particular, proposals which might lead to the closure of six existing day care centres – Bramley Lawn, Doreen Hamilton, Holbeck, Otley, Woodhouse and Naburn Court.

Present at the meeting and responding to Members’ queries and comments were:-

-  Sandie Keene, Director of Adult Social Services

-  Dennis Holmes, Deputy Director (Strategic Commissioning)

-  Kim Maslyn, Interim Head of Service, Adult Social Care

Sandie Keene, Director of Adult Social Services, gave the Board a presentation on the reasons why the service was introducing the proposals. This covered the financial position in Adult Social Care Services and increased demographic profile in the City. The need to continue delivering efficiencies and modernise the service was highlighted. The background to the national shift away from more traditional, buildings-based  services, such as those provided at day care centres, was explained. Utilising direct payments and personal budgets, the aim was to offer a more personalised service, with an emphasis on people exercising control and choice in the provision of services to meet their personal needs.  Often this was via Neighbourhood Networks and community based, universal services and facilities, which also assisted integration within the wider community.

This fundamental shift in emphasis meant that in future, local authorities could concentrate on providing, or commissioning, services for those with the greatest needs, including specialist services, rather then having to promote general services for all.  In Leeds, this was evolving into the development of services for people suffering from dementia, re-enablement services, specialist BME services, services aimed specifically at carers, and other initiatives such as the development of Well-being Centres and an increase in the number of outreach workers. Day services for those with specialist needs were currently over-subscribed.

There would always be a need for some specialist day care centres, and no-one with eligible need who required this service would be denied it. Everyone who currently received day care services would be offered an alternative placement.  However, currently there was over-provision of places in Leeds and rationalisation was necessary, which would almost inevitably lead to the closure of some existing day care centres and the transfer, after consultation, of their users to other, similar facilities.

The Council had embarked on a widespread consultation campaign, including extensive individual consultation with service users and their carers, which was due to expire at the end of September.  Although certain assumptions had been made, based on statistical evidence, the condition of centres and the geographic spread of day care centres across the City, that the six named centres would no longer be required for that purpose, the Director emphasised that no decisions had yet been made.  Following the consultation period and the collation of the results, a further report would be submitted to the Executive Board on 4^th November 2009.

Following the presentation, the Chair opened up the meeting for Members’ questions.  In brief summary, the main areas of discussion were:-

·  Allegations that staff at the affected day care centres had been instructed not to talk to Members.

The Director made it clear that she had issued no such instruction.  Reference was made to the formal protocol on Member/officer relations contained in the Council’s Constitution.  It was agreed that this allegation should be examined separately outside of the meeting.

·  The consultation exercise  -  In response to a Member’s query, the Director re-emphasised that no decisions had been taken regarding the future of the six day care centres in question.  Yes, consultations were currently taking place in respect of these centres, but if, as a result of the exercise, other possible options emerged involving other centres, then all possible options would be thoroughly evaluated.  Similarly, if the proposed consultation period was found to be inadequate, then it could be extended. In respect of the six named day care centres,  the Director emphasised the detailed consultation which would take place with existing service users and their carers to ensure that their needs were taken into account, and the attention to detail, such as ensuring that wherever possible, friendship groups and staff contacts were maintained in any possible transfer of users between centres.  Existing service users would also be informed of the possibility of direct payments and personalised services, and would be able to participate in ‘taster’ sessions. 

In response to a question regarding Member consultation, it was reported that the Area Committees affected by the proposals would be consulted.  Other Member briefings were taking place, including Local Members. Details of the consultation had gone to all Members, and this was being followed up by a weekly briefing. Members of the Scrutiny Board suggested a drop-in and/or Members seminar for further debate.

The Director acknowledged a point regarding the practical difficulties of consultation with people with learning disabilities and the need to utilise carers and advocacy services in these cases.

·  Concern was expressed at the possibility of cases of abuse not being so readily picked up if more people were engaging personal and professional carers and less people were attending day care centres.

This possibility was acknowledged by the officers, who stated that a robust and stringent monitoring and quality assurance system would be required.  Of course, it was also true that service users were open to the possibility of abuse at day care centres. The Board was advised that only 2% of abuse referrals received were via day care centres, and of those, 18% of the alleged cases had actually occurred within a day care centre.

·  Had social workers actually stopped referring people to these day care centres now, which meant that, in effect, it became a self-fulfilling prophecy?

The Director responded that  there were a number of National Policy initiatives which impacted on the use of day services. Firstly the requirement since 1992 to prioritise resources on those with the greatest need. Secondly the recent drive for more personalised and inclusive services which is resulting in Direct Payments, Individual Budgets and better access to universal services such as libraries and leisure. Examples were given of the work the Directorate was doing with City Development to develop a wellbeing centre at Holt Park alongside the potential development of extra care housing in the area.

A criticism and a suggestion that statistical information was being used selectively, or manipulated, to ensure a certain outcome was firmly rejected by the Director.  However, the Department would give further consideration to the way in which information was presented to see if a consistent approach was possible.

·  In response to a specific question regarding the future of the Holbeck Day Care Centre and the regeneration plans for the area, the Director stated that these aspects, and demographics, would be considered in consultation with the Director of Environment and Neighbourhoods as part of the exercise.  However, it had to be acknowledged that the Centre was currently greatly under-utilised, and an alternative existed at the Springfield Centre.  Whether the building might be suitable for alternative use was another issue.

·  Otley – In response to a question regarding a time lag between the possible closure of the Otley Day Care Centre and the provision of an alternative facility at the Holt Park Centre, the Director stated that the individual needs of all 14 current service users at Otley would be assessed, in consultation with them and their carers, and individual packages developed which met their needs.  Again, the Otley Centre was vastly under-utilised and the building condition was not good for the purpose.

·  The Director undertook to supply Members with the demographic information regarding where service users at the various day centres actually lived, as well as details of the consultation process and a point of reference to enable Members to raise their concerns individually. 

Joy Fisher was offered a separate meeting, if necessary, with John Lennon, Chief Officer, Access and Inclusion, to discuss engagement around citizenship and advocacy.

The Director also undertook to supply Members with details of the numbers of, and reasons for, people refused day care services in the past 12 months, and also how many people had started using day care services, broken down into categories such as mental health, learning disabilities, etc.

The Board also requested to be supplied with a copy of the consultation questionnaire currently being used as part of the consultation process.

·  Reference was also made to an email from a carer addressed to the Leader of the Council, and this was referred to the Director for consideration.

The Chair concluded by thanking the officers for the information provided and the manner in which they had responded to Members queries and comments.

RESOLVED –

a)  That the reports and presentation be received and noted.

b)  That an update report be submitted to the Board at its meeting on 7^th October 2009.

c)  That further consideration of this matter also be given at the Board meeting to be held on 14^th November 2009, when the report to the Executive Board meeting on 4^th November will be available.