Age UKWest SussexResponse

to WestSussexCountyCouncil Consultation on

Your day. Your say - Developing day services and activities in West Sussex

Introduction

We welcome the opportunity to respond to your consultation on the future of day activities in West Sussex. We found the questionnaire structure somewhat restrictive for our comments hence this written response. In view of our charitable remit, we concentrate on the issues that arise in respect of older people.

We provide 5 day activity centres and 15+ community clubs in Crawley and Adur,are developing outreach clubs from the centres and are maintaining networks of older people organisations that are service providers, following the ending of POPP. In addition we regularly run activity events for our 1:1 customers who have been in receiptofservice from our Good Neighbour Schemes and Health Trainer and “Fit as A Fiddle” programmes by whichour customers continue to meet for activities after theirparticipation in the programmes hasended. The Fit as AFiddle programme has also enabled us to gain direct experience of the provision of day activities in neighbouring areas, as we cover East Sussex, Kent and Brighton and Hove, as well as West Sussex.

General

Wecompletely support the need to increase choice and control for older people and to offer more options for carers. We agree with the general direction of travel of the consultation paper and the “inverted triangle” model. We would also prioritise meeting the social support needs of older people as it is clear that meeting the social needs of older people results in an increase in general health and well being resulting in a corresponding reduction in the demandsupon both health and social care providers, be they statutory or non statutory.

We do not think it appropriate for us to comment on the proposals to close specificcentres as local people and the customers of the affected centres, and their family and friends,are best able toprovide input on those issues.

The Model

The inverted triangleprovides a good theoretical description of the needs and opportunities that older people have for day activities.However we are very concerned that the level of support required at all three stages has been under estimated. Our services fall into Level I according to the model. We have the capability,if appropriately resourced, to do much more at level 1 and to provide services at levels 2and 3.

Level1 issues:

Older people, like the rest of the adult population, already make many of their own arrangements as to what to do during the day or evening.We welcome the possibility that many older people in receipt of social care funding may be able to do the same.

However it is important to recognise that older people specific services also provide, as a matter of course, a level ofpreventative work that is not available to those accessing general services. For instance, our staff/volunteers are astute to look for changes in our users’ demeanour and behaviour as a norm in our level 1 services. Older people are also more likely to disclose concerns to staff/volunteers whomthey see regularly. Doing this in a timely way can prevent more serious falls or a decline into ill health that would put more strain on the shrinking statutory services. Preventative work of this kind is not a feature of general (as opposed to older people specific) activity/leisure groups.

Our experience tells us that there are activities that can be made accessible to older people if minor adjustments are made to recognise the specific requirements of age.Many general service providers may not be able to identify the need for such adjustments.

It has to be recognised that higher staffing/volunteers numbers are required to be available to signpost older people around buildings, to meet and greet them and to encourage and keep them engaged and feeling welcome.

We do not believe that the existing provision of level 1 services is sufficient having regard to the potential increase in numbers of older people looking for level 1 services envisaged by the proposed changes.. Pump priming funding, although welcome,can not provide a secure long term solution to the provision of sustainable level 1services.

From our ongoing involvement with many local clubs we know that groups struggle with being open to the diverse range of older people that will be requiring services, this will require monitoring to determine if there is real choice for older people and will potentially be a burden on limited resources

In addition we know from the detailed club lists we have (from the Partnership for Older People Pilot) that level 1 service provision is extremely patchy across the county.Coupled with the never ending issues surrounding local transport, this meansthat there is a danger of older people becoming isolated at an earlier stage of their later life unless the model is fully funded.

We note that the public consultation process did not excite the engagement of many (if any) new potential providers of level 1 activities.This leaves a major concern as to how older people, who have been poorly enough to have contact with adult social services, are going to find activities of the variety and level of activity they need. The current system does at least provide a “one stop shop” of activity that is much easier to access, despite its limitations.

Anygeneral Level 1 service providers who want to cater for older persons will need to consider the requirements for dealing with issues such as increasing incontinence, trips and falls, ulcerated legs, intolerance of fitter older people (althoughmany are supportive) and have the staffing/volunteer levels to cope. We are doubtful whether such provision would be available in sufficient supply. We fear the funding required for this group would be higher than likely to be available.

Offering respite and activities on Saturdays and Sunday lunch opportunities are also very important and often need subsidy to sustain the vital contact this provides.

Level 2 issues

We are most concerned about the proposed service provision for the people in this group who currently are absorbed into the current day service provision and receive a good service.

  • As public finances become increasingly difficult to access, people will be excluded from access to the funds for a level 3 service (move from funding “moderate” need to “substantial” or “critical” for example) or if the centre is just not there,people who need and possibly currently receive a near level 3 service will be excluded,leaving very vulnerable but not “long term high support” people without an appropriate service.
  • Will people who dip in and out of level 2 really be able to understand when they are eligible for what support? We find ill health and frailty can easily exclude people from making choices and taking control. This consultation does not detail plans for advice or advocacy for people in later life. Discussions elsewhere are about “non age specific” advice and we believe this potential reduction in age specific advice services linked to older peoplewould result in more inappropriate choices and decisionsand would be a recipe for disaster for the older person concerned.

Level 3

We believe WSCC know and understand the requirements here and will continue toprovide a good service to older people requiring long term high intensity support and specialist services, funding permitting. We are aware that transport and length of journeys to WSCC or Shaw Trust centres are issuesstill needing to be resolved.

Areas you request a response on the questionnaire not covered above:

We are in an excellent position to provide Information and Advice on what services are available.Our Service Level Agreement runs out in March 2011 so we would be concerned if this age specific service was not continued.

Strength of the voluntary sector: There has been a lot of discussion doubting the capacity and probity of the voluntary sector from current workers in the existing day centres, Unison and some family and carers. We are disappointed the voluntary sector has been targeted in this way as we believe that with the right financial support, there are more than sufficient professional voluntary sector organisations to support older people with the day activities they want. There is a core of countywide professional organisations ready now to offer this support and all of them have a value base that would also support smaller specialist groups to provide good services. We are well placed to provide flexible and appropriate services.

Specialist Services: It is important they are available at a high quality and accessible both in terms of access and cost.Who the provider is less important. The accessibility of these services is vital to the model working as without them the whole project would fail.

Use of LA money: it is not for us to make such decisions but we would mention that voluntary organisationsare not cost-free. Support to volunteers in terms of training, expenses and ongoing support has a financial cost that must be borne to ensure the quality of provision of day activities for older people in West Sussex. These may exceed the self directed budget or the personal income of older people so grant/contracts would still be necessary in order to provide the requisite services.

Appropriate consultation: The county did not include us in any meaningful discussion before the consultation was made public.We believe we, and other voluntary sector organisations, could have contributed significantly at that point and so improved the public consultation process.

The county invested a lot of energy time and money inthe public consultation process but did not plan any consultation sessions for the possible organisations that would provide services to the county’s level 1customers (and perhaps level 2). We believe this was a missed opportunity and may have given ammunition to campaigners opposing the proposalssince the county were able to offer no clear examples of how services might look in the future.

Conclusion:

We believe that, in principle, level 1 services can be provided by the voluntary sector and others although there are areas where current provision is insufficient and requires development. We consider that older people’s needs are more appropriately met by older people specific services.

We have concerns as to whether level 2 service users’ needs can be met. We are happy with the proposals concerning level 3 services.

We consider that sufficient funding must be provided to ensure the model operates well, this cannot be met by older people using their Self Directed Support funds alone,

We believe that we are well placed to support the aims of the review in providing a modern service giving choice and control to older people. We would welcome more detailed discussion and inclusion in the next level of decision making on the changes.

Version 1.4 October 20101