PURPOSE OF REPORT
To provide Members with an update on Day Service developments.
BACKGROUND INFORMATION
1. On 14th November 2007, Scrutiny Committee considered the Social Care’s Day Services Direction Principles and 2007/11 Strategic Milestones and supported them for full consultation.
2. The developments identified have a clear link to 'Wrexham Refreshed' and the Council's core business objectives - of ensuring prosperous businesses, skilled workforce and regenerated communities; of strengthening community cohesion and of improving the health, social care and well-being of citizens. The proposed developments will support the achievement of the strategic priority relating to increasing the number of older people receiving support and improving the range of services available.
3. Scrutiny Committee requested an update on work achieved after six months.
ACTION TAKEN
4 The Service Direction Principles and 2007/11 Strategic Milestones (as Appendix 1) were subject to a 12 week consultation, during which a number of meetings were held with key stakeholders. Consultation questionnaires were sent out to service users and their carers, service providers and other interested parties. A range meetings were held (e.g. with Council Day Service staff and care home owners), to support consultation process.
5 Details and results of the consultation are in Appendix 2 below.
6. A reference group has been established, involving services users (and/or their representatives) carers, service providers and voluntary groups and a first meeting held to report on the outcomes of the consultation.
7. Two Focus Groups have been held, involving stakeholders in identifying the types of activities that would be required to be provided or accessed through day services and in determining the building specification for future services.
Details of the workshops are in Appendix 3 below.
8. A Project Board has been established, to oversee and co-ordinate the project objectives.
9. An internal management development group has been established to commence internal service developments in line with the Strategic Milestones.
10. The Departments Community Resources Directory has been reviewed and reformatted to be available in real time to care co-ordinators and the Community Inclusion Team.
11. Due to vacancies within the Commissioning & Planning Team a formal Project Manager has not yet been appointed, however it is anticipated that this is imminent.
12. A consultation register has been commenced and is available from:
PROPOSED FUTURE ACTIONS
13. As these developments have been identified as a significant project, it is proposed that a full Project Plan be developed, to include:
i) Detailed Council provided Day Services/ Day Opportunities development objectives.
ii) Determination of the need and specifications for special services for people with dementia and people with significant sensory needs.
iii) Further service mapping to enhance the Community Service Directory and thus increase the range of opportunities available for service users within their own community networks.
iv) Identify expressions of interest for preferred partners to work alongside the Council in providing day services in future.
v) Establish working group of both internal and external providers to identify how services need to develop to meet the service outcome specification (developed in line with the Care Service Improvement Partnership good practice guidance).
vi) Identify the geographic ‘locality’ boundaries in which the Intergenerational Services will be developed.
vii) Audit current Social Care buildings against the building specification identified within appendix 2 below and utilise this for any future service developments.
RECOMMENDATIONS
That Scrutiny Committee:
i) Notes progress to date and
ii) Supports the proposed future actions
BACKGROUND PAPERS
Source / Report Ref / TitleSocial Affairs, Health and Housing Scrutiny Committee Report – 14/11/07 / CSCO/23/07S / Update on Day Service Developments (including proposed consultation material on Service Direction Principles and Strategic Milestones 2007/11)
Social Affairs, Health and Housing Scrutiny Committee Report – 09/05/07 / CSSO/13/076S / Older Persons Day Services Options Appraisal
Members Library / N/A / Service outcomes specification for community day services
Report Ref: CSCO/ 19/08s
Appendix 1: Service Direction Principles for the development of day services for eligible adult social care services users.
1 It is proposed that the same level of service will be offered for younger and older adults. Age will not be used as access criteria for services; this will provide increased opportunities and more flexible services, particularly for older people.
In order to achieve this, we will have to make some changes to our staffing arrangements. There is no intention to cut staff or make redundancies; staff will be given opportunities to work across a wider range of services and appropriate training to do so.
2 It is proposed that services will be delivered within extended hours on 7 days per week (aiming to ensure that they are available where needed earlier in the morning and later in the evening).
It is proposed that we consult upon the appropriate opening hours of such services, although not all centres/ services will operate within extended hours, these opening hours will be available across the range of services.
Services will be based around activity sessions rather than standard time periods, e.g. half days.
Users will be encouraged to arrange their own transport, where possible, rather than relying on minibuses transporting large numbers at set time intervals - support to access community transport will be provided in the short term for those requiring this and transport will be provided where there are significant additional support needs.
A transport eligibility criteria and charging policy is being developed.
3 It is proposed that people will not be offered places for day services within care homes after 1st April 2009, unless these services are provided separately to the accommodation used by permanent residents.
This proposal is made pending discussions with the care homes owners to ensure a minimum standard of service.
This will not affect those already attending care homes for day care up until this date; unless the individual wishes to change their service or the home no longer offers day care.
4. We will discuss joint arrangements with the Local Health Board for people who require day services with nursing intervention (people with disabilities and people with mental health needs). E.g. where this is provided in nursing homes.
5. We would aim that by 2010 all day services will meet the minimum standards identified by Wrexham Council.
6 It is proposed that by 2010, day services will be offered from a base of at least 3 Day Centres linked to the 3 localities of Wrexham (e.g. North, Central and South). Such day centres will be accessed by people of all ages and with a range of needs and may include a dedicated centre for people with complex health and social care needs.
Services will also be available on certain days in a range of community venues (e.g. church halls, community centres, leisure centres etc) in order to reduce the amount of travelling for service users.
These venues may be owned by the Council, by private companies or by voluntary or community groups.
7 It is proposed that the Social Services Department will support the development of Luncheon Clubs within each Geographical Ward by 2010.
8. It is proposed that if efficiencies are made from the above service changes, that:
i) A budget is set aside for small grants to be made available to voluntary sector groups wishing to set up luncheon clubs in areas where there is currently no provision.
ii) A scheme will be developed aimed at recruiting volunteers and paid staff who will work with individuals over a time limited period to introduce them into mainstream leisure/ education and social opportunities within their local community. It is envisaged that individuals who do not require a high degree of personal care, supervision or support will be encouraged to access ordinary activities independently, thus without becoming dependent upon social care services and without an ongoing service charge.
9. It is proposed that the day service for younger people with dementia ("Ty Agored") is re-provided within one of the current short break homes. (This is also dependent upon the outcome of consultation on the reconfiguration of short break services)
10. It is proposed that alternative accommodation is sought for the day services offered to older people with mental health problems at Nant Silyn. This is due to the fact that the home is designated for eventual closure and it has been proposed that day services are not continued within communal areas in care homes. This is consistent with an ongoing review of services for Older People with mental Health issues in Wrexham (The "EMH service reconfiguration").
Strategic Milestones 2007/11
Appendix 2
SOCIAL CARE DEPARTMENT:
DAY SERVICES DEVELOPMENTS (2007 - 2011)
************************CONSULTATION RESULTS*************************
During 2006, the Social Care Department reviewed Day Services for Older People, both provided internally and purchased from the independent and voluntary sector. A Day Services Steering Group including representation from day service providers, councillors, social work managers, Age Concern, the Over 50’s Forum and the Older People’s Strategy Planning & Development Officer (reporting to the Older People's Programme Group) have overseen the review.
From the review, it was agreed that the outcomes to be achieved for Older People accessing day services is unlikely to be different to those for younger adults. Therefore,
“The vision for future Day Services will offer a range of community based services which can provide an individual with leisure & social activities, work opportunities and/or skills development in a variety of settings, regardless of age or condition. The primary outcome is for the service user; the secondary outcome can provide the carer with a break.”
In total, over a 2 month period we received 40 responses from service providers, service users and “other” i.e. members of the Over 50’s Forum, carers, social services operational staff. The full consultation registration details are attached at the end of this report (Appendix A). We have also included the minutes of consultation event with Homeowners/ Managers (Appendix B) and information from Night Rider transport scheme (Appendix C).
We put to you a number of questions around the service direction principles and allowed you to respond with tick boxes and freehand commentary. Following this page the questions are listed with responses we received underneath.
CONSULTATION RESPONSES FROM THE DAY SERVICES DEVELOPMENTS (2007 – 2011)
Out of the 40 questionnaires returned:-
11 (27.5%) were service users;
5 (12.5%) were from service providers;
24 (60%) were from “other” (E.g. Over 50’s forum; Carer’s; SSD staff)
1a) DO YOU SUPPORT THE SERVICE DIRECTION PRINCIPLES?
YES – 35 (87.5%) NO - 0 DON’T KNOW – 5 (12.5%)
If answered Don’t Know, please state why:-
COMMENTS FROM “OTHER”
1. I need many questions answered before I can support the project.
2. It would appear that some of the proposals might be for “financial” gain rather than for client benefit.
3. I do not agree with much of what is said but think principles 2 (paragraph 1) and 7 are good.
4. If it means increased numbers of service users within one building I don’t think it is necessarily a good thing. It’s not clear to me whether intergenerational mix involves a very wide age range within the same group. I would not be in favour of younger service users in with older ones. I agree that either everyone pays or no-one pays for transport. The current system is unfair to some.
1b) WOULD YOU PROPOSE ANY AMENDMENTS TO THE SERVICE DIRECTION PRINCIPLES?
10 (25%) said YES 30 (75%) said NO
If answered yes, please list suggested amendments:-
COMMENTS FROM SERVICE USERS
1. I like drop-ins, especially where I can do something like art (painting), music (jams) or writing groups.
COMMENTS FROM SERVICE PROVIDERS
1. That groups already providing the service of a luncheon club should also be eligible for grants and support with activities.
COMMENTS FROM “OTHER”
1. Indicate who would get the training
2. I am all in favour of users paying for transport because this will keep costs down. Also users are paid benefits for uses such as this.
3. Regarding principle 3 – day places should be kept until other provisions are ready.
4. for the service to be more flexible where possible.
5. Transport should always be available.
6. I’m not sure that mixing the generations in certain “fields” is beneficial – especially to younger people.
7. Think about the model of Night Rider Community Transport as used in Denbighshire (see Appendix C)
1c) WHAT IMPACT WOULD THIS CHANGE HAVE UPON YOU/YOUR SERVICE?
COMMENTS FROM SERVICE USERS
1. More stimulation – something to do with an end product.
2. Better quality of life
3. I can’t see how new changes will effect my day centre services or respite.
COMMENTS FROM SERVICE PROVIDERS
1. It would improve the level of care and interests that we are able to provide.
COMMENTS FROM OTHER
1. I think respite care for carers is greatly needed
2. Needs a level professional care so would be affected if this was reduced.
2a) THE DEPARTMENT IS KEEN TO PROVIDE MORE FLEXIBLE SERVICES – WHAT OPENING TIMES DO YOU THINK WOULD BE MOST BENEFICIAL?
RANGE REQUESTED FROM SERVICE PROVIDERS
8 -7 Monday to Friday
9-1 Sat & Sun
COMMENTS
“I haven’t had the need to contact the department so really do not wish to comment, although carers would benefit from someone they could contact by telephone particularly in an emergency. At a meeting I recently attended ….it was suggested by a member that a number (not ambulance) to contact should someone have a fall but not badly hurt, to help lift that person, would be a tremendous help.” (S/P voluntary sector)
RANGE REQUESTED FROM “OTHER”
Monday to Friday - 7am – 7pm
Saturday/Sunday 9am – 1pm; 11am – 3pm; 8am – 5pm
COMMENTS
1. The weekend can be a lonely difficult time for many elderly people.
2b) WOULD THESE HOURS NEED TO VARY SEASONALLY?
12 (30%) said YES 25 (62.5%) said NO 3 (7.5%) did not give an answer
COMMENTS FROM SERVICE USERS
1. The current hours suit my needs as a service user