Ian Wake presented the report that set out the proposals to transform the adult social care provider services division and stressed that these were proposals and that no decisions had been made. This would be a Cabinet decision that had invited overview and scrutiny members to comment on the proposals as part of the normal consultation process. Ian Wake referred Members to the three proposals contained within the report which were (1) Restructure and transform the way that we provide care to create self-directed teams that he firmly believed would improve outcomes for residents and staff (2) Transformation of the day care services and (3) Proposal to decommission the meals on wheels service and action to provide this service through other mechanisms.
Councillor Ralph stated that this was the first time this report had been presented to this committee for members to review and to comment on.
Councillor Ralph welcomed Councillor Huelin, Cabinet Member for Adults and Communities, to the meeting to add any additional comments. Councillor Huelin stated that the report was very positive that would allow people who were receiving care to have much better control and to have a better understanding of individual needs who they could connect to in smaller groups locally. This in turn would connect them to other people and have the ability within their line of management to make changes rather than undertake a full very lengthy referral system. Councillor Huelin stated the day care provision was not disappearing it was being improved and stated the proposals would improve outcomes and health and wellbeing.
Councillor Ralph referred to the options of whether respite would be extending at Cromwell Road to which Ian Wake stated that by offering bespoke acceptable services and by rationalising the care on one site, money could be saved on buildings and more comprehensive services in terms of day care and respite would be available.
Councillor Ralph questioned the maximum distances that service users would have to travel to which Dawn Shepherd referred Councillor Ralph to Appendix 2 of the report that detailed the mileages in more detail. That an impact assessment would be undertaken on every service user to look at their distance of travel to Cromwell Road.
Councillor Ralph asked for reassure again that no services were closing down and the services were being relocated to a better location which would offer extended hours to which Ian Wake agreed.
Councillor Ralph noted that this industry was low paid, low valued and had a high turnaround of staff and questioned what could be done.
Councillor Holloway was upset to read the meals on wheels service was a nice to have service rather than an essential one, and continued to state that this was more than just a delivery service. Councillor Holloway was concerned that no proper consultation had been undertaken and there needed to be one.
Councillor Holloway questioned what “much higher” meant in paragraph 3.6.3 of the report; paragraph 5.1 referred to the consultation and questioned what consideration had been given to the other 34% service users who did not have alternative options should the service no longer available. Councillor Holloway stated this report focused on the elderly and the Council needed to make sure they were all ok. Councillor Holloway also stated there appeared to be no service in place yet to replace it and although she understood we had to be efficient but something needed to be in place and not just waiting for a service to pop up; paragraph 3.7.2 referred to the savings of £554,000 and questioned whether this would be reinvested back into the service to make sure that overall adult social care had that investment to provide the best services for those people that need it. Ian Wake replied in order to Councillor Holloway questions by stating that once all the £4 incomes had been tallied up alongside the cost to run the service, the cost to the Council would be £190K. In regards to timings this would be a fair challenge as development on those services could not start before a decision had been made to close this and that conversations had taken place with the service manager to look at the wider range of alternatives that were available. In regards to the final question the budget for next year would go to Cabinet for approval and could not give any guarantee that the £554,000 would go back to adult social care.
In relation to Councillor Holloway question, Councillor Huelin stated that calculation would be £190,000 divided by the 29 service users which totalled just under a £18 per meal.
Councillor Ralph referred to another proposal which had set up a micro enterprise to provide an alternative option and questioned how much they would be charging per meal to which Ian Wake stated the programme had not been set up yet and therefore this figure could not be calculated at this time.
Councillor Holloway stated that the calculation provided by Councillor Huelin did not present value for the service that was being provided and recognised that the service should be run in a better way. Her concern was the reduction of the service not supporting the user and there being no plans in place and that there was no safety net to ensure there would be a service for those people who would be impacted. Councillor Holloway recommended the service should not be cut until a consultation had taken place and a replacement service was in place for those that needed it, this will ensure that no one would be forgotten or missed.
Councillor Ralph agreed that it was part of this committee to scrutiny and comment on the report before it goes to Cabinet and was also concerned that in theory those 29 service users could be left without a meal.
Councillor Fish stated the report referred to independence which he understood as giving people the choice and control over what happened to them, the support they actually needed and would like to see the service developed alongside service users. Ian Wake stated that the Council, under the Care Act 2014, had a legal duty to ensure every service user had a package of care and support and reassured Members that every service user would be assessed to ensure the correct care package was in place.
Councillor Polley agreed that micro enterprises could offer more specific meals to individuals and could offer a self-centred approach that would focus on the elderly residents and agreed that there needed to be a safety net with a service in place before services were closed. Councillor Polley had concerns on the quality of the consultation and questioned how day care would work at Cromwell Road when it was opened to all. Councillor Polley welcomed the report which had lots of positives as a starting point but conversations should commence that would offer the potentials to service user care and more people friendly services.
Councillor Piccolo questioned whether transport would be available to Cromwell Road as required; if a service user cannot source a meal would this be provided at Cromwell Road until something was in place and agreed that small teams were a good system with massive benefits for both the service user and carers. Ian Wake stated that residents would be offered much more choice of how service users got to Cromwell Road with a bespoke service and an available constant flow of traffic. Councillor Piccolo questioned whether the transport service would cope with the influx of service users to Cromwell Road to which Dawn Shepherd stated there would be an increase in drivers with 85% of service users arriving by mini bus.
Councillor Ralph questioned how those service users would receive a meal if they were not able to use the mini bus to get to Cromwell Road to which Dawn Shepherd stated that assessments would be carried out on all service users to identify those and put safety nets in place to ensure that every service user received a meal.
Neil Woodbridge stated that in regards to meals on wheels he reassured members that in the community there were solutions available for individuals that received meals from family members, from a pub or local café and these solutions could be worked on through the health and wellbeing teams. In regards to the day care centre Neil Woodbridge stated it could be seen as a consolidation rather than a closure and that transport required some careful solutions put in place. In regards to the consultation his comments were that the voice of the elderly and also carers, especially family carers, should be heard. Also Neil Woodbridge asked how future proof were the proposals in regards to future capacity in terms of population in Thurrock with more vulnerable people who may need this service. Ian Wake stated that was a challenge with the growing elderly population and that a range and bespoke provision was required to best future proof provisions rather than having a single model and trying to expand as one size provision would not suit all.
Councillor Ralph questioned whether Cromwell Road had the opportunity for expansion to which Dawn Shepherd stated the plan would be to change the rooms currently used by staff and for storage into rooms for activities which would offer a menu of activities such as arts, crafts and cooking. Residents would have a choice of what activities they would like to do either as a group or individually. That there was also an outside area with the opportunity to undertaken garden activities.
Councillor Sammons commented that the journey for some residents was part of their day and encouraged the interaction on board. Councillor Sammons stated the opportunity to offer varied entertainment activities was good but support must be encouraged around meal times but concluded that the report had some very positive and promising recommendations.
Councillor Holloway suggested the recommendation be amended to reflect the comments made this evening and that a consultation be undertaken. Following some discussion on the recommendation it was agreed that democratic services would take this away and look at the recommendation wording and send to Members for approval.
Councillor Ralph referred Members to the three proposals contained within the agenda and agreed and commended the work undertaken under proposal one to restructure and transform the way that we provide care to create self-directed teams that he firmly believed would improve outcomes for residents and staff; ensure that the transportation had to be the right transport and the most suitable transport in regards to the second proposal on transformation of the day care services. In regards to third proposal to decommission the meals on wheels service and action to provide this service through other mechanisms it was agreed that a new recommendation be added as shown below as recommendation 2.
1. That the Health and Wellbeing Overview & Scrutiny Committee commented on the proposals to transform and improve Provider Services set out in this paper.
2. That the service should not be cut until a consultation has been held and individual plans for those currently receiving the meals on wheels service are designed in a collaborative approach with service users, service user families and their carers.
Councillor Huelin left the Council Chamber at 8.33pm.