Councillors debate changes to adult social care. Cuts and cost savings equate to more choice and improvement in choice and quality say officers
DESPITE concerns from residents Thurrock councillors gave a relatively positive response when briefed on plans for a shake-up of Thurrock's adult social care provision, even though it will mean the closure of two day centres and, in all probability, the ending of the borough's Meals on Wheel service.
The changes – which may mean staff redundancies – will save the council approach half a million pounds a year.
Thurrock Council's Health and Wellbeing Overview and Scrutiny Committee were briefed this evening (Thursday, 17 June) by recently appointed corporate director of adults, housing and health Ian Wake, who told the meeting there the main proposal is the transformation and restructure about the way the council provides home care, saying current practices were outdated and not effective in meeting the needs of residents.
He broke his report (which can be read in full via this link into three sections.
There will be a major change in the way the council delivers care at home for residents.
The new model proposed will consist of small teams of 10 full time equivalent independence support workers, alongside a medication support worker and a planning support worker dedicated to a group of individual service users.
The teams will be working in either residential or community services with back office support, and a co-ordinator.
Mr Wake told members: "The planning support worker will become a trusted assessor who is upskilled to make decisions regarding commissioned hours of care, this level of localised decision-making based on service user requirements will lead to better outcomes.
"We have trialed and evaluated the service and I was astonished at the differences in outcomes."
Mr Wake then moved onto the controversial subject of closing two of the borough's three day centres, at Kynoch Court in Stanford-le-Hope and Bell House in South Ockendon, with participants in activities there being offered an alternative at a 'much-improved' central site on Cromwell Road in Grays.
Mr Wake said: "We will be transforming our day care provision. Historically we have provided care at three sites. The residents at Kynoch Court are not particularly happy at sharing their communal area, the shop at Bell House is not really suitable so we wish to centralise services to Cromwell Road in Grays."
The report said: "Bell House is a converted shop within a parade of shops in South Ockendon. It has no outlook to the front except to the shopping precinct, and the back leads out onto a loading bay. Above the shop are Council flats and there are other shops either side.
"This restricts the natural light to the building and prevents any garden/outdoor activities. It is unsuitable as a 21st century day care facility.
"Kynoch Court is a sheltered housing scheme; Day care services are run from one of the communal lounges. Space is extremely limited meaning activities are confined to only one room. Sheltered housing residents are generally unhappy with this use of their communal space and this often causes friction between tenants and service users.
"Cromwell Road is a much larger purpose built site with a number of rooms suited for various activities. It has parking on site for minibuses, outside garden areas that could be further developed and disabled facilities. Almost 50 per cent of Day Care attendees use this site."
And he then told members that it is planned, in around a year, to close the home meals service run by the council, replacing it with new micro enterprises It is anticipated that 28 of the current 90 people who use the service will not be served by the new system, but the alternative is planned to be taking them to Cromwell Road to eat.
Mr Wake said: "We inherited this service from WRVS and demand for this service had declined year on year and now we currently only have about 90 users and we find it increasingly difficult to justify the cost of this."
The impact of the changes, which officers and portfolio holder Cllr Deborah Huelin stressed is about service, nit just cost-cutting, will nevertheless cut around half a million of the existing bill.
Councillors expressed concern when they heard that this might not be returned to the adult social care budget! The council's corporate fiancé strategic lead, Mike Jones, reported to the meeting, telling councillors: "Reductions in staffing in the new structure will result in annual savings of around £339k. Current vacancies and assimilations will reduce the need for redundancies; however, it may be impossible to completely avoid redundancies. "Closing of the Meals on Wheels service will result in annual savings of £190,000 i.e. annual cost of running the service including staffing. A reduction in the use of buildings will be achieved. Bell House Day Care is accommodated in a shop in South Ockendon that, if vacated, could be let commercially. "The Meals on Wheels building at Corran Way sits on land that could be developed or sold. Both buildings are assets maintained by the General fund and once vacated will be handed back to the Assets team. Additional savings are achieved through the reduction in building maintenance and utilities. The savings identified will be include as part of the Council Medium Term financial strategy, and form part of the Department savings target." There has been criticism of the media, including Thurrock Nub News, by senior councillors and officers for reporting the planned changes with allegations that the reported facts are incorrect. Even though the changes, closures and cuts reported were confirmed at tonight's meeting! Committee chairman Cllr Shane Ralph said: "The media coverage does not represent this report" and his conservative colleague and adult social care portiolio holder Cllr Deb Huelin told the meeting: "I find this report to be very positive, it allows people who are receiving care to have much better care with better control of their needs. "For me this is about improving outcomes, it will be so much better. "Day care provision is not disappearing, we will be improving it." She criticised the conditions day car users were put in at Bell House and Kynoch Court, saying: "This is wrong in the modern 21st century. We have seen visitors suffering stress, being unhappy and not getting on. They are not having a great experience. "I don't understand why there has been do much derogatory media about this." Mr Wake told the meeting: "We can save money on buildings and invest in the care." That did prompt Cllr Ralph, to raise the issue of travelling but Mr Wake brushed away any concern, saying: "We looked at the distance service users would have to travel. it came to just under ten minutes extra journey." That appeared to appease the chairman who said: "We want to make it clear we are not closing down any service, we are relocating to a better venue that already exists." There was concern about the loss of the meals on wheels service. Cllr Victoria Holloway said: "We know that it is more than just delivering a meal, it's people checking on their well-being. I am concerned there has not been a proper consultation, where people have been asked the question, about this. "These are our older people and we need to make sure they are OK. "We appear to have nothing to replace this, we are just hoping that something will 'pop up'." Mr Wake responded by saying: "It's a bit of chicken and egg. We can't start developing new services unless we have agreed to close this! If cabinet were to make a decision on meals on wheels it would not come into effect until the next financial year with gives us time tofind alternatives." That didn't really appease Cllr Holloway who added: "My concern is there is nothing in place, there is no safety net to ensure there is a service. We should recommend that this should not be cut unless a replacement service is established, so we can be assured they will not be forgotten." That was echoed by Cllr Tony Fish who said: "I would like to see more consultation and service users fully involved." He said the scheme was short on detail. Cllr Georgette Polley said she could understand why change was needed, adding "We have a diverse demographic in Thurrock. Appetite is often very poor with the elderly, you have to give them what they want to eat." She recognised that there was an opportunity to make the choice of food and timescales of delivery more effective, adding: "There may be benefits from a more bespoke, localised service. Some of these micro enterprises may be able to deliver this because they are a much smaller scale. "We can deliver a much more personally focused approach." However, Cllr Polley also advised caution about the speed of change saying: "We can make sure that our elderly people get something that they want. But there has to be something in place until we can offer that. I do see a lot of positives in this – as a starting point! Present at the meeting for the first time was Neil Woodbridge, co-opted to represent Thurrock Lifestyle Solutions (TLS) and bring a fresh and informed perspective to meetings. He said reflected on transport issues that might affect both the day centre and meals supply service, saying: "Closing these centres could be scary. It's not so much a closure as a consolidation, but there are concerns, including transport," and he pointed out the frequent problems of travelling around Thurrock, suggesting delays could be longer than officers anticipated or accounted for. He said he felt there could have been more consultation to hear the voice of the people concerned, including their family and carers. And he asked: "How future proofed is this? What about future capacity? How confident are the officers it is future proofed." Mr Wake said: "It is a good challenge, we have a burgeoning older population, we need a variety of provision and we will look at different measures of future proofing. "As the new generation comes through and as people get older there will be an element of more personal choice. That becomes more and more important, offering a greater freedom of choice. We need to watch things. I think the model is future proofed for the next few years but I wouldn't like to give any guarantees beyond that." The issue of transport was touched on by Jo Broadbent, the Interim Director of Public Health, who said: "We will still retain the mini busses and drivers we have now, so it's just a case of driving somewhere different but we want to give people more choice, ie making the attendance more bespoke." She made no reference to the possibility of cutting staff in fact spoke to the contrary, saying: "There would be more capacity, with more drivers. I can't see transport being a problem." Cllr Sue Sammons said she was pleased to hear that and added: "The journey is part of their day, they get quite comfortable and so ten minutes extra may be very nice for them to mix with people. If you are offering more varied entertainment at the day centre, that has also got to be a good thing." The issue of cost saving reared its head when Mr Wake was asked if the money saved by closing day centres and the meals on wheels would be recycled into the already stretched adult social care budget. He responded by saying: "It is beyond my paygrade, experience or control. I can't give you a guarantee the money will come back to adult social care. That's not the way it operates." The whole meeting can be viewed via this link.
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