Issue - meetings

Cabinet Member: Adult Social Care

Forward Plan Ref: 2015/121

Contact: Benedict Leigh, Strategic Commissioner (Adults) Tel: (01865) 323548

Report by Director for Adult Social Care (CA8).

The current system of short term support social care in Oxfordshire has evolved piecemeal with services created in response to perceived problems and without a proper strategic consideration of the pathway as a whole. There are currently seven different services in place, and so it is difficult for professionals or members of the public to understand the most appropriate route that people should follow through them to meet their specific needs.

These short term services provide reablement, a key element of the council's aim to prevent further escalation of need for older adults and other vulnerable people; and crisis support at home, a safety net for people living in the community.

The pathway redesign proposed in the report brings together the functions of the seven current services into two new services: the Urgent Response and Telecare Service; and the Hospital Discharge and Reablement Service. If successfully delivered, this new pathway will provide the modelled demand for these services and the desired outcomes for people, at a reduced cost to the council by reducing duplication and by the services becoming more efficient and more effective.

The report describes the alternative methods available for purchasing the services and makes recommendations for the preferred options, after consideration of the risks and financial implications involved.

The Cabinet is RECOMMENDED to approve:

(a)          the service model and procurement approach for the Urgent Response and Telecare Service;

(b)          the Continuity of Provider approach to deliver a combined Hospital Discharge & Reablement Service (including community reablement);

(c)          the proposed gateways, including the option to change the approach to the procurement option if the provider fails to meet the gateway targets, delegating final approval of the gateways to the Director of Adult Social Services.

Recommendations agreed subject to the amendment shown in bold italics.

^{The Cabinet heard that the current system of short term support social care in Oxfordshire had evolved piecemeal with services created in response to perceived problems and without a proper strategic consideration of the pathway as a whole. There were currently seven different services in place, and so it was difficult for professionals or members of the public to understand the most appropriate route that people should follow through them to meet their specific needs.}

^{The pathway redesign proposed in the report brought together the functions of the seven current services into two new services: the Urgent Response and Telecare Service; and the Hospital Discharge and Reablement Service.}

^{The report described the alternative methods available for purchasing the services and made recommendations for the preferred options, after consideration of the risks and financial implications involved.}

^{Councillor Laura Price, Shadow Cabinet Member for Adult Social Care welcomed the removal of duplication of services. However she had some concerns about dealing with a new provider and noted that the report was short on details. She would want to see information about how the geographical provision would work; on whether the lower cost was just about the removal of duplication or about a different service; what was the length of contract for continuity; how will the telephone response service impact on carer support; on the programme of review to ensure that it was robust and measuring the impact of changes from the outset; and how it fit with the wider discussions on health evolution. Councillor Price asked that existing health and Wellbeing Centres be involved.}

^{Kate Terroni, Deputy Director for Joint Commissioning responded to the questions asked: there would be a single co-ordinated service provided on a locality basis to prevent zig-zagging across the County; the savings would be delivered through a reduction induplication, through reduced handovers and less travel; the length of the contract was to be discussed but it was not a short term exercise; there would be no impact on carer support; the Health Overview and Scrutiny Committee would have oversight; and subject to the budget decisions on 16 February if Health and Wellbeing Centres were available they would want to use them.}

^{Councillor Heathcoat moved the recommendations including a change to recommendation (c) to ensure that the final decision is taken in consultation with the Cabinet member and the Head of Paid Service.}

RESOLVED:                  to approve:

(a)           the service model and procurement approach for the Urgent Response and Telecare Service;

(b)           the Continuity of Provider approach to deliver a combined Hospital Discharge & Reablement Service (including community reablement); and

(c)           the proposed gateways, including the option to change the approach to the procurement option if the provider fails to meet the gateway targets, delegating final approval of the gateways to the Director of Adult Social Services in consultation with the Cabinet Member for Adult Social Care and the Head of Paid Service.