13:40
The Director for Social & Community Services will give an oral update on key issues.
Minutes:
The Committee noted the update from the Director for Social & Community Services as listed below:
National level
· The NHS White Paper (Refer previous agenda item);
· The government’s spending review – submissions for efficiency savings had been made by each department (these were not public) and directorate. The Director for Social & Community Services had been working on the adult social care submission which would be approved by the Local Government Association Executive on 16 September;
· Funding of long term adult social care – the government had now come forward with proposals to look at funding – the Commission had a quite broad terms of reference and was due to report next summer. There would then be a White Paper on adult social care in 2011;
· Support for younger adults with disabilities – decisions had been made in March to cut back on the Independent Living Fund which awards payments directly to people with disabilities to support the cost of their personal care and/or domestic assistance. The government had also increased the amount that local authorities must contribute to support packages to £340 per week which was causing pressures for adult social care. The Director for Social & Community Services stated that he had just received a letter from the Department for Health which stated that the funding might be transferred to social services. New applicants would not be entitled to any funding. Discussions with the Association of Directors of Adult Social Services (ADASS) had not yet taken place. Adult Social Care was quite heavily dependent on such benefits and Supporting People funding, as well as other funding.
Local Level
· Internal Home Support Service– the future of this was a challenging issue. Discussions with staff would need to take place. There was a very good internal work force but people with personal budgets could choose where to go to for care. The Resource Allocation Policy assumed an hourly rate of £15 per hour for home care. This was in line with the average rate. Some local authorities in the South East paid £12 per hour. The cost of employing a home support worker was currently £11 per hour. The Directorate were going to market to get providers would provide services for £15 per hour.
· Carers’ Strategy– the Directorate had been heavily involved with a number of different forums regarding carers’ issues and the Director had recently spoken to a large group of carers about their issues. It was important to emphasise that the changes in service provision for carers was not being driven by the need to make efficiency savings but about enabling people to look after themselves and to reach a much larger number of carers. Although some people did heavily use the carers’ centres, they were only being used by approximately 15% of carers in Oxfordshire and money was being spent on buildings and infrastructure which could be better invested elsewhere. The key point was the need to reach more people and better advertise existing services to them. The new Carers’ Strategy was been based on feedback received from carers. The new Customer Service Centre would assist with identifying and advising carers. Everyone who telephoned the Centre with any query would be asked if they had a caring responsibility and if they needed any assistance. Some of this marketing of information would be carried out through the new Information and Advice (and Advocacy) Strategy.
A few members of the Committee then expressed the following concerns regarding the new approach:
o a number of carers would not have any other connection to adult social care and might not telephone the call centre with any queries relating to council services;
o people needing help might be put off from seeking help because they did not want adult social care involvement;
o carers often needed more than just information. The lack of certainty regarding future funding for services caused considerable anxiety for carers and carers faced complex issues. Many carers needed to sit and talk face to face with another person, especially at points of crisis;
o a lot of carers would need more help than the carers’ centres or a help line could provide;
o working with GPs was very important because they treated the patients for physical and mental symptoms but often did not see beyond this. GPs needed to be trained in asking the right questions and signposting, not just giving someone an information sheet;
o Surely the call centre and outreach approach had implications for people without good English or for whom English was not their first language?;
o One stop shops were often not being used and should be subsidised by the county council. The one in Wantage had closed.
The Director for Social & Community Services stated that these were all important points and responded as follows:
· Carers often did not identify themselves as carers and identifying how to reach them was key, hence the suggested approach for the Customer Contact Centre. A lot of older people came into contact with adult social care via the Access Team and officers needed to think about how to publicise the importance of people coming forward. Many carers did not like the term ‘Access Team’ and the term ‘Social Services’ carried a stigma for many people. People often did not know anything about adult social care until they had a problem. There was a need for more signposting to information on the county council’s website, for example, how to adapt your house to changing needs;
· Outreach workers would be tasked with going out into communities and identifying carers needing assistance;
· The single person translation service was based in the Access Team and thus is now part of the Customer Contact Centre. There were also community development workers who spoke the language(s) of and worked with particular ethnic communities;
· There was no reason why the existing Carers’ Centres could not continue to operate but they did need to use a different model.
A few members of the Committee then put forward a number of suggestions to increase identification of carers. These included:
o using the Media for publicity;
o using local parish councils to gather intelligence. For example, the parish clerks could be asked to raise awareness of the need to identify carers who needed help and parish magazines were also useful sources of publicity;
o People that ran luncheon clubs and the like could also be a valuable source of information;
o Councillors could also be useful conduits of advice and information.
The Cabinet Member for Adult Services then responded as follows:
· with regard to the Customer Contact Centre, people often did not identify themselves as a carer. For example, they might ring up wanting to report a pot hole as their husband had gone over it on their mobility scooter. A discreet approach could then be taken, ie “You sound like a carer, do you need any help?”;
· publicity was important but officers needed to wait until outreach was in place across the county before spreading the word in local parish magazines as local carers services needed to be put in place first;
· funding was being withdrawn from the Carers’ Centres on the grounds that it could be better spent elsewhere. They were no longer fit for purpose in the current model and money was being reallocated to different ways of delivering services. The Chief Executive of Carers’ UK had endorsed this service change on the grounds that a new model of delivery was more suitable to current demand.
The Director for Social & Community Services advised the Committee that should they have any queries regarding casework if they emailed him directly or his PA they would receive a comprehensive response.
· Day Opportunities – this was about trying to protect and improve provision.
· Older People’s Pooled Budget– there had been pressures on this for some time. It would be important to reduce very significantly the spending on residential care for older people. The Directorate was being careful about when it started care packages, which was therefore impacting on delayed transfers of care, as people were staying in hospital for longer. However, the key point was to keep people well for longer to avoid admission to hospital, as going into hospital often led to further deterioration in physical and mental wellbeing, for example, loss of confidence and mobility. Discussions were underway with the Oxford Radcliffe Hospitals NHS Trust (ORH) and NHS Oxfordshire.
The Whole System pilot was taking forward ideas form Professor Ian Philp – the previous government’s older person’s tsar (author of ‘Better Health in Old Age’), now Professor of Health Care for Older People at Sheffield University and a part-time medical director at Warwickshire PCT. His speech at a seminar had highlighted the importance of trying to prevent older people going to the acute sector as quickly, trying to reduce their length of stay in hospital and discharge them quickly and avoid the need for them to require more provision once discharged. The PCT, Adult Social Care and Community Health Oxfordshire were working with consultants in the ORH to implement this approach.
Following the update, it was AGREED that an oral update on the current position of the Council’s internal home support service would be provided under the Director’s update at the Committee’s next meeting.