10.15
The Head of Adult Social Care will give an oral update on key issues on behalf of the Director for Social & Community Services.
Minutes:
The Committee noted the update from the Head of Adult Social Care as listed below:
· Internal Home Support Service – the full proposals would be brought to this Committee’s December meeting for comment;
· Adult Placement Service (Shared Living) – the Committee had previously requested data on the number of people receiving assistance, which was as follows:
- 21 people with mental health problems;
- 26 people with physical disabilities;
- 87 people with learning disabilities;
- 16 older people.
Net costs varied between £303 and £461 per week. The costs were at the higher end, as the service users were predominantly people with learning disabilities. However, this was a cost effective service. Officers had tried to increase the number of older people using this service in the past. The service was now under new management and it was probably timely to try to increase the number of people using the service, including older people.
The Cabinet Member for Adult Services stated that at the last panel meeting it had been encouraging to see that younger people were coming forward to offer the service to people, as well as older people. He further stated that there did not seem to be a problem with recruitment at the moment.
· Prevalence of mental health problems in adults – the Committee had previously requested any empirical evidence on whether the number of adults with mental health problems had increased over the past few years. Some data had been circulated to Members via email, but overall the statistics were hazy as there was little data at a national or local level. The available data showed that there had been an increase in common mental disorders between 1993 and 2007, by 17% overall and by 20% for women. Work on gathering more evidence was being undertaken by Oxfordshire PCT. This was important as the Directorate could then take this into account in its medium term planning and any further data would be circulated to the Committee once available.
· Carers Services – the procurement exercise for the new carers services was underway. Eight organisations had been shortlisted and invited to tender and two had dropped out.The intention is that the new contract will start on 1 April 2011.
The same amount of money would be spent on carers as previously, but it would be reallocated differently. Slightly less money would be spent on the new contracts to enable extra funds to be put towards personal budgets.
Officers were currently developing a service level agreement with the new Customer Contact Centre, who were engaging very positively with the brief. In two month’s time, the Committee would have the opportunity to see the final Service Level Agreement. All staff in the Customer Service Centre would be trained to a basic level and there would also be some staff who would be designated specialists. Mystery shopping would also be carried out for quality control. There would be a number of options depending on carers’ levels of need. If their level of need was deemed to be higher than information provision they could be passed onto a social worker who would undertake a full community care assessment and offer them a home visit from a Carers’ Support Worker if necessary. They could also be signposted to other Carers’ Support Organisations.
A member of the Committee asked if there would be sufficient funds to provide the necessary additional support to carers.
The Head of Adult Social Care stated that it was anticipated that most carers could be signposted to places other than to a social worker and that this would be monitored in due course.
The Cabinet Member for Adult Services stated that the Council now wished to put more resources into services to carers rather than spend resource on infrastructure (ie the cost of the buildings for the Carers’ Centres).
· Intermediate Care Short Stay Beds – a decision had been made in August of this year to end the contracts with Watlington Care Home (13 beds) and Millhouse Care Home (9 beds) which are both private providers. These contracts had already ended, but were being rolled over on a month by month basis whilst the Directorate decided whether or not it wished to renew them. The decision to terminate the contracts would save approximately £800,000 per annum. A decision had been made to spend this money on the re-ablement service, which was part of the strategy to reduce delayed transfers of care. The decision regarding Watlngton Care Home had caused concern amongst some Members and the NHS. However, the occupancy rate was about 86% whereas officers would be looking for the mid 90’s and this was one of the factors that officers had taken into account when making their decision. Officers had decided to review this decision in light of the concern and would be doing so at the meeting of the Joint Management Group on 12 November. The Head of Adult Social Care would be reporting to the Oxfordshire Joint Health Overview and Scrutiny Committee (OJHOSC) on 11 November on the current position.
The Chairman of the OJHOSC stated that the process used in making the decision was its concern, rather than the decision itself.
· Service and Resource Planning and Star Chamber – Star Chamber had been held the previous week and there was a lot of follow up work to be done. There were areas where it was thought that savings could be identified. Another star chamber would be held on 24 November.
· Pilot with the NHS – Abingdon Whole Systems Pilot – This pilot was designed to avoid unnecessary acute admissions of older people to the Horton and John Radcliffe Hospitals and was one of the Oxfordshire PCT Chief Executive’s top priorities. Officers had decided to call the system a ‘diagnosis and triage unit’. A multidisciplinary team of doctors, therapists and social workers would work as a team with local GPs to bridge the gap between acute hospitals and primary care. GPs would make referrals for older people that they thought needed to go to hospital and the triage unit would attempt to deal with them to avoid the need for admission to the JR or Horton.
· Implications for Adult Social Care from the Comprehensive Spending Review
There were three main financial implications:
o approximately £1 billion by year 4, starting at approximately £800,000 would go from NHS capital to revenue, then should be made available for ‘social care that supports health’. This could result in about £8m per annum to Oxfordshire. All councils would have to wait to see how much of the £1b goes to Adult Social Care;
o the second tranche of money from the NHS to local authorities would be £1b per annum to the revenue support grant. However, the overall impact on local government is a 26% reduction in funding including the £1b;
o the Learning Disabilities and Health Reform Grant – further detail was awaited on this. It was thought that this was existing money going from the NHS to local authorities and officers had already transferred this money.