Agenda item

[To consider the responses received during a public consultation into the decommissioning of existing services, the recommission of services and to consider the progression of the Better Care Technology Offer.]

Cllr Paula Brookfield welcomed Elias Mattu, Cabinet Member, Adults and Anthony Ivko, Service Director Older People to introduce the ‘Better Care Technology and Strengthening Support at home’ report to Panel.

The Service Director highlighted from the report that the Council is progressing an ambitious development of its services in line with the Care Act policy drivers. The objective being to intervene and support people earlier, reduce, defer and delay the need for more intensive support by having better information and alternatives of less intensive care to help people be as independent as possible.

He advised that Cabinet had approved five recommendations in July 2015 which are an integral part of the transformation of older people’s services, from ‘care home to care at home’ and that the report before the Panel provided the outcomes of the consultations and actions to mitigate risks associated with the recommendations, advised of the progression and development of ‘Better Care Technology and of work with Wolverhampton Homes (WH) and discussions with statutory agencies to explore a collaborative approach for the delivery of Better Care Technology offer. 

The Service Director informed the Panel that the pubic consultation events had been carried out but had not been well attended and that a petition signed by 5,637 residents had been received at Council and a discussion had taken place regarding concerns raised. He advised that concerns raised during the consultation process had been detailed in the report. 

The Scrutiny Panel raised a number of concerns relating to the following:

·         The quality of service provision being maintained by private sector providers. 

·         The commitment to long term residents maintaining friendship groups

·         Social workers capacity to maintain regular visits

·         Carers also need some support

The Service Director advised that 98% of services were already delivered by the care sector and quality is monitored and inspected by the Care Quality Commission (CQC). Cllr Elias Mattu, Cabinet Member Adults indicated that of the 72 beds in the residential facility there were 10 full time residents and that the cost of running the facility is high. He informed the Panel that the cost of private sector care is less than half the price per bed.

In response to concerns about the long term resident groups he clarified that a commitment had been given at the Council meeting that every effort would be made to maintain friendships groups.  He advised that there was enough capacity for a group of four and six people together.

Cllr Patricia Patten highlighted the need to address concerns and reassure individuals about the changes, the Service Director advised that there is a Social Worker allocated for each resident in the homes, the social worker will support them through change. He confirmed that all carers and residents will be fully involved.   

The Cabinet Member informed the Panel that the Care Act and Better Care Technology are the crux of safeguarding for adults moving forward. He emphasized that Unison comments will be taken into account and that in addition to the new accommodation being more cost effective the facility will be better and modern.  The Service Director highlighted that this option can increase reablement by between 27,000 - 40,000 hours per annum. He advised that for respite care there will be flexibility of choice and sufficient capacity for individuals to be in the area of choice and for individuals to book direct to the home of their choice.  He clarified that this will be achieved by block booking beds across the City for each day of the year.

In response to questions about the responder service to be provided by the Fire Service the Panel were advised that the Fire Service has for a number of years, provided visits to homes to check and install fire detectors; the fire service will highlight any concerns for the safety of an individual to the Council. 

The Chair, Cllr Paula Brookfield asked whether the places currently available were to be type specific.  The Service Director advised that that individual needs are known and that a brokerage team checks bed availability weekly. He indicated that there would be a clear pathway where the Council is an enabler, and to be clear that there are ways or reassurance and re-enabling to help individuals who may feel isolated.

The Service Director referred to the assistive technology visit for the Panel planned in January 2016 and that at the visits councillors would see a range of technology, interactive and passive that help people in their homes.  He advised that the hands on technology also supports carers and gives confidence to the individuals offering peace of mind that there is someone available to contact, something to remind them when it is time to take tablets or a pressure pad mat to turn on a light.

Cllr Lynne Moran voiced concerns that ‘the new technology may not work for people with dementia who may only relate to a person’. The Chair welcomed the technologies ability to help carers and people with dementia, she indicated that people with dementia may revert back to first language or forget how to use technology as part of their condition and that some individuals with specific needs may not be able to comprehend modern technology.  She asked how we can demonstrate that people will have a comprehensive service and that individuals do not fall between the cracks.  The Service Director listed the following points:

·         Reablement hours

·         New technology

·         Social Workers working at constituency level

·         Better Care Fund is supporting the development of integrated teams

He advised that the Council aims to spend more to support people living in their own home and if and when they need more care they will move to a nursing home, better care technology will help this to happen.

Cllr Barry Findlay asked about the timetable for de-commissioning and how the introduction of ‘telecare’ dovetails into the timetable.  The Cabinet Member and Service Director advised that a programme for changes will be prepared following approval by Cabinet. The Chair and Panel sought reassurance that the Scrutiny Panel would have opportunity to review the timetable before the plan is moved forward.

Cllr Daniel Warren referred to recent issues with hospital bed discharge targets and was advised that the hospital and adult services have daily contact and know every person moving home or into hospital first thing in the morning.

The Service Director  advised that the number of people moving into acute care is on average 270-330 per day.  However for the last three months this figure is up to 360 per day putting pressure on admissions to hospital.  He clarified that the Royal Wolverhampton Trust (RWT) and Clinical Commissioning Group (CCG) work closely with the Council regarding flow of people in and out of hospital, home and care homes.  He informed the Panel that there is an integrated team based in the hospital, nurses, social workers / physician and one manager and that the discharge team are unique in that they are the only team to have dual access to patient record.

Panel voiced concerns that the cost of the service will go up as a result of the planned national minimum wage / living wage increase. The Service Director acknowledged that living wage increases are a concern but that it has to be addressed

The Chair referred to the issues highlighted around compliance and inspection. She identified the need to seek assurance that there is some sort of contract for the services provided.  That they are fully transparent, that carers and service users understand what they do, what to expect and who to contact if the service is not compliant. The Panel considered how CQC could monitor this level of care and suggested that monitoring would be needed.

Cllr Patricia Patten enquired if something about carers pay level and the quality of training should be a requirement of the contract for services. The Service Director welcomed the suggestions and agreed that any contract would include specifications such as training.

The Chair thanked the Cabinet Member and Service Director for presenting to and responding to the Panel.

Resolved:

That the Adult and Safer City Scrutiny Panel support the proposals contained in the report, subject to agreement to proceed by Cabinet, that:

·         The technology used is accessible for all those who are vulnerable

·         The implementation planning is properly coordinated to prevent gaps in care arising and keep the focus on keeping people safe

·         The implementation plan is monitored and reported on to Councillors     

·         There is sufficient capacity to monitor the quality of care and assurance systems for compliance with care standards

·         That sufficient capacity is developed to meet the increasing demographic pressures 

·         Sufficient Social Workcapacity is maintained to monitor the on-going needs of our vulnerable people and respond to changes in their care needs

·         Assurances can be built in on the quality of training for contracted services providing care to our vulnerable people