Agenda item

Following the announcement by the City Mayor of a forthcoming proposal, following statutory consultation, to close Martin House Day Centre and Visamo Day Centre that provided services for older people with mental health issues, a statutory call-in by members was made and it was agreed that the issue be brought to this Scrutiny Commission.

The Scrutiny Commission received a report that set out information relating to the consultation process and the key findings were detailed within the report. The recommendation within the report was to close both services as the quality of service had been adversely affected by the low numbers using the service and therefore they were no longer financially viable.

A number of options were set out in the report and these are set out below: -

Option 1.Do nothing.  This is not an option because the service is no longer adequate for service users and is financially unviable.

Options 2.Expand the services offered by actively marketing and attracting people into the service.The service would need to be totally redesigned and change the way it operates in order to ensure the long term sustainability as evidence already shows that people are not choosing traditional day services and are instead opting for community based services that offer greater innovation and flexibility, including evening and weekend provision.

Option 3. Combine the two services to run from one building.  This is not a viable option as based on current evidence, the combined service would still be relatively small and would therefore be unaffordable when applying true costs of the service which currently stand at £111 per person per day, compared to an average of £28 per person per day in the voluntary sector.

Option 4. Develop the services into an Enablement /outreach service. Whilst this fits in with current model around the future of in-house provision, the proposal is premature as the redesign of in-house day care is in the early stages. Substantial change of this nature would mean current job descriptions and salary scales would have to be consulted on and revised and the opportunity to be part of the new service offered to a wider group of staff.

Option 5. Close the service and move existing service users to alternative provision.  This would ensure the provision of suitable stimulating services for individuals and deliver a cost effective solution.

·         In order to ensure the most sensitive and appropriate method of transition both service users and staff at the current OPMH service, the Council will:

·         Carry out an assessment of each individual during August and September 2013. This will be done with the full involvement of family carers and with the offer of advocacy support. The assessments will be carried out and followed through by a dedicated team of care managers who will then support individuals and their families to find appropriate services that meet their needs.

·         There are currently 152 vacancies within this type of provision in the voluntary sector and a number of other organisations keen to explore extending their offer to this client group.

·         The services include specialists in Dementia and Alzheimer’s and services that are able to meet the cultural needs of specific groups.

·         Following the transition of individuals to the new services care management officers will be identified to track their progress at 3, 6 and 12 months in order to ensure the new arrangements are meeting people’s needs.

·         It is envisaged that staff will be served 3 months’ notice at the end of August 2013 at which point they will be eligible to apply for redeployment opportunities across the whole council.

·         Where possible this may mean some staff will transition into the existing provider service and replace agency staff, thus bringing more stability and continuity in the services provided.

Councillor Willmott – expressed concerns at the proposals and questioned whether we should be closing both centres. It was realised that not all provision for people with mental health issues was with the City Council and that there was no overall consistency. Whilst it was accepted that the two centres might not be the best way to continue he strongly felt that the City Council should retain some provision. The report provided did not specify what alternative provision was in place, where, and what times. Councillor Willmott questioned whether the alternative provision was reliable.

Councillor Chaplin – recognised the need for the Council to make savings and recognised that the services outlined were not as well used as previously. Councillor Chaplin expressed concerns that Adult Social Care did not communicate their services particularly well, along with other areas of the Council. There was a need to undertake a thorough assessment of what was communicated. Councillor Chaplin also expressed concern that the report did not specify who the other providers were, and outline what they did.

Councillor Joshi – stated that his main concerns centred around the Financial Implications and expressed concern that there was currently a lot of uncertainty within the voluntary sector. Having looked at the Options referred to in the report Councillor Joshi favoured Option 5.

Councillor Chaplin – Suggested the following recommendations: -

i)          that communication issues around Adult Social Care services be addressed, the emphasis being to be proactive about communicating services.

ii)         that those people who may be moved from one service to another be subjected to the necessary care and that the necessary checks are also put in place.

Councillor Patel – welcomed the recommendations proposed by Councillor Chaplin around communications and gave assurances that this area was improving. Regarding the comments around the voluntary sector, it was apparent that all areas were being squeezed financially and that when capacity was being talked about it must relate to real capacity. Councillor Patel stated that she would like officers to respond to the comments made in detail.

Officers reported that the City Council had a personalisation programme in place and people were able to calculate their own personal budget. Because City Council services were more expensive compared to the voluntary sector people tended to go to the voluntary sector to get better value for money. A list setting out voluntary sector provision and vacancies was available and processes were in place to monitor care of those voluntary sector services.

Gaynor Garner (UNISON) – stated that she was aware that this topic had previously been discussed by the Scrutiny Commission, prior to the statutory consultation, but UNISON had not had the opportunity to speak to staff and provide feedback to the Scrutiny Commission in time for the meeting. Of the options specified in the report UNISON favoured Option 4 to develop the service into an enablement service.

Officers informed the Commission that voluntary sector providers offered greater flexibility in what they offered. Enablement Services were something that the City Council was looking at for the future. Day Care Support was already in place to support people.

Councillor Alfonso – questioned the capacity and current usage of each of the two City Council facilities.

Officers stated that the combined capacity was some 40 people per day, the current usage being only some 8-9 people per day across both facilities.

Councillor Joshi – sought explanations as to the main reasons for the drop in numbers using the two City Council facilities.

Officers stated that the main reasons were deaths, a move to residential care and the move to voluntary sector facilities to achieve better value.

Chair – stated that this was again a situation whereby  closure of City Council facilities were being recommended and a reliance placed on the voluntary sector to provide services. Councillor Moore suggested that the position outlined in the report should be noted and that communication issues around Adult Social Care services be addressed, the emphasis being to be proactive about communicating services.

Councillor Willmott – stated that he was really concerned that the City Council would no longer have a provision of day services for older people with mental health problems. Councillor Willmott expressed a view that a officers should be asked to look at a combination of Options 3 and 4 should be looked at with the aim of reducing costs. Councillor Willmott stated that he was not convinced of the costs quoted in the report.

Councillor Chaplin – stated that maybe if the two facilities were not closed then the various options could be looked at that would be cheaper than the voluntary sector. If a re-configuration was being considered then surely all services provided should be looked at as a whole.

At this point the Chair suggested that votes be taken on the two options favoured by members: -

i)          that officers be asked to look at a combination of Options 3 and 4    referred to in the report, with the aim of reducing costs.

ii)         that Option 5 be supported, close the service and move existing       service users to alternative provision

Voting took place and 2 members voted for recommendation (i) and 3 members voted for recommendation (ii).

Recommendation (ii) was carried.