Agenda item

The Director for Care Services and Commissioning (Adult Social Care) submits a report recommending the way forward following the consultation on proposals to remodel the Adult Social Care Non-Statutory Support Services, (previously known as Housing Related Support/Supporting People), to deliver required savings as set out in the budget setting process.  The Commission is recommended to receive the report and comment as appropriate.

The Director for Care Services and Commissioning (Adult Social Care) submitted a report recommending the way forward following the consultation on proposals to remodel Ault Social Care Non-Statutory Support Services, (previously known as Housing Related Support / Supporting People).

 

Alistair Jackson, Chief Executive of the Leicester Quaker Housing Association, addressed the Commission at the invitation of the Chair.  He reminded Members that the Association ran John Woolman House and thanked the Council for accepting the concerns previously identified, (minute 68(a)(i), “Representations on the Housing Support Services Consultation: Representations – Alistair Jackson-Chief Executive of Leicester Quaker Housing Association”, 5 December 2013 referred). 

 

Alistair Jackson stated that the funding it was now proposed would be made available for core support services was welcomed, but there was concern about the continuing decision to no longer fund from the alarm system.  This meant that residents who wanted to use the alarm system would have to pay for it themselves, but no benefits payments or subsidies were available to cover this cost.  Some of the tenants of John Wolman House had very low incomes and there was concern that they would not be able to afford this additional charge.

 

Under the amended proposal for funding, John Woolman House would lose approximately £50,000.  The Leicester Quaker Housing Association therefore would need to find its own resources to meet the shortfall and would have to work closely with the tenants to identify what services the tenants wanted funded.

 

Council Senior, a Member for the Castle Ward, addressed the Commission at the invitation of the Chair.  She stated that the decision to provide core support for John Woolman House for 15 hours per week was welcomed, but 15 hours was not enough.  In addition, providing piecemeal support at different times on different days could fracture the community.  In view of this, Councillor Senior suggested that it would be preferable for housing-related support to be provided en bloc and on-site.  This also would save the costs of officers having to travel to visit the scheme.

 

Councillor Senior also raised concerns that having some residents using the alarm system and some not using it could be significant in an emergency situation.  An alarm system should be integral to sheltered housing.

 

Councillor Kitterick, a Member for the Castle Ward, addressed the Commission at the invitation of the Chair, making the following points:-

 

·           It was recognised that people preferred to stay in their own homes, but their needs could change.  Housing schemes such as John Woolman House were important in these situations, providing a place people could go when they were unable to live in their own homes, but could still lead a full life.  The quality of life for these people was better and living costs were cheaper than in residential care;

 

·           Although further discussions were needed on the details of how it would operate, the funding of core hours was welcomed.  However, 15 hours could be insufficient, so further negotiation could be needed on this figure;

 

·           Having regular core hours was suitable if people had predictable needs.  Floating support could be unavailable when it was needed;

 

·           Confirmation was sought on whether core support would be provided by existing housing managers; and

 

·           The alarm system gave very good value for money, the cost of not having it potentially being greater than having it.  In addition, the £16,000 that it cost to operate for those tenants with no other on-site support was a small part of Council expenditure, so should not be hard to fund in the future

 

Councillor Clayton, a Member for the Castle Ward, addressed the Commission at the invitation of the Chair.  He stressed that schemes such as John Woolman House were important to the residents and to the Council.  These schemes offered a stage between living in their own accommodation and residential care.  This was important as, for example, the health of people going in to residential accommodation earlier than they needed to could decline more quickly than that of people living in schemes such as John Woolman House.  The schemes had a community atmosphere and the residents supported each other.

 

Councillor Clayton reminded the Commission that these schemes cost less than residential care to provide.  This was particularly significant, as the current financial situation meant that more importance needed to be given to the long-term consequences of decisions.  For example, the cost of the alarm system currently provided was a relatively small, but the benefits of it were great.

 

In reply, the City Mayor reiterated that that the scale of the financial reductions that the Council had to make was unprecedented.  As a result, it was important to undertake reviews of significant issues, to enable proposals to be properly examined.  In this case, the views submitted had been taken account of and some changes suggested, but further work needed to be done to develop the proposal.

 

The City Mayor confirmed that the cost of the alarm system was comparatively small for those tenants with no other on-site support, but noted that the Council funded a lot of items at this level and these small amounts could add up to a significant sum.  He also reminded the Commission that residents in other settings paid for alarm services through their rents and some of these people had similar levels of need as the residents of John Woolman House

 

In reply to a question from the Commission, Alistair Jackson advised that:-

 

o    Some of the tenants at John Woolman House were not very vulnerable and some were.  The Housing Association would need to consider the needs of the tenants and the demands on the Housing Association’s capacity and resources to see if those levels of needs could be met.  However, it was not possible to state that particular things could be done with particular numbers of hours of support, as needs could vary greatly;

 

o    Housing officers currently were on-site at John Woolman House from 9.00 am to 5.00 pm five days per week (Monday – Friday) and, where possible, some hours were provided on Saturdays.  If possible, there was more than one member of staff on duty at a time;

 

o    The Housing Association’s only other source from income was from tenants’ rents.  These would be used to pay for the additional support that would be needed if only 15 hours of core support was funded by the Council; and

 

o    The Housing Association had already had to make savings, which it had tried to do through reducing central costs, headquarters’ officers and computer systems.  If the Council moved to providing the level of support now proposed, consultations would be held with residents on how the savings could be achieved.  Negotiations also would be needed with staff.  Things such as single staffing could be considered, but the services offered needed to benefit the tenants.

 

In response to this, it was suggested that the City Mayor and Executive could be asked to seek to maintain a service that prevented people having to go in to more expensive care and maximised their ability to stay independent.  Maintaining an alarm system for the current tenants who had no other on-site support was welcomed, but it also was suggested that the City Mayor and Executive could be asked to maintain it for future residents, possibly on a means-tested basis, with funding coming from the proposed planning provision. 

 

The City Mayor questioned the rationale for continuing to provide an alarm system for these tenants, when there would be tenants in other settings who also could not afford to pay for an alarm system.  Members also questioned whether it would be feasible or equitable for some members of a particular community to receive assistance towards an alarm system, but not others.  To have disjointed provision of alarms also could have implications for things such as winter care planning and care for people with degenerative conditions.  It therefore was asked if an indication could be given of the number of people who currently used an alarm system.

 

The City Mayor stressed that an alarm service would continue to be provided for people who currently received it, who had no other on site-support.  He noted that it was not unusual for different providers to give different support to individuals.

 

Councillor Senior suggested that having to meet additional costs, such as those for an alarm service, could discourage people from using similar schemes in the future.  This could result in some people going straight in to residential care, rather than the type of “half way” setting provided by schemes such as John Woolman House.

 

Councillor Kitterick suggested that discussions could be held between the Leicester Quaker Housing Association and the Council to determine what support was needed to stop the quality of life for the Association’s tenants reducing and to prevent early entry in to residential care.  It was recognised that the position with the alarm system funded by Housing Related Support monies for some tenants with no on-site support was an anomaly, but views could be sought on whether it should continue to be funded

 

It was noted that different alarm systems cost different amounts and concerns were raised that these varied considerably.  Approximately 130 people currently used alarm only systems.  They lived in housing association blocks across the city, where no other support was provided.  As they stopped using them, the system would be phased out.

 

In response to a question, the Lead Commissioner (Supported / Independent Living) advised the Commission that an approach had been made to Leicestershire County Council, to see what type of alarm system it provided and whether economies of scale could be achieved by operating a joint system.  However, the County Council had been at the point of procuring its own system, so the City Council had not been able to link in with it.

 

The Commission welcomed the suggestions being made, but questioned how an alarm system would be incorporated in to new care packages.  The Director for Care Services and Commissioning (Adult Social Care) reminded the Commission that not all residents in places such as John Woolman House had social services assessments.  Those that did not would not have a formal care package. 

 

However, in all settings such as these, the landlord would decide how the costs of an alarm system would be met.  Alistair Jackson confirmed that any new tenants at John Woolman House would be told when they moved in that the alarm was in their property, the cost of using the system, that it was the tenant’s responsibility to pay for it and that there would be no subsidy available for it, (unless this was found from elsewhere).

 

In response to further questions from the Commission, Alistair Jackson advised that:-

 

o    A range of things were provided through the core support offered.  For example, dealing with social isolation, resolving problems with care packages, helping people to remember to take their medication (the support workers could not administer medication), and helping those with mental health issues or learning disabilities.  The ability to offer this range and depth of services could not be maintained if funding was cut;

 

o    If tenants needed more support, the Council could consider providing floating support for individuals beyond the core hours.  The problem with this was that support could be needed outside of the scheduled hours for the floating support and that the person providing the floating support would not necessarily know the residents they were supporting; and

 

o    It was likely that a provider coming in to the setting for a few hours would not work well.  This type of support was more suitable for domiciliary care.

 

The Director for Care Services and Commissioning (Adult Social Care) advised that people would be assessed against a set criteria to determine if they were eligible for floating support, which was below the Adult Social Care statutory eligibility.  A framework agreement would be in place through which this support would be provided.  John Woolman House would be included in this, providing they got on the framework agreement, and so could be used as a provider if wished, but the choice of provider would be determined by the individual service user.  If the service user wished, they could receive a direct payment and pay a provider themselves. 

 

When children had special educational needs, a statement of those needs was made and their school received funding based on this.  The Commission suggested that housing associations could be encouraged to adopt a similar model for people in sheltered housing schemes who needed floating support.  Members noted that government policy was to move towards the personalisation of budgets, where funding was given directly to individuals, not support organisations.  However, not all recipients of floating support would receive a personalised budget.

 

RESOLVED:

1)     That it is recognised that supported housing schemes work well;

 

2)     That the changes made to the proposals for future non-statutory support services following consultation be welcomed;

 

3)     That, in view of concerns that 15 hours of core support will not be sufficient to enable effective care to be given, the Director for Care Services and Commissioning (Adult Social Care) be asked to discuss with providers and Council officers what the correct level of support should be, and the appropriate mix of core and floating support that this should include, to enable sheltered housing schemes to operate effectively;

 

4)     That the Director for Care Services and Commissioning (Adult Social Care) be asked to review housing alarm services being used across the city to see if more equitable costs can be achieved, this to include discussions with Leicestershire County Council to see if joint provision of one or more alarm systems will be advantageous;

 

5)     That the Director for Care Services and Commissioning (Adult Social Care) be asked to report the findings of the review requested under resolution 4) above to this Commission for scrutiny before a recommendation is made on the future operation of housing alarm systems; and

 

6)     That, pending the outcome of the work requested under resolutions 4) and 5) above, the City Mayor and Executive be asked to retain funding for alarm only provision at its current level, this funding to be available to current and future users of the alarm only system.