To consider the findings and recommendations of the review of future social care needs of older people and people with learning disabilities and the services needed to meet them. 

The Committee considered the findings and recommendations of the review of future social care needs of older people and people with learning disabilities and the services needed to meet them. 

The context for undertaking the review had been that Herefordshire’s adult social care services had been facing increasing financial pressures, against a background of continuously increasing user demand.  Substantial additional investment and improvements had been made but the Council’s performance continued to lag behind high-performing comparable local authorities.

In order to understand the demographic pressures facing the County and the way the pressures might translate into service needs to vulnerable adults the Council, jointly with the Primary Care Trust (PCT) had agreed to commission a detailed needs analysis looking at the demographic pressures and how these might translate into service needs.  This work had been independently validated and benchmarked with high-performing authorities elsewhere in the country and was regarded as representing best practice. The costings in the report were also considered robust.

The report and appendices set out the analysis undertaken and summarised the conclusions both in terms of the demography and the way in which that demography would translate into increased service needs and budget pressures. 

The reports also set out a strategy for the future based on a significant shift to a more preventative model of services, which would require a much greater contribution from the voluntary sector. 

It was stated that this new model of service would require some additional investment but not as much as would the current model of service.  It would also enable the Council to improve significantly the quality of services available to the residents of Herefordshire. 

The Corporate Policy and Research Manager gave a presentation highlighting key aspects of the report.  This summarised the assessment of the needs of older people and people with learning disabilities, how the Authority’s performance and approach compared with comparator authorities and the proposed way ahead.

In the course of discussion the following principal points were made:

·          The issue of housing needs and provision of affordable housing was discussed.  It was noted that it was hoped that the new Unitary Development Plan would help deliver more affordable houses. 

·          The report noted the importance of the voluntary sector contribution to the proposed better services, particularly so as to enable people to continue to live independent lives in their own communities.  The Committee was informed that from the Voluntary Sector’s perspective the report was impressive.  The Herefordshire Alliance of Voluntary Sector Organisations was undertaking a considerable amount of work to improve service delivery capability and accredit suppliers.  Nevertheless a huge task was faced.

·          Attention was drawn by Members to the references in the report to the fundamental importance of good ICT systems including systems for data collection and analysis.  It was proposed that the importance of developing appropriate, effective and compatible systems with the Council’s partner organisations should be emphasised to Cabinet.

·          A question was asked about changes to the thresholds governing eligibility for care.  In reply it was stated good practice focused on preventative action and utilising alternatives to professional health and social care where these were appropriate.  Making this change in the approach to service delivery could make it possible to avoid raising the thresholds for professional care, although thresholds would need to remain. 

·          The proposal to generate more income from users and its implications was discussed.  It was noted that whilst the issues were undoubtedly complex,  there were higher performing authorities who were equally committed to avoiding creating a bigger poverty trap and had at least as high levels of income deprivation. (The highest charger of the comparator authorities, East Riding, had a higher level of income deprivation than Herefordshire.)  It was further noted that those who were income deprived would not pay charges. 

·          Whilst raising charges was a difficult decision to take, in the financial climate councils faced it appeared to be one of the few ways of increasing the resources available, so ensuring that an appropriate level and quality of services could be provided to all who would need them.

·          The question of respite provision for family carers was raised in particular, referring as an example to the planned closure of Windsor Place, Leominster.  In reply it was stated that the intention to reduce the number of properties the Council held had been agreed by Cabinet.  A commitment had been given that Windsor Place, Leominster would not be closed until alternative provision was in place.  There were a number of possible models of care.

The importance of keeping people including Ward Members clearly informed of the Council’s proposals was emphasised.

·          It was proposed that given the importance and complexity of the issues and the careful consideration these would require that steps be taken to ensure that every Councillor was made aware of the issues and kept informed.  The Director of Adult and Community Services stated his intention to brief Members and to hold a seminar with the voluntary sector, a range of other users, stakeholders and staff.

RESOLVED:

THAT        (a) the recommendations of the review of future social care needs of older people and people with learning disabilities and the services needed to meet them be endorsed for consideration by Cabinet;

                  (b) the Committee’s concern about the current ICT systems for data collection and analysis and the importance of developing appropriate, effective and compatible ICT systems, including with the Primary Care Trust as part of the development of the proposed Public Service Trust, should be emphasised to Cabinet;

                  and

                  (c)              recognising the importance and complexity of the issues and that these will require careful consideration Cabinet be advised that every Councillor needs to be made aware of these issues and kept informed.