To consider the Stage 3 report of the Best Value Review of Social Care Services for people who have a physical disability.

The Committee considered the Stage 3 report of the Best Value Review of Social Care Services for people with a physical disability.

The detailed review report had been circulated separately to Members of the Committee.

The Best Value Review Project Manager and Mrs B Millman, a service user and a voluntary sector representative on the Committee, explained the conduct of the review and presented the report’s findings, emphasising the extent to which the recommendations had been informed by the views of service users.

The following areas for development and redesign were identified and recommendations made in respect of each area: assessment and care management, day care opportunities; adaptations and equipment, complaints and advocacy, short-term breaks and transport.  The recommendations drawn form section 4 of the review report were summarised in paragraph 11 of the covering report.  There were also a number of additional recommendations made in section 5 of the review report, extracted to form appendix A to the covering report, which it was considered would improve existing services without radical redesign.

The covering report indicated that the main improvements would be managed within existing resources.  A complex proposal for a Disabled Living Centre would, however, require a further feasibility study.

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

·         In response to a question the Best Value Review Project Manager confirmed that partner agencies who would need to be involved in the redesign of services had had some involvement with the Review Team and the option appraisal report had been sent out for consultation.

·         The review proposed the extension of the direct payments scheme to the purchase of equipment.  It was noted that, whilst it was not necessarily the case that providing an individual service user with direct payments would be more costly, the extension of the direct payments scheme on a widespread basis could present a challenge to the Directorate of Social Care and Strategic Housing in commissioning services.  The Head of Social Care (Adults) commented that if, for example, a block contract was let for the provision of a service but the uptake was low, with service users opting for direct payments to select their own provision in preference to the contracted service, the financial implications could potentially be significant.  This emphasised the need to involve service users in determining service provision and the Directorate recognised the need to carry out further work in this area.  The desire of service users to exercise their independence and the extent to which this reflected the national drive for choice was acknowledged.

·         There was discussion of the information available to individuals in need of equipment.  It was noted that it was a complex issue and suggested that service users really needed independent advice on what equipment was available in order to make an informed choice about what would suit them best.  It was also important that once installed and in use the suitability of the equipment was monitored.

·         In relation to the complaints system the review report proposed the development of a peer advocacy service to assist service users in making complaints about service delivery.  The review report suggested that in the longer term the possibility of the development of an information and advocacy service as part of a Disability Living Centre merited consideration.  It was noted that there were currently Disability Living Centres in Shropshire and Worcestershire but not in Herefordshire or mid–Wales.  Several service users were reluctant to travel to Shropshire or Worcestershire but there was uncertainty over the ability to support a Centre for a sparsely populated rural area.  The review had acknowledged that development of a Centre would require a feasibility study.

·         That recommendation 8 as set out at page 37 of the review report should be shortened by the deletion of the last few words: “where appropriate instead of the ad hoc approach which can lead to crisis”.

·         In relation to transport it was considered that there remained considerable scope for improvement and cost savings, although it was reported that new Regulations in January 2005 would increase transport costs.  It was requested that the Strategic Monitoring Committee’s attention should be drawn to the need for those responsible for implementing the findings of the Transport Review to ensure that account was taken of these concerns.

·         Reference was made to a specific instance where there had been a communication failure about transport provision.  In reply the Head of Social Care (Adults)advised that an apology had been given to the service users and action taken to resolve matters.

·         Concern was expressed about how realistic it would be to implement the review’s recommendations within existing resources.  It was noted that the review report acknowledged that the proposal for a Disabled Living Centre would require a further feasibility study.  The Director of Social Care and Strategic Housing advised that she considered that it would be feasible within existing resources to progress recommendations 2, 8 and 9 as set out in section 4 of the review report relating to service development and supervision of specialist staff through the appointment of a Team Manager and resourcing for short term breaks.  However, the other recommendations in section 4 of the report would need further feasibility work.  It was proposed that the recommendations in section 5 of the report would be progressed as feasible within existing resources.  She confirmed that the review and its recommendations would now need to be referred to the Strategic Monitoring Committee for consideration.  The Committee expressed the view that in the light of this advice, in forwarding the review to the Strategic Monitoring Committee, a distinction should be drawn between those recommendations which it was thought could or could not be progressed within existing resources.

RESOLVED

That       (a)     the Strategic Monitoring Committee be recommended to endorse the findings of the review of services for people with a disability, subject to advising the Cabinet Member (Social Care and Strategic Housing) in considering the recommendations and preparing an Improvement Plan to have regard to the Committee’s view:

(i)     that  recommendations 2, 3, 4, 5, 8 and 9 as set out in section 4  of the review report could be implemented within existing resources and should be progressed;

(ii)   that the remaining recommendations in section 4 of the review report , recommendations 1, 6 & 7 should be the subject of further feasibility work to ensure that sufficient resources were available to implement them; and

(iii)that the additional recommendations in section 5 of the report  be progressed as feasible within existing resources.

                        (b)         that the Strategic Monitoring Committee’s attention be drawn to          the need for those implementing the findings of the Transport          Review to ensure that account is taken of concerns identified          in          the review of services for people with a disability regarding the          provision of social care transport.