The Brent Library 'Transformation' project, which really meant closures, has given the word a bad name but it is back again at Cabinet on Monday July 27th with a report 'Adult Social Care Transforming Day Care - Direct Services'. LINK
Given the history it is worth careful perusal.
KINGSBURY RESOURCES CENTRE
The Kingsbury Resources Centre provides day care services to older people aged 65+ at its premises in Stag Lane. The reports says that it currently supports about 60 people with average daily attendance 25 including 4 wheelchair uses. Eight users have a learning disability. It operates between 9am and 4pm and users attend for an average of 6 hours 3 days a week. There are 8 staff.
The consultation about its future found that 'users do not want to lose the day centre as a meeting place and they value and do not want to lose the friendship groups they have formed at the centre'.
One worrying aspect is the comment that 'Some people expressed that the repeated focus on day centres made them feel like a burden to the council and did (sic) that they did not feel valued.'
The reports says that the concerns raised were 'not unexpected' and officers were 'able to reassure both users and carers by clarifying that the consultation was about providing services in different ways, not reducing or removing services.'
Various options are discussed and rejected in the report including asking 'the voluntary and community centr'( MF that may mean 'sector') to take over the the Centre's running, a Council partnership with another organisation to share risk and jointly manage the Centre, the council continuing to own and run the Centre but to develop it into a specialist dementia care service.
The reasons for rejection of the options include under-utilisation, spare capacity in existing dementia day opportunities and the lack of any appetite for risk share or joint management.
The report therefore opts to close down the Kingsbury Resource Centre and either sell it off or transfer it as part of a community assets transfer project. 'Spot purchase placements within the voluntary sector' would be made:
This is a purpose built Centre close to Willesden Centre for Health and Care and the Council has a 90 year lease. It provides day care to 87 people who have a physical disability, 28 people who have a learning disability 'of which 8 are between the ages of 55 and 77 and could be considered eligible for older people and dementia services'. An average of 35 people use the day centre on any given day and some have been attending for up to 30 years 'and have become very attached top the Centre.'
It operates Monday to Friday 9am to 4pm and has 14 full time staff.
The report states:
The report states:
That is is perhaps the sting in the tail when the wider 'transformation of direct services initiative has a full saving requirement of £755,000 over 2015-16 and 2016-17 (£432,000 and £323,00).'
TUDOR GARDENS RESIDENTIAL CARE HOME
Tudor Gardens is a relatively new residential care home. Most of the staff and residents moved from Melrose House 4 years ago. It is the only in-house, directly provided residential care home left ion Brent. It currently provides support for 14 people who have a learning disability and has capacity for 15. 24 staff provide support.
The proposal LINK is to de-register the home which the report argues will give tenants greater security and enables them to claim a wider range of benefits, including housing benefit. Housing benefit would reduce the council's Adult Care costs with an expected income stream from rents of £100k annually.
The Tudor Gardens budget for 2015-16 is £872,000 and conversion to a 'Supported Living facility' is expected to save £300,000.
This would include savings through out-sourcing care and support and would affect the current care workers.
Residents wanted to keep the existing staff, specifically individual key workers. Officers told them that this may be possible through TUPE but could not be guaranteed.
Since the Cabinet agenda was published an addendum has been added which I think speaks for itself:
Inserting a personal note a similar process took place in my mothers' care home in Bedfordshire and I well remember the confusion, anxiety and depression of residents when they realised that they might lose the care staff with whom they were familiar and often saw a friends.
In turn the care staff knew the individual histories, character and idiosyncrasies of the elderly people which resulted in especially sympathetic and supportive care.
The value of those relationships and that background knowledge must not be under estimated.
As with all out-sourcing the eventual reduction in the pay and conditions of workers is a major concern and particulalrly when care workers are already underpaid.
Given the history it is worth careful perusal.
KINGSBURY RESOURCES CENTRE
The Kingsbury Resources Centre provides day care services to older people aged 65+ at its premises in Stag Lane. The reports says that it currently supports about 60 people with average daily attendance 25 including 4 wheelchair uses. Eight users have a learning disability. It operates between 9am and 4pm and users attend for an average of 6 hours 3 days a week. There are 8 staff.
The consultation about its future found that 'users do not want to lose the day centre as a meeting place and they value and do not want to lose the friendship groups they have formed at the centre'.
One worrying aspect is the comment that 'Some people expressed that the repeated focus on day centres made them feel like a burden to the council and did (sic) that they did not feel valued.'
The reports says that the concerns raised were 'not unexpected' and officers were 'able to reassure both users and carers by clarifying that the consultation was about providing services in different ways, not reducing or removing services.'
Various options are discussed and rejected in the report including asking 'the voluntary and community centr'( MF that may mean 'sector') to take over the the Centre's running, a Council partnership with another organisation to share risk and jointly manage the Centre, the council continuing to own and run the Centre but to develop it into a specialist dementia care service.
The reasons for rejection of the options include under-utilisation, spare capacity in existing dementia day opportunities and the lack of any appetite for risk share or joint management.
The report therefore opts to close down the Kingsbury Resource Centre and either sell it off or transfer it as part of a community assets transfer project. 'Spot purchase placements within the voluntary sector' would be made:
Closing Kingsbury Resource Centre would generate a potential saving of £150k on the current budget and a potential capital receipt if the buildings is sold.NEW MILLENNIUM DAY CENTRE
This is a purpose built Centre close to Willesden Centre for Health and Care and the Council has a 90 year lease. It provides day care to 87 people who have a physical disability, 28 people who have a learning disability 'of which 8 are between the ages of 55 and 77 and could be considered eligible for older people and dementia services'. An average of 35 people use the day centre on any given day and some have been attending for up to 30 years 'and have become very attached top the Centre.'
It operates Monday to Friday 9am to 4pm and has 14 full time staff.
The report states:
'The focus at this centre was to explore the opportunity to support users to access alternative existing provision and to involve them in a co-production process to develop new services which will not only meet existing needs but also support greater independence.'All laudable but likely to raise suspicion when the Council is also anxious to save money. Rather than consultation the process here was 'co-production' and consisted of 13 users and carer meetings, followed by further meetinsg with carers, visits to Thurrock council to review their service model, further meetings to share a potential model with users and carers and meetings to get feedback on the models.
The report states:
Users were worried about the centre closing and felt that the changes to their services seem to be a continuous process and have been ongoing for at least the last 6 years. They felt the change needed to stop.Then comes the reassurance:
However, through discussion users were confident that a co-produced solution would be the best way to ensure that they had more control over changes to that service, and they were clear that the aim of co-production was to develop a more sustainable service which would hopefully mean that there would be less need for a change to the services in the future.Referring to lack of trust in the Council the report states:
Discussions showed that this was primarily as a result of the many users having been through changes to in house day services in 2012 and some issues with the process. Through the co-production process people were able to separate their feelings about previous experiences and the need to bring a positive attitude and open mind into the discussions about the future of the service.The centre itself was strongly supported:
All users and carers spoke in strong terms about how much they valued their day centre. Users were clear that the centre is special and that they feel like one big happy family....Many users raised concerns that they do not want to lose the relationship they have with staff.The report says that the co-production process established that it order to maintain quality sustainable services and end uncertainty an enhanced 'social enterprise model' would be most suitable to include:
- Using the centre as a hub but supporting users to access the community more
- Make better use of the buildings through extended hours, potentially including evenings and weekends
- Offering 'different and more personalised respite support for carers as well as users - including the possibility of pooling budgets so groups could make 'holiday arrangements at Centre Parks or ehsewhere'.
That is is perhaps the sting in the tail when the wider 'transformation of direct services initiative has a full saving requirement of £755,000 over 2015-16 and 2016-17 (£432,000 and £323,00).'
TUDOR GARDENS RESIDENTIAL CARE HOME
Tudor Gardens is a relatively new residential care home. Most of the staff and residents moved from Melrose House 4 years ago. It is the only in-house, directly provided residential care home left ion Brent. It currently provides support for 14 people who have a learning disability and has capacity for 15. 24 staff provide support.
The proposal LINK is to de-register the home which the report argues will give tenants greater security and enables them to claim a wider range of benefits, including housing benefit. Housing benefit would reduce the council's Adult Care costs with an expected income stream from rents of £100k annually.
The Tudor Gardens budget for 2015-16 is £872,000 and conversion to a 'Supported Living facility' is expected to save £300,000.
This would include savings through out-sourcing care and support and would affect the current care workers.
Residents wanted to keep the existing staff, specifically individual key workers. Officers told them that this may be possible through TUPE but could not be guaranteed.
Since the Cabinet agenda was published an addendum has been added which I think speaks for itself:
Clearly the last change is hugely significant.Subsequent to publishing the Tudor Gardens report, one of the consultees, requested that two changes be made to the report. The changes requested related to the specific reporting of the consultation and what was said at the consultation meetings.The first change is in the main report Section 3.6 to provide further clarification. From: In February 2015 Cabinet agreed to consult with residents, families and stakeholders on the proposal to de-register Tudor Gardens. The results of the consultation suggest that relatives did not want change but supported the supported living model.To: In February 2015 Cabinet agreed to consult with residents, families and stakeholders on the proposal to de-register Tudor Gardens. The results of the consultation suggest that relatives did not want change. They would prefer Tudor Gardens remain as a residential care home. However, they also said that they would work with Brent officers if the decision was made to move to Supported Living, especially if this meant no-one moving out."The second change is a point of accuracy in the consultation report. The change is required on the last but one page of the consultation report, page 13. From: "Most of the residents understood or had the mental capacity to understand the changes proposed in the view of all relatives and carers, and the independent advocate, in addition to attending the meetings the advocate went to see residents individually to see if she could help them understand the proposals. She concluded she could not, and agreed with Ken Knight's summary of their inability to follow what was being discussed at the meetings, where their interjections bore no relation to the matters in hand."To: "None of the residents understood or had the mental capacity to understand the changes proposed in the view of all relatives and carers, and the independent advocate, in addition to attending the meetings the advocate went to see residents individually to see if she could help them understand the proposals. She concluded she could not, and agreed with Ken Knight's summary of their inability to follow what was being discussed at the meetings, where their interjections bore no relation to the matters in hand."
Inserting a personal note a similar process took place in my mothers' care home in Bedfordshire and I well remember the confusion, anxiety and depression of residents when they realised that they might lose the care staff with whom they were familiar and often saw a friends.
In turn the care staff knew the individual histories, character and idiosyncrasies of the elderly people which resulted in especially sympathetic and supportive care.
The value of those relationships and that background knowledge must not be under estimated.
As with all out-sourcing the eventual reduction in the pay and conditions of workers is a major concern and particulalrly when care workers are already underpaid.