Agenda and minutes

Resolved:- That the minutes of the meeting held on 6^th April, 2009 be approved as a correct record.

Lesley Dabell, Chief Executive of Age Concern gave a presentation in relation to the work of Age Concern.

The presentation drew specific attention to:-

• Introduction
• Background information
• Our aims
• What we do
• Providing service and support
• Working as partners
• Future Focus
• Future challenges – sustainability
• Future challenges – personalisation
• Future challenges – population

A question and answer session ensued and the following issues were discussed:-

• It was felt that the Council had been unfairly criticised by the press for the withdrawal of funding in relation to Age Concern Rotherham.  Lesley confirmed that as the new Chief Executive of Age Concern Rotherham she would be working with the Council to provide a better service for the older people of Rotherham.
• What work was being undertaken in respect of hospital aftercare?  Lesley confirmed that they were working closely with the PCT on a 2 year pilot which the PCT were funding.
• How did the services of Age Concern Rotherham differ for those of organisations such as Rothercare.  Age Concern offered a short term intervention offering intensive support to people after they were discharged from hospital and to link them into longer term support such as Rothercare after that if they needed it.

Members thanked Lesley for her presentation.

Kirsty Everson, Director of Independent Living presented the submitted report in relation to the petitions received in respect of Extra Care Housing.

The first scheme “Oak Trees Resourced Centre” opened on 3^rd April, 2006 and the second scheme “Potteries Court” opened on 16^th April, 2007, and “Bakersfield Court” opened 9^th March, 2009.

The current staffing arrangements at Potteries Court and Oak Trees provided a team of Care Enablers who were based on site covering 24 hours, 7 days per week.  The staff group were currently carrying out a dual role in relation to the delivery of both personal care and housing support.  There was a dedicated team of night staff who were based at Potteries and Oak Trees; however there were no service users who received planned care or support throughout the night.

The current staff group had spare capacity in that there were substantial numbers available where no care and support were required.  Although this fluctuated dependent on the changes in service users care packages, there was still an obligation to ensure that staff resources were maximised.

Discussions were held with the Director of Health and Wellbeing and it was proposed that the Care Enablers be transferred across to Health and Wellbeing to be managed as part of Domiciliary Care Services under the Registered Care Managers.  This would allow spare staffing capacity to be used more flexibly as part of the broader Care Enablement service and would also see the care managed as part of the Council’s registered domiciliary care service with the Care Quality Commission.  It was also proposed that a separate staff group should be created to deliver dedicated Housing Support Services in line with Supporting People expectations, and to make better use of the income being received from each tenant in relation to this service.

Discussions took place with individual Care Enablers to explain the proposals and to obtain any preferences.  The Housing Support roles were also agreed and were advertised on an expression of interest basis. 

A consultation process took place with tenants at Potteries Court and Oak Trees, which comprised of a letter to all tenants outlining the changes, followed by a number of face to face meetings with tenants, family members and Local Councillors.  The outcome of this consultation had so far resulted in resistance around the removal of the “on site” 24 hour care; even though very few residents had high care needs.  This perception went against the ethos of independence which Extra Care services should promote.  Expectations about responses in an emergency had become akin to residential care, rather than the response that should be supported to enable continued independence.

The most contentious issue raised was that there would not be a presence in the buildings 24 hours, 7 days per week.  This was due to people not feeling safe, and there not being anyone to pick up emergency calls through the warden control system immediately.  The proposal was to use Rothercare  ...  view the full minutes text for item 141.

Mark Scarrott, Finance Manager (Adult Services) presented the submitted report which provided a forecast of the Revenue Outturn for the Adult Services Department within the Neighbourhoods and Adult Services Directorate based on actual income and expenditure to the end of March 2009.

The approved net revenue budget for Adult Services for 2008/09 was £68.5m. Included in the approved budget was funding for demographic and existing budget pressures together with a number of efficiency savings identified through the 2008/09 budget setting process.

During the year there had been a number of budget pressures within the service, mainly in respect of the delays in implementation of shifting the balance of home care from in-house to the independent sector due to the decision taken by the Council to undertake a further round of consultation with Trade Unions and employees. On 21^st January 2009 Cabinet approved a revised estimate for the service of £1m and the latest report showed a forecast balanced outturn against budget.

Budget pressures had continued within physical and sensory disabilities residential care due to an increase in demand and the average cost of care packages, increased demand and cost of direct payments, home care as a result of delays in shifting the balance and increased energy costs within in-house premises.

These pressures were being offset by additional income from continuing health care funding, further slippage on developing supported living schemes within learning disabilities, slippage on vacant posts within assessment and care management and outcomes from management actions identified through budget performance clinics throughout the year.

This overall forecast outturn also included the impact of the delays in finalising the construction and opening of the two new residential care homes including the decommissioning of the five residential care homes.

Further income and expenditure continued to be accounted for as part of the process of closing down of the 2008/09 accounts and the final outturn position would be reported to the Cabinet Member next month.

Resolved:- That the forecast balanced outturn against the revised budget for 2008/09 be noted.

Resolved:-  That, under Section 100A(4) of the Local Government Act 1972, the press and public be excluded from the meeting for the following items of business on the grounds that it involves the likely disclosure of exempt information as defined in paragraph 3 of Part 1 of Schedule 12A to the Local Government Act 1972, as amended.

Kirsty Everson, Director of Independent Living presented the submitted report which provided Members with an update on the progress made in respect of Rothercare Direct and also set out a proposal to further develop the service going forward.

Resolved:- That the Cabinet Member note the progress being made to deliver the new service and agree the developments proposed for the service, including restructuring staff roles where required.

Dave Roddis, Service Quality Manager presented the submitted report in relation to Home from Home, a new and innovative way of raising standards in contracted residential and nursing care homes in Rotherham.

Two Pilot assessments were completed at Melton Court and Layden Court and the report documents the learning from these.

Following the success of the pilots the main Home from Home programme had now started with services prioritised on the basis of risk and the following homes had had assessments and reports completed:

• Cherry Trees
• The Abbeys
• Athorpe Lodge
• Laureate Court
• Moorgate Croft
• Swinton Lodge
• Ackroyd Clinic
• Moorgate Lodge

Resolved:- (1) That the learning from the pilot be noted

(2) That the Home from Home programme be delivered in 2009 on each contracted residential and nursing care home in Rotherham, and the quality premium be paid from October 2009 following completion of assessments of each home.

(3) That a quarterly update report be submitted to the Cabinet Member commencing in June 2009.

Tom Sweetman, Innovation Manager gave a powerpoint presentation in respect of Personalisation.

The presentation drew specific attention to:-

• Government Agenda
• What Personalisation means
• What its about
  • People
  • Services
  • Partnerships
  • Vision

• What will need to change
• Where did it begin
• Guiding Principles
• What does it mean for Members
• Key Role for Members
• Feedback
• Conclusions
• The Way Ahead
  • Personalisation Plan
  • Two days in May
  • Rotherham’s Greatest Hits
  • Involvement of Staff
  • Consultation, Consultation, Consultation
  • Strive to be the best in the country.

A question and answer session ensued and the following issues were discussed:

• Members felt that there were a lot of services which the council could offer to the people of Rotherham instead of going out to outside agencies.  The Council needed to involve more people around the table when making decisions, ie Trades Unions and Elected Members
• A concern was raised that people would be assessed on what they wanted rather than what they needed.  The Director of Health and Wellbeing confirmed that the Council aimed to deliver what the customer needed in the way that they wanted.
• Concerns were raised that there was no mention of carers within the presentation and it was felt that they were a crucial part of the personalisation agenda.

Members thanked Tom for his presentation which they found very informative.

Shona McFarlane, Director of Health and Wellbeing presented the submitted report which informed Cabinet Members of progress made in increasing awareness and take up of Adult Social Care Services for older people from Black and Minority Ethnic (BME) communities as a result of a 6 months pilot undertaken at Rotherham GeneralHospital.

The methodology for this was by interview/questionnaire which were undertaken by staff with the relevant communication skills who attended the hospital 2 mornings each week, working with the Hospital Assessment & Care Management team to identify older people from BME communities who had been admitted into hospital.

The was to focus on the Pakistani community who were identified in the Rotherham 2001 census as the largest BME group with specific focus upon the older people from that community.  The Older People group were chosen as performance management information systems identified that there was a disproportionate under representation of this population in proportion to older people in Rotherham who accessed assessments and subsequent service provision.

There was sufficient evidence to suggest BME communities accessed services at crisis point.  The hospital setting was chosen as the preferred way of identifying and engaging vulnerable BME customers who from past initiatives had been/were difficult to engage with, and because of their current circumstances be more likely to require support and meet the eligibility criteria for assessment and support services whilst in hospital.

A total of 59 interviews were undertaken and enquiries were made by customers for information on health and social care services which included services for Carers, Direct Payments, BME Day Care, Memory Clinic, Intermediate Care, Meals on Wheels and community based service provision by the Voluntary/community sector.

The outcomes had been grouped by emerging themes as follows:

• Knowledge/awareness of Adult Social Care Services
• Access to services
• Assessment of care management
• Social care needs
• Carers issues

Outcomes

• Four care packages were currently in place and clients receiving services (approx 10% of patient sample)
• Identification of the need for service to be extended for a further 6 months phase commencing April 2009

The action plan would address both how services would be changed and evaluate the success in improving access to information and services for BME older people and what hospital needs to address as a result of the research project.

Resolved: (1) That it be noted that the NAS PAF E47 was off target for achieving best percentage performance for 2008/09

(2) That it be noted that NAS PAF E48 had exceeded best percentage performance for 2008/09

(3) That the development of a partnership approach with the Rotherham NHS Foundation Trust to implement the protocol that would increase service take up be supported.

Resolved:- That the next meeting be held on Monday 8^th June, 2009 commencing at 10.00 am.