Agenda Item No
The Vale of Glamorgan Council
Scrutiny Committee (Social Care and Health): 3rd September, 2012
Report of the Director of Social Services
Purpose of the Report
1. To update Elected Members about the development of assistive technology services such as Telecare within the Vale of Glamorgan and about proposals for a more regional approach to providing a community alarm and Telecare call monitoring service.
THAT Scrutiny Committee:
1. Notes the work being undertaken to deliver Telecare services within the Vale of Glamorgan.
2. Notes the potential development by the South East Wales Improvement Collaborative (SEWIC) of a regional Community Alarm, Telecare and Telehealth monitoring centre.
3. Notes that a proposed business case put forward by SEWIC for developing such a centre will be examined further by officers and reported to Scrutiny again at a later date.
4. Receives a further progress report in twelve months on the take up of the service and the impact on the Council’s budget.
Reason for the Recommendations
1, 2, 3 & 4 To ensure that Elected Members exercise effective oversight of this key service for promoting independence and enabling vulnerable people to remain in their own homes.
2. Telecare is a means whereby care and support can be provided to people through the use of telecommunication and technology in their own homes. These services are being developed in ways that will benefit the whole community, as well as people who depend upon help from social services. The objectives for Telecare services in the Vale are to:
· allow people to maintain or retain their autonomy;
· provide them with greater flexibility and choice in the care and support they receive;
· help them to live safely at home;
· help to reable people following a crisis such as a fall or hospital admission;
· improve service user confidence and mobility;
· promote healthy lifestyles;
· improve and make safe the living environment; and
· enable service users to maintain their dignity and self respect.
3. Telecare services in the Vale are known as TeleV and TeleV+. TeleV is a self referral service and offers the service user a choice of packages aimed primarily at safety or security. The users of the service do not have to be clients of social services. The safety package includes smoke and heat extreme detectors linked wirelessly to the Lifeline telephone, enabling alarm messages to be conveyed automatically to the 24 hour monitoring centre in the event of an emergency. The security package replaces some of the environmental sensors with sensors to detect intruders, to reduce the likelihood of distraction burglary and doorstep crime.
4. The TeleV+ service is tailored to the individual needs of more vulnerable groups who are in receipt of health services or who have been assessed as requiring community care services. The target groups for TeleV+ include:
· older people who are in hospital and who may need support and reablement to enable them to return home and live independently;
· people with poor mobility who are at risk of suffering a fall and being left on the ground for a long period of time;
· people with long term conditions or chronic diseases who are likely to be admitted to hospital on a recurrent basis as a result of exacerbations of their disease;
· people who have a cognitive impairment which makes it unsafe for them to live alone or without continuous supervision; and
· adults with learning disabilities so that they can maximise their independence.
Relevant Issues and Options
5. There have been a number of developments in the TeleV and TeleV+ service in the past year.
6. The number of TeleV installations has increased and 486 packages are now in place, compared with 136 in March 2009. The working relationship established with Care and Repair, a third sector organisation, has been vital to this growth in the service. Care and Repair install the equipment on behalf of the Council.
7. There has also been an increase in the number of TeleV+ packages with 61 now in place. Initially, such packages were quite simple, using standard equipment and focusing particularly on alerts in respect of falls. A temporary Telecare Specialist Advisor post has enabled the service to provide better support to the social work teams with regard to Telecare options. As a result, more complex packages are being supported; two recent examples are attached at Appendix 1. The Telecare Team has been sourcing and trialling alternative equipment, to ensure that the best options are available for individual service users. As a result, social workers and occupational therapists are more confident in making referrals for Telecare equipment. The support that Telecare offers to informal carers is acknowledged and links have been made with the Carers Development Officer.
8. Work with partners is becoming well established. Care and Repair install equipment on behalf of the Council and their staff receive regular updates with regard the equipment available. Additionally, there is ongoing work with Atal Y Fro, to pilot a service that supports families to break the cycle of domestic violence.
9. The Learning Disability Team has started to offer TeleV+ to individuals living in their own homes and to people living in supported accommodation, to improve their independence and quality of life while mitigating risk. Some efficiency savings have been found through this work, with fewer staffing hours required at night in supported accommodation settings.
10. Pilot schemes have been introduced with health services including:
· the use of bed occupancy monitors in Baruc Ward, Barry Hospital;
· equipping a bungalow at Rookwood Hospital with Telecare equipment, to facilitate a stepped discharge for some patients.
11. The Social Services Directorate is an active member of the South East Wales Improvement Collaborative (SEWIC). With the support of Leaders and Chief Executives in each local authority, ten Directors of Social Services (Vale of Glamorgan, Bridgend, Cardiff, RCT, Merthyr Tydfil, Blaenau Gwent, Caerphilly, Torfaen, Newport and Monmouthshire) have formed the South East Wales Improvement Collaborative (SEWIC). They are working together to improve the provision and commissioning of social services in the region. The collaborative has already established a number of pioneering initiatives, including:
· a Regional Commissioning Unit to negotiate with independent providers of fostering and residential placements for children regarding fees and service quality; and
· a similar unit for high cost external placements for people with a learning disability, a physical disability, functional mental health issues or sensory loss.
12. On 19th January 2011, Cabinet endorsed a number of improvement projects proposed by SEWIC. This collaborative programme is designed to provide the ten local authorities with an additional means of delivering service modernisation and cost effectiveness, supported by options appraisals and business cases. One of the work streams is the development of a more collective approach to the provision of assistive technology. The project aims to examine the collaborative benefit and opportunity to plan, develop, commission and deliver assistive technology services on a partnership basis. It has now developed a business case consolidation paper, exploring the merits of possible regional options for providing a community alarm and Telecare call monitoring service. This business case is being reviewed by officers and there will be a further report to Scrutiny Committee.
Resource Implications (Financial and Employment)
13. The Council charges £19.50 per month for the basic Telecare packages, which can be paid for either on a monthly or an annual basis.
14. Assessed clients in receipt of a TeleV+ package will be charged £7.50 per week, although this is subject to a financial assessment to determine if an individual is able to pay that amount.
Sustainability and Climate Change Implications
15. There are no sustainability and climate change implications as a result of this report.
Legal Implications (to Include Human Rights Implications)
16. Commissioning, especially on a collaborative or joint basis across organisations, is an area of great complexity and there are considerable legal constraints. Services secured externally via a procurement exercise are subject to EU Procurement Directives. These place a requirement upon the public sector contracting authorities to determine whether the services they procure fall into the Part A or Part B categories of the legislation. The majority of social care services are designated as Part B. Procurement exercises are required, therefore, to comply with only a subset of specific provisions - including (but not limited to) transparency; equal treatment; reporting of contract award notices; and inclusion within spend statistics. The obligations of transparency and equal treatment mean that a contracting authority must ensure an appropriate degree of advertising, sufficient to allow the services market to be opened up to competition and awards to be made on a demonstrably impartial basis. It is the responsibility of individual contracting authorities to decide upon the relevance of the specific contracts to the market and this should be the key factor in determining the nature of advertising and other procedures to be followed to meet the Treaty obligations. Relevant factors to be considered include the subject matter of the contract, its estimated value, the specifics of the sector concerned (size and structure of the market, commercial practices, etc.) and the geographic location of the place of performance.
17. Local authorities may also wish to consider the use of social clauses. These are requirements within contracts or the procurement process that allow the contract to provide added social value by fulfilling a particular social aim, such as the need to train or give opportunities to the long term unemployed. The social outcomes are then “purchased” from the suppliers as part of the procurement process. It is for local authorities to take their own legal advice on a case-by-case basis as to the legitimacy of including social clauses in any given contract.
18. Local authorities are required to take into account the importance of the continuity of care for individual service users in social care provision. Commissioners require good quality information on standards of care and contract performance data. Clearly, in cases where the services provided have not met the quality required, improvements are necessary but initial steps should be to achieve these through discussion with the provider. The reasons for performance failure need to be investigated. This is in the best interests of service users and their family and local communities. The continuity of care to individual service users can be broken where local authorities insist on regular retendering even in circumstances where services are seen to be good and cost effective. In cases where improvement does not occur it is legitimate to seek a change of provider. The wellbeing of service users must be the primary concern.
Crime and Disorder Implications
19. The Telecare security package helps to reduce the likelihood of distraction burglary and door step crime.
Equal Opportunities Implications (to include Welsh Language issues)
20. The basic TeleV package is available to all the residents of the Vale of Glamorgan. The TeleV+ package is available to those individuals who are assessed as having either substantial or critical needs following a Unified Assessment.
21. Social Services meet the corporate objective ‘to make the Vale a safe, healthy and enjoyable place in which individuals, children and families can live their lives to the full’.
Policy Framework and Budget
22. The report is in accordance with the Council’s policy framework and budget.
Consultation (including Ward Member Consultation)
23. There are no matters in this report which relate to an individual Ward.
Relevant Scrutiny Committee
24. Social Care and Health Scrutiny Committee.
Carys Lord, Head of Business Management and Innovation
Corporate Management Team
Phillip Evans, Director of Social Services