Agenda Item No. 4
THE VALE OF GLAMORGAN COUNCIL
HEALTHY LIVING AND SOCIAL CARE SCRUTINY COMMITTEE: 12 FEBRUARY 2018
REFERENCE FROM CABINET: 22 JANUARY 2018
C195 RESHAPING SERVICES - REVIEW OF LEARNING DISABILITIES DAY SERVICES (SCHL) (SCRUTINY COMMITTEE – HEALTHY LIVING AND SOCIAL CARE) -
Cabinet was provided with an update in relation to progress of a review of the Council’s learning disabilities day services and approval was sought to consult regarding the closure of the existing provision in our Castle Avenue facility, located in Penarth.
The Vale of Glamorgan Council currently provided support to adults with learning disabilities in a number of ways.
Internal day services currently operated from three buildings. These were Castle Avenue in Penarth, Woodlands (operating from Hen Goleg, Barry) and Trysor O Le (operating from the Hub, Barry).
Externally commissioned providers, for example; Valeplus, Vision 21, Scope and Innovate Trust complement our internal provision, providing a range of educational and work based experiences.
Direct payments had also provided people with greater choice and control over how to meet their outcomes. For example by employing personal assistants people could choose to be supported to access community groups and education classes. As a direct consequence of this strategic intent to improve outcomes for people with a learning disability, the number of people accessing our internal day service provision had fallen from 76 people a year in 2013, to 39 in 2017across three sites.
Following legislative changes implemented through the Social Services and Wellbeing (Wales) Act (2014), there was an expectation on local authority social services to change the focus of care to more person-centred practice. This was consistent with the existing joint Cardiff and Vale Day Opportunities Strategy 2014-17. The Strategy set out how the Councils would work with people and their families to enable access to support arrangements that were appropriate to their identified needs and personal outcomes. The Strategy was currently being reviewed and would reflect the emerging regional agenda.
Whilst the regional agenda offered the opportunity to further build on the good work that had been accomplished to date, there was also a need to focus immediate attention on specific issues relating to the operation of the current day services within the Vale of Glamorgan.
The first of these issues to address was the issue of the Castle Avenue facility in Penarth. This had decreasing attendance levels which had made the facility financially unviable. The second activity was to consider the longer term delivery of services for people with learning disabilities within the Vale of Glamorgan.
Internally operated day service provision was currently operated from the from the following buildings;
Castle Avenue, Penarth
Castle Avenue Day Service was situated in a residential area of Penarth. It was open 253 days of the year and was originally established 25 years ago as a house for people with a learning disability. The building had not been adapted and with more sophisticated health care practice and guidance in respect of positive behavioural management, was now no longer fit for purpose to support people with complex needs. At its inception and for many years following, Castle Avenue supported approximately 12 people over a five day week, providing a predominantly building based service.
Woodlands Day Service Centre (Hen Goleg, Barry)
Woodlands Day Services Centre had been operational in excess of 40 years; previously known as Barry Adult Training Centre (ATC) the service was based at Woodlands Road before relocating to Hen Goleg in 2013. This brought together people who had previously attended ‘Sorted’ (a learning disability service that had been relocated to Hen Goleg in 2011) on the same site as day services provision for people with physical disabilities.
Trysor O Le (Hub, Barry)
Trysor O Le Day Services was based in the YMCA Hub at Gladstone Road and had been operational in excess of ten years. The service supported people with complex health and social care needs. In 2007, the Vale of Glamorgan Council provided funding to the YMCA to assist with an upgrade to the building which included provision of a dedicated area for people with profound disabilities. The service was therefore able to accommodate the needs of people with severe learning and physical disabilities. It was fully accessible and had appropriate changing facilities. Staff were trained to support people who require specialist equipment and who have specific communication, sensory, dietary and medication needs.
The following table provided a summary of Costs of Current Internal Provision
Reshaping Services
|
|
2016/17
|
2017/18
|
|
|
Attendance
|
Unit Cost
(£)
|
Attendance
|
Unit Cost
(£)
|
|
Castle Avenue
|
8
|
81.04
|
3
|
239.59
|
|
Woodlands
|
20.2
|
98.23
|
15.8
|
125
|
|
Trysor O Le
|
8.6
|
117.42
|
8.6
|
110.16
|
|
Total / Average
|
12.3
|
99.00
|
9.5
|
158.25
|
In summarising current internal day service provision, the information above showed that there had been an average increase in unit costs of £59.25 per person per day between 2016/17 and 2017/18 due to numbers having declined in Castle Avenue and Woodlands for the reasons outlined in the report.
Young People in Transition
It was important that any decisions made considered the needs of young people transitioning from Children’s and Young People’s Services to Adult Services. Predicting the exact numbers of young people who would require and take up the offer of an internal complex needs day service was challenging and liable to change.
People with complex care needs and their families often chose to pursue a specialist residential college, in accordance with procedures set out in the Learning and Skills Act 2000. However, based on the current data available – which was liable to change, the number of young people who would be eligible to access a complex needs day service in order to have their needs and outcomes met over the next three years were as follows:
Complex Needs
|
|
2018/19
|
2019/20
|
2020/21
|
2021/22
|
|
No. of young people transitioning who may require a complex needs day service
|
3
|
7
|
2
|
1
|
Out of the seven people identified in 2019/20, two had very high health needs and were currently supported in out of county specialist provision. As adults it was highly likely that the Health Service would continue to commission their care and support and this may continue to be in residential out of county provision.
The primary focus of the report was in relation to the proposed closure of Castle Avenue, should this be agreed and subject to consultation. However, it was also important to recognise that attendance over recent years had also declined at Woodlands (Hen Goleg), evidencing the successful implementation of the Day Opportunities Strategy 2014-2017 and the move towards a more person centred approach to meeting individuals’ personal outcomes. Attendance at Trysor O Le remained static at around nine people each year. People attending Trysor O Le access the community, but due to the complex nature of their needs, they required an adapted building base to receive care and support from. There were limited alternatives for people with these needs, which was why the Day Opportunities Strategy had moved the focus of internal day services to specialise in this area for this group of people whilst emphasising the use of community resources for the majority of people with learning disabilities. The emphasis on meeting people’s outcomes through community resources means there was less need for a traditional day service model.
It was recognised that people may require information, advice and assistance to access community provision. As a result it was intended to develop a new role in the service, the Support Planner, which would be piloted for 6 months in the Vale commencing in January 2018. Support planners worked with people with learning disabilities to design a person centred plan that reflected their needs and outcomes, with a focus on exploring ways in which these could be met within their local communities wherever possible. Support Planners were identified within the Joint (Cardiff and Vale) Day Opportunities Strategy 2014-2017 and had been employed in Cardiff Council with good effect, delivering positive outcomes for people and assisting to manage the demand for commissioned services. This pilot role would be ring fenced for existing Day Service Officers and Social Care Officers within the learning disability service who could apply for a post via an Expression of Interest process. This would be on a secondment basis for a period of 6 months during which time the operation and effectiveness of this approach in the Vale of Glamorgan would be evaluated.
The second piece of work, as referenced at the beginning of this report was to consider the longer term delivery of services for people with learning disabilities.
The Joint (Cardiff and Vale) Day Opportunities Strategy 2014-2017 at Appendix 1,for adults with a Learning Disability was developed collaboratively between Cardiff, Vale and partners drawing upon the strengths of individual agencies in order to build resilience into an increasingly pressurised system. It was also borne out of the need to meet the requirements of the new Social Services and Well-being (Wales) Act 2014, to focus on outcome based, person centred models of service provision. Part 9 of the SSWBA was concerned with improving the outcomes and well-being of people as well as improving the efficiency and effectiveness of service delivery through greater partnership working. Developing a regionalised service to meet the care and support requirements of people with highly complex needs would enable a resilient, sustainable and specialist model of care and support. Cabinet would receive further information in respect of the future Day Opportunities Strategy and regionalisation in 2018.
Next Steps & Timetable
The following table proposed an indicative timetable for the activities required should the proposed closure of the Castle Avenue facility be agreed.
Reshaping Services
|
Key Activity
|
Description
|
Timescale
|
|
Pre- Cabinet Preparation
|
Information provided to Castle Avenue service users and their families, Castle Avenue staff and Trade Unions
|
January 2018
|
|
Cabinet Report
|
Cabinet consideration of proposals in principle
|
22nd January 2018
|
|
Scrutiny consideration
|
Scrutiny consideration of proposals
|
12th February 2018
|
|
Cabinet Report
|
Consideration of proposals and views of scrutiny committee to reach final determination.
|
5th March 2018
|
|
Consultation with and reassessment of, people using Castle Avenue
|
Service users and families contacted and reassessments undertaken along with support to enable transition to new arrangements (if applicable).
|
February 2018
|
|
Proposed Closure of Castle Avenue
|
|
March 2018
|
This was a matter for Executive decision
Cabinet, having considered the report and all the issues and implications contained therein
RESOLVED –
(1) T H A T the contents of the report be noted.
(2) T H A T the proposal contained in the report to close the Castle Avenue facility in Penarth be approved in principle.
(3) T H A T the report be referred to the Healthy Living and Social Care Scrutiny Committee for consideration.
(4) T H A T a further report be presented in February 2018, to include Scrutiny Committee comments and feedback from the consultation held with people using the service and their carers / advocates.
Reasons for decisions
(1) To note the update on the review of learning disabilities day services.
(2) To enable people with learning disabilities to be supported in the most appropriate setting to meet their needs taking into account both quality and cost and to enable the views of the Scrutiny Committee to be taken into account in reaching a final determination.
(3) To ensure Scrutiny members had effective oversight of proposals and opportunity to provide comments.
(4) To allow for consultation with the five people who used the facility and their carers / advocates and to consider appropriate alternative services for them.
Attached as Appendix – Report to Cabinet – 22 JANUARY 2018