Decision details

Reconsidered decision following Call-in of Decision Number CAB 14/15 13739 on the 15th January 2015:-

Cabinet agreed the modified recommendations:

(i)  To consider the responses received during a public consultation into the future of Southampton Day Services conducted between 24 July and 23 October 2014, outlined in Appendix 1.

(ii)  To authorise the restructured Southampton Day Services service to cease service delivery out of two centres, (St Denys and Freemantle) and all satellite bases when all of their current service users have been supported to move to suitable alternative care settings and to restructure the remaining service to provide an alternative model of delivery that is fit for the future needs of Southampton residents and users.

(iii)  To note that the needs of current service users and their carers will be thoroughly assessed prior to and following their moves to ensure that these needs continue to be met and to reduce any impact on their wellbeing.

(iv)  To note that if the proposal is agreed to undertake a 45 day consultation with affected staff with a view to minimising or avoiding compulsory redundancies.

(v)  To note that a further review may be required into alternative delivery models following a restructure.

(vi)  To delegate authority to the Cabinet Member for Health and Adult Social Care following consultation with the Leader and the Director, People to do anything necessary to give effect to the proposals in this report.

(vii)  To approve the establishment of a dedicated team of experienced social work practitioners (from existing resources) to complete a thorough assessment of the needs of all individuals who currently receive a directly provided day and, or, respite service and that the anticipated outcome of these assessments will be:

(a)  The individual will be deemed not to have eligible social care needs and so will be signposted to access universal or other appropriate services or support;

(b)  The individual or their representative will choose to receive a Direct Payment and will use this to purchase the care and support needed to meet their eligible social care needs; or

(c)  The council will commission the care and support needed to meet an individual’s eligible social care needs on their behalf.

(d)  The council will then seek to carry out an annual assessment of individuals’ and carers’ needs.

(viii)  To note that it is anticipated that the assessments will be completed by 28 February 2015.

(ix)  To note that no service will be closed or withdrawn until all assessments have been completed and individuals with eligible social care needs have been supported to move to suitable alternatives.

(x)  To require a progress report at the Cabinet meeting in March 2015.

(xi)  To note that the commissioning of any new service will involve engagement with service users and carers. 

(xii)  To authorise support for those service users and their carers (who need it) wishing to take a Direct Payment, provided either by the council or a contracted third party.

1.  The Council would like to develop a wider range of options for individuals who require support to access day opportunities, such as further developing a wider range of commissioned services and supporting service users to access existing community facilities through greater use of direct payments and personal budgets, instead of directly providing care and support.

2.  Traditional day services have been matched to individuals instead of individual packages of care tailored to meet personal preferences and lifestyle. Services are currently delivered in 4 community centres (Sembal House, Woolston Community Centre, Freemantle Community Centre and St Deny’s Community Centre) and 4 satellite bases (Nutfield, TFSR, Stella Maris and Wooden reflections), with users being exclusively people with assessed and eligible social care needs. While some progress has been made in moving away from traditional building based services, the service currently offered does not make best use of existing available community assets and services, and does not encourage inclusion into the wider community.

3.  The need to move towards more personalised forms of care, where individuals can exercise more choice and control over the support and services they access is a priority both locally and nationally. In concert with this, the requirement to offer direct payments to individuals is national policy. The council currently performs in the bottom three of all councils nationally around this performance indicator, with our take up rate of direct payments currently standing at only 6% compared to a national average of 21.03% (data taken from Ascof outcome (1c(2) 2013/2014). The policy direction and imperative to offer more personalised forms of care and in particular to offer direct payments continues to be a national driver as set out in the Care Act 2014 becoming a legislative requirement from April 2015.

4.  There is significant evidence nationally that direct payments support people to have increased choice, control, flexibility and an improved quality of life. They can provide bespoke solutions for unique needs which then improve outcomes for individuals. Improved outcomes can have a cost benefit by reducing the need for other services. Direct Payments cannot be used to purchase council run services.

5.  Whilst there is some alternative provision of day services of the required type and quality in Southampton, it is unlikely that this is able to meet all current and forecast demands. Service users currently accessing SDS have a range of differing levels of complexity of need and span a wide age range and it is not possible to tailor the existing service to meet everyone’s individual needs and interests.

6.  The longer term viability of SDS may be at threat if no changes are made. This is due to an expected increase in the uptake of direct payments and evidence of people using their direct payment to purchase less traditional, more creative care solutions such as employing personal assistants, paying for community based activities or supported holidays. In the 14-18 years age group of those with a learning disability – who in the past may have been expected to access SDS when they become an adult – the uptake of direct payments has increased from 12% in 2009/10 to 32% in 2014/15 and this trend is expected to continue over the next few years, particularly in light of the right to request a personal budget and focus on more personalised services brought in by the Children & Families Act 2014 and the Care Act 2014.

7.  The statutory requirement to consult with service users, their families and other stakeholders has been fulfilled and although the overwhelming response was to keep SDS open, their comments have helped to ensure that all relevant factors have been taken into consideration.

8.  Evidence from discussion with service users, their families and carers and with experienced social care practitioners shows that the development of services for individuals with the highest needs and most challenging behaviour will take time. It will also be important that users and their carers are confident in and comfortable with these alternatives. A phased approach supports this period of transition. A full Equality and Safety Impact Assessment has been carried out to identify the potential impact and mitigation of these proposals on servicer users and their carers and is attached at appendix 2 for consideration.

9.  Consultation undertaken with staff during the formal consultation period suggested a desire to restructure the service. The proposals within this report have been developed in conjunction with SDS staff and reflect their views that the service needs to be restructured to provide a sustainable and desirable delivery model for the future.

10.If the proposals are agreed there will be full consultation with affected staff on the future structure and staffing model. Officers will also ensure that the implementation of agreed proposals will be done in conjunction with the current work on the Community Asset Strategy, as the pilot phase focuses on Council owned community centres. 

1.  The alternative option of keeping all services currently provided by SDS was considered and rejected for the reasons set out above. 

2.  The option of ceasing activity at all sites used by SDS was considered and rejected because there is recognition that further market development will be necessary to ensure that all service users can access appropriate services. In particular, it was recognised that those service users with the most complex and challenging needs, along with those service users who have been attending SDS services for a significant number of years, will require time and support to transition to alternative services, and that services for those service users with the highest needs are not currently widely available or with sufficient capacity to meet the likely needs of all of our existing service users.

3.  The option of developing a social enterprise or other alternative delivery vehicle to provide the full range of services currently provided by SDS was considered and rejected because of the likely time it would take to develop an enterprise of the size and scale necessary. However, it was felt that this is an option that should be revisited in the future.