Decision details

To consider the report of the Cabinet Member for Housing and Adult Care seeking approval to commence a procurement of a new Community Wellbeing Centre Service Model, which over time will transform the current traditional model of Day Centre provision for older people into a new more inclusive model, catering for a broader range of needs and offering greater choice of a wide range of opportunities and increased community engagement.

The proposed procurement follows on from an engagement exercise with current day care users, their carers, service providers and wider services into the future model of providing support and day time activities to help people to maintain their health, well being and independence. It will focus on giving people more choice and control over the support and services they are able to access, utilising personal budgets to offer more personalised forms of care and will promote the ethos of early intervention and prevention, maximising the use of community assets.
The current day care service contracts with SCA and Age UK expire on 31 March 2018 and so a re-procurement is required.

The report to Cabinet will outline the feedback from the engagement exercise and the proposed model of provision which will be set out in the Service Specification for the procurement.

(i)  To note the feedback from the engagement with current day care service users, their carers, service providers and wider services and residents.

(ii)  To approve the proposals in this report to develop a new model of activities and day time support across the city to help people maintain their health, wellbeing and independence. 

(iii)  To approve the recommendation to proceed with a procurement to deliver the new service model, which over time will transform the current traditional model of day centre provision for older people in Southampton.

(iv)  To delegate authority to the Director of Quality and Integration, following consultation with the Cabinet Member for Housing and Adult Care to decide on the final model of commissioned services and all decision making in relation to this procurement.

1.  The over 65 population makes up 14% of the Southampton population (34,600 people) and is set to grow more than any other age group, increasing by 15% between 2015 and 2021 (to 39,800 people), with the over 85 population set to increase by over 20%. 

2.  As people get older they are more likely to have health problems that limit their day to day activities and impact on their independence.  Furthermore there is evidence that the prevalence of depression increases with age. It has been estimated by the Scrutiny Inquiry on Combating Loneliness in Southampton (2017) that 5,482 people aged 65 and over are experiencing loneliness. Evidence shows that loneliness can have serious consequences and negative impacts at both a personal and community level.  It can cause and, at times, worsen existing personal problems (psychological, social, and behavioural) and community issues (fewer social connections, lack of confidence to leave the home).

3.  Given the changing demographics and increasing demand, it is important that the health and care system in and around Southampton adapts to meet the changing and growing needs of the population and has a focus on promoting healthy ageing. The Southampton Health and Wellbeing Strategy notes that there is a clear need to empower people to stay well. 

4.  Current day care provision is a traditional basic range of activities and personal care. Services are provided under block contract with limited flexibility for individuals.  The current day care service contracts, which are with Social Care in Action (SCA) and Age UK, expire on 31 March 2018 providing an opportunity to review the current model. 

5.  The new model has been developed through a process of co-production and engagement with current day care users, their carers, service providers and wider services. It will improve outcomes by focusing on giving people more choice and control over the support and services they are able to access thereby promoting independence, utilising direct payments to offer more personalised forms of care and will promote the ethos of early intervention and prevention by broadening the offer to more people and maximising the use of community assets. It will encourage independence and community resilience.

In considering the future procurement of older person's day care provision, a number of alternative options were considered.  These included:

•  To re-commission the day care services as is (this would still require a procurement as contracts end on 31 March 2018)

This option is not recommended because it does not respond to increasing demand and the need to broaden the offer to also focus on early intervention; it does not offer greater choice for people; and it does not promote people’s independence. 

•  To decommission day services entirely and provide current and future service users (on the basis of assessed need) with a direct payment to purchase their own support and care from the market.

This option is not recommended as the market does not currently offer sufficient choice and capacity to meet the needs of all current service users. There would therefore be a strong likelihood that this option would  increase pressure on already over-stretched social care provision e.g. domiciliary care.