Agenda item

Resolved: to note the update reports; the Committee also noted its concerns about the combined impact of the proposals on service users and asked to be kept updated about the development of other options for funding provision of transport.

6.1      The report provided additional information about savings proposals that had previously been brought to Committee.

6.2      Martin Wilkinson (Chief Officer, Lewisham CCG) provided an overview of the CCG response to the consultation the savings proposals for Public Health; the following key points were noted:

• The CCG had been given two weeks to respond to the consultation. The proposals had been reviewed against the CCG criteria for improving local health.
• The CCG wanted to emphasise the importance of health promotion and prevention – and would be interested to see the proposals being brought forward to distribute the reallocated funding.
• There were concerns about some of the prevention work that would no longer take place, including smoking cessation activities and work with schools.

6.3      Aileen Buckton (Executive Director for Community Services) and Danny Ruta (Director of Public Health) provided an update to the Committee; the following key points were noted:

• The proposals were designed to ensure that public health outcomes could be achieved more efficiently with the least impact on frontline service delivery.
• There had been a mixed pattern of take up of health initiatives from schools over a number of years. Further work would take place to encourage schools to take up health initiatives and to deal with potential obstacles.
• The proposals would deliver better health outcomes for less money.
• The proposals had also been considered by the Health and Wellbeing Board.

6.4      Aileen Buckton (Executive Director for Community Services) introduced the update on the day care services savings proposal; the following key points were noted:

• Fewer people were using day care centres; the Council supported the development of flexible service provision.
• Work was taking place to develop the role of local community based activities and voluntary provision in order to offer a wider range of services.
• A further set of proposals would be brought forward about the proposed changes.
• It was intended that day centres would remain open; the Council intended to work with community and voluntary sector providers to enable this to happen.
• The proposal would be to save £1.3m
• One centre would be allocated as a care centre for dealing with complex needs.
• Ladywell would provide a specialist dementia service.
• Some service users would move from Leemore to Ladywell and some would move from Ladywell to Calabash.
• Officers would consult with centre users to ensure that this was a smooth process.
• Other day centres would be redeveloped as community hubs with disability provision.
• In April, Care Act changes to eligibility criteria for services would come into place; the Council would work on market development with the community and voluntary sector to offer choice.

Door to door

• Provision was very costly in some instances so officers had been working to improve cost effectiveness and facilitate the use of personal independence, choice and the use of direct payments.
• The Council recognised the importance of clubs; as of yet details about the future operation of clubs had not been agreed.
• In order to be eligible for transport, service users needed to have an assessed care need.
• Where changes were carried out formal consultation would be carried out. Proposals were currently in a pre-consultation phase – and have been brought before the committee for comment before a decision my Mayor and Cabinet about whether or not to carry out further work on developing the scope of the consultation process.

6.5      Nick O’Shea (Volunteer, Lewisham Mencap) requested to address the Committee and was given five minutes to do so- the following key points were noted:

• The Lee Grove Disco was a popular evening club for a variety of people across a wide age range.
• The club enabled people to leave their homes and to meet other people; it had a range of social and community benefits.
• Mencap had serious concerns about removal of day service provision and the Council transport to evening clubs.
• A bureaucratic change meant that a personal budget could no longer be used to buy a club place. This would have a serious impact on future provision.
• 400 people using services would be subject to major changes
• The proposal for light touch and drop in services would be inadequate for some of the people currently in receipt of services.
• The changes being proposed would not save the Council money. A great deal of the cost of Mencap services was provided by the organisation itself; but it would struggle to survive if service users were no longer able to access transport or use their direct payments to buy club places.

6.6      In response to questions from the Committee Aileen Buckton (Executive Director for Community Services) and Heather Hughes (Joint Commissioner, Learning Disabilities) made the following key points:

• All provision was based on assessments of individual needs.
• The Council was working to provide choice of services.
• Light touch and moderate care services were proposed for people who would not be eligible for other services under the Care Act criteria.
• The Council had no interest in closing Mencap clubs.
• If the proposal to end door to door provision for clubs was ended, support would be provided for people to access alternative means of using transport
• Busses could no longer be provided for people who did not have an assessed need for transport.
• Detailed work was taking place with community and voluntary sector organisations to explore future options for the use of community spaces.
• For people who had an assessed need formal needs for transport.
• It was recognised that there were multiple demands on some carers and that some may not want direct payments.
• Current policy supported the greater use of direct payments and the Council was required to offer choice.
• Further information would be provided to services users about changes before any decision was taken.
• Officers would work with voluntary providers to support the transitions and to develop solutions.
• It would not be possible for another provider to take over the running of the door-to-door without it registering as a bus service.
• It was not a legitimate use of the adult social care budget to provide a blanket service, which was not based on identified need. Service users would be assessed for their transport needs on a case by case basis.

6.7      In response to a question from the Committee about the legality of the proposals – Georgina Nunney (Principal Lawyer) advised that the Council was required to review all of its budgets and provide statutory services in line with its published criteria. It would not be under any obligation to provide funding for other services.

6.8      Councillor Best (Cabinet Member for Community Services and Older People) noted that the Council was in an extremely challenging financial position and committed to keeping the Committee updated about the options for the future development of services.

6.9      The Committee discussed the proposal and noted that people often found transport a concern. Members highlighted problems with other means of transport, noting that door to door is seen as a reliable service.

6.10    Sarah Wainer (Head of Strategy, Improvement and Partnerships) introduced the update to the adult social care charging and contributions consultation; the following key points were noted:

• The consultation was underway.
• Officers were seeking the Committee’s formal response to the proposals.
• It was estimated that of 2500 service users half did not currently pay towards the services they received. It was anticipated that, should the proposals be implemented, 300 users would need to pay for the first time – depending on their circumstances.

6.11    The Committee discussed the proposals and commented on proposal number 6 – transport charges. The Committee highlighted the discrepancy between people with lower and higher level needs. Members felt that if most people with lower level needs would be entitled to free public transport it might be problematic to charge users for higher level services.

6.12    The Committee also noted its concern about the cumulative impacts of the proposals on service users – Members were concerned about any individual service user who might be subject to all of the new charges being proposed.

6.13    The updates on savings proposals B1; A1; A2; A3 and A9 were noted.

Resolved: to note the update reports; the Committee also noted its concerns about the combined impact of the proposals on service users and asked to be kept updated about the development of other options for funding.