Agenda item

Having considered an officer report, and presentations by the Cabinet

Member for Health, Well-Being and Older People, Councillor Chris Best, John

O’Shea of Lewisham Mencap, Helen Bashford, the Mayor agreed that:

 

(1) officers should report to him and Cllr Best on a confidential basis every 4

weeks detailing progress on implementation including problems encountered

in individual cases;

 

(2) the outcomes of the consultation as set out in section 6 and the Equalities

Analysis Assessment in Appendix 12 be received;

 

(3) the report be considered in conjunction with the ’Voluntary Sector

Accommodation Implementation Plan’ report;

 

(4). service provision be consolidated to the three services for service users

with complex needs – the Intensive Support resource (ISR), the Challenging

Needs Service (CNS) and the Specialist Dementia Service;

 

(5) an undertaking be given to identify specific partners to work with

the Council to maintain key activities in the areas of supported

employment (e.g. Grow and ‘Tuck Stop’) and also performance art (i.e.

‘Uproar’ and ‘Dare to Dream’);

 

(6) the Intensive Support (ISR) service for people with profound

learning disabilities and complex needs currently at Leemore moves to

the Ladywell Centre;

 

(7) a service to be known as ‘A Place to Meet’ (the ‘drop in’ service) is

commissioned to support people no longer eligible for Council funded day

care.

 

(8) the older adults currently using the Ladywell Centre who have not

already moved to the specialist Dementia Unit move to the Housing 21

managed day centres at Cedar Court and Cinnamon Court or other

similar provision of their expressed preference;

 

(9) specific areas be allocated for the delivery of services to people

with a learning disability in Mulberry, Leemore and Naborhood and these

centres extend their use to the wider Lewisham community as

community hubs for a wider range of purposes in partnership with

existing third sector organisations;

 

(10) the three centres, Leemore, Mulberry and Naborhood be recognised as

community hubs as part of the Community Services Assets portfolio, and

there be different rental and running costs and charges from those applied to

general lettings;

 

(11) voluntary and community providers be invited to offer activities and

support to people who will be receiving a direct payment or

personal budget, either via the community hubs or alongside them;

 

(12) service users have the opportunity to use their direct payment to

employ a personal assistant and make use of the community hubs;

 

(13) the in-house Door2Door transport be maintained only for older

adults, the most complex service users with long term conditions, and

the remaining Council directly managed service users (ISR, CNS,

Dementia) with the travel needs of remaining eligible day service users

be met by a variety of alternatives including travel training and

buddying; shared escorted and unescorted taxis and volunteer drivers; and

 

(14) £14,000 per annum continues to be available to fund transport to

evening clubs for those existing people living at home with their families.

The Mayor opened the discussion by welcoming the many public members

who were present to listen to this item. The Mayor recognised change was

disturbing for some service users but that it had to be placed into the context

of reduced public funding for all services. He further stated that even without

the financial drivers it was appropriate for all services to be reviewed from

time to time

 

The report was presented by the Cabinet Member for Health, Well-Being and

Older People, Councillor Chris Best, who set the context of the proposals

including the intensive consultations which had been undertaken since the

item had last been considered in February. She said she appreciated that

some service users and their families still held deep concerns about the

proposals. She stressed though that all the existing Day Centres were to be

retained but that their use would be wider than before.

 

Greater detail about the proposals was then given by the Executive Director

for Community Services and her staff. The Executive Director stated that in

her professional opinion there was a firm rationale for change. Firstly she

pointed out fewer families were making use of the Day Centres and there was

considerable spare capacity. Secondly, opportunities could be developed that

were accessible in other parts of the community and not just at Day Centres.

Thirdly, Day care provision had to be set in the context of the Council’s overall

budget position and the enactment of the proposals would effect a £1.3 million

saving.

 

The Executive Director referred to the recent receipt of several letters and a

petition signed by 757 persons objecting to the proposals. She confirmed

those had been considered in the process and observed that since February

various changes had been made to the original preferred option in light of the

comments received. These included enhancing personal safety and security,

providing for older residents, increasing staffing during the transitional

period and working, as requested by the Healthier Communities Select

Committee, with Mencap to improve the evening transportation scheme while

lowering costs.

 

The Executive Director’s presentation was reinforced by the Joint

Commissioning Manager who provided greater detail on the consultations and

by the Operations Manager who reported on the assessment process.

 

Mr Nick O’Shea, representing Mencap next addressed the Mayor. He pointed

out the anger felt by otherwise reasonable people and recognised the

challenges caused by austerity across the public sector. He stated he had a

clear and costed alternative which would require no savings requirement from

adult day care services. He drew the Mayor’s attention to a response he had

received to an FOI request which reported Lewisham had a £248M PFI debt

which was being repaid at a 10.3% average interest rate. He said the Council

was spending £26M in interest repayments every year.He claimed the Council

could reneogiate the loans on the lines of a domestic remortgage and ensure

money was available for services to vulnerable people rather than going to

bankers.

 

Helen Bashford, the mother of a service user, made the next presentation to

the Mayor. She stated people were not using Day Centres because they were

not being offered to clients and that there had been numerous cases of

people having providers forced upon them without a choice being given. She

said she had no confidence in the consultation which she believed amounted

 to little more than box ticking by officers and that she had subsequently set

up a parents and carers support group which now had more than 50

members. She said the written report did not adequately reflect the opposition

to the proposals and she called upon the Mayor not to pass the proposals in

their entirety, but postpone them until all personal assessments had been

concluded and parents and carers knew what their budgets would be. She

said the Council could face increased costs if carers withdrew their support

and pleaded for an alternative way forward to be found.

 

Councillor Kevin Bonavia responded to the points made by Mr O’Shea saying

the Council’s actual borrowings were £1.3B and commitments had been made

to 8 PFIs. The interest payments of £26M had to be set in the context of this

higher figure which included expenditure on the refurbishment of the entire

school estate. Councillor Bonavia offered to speak to Mr O’Shea about his

contention subsequent to the meeting.

 

Councillor Joan Millbank advised the Mayor of her direct experience with the

community model in another borough providing services for people with

learning disabilities. She said she was convinced the integrated model could

work well and that it gave vulnerable people the opportunity to mix with others

in a safe way.

 

Having carefully considered all the representations that had been made, the 

Mayor concluded that he firmly believed some change at some point was

inevitable irrespective of any financial imperatives. He stated that halting the

proposals would only lead to a bigger and more wide ranging impact later. He

stated he thought the transition would be absolutely critical. In going forward

collectively if things did not work he expected quick action to be taken. The

Mayor wanted Helen Bashford’s new group to be engaged in the monitoring

process. In order to reinforce scrutiny of the transitional arrangements, the

Mayor inserted a further recommendation requiring officers to report

confidentially to him and Councillor Best on a four weekly basis detailing

progress on implementation including problems encountered in individual

cases.

 

Having considered an officer report, and presentations by the Cabinet

Member for Health, Well-Being and Older People, Councillor Chris Best, Nick

O’Shea of Lewisham Mencap, and Helen Bashford, the mother of a service

user, the Mayor, for the reasons he had stated and as otherwise set out in the

report:

 

RESOLVED that:

 

(1) officers should report to him and Cllr Best on a confidential basis every 4

weeks detailing progress on implementation including problems encountered

in individual cases;

 

(2) the outcomes of the consultation as set out in section 6 and the Equalities

Analysis Assessment in Appendix 12 be received;

 

(3) the report be considered in conjunction with the ’Voluntary Sector

Accommodation Implementation Plan’ report;

 

(4). service provision be consolidated to the three services for service users

with complex needs – the Intensive Support resource (ISR), the Challenging

Needs Service (CNS) and the Specialist Dementia Service;

 

(5) an undertaking be given to identify specific partners to work with

the Council to maintain key activities in the areas of supported

employment (e.g. Grow and ‘Tuck Stop’) and also performance art (i.e.

‘Uproar’ and ‘Dare to Dream’);

 

(6) the Intensive Support (ISR) service for people with profound

learning disabilities and complex needs currently at Leemore moves to

the Ladywell Centre;

 

(7) a service to be known as ‘A Place to Meet’ (the ‘drop in’ service) is

commissioned to support people no longer eligible for Council funded day

care.

 

(8) the older adults currently using the Ladywell Centre who have not

already moved to the specialist Dementia Unit move to the Housing 21

managed day centres at Cedar Court and Cinnamon Court or other

similar provision of their expressed preference;

 

(9) specific areas be allocated for the delivery of services to people

with a learning disability in Mulberry, Leemore and Naborhood and these

centres extend their use to the wider Lewisham community as

community hubs for a wider range of purposes in partnership with

existing third sector organisations;

 

(10) the three centres, Leemore, Mulberry and Naborhood be recognised as

community hubs as part of the Community Services Assets portfolio, and

there be different rental and running costs and charges from those applied to

general lettings;

 

(11) voluntary and community providers be invited to offer activities and

support to people who will be receiving a direct payment or

personal budget, either via the community hubs or alongside them;

 

(12) service users have the opportunity to use their direct payment to

employ a personal assistant and make use of the community hubs;

 

(13) the in-house Door2Door transport be maintained only for older

adults, the most complex service users with long term conditions, and

the remaining Council directly managed service users (ISR, CNS,

Dementia) with the travel needs of remaining eligible day service users

be met by a variety of alternatives including travel training and

buddying; shared escorted and unescorted taxis and volunteer drivers; and

 

(14) £14,000 per annum continues to be available to fund transport to

evening clubs for those existing people living at home with their families.