Agenda item

Future of Learning Disability Services (Day Care)

Report of the Director of Integrated Adult Social Care, (IASC/24/04) on proposals for the future of adult day care services, attached.

An impact Assessment has been prepared and is also attached for the attention of Members at the meeting and is available on the web at - Day Services - Impact Assessment)

Decision:

RESOLVED

(a) that the information in the Report relating to the rationale for change and the consultation process, be noted; and

(b) that closure of the Learning Disability and Older Persons Services listed below, which currently have one or no people attending, be agreed, noting that usage rates were not the only reason prompting the decision.

(i) Learning Disability Services

a. Lyric, Okehampton

b. Newholme, Honiton

c. Rosalind House, Tiverton

d. Silverhill, Barnstaple

e. Tumbly Hill, Kingsbridge

(ii) Older Persons Services

a. Tumbly Hill, Kingsbridge.

Minutes:

(Councillors Brazil, Dewhirst, Leaver and Whitton attended in accordance with Standing Order 25(2) and spoke to this item).

The Cabinet considered the Report of the Director of Integrated Adult Social Care, (IASC/24/04) on proposals for the future of adult day care services, circulated prior to the meeting in accordance with regulation 7(4) of the Local Authorities (Executive Arrangements) (Meetings and Access to Information) (England) Regulations 2012.

The recommendation to close the services had stemmed from a number of changes first introduced in 2014 and followed by various consultations, engagement strategies and service changes, with the most recent being in 2023. Integrated Adult Social Care remained committed to promoting an individual’s independence and their access to community opportunities to meet their varying needs in different ways.

The COVID 19 pandemic had halted all provision of day services and when they recommenced, the numbers attending were very much lower than had been attending pre pandemic.

In July 2022, a family representative from each of the active day services was invited to a co-production event, to explore future options for day services. Following this, a public consultation paper was written, which described a proposal to reduced days of opening, with higher numbers of people attending services each day and to close other day services. This was launched in February 2023, but halted midway to enable the Council to carefully review the comments raised from stakeholders. This led to a revised approach, with a new consultation being launched on the 14 November 2023 regarding specific in-house day services (Lyric, Newholme, Rosalind House, Silverhill and Tumbly Hill).

Section 5 of the Report described the process and the feedback received from the 17 attendees of the focus groups, hosted by Living Options. 10 email responses and 11 on-line responses were also received about the consultation. The table at paragraph 6.2 showed the themes that had emerged from the focus groups, that were organised by Living Options, and the number of times that the respective themes had been mentioned. Living Options added that many were interested in keeping their specific locality provision active and the table at 6.4 below showed the themes from the comments received by DCC (Online and via email).

The Council currently operated 10 in-house day care services over eight sites and the services proposed for closure currently had no people in attendance, except for Rosalind House, which had one person, who was also accessing another service. The number of eligible people accessing the Councils in-house learning disability day services had also reduced in the last eight years. From 116 in 2015, to 85 in 2020. Current attendance was now at twelve people accessing four services (Abbey Rise, Nichols, Rosalind House, and Rushbrook).

The detail of the building provision was contained in Appendix C of the Report.

The Report outlined how the Council had undertaken a needs assessment and gained a better understanding of day service supply across Devon. This further suggested that current and projected future demand for people eligible should be able to be adequately met by the independent and voluntary sector.

The Report also highlighted a scoping review that had been undertaken to examine the extent, range, and nature of research activity on adult social care day service provision in the UK. This demonstrated a reduction in traditional day service provision and models of day care emerging. It also explored the LGA report (published January 2023) on bespoke support for people with learning difficulties and autistic people. The provider market appeared willing to work in this bespoke way but needed support from commissioning to do things differently, demonstrating change was occurring away from traditional ways of day care.

The outcome of the public consultation on the future of adult day services was outlined in section 3.17 and in full at Section 6. The full feedback report from Living Options Devon was contained in Appendix A, however, there was no strong consensus towards any of the options described in section 4, which covered options such as continuation, reduced days, reductions in some locations and the ceasing of services. Other options were sub-leases to the community, request additional funding, provision of one-to-one service provision and rolling rota’s.

Whilst all the alternatives were carefully considered, option 5 (to cease providing day services from all six of the in-house day services in the five locations), was chosen as the preferred option. However, the Council would continue to comply with its obligation to meet a person’s eligible needs, following a Care Act assessment and support plan.

The Cabinet noted that a combination of high inflation and rising demand had left local authorities facing some of their toughest budgetary decisions. Some of these unutilised services had staff along with the costs associated with running the buildings. The savings associated with the proposal was in the region of £300k.

An impact Assessment had been prepared and was also attached for the attention of Members at the meeting and was available on the web at - Day Services - Impact Assessment). The Impact Assessment had been consulted upon and updated following the consultation process.

The Cabinet noted that the proposal had been assessed and all necessary safeguards or action taken to safeguard the Council's position as well as risks to service users, staff and buildings.

If the proposals were agreed, formal closure would take place from the 1^st April 2024, and the Council would continue to work with the independent and voluntary sector to encourage the continued development of suitable alternatives.

The matter having been debated and the options and alternatives and other relevant factors (e.g. financial, sustainability and carbon impact, risk management, equality and legal considerations and alignment with the Council’s Strategic Plan) set out in the Director’s Report having been considered:

it was MOVED by Councillor McInnes, SECONDED by Councillor Hart, and