Agenda item - Transformation of Day Opportunities in Harrow

Report of the Corporate Director of Community, Health and Wellbeing.

RESOLVED: That

(1) a new service model, which incorporated a focus on internal services for those with the highest needs, provided in specialist environments and in which people with lower needs would be supported by alternative providers in the community, be agreed;

Phase One: Reducing & Rationalising Buildings

During Phase One, the Council would make operational changes to services to tackle the current over provision of spaces and offer best value for money. This would deliver required Medium Term Financial Strategy (MTFS) savings during 2013/14 whilst moving towards the proposed service model.

During this phase the Council would reduce the number of Council buildings used by in-house services from seven to four. Capacity at Sancroft Hall would also be utilised as the Council moved to this approach. Current vacancy levels in all five facilities would ensure that the Council could continue to offer high quality day opportunities as it transitioned to the new model.

The Council would support service users to maintain friendship and peer groups, which consultation had demonstrated to be important to them. Services provided would be at the current level, and of a similar type. The Council would commence planning for comprehensive reviews of individual needs to take place in Phase Two.

Phase Two: Longer Term Changes to Delivery in NRCs

During Phase Two we would implement changes to deliver the new day opportunities model. This will include the development of specialised services to meet the needs of the most vulnerable in the community.

Phase Two would involve changes over a period of time, including individual assessment and support planning to help people to identify the most appropriate service for their needs.

(2) the transformation of individual services during Phase Two of implementation, as described below, be approved:

A: Byron Neighbourhood Resource Centre - A specialised service would be provided for people with a learning disability including challenging behaviour and Autism;

B: Kenmore Neighbourhood Resource Centre - A specialised service would be provided for people with Complex Physical and/or Sensory Disabilities;

C: Vaughan Neighbourhood Resource Centre - A specialised service would be provided for people with a learning disability and complex needs;

D: Milmans Neighbourhood Resource Centre - A specialised service would be provided for older people including people with dementia;

(3) the Council cease to use the following buildings for day opportunities for vulnerable people:

Bentley Neighbourhood Resource Centre – the Council would consider alternative use or potential disposal of this property.

Gordon Avenue – Officers would negotiate with the owner of the property in relation to changing/ending use.

Bedford House – The building would continue to be used as a permanent residential care home for ten people with a learning disability as approved by Cabinet in March 2013. The Council would consider the future use of this building;

(4) theCapital Programme be amended so that this resource could be made available for capital works which arise from this review, and the recent review of Residential Care services. This would rename the capital project for "Bentley Day Centre Remodelling and Refurbishment" to "Remodelling and Refurbishment of Adult Services Residential Care and Day Care Services";

(5) the further development of a marketplace of community-based services for people with personal budgets delivered through the Council’s on?line market place – My Community ePurse – be noted;

(6) the further development of integrated services, offering a greater range of health related services and therapies within the four designated Neighbourhood Centres and other community facilities, as part of the new responsive model of day opportunities, be noted.

Reason for Decision: The development of this new model of day opportunities for vulnerable people in Harrow would

· deliver a model in which services were strategically aligned and financially affordable for the future;

· ensure that the London Borough of Harrow was using its resources to support those most in need in safe and high quality services;

· deliver revenue savings of £300,000 in 2013/14 and £300,000 in 2014/15;

· ensure that we use the buildings available to us in the most effective and efficient ways;

· support greater integration of health and social care services in order to develop improved seamless, preventative services, for example, using centres for physiotherapy and health education;

· respond to the changing demographic profile of people who use day opportunities, for example, by providing services that were able to respond to young people with severe autism and challenging behaviour support staff.

Alternative Options Considered and Rejected: As set out in the report.

Conflict of Interest relating to the matter declared by Cabinet Member / Dispensation Granted: None.

The Portfolio Holder for Adult Social Care, Health and Wellbeing introduced the report, which set out the conclusions of the consultation, including further work that had taken place, on a new Model of Day Opportunities in Harrow following Cabinet’s decision in January 2013. The report sought approval for transforming Day Opportunities in Harrow.

The Portfolio Holder added that the consultation had engaged with approximately 650 people and it was important to make the changes for the following reasons:

· to ensure that the services provided were used effectively and levels of underuse addressed;

· that the Council was responding appropriately to the demographic changes;

· the need to respond to the personalisation agenda which gives people a choice of services to use;

· the need to support those most in need by ensuring they can access the services provided by the Council.

The Portfolio Holder appreciated that the proposals would entail change which would concern some users and she was sad about this but felt that service provision would improve as a result of the proposals. She added that the situation would continue to be handled with the utmost sensitivity and trust, as there was a great deal of work to be done to bring the proposals to fruition. The Equality Impact Assessment (EqIA) was thorough and explained how the Council would mitigate adverse impacts.

The Portfolio Holder added that the process had been put in train by her predecessor and that she had seen some of the benefits that would ensue as a result of the proposals. However, the process was not complete and discussions would continue and she empathised with the disabled movement, with whom the ongoing work would continue.

The Corporate Director of Community, Health and Wellbeing referred to the report, which set out many benefits of the proposals alongside some challenges. He added that the proposals would also allow some disabled people to return to Harrow and use services near their families.

An officer detailed the feedback received from various organisations and users and explained that the recommendations set out in the report allowed for the same level of service to be provided to users. The officer added that the Council was committed to working with users to identify their requirements, such as friendship groups which many users wanted retained. He added that it was essential that there was choice but where there were preferences, the Council would aim to support them. In addition, service users would help design facilities, such as the provision of gym(s) within the buildings.

The Non-voting non-Executive Cabinet Members asked why the original proposals to Cabinet were not being revisited by the new administration.

In response to some comments about the use of Bentley Day Centre, the Corporate Director of Community, Health and Wellbeing stated that whilst he could not comment on individual cases, the process culminating into the report before Cabinet had commenced in January 2013 when Cabinet authorised consultations, and he confirmed that substantial changes had been made to the original suggestions. There was a need to balance choice with financial considerations. The Corporate Director added that the report was silent on the future of some of the Day Centre buildings and further opportunities to learn and share would be available through the Steering Group which would continue to exist as part of this process. In responding to questions, the Leader of the Council confirmed that an interest in a site had been received; however the Council had continued to focus on the needs of service users which had ‘driven’ the proposals before Cabinet.

The Chief Executive referred to the extensive consultations carried out, including the outcomes which had been shared widely and detailed in the report. He added that the Council was under immense financial pressure and all service areas were being asked to identify savings. It was essential that the Council focussed on the most vulnerable and he confirmed that existing service users would not have a reduction in their service. The proposals were underpinned by the issue of personalised budgets thereby giving choice to users and there was a need to integrate health and social care budgets. The proposals were intended to provide a better service in an adverse financial climate.

The Portfolio Holder said that she was aware it was a transitional period and was disappointed with the number of processes that had arrived at the same time. She was of the view that it was an opportune time for all sections of the community to come together to ensure successful outcomes. She was confident that the EqIAs had been undertaken and were thorough but further discussions would be required on the overall implementation of the proposals.

In response to additional questions from the non-voting non-Executive Cabinet Members about the utilisation of the Bentley Neighbourhood Resource Centre and its capacity which ought to be exploited, an officer replied that there was a need to manage within available resources and the building was not sustainable in its present form. The officer added that the matching of staff to jobs as part of the proposals would be carried out and he expected a much lower level of redundancies than the 11 identified, due to redeployment opportunities that would be made available to staff affected by the proposals and people choosing retirement.

In conclusion, the Corporate Director of Community, Health and Wellbeing explained the implications of not going ahead with the proposals as they would impact on the young people arriving through the transition process and those who were using services outside the borough as they would not be able to receive services in Harrow near their families. He added that the EqIA had been vigorous and thorough, extensive consultations had taken place on the proposals and there were opportunities for mitigation measures to be put in place.