Issue - items at meetings - Learning Disabilities Accommodation

Report of the Director of Adult Social Services/Lead Commissioner People (copy attached).

(1)       That it be agreed to re-model the council’s accommodation for people with learning disabilities as set out in Option 1 (paragraph 4.1).

17.1    The Committee considered a report of the Director of Adult Social Services/Lead Commissioner People which reminded members that a report had been presented to the Committee in June following a three month consultation which recommended the re-modelling of the council’s accommodation for people with learning disabilities.  The Committee decided to defer a decision pending consultation with the service users and additional information being provided.  The report set out the additional information requested by the committee, and the proposals now based on that additional information.

17.2    The Director of Adult Social Services/Lead Commissioner People thanked staff and members of the public for attending the meeting.  She explained that officers had to decide how to make savings year on year.  A consultation had been carried out with staff and families regarding the proposals for re-modelling the service.  The Director stressed that the learning disability service had high unit costs.  Brighton & Hove had the 12^th highest unit costs in the country as the units were very small.  Officers were also mindful of young people coming through transition from Children’s services into adult services.

17.3    The Head of Adult Care & Health (Provider) informed the Committee that officers were tasked with delivering a service that was cost effective and sustainable.  The in house learning disability service was high quality and high cost.  The budget for the service was based on £840,000 savings over the next two years.   

17.4    The Head of Adult Care & Health stressed that she wanted to make the best use of the in house service.  A three month stakeholder consultation had been brought to the June meeting of the Committee.  The committee decided to defer consideration of the report in order to obtain additional information.  The outcome of the consultation with service users was attached as appendix 2 in the report and the additional information requested by the committee in June was provided within this report. 

17.5    Information in the Report now being presented to Committee on the planned moves was set out in paragraphs 3.3 and 3.4 of the report.   The proposal in option 1 in this Report was to re-model the accommodation service including reducing the number of homes by 2. This option would maintain an in house service, and would allow existing staff to move with the service users.  It would result in a more efficient and sustainable service and would make the required savings.   Alternative options included outsourcing the service.  This would not be acceptable to relatives who wanted the council to continue the service.  A further option was to expand the service.  That option would not deliver the required savings or meet commissioning requirements to deliver improved value for money which would make the council’s services financially un-sustainable when compared to the private or voluntary sector. 

17.6    Councillor Mears referred to paragraph 1.2 in relation to Ferndale Road.  She had visited the excellent service there.  Councillor Mears was concerned at the wording of the paragraph and asked for clarification as to whether a report on the future of Ferndale Road would be taken to a future meeting.

17.7    The Head of Adult Social Care explained that officers had carried out further work due to the concerns raised about the closure of Ferndale Road.  Officers had decided that because they had been unable to identify suitable alternative housing for the two service users whose families wished to remain living together, they had removed the closure of this house from the recommendations and instead proposed to deliver savings and efficiencies without the closure of this home.  

17.8    Councillor Mears thanked the Head of Adult Social Care for her time in taking her round the homes.  She asked for reassurance that Ferndale Road had a long term future.  Councillor Mears referred to the report submitted in June and stated that she was aware that Ferndale Road was partly funded by East Sussex County Council who contributed £150,000 to its running costs.  This information was not clear in the report. 

17.9    The Director of Adult Social Services agreed that the cost of the service versus income was not clear, and apologised for this omission.    

17.10  The Chair reassured Councillor Mears that there were no proposals to close Ferndale Road at this stage. 

17.11  Councillor Meadows asked how many users were coming into the service.  The Head of Adult Care & Health replied that approximately an additional five service users would join the service.   During the next 18 months to 2 years, officers would look to increase capacity in homes by 1 or 2 people where practicable.

17.12  Councillor Wakefield referred to the proposed transfer of service users from Old Shoreham Road to Windlesham Road which would be an all women service.  She asked for reassurance that if the move was made attention would be paid to the exact layout of rooms.  Service users would want their surroundings to be in the right place and the right order. 

17.13  The Head of Adult Social Care explained that there were very few women in the service.  If the proposal was agreed, Windlesham Road would be a women’s service.  The move would be carefully planned with families and staff, and the property would be adapted to the individual needs of service users before they moved in.  It was anticipated the timescale would be 3 to 6 months.   

17.14  The General Manager, Integrated Learning Disability Service explained the way the proposed move would be managed.  A team was working with families and staff to prepare for the move.  Advice was also being sought from the Behavioural Support Team.  Officers wanted to work in a person centred way and to work with families in the detailed planning involved.  The General Manager had every confidence that officers could support a good transition for people.

17.15  Councillor Marsh stated that she had looked at the proposals in an open minded way and had been moved and changed by what she had seen.  She stressed that the service users were vulnerable adults and that the council had a corporate responsibility for them.  She considered it would be a cynical cost cutting exercise to go ahead with the proposals.  Councillor Marsh acknowledged that the service users could not be consulted about the changes and that they became very distressed at any mention of change.   

17.16  Councillor Marsh stated that she had seen the importance of the home environment for the service users.  It had taken a dedicated team to settle them and make them comfortable. 

17.17  Councillor Meadows thanked the Head of Adult Social Care for an interesting visit to the homes.  Councillor Meadows remembered her first visit to Old Shoreham Road when it was new.  She had been told at the time that small homes were the right way forward.  Councillor Meadows stated that the women in Old Shoreham Road were all progressing far better than expected. 

17.18  Councillor Meadows questioned the need for an all women service as there was a mixed gender group of service users at Beaconsfield Villas, where separate flatlets were provided.  Councillor Meadows considered that too many lives were being disrupted for a cost cutting exercise.  Councillor Meadows asked why properties were being closed when more people were coming into the service.   She stressed that Windlesham Road needed a great deal of adaptation.  Meanwhile, New Church Road had only just been furnished and seemed very comfortable. 

17.19  Councillor Meadows made the point that the total savings from the proposal in one year would be £600,000.  She stressed that without information about the cost of the adaptations to Windlesham Road they could potentially cost £600,000 and queried how that could be seen as a saving.   Councillor Meadows was concerned at the loss of 8.78 staff, and asked what would happen when staff went on leave and cover was needed.  Councillor Meadows stated that officers should come back with a model that supported the needs of all service users, including those coming through transition from Children’s Services.  Councillor Meadows suggested that finance for the service could be found by moving finance from other projects.

17.20  Councillor Mears stated that she considered Option 1 to be flawed.  She stressed that Windlesham Road was an expensive area and said she would be interested to know the value of the property.  Councillor Mears spoke of her visit to Windlesham Road and questioned the suitability of the house and explained that she had been out of breath when she had reached the top flat.      

17.21  Councillor Mears considered Windlesham Road to be a depressing property and parking was £3.50 an hour in this area.  She stressed that there was no detail on the cost of the adaptations required at Windlesham Road. 

17.22  Councillor Mears raised the issue of children coming through transition.  She stated that Adult Care & Health should be working with working with Children’s Services on this issue.  Vulnerable children could not be transported to school in large groups yet it was proposed to place them in larger homes.  

17.23  Councillor Mears agreed with Councillor Meadows’ comments regarding funding.  Other areas of the budget could be reviewed.  Councillor Mears stated that she would not support the proposals. 

17.24  Councillor Shanks stated that it was right to think about the transition of young people into the adult service.  She stated that savings had to be made and the proposals were necessary.   She assured members that the moves would be planned and would lead to more available space.  She supported the proposals.

17.25  Councillor Jones stated that he had visited the homes and been impressed by the quality of care.  He agreed that 267 Old Shoreham Road was a beautiful home and that the residents were very happy.  However, he had looked at the figures and had been concerned at what might happen in 2 to 4 years time.   Councillor Jones considered that if the changes were made now, the service users would be able to move with their dedicated staff group and would be in a new property which could be adapted in an appropriate manner.   He supported the proposals.   

17.26  The Director of Adult Social Services stated that the proposals were about maintaining quality homes and planning for transition.  The proposals would provide a local service for the most vulnerable.  One off capital funding from a separate budget would be used to carry out the adaptations to Windlesham Road.  With regard to staff, vacancies had been held open and agency staff had been used.  The proposals would not lead to any redundancies.

17.27  Councillor Norman thanked the General Manager, Integrated Learning Disability Service for taking him around the service.  Councillor Norman referred to comments about the proposals being a cynical cost cutting exercise.  He stressed that the service had to rely on government funding and had to work within those limits.   Councillor Norman stated that he was sure that the council would not place people in shared space if it was not appropriate.

 17.28Councillor Norman stressed the need for single sex accommodation.  There was a need to move forward to provide for the needs of the city, not just for now but for the future.   Councillor Norman had noticed that there are areas of the existing homes that needed to be upgraded.  He believed the proposals would improve the service to give vulnerable people security.  The carers he had met bar one had seemed happy with moving with their service users. 

17.29  Councillor Norman stated that Windlesham Road would be adapted with capital funding that was available to improve the property and bring it up to a higher standard than before.  He stressed that it should be possible to alter the internal structure of the building.  Councillor Norman mentioned that there was an empty building next door and suggested that that building could used as well. 

17.30  Councillor Norman stressed that he would not want to support anything that was not in the best interest of the residents.    If the proposals were agreed it would be the start of a development to improve the service for the residents in the longer term.  

17.31  Councillor Meadows noted that five new service users needed to be accommodated but asked why those who were happy and comfortable should be disrupted.  She stressed that more space was required not less.  She agreed it was a very expensive service but stressed that the council had a responsibility to ensure the service users were happy and reached their potential.  Councillor Meadows thought that the move would not achieve that aim.   

17.32  Councillor Meadows referred to funding.  She asked how savings could be made if the property needed adapting.  She considered that the finances did not add up.  Councillor Mears concurred and stated that there was insufficient financial information in the report in order to make a decision.  

17.33  Councillor Pissaridou stated that she could not support the proposals.  She congratulated Brighton & Hove Council for achieving what they had with the current service.  She asked why the council was proposing to edge back to having institutions. 

17.34  Councillor Barnett stated that not one carer she had spoken to was happy with the proposals.  She could not support the recommendations and would vote against them.  The service users were happy and contented in their current homes.  

17.35  Councillor Wakefield referred to the empty property next to the Windlesham Road home.  22 Windlesham Road had been handed over to Seaside Homes who would use it to convert to flats.  The property had potential to be used for adults in supported care.  Councillor Mears stated that she was surprised this very expensive property was being transferred to seaside homes.  She thought it would have been better to sell the property and invest the money in houses.

17.36  The Head of Adult Care & Health stated that officers were working closely with colleagues in Children’s Services to manage transition.  The council were facing the challenge that their services were very expensive compared to the private sector. It would not be an option to expand the service whilst the unit costs remained so high - this was not sustainable when Adult Social Care budgets are reducing.  There were no proposals to have institutions.   The proposals were about retaining family houses.  The Head of Adult Social care stated that she did not have the exact figures available on the cost of the adaptations but that these were funded through separate capital budgets.

17.37  The Chair read a letter from Councillor Stephanie Powell who was not able to attend the meeting; Councillor Sue Shanks was substituting for her.  Councillor Powell wanted the committee to know that she did not support the proposals.

17.38  The Chair stated that the proposals would not lead to anything resembling an institution.  There would be larger family homes.  The intention of the proposals was to future proof the service.  The Chair stressed the need to make savings in the Adult Care & Health budget and spoke about the anticipated reduction in funding to local government.  The Chair stated that he wanted to maintain a high quality in house service. 

17.39  At this point Councillor Meadows moved that the committee should vote on the recommendations without further discussion.  Councillor Mears formally seconded this motion and it was carried by the committee.

17.40  RESOLVED – That it be agreed to re-model the council’s accommodation for people with learning disabilities as set out in Option 1 (paragraph 4.1).