Stockton-on-Tees Borough Council

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Cabinet Decision: 30th September 2010
Title of Item/Report
EIT Review of Adult Operational Services
Record of the Decision
Cabinet was reminded that the overall objectives/aims of the Adult Operational Services EIT review had been to identify options for future strategy, policy, and/or service provision that would sustain or improve quality outcomes for Stockton Borough clients and their carers within the Adult Operational Services of CESC and deliver efficiency savings.

Cabinet, at its meeting in March, agreed the specific recommendation for STEPs at Tithebarn to authorise officers to enter consultation regarding the direction of travel of services provided to current clients in order to address more appropriately each clients assessed needs.

Members noted that the service was under utilised and had not reached its potential since its inception in 2004. Attendance had routinely averaged one third of anticipated capacity.

The first clients to attend the service formerly attended Alma Day Centre. Those clients were identified as being receptive, and able, to undertake skills development to access further education or employment. Contrary to the initial plans for the service, whereby clients were anticipated to attend on a session basis at pre-determined times they actually accessed the service daily in line with their former attendance at Alma Day Centre. This attendance pattern created a requirement for 2 buses through the Community Transport services at a cost of 80k per annum. This corresponded with an increasing under provision of buses for the adult and older person's Day Care Centres.

STEPs at Tithebarn has an employee group comprising 6 personnel

It was explained that of the 23 clients attending STEPs at Tithebarn at the time of the assessments. Following assessment it was anticipated that the requirements of all of these clients could be met appropriately through access to existing services and/or individual directed support through a personal budget.

Meetings were anticipated to continue throughout September in order to determine the best mode of delivery for each individual in line with the recommendations approved by cabinet in the report of 11 March 2010.

The re-occurring theme of the benefit derived from access to literacy and numeracy tuition had been recognised and this training would also be available routinely at alternative, existing, In House Day Care Centres.

On 11 March 2010 two recommendations for Blenheim House were agreed by Cabinet. They were to authorise officers to enter consultation regarding the most appropriate future services for current long term clients and to review the provision of services for adults with physical disabilities who required medium term or respite care services.

. The E.I.T. Review of Blenheim House was influenced by the reducing long term resident population and the potential impact of funding sources being reduced or withdrawn by the Tees Unitary Authorities currently purchasing care from Stockton-on-Tees, at Blenheim House.

Of the remaining 15 long term care clients at Blenheim House, prior to the EIT reviews, 6 were funded by Middlesbrough, 2 were funded by Redcar/Cleveland, 1 was funded by Hartlepool and the remaining 6 were Stockton-on-Tees residents. Middlesbrough had previously expressed a wish to speak to the clients funded by that Authority with a view to offering repatriation where appropriate.

Following a quality assessment survey of long term clients in which 4 stated they would like to live differently, informal reviews of all 15 were undertaken, all expressed a wish to be more reliably informed about alternative care provision for people with assessed needs.

Formal reviews followed, and in line with specific client/carer wishes, 12 of the 15 were supported to view Extra Care and alternative facilities in areas of their choice. All elected to apply for a placement in their area of choice, often to be closer to remaining family. Of the remaining 3 clients, 1 had requested to return to her former home with her family prior to the EIT reviews and was anticipated to move on 1 October 2010. One gentleman had spent most weekends with friends and after discussions decided to share a property with his friend when a suitably adapted alternative became available. The last remaining client had spent up to 5 days each week for many months with friends and asked to be re-housed near those friends.

Since the start of the formal reviews, 4 clients had accepted alternative care provision and a further 1 was anticipating moving by 1 October 2010. 4 of those clients were funded by Middlesbrough and 1 by Redcar/Cleveland. The remaining 10 clients were waiting for placements of their choice.

There were two medium term clients waiting for alternative placements and anticipated returning to independent living in the near future.

Respite placements average three beds per week at Blenheim House. Those clients were having their services reviewed in order to manage their provision within a diminishing service.

As residents funded by other Tees Valley Unitary Authorities moved to independent living, there would be a loss of income to the service.
Members were provided with details of financial implications connected with this issue and noted potential cost and savings associated with any future re provision of services.

RESOLVED that:-

1. officers be authorised to enter consultation with staff, clients, carers, trades unions and stakeholders regarding the re-provision of alternative services to current clients and potential cessation of the STEPs at Tithebarn element of the STEPs group of services with the aim of re-deploying existing employees as appropriate.

2. officers be authorised to enter consultation with staff, clients, carers, trades unions and stakeholders regarding the potential cessation of services at Blenheim House with the aim of re-deploying existing employee's, as appropriate, in recognition of the ongoing re-provision of alternative services to long term clients, in line with their individual preferences to live more independently in a location of their choice. It is also in recognition of the low number of clients whose carers request respite breaks at this facility.
Reasons for the Decision
The Efficiency, Improvement and Transformation Reviews, (EIT) a three year programme across all the Council's activities and were in response to the slow down in the national economy and the impact this will have on the Borough's Medium Term Financial Plan, coupled with increased expectations and demand for services. The EIT programme's aim was to maintain high performance, continue to improve satisfaction and enable further improvement across the Borough

Following implementation of the recommendations approved by Cabinet on 11 March 2010 the outcomes had been assessed and the proposed future direction identified.
Alternative Options Considered and Rejected
None
Declared (Cabinet Member) Conflicts of Interest
None
Details of any Dispensations
Not applicable
Date and Time by which Call In must be executed
By no later than midnight on Friday 8 October 2010.
Attachment

Date of Publication: 04 October 2010


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