A new approach to helping the vulnerable in and around Sudbury

A 'person centred' approach

Vulnerable people who live in and around Sudbury (including villages such as Lavenham, Long Melford, Chilton, Acton, the Waldingfields and Monks Eleigh) will be benefiting shortly from the introduction of ‘Local Area Co-ordination’.

It is hoped that the new scheme will create a much more joined up approach to helping people access the services that they need. The improved way of operating should both reduce demand for public services and provide a more ‘tailor made’ approach for individuals.

It is believed that at present people find accessing the services that they need complicated and confusing. To try to make life easier two local area coordinators are now being recruited to work with the elderly and other vulnerable people, together with their families, in finding the right service solutions for them.  The co-ordinators will help people to access the right information.  They will listen to their preferences and help them to choose the right options.  They will help to find new ways of doing things which may mean that public service provision is not actually necessary.  They will help people who feel isolated or lonely to build up social networks and community support systems.

This is a new way of doing things which has had significant success in other parts of the country. The new posts for the Sudbury area are being advertised currently here, and the job descriptions give a good idea of what is involved.

If you would like further information about this new way of doing things please contact me.

The Care Act and Budgeting

Suffolk County Council has now published its budget for 2015/16 and this will be considered by the Cabinet on Tuesday before being debated by full council on 12th February.

We will be seeking to fill a budget gap of some £38m next year and we are aiming to do this largely through a series of transformation programmes.  These are based on radical service redesign, increased use of IT, demand management and partnership working.  We very much hope that these will prove succesful since they are the main hope of maintaining front line services while saving money.

One of the most uncertain and highest risk areas for us over the next year or so is the implementation of the Care Act.  This comes into force in stages this year and next.  The Act involves us in a range of  increased responsibilities in the area of care, particularly in respect of those needing care in their own homes.  We have received an additional £7m or so to help us with this, but we estimate that this sum is not really adequate to do all that is required by the Act.  Demand for care in a county such as Suffolk, which has a disproportionate number of people over 65, rises exponentially every year and it is a real challenge to know how this growth can be contained within current budgets.

If you are interested in the details of the Care Act, there is a useful introductory video available here.

Care UK

Suffolk County Council is taking a zero tolerance approach with regard to shortcomings at the new Care UK care homes in Mildenhall and Ipswich.

The Leader of the Council, Mark Bee, called the management of Care UK into Endeavour House yesterday for a meeting at which the council's high expectations of our care home providers were reiterated.  We will not be sending any more people to the homes until we are happy that all is as it should be, and it is possible that future openings of homes might be delayed.

Officers from Adult and Community Services were very quick to get onto the case as soon as problems at the homes were detected by the Quality Care Commission.   The incident demonstrates how very important it is to make sure that when services are outsourced the local authority retains sufficient capacity to maintain an element of control at all times.   This is not 'keeping a dog and barking oneself', but good commissioning practice.

The contract with Care UK has meant that the council has been able to provide several new, state of the art, care homes for our residents.  We would never have been able to afford these out of our own resources.  Although inevitably we will be criticised by those who believe that public services should never be delivered by the private sector, I believe that despite the current problems (which will be short lived) this was the right long term decision for our most vulnerable residents.

Living Wage Debate

At the Suffolk County Council meeting on Thursday the Labour Party put down a motion that, in essence, would have meant the council committing itself to impose payment of the Living Wage on all our contractors.

The Living Wage is, like the minimum wage, a calculated wage per hour.  At present it amounts to £7.65. This compares with £6.50 (from October) for the minimum wage, which, of course is the lowest level at which it is legal to employ anyone over the age of 25.  The Living Wage has been described by the BBC as the minimum amount necessary for a worker to live ‘a decent life’.  Its payment has much political support, but many employers are against it, arguing that it will cause job losses and damage competitiveness.

Who would not, all things being equal, not wish to improve the lot of the poorest workers in our society? In June Suffolk County Council agreed to pay the Living Wage to all directly employed staff, costing us £113,000 and affecting the wage packets of 90 people.   However, in the debate on Thursday, I was obliged to argue that to extend this requirement to our contractors would in current financially constrained times be unaffordable, potentially costing us millions, if not over ten million pounds, in additional contracting costs.

Our social care activities would be put under most pressure. This area, which is largely delivered through contractors, is already in difficulty due to the constantly increasing demand for services for the elderly.  Recognising this, the Government some time ago decreed that a solution could be achieved if the National Health Service worked with us to cut costs by closer co-operation.  Funds, belonging to the Health Service,(The Better Care Fund), were earmarked for this purpose, but, due to cost pressures within the NHS, it has been very difficult to access these.  It should be added here that, somewhat disingenuously, the Government made no new funding available, hoping that a cash strapped health service would see the cost benefits to them and simply hand over the money.

Unsurprisingly this hope has not, by and large, been fulfilled.  Cuts to our own budgets means that we have no additional resources to contribute to this area, and there is a real danger that spending on care, which we are obliged by statute to deliver, will start to devour resources committed to all our other services.  These are services which are already being reorganised to avoid further cutbacks in funding.  Libraries, children’s services, transport all come to mind.

There are other, more ideologically based, reasons for not wishing to comply.

As I said in the debate: to agree to the motion would result in the addition of another uncontrollable externally imposed commitment to the already enormous, burden of red tape and regulation that we put up with on a daily basis,   It would also represent unwarranted meddling in the businesses and competitive positions of the independent companies on whom we rely for service delivery.

In the event the motion was defeated by, I believe, 41 to 21 with 2 abstentions.  All the Conservatives voted against and, I think, most of the independents and the Liberal Democrats.

Care at Home

My mother in law, Pauline, who is over 80, had a fall this week, and was obliged to visit the Accident and Emergency Department at the West Suffolk Hospital.  The outcome was not too bad, but she has cracked a bone in her arm and will have to wear a sling for a few weeks.  In the old days Pauline would probably have been taken in to hospital, at least for a few days.  It is a sign of the times that she was in fact home again within a few hours and now has carers, arranged by the hospital, coming in morning and evening to help her out.  (I am happy to say that she was very pleased with the service that she received at the hospital.)

My mother in law’s experience is not unusual.  Hospital beds are at a premium and funding for public services generally is limited to say the least.  Councils and the NHS have realised that it is much better to look after people in their own homes as far as possible.  Patients generally prefer it, and in general it is a more cost effective solution for the organisations involved.

The same applies to those who need longer term care; better to support them in their own homes than to assume that a care home is the short term rather than a possible long term solution.

Caring for people at home is a huge topic and means a totally different way of working for both the County Council and for the National Health Service.  Importantly it is a function that neither organisation can fulfil alone, and therefore co-operation between the health and care services is vital.   

In my Mother in Law’s case the system worked well.   This is not always the case however, and getting it right in all circumstances is a challenge.

The Health and Adult Care Policy Group that I chair at the County Council will be looking at the whole subject of ‘Care at Home’ over the next few months.  At the end of last year the council undertook a wide consultation on the issues involved among care users, carers and care providers. The panel will be looking at the results of this to see how services can be better designed.  We will also be looking at how the community at large can be encouraged to help those at home, how housing might be adapted, and how those who need care can fund it.  I am sure that other topics will also arise in the course of discussion.

Any feedback from readers of this site will be much appreciated!

Care home in Haverhill recalls town's links with Anna of Cleves

On Monday I went to Haverhill to take part in the official start of construction of Cleves Place, the seventh of ten new care homes that are to be built by Care UK on behalf of Suffolk County Council.

Cleves Place will be built on the site of a former Middle School. It is a perfect spot, just minutes from the town centre, in a quiet elevated position with good views.  In addition to 60 beds, the Home will have a centre for day residents, a hairdressers and other innovative facilities.

The name was chosen from a number of suggestions submitted by residents of other homes.  It recalls Haverhill’s connections with Anna of Cleves, the fourth wife of Henry Vlll.  Their marriage did not last much beyond their first meeting, at which, disappointed in her looks, the King turned to Cromwell and said ‘I like her not’.

Divorce followed shortly, and, probably as part of the settlement, Anna received the parsonage in Haverhill, accompanying lands and right to appoint clergy in January 1541.  History does not relate if she actually ever visited the town, but she did live on in England in conditions of considerable comfort, long after Henry’s death in 1547.   In fact she was the last survivor of all Henry’s wives, Catherine Parr, the sixth wife, only outliving him by a year or so.  Anna attended the coronation of Mary l in a carriage with the future Elizabeth l and she died at Chelsea in 1557, a little over a year before Elizabeth's accession to the throne. She is buried in Westminster Abbey.

Reputedly a somewhat flattering painting of Anna of Cleves by Holbein.

A guide to Care

Last week the Adult Care and Health Policy Panel, which I chair, made what I hope was a useful contribution to the debate about how Suffolk County Council responds to the current Government consultation on the issue of how we pay for care, whether at home or in a care home.

The consultation relates to the Care Bill that is currently going through Parliament, and particularly concerns new measures that are to be introduced to ensure that no-one has to sell their home during their lifetime to pay care costs.

The issues are very complex, and the proposals could increase the bureaucratic burden on Local Authorities significantly at a time when their finances are already under extreme pressure.  The burden of our song therefore was that the government should ensure that implementation of the bill is as simple as possible, allowing us to work in partnership with others, and ensuring that those needing care and their families have the information to help themselves as far as possible.

I am pleased to say that the Council accepted the recommendations of the officers, which the Policy Panel had helped to shape, and passed them without a division.

The implementation of the Care Bill is something for the future of course.  However, if you, or someone you know, is currently trying to navigate the minefield that is the world of long and short term care, I notice that the Telegraph has recently produced a guide that aims to help you.   You can download the information here.

Care conference in Harrogate

The Conference Centre, Harrogate

I spent much of last week in Harrogate attending the Childrens and Adult Care Conference at the astonishing Harrogate Conference Centre.

It is a long time since I went to a conference of any kind.  I did wonder about how useful the experience would be, knowing that many regard these events as the next best thing to taking a holiday at one’s employer’s expense.

However since I was starting from a position of almost total ignorance, the fairly intensive programme proved a good way to get a handle on many of the hot topics that are concerning the world of Adult Social Care at present.

Co-operation between the National Health Service and Local Authorities that deliver Adult Care services is high on the agenda.  The Government has recently transferred funds from the NHS to Adult Care to encourage service integration and partnership working.  This meant that there was a good deal of input from officers from the Department of Health who seemed to be present at almost all events.

I was amused, when I attended a breakfast meeting hosted by the Department in order to discuss the Care Bill that is currently going through Parliament, to find that instead of healthy dishes of porridge or fresh fruit we were served delicious bacon butties!

 
I had hoped, while in Harrogate,  to find time to visit the legendary Betty’s Tea Rooms, pictured below,  where I understand the pastries are exceptionally good.  Unfortunately I didn’t make it, but the Department of Health  butties were some compensation