1. Health and Disability Provider Services Update October 2010 Paul Haigh

2. Background Health and Disability Provider Services include: Oakdene Residential Care Home Adult Placement Scheme Acorn Day Service / SLA Rushcliffe Springwood Day Service Bestwood Day Service Summerwood Day Service

3. Residential Update Riverside closed Sept 30th 2010 – citizens and services relocated: Oakdene, Adult Placement Scheme, Older Persons residential services. Oakdene (25 beds) refurbishment completed - 16 long-term, 9 short breaks/emergency beds, Ceiling tracking systems fitted, bathrooms with specialist equipment, now accessible to most physically dependent citizens.

4. Adult Placement Scheme Team expanded in 2009 and service growing; Sept 2009 – Long term placements = 31 Short breaks = 25 Sept 2010 – Long term placements = 39 Short breaks = 34

5. Day Services Update (1) Acorn / Rushcliffe (via SLA) Both day services for citizens with physical / sensory impairments. Acorn service now established at the Mary Potter Health Centre. (50 a day) Rushcliffe Resource Centre – all 11 city users to be reassessed Oct 2010 to March 2011. Those eligible to be offered Personal Budgets

6. Day Services Update (2) Bestwood to Aspley Wood – Project now released aim to complete June 2011. Catchment areas to be introduced to all Learning Disability day services on completion. Actual Attendance Figures – October 2010 Springwood 160, Summerwood 37, Bestwood 100 Predicted attendance - April 2011 (post-intro of zero days) Springwood 125, Summerwood 28, Aspley Wood 100 Local Authority Trading Company for provider services being considered as part of the joint venture.

7. 2008 Mapping Exercise Review Year.No of School leavers.No School leavers to day services. 200825 10 2009102 2010 85 These figures do not show the admissions of those over school leaving age. A trend we see is that Day services admissions from school age are the most dependent citizens. Another trend is that admissions of 20+ year olds are made after citizens have left college placements.

8. Reduction in Day Services Full Council decision March 8 th 2010 Reduce day centre attendance for all those living in private sector residential care, irrespective of cost, to 2 days per citizen per week. The 2 day provision was to enable a safeguarding mechanism to be in place to oversee the effect of the reduced service. MTFP Additional saving for 11/12 reduces attendance to zero days

9. Reasons for the Proposals We pay a high premium for some people living in residential care Residential care is seen as ’24/7’ care Therefore residential care should include ‘meaningful activities during the day’ Some residents, though, still attend our day centres, hence the proposal to further reduce to zero (This proposal brings the situation for Under 65s in line with Over 65s where people in independent residential care do not also receive day services)

10. Risks Will meaningful day time activities be provided? Safeguarding - Ongoing monitoring of vulnerable people via our staff at day services will be lost Residential care providers may inflate costs to pay for day service provision

11. Current rating of the day service provision within residential homes (all post-June 1st 2010) Home / cost per week No of residentsRag rating / 12 Home A £674.91 312 red Home B £628.42 23 amber 9 green Home C £604.70 21 red 5 amber 6 green Home D £364.61 47 red 4 amber 1 green Home E £343.36 41 red 3 amber 8 green Home F £875.00 15 amber 7 green

12. Current rating of the day service provision within residential homes (all post-June 1st 2010) Home / cost per week No of residentsRag rating / 12 Home G £892.82 24 red 5 amber 3 green Home H £998.44 41 red 5 amber 3 green Home I £345.00 11 red 5 amber 6 green Totals 9 out 25 homes assessed23 out of 65 citizens37 red out of 108 35 amber out of 108 36 green out of 108

13. Savings 5 days to 2 Strategic Choice submitted last year to start from 2010/11 was originally for a net saving of £225K in 2010/11 increasing to £265K from 2011/12 and thereafter. This was reviewed and for 2010/11 only reduced to £110K (fye £180k). 2 days to zero Proposals should achieve total full year effect savings of £265k in year 2011/12

14. Actions being undertaken now by the Quality Monitoring Team 1.A draft contract is currently under consultation which makes the whole area of activities more robust. 2.Quality monitoring Visits are in progress, those that are poorly performing in this area will be put through a process of action planning prior to being revisited.

15. Future Actions identified by the Quality Monitoring Team 1.Contracts for services in this area to be more robust - Providing greater clarity within service specifications leading to person centred outcomes 2.Define what is meant by meaningful activities within contract specifications. 3.Ensure that each residential care home employs an activities coordinator full time, this may be seen as institutionalised in approach so needs to be more innovative to cater for all individuals

16. Future Actions identified by the Quality Monitoring Team 4. Providers to be requested to explore greater community links, this could be identified in contractual documentation 5. Greater networking amongst providers through residential forums (not necessarily contractual) 6. Regular Quality Monitoring Visits to services leading to action planning and follow ups