Day activities for adults with learning disabilities

This consultation period has now been extended to the 6 January 2020.  A letter to stakeholders explains the reason for the extension. 

Current and possible future users of day centres in Bexley are being asked for their views on the day activities offered by the Council.

Contracts for all of the day centres are due to end in May 2020. The Council wants to take the opportunity to increase the choice of activities offered to people with a learning disability in Bexley.

It is looking at –

  • Imaginative use of personal budgets either individually or collectively to create bespoke activities
  • Participate in activities already available through the universal and prevention offer such as art and dance classes
  • Providing new opportunities for adults with a learning disability to meet locally
  • Linking up activities or groups in a way that works for everyone involved.

The Council is asking people with learning disabilities to take part in an online survey 

An easy read version of the survey will be available later this week. 

Paper copies of the survey will be available from the Civic Offices, Bexleyheath and local libraries.

Centre users and their families will also be invited along to speak to Council staff during the consultation. 

Find out more about the Cabinet Member Decision. 

A list of frequently asked questions and answers are below for information. 

Meetings times - 

Date of Meeting

Time

Location

5 November

12pm – 1.30pm

Smerdon Day Centre

7 November

10.30am – 12pm

Carlton Day Centre

 

7 November

12.30pm – 2pm

Ken Boyce Centre

 

13 November  10am - 11.30am Crayford Library 

13 November

7pm – 8.30pm

Bexley Civic Offices

21 November  11.30am - 1pm Welling Library 

21 November

7pm– 8.30pm

Bexley Civic Offices

 

For more information please contact 020 3045 5900 or email LDTransformation@bexley.gov.uk

Start Date
End Date

Our data shows that fewer people are choosing to attend a day centre such that the average unused places are running at 15%, with a general downward trend. Whilst those who do use the day centres (and their carers) generally express high levels of satisfaction, it is particularly true that younger people are attending less.

The trend shows that under-usage will be exacerbated over time. It is not sustainable to continue with guaranteed funding for more places than is needed. Equally, we do not as a rule provide guaranteed funding in this way for other services, e.g. day services for older people, residential and nursing homes or homecare – these services are viable on a payment per person basis because there is demand for that service model.

This is not a consultation on the closure of any existing day centres.

It is a consultation about the contract payment method, which is currently to give guaranteed funding for the service provider to the agreed capacity of the centre, regardless of the numbers attending.

Day centres will continue to be an option as long as there is a willing provider to run the centre.

The day centre contracts run for five years. At the end of the five-year period, the Council is required by law to open the contracts to competition so that any suitable provider can bid.

We currently pay for these day centres on a guaranteed funding basis (block contract), i.e. the service provider is paid for a set number of places whether those places are taken up. We know that fewer people have chosen to take up a day centre place, meaning we are paying for spaces that are not being used. The current total annual cost of unused places amounts to c£270,000. This is not sustainable when set against rising demand for social care services.

At the time it seemed the right approach. We recognise a change in how all services are procured now and want to move in line with current practice across the council to ensure money is not spent on spaces that are not used.

This is not a consultation on the closure of any existing day centres.

We are proposing that we don’t seek a provider to run the Ken Boyce Centre on a guaranteed funding (block contract) basis from June 2020.

This is about choice. If enough people want to use their personal budget to buy a day centre place – and there is a willing service provider to run the centre at its risk – then the Ken Boyce Centre can continue to be one of the choices available to people. What can’t be right is that public funds are used to subsidise the (KBC) Ken Boyce Centre if fewer people want to use it than can make the centre viable.

We also have to acknowledge that the Ken Boyce Centre (KBC) needs significant investment and improvement to bring it up to the standard to provide day services that the council expect.

We are proposing to develop three hubs within the borough as part of transforming the services for adult social care in Bexley in line with the agreed Learning Disability Strategy.

It will take time to develop the three community hubs. So, we want a provider to continue to run the Smerdon Centre until May 2021, with an option to extend to May 2022. This will ensure we have capacity to meet everyone’s need and provide for a transitional period.

At the end of the contract period for the Smerdon Centre, the proposal is to not seek to contract with a provider on a guaranteed funding basis (block contract) – but of course if enough people choose to continue to use the Smerdon Centre using their personal budget and there is a willing provider to run the centre on the basis of individual payments, the Smerdon Centre would continue to be available as a day service choice.

There is not a life-long guarantee that Smerdon as a day centre will always be there even with sufficient demand. There may be future unforeseen issues or events either within or beyond the control of the Council that cannot be anticipated at this time.

We will be having three hubs in three parts of the Borough: North, middle and South. The hub for the South of the Borough (Frognal) has been identified as the Carlton Day Centre. This is a modern fit for purpose building that has had recent significant investment.

The other two hubs, in the North and middle of the borough are yet to be decided.

We are looking to co-design the hubs and want to engage with all who have an interest about what the locations and the dedicated space within those buildings for people with learning disabilities will look like and we would welcome your views and suggestions. So, although we propose to ensure that there is a building based (hub) service, it should be as part of a building that is also used by the wider community and in a central community setting. There will be separate, dedicated space for people with learning disabilities, but given that we anticipate people will spend much more time in community-based activities, the hub will not be at the scale and size of the Smerdon Centre.

This is a council owned property which would come within the ambit of the Council’s overall asset management strategy. Currently, the Council has no intention to sell the Smerdon Centre.

There are no current plans to develop the sites.

We are not.  We are changing a contract based on actual spaces used for day activities and paying the same way as we do for all other people who use social care.  Current evidence suggests that young people coming into the service prefer to use their direct payments / personal budgets to do other activities than going to a day centre.

Current practice is to inform young people and their carers about day centre opportunities. When going through the Preparing for Adulthood (PfA) process day centres are considered and staff also attend schools to highlight what opportunities day centres offer

We have spoken to the providers. The providers for two centres have confirmed there is no waiting list. We have investigated the waiting list at the third day centre and they have confirmed that, although they hold a list of interested individuals, they are not referrals at this time and there is no waiting list.

However, we do have people waiting for an assessment to acquire more days and those waiting to change which day they attend a centre.

Some centres may be busier on certain days than others. But the evidence clearly shows the spaces we are paying for are not being used and this is costing the council  c£270k a year.

The Learning Disability Strategy 2017 – 2021 sets out a shared vision for people to have a full and active community life. Over the time from 2017 to today, we have expanded the range and scope of community activities and these have proven very successful; however, everyone recognises that there is a need for a sizeable dedicated space (or spaces) for people with learning disabilities, suitably adapted and equipped for managing personal care.

A hub is intended to be part of a mixed-use community building, but with sizeable dedicated space within for people with learning disabilities to use as a base. The idea is that people will be supported to access a range of community activities, but, given that few of us are active every hour of every day, there will be a comfortable, well equipped hub (but not at the scale of a day centre) to go to when not enjoying a community activity. Hubs should be part of a building that is also used by the wider community and in a central community setting.

We are still in the process of choosing two of the hub sites. We want to co-produce with our residents and would welcome your views and suggestions.

This consultation will be used to make decisions about how we contract for day centres and therefore may influence the shape of day services for people with learning disabilities in the future. But we also want people thinking about the concept of community-based hubs and options for community activities that enhance learning, employment or simply enjoyment.

For those with more profound disabilities, we recognise there is a bigger challenge to ensure options are available that reflect their unique needs and we are committed to ensuring that is considered as new options are developed.

The hub is intended to be part of a building that is used by other community groups but is unlikely to have ‘open’ public access.

We recognise that there is a need for a sizeable dedicated space (or spaces) for people with learning disabilities, suitably adapted and equipped for managing personal care. Therefore, a hub is intended to be part of a mixed-use community building, but with sizeable dedicated space within for people with learning disabilities to use as a base.

It is absolutely paramount that there will be a dedicated safe space within the hubs for people with learning disabilities. The council put the safety of people who use the service first. It should be recognised however that dedicated learning disability services do not of themselves guarantee safety,

Absolutely. And we will need to consider the appropriate transitional arrangements for each person on a case by case basis. However, we are not saying day centres are closing – just the way we pay for the spaces for people to attend.

One hub at present at the Carlton Day Centre. The other two hubs, in the North and middle of the borough are yet to be decided. We are looking to co-design the hubs and want to engage with you about where the locations could be and what the dedicated space within those buildings for people with learning disabilities will look like and we would welcome your views and suggestions.

 

Transport arrangements will be factored in to any service provision as they currently are but we welcome your views. We currently pay £1m (so £5m over a five-year contract) for our transport but we are not sure we are drawing out the best value from this service. We want to see better outcomes from our transport provision, providing more choice and access for people that use the service and we need to look at ways to improve this.

It is absolutely paramount that within the hubs there will be dedicated safe space. This is unlikely to be at the scale of existing day centres because people will be attending activities in the community much more, using existing leisure services such as dance studios, music and drama spaces, sports and leisure centres, arts and crafts studios etc.

In terms of level of service, if your circumstances do not change and your assessment does not change, then the same number of hours will be provided.

We understand that some of the day services support you as carers go to work, look after other family members, be in education, volunteer etc. If you need your cared for person to be supported to leave the house at a certain time the hubs will be able to accommodate this as this is part of the eligibility criteria under the Care Act requirements.

 

Personal budget amounts are calculated based on assessed level of need.

Personal budgets are calculated on the person’s needs and the council is obliged to demonstrate that it is sufficient to meet identified needs by reference to actual available services.

There is no reason why they should. Even if a different provider wins the contract, staff have employment rights under something called ‘Transfer of Undertakings, Protection of Employment Regulations’ (TUPE) which means that generally they are entitled to continue to work under the same terms and conditions.

As above. Obviously existing staff can choose not to take up employment with a new provider, but in our experience almost all do.

We are aware that some letters may not have been delivered. Our databases are as up to date as possible and so we are not sure why this has happened. We have ensured that all day centres have copies of the letters and consultation and converted them into easyread and publicised the consultation online. We have also written again to set out more clearly that this is about a re-procurement of the block contract and we have extended the consultation deadline until the 6 January 2020.

 

We have written to all people on our data base who are currently in receipt of day centre services. We will be writing to other people with learning disabilities and carers soon. However, we are aware that there was some delay and confusion with some of the letters and have extended the consultation date until 6 January 2020 and arranged further consultation events as a result to reflect this.

We are very sorry for any concern or confusion as a result of the letter we sent out. We acknowledge it could and should have been better phrased. We have listened to the concerns raised following the initial letter and re-issued a revised letter setting out more clearly that this consultation is about the contract payment method, which is currently to give guaranteed funding for the service provider (a block contract) to the agreed capacity of the centre, regardless of the numbers actually attending. This letter has now been sent to a wider group of people we wish to consult with, and we have extended the consultation deadline until the 6 January 2020.

LB Bexley is an efficient council when benchmarked against similar councils. As we currently pay for day centres to be at full capacity when occupancy is significantly below, this is one area where we are guilty of wasting money. If we re-contract on the basis that we only pay for the services used that ensures efficiency and a common-sense approach for the Council

Anyone requiring a day opportunity service are given information about a range of services provided by the council which includes day centres.

Day centres promote themselves as part of their contract and as they move to price per person, they may advertise their opportunities more thoroughly to improve attendance.

Our day centres contracts are ending in May 2020. Before we reach that date, we need to decide how we are contracting and paying for this going forward. This is simply about the method of payment. In the event that the shift to paying on the basis of people actually attending affects the viability of the service, any change to the service would be manage carefully and over a prolonged period of time. As things stand, those who run the day centres are saying that they do not expect this change to compromise the current services

We try and involve carers as much as possible. We have a carers newsletter and carers sit on the carers partnership board and Learning Disability Partnership Board.

We are also developing a dedicated carers space on our website and creating a sub group of the carers partnership board specifically for carers with people with learning disabilities. We also write and email when we need to communicate messages.

It is a competitive process and we cannot say who will be successful in winning the contracts to provide the day service opportunities. However, whoever does win will have been through a very rigorous process to ensure they are able to deliver a high-quality service.

Carlton is on a guaranteed block funding basis for at least two years based on existing occupancy. After two years up to the five-year term the guaranteed block funding will reduce so that at least some of the income will be from people choosing Carlton, using their personal budget/Direct Payment.

Smerdon is on a guaranteed block funding basis for one year (with an option to extend by one year) after which payment will be by personal budget/Direct Payment based on people choosing to attend Smerdon

For KBC there is no guaranteed block funding therefore it can only remain open if there are enough people to use their personal budget and there is a provider to take on the building and service on that basis.

Like any commissioned service, it will continue to operate if enough people want to use that service.

All budgets are based on a needs assessment and set by the Care Act eligibility. Many people with Direct Payments use it to pay for a personal assistant, so it is clear that the funding provided is sufficient to get a personal assistant. We do recognise however that there is a problem with supply and we have a programme of work to increase the numbers and availability of personal assistants.

We recognise those with more profound and complex need require more support and specialised provision in terms of day services. In developing future plans for day opportunities in the borough with our stakeholders we will ensure that those with profound and complex needs are not forgotten so that they have both specialist provision for e.g. personal care and an extended menu of activities that is appropriate to their needs.

We will co-design with carers, people that use the service and other stakeholders. This process will be much more than consultation

A timeline of the procurement phases in below:

 

Activity

What this means

Time period

Procurement phase

When we go out to the market and invite providers and organisations to bid

4 weeks

Evaluation phase

When we evaluate the bids from organisations and decide on who will be the future providers

12 weeks

Award phase

When we award contracts to organisations ahead of the new day opportunities model starting

4-6weeks

 

 

Historically we have contracted for 24hour support for individuals from the accommodation and care provider, which has meant there is not spare funding for day activities.

We will make our best endeavours to renegotiate for people to go to day services and for the future we will try to not contract on a one size fits all basis; however in any circumstance where that is not possible, we will make it absolutely clear at the point that the person chooses accommodation with care whether it is an ‘all inclusive’ contract or that accommodation and support and day opportunities are separate.   

Personal Budget: this is the general term for funding required to meet the person’s needs. A personal budget can either be managed on the person’s behalf by the Council, paid to the individual (or their representative) as a Direct Payment, or paid to a named service provider as an Individual Service Fund for that provider to manage on the person’s behalf.

Direct Payment: the monetary sum identified in the Personal Budget, which is paid directly into the bank account of the person for them to use to arrange care and support to meet their eligible needs. Alternatively, the funds can be accessed through a pre-payment card (similar to a credit card). Direct Payments require the person to account for spend by reference to the person’s care plan.

Individual Service Fund: the monetary sum identified in the Personal Budget, which is paid to the person’s nominated service provider. The provider uses the ISF as directed by the person, both to pay itself for services it provides to the person and to arrange for other care and support by other providers.

Individual Payments’: not a technical term (i.e. not in any statute or statutory guidance) but is often used to describe either a Personal Budget or a Direct Payment.

Most importantly, no-one will (or can) be forced to take a Direct Payment or an Individual Service Fund. That is a matter of personal choice. Everyone, however, will have a personal budget. Where any individual chooses not to have that as a Direct Payment or Individual Service Fund, it will be managed on their behalf by the Council or an agent of the Council. The individual may exercise as much or as little control as s/he wishes of their personal budgets. For those who do not want to be involved at all, the process will be invisible (apart from an initial letter informing them what their personal budget amount is) and they will simply receive the agreed services.