Agenda item

7.1

Barbara Carlisle, Head of Strategic Commissioning and Partnership, Communities, reported on the present policy, at both national and local Government level, to ensure that people with learning disabilities lived in accommodation that met their individual needs.  She stated that, in accordance with the policy, the Council had commenced the process of de-registering its Learning Disability Care Homes, and moving towards a system of Supported Living Services.

7.2

Kate Anderson, Contracts Manager, Communities, gave a presentation on the present position with regard to the de-registration of the Council’s Learning Disability Care Homes to Supported Living Services, indicating that there were nine Care Homes to be de-registered, five registered to the Care Quality Commission by Housing Associations, with care and support delivered by Sheffield Health and Social Care NHS Foundation Trust, and four provided by Dimensions.  Three of the Care Homes (Handsworth, Cottam Road and East Bank Road) had been de-registered, with TUPE (Transfer of Undertakings (Protection of Employment)) having been applied in all three cases.  Wensley Street was currently going through the Deciding Together process, following Assessments and Support Plans, and Beighton Road was in the process of having Assessment and Support Plans completed.

7.3

Ms Anderson referred to a number of issues which had been experienced during what had sometimes been quite a complex and difficult process, and which had involved major changes in terms of culture and practice for staff and service users and their relatives.  She also reported on the lessons learnt in terms of the process, with regard to the Care Homes that had already been de-registered.

7.4

Ms Anderson concluded by referring to the changes to services, following de-registration, which included improved independence and better social inclusion for people with a learning difficulty.  She added that the Council had commissioned a report from Cloverleaf, an organisation providing an independent and confidential advocacy service that could be used by adults with a learning disability and their families, providing an independent review of the de-registration process to date, which would be circulated to Members of the Committee. She also referred to monthly newsletters produced by the Council, providing updates and general information in terms of the de-registration process.

7.5

Members raised questions and the following responses were provided:-

·                Whilst it was accepted that often people did not like change, the majority of feedback received following the de-registrations that had been completed had been positive.  The majority of staff had transferred under the TUPE regulations, which had resulted in there being no major change in terms of staffing.  There had been an increase in staff hours in the Supported Living Services, which had resulted in staff being able to spend more time with people.  Staff were also able to carry out more and varied activities for people, including activities within the Services and trips out. 

·                The Council would be involved in the process for at least another 18 months, and longer if required, depending on people’s needs. 

·                The decision had been made in terms of the de-registration of the Care Homes on the grounds that it was both local and national government policy to move towards provision of Supported Living Services to ensure increased independence, choice and control in people’s lives.

·                It was accepted that there had been a number of issues following the de-registration of Handsworth, some of which had been linked to the Residential Service and others to the new providers approach.  There had also been some concern over the fact that the manager had left, although this had been the Area Manager, who had left at her own choice, and not the Scheme Manager, who would be responsible for the direct management of the Service.  A new Area Manager had now been appointed who, having been the Development Manager, responsible for developing the project through transition, had considerable knowledge about the service and its staff, which had resulted in considerable progress and improvement being made.

·                Communication with staff, people living in the homes and their relatives had been viewed as a priority within the staff teams in the Services, and the Council had made significant efforts to ensure that all parties were provided with as much up to date information as possible.  This initiative had included group or one-to-one meetings with relatives, at which they had been asked which method of communication would be best for them, together with the production of a monthly newsletter providing information on progress with regard to the de-registration process and details on activities available within the Services.  It was also stressed that it was important that providers also maintained efficient and effective communication with staff, people and their relatives.

·                Although three Care Homes had been de-registered, the Council had not yet had the opportunity to arrange consultation sessions with those members of staff who had transferred under the TUPE regulations, although there were plans to undertake this work in the future.

·                Assessments in terms of the budget implications following the de-registration process were still being undertaken, although officers were aware that the transfer of staff under the TUPE regulations had resulted in there being significant budget implications.  Although it was likely that savings would be made in the long-term following the de-registration process, such savings would not be as significant if staff had not transferred under the TUPE regulations.

·                Approximately 100 people with a learning disability had been affected in some way, as part of the de-registration process.

·                The providers in terms of the Services following the de-registration of the next six Care Homes would be decided under the ‘Deciding Together’ process, whereby all 27 providers on the Council’s Approved List would be invited, and a shortlist would be drawn up after the initial submission of bids.

·                A Commissioning Officer had been appointed to work on transformation, based on the ambitions set out in the Learning Disability Commissioning Strategy and the quality standards in the Supported Living Contract.

·                In most cases where staff were undertaking outreach work, they would be expected to make arrangements for their own meals and, to date, there had been no feedback indicating that this was causing any particular problem for them.  This is one of the issues that would be raised with staff, as part of a wholescale feedback exercise.

·                Whilst it was accepted that as people grew older, there may be a need to consider care home placement, at the present time, the main aim was to build up their ambitions in terms of Supported Living, and this was what the Council was focusing on at the present time.

·                There was a need to ensure that the culture in connection with supporting people with a learning disability in the City was changed, particularly with regard to the institutionalisation of such people.  The approach that was being looked at by the Council was changing its contractual monitoring procedures.  There would also be an emphasis on the providers themselves to inform the Council of the changes they had made, as well as the providers being challenged to make improvements to the services they were offering.  The providers would also need to demonstrate to the Care Quality Commission how they were meeting the required outcomes.

·                Three staff had left Handsworth, and a further member of staff had resigned.  There had been a number of practice/safeguarding issues involving staff who had transferred under the TUPE regulations, as well as other issues which had not involved such transferred staff.  There were no agency staff working at Handsworth, and details of the total number of staff would be forwarded to Councillor Joyce Wright.

7.6

RESOLVED: That the Committee:-

(a)       notes the contents of the report now submitted, together with the information now reported and the responses provided to the questions raised;

(b)       thanks Kate Anderson and Barbara Carlisle for attending the meeting, and responding to the questions raised;

(c)        based on the information provided, is (i) happy that adequate progress has been made in connection with the de-registration process so far and (ii) satisfied that the lessons learnt following the problems and issues experienced as part of the de-registration of the first three Learning Disability Care Homes have been built into systems and processes, which should ensure that the de-registration process would continue to progress satisfactorily; and

(d)       requests that a report containing details of the feedback from staff and service users in terms of the impact of the de-registration on them, in a suitable format to be decided, be made available to the Committee.