Agenda item

6.1  Sarah McClinton,  Deputy Director of Adult Social Care gave her presentation on Southwark’s Vision for the Future of Adult Social Care provision.

6.2  The presentation covered the reasons why Southwark needed to change the way it delivers services:

·  Government finance settlement for Southwark means significantly less money available.  £33m cash loss 11/12, another £18m the following year.

·  No inflation allowance – so loss greater still.  2 year settlement so position in 13/14 could be worse.

·  Adult social care represents about a third of Council’s total budget - £114m.

·  Savings £7.7m 11/12.  Growth £1.9m.

·  Rising demand and expectation around services:

-  medical advances mean people are living longer with severely disabling conditions

-  prevalence of long-term conditions, such as dementia, is rising

-  we expect a 17% rise in over 85 population over next 10 years.

·  All this means we need to radically rethink the service model for Southwark

·  New adult social care vision agreed by Cabinet 19th April 2011.

6.3  There are budget reductions across Southwark and this is how the budgets look for 2011-12:

6.4  Current patterns of services in Southwark are as follows:

·  Balance of care in Southwark is heavily weighted towards costly residential care provision, 47% older people spend.

·  Evidence from local research on our recent placement activity gives clues about how we can provide better quality at lower cost – eg target better support for carers, use of telecare. 

·  More people now ‘self-direct’ their support – 11% April 10 to over 30% by April 11.  Significant change in last 6 months.

·  Some very good services, some cutting edge, some less good and some quite old fashioned

·  Fair Access to Care (FACS) currently set at substantial and critical – either we raise criteria to critical and very few people get any service or we prioritise funding for people who meet the current criteria ( and will need to manage with less Council support than historically provided) and reduce levels of discretionary areas of spend.

6.5  In the future Southwark will develop:

·  Single point of informed contact for people who need help, more self-service.

·  Better signposting and use of mainstream community resources. 

·  Prevention will need to be more targeted – carers, telecare, specific at risk populations – evidence from work done by Nuffield.

·  Help to get back on your feet – more short-term home care and day services, including ‘re-ablement’ services.

·  Personal budgets for people needing longer-term support (following reablement), offering real choice and control with more people managing their own money.

·  Intensive support will be for the most vulnerable only – eg day services increasingly for people with dementia.

·  Safeguards in place for those who are most at risk.

·  Simpler processes, less assessment, people encouraged and expected to do more themselves

·  Skilled, knowledgeable and well trained workforce.

6.6  Peter Hay, ADASS president says:

“The current model is unsustainable….we need a ‘new adult social care offer’ of investment in prevention, re-ablement and better information and advice, alongside tightened eligibility criteria for formal care services….Increasingly what we have got to recognise is that less state funding means more contributions both in cash and kind from citizens themselves”

Community Care 6 April 2011