Agenda item

Evidence will be taken from Community Action Southwark (CAS) and community stakeholders. A report from CAS is attached -  Rachel Clarkson , CAS Policy Officer will attend to report and take questions.Lewisham & Southwark Age UK will also attend.

A officer update report on the number and proportion of people receiving cash Direct Payment and Direct Payments via a third party is attached. Jay Stickland, Director of adult social care, will attend to present and take questions on this item.

7.1  The scrutiny project manager, Julie Timbrell, reported that Jay Stickland, Director of adult social care sent apologies as he was unable attend to present and take questions on the report detailing the number and proportion of people receiving cash Direct Payment and Direct Payments via a third party . The report was noted. 

7.2   The chair invited Rachel Clarkson, Policy Officer, Community Action Southwark (CAS), Jacky White, Chief Executive, and Lewisham & Southwark Age UK to briefly present their papers. Eleanor Batement, Service Director, SLaM and Verinder Mander, Southwark Carers Chief Executive participated in the discussion.

7.3  Age Concern CEO explained that often people do not know they are on personal budgets, but the organisation does have to carry out administration on their behalf. Care costs money, and personalised care costs a little more. Age Concern are managing a pilot "Be your own boss " innovation fund  and  receive extra money, however this is not sustainable as people do need ongoing support to manage their own care.

7.4  Southwark Carers CEO reported that the regular breaks carers re entitled to have been changed to "Fix yourself a break”. This year Southwark Carers have conducted about 800 assessments and given out 600 grants. Southwark Carers commented that they were involved in a redesign following a critical report. Southwark Carers administer £192,000, and this year conducted about 800 assessments and given out 600 grants.  The h grants are often for small amounts but the CEO reported make a big difference – some quotes were read out from recipients; “I was able to see my husband”; “the extra money enabled me some light relief. I did not feel so isolated. I felt happier and therefore could be kinder “and “the personal budget helped me to recover - the stress levels went down”. The maximum carer’s budget is £300 and the minimum is £150. Where we can't help them we do help people access charities. Undertaking assessments and providing grants is part of Southwark Carers core offer and 90 % of time is spent on this.

7.5  Rachel Clarkson form CAS said that CAS has done a fair amount on Personalisation as this is an important issue. CAS held a conference looking at Personalisation and there was quite a detailed action plan that came out of that. She added that the CCG and council have been very helpful. Issues that emerged were that only a few have a Personalised Budget; the eligibility criteria is too harsh ; there is insufficient awareness , the cash given does not meet the requirements and organisations struggle to operate within this framework. The recommendations were : keep awareness high;  - organisations  need early information to plan;  more transparency on eligibility criteria  and developed an E-market place ( like the SEND offer )

7.6  Eleanor Batement, Service Director, SLaM reported that all new recipients of services go through an assessment.  A joint council event was held looking at people’s experience of Personalisation. One issue is Mental Health fluctuation and trying to grapple with not incentivising unwellness, and how to ensure people don't lose service when better, but then crash. Some people like traditional day services.

7.7  A member asked what proportion of the Age Concern budget was came from Personalisation and the officer reported it was around a fifth – across both Lewisham and Southwark. He went on to remark that he found the CAS report interesting and liked the recommendations. Personalisation has support across all the main political parties however the losses for voluntary organisations of block grants of 100 or 200 k, can create a lot of challenges.

7.8  The Age Concern CEO commented that  they are a much larger organisation and had were able to use reserves;  then money came in from Personalisation.  She commented that there was an issue about debt - there was an agreement that the council would chase this, which can be really difficult. We also have to be tough on charging, which can be challenging.

7.9  The CAS officers commented that there is agood relationship with SEND officers and a diverse marketplace.

7.10  SLaM commented that Personalisation does cost more to administer, and also some provider do not survive and that is the market, but how this is managed is a political matter. She said it is important to have a wide market place. A member asked to what extent to providers try and harmonise with other services, and added that he felt uncomfortable which the notion of competition and with providers ‘crash and burning’. Southwark Carers commented that when people came to us and requested a choir we used our community links to accesses Koruso. When the cuts stared to effect provision we were able to help make decisions about what would work best. SLaM responded that providers can range from the range can vary from top big corporations end with very slick brochure, to one person. However the big is not nessessarily better and the smaller organisations may need more support to access and thrive. She report that is real churn. CAS reported that they have a person working on catalysing and supper micro providers. There is also work on mapping to see where that are gaps. Age Concern added that market brutality has meant that many of the BME services have closed, or at risk. Age Concern has helped by housing the Golden Oldies. A member advocated a commitment to a cooperative rather than a competitive market place. SLaM commented that consortium are very helpful in realising this.

7.11  A member asked about further practical recommendations and Southwark Carers supported the development of an E market place and noted the provider forum was good. It had gone on too long but a shorter version would be good. Agreed by CAS and SLaM supported these comments. CAS said that the SEND Local Offer online was very good, however a member commented that when she visited the online portal she found it very higgledy-piggledy and not that good. Not that good. She added that her daughter was on a potential user of the Local Offer and Personalisation.

7.12  A member commented that he was disappointed that the participants not listed on the CAS survey and was also dubious about the validity of the results when only 5% responded. CAS and Age Concern said the low response rate was probably because providers are very busy; however we can feed this back. The solution might be to have a simpler form to make it easier to complete.

7.13  A member commented that while it was only a small sample it does however very much reflect the comments received from voluntary providers. Preventative care is very important and there is an issue about providers providing care to people with no budget and how do we support.

7.14  A member said that the review needs to hear the service user perspective. SLaM mentioned a conference the council is organising. Southwark Carers offered to provide a report on respite services. SLaM recommended talking to the brokerage service and gave some examples of how people have used budgets, including getting a dog and a season pass to go out with children. Age Concern commented that her client group really often don’t want done with, often want done for.

RESOLVED

Healthwatch will be invited to give evidence on behalf of service users

Information given to Patient Opinion will be considered.