Meeting documents

Apologies for absence were received from Elaine Norris, Paul Bootle, Michael Quinlan and David Keston.

The minutes of the meeting held on the 30 May 2013 were agreed as a correct record.

Matters Arising

Workability Website (page 2)

BuDs were asked by the Workability Group (the Department of Work & Pensions, Job Centre Plus and a number of other disability organisations) to secure the future of the Workability website. The website was previously hosted by Bucks PCT which is no longer in existence.  There has been a delay due to technical details but the site has now been re-hosted.  Work is taking place to update the website (it was last updated in 2009).  A notice has been put on the website not to follow the advice shown until the update has been completed.  Promotion will also take place as the website is a resource for disabled people looking for work.

Day Opportunities (page 5)

Linda Warmbier provided the following written update to outstanding actions;

What would happen in the case of an emergency i.e. if something happens to the carer? This was in relation to the discussion about respite care and if someone requires emergency respite care then they contact the Council and are allocated an emergency placement at Seeleys respite centre or in one the local care homes which have vacancies.

If a client went to a day centre for five hours are they now getting five hours in the community?  Everyone was assessed individually by care management and were allocated a service according to their needs. If a person was assessed as requiring five hours of day opportunities but not requiring a day centre then they would be receiving this.

Debi Game advised that she has recently met with Linda Warmbier. An engagement exercise is taking for service users and carers around the draft specification for day opportunities and the Local Trading Company.  Meetings are taking place on 1 August and 21 August 2013.  A flyer with event details is to be circulated to Board members.

Action: Sharon Griffin

Update from Natalie Fleming, Brokerage Service Manager

Natalie Fleming, Brokerage Service Manager, was welcomed to the meeting.

Ms Fleming began her update by explaining the process around Support Brokerage.

The reason why the County Council developed brokerage within Bucks was to make the overall Self-Directed Support system easier to use, to facilitate easier engagement in the support planning process and to ensure that the individual was completely involved in the entire process.

When pricing from providers was looked into, it emerged that the County Council was not making the best use of community resources. 

Previously care managers and workers carried out assessments and wrote support plans but they did not have enough time to research all of the community services that were available.  With the introduction of Brokers there is more time to talk to the client and offer a creative person-centred support plan.  Their skills enable them to match services appropriately with clients or carers. 

Accreditation process

Care managers expressed concern about the training of brokers, the writing of support plans and asked how clients would be supported in the best way.  The National Brokerage Network has a five day training course in place which is delivered throughout the UK by the Open College Network.  In addition ‘Support with Confidence’ a scheme which is jointly managed by Trading Standards and Adults & Family Wellbeing ensures that Brokers deliver a quality service.  Each Support Broker must register with the ‘Support with Confidence’ Scheme and is vetted and verified.  All Brokers undergo CRB/DBS disclosure and barring service checks.  A robust training programme is in place which covers areas such as Safeguarding for Adults & Children, Deprivation of Liberty Standards (DoLS), The Mental Health Capacity Act, dementia awareness, mental health awareness, benefits overview etc.

The Brokers have a vast amount of experience and truly understand the service user or carer’s point of view.

Who are the Brokers?

·        11 Accredited Brokers from affiliated provider voluntary organisations e.g. Action on Hearing Loss, Bucks Vision etc.

·        11 Independent brokers e.g. parent carers, carers, Drug & Alcohol officers, barristers, Alzheimer’s specialists etc.

What does a Support Broker do?

·        Provides support to clients in making informed decisions i.e. discusses the advantages and disadvantages of each option

·        Assists the individual to make contact with the relevant community resources

·        Helps to write and cost a support plan

·        Direct Payments only provide a certain amount of money.  A Broker can help a client source additional funding streams where possible.

A Broker cannot

·        Determine the individual budget of the direct payment a person will receive – (this is calculated by the Resource Allocation System/RAS assessment)

·        Deliver services or advocate on behalf of individuals (a Broker will ask an Advocate i.e. PoHwer to accompany them to a client meeting)

The Story so far

The Day Opportunities review was a good starting point for brokers.  Alternative community day opportunities for older clients and clients with learning difficulties currently in Day Centres have been sourced.  800 clients went through the entire process, some of whom are due for a second review.  Some clients have  ...  view the full minutes text for item 3.

Update from Mike Walsh, Walsh Social Care Consultants Ltd

Mike Walsh, Walsh Social Care Consultants Ltd was welcomed to the meeting.

Mr Walsh explained that he has been working with the County Council and Ernst and Young to look at the options for a new delivery of in-house social care services.  An appraisal of current services took place followed by the compilation of a business case which went to Cabinet for sign off.

Background / reason and benefits

·        Fundamentally the reason for creating a Local Authority Trading Company (LATC) is about the sustainability of adult social care services provided within the County Council which mainly relates to Self Directed Support and Direct Payment

·        The County Council was tasked with making significant savings in light of austerity measures from the Government (savings of 40% to be made). All services were asked to find savings – one of the few ways to make savings is to provide services outside of the County Council.

·        Any services need to be effective, efficient and best value for money. 

An increasing number of people are in receipt of a direct payment.  Those in receipt of a cash direct payment are not legally allowed to buy services back from the Council.  They therefore look to purchase services from outside the Council which results in double running costs as well as reduction in choice and control.

The County Council originally went down the route of a soft market test with independent providers in 2012.  Six different options were looked at but there was a lack of response around the external provision of services.  The option of the services remaining in-house was considered but this was not sustainable long term. The option of putting the services out to tender was also considered.

The decision was made to create a Local Authority Trading Company (LATC), which is wholly owned by the Council, as shareholder, but is independent of the County Council whilst retaining an element of control.  The LATC will have a contract with the Council to deliver services on its behalf.  It provides a sustainable model of provision without the current constraints.

The benefits of a LATC for Bucks County Council include;

·        Improving performance and productivity

·        Ensuring future sustainability of services

·        Managing financial pressures

·        Promotion of choice

·        Involving the workforce and customers

·        Allowing clients greater engagement in their services

The LATC Board will report back to the Shareholders Scrutiny Group on a quarterly basis.  A business plan has been produced for three years against which performance will be determined and measured.

One of the benefits is that the LATC can trade with private funders i.e. those who want to buy their own care and have a /Direct Payment contract with the County Council.  The LATC will have a contract with the County Council but are also able to bid for tenders issued by other Local Authorities and trade across the county border.

Any profit/surplus generated would go back to the County Council as a dividend or would go into the company to invest in other service provision

The  ...  view the full minutes text for item 4.

Report from Diana Fentiman, Project Manager Adults and Family Wellbeing

Diana Fentiman, Project Manager, Adults & Family Wellbeing was welcomed to the meeting.

Ms Fentiman explained that the focus of the programme is to identify and support individuals who may be experiencing difficulty to maintain their independence and to offer help and support before their condition deteriorates.

There are four components to the Prevention Model;

·        The Community Links Officer (CLO)

·        The Community Practice Worker (CPW)

·        The Intelligence Hub

·        The Volunteer Hub

13 out of the 14 CPWs have been recruited and will be aligned to 7 GP Localities across the county.  Their work will include promoting and publicising the service, making contact with GP surgeries and liaising with Practice Managers, District Nurses and Receptionists.

A central access point/number has been set up.  Although GPs are the key source of referrals anyone can self refer.

The CPWs have been on a basic training programme.  Training will be on-going through monthly meetings to pick up any issues.  Additional training and information sessions can be added as part of these meetings.  Monitor and reporting are key in terms of understanding the needs of those coming through the service.

The CPWs were all been recruited via voluntary sector organisations which was part of the grant application process run earlier in the year.  Meetings take place with the managers of the CPWs as part of the Service Development Group.

From January onwards Adult Integrated Service (AIS) system will be used which is a more sophisticated version of the current care management activity system SWIFT.  The CWPs are the first group to pilot the new system.

The CLOs play a key role in making sure that the right services are available.  If a CLO is unable to source a suitable service for a client, a referral would be made to the CPW.  Work takes place with organisations to see if they are able to respond to the needs of individuals.  If not, this would be flagged up as a potential new development which needs to be supported.

The CLOs also carry out Asset Mapping which allows the identification of strengths/weaknesses/key players in each community and who has knowledge of the community they are working in. The CLOs provide support and information to the organisations as well as looking at new ways of providing services.  Monitoring and development of activities also takes place through the CLOs.

The Volunteer Hub has been commissioned in two parts.  Following a grant application process, Community Impact Bucks have been commissioned to recruit a Volunteer Coordinator. Discussions with the voluntary sector revealed that there needed to be more effective recruitment and support of volunteers.  Screening and training functions are therefore being centralised.  Another priority for the hub is the tender of the time banking process which is due to be completed in September.  Organisations who have a track record of already providing time bank are being invited to tender for the process.  Time banking is effective in attracting a variety of volunteers, particularly young people.

Service Model

There is a separate ‘pot’ of  ...  view the full minutes text for item 5.

Andrew Clark explained that as a result of the changes to the benefits system, the Pensions Service Working Group has been very active.

Bucks County Council are using a new system called the Performance Dashboard to collect data and monitor trends to see how Buckinghamshire is responding to welfare reform i.e. crisis intervention etc

Benefit changes

Disability Living Allowance (DLA) is now closed to new claimants.  Anyone over the age of 16 will not have to apply for Personal Independence Payment (PIP). Claimants whose award for DLA ends in October will have to apply for PIP. Anyone on a fixed or permanent award of DLA will be reviewed in 2015.

The consultation on the 20 metre rule ends on the 5 August 2013.  The 20 metre rule is the new distance that has been introduced for peopcar to qualify for the enhanced rate of the mobility component of PIP. The PIP criteria states that only those who, ‘can stand and then move more than 1 metre but no more than 20 metres, either aided or unaided’ will qualify for the enhanced rate of the mobility component.  Individuals must be able to complete the distance safely, to an acceptable standard, repeatedly and in a reasonable time period, but can use aids such as walking sticks, crutches and prostheses.

Many feel that the 20 metre standard is too severe.  A consultation of BuDs members has shown that 90% of people already on DLA higher rate mobility feel like they are at strong risk of no longer qualifying for the higher rate.  Only those in severe discomfort who are able to provide balance of proof will qualify for the higher rate.  If a claimant does not qualify for the enhanced rate they will not have access to the blue badge, scooter or Motability scheme resulting in the loss of a vehicle.  For many of those who receive the enhanced rate their vehicle is essential to get them to work.

When was the consultation announced as there was uproar at the short amount of time given to respond.

Will there be a review of those claiming for benefit? Is the impact of the changes known? An early indication is that from October 16 year olds who are presently on DLA will have to reapply for PIP on their 16th birthday.  If they lose the higher rate of benefit there could be a marked effect on free school meals, Higher Education funding etc because of the money that follows on having a disabled student.

Will the review be rolled out gradually?  After October 2013 DLA awards expire and cannot be renewed.  Claimants will have to apply for PIP.  The DLA has the right to re-assessment a claimant at any time without giving a reason for the reassessment.  If an individual is re-selected, they would have to apply for PIP.  From October 2015 anyone who is on a DLA permanent or indefinite award will be selected at random and asked to reapply for PIP.  When a  ...  view the full minutes text for item 6.

Christopher Reid explained that at the last meeting he had reported that the Health and Wellbeing Board had agreed the proposal of the formation of a separate new Board with the responsibility of the promotion of the Dignity in Care agenda.

The Dignity in Care Strategy Group will be responsible for raising the profile of dignity and pushing through any dignity actions. Membership will be discussed during the first meeting of the group which will include officers at Director level, commissioning and provision (Health and Social Care), a service user/carer from Bucks Healthwatch and the Older Peoples Champion Forum.  Involvement is also expected from other organisations such as District Councils.

Christopher Reid explained that the existing membership list of the PSDPB needs to be reviewed.

Members of the Board were referred to page one, point 2.1/2.3 of the Terms of Reference which give details of the requirements of the membership and chairs for the PSD Partnership Board.  These requirements are taken from the Constitution.

During discussion the following points were made and questions raised;

The membership will be very limited if there are only four service users/carers. Debi Game explained that the aim is to increase the number of service users/carers to eight.

When is an individual classed as a service user or representative of a voluntary organisation?  Some of those on the membership list are voluntary sector representatives and also have a disability.  Could this be a way of increasing service user representation on the Board without having to find people who so not have an affiliation to an organisation? Debi Game said that she would speak to lead commissioner to get guidance on this issue.

Action: Debi Game

The role of the Board is to make sure that the voice of service users and disabled people are heard.  How can this be done most effectively?

Some members of the PSDPB are also a member of a support group. 

Members of some groups such as Breathe Easy are volunteers or service users whereas other groups employ and pay for admin staff.

There needs to be clarity around members of commissioned organisations and voluntary organisations.

The Older Peoples Partnership Board has representatives who are not service users but have an expert view.

Members agreed to the following changes to the current membership of the Board;

Members to be removed;

Steve Goldensmith - BCC

Trevor Boyd - BCC

Jackie Clarke – Action on Hearing Loss

Brian Jones – Bucks Vision

Matthew Koshy – BHT

Gill Manning-Smith – BCC

Jane Taptiklis – NHS Bucks

Gillian Sherwin – Service User

Janine Thomas – Pensions Service

Andrew Walker – Bucks LiNK

Adam Willison – BCC

Rachel Rothero and Stephen Archibald to be changed to notify

The District Councils, PoHwer, Healthwatch and Peoples Voices to be contacted for representation

Action: Chris Reid

Andrew Shipley to be contacted to clarify who he is representing on the Board i.e. visual impairment

Action: Debi Game

Christopher Reid took members through the Action Plan highlighting the following key points;

Page 1

1.2 – That statutory organisations are fulfilling their Equality Duty

Buckinghamshire Healthcare Trust are to provide an update to the Board on how they are addressing its equality duties.

At a previous meeting of Thames Valley Police the Independent Advisory Group asked BuDs to put forward a plan on how to address low level hate crime against disabled people in Bucks. The aim is to start the work in November.  A report could be given at the January meeting of the Board.

Action: Andrew Clark

Page 2

5.2 – That priorities for disabled people are addressed within the development of a single point of access etc

This action is on hold at the moment as there has not been any further development.

The suggestion was made of looking at more proactive work as part of the Action Plan as well as the long term aspirations of the Board i.e. actions to take away and progress as part of the role of a Board member.

When a presentation is made to the Board issues to be addressed and accountability measures need to be raised.

No items of other business were raised.

The next meeting of the Board will take place on Thursday 26 September 2013, 10.30am, Seminar Room 1, Green Park, Aston Clinton.

Dates of future meetings for 2013;

28 November

The next meeting of the Board will take place on Thursday 26 September 2013, 10.30am, Seminar Room 1, Green Park, Aston Clinton.

Dates of future meetings for 2013;

28 November