To report back from service visits to:
Ermine Road – Learning Disability
The Grange – Older People
Keston Road – Learning Disability
Minutes:
Panel Members reported back on their visits to day centres at Ermine Road, Keston Road and The Grange. A summary of the main points to emerge from a discussion of these visits is given below:
§ Members indicated that they had found the service visits both interesting and informative and wished to record that they were impressed with the professionalism of staff and the quality of care provided to service users. Members indicated that they had observed many instances of excellent care provided by staff and wished this to be conveyed to the services.
§ Members noted that The Grange has the use of one vehicle for 55 service users whereas other day centres (Keston and Ermine) have more vehicles per service user (i.e. Keston has 6 vehicles for 120 service users). Managers present reported that the service model used for learning disability and older people day centre care was very different, where the needs of service users precipitated a different pattern of vehicle usage. It was noted, for example, that the needs of older people using The Grange allowed for a more flexible approach to transport planning as compared to service users from Keston and Ermine Road.
§ Members were concerned at the duration of passenger journeys to and from The Grange: at the time of Members visit, the pick up was in excess of 1hr 40 minutes. The service recognised that journey times can be long, though normally the route at The Grange is split in to two shorter journeys. Members also acknowledged that service users had been unprepared for the pick up which exacerbated the journey time. The service also reported that whilst journey times were long, these were still considered to be beneficial in the context that many of the passengers were socially isolated adults.
§ It was confirmed that Keston Day Centre is currently not taking any further referrals because of the imminent transfer of services to new sites. This is to lessen the anxiety and disruption that new clients would experience if they were required to transfer out of Keston Day Centre at a later point. New service users are currently being managed through the Outreach Service on a 1-1 basis until the transfer in April 2009.
§ The Panel noted that Day Centres had taken a number of measures to improve the serviceability of transport routes. Drivers were not restricted to specific routes so were aware of a number of different transport runs should they need to provide staff cover. In addition, a buddying system was also introduced to ease new drivers on to planned routes. There are also reciprocal arrangements between some of the smaller Day Centres (The Grange and The Haven) to provide emergency cover.
§ Panel Members that had visited Keston Day Centre were concerned at the disrepair of the building: there was a lot of water damage to the walls and plasterwork from the ceiling had also come down in the main hall. Whilst it was recognised that the service would be moving to new facilities in April 2009, Members felt that the level of disrepair was unacceptable and should be remedied for the benefit of service users and for the future use of the building.
Agreed: The Chair would write to the Cabinet Member for Adult Social Care and Well Being make him aware of the state of Keston Road facility and ascertain what and when improvements could be made.
§ The issue of out of hours contact with transport service arose during the visits. Members were concerned at the lack of provision for carers to leave messages with the service about possible variations in transport requirements. It was noted that whilst there were mobile phones on each vehicle, circumstances may not always allow carers to contact the bus directly. Members suggested that answer-machines be installed for each day centre to improve carer responses.
Agreed: That respective services should assess the benefits of installing answer machines in day centres tom assist transport / route planning.
§ Through the course of the visits to local Day Centres, the Panel were unclear as to how routes were planned and how individual service users were allocated to particular routes. For instance, on one of the transport runs there were just 4 service users dropped off from a vehicle with 15 seat capacity. The Panel were of the opinion that this may not represent efficient use of the vehicle, unless there were other circumstances or criteria used to determine routes.
§ It was reported to the Panel that routes were planned in-house taking in to consideration a wide range of variables and other issues. As well as the geographical location of service users, Day Centre staff also had to take in to account the physical needs of service users (whose needs preclude them from taking long journeys), the interactions between service users (behaviour of service users may challenging to others) and the needs of carers (who work or have other appointments themselves).
§ Given the range of issues and variables assessed, it was acknowledged that route planning was not an exact science, indeed, there was a degree of fluidity and flexibility to most routes. Although electronic and other technologies were used (i.e. multi-map) to inform planning, route determination was more often performed through physical resources (maps).
§ It was reported to the Panel during visits that the transition from centrally managed passenger transport to service based transport had been difficult in that there was not the local transport expertise to facilitate the process. These difficulties have subsided since local staff had become more aware and experienced in transport planning issues (i.e. since the transfer of services).
§ During the course of the visits, the Panel were not aware of any specialist input from the JTPU (at Ashley Road) or other transport consultants in to passenger route planning across day centres. The Panel was strongly of the opinion that day centres would benefit from such specialist input in helping them to plan and model routes and to make more efficient use of vehicles.
Agreed: That adult social care service would benefit from occasional/ periodic specialist advice to support the planning, development and more effective operation of local passenger transport services.
§ The Panel noted that the majority of support staff at Keston were dual trained as Escort / Drivers. This meant that there was a large pool of experienced drivers which the day centre could utilise in transport planning. The Panel felt that this was an excellent example of integrated working which was beneficial to the service and service users.
§ It was reported to the Panel that service based transport had revolutionised recruitment as the flexibility of the new system prompted day centres to focus on recruiting drivers through social care route (i.e. support workers who drive rather than segregating two work roles).
§ The Panel was due to visit the Ashley Road site to asses the support services for service based transport under the agreed Service level Agreement. The Panel noted that the Ashley Road site is currently undergoing a major re-organisation: all passenger transport routes have been contracted out and there is no longer any in-house transport. The Panel agreed that it would not be appropriate to visit at this particular juncture, though an update from the service would be requested.
Agreed: That a briefing would be requested from the Children and Young Peoples Service regarding the current position of passenger transport services from Ashley Road.