To consider any requests received in accordance with Standing Orders.
Minutes:
RECEIVED the following deputations in relation to item 8 of the agenda (Corporate Plan Priority 2, outcome of consultation and decisions on proposals relating to Adult services).
a. Haringey Autism and Save Autism Services Haringey
Martin Hewitt on behalf of Haringey Autism and Save Autism Services in Haringey:
Mr Hewitt stated that whilst the consultation on the closures of the services detailed in the report was comprehensive, it was not transparent about what new provisions would replace the closed Day Centres. Mr Hewitt, the father of an autistic person, emphasised that the parents and users of the provisions would suffer as a result of the closures. Parents relied on the Roundways for a good standard of care and respite. He felt that the report was not clear in stating that the respite provision would be preserved. The National Autistic Society had conducted research to establish the importance of the provision at The Roundways and had made it clear that users did not want to see it closed. Mr Hewitt contended that the envisaged staff reductions were the most fundamental cuts in London. Mr Hewitt expressed that the Council would not be able to deliver the promises made in the consultation and would be open to legal challenge with cuts of this level.
In response to a question from the Leader about whether he was sceptical of outcomes to be delivered or had uncertainty of the unknown, Mr Hewitt said that he was making an empirical point and that the Council could not provide the promised outcomes with the level of cuts. Mr Hewitt felt the Council would not be able to comply with the Care Act or effectively monitor the quality of care which would have an impact on parents and users.
The Leader spoke on behalf of all Cabinet Members, who were all aware of the gravity of the decisions being taken forward and that these decisions were being considered in the interest of the community.
Councillor Morton was invited to respond to the deputation and also made clear that, at this stage of the meeting, Cabinet Members had not yet made up their minds on how they were going to vote for the recommendations. There had been a significant 3 month consultation in the summer to draw out the issues being raised in the deputation.
Councillor Morton reminded Cabinet of the principles that would underpin the re-provision of services including: providing dignity and respect, meeting Care Act responsibilities, supporting independence, personal choice. In the co-design of services, the Council would be using the findings of the equalities impact assessments and actions to mitigate the impacts of transition would be taken forward. The services provided at the Roundways would be provided at Ermine road and there would be individual assessments and support to enable service user, currently at The Roundways, to choose services that will benefit them.
Councillor Morton added that in recent years, fewer people had been placed in the Council’s directly provided services for complex needs and were using direct payments or personal budgets for other day opportunities and support. There would be continued work on: transition arrangements, on co design, co production and assessments with the welfare of the service users in mind .All this work would be taking forward the issues identified in the EQIA’s from having changed services. Councillor Morton referred to the section on the Equalities Assessment, at page 41, which had information on how Ermine road site would be managed.
b. Older People’s Reference Group
Gordon Peters, Chair of the Older People’s Reference Group, in Haringey echoed many of the comments made by Mr Hewitt as recorded above, and included the following issues.
He felt that the feedback from the extensive consultation had been included but the specific concerns had not made their way through to reflection in the recommendations before Cabinet, as closures were still recommended without fixed plans and costings for alternative services.
Mr Peters urged the Council to postpone these and other closures until the needs of users and carers were fully assessed and a genuine strategy on integrated care developed, scoped and costed. This should be fully shared with users and carers, as Healthwatch had pointed out in its letter to Councillor Morton.
Mr Peters spoke further of the potential difficulties for Tottenham residents travelling to provision in Hornsey and he thought that there was lack of planning for the safety and well being of service users and specifically for 76 people who used the Day Centres. He felt that the Council had not adequately explored other funding routes to avoid withdrawing services or considered co-operative models, which could have long term cost benefits to the Council. Mr Peters spoke about the wider economic benefits of having the Day Care Centres and asked for the Council to join the argument for more funding for social care.
Mr Peters referred to research on co-operative models which he felt could bring cost benefit to the Council and there was work available on this that could be considered alongside the Ethical Care Charter promoted by UNISON which puts forward, providing living wage to carers, and an end to 15 minute care visits.
Mr Peters contended that closures would further reduce trust in the Council, adversely affecting the wellbeing of older people at risk, and be open to legal challenge.
The Leader thanked Mr Peters and acknowledged his paper on co-operative models, which the Cabinet Members had received.
Councillor Strickland, Cabinet Member for Housing and Regeneration, spoke about the Council being on the difficult receiving end of cuts and asked the deputation party what the Council could do to affect national developments. Mr Peters set out his thinking on ways to increase funding which included: joining the national argument for more social care funding, seeking inner London banding for funding, raising Council Tax and exploring options for social bonds whilst deferring a decision on the closures.
In response to comments, the Leader explained that raising Council Tax was not a viable option .The Council could only raise Council Tax by 2% without a referendum and this would only bring in £650k a year net income for Haringey. Also about a third of Haringey Households were in receipt of Council tax subsidy; therefore raising Council Tax would not bring in the required amount and impact on those least able to pay.
Councillor Morton thanked Mr Peters for his deputation and conversation during the consultation. Councillor Morton spoke of the significant amount of responses to the proposals and explained that the funding formula for local government was unfairly distributed with Shire County Councils receiving more funding for social care than London boroughs. This was part of the political choices being by the Government. The Council has made representations about the £200m cut to funding and were continuing to make representations to government as well as making sure that its remaining resources were well used.
Councillor Morton stressed that people who received Day Care opportunities would continue to receive alternative services based on the assessment of their individual needs. The Council would offer support to guide service users through the process of finding and choosing the care they want to receive.
Councillor Morton added that, the Council had been considering the needs and requirements for The Grange service users. The mitigating factors were detailed in the report and consideration was being given to the where alternative services can be provided in the area. The Council would develop an approach for travel arrangements that would give people more support options to meet their requirements.
The proposals for Osborne Grove were different to the initial proposals as a result of consultation feedback. There was already mixed use at Osborne Grove, evidence of the nursing care market and the partnership with the NHS would keep the provision within the public sector
c. Social Care Alliance Haringey
Rod Wells made representations on behalf of the Older People’s Reference Group and TPE14H [Group representing disabled people in the borough], and these representations included the following:
The closure of Day Care Centres was unfair for the most vulnerable part of the community who had to suffer from such large cuts and fundamentally flawed as there was no defined alternative provision and Mr Wells contended that the Council could find alternative funding. Mr Wells asserted that net savings from closing the Day Care Centres could not be known until alternative provisions and costs have been established.
Mr Wells contended that the cuts affect integrity and the quality of life of service users and the ability for them to be visited. He felt that reassessed personal budgets may not be enough for people to pay for alternative provision and long journeys to such alternative provisions would be difficult for them. Also closing services when new provision was not known to be effective was worrying for service users.
Mr Wells provided information about various community care services that were either closing or were having difficulty obtaining charitable funding and asked how service users would be able to afford alternative private provision at a cost of £60-100 per day.
The Social Care Alliance Haringey, wanted to see further studies taking into account the possibility of offering more social care services and exploring how Camden and Islington provide services.
The closures would have direct cost implications for families whose members might have to give up working and claim benefits, more carers would be needed and more people would be forced into residential care at a cost of £30k per annum for older people and £70k for a person with learning disabilities. Some of these costs would fall onto the Council.
Mr Wells urged the Council to: press the government for higher levels of funding from the government to match inner London Councils; explore other funding steams including the use of Council reserves, to support services for vulnerable people, and; vote to defer the closure of Centres to enable.
The Leader invited questions from Cabinet Members
Councillor Arthur, Cabinet Member for Resources and Culture, in response to the deputation, explained that there would be use of the Council reserves to over the next three years to smooth some of the impacts of the cuts. But the challenge of how to continue to fund those services would still remain.
In response to Councillor Arthur’s questions to the deputation about how Mr Wells felt the Council could change its proposed model to provide services, or how it could protect the current model, it was stated that with good quality community mapping some good alternative quality provision could be provided but the Council would need to build in some time and security for the under-utilised buildings and community centres to develop this provision. It would require guarantees of specialist staff being available and security of tenure and financing. Delaying closure was vital to ensure these alternatives were adequately planned and costed. It was reiterated by the deputation speakers that investment in Cay Centre care saved future costs on residential care.
The Leader acknowledged the point that investment was required to save money in the long term, but also drew attention to the fact that the local government funding formula will not, in the future, take into account ‘need’ and ‘deprivation’. The Leader also highlighted the recent cuts to DCLG budget and impact of this on local government .The Leader explained that the government had abolished any deprivation factor in the funding formula, meaning that the Council would likely see greater reduction and impact in funding than other parts of the country. The Leader also referred to the deputation’s examples of services provided at that both Camden and Islington. These boroughs received inner London funding, higher than Haringey which received outer London funding, and the examples further demonstrated the level of inequity in the services provided due to funding formula distribution.
Councillor Morton thanked the deputation and would talk to them separately on the care package issues raised .The savings attached to proposals were from; page 49 onwards and emphasised the validation exercises taking place. The report was clear and explicit on all of the points concerning how the savings would be taken forward. It terms of alternatives, Councillor Morton clarified that services would not be closed without alternative provisions being identified and being adequate. The recommendations in the report builds in the appropriate requirements for provision in the borough, required transition plans, keeping to statutory responsibilities. Co design and co production was being taken forward at the beginning of new services which was why the Council were including users in co-design plans and considering mitigation risks, as detailed in the appendices of the report.
Councillor Morton also discussed the recruitment drives taking place to recruit more in-house staff and that interims were only recruited when there was a necessity and gap in service. Consultants were only used where there were projects to be completed which required specific expertise.
Councillor Morton reiterated that the Council want to work with the service user in the transition process. Within the annexes, which were over 700 pages, there was a significant co production report identifying issues. This included the deputation’s reported issues on transport, meeting the particular needs of clients and how, when building services and taking forward transition, the service user will have substantial involvement. There was a specific risk register looking at mitigation and the required actions around this which would be followed up by the Council and the Safeguarding Adults Board, should Cabinet agree the recommendations.
d. UNISON
RECEIVED the deputation from Chris Taylor on behalf of UNISON, about the consequences of the Cabinet taking the decision to close the Centres. Mr Taylor expressed that: people will either not receive the services they need to keep them well or they will receive often unsafe services outsourced from the private sector; staff will be required to work in the private sector with poor pay and conditions, zero hours contracts, lack of training and exploitation. Not-for-profit companies such as social enterprises and co-operatives sometimes resulted in being taken over by the private sector because local authority funding ceased after the initial few years. Mr Taylor contended that the re-ablement service was one of Haringey’s most successful services and should not be handed over to the private sector who he claimed had neither the required the standards or expertise to provide the care.
Mr Taylor added that the closure of the Haven will result in a decline in health to its current service users and would put pressure on carers. The closure of The Grange would mean no services in the east of the borough for people with dementia. Closure of the Roundways would mean having no specialist service for people with autism.
The main consultation responses requested the Council not to close the services and indicated that the cuts would be a false economy and UNISON urged the Council not to make them.
The Leader spoke of the 754 pages of responses to the consultation attached at appendix 1, which she had read through and agreed that the overwhelming response was not to make changes and closures. However, Cabinet were in a different position as they need to ensure a balanced budget and only making use of reserves, at the moment, to smooth the transition as long term use of reserves was not sustainable.
Councillor Morton drew attention to his response to the previous deputations and added that, in relation to comments about The Grange, at page 44, and taking into account the EQIA and mitigation, the Council’s intention to commission an alternative service in Tottenham.
Councillor Morton further explained that although services would not be available at The Roundways, in terms of the building, the Council will be commissioning services at Ermine Road which would be the base for service users that currently use Roundways. Councillor Morton emphasised the support that would be available for service users in the transition to access care and support .He also remarked that, in the last couple of years, services users had also chosen alternatives to the Roundways.