To track progress against the recommendations of the Adult & Health Scrutiny Panel’s review report on Day Opportunities that was originally published in June 2019.
Cllr Connor noted that the report provided updates on the recommendations from the Panel’s previous Scrutiny Review on Day Opportunities in Haringey.
Recommendation 1 related to Canning Crescent. Charlotte Pomery, AD for Commissioning, explained that Canning Crescent was previously a mental health clinic owned by Barnet, Enfield & Haringey Mental Health Trust (BEH-MHT) before the premises was purchased by the Council. It was being redeveloped with stakeholders as a new crisis café for people at risk of mental health crisis and a space for the relocated Clarendon Recovery College which was for people coming through mental illness. It was being delivered by BEH-MHT and the Council working with service users. A neighbourhood engagement event had recently been held.
Cllr Demir noted that the recommendation included a reference to the model adopted by Mosaic Clubhouse in Lambeth and said that this was a brilliant service, centred on service user involvement. Charlotte Pomery said that they had looked at best practice from various different models in responding to the recommendation made by the Panel. The model of the Clubhouse was a mixed model that responded to service user need, avoiding admission, supporting discharge and helping people to live in the community safely. Asked by Cllr Connor about co-production, Charlotte Pomery said that a group of service users were working with clinicians and practitioners to develop the model.
Cllr Peacock expressed concerns about the impact on people with mental health needs of the previous closure of mental health facilities at 684 High Road in Tottenham. Charlotte Pomery said that this underlined why such provisions were needed in local communities that are inclusive, accessible and provide meaningful occupations for people with mental health needs. Cllr Peacock highlighted the transport issues for people in Tottenham to get to these new services in Wood Green. Charlotte Pomery responded that the crisis café was an additional service in the borough which was centrally located and had good transport links. Cllr Lucia das Neves, Cabinet Member for Health, Social Care and Well-being, noted that one of the relocated services was originally located in the west of the borough and that it would be useful to review what other provision was available in other parts of the borough. The Council was fully committed to continuing this new service and partnering with BEH-MHT should help with sustainability of the funding and prevent the kind of closures that Cllr Peacock had referred to in the future. She added that the building in Canning Crescent would provide a therapeutic space for people with a good amount of space and interaction between different services.
Cllr Bull raised the importance of preventative measures on mental health. Charlotte Pomery agreed that access to good quality education, employment, housing, and many other factors were clearly relevant to maintaining good mental well-being and so wider preventative measures were fundamentally important. Beverley Tarka concurred with this and added that the Council had recently been successful in a bid to the Great Mental Health fund which would provide over £300k to support wider community mental health.
Recommendation 2 related to the three former day centres that were brought back into use. Cllr Bull welcomed the provision of new services at Waltheof Gardens and asked about current day care provision for older residents with physical frailty. Beverley Tarka said that Disability Action Haringey was now based at Winkfield Resource Centre supporting people with disabilities with purpose-built provision to support the development of independent living skills. Charlotte Pomery added that the Ageing Well partnership approach had developed a range of support options for older people. The Grace Organisation formed part of the provision in the east of the borough while the Haynes Centre provided specialist dementia care in the west of the borough. Cllr Peacock commended the facilities and activities provided for older people at Protheroe House and Lorenco House in Tottenham. Asked by Cllr Connor how residents in the east of borough could access specialist dementia care, Charlotte Pomery said that part of the framework approach to day opportunities was to consider a centre of excellence in the east. Much of this work had been paused due to the pandemic but this was currently being revisited and so this could potentially be discussed at the Panel at a later date. (ACTION)
Recommendation 3 related to using the re-opened centres as part of a wider community offer. Charlotte Pomery informed the Panel that one of the posts being recruited to at the Chad Gordon Autism Campus was an Activity Coordinator which involved brokering the use of the space at times when the centres were not being used for day opportunities. The campus had launched in August and the spaces were designed to be autism friendly so were an asset to be used by other groups that would benefit from this. Cllr das Neves agreed with the importance of maximising the use of new spaces and opening them up to the wider community.
On Recommendation 4, which focused on the capital allocation for the re-opened centres, Cllr Bull asked where responsibility lay within the Council for the maintenance of the buildings. Charlotte Pomery responded that the Adults team played a co-ordinating role with other parts of the Council. Regular maintenance of the buildings sat with Corporate Landlord while maintenance of the outside grounds was partly supported by the Adults team through the services users involved in therapeutic activities such as gardening for example, in partnership with the Parks team. Any significant capital work to improve the buildings would sit with Capital Works.
Recommendation 6 related to demonstrating social value. Cllr das Neves said that the Bridge Renewal Trust provided support to organisations in the Borough as how to do this and that it was a learning journey for many. The Council had done a lot of work to consider how best to enable organisations to show the impact that they have. Charlotte Pomery added that a matrix was used for the Local Area Coordinator model to measure social value and that a public health approach had been taken in building social value into commissioning with a focus on social isolation, local employment, health and wellbeing and impact on mental health. Cllr das Neves added that there had been a lot of discussion recently about how to engage service users and residents in the commissioning and monitoring of services and this connects to social value as it emphasises the point of view of the community rather than the Council.
On Recommendation 7, which was about the reduction of social isolation, Charlotte Pomery commented that this was an issue that had been exacerbated by the Covid pandemic. Many residents were still affected by anxiety about leaving their homes and the Council recognised the importance of addressing social isolation.
Recommendations 8 and 9 focused on transport links to access services and Charlotte Pomery agreed that the importance of this was recognised with measures such as the provision of transport services or buddying/mentoring systems to help people reach services. The importance of local provision, as discussed earlier in the meeting, was also recognised as a key part of addressing this. Asked about the comment in the report that the transport offer didn’t tend to be advertised, Jeni Plummer, AD for Adult Social Care, clarified that this was because it would usually be offered directly on an individual basis and included in their care and support plan if required.
Cllr Connor noted that Recommendation 10 referred to the Haricare website which she said still contained some out-of-date information. Charlotte Pomery acknowledged the importance of information provision and said that, as noted in the report, the Department was moving more towards targeted information and campaigns such as through the new Ageing Well Guide. All directories rely on information being regularly updated and often the resources available to do this was limited. Cllr das Neves added that feedback from users and a content design approach was increasingly part of ensuring that the right information was delivered at the right time in the right format. Charlotte Pomery also highlighted the new NavNet initiative which involved frontline practitioners coming together to share information to improve navigation of services.
Cllr Connor expressed support for the Preparing for Adulthood Pathway Guide referred to under Recommendation 11 as an example of information being provided in the right way. Cllr das Neves informed the Panel that she was shortly due to talk to Cllr Zena Brabazon, Cabinet Member for Early Years, Children and Families, about transitions between services and the provision of the right information to people was a relevant part of this.
Asked by Cllr Peacock about the Dementia Care Navigators referred to under Recommendation 12, Charlotte Pomery said that a number of these Navigators were now in place to help support people with dementia through the system. The Ageing Well Guide also helped to supplement this advice with information about the services available to people in this area.
Recommendation 14 referred to the establishment of a secure online portal to enable service users and carers to access documents. Asked by Cllr Connor about the timescales for the new care management system referred to in the report, Beverley Tarka confirmed that there would be an approximately 18-24 month implementation period.
Cllr Connor noted that information about the payment of the London Living Wage referred to in Recommendation 15 would be provided in the Annual Report.
Cllr Connor highlighted the provision of dementia support in the east of the borough and the provision of mental health support in Northumberland Park as areas that could be monitored further by the Panel. (ACTION) Cllr das Neves suggested that it may be useful to look at a summary of the overall mental health offer at a future Panel meeting. (ACTION)