Agenda item

To consider a report by the Principal Manager: Community Support Services regarding changes to be made to the allocation of funding to individuals eligible for a managed care and support plan in Denbighshire.

11.00 a.m. – 11.45 a.m.

Councillor Bobby Feeley, Lead Member for Well-being and Independence, the Head of Community and Support Services and the Principal Manager: Community Support Services presented the report (previously circulated) regarding changes made to the allocation of funding to individuals eligible for a managed care and support plan in Denbighshire.  The changes in processes and approach to the allocation of money had been made in line with the Social Services and Well-Being (Wales) Act 2014 in order to increase the choice, voice and control of the individual supported.

The report signalled a move to a new approach with staff having different conversations with citizens usually described as ‘what matters’ conversations – asking what mattered to them and how they wished to achieve their desired outcomes, rather than what was the matter with them, to determine if they were eligible for care and support by applying the resource wheel.  Where total care outcomes could not be achieved support budgets would be provided in one of three ways (1) a self-managed budget (direct payment), (2) a third party managed budget (brokerage), and (3) a local authority managed budget, and it was recognised that many older people would still want a traditional domiciliary care package managed by the local authority.  However, where money was allocated via direct payment to individuals it could be used creatively providing the agreed and desired outcome was achieved, e.g. buying in-house services, employing family members, and paying for an air/season ticket for a family member to provide respite care.  If direct budgets were effectively used outcomes could be achieved in a better way and could result in cost reductions in some cases.  Finally reference was made to system changes required which would affect social care staff, finance officers and other support services and providers which needed to be appropriately managed.

In response to members’ questions and comments the Lead Member and officers –

·         referred to the potential for a Welsh Language care brokerage system to connect with carers and acknowledged the number of Welsh speakers across the whole county with demand in large towns as well as rural areas

·         reported upon safeguards to protect against money mismanagement with a managed account service in-house for direct payments paid on a monthly basis – the Social Services and Well-Being (Wales) Act stated that budgets should be reviewed in the first six months; the care and support plan detailed specific outcomes which would be assessed through the review process and expectations would be explained to individuals and rigorous contract monitoring undertaken.  If money was found to be misused there was a mechanism for clawback

·         confirmed that direct payments had not been promoted well to date with approximately 90 out of 1500 individuals receiving direct payments; the majority of those receiving direct payments had been younger adults with complex disabilities but there were examples where the needs of older people could be met at home with family support and social care instead of in a residential care home setting thereby providing greater choice for the individual

·         advised that options to raise awareness of direct payments were currently being explored and direct payment would be the default position at the outset (if appropriate) for those eligible following assessment and assurance could be taken from the early implementation of suitable systems and procedures in place

·         explained the use of the resource wheel as a tool to ensure an asset based approach maximising the contribution of people’s own strengths and the support which might be available from within their family and community; isolation was a key issue and Single Point of Access and Talking Point were key to connecting people who were isolated which was also a focus for the Community Navigator

·         clarified that if an individual was not eligible for social care and a managed care and support plan it may still be possible in particular circumstances to offer a direct payment for equipment as a preventative measure

·         reiterated that there were three support budget options to meet the needs of eligible individuals – if an individual did not have the necessary skills or mental capacity to manage direct payment a third party brokerage system would provide a level of support to that individual and a degree of independence.  The third option provided for local authority managed accounts.  The most appropriate option for the individual would form part of the initial ‘what matters’ conversation – all options included a care and support plan with clearly identified outcomes

·         agreed to provide an information report on Disabled Facilities Grant/Adaptations Service outlining the Council’s process for dealing with grant applications and its performance in processing and delivering grant associated home adaptations (to include information on the Care and Repair Service, uptake for its services and details of the Council’s financial contribution towards the service).

Members were keen to review the impact of the changes and progress made in developing, promoting and rolling-out support budgets for eligible people in approximately twelve months’ time.  It was also suggested that it would useful to include a service user satisfaction survey and case studies as illustrative examples.

RESOLVED that the Committee –

(a)       confirmed that it had read and understood the changes to be made;

(b)       has read, understood and taken account of the Well-being Impact Assessment (Appendix 1 to the report) as part of its consideration;

(c)        requests that a progress report on Support Budgets for People with Eligible Care and Support Needs be presented to the Committee at its meeting in May 2019, and

(d)       requests that an information report on Disabled Facilities Grant/ Adaptations Service be provided to the Committee prior to the next meeting in June 2018.