On October 1 2017, Oxfordshire’s health and wellbeing centres and learning disability daytime support services were replaced with a new community support service.
This operates from eight centres across the county at Abingdon, Banbury, Bicester, Didcot, Oxford, Wallingford, Wantage and Witney. Oxfordshire County Council says that everyone with eligible care needs for daytime support is guaranteed to receive a service and can choose to receive this from the council.
For people who are assessed as not having eligible needs, there is a range of options available, including buying support from the new council service.
The eight former community support centres are now used by a range of service users. Many people who use day care have multiple needs: older people with learning disabilities, people with learning disabilities and dementia etc.
Following a visit to the day centre in Bicester, Healthwatch Oxfordshire became aware of a number of concerns voiced people using these new services, and addressed the following questions to Kate Terroni, Head of Adult Social Care at Oxfordshire County Council. These are listed below with her responses.
When where all centre users were informed of the changes?
People attending services, their families, volunteers and staff have been involved throughout, since the review began in March 2016. Many people shared their views in focus groups and through other routes, including one to one conversations, during the review and the subsequent consultation on the options.
Letters have also been sent to everyone attending services following the outcome of the decision in March 2017, and since then to update them on the transition process and support available to them during the process of change.
Staff have also held one to one discussions with service users and their families.
When and how were all centre users informed of the changes in access criteria, times of opening and associated changes in costs to the individual?
Information on access criteria, times of opening and associated changes in costs formed part of the consultation on the options, and the final report on the outcome of the decision. We have ensured that everyone attending services has a personalised discussion with a member of the Transitions Team of social workers or the Community Information Network team, to review their needs, consider the options available to them, and support them to make choices. This has included detailed discussion on the nature of the new service, including access criteria, opening times and charges.
Confirmation is being sent this week to people who have eligible needs who are either required to pay the full cost of their services or who pay a high contribution to the costs to set out how much they have been assessed to contribute for the new service. This is in line with national financial eligibility criteria, and people will only be required to pay what they can afford to pay. Contribution costs for many people are not likely to change from what they are currently contributing.
Can you onfirm that all centre users have had a completed assessment and been informed of the outcome?
Everyone attending services has had an individual meeting to discuss their needs and the options available to them. As stated above, letters are being sent out this week to people with eligible needs to offer them a place in the new Community Support Service. The Community Information Network is continuing to work with people who do not have eligible needs to identify alternative options and services in their local communities. Many people have already started to attend new services.
Please outline what support centre users are being given to adjust to the new regime
Everyone attending services has been supported throughout by centre staff and day service managers, through individual discussions, as well as the discussions with either the Community Information Network or a social worker as outlined above. In order to support service users who will be moving to a new building, there have been coffee mornings and visits and further visits are now planned.
What information has been given to the volunteers regarding their future at the centre?
We are very grateful for everything volunteers do and they will continue to be very welcome in the new Community Support Services. We hope they will continue offering their support as their input has been, and will continue to be, crucial and it is hugely appreciated by everyone at the centre.
Managers in each of the centres have acknowledged how much volunteers are appreciated within the services directly, and are writing directly to all current volunteers this week.
What briefing has been given to staff and how they have been supported to support existing centre users? – Staff were reluctant to speak to us on our visit
Staff have been briefed throughout on the changes and the processes in place to support the transition to the new service, with regular written and verbal briefings, weekly meetings as well as a Staff Forum, which is a representative countywide group of frontline staff, who have informed decisions on how the new service will operate. The Staff Forum has been involved in developing the approach to supporting people through the transition, as well as the staff induction process and training plans.
We recognise this has also been a difficult period for staff and there have been individual meetings to address concerns and to support staff in supporting people using services through the changes.
And specifically are we right in thinking that from October there will no longer be a hot meal available to centre users in Bicester and is this so across the county?
For people choosing to use the new council Community Support Service, there will be a number of meal options. We know that eating food socially is an enjoyable experience and provides the pleasure of conversation and nutrition, as well as the opportunity to meet other people. We understand that in day services, food is an important part of people’s day and in the eight new Community Support Services there will continue be an emphasis on food and social eating.
Meals are not included in the cost of the service. Staff will work with people to plan their support and options for food will be varied:
- The team can provide transport and support to go to an eating place of a person's choice - this could be a local pub, café or restaurant
- Cooking as part of a small group: the team can support people to prepare a meal for the group
- People can pay towards a group meal that is being prepared by others without cooking themselves
- A simple hot meal could be prepared by staff
- People can bring their own pre-prepared meal or light lunch into the service to eat
As a contingency plan, our services will hold a small number of readymade meals for use if required.
For people who are not attending the new Community Support Service, many of the daytime support services provided by the community and voluntary sector provide a hot meal, often two or more courses, freshly prepared by volunteers and or/staff. We want to support these services to continue, and are delighted that the vast majority have decided to apply for - and have been awarded - transition grant funding. There are also a wide range of other community and voluntary services, including those which meet in a café; for example, there are several dementia cafés across the county.