1Girtrell Court (GC) Q&A Friday 22 January 2016

Speakers:GH: Graham Hodkinson - Director Adult Social CareCJ: Cllr Chris Jones - Cabinet Member responsible for Health & WellbeingJM: Jayne Marshall - Commissioning Manager JO: Jason Oxley - Head of Service including Girtrell CourtJL: Judith Lambert - Responsible for Social WorkersAK: Amanda Kelly - Responsible for Quality of Contracted Services

Purpose of meeting is to hear from families directly affected by the proposal to re-commission Girtrell Court (GC). Important to share how the process works and key decision points as well as to hear your views.

Q1: I get the impression your mind is made up I thought this was supposed to be a consultation?GH: There are three consultations underway. • There’s a broad budget consultation which all of you and the general public can comment on.• There’s the staff consultation. • There’s the consultation on the impact on people who use the service and their families of the proposal

to recommission GC.

Q2: What about the quality of the independent sector as well as the cost and value?GH: The quality can be very high, the quality can also be not as high, it’s mixed. Council services have very mixed quality as well.

Q3: Are you saying that you’re going to save £0.5 million and still provide the service?GH: Yes, we’ll be able to re-provide the service for £1,000 per week for every existing service user in the private sector instead of the £1,500 that it costs now at GC.

Q4: The point you’re missing is that the service users don’t like change, they need stability and if they are put in different placements each time they won’t settle.GH: We’ll get into that later and also deal with it in the 1 to 1s.

Q5: There a lot of land at GC why can’t you still use it while you add other buildings?GH: Yes we could and there is capital to enable us to do that, we don’t have to demolish the existing buildings to build the additional housing. The problem is that we’re not able to make the saving of £0.5M.

Q6: You said that this is the only proposal at the moment, other people are asking for other options including holidays, can you give us actual figures on how many people are asking for other options or have you just pulled that out of the air?GH: I haven’t got these figures with me today. There are quite a number of people. I can provide those figures as part of the consultation i.e. the number of people who are asking for other types of services.

Q7: There are other brown fill sites on the Wirral vacated by Day Services, why aren’t you tearing those down instead of GC?GH: I do think we need to redevelop other places, GC wouldn’t be the only one. We have been working with Housing Associations to develop extra-care housing in particular.

Q8: Why not just re-open Maplehome or Sylvandale?GH: What you’re asking is ‘why are we having this continual downsizing’? The answer is that Councils directly delivering services is not cost effective. Very few Councils directly deliver Social Care services. GC is our last directly delivered service.

Q9: Peter Linnane delivers results of his review of all of the twenty alternative respite providers given by GH’s department as being suitable for his son. Having investigated none of these are suitable for his son. Two closed down in 2015. Two failed the latest CQC inspection. One is female only. One said that the person needs to be diagnosed with Autism or funding won’t be provided. Many do not have lifts or hoists. Four said they did not provide respite. Only nine had vacancies and these are mainly for supported living. Some of these vacancies are for shared rooms. None of the nine have vacancies on the ground floor. Narrowed the list down to four properties which he visited. The first had a lift which was not only not working but was too small for a wheelchair. The second catered for children with challenging needs where the manager stated ‘if your son is vulnerable he could be kicked, punched or spat at’. PL asked CJ

2whether this is what her personal guarantee means for quality at other settings on the Wirral. We and our relatives need reassurance of quality and consistency of care. It could be suggested that the Council has been negligent in its duty of care to his son for even suggesting these places as they are wholly inappropriate for him. Following his comprehensive research PL completely disagreed that the private sector provides more choice. It’s important to note that closing GC affects around 130 vulnerable individuals of which fifty one have mobility problems or are wheelchair users. He was shocked and extremely disappointed to find that none of the alternative options were appropriate for his son. He feared that this will be a common problem for all 130 people affected. He could not see how closing GC is cost effective, practical and sensitive to the needs of these vulnerable people. GC and the lifeline service it provides must remain open. GH: It does emphasise very strongly the need for individual 1 to 1 reviews and assessments. I was asked to provide a generic list of those services that are available out there. So that’s what was sent. It wasn’t a list for you Peter in terms of your son. The whole point is that in 1 to 1 reviews Social Workers will have information available about your relatives needs. These are the people who need to sit down and work out needs, not a director at the centre. That’s not appropriate. The process has to be about us working with individual families to review the need. Those lists were only a snapshot of what was available at that time. We have more information about respite and holiday providers but they need to be tailored to specific needs.

Q10: My partner has been in various homes and the care he got in those homes was disgusting compared to the A1 care in GC. GH: Absolutely, quality of care is critical.

Q11: What happens if the care can’t be provided by an outside organisation after GC closes, the person has been assessed but the Council can’t meet that need anymore?GH: There’s a very important link between those individual 1 to 1 assessments and reviews and what happens to the service. This process is about identifying the range of services and tailoring it to individuals. GC cannot close until after the assessment process. That individual review process will take 12 weeks. My understanding is that they’ve started this week. So we’ve got until the middle of March to undertake that process. That will provide a much clearer picture of acceptable services which will meet those needs.

Q12: You’ve clearly underestimated the strength of feeling in the room today, you’ve only laid out 40 chairs, that’s less than half the number required. There’s only 25 minutes left of the meeting, we need more time to discuss things. GH: The key is that those 1 to 1 reviews are completed to have detailed discussions with every family about their particular needs and those of their loved one. I will extend the meeting for an hour from now in order to allow people to ask questions and make points.

Q13: I have a daughter who has severe learning difficulties who goes to GC. She can communicate a certain amount. She’s not happy going into GC if certain friends don’t go in with her. She looks after other people who are not as able to speak or look after themselves. She is able to identify when things are not being done properly. That’s a very important part of their respite because it’s also a holiday for them. They have to enjoy going to respite and it’s part of their socialising needs. They haven’t got a social life unless we take them. We as a family get reassurance knowing that our loved one enjoys the company of others at GC and that we’ve got an extra means of communication if something’s gone wrong or that they’re not well. The staff at GC do a fantastic job but having that independent line of communication, that otherwise wouldn’t exist, is a vital factor in feeling secure enough for them to go to GC. If you privatise this service we will potentially lose that ability and we will then not have the confidence that every single carer has in conveying their loved one to GC, knowing that they will be looked after properly.GH: That’s the sort of thing that we need to pick up in terms of the individual needs and the groupings of people who want to use the service together. At this moment we haven’t got a clear picture.

Q14: What happens when you’ve done all the reviews and you find their needs gave grown since you did the last one? Parents get older and their needs change as well. so you could end up with needs which will cost even more than now. GH: I do think it’s very important that we understand the impact of this proposal on people. It will identify individual needs. I don’t think all of our reviews are up-to-date and I have had information that some people haven’t had a review for some time. So it’s very important that we undertake those reviews in terms of the individual person and the carer.

3Q15: I’m very interested in the continuity of care. I’m very interested to find out how this work because when we’re given the option of residential homes, will we be going into different residential homes? With GC we get a form, we tell them what weeks we want, it goes in at the beginning of the year, we get the approval. My daughter has been going into respite for many years and she’s never had her weeks refused. So we know from the beginning of the year what weeks we’re going to have and we’re able to book our holidays and do as we want, knowing there is that continuity of care. Now what’s going to happen if we’re offered residential homes? Are we going to have to apply for them ourselves? Would you put your child in a place you haven’t visited, that you haven’t looked at, that you haven’t approved? You’ve heard horrific stories from this gentleman here. So how is that system going to work to make us feel safe?GH: It’s that continuity, how you’re able to book in advance, all of that sort of thing we recognise are important to people. I’m going to ask JO to address this issue.JO: We do recognise that families do need to be supported to know that they’ve got availability for respite care in advance and know the dates so that they can have holidays and so on. JM will talk about the service we’re setting up where you can have the ability to book ahead throughout the year. We’ll have a number of beds with a provider in the independent sector, specifically for short term care beds, so you wouldn’t need to look at your family member going to different places for each of their respite stays. We acknowledge that and we do have a plan in place which JM will talk about after. Some people won’t have an allocated case worker, so we’ve got a project plan and a project team set up and we’ve got a list of all the people that use GC now. Each of these people have now been allocated a case manager. They are in the process of contacting everyone to set up appointments to see you individually and talk the other options that may be available. The purpose of the review is firstly to talk to you about the consultation process to get your views and comments, your suggestions and the alternative proposals that you may have. They are not experts on the proposal but they will be able to take your comments back. the other purpose of the review is to check we have an assessment of your needs that is up-to-date. We’ll also do a new assessment if that is necessary. They will also talk to you as a carer. It’s an opportunity to ensure we’ve assessed your needs as a carer. Then once we know what the needs are we will talk to you about alternative proposals and services that might be available. A range of options will be talked through and the case manager will help to advise you on what services we feel are right for the person who is currently using GC as well as yourselves saying what you think is right. What we would suggest is rather than you going off individually now going and looking at all the registered services in Wirral and being disappointed they don’t meet the needs of your particular family member, I would suggest you do wait for the appointment with the case manager to help hone that down to the most appropriate services and take the advice of the case manager. That’s not to say that you’re not free to look at other services but it will serve to increase your anxieties and disappointment if you find that other services are not meeting your needs. The list we have may be different from Peter Linnane’s list. If we can’t get hold of service users or their families by phone we will send a letter to make sure we’ve tried very hard to engage and we’ll make sure we find a way of getting in touch with you. I want to emphasise that this is looking at alternative provision for the person who needs the support in the event that the decision is made to close GC. I know that some of you may want to pursue those alternatives now and I’ve been contacted by case managers for one or two individual people that want to start looking at alternatives now. That’s absolutely fine, that’s people’s choice and we will support you. We won’t force you to make alternative arrangements. It’s about looking at what’s available for when the decision is made. We aim to have these assessment completed by early to mid-March.

Q16: GH mentioned the interaction with the NHS and there were consultation meetings held at Girtrell Court some time ago to discuss those proposals and at that time we were promised these 1 to 1 meetings which had been alluded to on a few occasions. Why weren’t those meetings undertaken then and perhaps people would have realised that actually GC was important to sustaining what we need as carers and indeed our offspring instead of having to rush it through in March? You would have known GC meets all the requirements we have.JO: I think I’m right in saying that those proposals for the service didn’t really reach the stage of a final proposal and consultation and so the 1 to 1 meetings didn’t take place.

Q17: It’s fairly evident to me just listening to what’s going on that there’s was an alternative proposal sat in the background, which is if the NHS proposal falls down we’ll just close GC down and take everyone out of it.JO: At that stage it wasn’t known.

Q18: We’ve been through this process before when Sylvandale closed and there was nothing suitable as an alternative for my son. I don’t believe in the last year things have changed enough to deliver a wonderfully suitable alternative.

4JO: There may have been changes because due to these proposals we’ve asked the market providers whether they’re interested and what they might do if this decision goes forward. Some of those services are looking at developing a different range of services. We have a duty to meet the needs of everyone who’s got assessed eligible needs and we will ensure everyone’s needs are met.

Q19: How are you going to achieve all these 1 to 1s inside 12 weeks when my brother-in-law hasn’t had a review in 5 years? It’s going to require a massive amount of staffing and will cost a lot more money.JO: I can give you an assurance that we’ve allocated case managers to all the people and we will aim to get all those assessments completed within the timescales. We think that’s achievable and we’ve got a plan to do that. It is different from situations previously because I do know that some of you haven’t had a review for a long time. For these assessments we’ve got a dedicated project team that will make sure these assessments are done in time.

Q20: It seems to me you’re running a divide and rule policy here because nearly every question that’s asked you keep going back to your own personal assessments. You don’t want us to act as a group. Let’s wear you down individually and find one home we think you can’t complain about. I will complain because there aren’t any private homes out there from my experience. My daughter couldn’t go to GC for various reasons and the Council didn’t have anywhere else suitable. She ended up going to Lymm, Stockport, Llangollen and each time the Council had to take her in advance to see the place to see whether it was acceptable in their transport and come back and then they could book it. When she went to stay, even though she’d seen it previously, we still found quite a few of those were still not satisfactory. Even though we thought they were on the initial visit. When you found what the care was in practice you found it wasn’t up to what you would expect. These homes are not flexible. I don’t want to book all of my dates a year in advance. I’ve just been in a situation where my daughter’s lift’s broken down and it couldn’t be repaired. The Council’s bureaucracy meant that she could still be living up in her bedroom or she’d have had to go into permanent respite. Where would she have gone? We couldn’t have pre-booked it. So what hovel would she have ended up in? There’s nothing out there. You can’t tell me that it’s changed that much as Peter mentioned earlier on so where are you going to find an emergency bed?JO: I know GC are very responsive and flexible, offer a good service and accommodate whenever they can but they can’t always accommodate people’s needs. So when GC is full we do currently have to place people in the independent sector. What we’re recognising in the range of options that we’re going to provide is that we do need some emergency response in the independent sector and we do believe that we’ve got that. Some services will be bookable and some will be responsive in an emergency.

Q21: It’s already going to costs you to pay social workers for all these 1 to 1s, don’t you think by moving into the private sector, which we’re not happy with and the service users won’t be familiar with, that the private sector will hike their prices up? You’ve got a purpose built place in GC which you could put put money into and secure and potentially expand because the other part is used by social workers.AK: The cost of the independent sector is cheaper than it is to run in-house services. There are no other in-house services for that very reason. People have talked about quality as well I’d just like to pick up on that point. The Care Quality Commission (CQC) is responsible primarily for the care in all establishments, they monitor the private sector and any in house services equally. You can go onto the CQC website and you can read the detailed inspection reports of any private sector as you can with GC.

Q22: Weren't they classed as not fit for purpose when they did the inspections for Winterbourne?GH: This is getting into the area of is the independent sector good enough? Post Winterbourne there have been significant changes., in terms of CQC and their role and how the whole sector works with CQC. To be absolutely honest there is a mixed market out there and we’ve got a whole range from very high quality voluntary sector type providers right through to some independent sector providers that aren’t as good quality and AK’s team are working very closely where there are problems with some providers across the sector.

Q23: What we have at the moment with GC, which is a very valued service, is professional, with properly remunerated staff. My experience with the private sector is that they pay National Minimum Wage to the care assistants. I have no confidence whatsoever that the level of care the standards of care and the compassion will be anything like the same in the private sector as we currently have in GC.GH: I’ll take that as a philosophical view rather than a question. Can I absolutely say the the quality of care in the independent sector matches up with the quality of care that the Local Authorities provide.

Q24: JO said that emergency respite will go out to the private sector. I look after my sister and she went 6 weeks to GC and in 2013 they wanted me to use my budget and I gave it a go and said OK four weeks GC and two weeks private. They gave me £450 on the budget per week to find a suitable place in the

5private sector for my sister with severe learning difficulties. I couldn’t find anywhere. I got barraged that I’m not using the money properly, you’re not using the money right, you don’t know what you’re doing. I do know how to use the budget I just couldn’t find anywhere. I said I’ll give it another go. I couldn’t find anywhere. I said I’ve only got two days respite per week when my sister goes to a day centre. I’m not spending all this time running around, give me our six weeks back at GC, I don’t want the budget. They say we’ve found somewhere for you. They referred me to a home in Wallasey. In 2014 I booked 2 weeks with them and 4 weeks at GC. A week before she was supposed to be going in they pulled the plug on that and said there’d made a mistake over the bookings. Last year she was supposed to have gone to this place in Wallasey in September. It was was booked in January. A week before they phoned me up and said we only have one room for respite and we’re no longer offering respite because we need it now we’re getting Social Services referrals. So they pulled the plug on me a week before she was due to go and I know why, because you’re referring emergency respite to homes like that which are running on the cheap. I ended up having no respite in 2014 or in 2015 even though I tried to give it a go on the personal budget. I’ve lost those holidays. I’ve lost that respite and my sister’s been shunted around and messed about. I said can’t you do this after Christmas and just give me that week and they said no we need it now. So we’re going to be running around looking at these private homes and you’re going to be running around filling them up with emergency cases which is going to take priority over our holidays. It’s really precious time for me. They also cancelled the week in the day centre so that instead of having a week away and having a break with my family and friends I ended up having my sister with me all week when she should have been looking forward to going away on holiday.GH: That’s an awful situation and I have to say that’s absolutely not good enough. I think that illustrates the problem we’ve got right now, where the resources are all in GC and with the independent sector we’ve got a very fragmented approach where there’s been the odd bed that been spot purchased. That doesn’t give the providers the opportunity to plan. There will be an average of £1,000 per week so we’re not talking £450 per week. When we’re talking about respite beds they’re beds that we would want people to be able to plan to book. So what that means is we would have to buy some beds on a block-booked basis in the sector for those types of beds. What we need to know is how many and what type of those beds we need. We can then give the independent sector providers that surety of buying the beds all of the time. If we only buy them on a week by week basis then you wouldn’t expect them to keep that bed open because they will fill it with someone else. In terms of emergencies, what we would do, we’d have to do a very similar type of arrangement wouldn’t we, where we have some additional beds that are available where and when required. For example, in the last 12 months, we’ve had some individual flats built, absolutely fully adapted. We can put some staff teams into those flats, depending on the needs of the individual. That’s for an individual wanting support on their own rather than those who want to go in a group. For someone who needs that type of support then that’s an ideal place for someone who needs either emergency support or planned support. JM: We’ve spent a lot of time with our big independent providers looking at what we need for the future and what does the shape of those services look like. We’ve increased the number of people on direct payments from 400 to over 600. That’s a lot of people who are choosing to have a more personalised method of having their care delivered. We have a range of services that we’ve commissioned. Part of our job as part of this budget proposal is to put together arrangements, running in parallel to the consultation process so that we don’t wait until we get to the end of it to have alternative services or provisions so that we can work with the people who are good to go as realistic options if the budget option is approved. We’ve worked with the market. They’ve told us of they’re availability. Some of them have already confirmed they will work with us to block book commissioned services for those people who are assessed as needing a like for like service. What we also want to be able to do is put on the table a modernised offer where people can have some more flexibility, if that’s what they want. We’ve already got people who are choosing that. We do have some providers who have joined the consultation today who are in the room, who are already providing respite care and emergency care for Wirral, as and when required. They’re already working flexibly with us in providing good quality services and you can go onto the CQC website and see that for yourself. Some of them have won national awards in terms of Autism, in terms of quality or training. They’re looking at developing respite services where people can go with groups of friends, where they can pre-book and pre-plan that in advance. Some of them have brought information along today if you want to have a look at that. I’m sure they’d be more than happy to stay at the end of the meeting to talk to you about that. Me and AK are confident with our QA Team and our commissioning leads that our market will respond to the needs if the budget options proposal is approved. We’d be more than happy to work with you as individuals and as a group to look at your needs, once they’re assessed, to see if we can group some people together into having personalised services and working together to have a much more responsive option.

Q25: I think if I was Cllr CJ sitting listening to this I’d be very worried about the stories that are coming out about the provision of care. I take what you say Jayne but it’s like a promise that it will be alright on the

6night! Could you give us a re-assurance that somebody like yourself or other Councillors and perhaps representative carers can actually go and see these places rather than leave it until the last minute? See whether they are going to be appropriate, so you can re-assure your Cabinet and colleagues that all the stories you’re hearing about are actually untrue and that there is something appropriate. I think that’s a vital thing that would give everyone confidence.CJ: I know the things that the Quality Assurance team does in this Council and I think that obviously some people have had some bad experiences in the past but I know the knowledge that JM and AK have gained is the absolute up-to-date stuff. AK works very closely with CQC. JM and AK know the providers who are out there and they are doing their best to get the best quality offer that they can.

Q26: I’m looking for the personal investment to make sure you are confident and thus advise the rest of the Cabinet. We’re not confident and I think that you need to make that personal investment yourself and preferably with a representative of this group as well. It’s something we did when they were looking at closing Maplehome, many years ago. We were involved. There was a panel of people. Councillors did go out and have look. We absolutely need that reassurance not once the assessments are finished but now, if you’re saying that the providers are there already. JM: I did say that we’re happy to work with people and work with you to deliver this new offer. We know that our providers will be more than willing to accept people going along to look at services but we need to be able to do that in a co-ordinated way. We can work really well with our providers to enable us to coordinate visits. I know that they will be happy to work with us in doing a market place, show casing their services that they’ve got available. They’d be really happy to share that with you and we know we’ve got our direct payments providers who can also provide brokerage service. We’ve got them lined up so that if people want to choose another option to help to broker services for direct payments for holidays to see if people want to do something other than have a traditional building based service. We know that some people will need that but not everyone will. Our direct payments team are lined up to start working with JL’s Team to help to broker services for you. The offer’s there in terms of working as a group. The offer’s there in terms of a market place where the providers can come and showcase there services. The offer’s there for us to do some coordinated with the right sort of people to go and have look.

Q27: We need to do that quickly though don’t we Jayne?JM: I can get that in place quickly for you. Me and AK can get that in place quickly. What I would really appreciate because we need to be mindful that our providers in the independent sector are providing services for vulnerable people. We can’t just have people turning up and I don’t want all their time spent speaking to individuals. They’ve got a really difficult job to do. We know that we can coordinate that so that people will feel they’re involved and that they’ve got the ability to go along and have a look and touch and feel and all that stuff.

Q28: Chris will you personally get involved in that as well? Would you do that for us?CJ: What I’d really like to do is go along and have a look at where the block bookings would be. I’d be really happy to do that.

Q29: GC provides caring care. Outside contractors are doing it for the money. We’ve had experience of these outside contractors with our son. We went to an outside contract recommended by the Council and he was abused 3 times by staff. All you’re talking about is outside contractors. You’ve made up your minds. JM: The Council will make the budget decision. That’s the job for the Council, to make that decision and that’s not for us to make. Our job is to put in contingency plans if that decision is made to then support you and the vulnerable adults.

Q30: Is there no provision for savings elsewhere in the huge budget rather than saving money from places like GC?GH: There are a lot of savings that the Council is looking at the moment. So GC isn’t the only saving by far but is one that directly impacts on people’s lives. Every area of the Council has been looking at a whole range of issues. We have put 40 of our own staff at risk in terms of Care Navigators and their roles, in addition to the GC staff. So we have a number of savings, both savings that we already have to make to reduce the cost of care and these new savings in the current proposals as well. So there is quite a lot in the budget in terms of alternative types of savings.

Q31: One of the key 20 pledges is to look after the most vulnerable in our society. If GC users aren’t the most vulnerable in our society I don’t know what is. We’ve got Cllr CJ making comments in the press, that you will get as good as if not better provision . I’m clear from the meeting we had the other night and what I’ve heard today that has not been given to everybody. This has been done back to front. You haven’t

7given the people here, who are the users, an option to say that’s your provision for the year. You’ve stopped taking bookings in the New Year initially, it was meant to stop in March and now people can’t book after March. There’s nowhere for these people to go. You’re just putting in place now packages that Jayne’s created and looking at where they can go and sending out Social Workers to meet them on a 1 to 1 basis. That should have been done first, that’s fundamental. We’re doing it the wrong way round to make the budget savings. We are facing these horrible cuts and they are tough decisions but the first one of these pledges is to protect the vulnerable in our society and we’re clearly doing it the wrong way round. GH: There is a process that we have to follow. That process is that we do the individual 1 to 1s during the 12 week consultation which is a statutory requirement. We do that whilst the public consultation is underway. That’s a standard process across all Councils. It’s not the wrong way round it’s the way it has to happen. If we did it the other way round we’d be accused of predetermining the outcome of the consultation. This is the way that every borough in the Country does it.

Q32: As an ethical employer and as a Labour run Council it would make sense to make this cut back in the future. You’ve got dedicated staff, worried sick about their jobs along with the people here who are worried about their provision. We were given this a week before Christmas, up until then 3 or 4 weeks before then you were still asking for provision for people. The staff know their jobs could go. You’re not allowing people to vote. If it comes to the point where there’s no provision for everybody can you hand on heart say that every single person here will have a provision because I can’t and they don’t know if there will be one.GH: There is a process. We’ve outlined the process. I can’t answer the question until we’ve undertaken those individual reviews. We believe there’s a mix at this point in time but we don’t know that until all of those individual 1 to 1s are done. There are 6 people who are living at GC that we’ve got a service in line for those. The service can’t close until we’ve got all that. The Council Section 151 Officer will have to make provision for any outcome.

Q33: What about some of your jobs. That would save a lot of money?GH: My leadership team is half the size it was when I came into post in 2012.

Q34: If this proposal doesn’t go through, have you got a contingency plan to save the money elsewhere?GH: Because the 1 to 1 consultation process will overrun the broader budget consultation process, then we will as a Council have to make provision within the budget for this potentially not going ahead. The Section 151 Officer who’s the Chief of Finance will have to decide with elected members how that’s done.

Q35: The last budget made provision for each Council to raise Council Tax to cover Social Care provision. Why aren’t you looking at that? Also under this private model, when things do go wrong and our loved ones don’t get the service they need or are abused or whatever else happens, who is accountable?GH: The Social Care precept is a 2% addition to the Council Tax. My understanding is that is part of the budget consultation. Elected members are considering taking that 2%. That will raise £2Million. That will be spent on Social Care. What we’ve got in the market today is the living wage and it needs to be paid for. There’s a key link between that £2Million and the cost of care out in the market. We’ve got to use that £2Million in order to stabilise what we’ve got out there. We’re hoping that elected members do take that decision because if they don’t we’ve got a £2M pressure in terms of the living wage. The other question was about your loved ones. We do remain accountable. So if the quality of care for the services we’ve commissioned falls down, then I’m personally accountable.

Q36: Our sister is one of the 6 living in GC. From March where’s she going to live? We’ve been refused two places now. We ask two question about are you hoisted and can you peg feed. If the answer is no then that’s it. She moved from Sycamore Court to GC in September because that was closing, now you’re closing GC. We’ve found 2 places but you won’t agree to the funding.JO: Your sister is obviously at GC for the time being whilst you find a permanent place. Your sister’s case manager will continue to work with you until we find you somewhere that is appropriate.

Q37: If GC does stay open, it seems to me that by the time this consultation process has gone through most staff will quite definitely be looking for a job. It’s only 2 months time. How are you going to run GC if the Council overrun this?GH: Those things are a real challenge in terms of keeping continuity of the current service when there’s lots of uncertainty with the staff, in terms of keeping staff motivated and Michelle has a very dedicated team there but it is an incredibly difficult time for the managers and the staff there.

Q38: It’s about quality control and assurance. You’re in control over the people who run GC. You’re losing control of the people who use it. If you put it into the private sector, you’ve got no control over the staff

8that run it. You’ve got no control of the other people who use the facility besides us. You’ve got no idea of the other people and the dangers you’re putting people into in those places. GH: You’re correct in so far as we won’t have that direct control any longer but that is a key factor in all of the other care that we purchase. We don’t have that direct control. What we do is work with our Quality Assurance team and the providers to ensure the quality of care of that service and with the CQC. Factoring in the needs of other people again that’s very mixed whether it’s at GC or in another place where individual service users impact upon each other. Again because we’ve only got one key option at this time actually it’s harder for us to offer alternatives for those people where they might have significant impact on others. So when you do have someone with significantly challenging behaviour in recent years we’ve been asking GC to manage that. That’s a big ask if you haven’t got a specific focus in a very small unit. They do a very good job.

Q39: A large percentage of people are saying we don’t want change. I know you’ve got to make budget cuts but in the long run if you get rid of GC and you put it into the private sector, which is going to happen, how do you know they aren’t going to put their prices up and then you’ve got nowhere else to go and nothing else to do?GH: We do have a lot of experience of working with the market overall so we did outsource all of our domiciliary care, all of the home care, all the people’s residential care and we’ve outsourced all the other services over time. We continued to work with providers in the market. Yes we have to give the market a fair deal but it tends to be that we’re able to manage that in a very reasonable and pro-active way. Certainly in terms of supported living providers, they’re working with us right now to try to reduce their costs and to work with us to make sure that they can continue to support people within a price that we can afford. They are very pro-active as well, the market.

Q40: Will we get any respite care because by March you could have made the decision to close GC? We’ve put our requests in for respite care. We’ve had no answer because obviously no-one knows what’s happening. By the time you’ve got all this private sector thing sorted out, there’s another 6 or 9 months gone. So we’re not looking at getting any respite this year at all no matter what you do. I think you should have done it the other way, you should have said we’ll close it 1st January next year, leave it so we can get our respite this year and we’ll all know by the end of this year what’s happening. GH: I know that you need respite this year and that we need to find a way of providing it this year, not to leave you 6 or 9 months without respite. I can’t guarantee bookings at GC beyond the end of March for obvious reasons. We do need to work through that review process in order to ascertain what the range of needs are. We will have to look at the timing of the closure of GC against the start of those new services. That’s going to be a very important factor going forward. I’m not at this point of time saying the service will close on 1st April, I haven’t said that at any point, What I’m saying is as part of the consultation ascertaining the whole range of services that are required instead of GC. Then JM’s team in terms of commissioning will have work through at what point we can have that whole range of services in place for everyone to meet those needs.

Q41: Why haven’t we heard about any proposals to save GC?GH: The proposal I’ve put forward isn’t a proposal to save GC. The proposal I’ve put forward to the elected members is to commission different services. My team is not working on a save GC plan of any shape or type.