This report (Alternative Service Models - Lessons Learned) to the BCC Cabinet is a 26 page document covering a number of initiatives. The failure of Bucks Care is covered on page 4 and in Appendix 3 (page 15). The key lessons they have identified relating to Bucks Care will not come as a surprise:
30. In the case of Bucks Care, there was evidence of a loss of sight of users and their families and they were not engaged sufficiently in care. Users have to be placed at the centre of the Council’s systems and processes to ensure that they are supported to achieve good quality lives. In the case of Seeley’s House, we are now working much more closely with service users and carers to keep them informed and engaged and to understand the service as they experience it.
32. Governance arrangements had been established for each of the new service models, involving both senior officers and Members, with the aim of holding the delivery vehicle to account for performance. However, the review has identified some concerns about the frequency of meetings as well as the scope and focus of the discussions. For example, in the case of Bucks Care, the meetings of the Shareholders Commissioning Group (the Council’s internal group overseeing the relationship with Bucks Care) focused primarily on financial performance. However, it should also have had a clearer remit in relation to quality of care and been supported to take a more robust and thorough approach triangulating contract monitoring information with service user and carer feedback and information from care managers as well as financial information.
35. Contract management in relation to the new service models has not always been as robust as would be expected with commercial suppliers and the Council’s approach has sometimes been too light touch. This was a particular issue with Bucks Care. In this case, contract monitoring should have coordinated intelligence from different sources – including users, carers, care managers, complaints etc - and triangulated this with performance data to ensure an accurate picture was developed about performance. Although numerical performance and financial data was considered, insufficient attention was given to other information which could have indicated emerging concerns in relation to Bucks Care prior to the CQC inspection in Autumn 2016.
An information meeting was held on Monday 17 July at Adams Park attended by about 30 parents and carers associated with Seeleys, Hillcrest and Spring Valley following a meeting between BCC and FOSH and SBAD.
Jane Bowie, Director of Joint Commissioning, Health and Adult Social Care, told us that the proposed move to a new building at the Orchard House site had been cancelled. In fact there will be no new Day Centres built. It appears that some of the existing Day Centres are running at between 32% and 77% capacity and that the plans proposed in the "Having a Good Day" consultation in 2010 were no longer valid.
They say they are not talking about withdrawing services but do want to work with carers and service users to look at alternatives (remember Orchard House would have catered for a wider range of people than Seeleys, including older people and people on the autistic spectrum as well as PMLD). It was pointed out that there are some people (perhaps 50 at Seeleys and Hillcrest) for whom a building based service was appropriate and needed.
As far as Respite is concerned it is clear that they must offer a service that is acceptable for both Social Care funded and Health funded clients and that only one centre in the south of the county is not ideal.
So now we know what is not happening. For the next step the starting point will be a couple of workshops on the 2nd and 8th August.
Buckinghamshire County Council has entered into a Formal Consultation on proposals to close Seeleys and build a new Day Opportunities Centre and Respite Unit on the Orchard House site in Cressex. If this goes ahead the clients would move from Seeleys in late 2018 (so this could be the penultimate FOSH Christmas Fair at Seeleys). Incidentally a site at Cressex was one of the options being explored by SBAD before the then Knotty Green First School became available (and became Seeleys House). The formal consultation started on Friday 14 October with meetings at Seeleys to which all parents and carers should have been invited and runs until 9 January 2017 with a mid-consultation meeting on the 6th December.
The Orchard House site will accommodate a new Respite Unit with space for 8 PMLD clients and 4 autistic clients (although on occasions it may be possible to allocate all places to PMLD clients) and a Day Opportunities Centre with offices for BCC Social Services staff on the third floor. In addition to Seeleys clients, clients from Hillcrest/Wycombe Hills, Southern Day Service, Spring Valley and Verney Avenue will be moving to Orchard House. There will be separate areas for PMLD, LD, Older People and those with Challenging Behaviour as well as a separate Autistic Unit. There would be scope for Seeleys clients to be involved in activities with other clients where it is beneficial.
Because various rumours were circulating, two pre-consultation meetings were held at Seeleys for parents/carers (on 23 and 30 September) along with a display of the preliminary plans on 6th October. These showed the area allocated to PMLD clients (80% of whom would be from Seeleys) of something like 200 m2 compared to over 600 m2 at Seeleys Day Centre. We therefore submitted a note to BCC outlining our concerns and in particular the inadequate space, and a new plans were shown on the 14th October. They now show between 350 m2 and 600 m2 allocated for PMLD clients depending on what use is made of shared space and of Respite. (These figures are my rough estimates based on the plans I have seen – no doubt the architects will be able to give us more accurate figures in due course).
It is very unfortunate that it looks as if we will have to move from Seeleys, but as far as Seeleys is concerned it is more expensive to run than a modern purpose built building and needs significant expenditure on maintenance (everything from making the entrance secure to new flooring) and to bring it up to the standard to make it thoroughly fit for purpose. Some desperately needed refurbishment is due to start this week but BCC do not have the money to do all that is necessary. They have seen an opportunity to fund a new building on the Orchard House site by selling off its building in Easton Street in Wycombe and in due course the Seeleys site. The most important thing for the Seeleys clients is that we should have a good service provided by the right staff in the right setting. I am encouraged by the fact that changes are being made in response to the points we have made, in particular the latest plans show much more space being allocated to PMLD clients
While there has been much focus on the building because the plans have to be signed off now in order for it to be completed on time there will be opportunities to have further discussions on how it is laid out and equipped over the coming year. There are other issues that will need to be addressed as well, such as when and how parents/carers should be consulted over whether their son or daughter should transfer to Orchard House or to Chesham or elsewhere. How this transition is managed will also need to be discussed but we have been assured that it will be phased over a period of time during which Seeleys and Orchard House will both be open. I have asked for a more detailed project plan so that we can see the key dates not only on the building itself but also transition planning and when choices have to be made for example. BCC are now seeking comments on the interior design (this is more than just the paint colours!) and would like comments back by 9th December.
The key dates over the next couple of months are:
Tuesday 6th December 10.30-12.00 Mid-consultation meeting at Seeleys Respite
Friday 9th December Ideas/ comments on interior design to be submitted
Monday 9th January 2.00-4.00 Design meeting re Respite (Location TBD)
Tuesday 10th January 9.30-1.00 Design meeting re Day Centre (Location TBD)
In meetings with BC and BCC we have emphasised that Seeleys clients are vulnerable individuals and many of them are in wheelchairs. They may require full assistance with all areas of personal, health, social and recreational care. Because many clients are non-verbal it is down to staff who know them well to interpret more subtle signals (especially those indicating pain or other problems). Retaining staff who know the clients well is absolutely vital. Many of Seeleys clients find change difficult. It may take some months for clients to adjust to the new surroundings especially when they have become used to Seeleys over ten or twenty years. Continuity of care and safety of the very vulnerable should be the top priority and specific ways in which this will be achieved must be addressed. It is vital that we get this right before attempting to relocate clients to a new facility.
As far as FOSH is concerned it is of course the clients not the building that we support and since 80% of the PMLD clients at Orchard House are likely to be from Seeleys there is no reason why we should not continue to support them in their new surroundings. This is something that can be discussed over the next couple of years along with how much of the equipment that we have bought can be sensibly transferred to the new site and so on.
Use the calendar or list of months to view entries made on those dates.
- July 2017
- November 2016
- November 2015
- October 2014
- November 2013
- October 2013
- July 2013
- May 2013
- November 2012
- August 2012
- June 2012
- May 2012
- April 2012
- March 2012
- November 2011
- October 2011
- May 2011
- March 2011
- December 2010
- November 2010
- June 2010
- May 2010
- March 2010
- November 2009
- September 2009
- June 2009
- May 2009
- October 2008