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Comments from provider events 9 April 2019 - 18 April 2019 | Adults Social Care Day Opportunities Consultation 2019 | Birmingham City Council

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Comments from provider events 9 April 2019 - 18 April 2019

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Use these links to go straight to the comments from each events


9 April 2019 - Hollyfields

  • Audit of Day Services Framework used by some external providers regarding quality
  • A Social Worker was concentrating on a service users cooking needs rather than their strengths, guitar playing which is suffering
  • External Day services providers felt they were not fully feeling the effect of the 3 conversations, due to an inconsistent approach - It was explained by a member of BCC staff that the 3 conversations was still being rolled out over the next 12 Months. The providers did fell that when the 3 conversations assessment was being carried out it was beneficial to the citizens.
  • The current strategy ran out in 2017. This is missing in the consultation and needs to be embedded
  • Need to include Autism in high level of needs
  • The review is welcomed and needed (External Providers)
  • Social Work is built on relationships. External providers would like to be able to pick up a phone and speak to named individuals
  • Community is not where people live, but where they go is where they see their community
  • Conflicting messages (reduce cost vs increase in quality). It is difficult to maintain levels of services when there are financial cuts
  • Concerns were raised about cuts in services e.g. no transport funding will make it difficult to deliver services.
  • Increase in minimum wage makes it harder on Day Services as this impact on Pension contributions.
  • Agree with the strategy-however difficult to maintain levels of services when financial cuts are being made
  • Logistics to deliver are labour intensive.
  • The standards are a good thing and will help to maintain quality.
  • Uncertainty around the quality standards. We don’t know how to position our business to meet what BCC needs (quality vs quantity).
  • Working towards providing highest quality in line with the strategy –High quality; reduced resources and providers need to understand how to change to fit new arrangements
  • The standards need to be realistic.
  • Families use us as a hub not just for Day Opportunity Services, they rely on us to provide a holistic service and we provide a lot of intervention which if ends all good work will be undone.
  • BCC don’t want a centralised building based service and want to see community access. BCC don’t have a clear strategy or proposal on transport and community access. This needs to be communicated.
  • Decision support tool- Social Workers should use this because it encourages Social Workers to involve everyone. Social Workers do not have a structured way of approaching their reviews/assessments.
  • Social Workers making decisions about our service users but have never met them
  • Social Workers are not getting all the information on who providers are and what services are available out there.
  • Not all providers’ information is on the list.
  • Resource Directory is required especially for Direct Payment users
  • Social Workers’ assessments don’t include the views of providers, families and other involved professionals.
  • Difficult initial referral to obtain effective information to maximise service user’s assets and goal. It’s a gradual process to identify potential, in some
  • There should also be a focus on the negative points to allow for better planning.
  • Provider mentioned they would also have their own care plan which is more detailed.
  • Quality standards trying to achieve, acknowledge the facts, pitch it, process takes time to evolve.
  • Period of settlement (via Reviews).
  • Embrace changes
  • Agreed, needs to be outcome focused, can change, person centred, addresses a lot of things.
  • Negative to positive – access the community.
  • Allow for a positive experience.
  • Facilitate the right support.
  • Direct payments with carers, sometimes carers change and quality of care is variable.
  • Personalisation.
  • Skills, employment – allow for choice, what does it mean to be employed?
  • Those who are keen should be identified and given the support to maintain.
  • Focus on enablement.
  • Employers have difficulty understanding the value for their business, as it requires sometime extensive support.
  • Jobs need to be tailored to meet individual strengths.
  • Requires specialist employer, with trained staff to support.
  • Impressed with Neighbourhood Networks. Thought it was important to focus on more local provision rather than sending people across to the other side of the city. Has found from own experience that this helps people to find out what else is happening in their local area and to make links. It is a good way of sharing information and what your service can do.
  • Agreed with the aims of the strategy but felt that the aspirations were high level and would be interested in learning in more detail about how BCC plan to implement the strategy.
  • The service found it interesting what was said about employment. Agree that this is appropriate for some but from their own experience of social work reviews the service felt that social workers did not have a full understanding of their clients and their suitability for employment. While some people at first may seem suitable for employment opportunities it was felt that social workers were not always taking additional factors – such as unpredictable behaviour - into account when recommending clients for employment schemes. Would like social workers to take more note of the expertise and knowledge that services have of the clients, particularly in reviews. Also felt that reviews were seldom and too brief. Social workers need to have a balanced picture when recommending or pushing people towards employment. It was felt that social workers go for the cheapest option. There needs to be a cultural shift within social work in order to implement the strategy.
  • People with learning disabilities need to feel that they are doing something useful even if they can’t hold down a job. Working also benefits those who are able bodied as it enables integration.
  • There are limited options for jobs with lots of health and safety issues for employers to consider.
  • People need to know the client. Providers know their clients better than social workers.
  • Would like to see a change in the balance of the working relationship between social workers and providers. Reviews are too brief.
  • The model seems to be very logical and makes sense. Particularly, in the way that the first stages of the model focus on people being able to help themselves as far as they are able. It is important to give people a sense of purpose dignity.
  • Safety is a big concern with accessing the community. Particularly for evening activities.
  • Transport is another issue when accessing the community. Services like Ring and Ride are essential and are a big asset to the community. If that goes bust it will create a lot of isolation.
  • Something else needs to be put in place if something happens to Ring and Ride.
  • This is a big move forward.
  • The focus of the strategy and presentation is on choice and control, but the social workers are concentrating on the needs and not the assets and strengths of the individual.
  • There is a need for a quality framework as part of the strategy.
  • The strategy links with the 3 conversations, but there is no mention of this in the presentation.
  • The Strategy states how things should be done.
  • Where the 3 conversations programme is rolled out we are seeing some real innovative work, from social workers.
  • This is a positive way forward, and it is much needed.
  • Autism is missing from the strategy.

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11 April 2019 - Highbury Hall

  • Work must be based on person-centred care. Numerous calls are received by providers regarding “day rates” – this is where most of the interests seem to focus on. Focus must be around the particular person and service packages must be tailored to meet their needs. Someone’s disability is often seen before their ability.
  • Some service users who are non-verbal face more challenges. Support workers who are on minimum wage find this challenging. Disability is a huge issue, especially when assessing a person’s needs. It is particularly frustrating when there is a lack of funding or money available to meet the needs. Focus needs to be around the person.
  • “Funding” in most cases follows the disability. The more a person with a disability is able to do for themselves, funding is not available. Providers feel that the majority of their work is a “tick box” exercise, which does not personalise or take the person’s disability into consideration.
  • For example, someone with a brain injury is not personalised or categorised as a person with Mental Health, learning or physical disability and they feel “excluded”.
  • It appears that although a person with a disability may be able to do a lot for themselves, there are times when accessing the community is difficult, again with funding not available. Sometimes there is disagreement with the outcome of some assessments.
  • Providers were of the opinion that Social Workers are not using the “3 Conversations” effectively when assessing people, so opportunities, support needs and budget can be affected based on the outcome of any assessment.
  • In some cases there is a 6 month backlog with assessments and Social Workers are not communicating very well with providers and information is not being “filtered” through. More Social Care Facilitators are using the “3 Conversations” more than Social Work staff.
  • When timeframes are involved, this can be difficult as every person’s needs are different. There is focus too much on timescale and not the person’s requirements; which can change over time and in some instances will need to be reassessed.
  • There is often no flexibility in terms of people accessing the community and much of this is based around costs/funding. There are few places in Birmingham who cater for people with disabilities, which can be difficult when trying to access the community and can be expensive.
  • It has been known that Taxi Services want to charge an excessive amount of money just because a person has a disability and the taxi driver will not assist that particular person. This leaves them vulnerable and upset. Although there is a vast transport system within Birmingham, citizens of Birmingham still face huge prejudice and access to the community due to lack of catered facilities for disabled people.
  • The transition for some young people who are now adults is extremely difficult. Some are “lost in the system” and the expectation is that training and employment is available. People with disabilities face huger challenges and prejudice when accessing training and employment; which can have a detrimental impact on their mental health and focus in terms of moving forward with their lives.
  • Direct Payments is a great way of allowing a person more independence and choice, rather than a particular amount of money or funding being made available.
  • There have been times when Direct Payments have been misused or not used on the purpose it was intended for. Some with disabilities often lose hope and confidence if services or access to the community prevent them from leading an independent life. In relation to Direct Payments, it is about equipping that person to develop their skills.
  • It has been noticed that a lot of younger people are not having their referrals looked at in a timely manner – where are these people meant to go and what are they meant to do. They are stuck in a system that they can do nothing about unless someone actively acts on their behalf.
  • Direct Payments can take a long time to be sorted out and people with disabilities may have problems using the Direct Payments card i.e. a person who has sustained a brain injury would struggle in remembering access details or passwords. Direct Payments can also be open to abuse and not used in the best interests of a particular person – this needs to be monitored and the right questions need to be asked as to how this money is being spent.
  • Some young people’s expectations are high and expect “everything now”. They have to be educated to understand that policies and procedures need to be followed during any transition. People with brain injuries often feel that they do not fit into any category and are often overlooked. One example is that a person with a brain injury waited almost a year to access services; at this time their needs had changed and had to be reassessed.
  • There is also a lack of invention from hospitals and communication is poor. Ring and Ride is often unreliable and in some instances providers have waited for over an hour to get through by telephone.
  • Any money or funding should be used wisely and not wasted; as funding is limited. A more personalised service should be adopted to cater for individual’s needs and support requirements. Communication is paramount in terms of assessments and funding as this can take some time and budget applications need to reflect the actual needs of a particular person and any change in their circumstances.
  • There is a danger that people with disabilities will reach a “crisis point” if there are delays in funding, assessments being completed and change in need. This is unfair and needs to be tightened up to ensure the person concerned is not at a disadvantage.
  • Re Person Centred Planning: important to have continuous reassessment. Vital to have advocates involved particularly for those with latter stages of dementia. People can communicate at certain stages of dementia but need more specialist input later on and their care needs also change. Services need to keep on top of changing needs to preserve people’s dignity.
  • Re Person Centred Planning: Agree that it is important to get input from carers. But also key to get full information at the start from social workers. This doesn’t always happen and we don’t always get the full picture and can put additional pressure on the service.
  • Re: Outcomes that service users and carers wish to achieve: Carers want to know that the person they care for is safe and in an appropriate environment for their needs. Have to be mindful also that what the carer’s see as a priority isn’t always shared by the service user themselves, e.g. carers might want them to go out and about but the person themselves might just want to sit and watch television.
  • It’s also important to know about people’s interests and previous experiences. Particularly for people with dementia, so that we can tailor activities that might trigger certain memories. It’s about maintaining people’s sense of value and self-worth. It’s good to know people’s life stories as this aids conversation and what is important to them. Breaks down the barriers of ‘them’ and ‘us’.
  • Re: Access to the community: We do take people out and about, we go to pub lunches, have contacts with local schools and scout groups as well as local churches.
  • It’s also an issue of knowing people’s capabilities and managing these. Some people you might be able to take to the theatre others maybe to a park or gardens.
  • Re: Access to the community: Availability and cost of transport is an issue for services and can limit how often and where we take people out to visit. There is also the issue of toilet facilities that we have to consider before we go anywhere as well as access for wheelchairs.
  • Re: Access to the community: Due to transport costs and availability a lot of options to get people out and about are not cost effective.
  • Ring and Ride is expensive and not always reliable. Would be useful to maximise voluntary transport schemes or look at other funding options. As many services will struggle if Ring and Ride folds.
  • Re: Access to the community: Would be good to create more awareness among churches and mosques about helping people to access the community.
  • Difficult with employment as most of our service users are beyond employment age and have dementia. Though on an individual basis we do work with service users to maintain their skills, particularly domestic ones.
  • Have done some work with assistive technology. We’ve been looking to utilise the skills of college students in the local area as well as our apprentices to help with this.
  • Advocates and carers tell us that they struggle with Direct Payments. Particularly, those who are not very competent or confident with computers. A lot of people have told us that they don’t want direct payments.
  • In favour of direct payments if it means not having to chase Birmingham City Council for payment of invoices.
  • There is also the length of time it takes to get extra days via direct payments. This can take a very long time as it requires having a new social worker allocated whenever a request goes. Some people end up funding the extra days themselves in some cases or not at all.
  • Re: make the most of what Birmingham has to offer:
  • Re: Day Service Model. 
  • Not many comments from the group. Only said was that the boundaries between the different levels are not always clear cut and can blur.
  • It needs to be continuous, looking at later years of life, getting advocates/ carers involved
  • 2 way process, certain stage of dementia. 
  • Carers can have greater involvement. 
  • Management and careful reflection. 
  • Lack of LD referrals. 
  • Match need to location. 
  • Respite for service users, feel safe, enable stimulation and benefits.
  • Feel a sense of achievement e.g. chair hockey being so much fun. 
  • Outcome - maintaining a set of values. 
  • Key worker understanding background, life story worker. 
  • Be open to bereavement - a loss of a friend
  • Go out to access the community/ local schools. 
  • Issues with transport. 
  • In some cases toiletry issues. 
  • Able to visit all cultural facilities – mosques. 
  • Transport support - can adopt a similar system to education. 
  • Life Skills support. 
  • Employment of choice. 
  • Assisted teaching, utilising colleague, apprenticeship scheme. 
  • DP – better for provider, advocate and carer (if support is available). 
  • Management of DP allows for control. 
  • Use Birmingham Connect to Support and Accessible. 
  • Overall, very good, however, must need for regular reviews. 
  • Point 1: focus on the individual their strengths, choices, assets, and goals through person centred planning. 
  • Continuous reappraisal is important, have to look for advocates. 
  • Close observation and familiarity of needs is crucial. 
  • Different people come at different stages of illness so is important to review care needs as their state is constantly changing.
  • Involvement with carers is crucial, as is connection with social workers in order to gain a full picture. 
  • Management is crucial – don’t want to fail patients so assessments to see if providers are able to provide the appropriate care is important. 
  • Ageing population – fit into many different categories of care, not just categorised as physical or mental illness. 
  • Point 2: focus on the outcomes that service users and carers wish to achieve. 
  • Outcomes must be specific, e.g. respite. 
  • Safety. 
  • Friendship, a sense of belonging. 
  • Activities that are beneficial. 
  • Not all consumers of care want to complete active activities, some would rather sit quiet and watch TV but it’s the surrounding company that’s important – crucial to understand this with delivery of activities, important to consider everyone. 
  • Animals, music and singing – activities that bring out the best in people. 
  • Activities that encourage reminiscing- particularly for the elderly, giving found memories of their childhood/ early adulthood. 
  • Quality of life à sense of self-worth. 
  • Key people in their lives should be known to providers -care workers contribute to this, then providers can have meaningful conversations with patients where they can reminisce. 
  • Bereavement – encouraged to talk openly about emotions. 
  • ‘Club member’ as opposed to service user. 
  • Point 3: provide support that enables the person to access a range of opportunities in the wider and their own community as an active and equal citizen. 
  • School visits twice a year, yearly pub lunch. 
  • Transport – availability & cost prevent some activities. 
  • Wheelchair access. 
  • Concerns towards ring and ride. 
  • Cost effective transport schemes. 
  • Raising awareness e.g. Mosques, giving service users a right to go and pray if required. 
  • Point 4: focus on skills development, improving independence in daily living. 
  • Maintaining domestic skills is important if possible. 
  • Employers see risk employing someone with a long-term condition. 
  • Assistive technology – useful. 
  • Young employees employed by provider encouraged to get qualifications and continue to higher education. 
  • Creativity. 
  • Point 5: maximise the opportunity to use budgets or direct payments to access support or activities of the citizen’s choice. 
  • DP – better for some, others refuse. 
  • Chasing invoices – time consuming issue. 
  • Patients would rather pay themselves than waiting for their DP as quicker. 
  • Point 6: make the most of a vibrant and developing city, ensuring access to the wide range of opportunities Birmingham has to offer. 
  • Maintaining standards. 
  • Always looking at the bigger picture. 
  • Advertising beneficial information – printing can be an issue for some providers with lower funds. 
  • Model: Boundaries are often blurred and cannot be distinguished as easily. 
  • Regular reviews needed. 
  • Ideas regarding users and decision making. 
  • The 6 point plan is a good starting point but clearly won’t work for everyone, many user may still have very traditional needs and access to traditional services. However with this plan there is room for progression for users to move between categories. The system must be flexible and user-centred. Regarding implementation, there must be conversations discussing where people fit.
  • Shaping the market: There needs to be work done to increase the market of services. It must be shaped to fulfil the needs of service users. Furthermore, there must be work done on the quality of services provided - current providers should be worked with to see how their strategy falls in line with the council’s vision and are of a high quality.
  • Change: People are very wary of change, and they are most likely going to be wary of the idea of changing the system. Users must be looked at to see if the services are still compatible with and reflect their needs – changing their services will be met with resistance most likely. There are many users who don’t fall under the 1600 that BCC have said, and there must be more partnerships formed when the strategy is finalised to widen outreach.
  • Partnership: One provider gave the example of a young autistic man who was held back by the lack of services provided. The Day Care setting was not challenging him enough, and limiting his progressions. Furthermore, the mum could not afford more than one Day Care session, as the direct payment did not cover it. This lead on to discussing how partnerships between providers would allow for a more tailored approach where vulnerable adults could have the right level of care.
  • Due Diligence: The market of services has changed, and that means service providers are trying to be the best to get contracts. However, we cannot let this mean that due diligence is overlooked. Other councils create a preferred providers list, which can be helpful – people can still use those not on the list as well. Adult safeguarding must be made a priority under the new initiative.
  • Focus Point 6:There must be a balance between ultimate safety and supporting people to reach their full potential – don’t want to ‘wrap them in cotton wool’. The idea of utilising the ‘vibrant city’ was widely liked, and discussed. The council could utilise local charities to help service users make the most of the city. This could help put people on their personal journey rather than keeping them stuck and still in their current position.
  • Accessibility: Accessibility in the community is still an issue. Whilst some supermarkets and other places country wide have made more of an effort for accessibility to be made the norm, this has not been rolled out everywhere. Opening up a dialogue with the places would help.
  • This surely about choice vs practicalities.
  • Making informed choices for service users to keep up independence is very important.
  • The Direct Payments model is highly confusing for people with complex needs. The strategy needs to focus on enablement, taking into account health problems.
  • This seems like a good model, if realised. We need a clearer vision for who this consultation benefits and does not benefit.
  • Clearer language is needed over the meaning of this strategy.
  • The Three Conversations would seem to me to be a return to old fashioned social work based on community individual needs again. This is good, as social work assessments of people’s needs for day services and in general should be less criteria led.
  • I have concerns over the harder to reach citizens, and particularly supporting them.
  • Safeguarding Training when working with people with disabilities -Needs better regulation of the day care market and assurances that there is an effective governance structure.
  • Organisations need a good grasp of Adults and Children safeguarding processes – There were serious concerns about the current situation.

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16 April 2019 - Hollyfields

  • The use of the 3 tier model on page 20 of the consultation document was discussed by the group in-particular their thoughts on the enablement tier. The group concurred that it was true to where it should be. The representative from an organisation stated that they had already offered a similar model and had done for many years and was surprised that a similar scheme had not been replicated in Birmingham a lot sooner.
  • It was discussed whether enablement had a time limit on the various categories as some citizens needs could move around the services. It was highlighted that time is not always relevant as some citizens in particular those with LD needs and disabilities may enjoy the service and want to stay.
  • The benefits of a personalised service were discussed.
  • It was agreed that the definition of enablement and re-enablement were closely tied
  • It was recognised that some citizens sit above the enablement tier and this could be signposted and were advised to use activities in the community.
  • It was acknowledged that there were grey areas between the 3 models and through these community schemes some citizens had retained friendships for life and this was important for all those involved. It was felt that it would be beneficial to have some form of exit plan and it may well be established that they are actually in the right place. It was suggested that they could benefit from specialist support over a longer period of time.
  • This event had provided a good forum for networking and producing a Community Assessment.
  • It was agreed that an asset strength based approach rather than focusing on disabilities was a no brainer. It was thought that not only would the Citizens gain new skills that they would revisit old ones. It would complement a tiered service model to accommodate different needs. It was agreed that the new approach is the way forward if it is timely benefits tie in and there is a support structure in place. It is inclusive all Citizens have the same dreams and as the rest of us.
  • It was confirmed that it would be a Birmingham based service with resulting informed strategies. It was agreed that it would benefit from having local venues to hold meetings – i.e. Sutton Town Hall, libraries, community hubs and churches such as the facilities at the United Reform Church Sutton and Holy Trinity were suggested.
  • It was stated that there was poor communication in respect to volunteers and they were not encouraged or advertised for. Some could only offer a few hours a day and were not available for full days as they were was an aging population of service users and volunteers alike. In contrast one provider could only attract college and University students who wanted to further their career path in particular with child based project. Both had difficulties attracting the 20 – 40 year old bracket. Another provider stated that they had requests for 1-2 hours support and they could not get anyone to fill it as most paid support is minimum of 2 hours
  • Our Citizens need to consider: It was agreed that education is key to increase awareness on what provision is out there if they need it although there is an element of choice.
  • We also need to consider how we reach the most social isolated who are unaware of available support in the community.
  • Providers said they adopt a lot of this strategy already
  • Residential care space bigger than needed for just residential care which is why they started to also run day ops
  • Important that people who don’t want to attend day trips don’t fall through the cracks – find out why they don’t want to go out
  • Believed the model was too focused on negatives. Need to expand on the concepts they use
  • Care is often an escapism from reality
  • Can’t predict how people will be feeling each day, planning is crucial
  • Mixing different groups of people
  • IT is an issue for elderly people who haven’t got family etc with internet access to help them access care
  • Most referrals come from online and from the sons and daughters of service users, not everyone has access.
  • Services working together and joining up is crucial and beneficial
  • Simplifying information in terms of what care is available – easier for people to understand
  • Unsure how their Service will fit into the new model. Citizens who attend are 55 plus and attend as they are extremely isolated due to communication issues. Many can’t read or write or speak any English at all and it will be difficult for them to engage in the new model. None of them have issues with Dementia although there are many that are over 80 years of age. It was recognised that the younger generation of British born Chinese who are English speaking will be the generation that will benefit from this model in the future.
  • Community Meeting Places and Buildings are still needed. Some form of activities still be delivered in the traditional way as a way of groups still being able to touch base in familiar settings. Elderly citizens depend on meeting for lunch with friends and other service users, they benefit form sharing mealtimes together. There are elements of the models principles that could be delivered to group such as The Chinese Community Group, maybe a way of looking at promoting enablement where possible and looking at services that could overlap with other cultures and groups, identifying similarities in what each group of Citizens may enjoy doing, e.g. Dance, games etc.
  • Transport was discussed and an example of where Ring and Ride Service now allows Community Group to book transport on behalf of Citizens as they have nobody who can support them to do this from home so this is supported through the group.
  • Direct Payment – How can Birmingham City Council link citizens with providers to encourage uptake of Direct Payments. 
  • Other people outside Birmingham take part in the consultation. 
  • We need to focus/ tailor services to individual needs. What facilities are available for individuals because one thing will not fit all and where do service users go for more information on this. We cannot ignore needs.
  • Fewer and fewer places are available and it is difficult for people who want to access Day Services if there is no availability.
  • I do not know of any BCC services that do the things e.g. SoLo do.
  • Provider said this was frustrating because they have been working in this manner for a long time. We have a lot of service users that are Solihull residents. Why not use people outside Birmingham to tell BCC what they need/want/like.
  • We have a range of experience that we can share with BCC.
  • BCC services are outdated. BCC services are not fit for people with Physical disabilities e.g. Osborne Centre.
  • Putting all these strategies into place is going to be difficult.
  • Service Users tend not to have the background understanding of why they want to attend Day Services. Most Service users will say they just want to get out of the house. Service users need more aspirations e.g. learning a new skill. Service users don’t normally come to the Day Service with aspirations and staff have to work with them to develop this.
  • Day Services need to undertake ongoing assessments and get feedback from individual service users.
  • Service users need to do more than just sit in a base room.
  • Need a separate activity room for service users who do not want to participate in a specific activity.
  • A lot of service users are sent to specific activities but they need more choice of activities
  • Some of the Day Centres specialise for specific needs but it needs to be more flexible e.g. Moseley specialises in woodwork, Elwood does something else instead of all activities being in one specific day centre. We need to utilise the Day Centres more so that others can attend.
  • Centralised transport would be needed (point 3 of the proposals)
  • BCC services not fit for people with Physical Disabilities- Service user wanted to go swimming but was told he could not because they needed to provide changing places and a hoist. The service user has to wear incontinent pads when going out into the community.
  • Service user also experience difficulties at eating places in Birmingham. Generally it is difficult for service users to access services out in the community.
  • Public transport is more accessible than it used to be, but there is still room for improvement.

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18 April 2019 - Highbury Hall

  • Discussion around responsibility for person centred planning and whether responsibility for this includes social worker assessment as well as the provider services. Some members of the group felt that sole responsibility shouldn’t just rest with the provider of the service.
  • A member of the group from Solihull referred the group to the Learning Disabilities stand and also referenced an organisation called Plan For You who support person centred planning in an non-biased way.
  • Some members of the groups expressed concerns that social work approaches are not always non-biased.
  • Need to be mindful that when a person enters a service they may behave differently in different environments. How they present at the assessment with a social worker will not necessarily be how they present at a service. Behaviour changes depending on what environment a person is in.
  • Some members of the group expressed that they thought it was very important to set outcomes for service users and to evidence this. They did state though that they wouldn’t want it to be treated as a negative by Birmingham City Council if outcomes weren’t achieved. But stressed that they would try to achieve outcomes wherever possible. They felt it was useful to have regulations and to have a structure and framework to evidence outcomes. They referenced the Quality Standards that are being implemented as an example.
  • It was pointed out that the quality standards do not constitute as part of the consultation and are business as usual for BCC. Outcomes link to person centred planning and are specific to an individual and may change according to an individual’s needs and circumstances.
  • Another member of the group was concerned that there may be a mismatch between setting outcomes for organisations (this seemed to be a reference to quality standards) as well as for citizens. Again some anxiety expressed over whether organisations would be penalised in some way for not achieving outcomes for individuals.
  • Another member of the group expressed that it was a sign that services were expected to be more accountable for what they provide.
  • A member of the group described the places that their service takes people to, e.g. shops, pub lunches, etc. The service provides the transport and the service users decide on what they would like to do. They have been told that they can’t refer to this as enabling people to access the community as the service has organised the activities.
  • The same group member also said that members their service see the centre they attend as a hub. Seems to be a built in bias in the strategy for centre based services.
  • Another member of the group referenced that Solihull have very much changed their focus towards accessing the community. In addition to this there are also services that can come to day centres, e.g. a mobile cinema.
  • Discussion about people being institutionalised. Other felt that it is just as important that people feel part of a group and it’s not just about being institutionalised.
  • Support is needed to facilitate access to the community. Queries were raised about Ring and Ride and transport. Transport is expensive and if funding is being cut this will have a massive impact on what services can deliver.
  • General consensus of group was that this was welcome and there was support for this part of the strategy.
  • Some members of the group felt that more could be done to improve the direct payment system. It was described as being clunky and reference was made to length of time to get payments through.
  • It was stressed that it was important to get the budget and the needs right at the initial assessment. This is key.
  • Members of the group felt that it was important that this needs to be done in conjunction with other areas and organisations, e.g. town planning. Hopefully this would improve access issues such as wheelchair or toilet access. Access at places such as railway stations also came up in discussion. Transport and accessibility of transport was again raised as an issue.
  • Comment was made that Solihull have developed a very similar model and approach.
  • Very pleased to see a return to person centred planning. There are excellent tools available to do this in the right way.
  • Consensus that the Day Services Consultation should have the Citizen at the heart of it and this should be done with the service user in mind.
  • A Third Sector Provider highlighted how national charities help support older people post discharge from hospital to prevent re-admissions in terms of providing assistance with hospital appointments and shopping helping to keep Citizens independent.
  • Additionally “Healthy, Happy Lives” work with individuals to reduce social isolation. This activity very much follows the proposed strategy.
  • Shared Lives Colleague commented that Providers were very much interested in the work of this internal service.
  • Provider representative commented – that the 3rd sector provide grant funded activities via the Neighbourhood Network Schemes developments.
  • Provider – Specialised in Dementia services commented that there was a marked increase in dementia in an area of North Birmingham.
  • Lead Managers at Internal Day Centre commented that moving to the enablement model has had a good impact on Citizens and many are achieving aspirations. This support needs to continue. Needs further investment in training and facilities currently offered. This is a genuine need. Day Services are a valid service.
  • Trust Provider – Non-profit, working with BCC for many years. Provide support in recruitment and apprenticeships. Support Citizens to manage their finances. Support is shaped to the individual and promotes independence.
  • Citizens are entitled to support to move from personalised payments to direct Payments if they wish.
  • Collectively Providers felt that there was nothing that they disagreed with fundamentally. They are pleased to see that the Citizen is at the heart of the proposals.
  • Concerns – Providers were concerned about Direct Payments. For some Citizens this is a difficult process and they need assistance. Difficult to recruit Personal Assistants who are not always available at the time which is appropriate or required. Also do not always meet the individual Citizen’s interest areas such as bowling or other social/hobby activities.
  • Provider suggest perhaps set up a “bank” of Personal Assistants or “PA Finder” who could be called upon for a range of support activities and interest areas.
  • Providers also acknowledged that this may not always work. Some Citizens do not always want a variety of people calling in.
  • An example of this – A Provider related a situation which may involve a young person with LD who might like to go out socially but is unable to because of an arrangement where they are “put to bed early” as that is the time the Personal Assistant is available.
  • Need to also think about older people who are Carers. Providers thought that this was a serious concern as many Carers are elderly.
  • In BCC Direct Payments cannot be used to attend internal day activities. Local Authorities choose whether to allow this. Not all Local Authorities prevent the use of Direct Payments to access internal provision.
  • BCC should promote choice and independence. There needs to be a level playing field and should be an individual’s choice where Direct Payments are used.
  • Providers further comments - Providers were further concerned that Direct Payments cannot be used for preferred activities and is limited to meeting care costs whereas Personal Health Budgets can be used more comprehensively and promote independence. There is no choice and control around Direct Payments.
  • Providers agreed. Service provision is not equal.
  • Further comments – for many years LD services were seen as a “Cinderella” service. Funding was not equally allocated in comparison with other services. BCC have been reactive rather than proactive. Need to establish standard practice across services.
  • Providers generally agreed to the strategy proposals.
  • Flexibility and fluidity were highlighted as being very important, and the ideas of choice, control and opportunities were liked. Furthermore, the promotion of services needs to also be at the core of this strategy, to allow service users opportunities they may not have had before. People shouldn’t have to be stuck in the same service doing the same thing for years and years with no change (unless this is what they want), so the promotion of a whole range of services needs to be put in place.
  • The families and carers of service users can often be reluctant to change, and the idea of movement between the stages of the model may have some resistance. This reluctance comes from a place of worry but must be addressed as can lead to limits on the choice/control of service user. Many are lost without the service users and therefore dislike them going on residential etc. 
  • Service provision is changing, with there being more opportunities out there and the ability to utilise services like direct payments – it has allowed there to be events outside of day centres. Yet day centres are still central to services and there must be an emphasis on keeping these open and well-funded, to aid the citizens with their choice/control and independence.
  • In the community, there needs to be more done by BCC to help change attitudes and promote accessibility. This is how people will really make the most of a vibrant city, as currently a large section of people cannot use it, even if they have skills/training. Care has to now push boundaries. 
  • Overall the strategy has good intentions, and there was nothing really that people disagreed with, just that this is obviously a broad strategy and it needs to be applicable to all.

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