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Comments from provider events 5 June 2019 - 24 July 2019 | Adults Social Care Day Opportunities Consultation 2019 | Birmingham City Council

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Comments from provider events 5 June 2019 - 24 July 2019


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

5 June 2019 - SEN Schools Colleges

  • Some parents choose not to send their child (young person) to a day centre because of the quality.
  • Pathway Plans are not completed until a young person reaches the age of 16, just as they are leaving school.  Schools are asked to prepare 14/15 year olds well in advance of a Social Worker completing the Pathway Plan.  School/College staff believes that the pathway plan should be completed at aground the age of 14/15.  Adult & Communities Access Point (ACAP).  service is far too long winded.
  • In some cases, the Pathway Plan is not completed before the young person leaves school and it could take up to three years for a Social Worker to make contact with the young person.
  • Parents are overwhelmed by the referral form which can only be completed online.
  • There isn’t enough choice for young people.
  • There should be a more robust transition process, Social Care lose sight of where these young people are after leaving school or college and they don’t know what they are doing in many cases they are sat at home.
  • Funding is confusing for parents, they cannot understand why when a young person is classed as an adult the funding reduces significantly.
  • How will the proposed model be supported across different agencies education, Health and Social Care all in different pockets at the moment makes funding very difficult.
  • Day Care is for all ages, however a young person doesn’t want to go to a day centre and do the same activities as an 80 year old with Dementia and the 80 year old doesn’t want to carry out the same activities as the young person.  It was felt that whilst people should interact with people of all ages and with different disabilities there should be a resource purely for young adults.
  • The group suggested a service specifically for the 18 – 30 age group should be considered as an option.
  • Generic services / day service doesn’t work it is too broad – very difficult to find staff that are specialised to work with all. 
  • It is very difficult for a young person to be allocated a Social Worker.  The young person may have been allocated three / four different Social Workers before they meet their Social Worker.
  • Day centres should become hubs; a network should be built up so that people are aware of what activities they can access where.
  • It is a continuous challenge to find the right opportunities and support for young people that have left / leaving school or college, better networking is required across to the different agencies to ensure the right level of support and activities are available to the young person.
  • Example – Standing frame in a day centre a young person had only been given the opportunity to use once a month.
  • Transferring young people with disabilities in to mainstream schools can work, however a lot of the mainstream organisations don’t have specialist staff to support / meet the needs of the young people e.g. not all schools have a nurse.
  • Staff that are not trained to deliver the required support can lead to safeguarding issues, parent don’t have confidence in the services that are available.
  • The group didn’t have any negative comment about the proposed six key principles or the model.  They believe that with the correct funding and specialist staff it would be successful.  Please don’t try to implement to quickly start off with small steps that are manageable.  Review as you grow.
  • Some people expect Social Workers to be the font of all knowledge.  Social Workers should admit when they are not able to answer a question, but you will go away and find out the answer and come back to the person / family.
  • Access to work will pay for transport for young people to travel to and from work.
  • It was suggested that a transition worker be allocated to a young person from the age of 15 until that young person reaches the age of 25. The worker would grow to understand the young person’s needs, their family network and what might be required to meet the young person’s needs.  A robust plan could be drawn up, the family would get to know the worker and have a level of confidence in both the service and the worker.
  • There is a requirement for additional social workers / transitions workers at the moment there is only two allocated to each school or college.
  • Social Worker / Transition Worker – As part of the team’s development each worker should cover placements in a school / college enhancing their skills and knowledge across varying levels / types of disability.

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13 June 2019 - Cerebral Palsy Midlands - Service users

  • Social workers are always changing we don’t get the same social worker.
  • Member of staff at the day centre - explains that you don’t need an allocated social worker once your package of care has been approved.  You only require the services of a social worker if there is a change in need or a review taking place.
  • Public facilities in Birmingham are getting better / more accessible.
  • Enablement helps you to live an independent life.
  • Enablement supports you with your reading.
  • Personalised support is available when we go swimming and horse riding.
  • If you don’t have a named social worker it is upsetting.

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18 June 2019 - Focus Birmingham - Carers

  • You have to supervise a P.A.
  • It is very difficult to access a good PA
  • There are some good PA providers that provide payroll services
  • Having a direct payment is like having a job you have to send out timesheets and send a report to the Court of protection.
  • Told by a social worker that had to have a direct payment for 3 days. No options were given; this has happened for a number of families in particular the transition team. Definitely didn’t have a choice.  Didn’t know they had a choice and could refuse a direct payment. BCC explains how the pre-paid card works.  Social workers are giving different messages about what a direct payments can be used.
  • QAC 106 leaves this year only 2 have applied to focus there will be a massive group of young people doing nothing.  There is nowhere for then to go.
  • How many of the 6 steps are relevant to the people in this centre.  They send their loved one to focus because they need to not because they want to.
  • The six steps won’t improve lives of people that come to focus they are not the most relevant to people that come to focus, don’t want to review to take place.
  • Leave it as - there is no need for change.
  • Left Victoria at 19 and her mother couldn’t find anywhere for her to go until she became 23 – she is now 40.
  • Some families go out into the community together
  • There are too many limitations & restrictions for both direct payments and managed budgets. Accessing activities in the community will cost money e.g. paying for a member of staff or PA to go in to the cinemas or eat a meal.
  • Activities are expensive not just for people with disabilities
  • The provider believes things will be forced on their client group that does not meet their need.
  • Enablement activities that will be paying for the additional activities such as using a suitable hydro pool.
  • Lots of great ideas, Cabinet will say “No” if there is no money.
  • There is no mention of finance within all documents
  • Need to locate a Hydro pool in Birmingham for daughter – Wilson Stuart and Victoria open in the evening Focus to investigate.
  • From school to adulthood – not much support - BCC should offer better support.  All enjoyed Victoria school, but the move from child to adult you lose a lot of support.
  • Can’t get on public transport – lack of accessibility, can’t accommodate. Suitable wheelchair support and personal changing rooms
  • Assessment need should be accommodated
  • Social services – no consistency- social worker changeover – lack of manager support – need to be better with the 3 conversations model.
  • Enablement support older age people
  • A lot of fine words about enablement but we have heard this all before.
  • Can’t see how any of this can be implemented given issues with costs and practicalities, e.g. cost of travel and cost and lack of availability of services such as hydrotherapy. Don’t imagine that Birmingham City Council will build any new swimming pools.
  • No enablement in practice – all pie in the sky ideas.
  • My relative can’t get into the city centre using public transport.  Wheelchair won’t fit on to the bus as the space from platform to seats is too narrow.
  • I don’t see how this will be put into practice when Birmingham City Council are no longer funding transport and are cutting community transport.
  • Find it difficult to access buses and taxies because wheelchairs don’t fit.
  • Wheelchairs have to compete with pushchairs on buses.
  • Still issues with reliability of Ring and Ride services as well as uncertainty around its future.
  • The clean air zone will make it more expensive to travel in to the city centre.
  • Have to pay £100 p/w to transport relative to and from the centre.
  • Compared to what services there are for children there is nothing for adults.  The gap in provision and support available is very large.  Experience of transition was very poor.
  • No changing facilities in a lot of places.
  • Have tried Access Able but their website is not easy to use.  Difficult to clearly see where facilities are located.
  • Can’t access a lot of places, such as the cinema, bowling, swimming pool because they don’t have hoists in the toilet.
  • Don’t even have sufficient toilet facilities in hospitals, e.g. Royal Orthopaedic.
  • This city centre is not safe – don’t want to go there.
  • Lack of money impacts on choice and range of activities available.
  • There is no money for all of this extra stuff.
  • BCC are only interested in balancing the books, their budgets and politics.  It’s all about money not on providing facilities.
  • Needs to be a commitment from the top to invest money in day care so that these principles can be implemented.
  • Sound great in theory but will not be implemented as there is not enough money to do it.
  • Agree with the ideas but have seen this all before – 30 years ago – and nothing has changed.

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18 June 2019 - YMCA Sutton Coldfield - Service users

  • Like to spend time with friends
  • Went to Wales
  • Enjoy cooking
  • Like to do Arts & Crafts
  • Like Computers
  • We do rehearsals – 2 shows per year
  • All use buses to go to New Oscott
  • Enjoy Relaxing here
  • Like the football
  • Service User has a job at Co-op – enjoys washing up.
  • Enjoy the swimming
  • Want to go to London – visit Arsenal FC
  • Wants to live independently with girlfriend.
  • Would like to see more toilets with hoists.
  • Would like the opportunity to go out on a 1:1 basis more – at moment have to go out in a group.
  • Have been travel trained but struggle with going on public transport as it is often too busy.
  • Use Ring and Ride but it is not always reliable
  • Would like to travel by train.
  • Not always traffic lights on busy roads which where I can go independently.
  • Enjoy shopping and swimming.  Do lots of different things.
  • Enjoy washing up and cleaning.
  • Important to come to centre as have lots of friends.  Also have friends away from centre too.
  • Enjoy cooking – where there are kitchens which accommodate wheelchair.
  • Enjoyed being a student counsel rep at college
  • Enjoy helping out with paperwork
  • Get a voluntary job at Aston Villa
  • Live independently but would still need some support
  • Good at using smartphone – would like to do a photography course

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19 June 2019 - Care First Carers

  • Would like GOLDD back (like at Fairways).  There should be living old with dementia in the south of Birmingham.
  • Would like to encourage the ethnic minority groups to be actively involved with carers group – they may need support
  • No Groups, no specialist nurses for dementia
  • Transport is costly and is a big issue
  • Accessibility (for people with Cerebral Palsy) – lack of changing facility.
  • Resources (lack of funding and support)
  • Needs better transport services from taxis/ buses.
  • DP issues – prepaid cards – it the transport you can’t get – mobility does not cover all cost – need to send receipts in even if you have this card.  It is very time-consuming.
  • Simplify process is D.P., no flexibility with change of days – won’t let activate a taxi if not within their list.
  • Carers need to be recognised as full-time employers
  • What to see actions please, less talk
  • Day centres should be CQC regulated - find this quite shocking
  • The principles are a good thing as long as the aim to improve the citizen
  • It will be difficult to meet a variety of level of needs
  • Offer varied activities to continue to stimulate with a day centre
  • My son goes to do wood work at the centre                   
  • Likes to come every day to Care First
  • Attending day centre 9 years. Not once contacted by Social workers
  • Lack of assessments (annual reviews)
  • Transport is a big issue, poor quality taxi system
  • Need to ensure its fit for purpose.
  • Carers have a lot of anxiety with the transport. 

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25 June 2019 - Hollyfields - Provider Post Amendment Event

  • Not seen as being significant, the principles remain the same across the board.
  • Can be hit and miss most times, BCC are offering Enablement but then restrict choice, discussion took place in relation to Social Workers pushing Direct Payments as explaining that BCC choices are limited.
  • Difference of opinions between Health and BCC Funding, there is no consistency.  Also the differences between packages of care offered to Children and Adults.  This can be detrimental to The Citizen who has come out of Child Care Services and then is offered less support as an Adult which leads to crisis.
  • Telephone reviews are good and some of the group felt that they had been productive.  There is some good work being done by some of The Social Work staff but unfortunately where there are agency Social workers involved then there is a lack of follow up and often what is promised in a review is never delivered.
  • Providers commented that the Health system is working much better than BCC as their assessments produce exact funding and identify very clearly what package of support is needed.  Social Work Assessments do not provide this level of support.
  • PA’s are not monitored and needs are often agreed by Families/Carers.  Work needs to be done to ensure that there is at least a minimum care standard to be reached e.g., First Aid certificates, minimum of Level 2 in Care.  There is clearly still a “Do as I say” attitude happening at the moment.
  • There is a lot of creative work being done by The Providers with positive outcomes within The Community.  Transport and access remains an ongoing problem.  Risk assessments are still needed in a number of areas before taking Citizens out into the community.
  • The providers are working well currently with local communities often forming good working relationships with Business Owners who will see Their Citizens on a regular basis and will form an idea of what their needs are.  Providers are challenging places that aren’t accessible.
  • Discussion took place around working with Parents and Carers to open up opportunities and hopefully remove restrictions and obstacles that prevent community based activities.
  • Amends make less threating and softer.
  • It has caused anxiety with the Internal; the “closure” word was not in the original.  As a manager, I’m trying to give reassurances, but it is not working.
  • The change was not there before, they will home in the sentence - it’s hard to disguise – very difficult to manage.  They want full answers.  They don’t want change; there is a big fear of the unknown.
  • Many have been at the centre for years – carers must be in a huge panic.
  • Ebrook staff/ service user – the change has been good as they have seen what’s out there in a different practice.
  • Learn from other internal centres strengths; give them a better choice of activities.
  • Ensure a very robust transport strategy e.g. wheel chair access on public transport is poor. 
  • Ring and Ride  (better processes are required)
  • Ratios would be greater
  • Manage routines dependant on the individual – support model may differ – variable level of need.
  • Don’t filter service users by level of need, some of the community not ready to take up this challenge e.g. service user attend church coffee morning – started to swear.
  • Difficult behaviours are not obvious; there is a need for research to find out more about the individuals.  A lot of service users want to be in a group not one to one.
  • Lack of confidence, fear going out, worried about the reaction of public.
  • PA’s are sometimes a waste of time – some workers not paying attention to the service user. PA’s should be monitored in terms of level of training.
  • Community with support would be beneficial dependant on the readiness of the community.
  • In house transport services to support specialisms.
  • Centre of Excellence would be a good idea.
  • Variable activities, with flexibility and appropriate integration.
  • Complex needs should be integrated with others to allow for stimulus.
  • Mixed group level of need to support each other.
  • Need to educate all within the community.
  • Model should not segregate

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28 June 2019 - MIND carers  

  • There is a fair amount of employability support available for people with mental health issues but very few people get a job.
  • Whilst going out into the community is important it should be recognised that day care centres can be their own communities.
  • Day centres are specialist meeting the specific needs of a diverse group of people.
  • Too many community services are not available to the public, e.g. swimming pools not open.
  • People’s needs are increasingly changing and becoming more complex.
  • Day care centre is not a medical model. It values people rather than focusing on the disability.
  • People with mental health issues often need a safe place in the community where they can drop -in, spend time, get support, all without being stigmatised.
  • Co-production with service users is essential and progressive.
  • Direct payments can be challenging for people who experience anxiety or who hoard.
  • Day care centres are not ideal for people with chaotic lifestyles.
  • Peer support can be very powerful.
  • There is such a Broadchurch of services and clients and you will always need services for people who are unlikely to ever fully integrate into the wider community.

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24 July 2019 - Dementia meeting regarding day opportunities consultation at Stirchley Baths 

  • Many adults with dementia need smaller groups and/or1:1 support
  • Providers are seeing a slowdown in referrals even though BCC talks about increases in numbers of adults with dementia
  • There is a lack of information about direct payments. It is challenging organising your own support.
  • Older adults worry about invasion of privacy and stigma.
  • Carers can find themselves having to give up their careers and independence. This is a form of bereavement.
  • Delighted – that the amendments have been made.  Older people want to be in a place where people can be well looked after.  Believes that the service is as much for service users as well carers.  Offers a life line to carers. People with complex needs require a day centre.
  • About bringing additional activities in the centre rather than people visiting a variety of different places.
  • A day centre doesn’t work for all some users do not want a busy day centre we support on 121.
  • Carers do get together and arrange things themselves taking their loved ones out themselves can be unstructured.
  • People are reluctant to offer support to other outside their family due to health & safety.
  • Direct payments not offered enough.
  • Service users are being told they cannot access this service with a direct payment it is too expensive.  They are told that they can attend if they top up themselves.
  • Age UK receiving referrals from other day centre as the centre can no longer offer the support that the person requires there is no increase in funding.
  • 8 clients to be reassessed because care needs had changed.  Response Group Manager did not have capacity at the time.
  • The 3-conversation model 2 slow things down.  No Flexibility with jumping from can 1 to can 2.  No consistency across social workers.
  • We are changing the way we work for younger people getting in their 50’s. Having sessional groups.  Within 1 centre – room divided in to different activities e.g. nail painting & gardening have increased the staff to support the model – We also have volunteers coming in and running activities.
  • Lower level dementia doesn’t necessarily need a day centre or supervision there is not enough, clubs etc.  Out there in the community. Some organisations don’t want people with mild dementia to attending their clubs etc out their clubs.
  • Council/organisation should be educated to work with people that have dementia.
  • Black, Asian and Minority Ethnic (BAME), we need to be inclusive. Assurance given to Cllr that we have involved people across many groups.
  • Difficulties of how we get people involved outside the house.  Some people are very private.  Some people’s perception of day centre is a feeling that their life is being taken over by other. 
  • We haven’t quite got where we need to be for a number of reasons.
  • Drying up of carers.