Agenda item

Purpose of the report: Scrutiny of Services

To inform the Select Committee of the proposed changes to how Surrey County Council commissions day care for older people and people living with dementia.

Declarations of interest:

None

Witnesses:

Jen Henderson, Senior Commissioning Manager, Adult Social Care

Dave Sargeant, Strategic Director, Adult Social Care

Key points raised during the discussion:

·        The Senior Commissioning Manager (SM) provided the Committee with a brief introduction to the report outlining ASC’s proposal to transform the services that it offers to residents with care needs arising from dementia. Members were informed that the one size fits all model based around days centres has become outdated as they aren’t able to offer the breadth of services required to support people at different stages of dementia. This is particularly true for individuals with early onset dementia for whom the services provided day centres often aren’t appropriate.

·        In light of this, ASC has done a great deal of work with existing providers as well as people with dementia and their carers’ in an effort to move away from block contracts towards commissioning bespoke services that can support people with all stages of dementia. Members were advised, however, that there is still a place for day centres particularly for in supporting individuals with advanced dementia and so some services will continue to be provided from day centres.

·        Some concern was expressed by Members that the model proposed by ASC for transforming the delivery of services to people with dementia could lead to a more fragmented access to services. Assurances were requested that ASC would continue to be able to deliver the suite of services across the county that were previously accessible through day centres. The SM stated that day centres will continue to be an important part of the framework through which services will be provided but the commissioning of bespoke services is about recognising that day centres aren’t suitable for everyone.

·        The Committee asked how ASC are planning to monitor providers to ensure that they are delivering good outcomes for people with dementia. In particular, Members asked what provisions there will be for assessing smaller providers who can’t necessarily deliver all of the desired outcomes but are still providing a valuable service to dementia sufferers. The ASM stated that providers commissioned by ASC to deliver services will be required to sign up to an outcomes framework against which their performance in relation to stipulated objectives will be evaluated. There will be some flexibility for smaller, less-established providers, such as community groups, who provide valuable support but don’t necessarily meet the outcome criteria, when they are ready they can join part the framework as it is a dynamic system

·        Members inquired about what provisions are being developed to help people who don’t know or refuse to acknowledge that they have dementia. The ASM acknowledged that there are a significant number of people who don’t know they have dementia with some estimates suggesting that 39% of people in Surrey with dementia aren’t aware they have it. SCC is currently working closely with health providers to promote timely diagnoses for people living with the illness to ensure they get the support they need.

·        Information was requested on the progress of Dementia Friendly Surrey amid concerns by Members that the initiative appears to have lost momentum recently. The Committee were informed that the focus has moved to dementia friendly towns and that work on commissioning dementia services has been more closely aligned with work being done on the Family, Friends and Community Support programme.

Recommendations:

·        The Committee endorses the direction of change for dementia day care services and note the improvements that this will make for older people and carers in Surrey.

Actions/ further information to be provided:

            None

Committee next steps:

            None

George Johnson left the meeting at 11.50