Agenda item

(a)       That the Committee support the implementation of the Learning Disabilities Commissioning Strategy following final consultation and informing sessions; and

(b)       That the Director of Community Services request current information on the impact of welfare reforms for discussion at the workshop on 8 November 2013.

The Head of Adult Services introduced a report detailing plans for the provision of accommodation and support to persons with a learning disability in Flintshire over the next five years.

In providing an overview of the report, he highlighted the key points in the summary and main strategy document which indicated current provision in Flintshire and the anticipated five year model.  He summarised the vision for a range of accommodation options to enable people to be as independent as possible with ‘just enough support’ to promote their wellbeing and ensure their safety.  The strategy also aimed to increase the number of people using direct payments/Citizen Directed Support (CDS).  In conclusion, the strategy aimed to give people greater choice on independent living, where needed, in light of the increasing population of people with learning disabilities.

Councillor A.I. Dunbar asked if there was sufficient housing and support available for people who wished to move on.  He referred to people with learning disabilities who currently lived with family members and said that enabling some to live independently was a major issue requiring adequate support.  The Head of Adult Services explained that additional housing options, such as 12 flats in Mold, were being developed for this client group over the coming year and future plans for extra care provision would include options for those with learning disabilities.  It was accepted that individual support planning was needed to cater for varying needs and the Council would continue to support those who were living with people with learning disabilities.  An appropriate measured process was in place to help individuals achieve more independent living if they wished.  Options for overnight care provision could involve a ‘keyring’ model of support or use of the Telecare service, however a particular model would not be imposed on any individual.

Councillor M. Bateman asked about the range of need and percentages of the client group.  The Service Manager (Disabilities) explained that learning disabilities spanned a wide range of needs and gave examples where high and low levels of support were currently being utilised.  She explained that although there was a lower percentage of people with profound and multiple learning disabilities in the county, the number in this particular client group was consistently higher than in other North Wales Authorities.  Officers worked with the Housing section and Accommodation Group to create opportunities for housing needs and could plan transition from an early age via Children’s Services through to adult lives.  When asked about the potential for a breakdown of a situation, the Service Manager said that officers would opt to change the level of support accordingly, as opposed to removing the person from their situation.  She added that individuals would have their own tenancy agreements and therefore the same rights would apply.

Councillor D. Wisinger sought information on the number of people with learning disabilities who may need to move to a smaller property as a result of the ‘bedroom tax’ and the financial impact of such moves.  The Contracts Manager advised that she had recently spoken with the manager of the Receivership Team, who were responsible for supporting individuals to manage their finances in their tenancies, and that no-one in this client group had been identified as being financially challenged by the new approach.

The Chair reminded Members that there was an opportunity to raise such issues at a workshop on Welfare Reform scheduled for 8 November 2013.  The Director of Community Services commented that there had been an impact from welfare reforms and would ask Paul Neave to provide the latest information for the workshop.  The Facilitator added that Paul Neave and a representative from the Department of Work & Pensions would be in attendance at the workshop.

Councillor D.I. Mackie felt that the flow of the report could have been greatly improved and questioned the range of choice available to those listed in the strategy.  The Contracts Manager explained that the layout of the report followed national guidance set by the Welsh Government (WG) and that a summary had been provided to show the needs analysis of this particular client group.  Whilst some people were in supported living arrangements in Flintshire, some were in residential homes (mainly out of county) due to specific individual reasons and the aim was to have an extensive range of accommodation available in Flintshire.  The figures in the table showed that a large number of people were in shared accommodation in three-bedroom models within Flintshire, although there were challenges in this matching-up process.  The assessment of those in historic complex out of county placements to potentially move to nearby provision was part of work being undertaken by the North Wales Commissioning Hub.

Whilst thanking officers for the informative report, Councillor W.P. Shotton sought further details on CDS and asked if there was adequate provision at extra care facilities for the increasing number of people with moderate to severe learning difficulties aged 65 and over.  He referred to the example shown in Box 3 of the strategy where a man with learning disabilities had moved on from his parents’ home to supported accommodation and said that in cases such as this, consideration should also be given to any support needed for the parents in going forward.

The Service Manager explained that a number of authorities, including Flintshire, had extended the concept whereby monies were allocated to individuals to pay for support or equipment to help them achieve what was important to them.  She gave an example where a one-off purchase by an individual with a physical disability had proved an effective way of meeting needs in a cost-effective way and said that this initiative could be broadened to help those with learning disabilities.  The Head of Adult Services said that provision for those with learning disabilities would be built into future extra care accommodation to meet needs.  He referred to the increasing number of people with Dementia and the facilities available at Llys Jasmine.  Officers would continue to work with young people who wished to remain with their parents with access to direct payments.

Councillor H.J. McGuill raised concerns about responsibility for the sexual health of people with learning disabilities in shared accommodation.  The Service Manager advised that the Learning Disabilities Nurse service worked alongside Social Workers to provide specialist support where a need was identified.  Work was also carried out with young people via group talks and general health support assistance could be provided by trained support staff.  In response to a further query, the Service Manager said that individuals with a tested mental capacity would assume responsibility themselves, otherwise responsibility would be established and agreed beforehand.  In addition, safeguarding procedures were in place for those harmed or abused.

Whilst acknowledging the need for changes, the Chair spoke about the challenges faced by some people in adjusting to a move from a structured care package to reduced arrangements and was concerned about protection for those for whom ‘just enough’ care was not sufficient.  She referred to the target for increased levels of access to direct payments/CDS and said that many people would not have the capacity to manage choice of care packages which may require the involvement of Social Workers.

The Head of Adult Services commented on the smooth transition from children’s services to adults and confirmed that appropriate safeguards were in place for those currently within the service through regular reviews by specialist nurses and social workers to identify any problems and re-assess care levels.  In response to comments about a case reported in press coverage from another area, the Contracts Manager spoke about the close working relationship with the Care & Social Services Inspectorate Wales (CSSIW) and said that information on organisations going into administration would be shared.

RESOLVED:

(a)       That the Committee support the implementation of the Learning Disabilities Commissioning Strategy following final consultation and informing sessions; and

(b)       That the Director of Community Services request current information on the impact of welfare reforms for discussion at the workshop on 8 November 2013.