EQIA 1 day services Version Revised
Argyll and Bute Council · 27 March 2024
Back to Argyll and Bute HSCP Integration Joint Board (IJB) — 27 March 2024 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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Version February 2020, to be reviewed 2022 Equality and Socio-Economic Impact Assessments Section 1: About the proposal Title of Proposal The proposal asks the board to support the review of the model of HSCP provided day services for older adults. This will maintain the current position as it is during this financial year with budget savings from vacant posts. The current budget allocation for services is £500,000 and the vacancies saving would equate to £160,000. The remaining £340,000 would be used to redesign the service in consultation with local communities, reduce building based services and reduce inequity of services across Argyll & Bute. At present there are 33 users of service. Current internal service provision in Argyll & Bute is delivered at: Struan Day Care in Dunoon Thomson Court Day Care in in Rothesay Lynnside in Oban It is acknowledged that these three services are unique in Argyll and Bute and the model is a priority for review to ensure modern equitable service provision is in place across the whole of Argyll & Bute for older adults. There is only one other day service for older adults which is a commissioned service. Efficiency savings are recommended for financial year 2024/25 (maintain status quo) alongside the commencement of full review and engagement. Review will include what day supports could be offered in each community for older adults whilst acknowledging that we need to maintain a focus on savings within the older adult budget given the financial climate. A more detailed proposal of this provision would be developed in consultation with communities and returned to the IJB In September via the Finance and Policy Committee. The review will include a focus on unpaid carers and supports for people with dementia, current service users, staff and local communities as well as the Third Sector provision in each area. Options of generating income will also be considered. Intended outcome of proposal For the fiscal year 2024/25, the maintenance of vacant posts will contribute to an overall savings plan within the HSCP. Some efficiencies may have to be made, but the overall position will be maintained as is. A full review and consultation shall take place in 2024. An EQSEIA has been completed as the outcome of the redesign may affect the delivery of service as it currently is, particularly if the full saving from day services is required in 2025-26. However, we require to engage on this redesign. A more detailed proposal for approval to the IJB on a modernised service after community consultation. Impact: operational Description of proposal
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Version February 2020, to be reviewed 2022 Proposal There are currently 3 day services provided internally in Oban, Dunoon and Rothesay. They currently support 33 people. However it is acknowledged that there is also a substantial waiting list for one service. People attending often have dementia and are cared for at home and the key risk to withdrawal of the service is the risk of carer breakdown. For 2024/25 a savings target of £160k is challenging but it will be largely delivered through the non-replacement of currently vacant posts. It is acknowledged however that maintaining this saving will require full discussion with local managers about how the service can be maintained at its current level. During 2024, the service will look to see how it could be redesigned to offer a more outreach and flexible model, and/or if income can be generated to cover costs, each location (place) we will look to see whether alternative day supports can be found in each community. A full proposal will be brought to the IJB in September as part of normal decision-making processes. Background Day services were closed during the COVID 19 pandemic and they reopened with a focus on delivering respite for carers, with fewer people attending and having very individual needs. This service is currently provided free of charge. The service largely moved away from the traditional building based model of support where people would attend day services to engage in a wide range of activities aimed at increasing independence and socialisation skills. People attending were previously charged for the service and this in turn contributed to the running of the service. All support is provided within the service location and to that extent this is a building based model. Whilst there are recognised difficulties within recruitment/retention across Argyll & Bute, Local Managers advise that day support service are not impacted by this. It should be noted that there is inequitable day service provision for older adults across Argyll and Bute and we would seek to address this with a model suitable for remote and rural locations. Proposal It is proposed that the HSCP reviews the model of day services as indicated and consults fully on any changed model, whilst accepting efficiencies and savings have to be made. Over the next financial year the service will examine the full savings to be made to the HSCP. HSCP Strategic Priorities to which the proposal contributes The Strategic priorities for the Health and Social Care Partnership are detailed in the Strategic Plan 2022-25. • Ensuring services deliver a more personalised type of support within the community. Increasing financial constraints and service demands created by a growing older population is increasingly challenging. Essential services such as care home provision and care at home services are not presently being considered within the scope of savings targets but are being examined to ensure they are as efficient and effective as they can be.
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Version February 2020, to be reviewed 2022 Lead officer details Name of lead officer Caroline Cherry Job title Head of Service Department HSCP Appropriate officer details Name of appropriate officer Simon Deveney Job title Senior Manager- Resources Department HSCP Sign-off of EIA Caroline Cherry Date of sign-off 26/3/2024 Who will deliver the proposal? Head of Service and Senior Manager (Resources) Section 2: Evidence used in the course of carrying out EIA Consultation / engagement Unit managers-Direct discussion on the proposals and impact. Staff working in the services-A letter informed potential closure so that this was clearly communicated however this now needs communicated that this proposal is not being considered this year and instead there will be a full review. Trade union representatives-Email sent and representatives sit on the IJB. People using the services- A letter informed potential closure so that this was clearly communicated however this now needs communicated that this proposal is not being considered this year and instead there will be a full review. This work has not yet started so the in depth engagement processes have still to be developed. Data Financial Data– Social Work Finance Team Staffing Data – HR/Finance Service level and demand data. Other information Discussions to identify interest from third sector providers with a view to moving forward with more community based approaches within existing budget constraints. Gaps in evidence Identified individual needs within each area and longer terms service planning Section 3: Impact of proposal Impact on service users: Negative No impact Positive Don’t know Protected characteristics: Age X Disability X Ethnicity X Sex X
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Version February 2020, to be reviewed 2022 Negative No impact Positive Don’t know Gender reassignment X Marriage and Civil Partnership X Pregnancy and Maternity X Religion X Sexual Orientation X Fairer Scotland Duty: Mainland rural population X Island populations X Low income X Low wealth X Material deprivation X Area deprivation X Socio-economic background X Communities of place X Communities of interest X If you have identified any negative impacts on service users, give more detail here: If any ‘don’t knows’ have been identified, when will impacts on these groups be clear? At the moment there are 33 older adults who would be directly affected. However it is acknowledged that there is also a substantial waiting list for one service. These individuals would be supported through in-year efficiency savings by ensuring person-centred assessment of current use and alternative supports. Impacts of the review will be made clear through engagement and the development of a proposal for service change. How has ‘due regard’ been given to any negative impacts that have been identified? Each individual’s needs will be reviewed and alternative supports will require to be found. Impact on service deliverers (including employees, volunteers etc.): Negative No impact Positive Don’t know Protected characteristics: Age X Disability X Ethnicity X Sex X Gender reassignment X Marriage and Civil Partnership X Pregnancy and Maternity X Religion X Sexual Orientation X Fairer Scotland Duty: Mainland rural population X Island populations X Low income X Low wealth X Material deprivation X Area deprivation X Socio-economic background X Communities of place X Communities of interest X If you have identified any negative impacts on service deliverers, give more detail here: Should redesign occur, all staff will be consulted over alternative employments offer that will
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Version February 2020, to be reviewed 2022 be in keeping with their existing employment terms and conditions. Relevant unions will be involved as normal. If any ‘don’t knows’ have been identified, when will impacts on these groups be clear? Once a full review has been undertaken. How has ‘due regard’ been given to any negative impacts that have been identified? As above, a full review involving staff and Trade Unions. Short Life working group. Section 4: Interdependencies Is this proposal likely to have any knock-on effects for any other activities carried out by or on behalf of the HSCP? Yes Details of knock-on effects identified Two of the current day services are delivered within existing internally managed HSCP care Homes – 1 in Dunoon and 1 on Bute. The current attendees have high levels of need and the alternative care requirements may fall to care at home services or admission to long term care. Local Managers give the perspective of pressures on carers and very little community support that can be seen as an alternative to the current model, particularly in Bute. This may have the knock on effect of more people needing to access 24 hour care services. Note there are also pressures on care at home and potentially unpaid carers. Mitigations A number of third sector providers deliver supports to older adults in Cowal and Oban areas. Further discussion with these providers will be required to identify any possible interest in development of a more inclusive and preventative approach to day supports in all areas across Argyll and Bute for older adults, although budget constraints must be acknowledged. Section 5: Monitoring and review Monitoring and review Short Life Working Group.